Analytics Stories

CHAPTER 19Evidence-Based Medicine

The great American statistician W. Edwards Deming (1900–1993) once said, “In God we trust; all others need data.” Evidence-based medicine (EBM) attempts to use data from well-designed research studies to help health-care professionals make better medical decisions. In this chapter, we will describe three examples of EBM:

• James Lind's 18th-century discovery that citrus fruits would cure scurvy
• Britain's 1946 randomized controlled clinical trial that showed streptomycin was effective against tuberculosis
• The late-20th-century controversy over whether hormone replacement improved menopausal women's health

James Lind and Scurvy: The Birth of Evidence-Based Medicine

During the 17th and 18th century, England and other European nations embarked on many long sailing expeditions (including circumnavigating the globe). Many sailors tragically died of scurvy. On one 1740–1744 around-the-world trip, over half the sailors died of scurvy. Scurvy had many painful symptoms, including bleeding gums, bruising, and swollen joints. Death often occurred from infection, bleeding, or heart failure.

In 1754, Scottish surgeon James Lind (1716–1794), chose 12 sailors on the HMS Salisbury with scurvy whom he believed were comparable in their health (or lack thereof) and age. He divided the 12 sailors into six groups of two sailors. The six groups were given the following treatments daily:

• Group 1: Cider
• Group 2: Oil of vitriol
• Group 3: Vinegar
• Group 4: Seawater ...