Evidence based medicine: Can we trust the evidence?

      “Evidence based medicine is the conscientious, explicit and judicial use of the current best evidence in making decisions about the care of individual patients” [
      • Sackett D.L.
      • Rosenberg W.M.
      • Gray J.A.
      • Haynes R.B.
      • Richardson W.S.
      Evidence based medicine: what it is and what it isn't.
      ]. The steps in the process involve defining an answerable question, systemic retrieval of the best available evidence, critical appraisal of the evidence, clinical application of the results and evaluation of performance. The process depends on published clinical research being complete, accurate and unambiguous. It relies on the integrity and conscientious efforts of investigators, because we accept on trust what they submit. The trust placed on medical researchers by society and other researchers is founded on the naïve belief that those who gain advancement through publication of medical research are more honest than those who gain advancement in other occupations. This belief flies in the face of evidence that much of what medical researchers publish cannot be trusted [
      • Wilmshurst P.
      Dishonesty in medical research.


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