Nature Podcast Inside the evidence revolution — how decision-making became data driven
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Apr 24, 2026 
Helen Pearson, science journalist and author of Beyond Belief, explores the rise of evidence-driven decision making across medicine, policy and management. She traces pioneers of evidence synthesis, discusses limits of randomized trials and political misuse of evidence. She also looks at global generalizability and how AI might speed up trustworthy evidence.
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How Evidence Replaced Eminence In Medicine
- Evidence-based medicine replaced varying 'eminence-based' practice by synthesising trial data.
- Ian Chalmers and Archie Cochrane pushed systematic reviews and randomised trials to reveal many common practices had little or no evidence.
Why Evidence Synthesis Matters
- Evidence synthesis aggregates many studies to reveal signals lost in single papers.
- Systematic reviews often focus on randomised trials and are 'pre-processed' evidence policymakers can use faster than reading dozens of studies.
Evidence Movement Spread Unevenly Across Fields
- Evidence-based approaches have spread beyond medicine to policing, development, conservation, and management with mixed uptake.
- Some fields like policing show strong trial evidence (hotspot policing) while management and parenting face fads and weaker adoption.
