IJE Advance Access first published online on March 14, 2007
This version published online on April 12, 2007
International Journal of Epidemiology, doi:10.1093/ije/dym002
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.
Cochrane Lecture 2006
European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
E-mail: martin.mckee@lshtm.ac.uk
Keywords Evidence, USSR, ideology
Accepted 22 December 2006
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Introduction |
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In his seminal work Effectiveness and Efficiency,1 Archie Cochrane asked why, despite their enormous potential, randomized trials were much less widely used that they should be. At the time that he was writing, their geographical distribution was very uneven. He wrote ‘If some such index as the number of RCTs per 1,000 doctors per year for all the countries of the world were worked out, and a map of the world shaded according to the level of the index, one would see the UK in black, and scattered black patches in Scandinavia, the USA, and a few other countries. The rest would be nearly white. It appears in general that it is Catholicism, Communism, and underdevelopment that appear to be against RCTs. In underdeveloped countries this can be understood but what have Catholicism and Communism against RCTs?’
In this article,
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The emergence of Soviet science |
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The benefits of ignorance |
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The western response |
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Wider implications |
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Conclusion |
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