Australasian Science: Australia's authority on science since 1938

What’s the Evidence?

By Sue Ieraci

The terms “evidence-based” and “peer-reviewed” have become touchstones for reliability, but why should the views of peers count so much and what does “evidence-based” medicine really mean?

Sue Ieraci is an emergency physician who has worked in NSW public hospitals for 30 years. While maintaining a continuous clinical career, she has held roles in management and medical regulation, and been involved in health systems research.

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To paraphrase Socrates: “A wise person knows what he doesn’t know”. How many people bandying around the term “evidence-based practice” or “peer-reviewed research” know what these terms mean? How many of us can honestly claim to be able to critically evaluate clinical research?

Many detractors of modern scientific medicine believe that much medical practice is not ‘“science-based” because it is not supported by a specific randomised controlled trial. That’s nonsense. A therapy can be science-based because it relies on the clinical sciences – anatomy, physiology, pathology and pharmacology. For example, draining pus from a wound is science-based, as is reducing a dislocated joint or slowing atrial fibrillation.

Furthermore, different research methods suit different interventions. While evidence from randomised controlled trials is recognised as high-grade because it eliminates various biases, it is not suitable for population studies. Basic laboratory science might demand precise measurement or observation – not necessarily randomisation or blinding.

Many people in the sciences understand that the publication of research is aimed at an informed audience who read journals specific to their practice or expertise. We understand that journal “peer review” does not validate the paper nor its findings – it is a test of suitability for publication in the...

The full text of this article can be purchased from Informit.