Evidence based practice uses up to date information to inform decisions on the management of an individual’s health problem.1 To most, this would seem a basic premise for medical practice, but there has been a backlash against the growth of the evidence based medicine movement.2 Some insist that their practice has always been evidence based and that responsible clinicians keep up to date by reading selected journals. But the sheer volume of modern medical publications is such that it is impossible for even experts in an area to be aware of all the relevant literature on the subject. We are inevitably selective, and it is easy for us to select the evidence that confirms what we want to believe. Others fear that clinical freedom is becoming increasingly constrained and that much of the art of medicine is being lost. These fears are unfounded. The evidence base provides us only with the tools we need to be good doctors; the hard earned skills of diagnosis, prognosis, and deciding exactly what balance of risks and benefits apply to the individual patient are enhanced by the knowledge that the options on offer are soundly researched.

The Cochrane Collaboration is a cornerstone of evidence based …