Evidence-based medicine and the role of the private sector in assisted reproduction: a response to Dr Fishel's commentary 'Evidenced-based medicine and the role of the National Health Service in assisted reproduction'.
We respond to Dr Fishel's commentary on evidenced-based medicine in assisted reproduction and the role of the UK's National Health Service. We agree that proper randomised clinical trials are not easy to set up or execute. Recruitment is also challenging but requires that all personnel involved in the study, clinicians, embryologists and nurses, agree with its aims and buy in to the need for an answer. Those who believe fervently in the method under scrutiny prior to the availability of robust evidence are likely to undermine the success of any trial. New technologies are not necessarily better technologies. Neither is the supposed 'logic' of a treatment nor anecdotal clinical experience a substitute for evidence properly gained and fairly demonstrated. Dr Fishel would agree that the first obligation of healthcare professionals, whether they are in the public or private sector, is not to do harm to their patients. Adopting new interventions without rigorous assessment of the potential for harm flies in the face of this basic principle.
Division of Women's Health, King's College, London, United Kingdom. Electronic address: peter.braude@kcl.ac.uk.
Peter
P
Braude
Yacoub
Y
Khalaf
D019317:Evidence-Based Medicine; D009313:National Health Programs; D027724:Reproductive Techniques, Assisted / Q000191:economics*
National Health Service; assisted reproductive technology; evidenced-based medicine; fervent belief; private sector; public funding