Welcome to BMJ Clinical Evidence, the international source of the best available evidence on the effects of common clinical interventions.
BMJ Clinical Evidence is a new kind of decision-support resource. At our heart is an international peer reviewed journal publishing systematic reviews of important clinical conditions, but BMJ Clinical Evidence goes well beyond the boundaries of a conventional journal. We constantly update our reviews and integrate them with a range of additional evidence based medicine (EBM) resources to create a powerful support tool, providing busy clinicians with access to the very latest and most relevant medical knowledge for treatment decisions. It is owned by BMJ Publishing Group Limited, a private limited company, incorporated in the United Kingdom, company registration number 3012371. Their registered office is situated at BMA House, Tavistock Square, London WC1H 9JP. VAT Number 674738491.
BMJ Clinical Evidence systematic reviews summarise the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. It is neither a textbook of medicine nor a set of guidelines. It describes the best available evidence from systematic reviews, RCTs, and observational studies where appropriate, and if there is no good evidence it says so.
At the outset, BMJ Clinical Evidence set out specifically not to make recommendations. The rationale for this decision was that we felt that it was difficult or impossible to give advice that was appropriate in every situation. Differences in individual patients' risks and preferences, and in the local availability of interventions, implied that evidence should be individually interpreted, rather than applied across the board. In short, 'we supply the evidence, you make the decisions'.
Increasingly we have been encouraged to revisit this position. Whilst we continue to believe, for example, that one role of BMJ Clinical Evidence is to point out where evidence is lacking or inadequate, we recognise that when a clinician has gone to BMJ Clinical Evidence to answer a question, to find no information at all is unhelpful.
We have a number of ongoing initiatives to address this issue; including encouraging authors to use the 'Comment' section within each 'option' to do just that, in particular where evidence is weak, whilst keeping as close as feasible to what reliable evidence there is.
In common with many other EBM resources, including producers of guidelines, we aim to answer the 'what' questions that doctors and patients might ask. The additional gap that BMJ Clinical Evidence seeks out is to answer the 'why' question. Without the 'why' answers, patients can only be treated in the kind of authoritarian manner that was out of date two decades ago. The 'why' questions describe the difficulty of achieving the complexity demanded of excellent clinical practice – where patient centeredness and evidence based practice intersect. Our challenge is to determine which 'why' questions matter most, and for that we need your help.
We may never claim to know 'which is the best anti-depressant' (assuming there ever is one), but we can hope to answer the question of why you might wish to use one, what you might expect as a result, and whether cognitive behavioural therapy may be as good, better, or not, as the case may be.
The following section of the site explains the story behind BMJ Clinical Evidence and how it is assembled and best used.