Medical Students Can Help Avoid the Expert Bias in Medicine

Abstract

Background: Applying the principles of Evidence Based Health Care (EBHC) in an academic environment we became aware of important differences between medical students and the users of clinical research. The latter may be clinicians, educators, guideline developers, or industry managers. These users are adapted to the system and have some kind of conflict of interest: they are either biased by patients’ demands, by main stream thinking, by medical standards and/or by economic interests. All are under time pressure, want to avoid conflicts with their employer and the analysis of scientific reports may not really be their main focus. Medical students were not exposed to these confounders. Methods: Medical students under professional supervision completed critical assessments of more than 100 published studies. Their analyses were limited to identification of mistakes, bias and errors using a check list of potential weaknesses in design and conduct but included the feedback to the academic supervisors. Results: Medical students trained in Evidence Based Medicine are capable of identifying problems in clinical trials by the systematic application of an assessment checklist. Conclusion: In our approach we demonstrate that students can assist health care professionals and academic teachers with the assessment of clinical evidence. The premise of the approach is that the final appraisals, which involve consideration of clinical, practical and value issues, necessarily reside with the academic teachers, writers of guidelines or industry managers who constitute the active users of research.