Interpreting the evidence
Randomised controlled trials can be approached from four viewpoints. Understanding these is vital to apply evidence in medical practice, argue Peter Davies and Seth Jenkinson
No doctor can seriously be against evidence based medicine, as described by Sackett and colleagues.1 The idea of resorting to “prejudice” or any form of non-evidence based medicine is absurd.2 And yet there are problems with evidence based medicine.34 These problems are with interpretation56 and with implementation78 of evidence. These problems are not unique to evidence based medicine; they are found in many other situations in which evidence needs interpretation.
The problems of interpretation are present at the level of doctors understanding evidence themselves.9 They are magnified when doctors try to present data about risks to patients in understandable formats.1011 The third layer of complexity comes when we try to understand how patients make sense of the information presented to them.12
We are under a duty to respect the autonomy of patients13 and to try to present the “facts” to them in a neutral unbiased way so that they can