Evidence Based Medicine

Archie Cochrane died in 1988 but in 1972 he published a little book in which he championed the EBM cause in the name of the Randomised Controlled Trial. He said that the first couple of chapters were an easy write, but the rest of the book was a depressing grind. He had said all he wanted to say in the first few pages, but was obliged by the sponsor to pad out the pages to make it into a book. The book sets off saying how little of what doctors do is based on evidence. 

But what kind of evidence is needed in medicine, and who is to be the judge? 

Archie Cochrane points out in his book that if you take a map of the world and place a black dot everywhere you find an RCT you will notice that all the countries concerned are those of a protestant persuasion. Communists and catholics are bereft of the thing. At least that was true in 1972.

This is a very interesting observation. Archie Cochrane, however, joked that it simply showed the natural superiority of the protestant.