The James Lind Initiative: books, websites and databases to promote critical thinking about treatment claims, 2003 to 2018.

Background: The James Lind Initiative (JLI) was a work programme inaugurated by Iain Chalmers and Patricia Atkinson to press for better research for better health care. It ran between 2003 and 2018, when Iain Chalmers retired. During the 15 years of its existence, the JLI developed three strands of work in collaboration with the authors of this paper, and with others.

Key Concepts for Informed Health Choices: a framework for helping people learn how to assess treatment claims and make informed choices.

Many claims about the effects of treatments, though well intentioned, are wrong. Indeed, they are sometimes deliberately misleading to serve interests other than the well-being of patients and the public. People need to know how to spot unreliable treatment claims so that they can protect themselves and others from harm.

Establishing a library of resources to help people understand key concepts in assessing treatment claims-The "Critical thinking and Appraisal Resource Library" (CARL).

Background: People are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered.

The PRIME project: developing a patient evidence-base.

Background: The concept of evidence has become firmly rooted in health care, with most importance placed on the outcome of research in clinical and economic spheres. Much less emphasis is placed on the patient's contribution to evidence which remains relatively vague, of low status and often difficult to integrate with other forms of knowledge.

Aim: This article proposes a concept of patient-based evidence, to complement clinical and economic forms of evidence, and demonstrates one way in which it has been operationalized.

Finding and appraising evidence.

Surgeons have tended to regard evidence-based medicine with a degree of skepticism. A variety of reasons for this have been proposed,ranging from the surgical personality to the nature of the research questions that occur when studying surgical treatment. The relative paucity of randomized trials of surgical treatment has been noted by many investigators, and there has been considerable debate about whether this reflects poorly on the scientific education of the surgical community or points to special problems in applying this methodology in this discipline.