Is evidence based medicine broken? That’s the question that Greenhalgh et al are asking in this Analysis article. From inside The BMJ, with our attempts to shed light on unpublished data, it’s easy to become jaded about the whole medical-industrial complex, and say that yes, it is.
But recently, while editing some videos collected as part of the joint BMJ/JAMA history of EBM series, it was hard not to be caught up in the excitement and passion of some of the instigators of the movement.
Greenhalgh et al suggest that the problem isn’t just that there is a skewing of the evidence base for some drugs. Now that the low hanging fruit have been picked, evidence of benefit is becoming more marginal, and there is a tendency to apply that evidence in a very algorithmic way, they argue. Their suggestion? Make medicine more patient centred, and use clinical judgement to apply the evidence to the individual.
That will be good news to some of the rapid responders to the “The BMJ’s own patient journey” Editorial. One in particular, Amy Price from Edmonton, north London, calls for including patients’ voices in the publication process, and giving them the opportunity to become peer reviewers. The good news there is that The BMJ is starting to do this—and the video below explains how you can sign up as a patient reviewer with us.
Peer review is one of those activities which, it is commonly supposed, happens during coffee breaks (though I’m told by some of our reviewers that a good, thorough one can take a few hours). In The BMJ’s coffee breaks, we often discuss work niggles, or check what Twitter is saying about us today (statins, usually), but coffee breaks are a luxury our GP colleagues are finding their increasing workload is squeezing out of their day. Margaret McCartney’s readers find them useful—tell us how do you take yours?
Duncan Jarvies is multimedia producer for The BMJ.