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Who was James Lind and did he have a library? Educated neurologists will know the answer to this question. James Lind was the naval surgeon who discovered that citrus fruits cured scurvy. He proved this by allocating sailors on HM 4th rate ship Salisbury to various cures of the day including vinegar, sea water, and cider, not at random but in a haphazard sort of way—in other words he used controls as a “fair test” of his ideas, although his sample size was only 12 in total! Moreover, he systematically reviewed the previous literature, albeit without the sophisticated electronic searching that throws up thousands of possibly relevant articles these days. Amazingly, over half of all the books he referred to, including his own—Treatise of the Scurvy, published in 1753—are in the library of the Royal College of Physicians in Edinburgh (RCPE).
Although James Lind almost certainly must have had a library of his own, as all serious doctors still do, the so-called James Lind Library is a web based resource, hosted by the RCPE and launched in 2003. It contains material relevant to the evaluation of “fair tests” of therapeutic interventions over the ages, from the Book of Daniel until the modern era of randomised controlled trials and meta-analysis. There are extracts of relevant books and papers, often with a commentary, a portrait, and translations where necessary – and the whole thing is growing all the time. There are also numerous essays on the modern structure of fair comparisons using randomised trials, their rationale, meta-analysis, and so on (but often the author is not revealed).
It comes as no surprise that the originator and editor of the library is Iain Chalmers—he who invented the Cochrane collaboration. Ever restless, and not content with just the Library—together with INVOLVE (www.invo.org.uk) and the Royal Society of Medicine (www.rsm.ac.uk)—he has set up the James Lind Alliance, a new coalition of organisations representing patients and clinicians collaborating to confront important uncertainties about the effects of treatments – which are the most important, how should they be identified, and how can the relevant trials be done?
Anyone with a serious interest in the evaluation of treatment interventions needs to know about this website, almost as much as they need to know about the Cochrane Library. Of course, to those of a certain age – like me – having it all on paper in a nicely bound book in my very own library would be more congenial than getting my head at the right angle to allow the glasses to focus and then applying my right hand to the mouse. Click on.
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