The Avoidable Scandal: Benoxaprofen and Theories of Medical Evidence

“This debate is about Britain’s greatest drug disaster. It is about the scandal of a huge United States pharmaceutical company coming to Britain and boasting of Opren, a new wonder drug to treat arthritis — with tragic results.” —Lord Jack Ashley Benoxaprofen, marketed as Opren in the UK, created a …

UBL and Variation

I’ve argued that information about variation in treatment effects is vital for doctors, patients and regulators alike. This information does not come from RCTs. Nonetheless, we can acquire high-quality, compelling evidence of variation. The case studies I’ve presented in the last few years show this in action but don’t prove …

Two Dogmas of Evidence Hierarchies

Hierarchies of evidence in Evidence-Based Medicine (EBM) come in many varieties and have been very influential in medical practice and policy since the late 1990s. However, two fundamental problematic assumptions underpin the use of hierarchies of any kind in clinical practice: (1) that evidence can and should be appraised in …