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Many modern physician specialists like to think of their work as grounded in strong science. Yet 5 years ago, a group of cardiol-ogists published their findings on the science underlying over 2700 practice recommendations issued by their specialty societies.1 Only 314 (or 11%) were based on ‘level A ’ evidence, that is, evidence based on multiple well-done randomized trials. Nearly half of the recommendations were based solely on ‘expert opinion.’ Even more disconcerting is the fact that despite the activities of many researchers, the vast majority of ongoing clinical trials are too small to provide evidence relevant
Collins et al. (Tue,) studied this question.