LETTERS: Operations based on sound evidence

Sir: Your positive reporting of the conference on the scientific basis of health services, which is exploring new methods of coping with the tidal wave of new health technologies, is welcome.

However, Liz Hunt's statement that "less than 15 per cent of health service interventions have been proved to be beneficial to patients" ("Routine operations on hit-list," 3 October) is a misinterpretation of Professor David Eddy's statement that less than 15 per cent of interventions are based on scientific evidence. This does not mean that interventions not so proven are ineffective. As a surgeon, I do not need the rigour of a randomised controlled trial to tell me that, unless I stop bleeding from a major blood vessel, the patient will die.

Additionally, Professor Eddy's views have recently been challenged in a paper by Professor David Sackett and his colleagues, published in the Lancet, which demonstrated that around 80 per cent of interventions undertaken in an acute medical ward of district hospitals indeed are based on sound evidence.

Yours faithfully,

Miles Irving

Director

NHS Health Technology

Assessment Programme

London, SW1

3 October