© 2002 Evidence-Based Mental Health
EBMH notebook
The scientific evaluation of mental health treatments: an historical perspective*
University of Verona, Verona, Italy.
The evaluation of treatments in medicine, done according to the rules of the scientific method, did not begin long ago: it is little more than 50 years old, a small period of time with respect to the history of medicine.
Its origin is generally attributed to Sir Austin Bradford Hill, since it is believed that with him the research methodology known as the randomised clinical trial (RCT), now considered the gold standard for the evaluation of the efficacy of treatments, was officially born. The first well documented RCT of medical treatment was organised by the Medical Research Council (MRC) and reported in 1948.1 Nevertheless, similar methodologies, called experiments, have been used before outside medicine by psychologists and have therefore a much longer tradition than the RCT. Moreover, the work of Sir Ronald Fisher, 1926 agricultural research (see below), and what Armitage describes as an RCT with group randomisation dating back
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