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Looking at a different medical milestone

I should have left this post to David, but he is out of range. Hopefully I won't shock him when I remark that the British Medical Journal’s nomination of “evidence-based medicine” as a major medical milestone since 1840 appears to show a singular inattentiveness to British medical history.

The BMJ does not acknowledge Addison and Bright, who collected and painstakingly recorded an extraordinary amount of helpful data from clinical observations and post-mortem findings, then published Elements of the Practice of Medicine in 1839. Their volume impressed doctors with the importance of observation and evidence long before the BMJ says that evidence-based medicine arrived on the scene in 1991. See Ingenious Timeline.

The BMJ says that "evidence based medicine" was coined in 1991 by a group at McMaster University, Ontario. It arose from a confluence of events and changes in our culture.” The McMaster group had noted there were “poor quality” clinical trials that provided poor medical advice for doctors. There was also evidence of bias in trials when they were not randomised. This is helpful for a doctor to keep in mind. It does not strike me as a milestone. Addison and Bright's work led to the identification and diagnosis of the diseases named after them. You can vote in the BMJ poll here.

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