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“Over-reliance on science is a very dangerous thing”


Senior Member
Satirical paper puts evidence-based medicine in the spotlight


RCTs are widely considered to be the gold standard for evidence-based medicine. But recent years have seen some doctors and researchers push back against the emphasis on RCTs, arguing that such studies sideline anecdotal evidence and professional experience, which they say is not always inferior to evidence obtained from clinical trials.

To point out some of the drawbacks of evidence-based medicine, Mark Tonelli, a physician and researcher at the University of Washington Medical Center in Seattle, made up a clinical trial to test whether mothers kissing their children’s injuries — or “boo-boos” — helped to relieve the pain. He was inspired by his experiences as a father of a toddler a decade ago. “We were a boo-boo-kissing family,” says Tonelli.

His paper, by a fictional collaboration called The Study of Maternal and Child Kissing (SMACK) Working Group, suggested that out of 943 mother–toddler pairs, children in the kissing group were actually “significantly more distressed” than those in the no-kissing group. The authors concluded by recommending a moratorium on boo-boo kissing.

Tonelli meant to criticize RCTs, particularly their failure to consider the importance of person-to-person interactions – a cornerstone of medicine. “Writing a report of a fictional clinical trial as satire allowed multiple limitations and pitfalls of clinical research to be addressed,” he says. Tonelli hopes that medical trainees will use the paper “to prime themselves to find similar issues in authentic research reports”. ...