Cochrane reviews and the behavioural turn in evidence-based medicine

Evidence-based medicine (EBM) has been one of the most important movements in clinical medicine and public health in recent years. At the heart of the EBM movement lies the Cochrane Collaboration, an influential organisation that produces systematic assessments of healthcare interventions known as Cochrane reviews. Although Cochrane methods were initially designed to test the efficacy of medical therapies, the desire for 'evidence-based' practice has pushed the movement far beyond its initial scope into the assessment of complex social phenomena. Through an examination of one particular Cochrane review - Physician advice for smoking cessation - this paper highlights the limitations of EBM 'creep', and some of the more problematic conceptions of human nature underwriting Cochrane principles and methodologies.