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Preface

Evidence is central to the practice of medicine. The amount of published medical evidence is immense, but there are widespread concerns about the quality of many studies. Deficiencies in the conduct of research studies often result in misleading estimates of the benefits of treatments, so that ineffective treatments may be used in clinical practice. In addition, many studies are wasted because they have been so poorly designed and conducted.

This book explores the nature of the deficiencies and flaws in the evidence about the effectiveness of treatments. It is the result of a career‐long interest in medical evidence. A recent career change provided an opportunity to read the extensive literature on research quality that has emerged in recent years. As befits a book on evidence, references are cited to support the statements made. Reviews and commentaries are used where available, although many landmark studies are also referenced. The approach taken is to cite sufficient papers to support a point, rather than give a comprehensive a review of it. The number of references cited reflect the wealth of evidence on the deficiencies in medical research.

I am grateful to the University of Dundee for providing the facilities to research and write this book, and to my colleagues for their support and encouragement. Special thanks are due to my long‐time colleague and friend Linda Irvine: she made several gently delivered, trenchant criticisms of early drafts and picked out factual, logical and grammatical failings in later drafts. The irony of writing a book about evidence is that it may contain errors of fact or interpretation. Equally there may be errors of omission. I take full responsibility for all flaws.