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The History of Evidence Based Medicine

The Work of Professor Archie Cochrane

Although the application of evidence based medicine is a fairly new practice, the concept itself has long-established roots. Documentation of ancient and medieval medicine shows some degree of decision-making based on the results of prior testing, however the most-widely recognised dawn of the evidence based medicine era is the work of Professor Archie Cochrane in 1972. Cochrane was director of the Medical Research Council Epidemiology Research Unit in Cardiff at the time and his book, Effectiveness and Efficiency: Random Reflections on Health Services is thought to have been the catalyst for serious thought on the issue of evidence based medicine.

Developments in the 1980’s

Throughout the 1980’s and early 1990’s, Cochrane’s work was being formulated into a more practical approach by scientists across the Atlantic, namely David Eddy, at Duke University, North Carolina and Gordon Guyett and David Sackett at McMaster University,
Toronto. Their work developed into a methodology capable of being applied to modern healthcare practice and in 1992 the National Health Service Research and Development Programme funded the establishment of the Cochrane Centre in Oxford in order to carry out further research into this concept.

The Cochrane Centre

Under the charge of Iain Chalmers, the centre was designed to improve the efficiency of conducting and evaluating systematic reviews of randomised controlled trials. In 1993, the Cochrane Centre became part of an international venture to be named the Cochrane Collaboration, which included the establishment of 12 additional research centres and a number of researchers totalling over 11,500. The work of the Cochrane Collaboration is widely regarded as vital component of making evidence based medicine a global concept and the work of the Cochrane Centre in Oxford has been proven so effective that an external review in 2003 recommended it be funded by the Government until at least 2010.

Evidence Based Medicine Today

Today, evidence based medicine is a fundamental cog in the workings of the British healthcare system and forms an integral part of both undergraduate and postgraduate medical studies. Older professionals, who have not received the relevant education relating to this concept are encouraged to familiarise themselves with this practice and keep up-to-date with modern clinical research, in line with BMA recommendations.