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JAMA Revisited
July 18, 2017

The Crucial Test of Therapeutic Evidence: Torald Sollmann, M.D., Cleveland

JAMA. 2017;318(3):304. doi:10.1001/jama.2017.5060

Originally Published July 21, 1917 | JAMA. 1917;69(3):198- 199.

According to the good old truism, the last and crucial proof of the pudding is in the eating thereof; and so, the last and crucial test of a therapeutic agent is its consumption by a patient. There is, however, one essential difference: When the pudding is eaten, with a sense of satisfaction, we know that it was a good, or at least an eatable pudding.

If the patient improves after taking a remedy, we do not yet know that he improved on account of the remedy. The post hoc type of reasoning or logic is not respectable; but it is all too apt to creep in unawares, unless one takes great precautions indeed.