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How convincing does the evidence need to be before we change practice? If we shift too early, then we risk giving patients useless or even harmful treatments, such as flecainide, hormone replacement therapy, and cox-2 inhibitors. But if we shift late then we (temporarily) deny the benefits of breakthroughs to our patients. Achieving the right balance is a challenge to the EBM journal, which tries to pick the innovations that are sufficiently convincing to change practice, but demands pretty convincing proof. This demand means we rarely publish the exciting but flawed "news," such as the association between the measles–mumps–rubella vaccine and autism, that later is proven wrong. Indeed, as John Ioannidis suggest in his essay "Why most published research findings are false" (PLoS Med 2005;2(8):e124), most early research findings turn out to be wrong. However, we also do not always wait for the definitive systematic review and
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