Why his framework matters
Goldacre’s Bad Science framework identifies specific recurrent patterns of unreliable medical claim: retrospective pattern-matching without pre-registration; absence of a control group; hypothesis-first rather than hypothesis-testing reasoning; absence of peer review; heavy reliance on narrative over data. Each of these is a warning sign for medical-evidence unreliability.
Applied to the Crown’s expert evidence at the Letby trial, each warning sign is present. The Crown’s causation expert (Dr Evans) conducted retrospective pattern-matching against selected events; there was no control group of similar-acuity preterm collapses without Letby present; the hypothesis came first and the evidence was read to fit; none of the methodology was published in peer-reviewed form; and the Crown’s closing speech was heavily narrative.
Professional background
- Professor of Evidence-Based Medicine, University of Oxford.
- Director of the Bennett Institute for Applied Data Science.
- Author of Bad Science (2008), Bad Pharma (2012), and the long-running Guardian column of the same name.
- Past winner of the Royal Statistical Society President’s Medal for services to statistical communication.
- Co-author of the OpenPrescribing platform and of the Goldacre Review of NHS data (2022).
The Bad Science framework applied to the trial evidence
- Retrospective pattern-matching. The Letby shift-rota chart and medical-evidence framework started from the pattern, not from the data.
- Absence of control. No comparison group of similar-acuity preterm deterioration events without Letby present was adduced.
- Hypothesis-first reasoning. The Crown’s causation expert worked from the suspect hypothesis toward confirming findings.
- Non-peer-reviewed methodology. Dr Evans’s methodology was not published in peer-reviewed form. The Panel’s methodology is.
- Narrative heaviness. The Crown’s closing speech framed the case as pattern and narrative, not as quantitative evidence.
Why the framework is the right tool
Bad Science is a popular-reference framework, but it encodes specific methodological criteria that professional EBM research applies formally. The same criteria professional epidemiologists use to evaluate clinical-claim reliability apply to expert evidence in criminal trials. Goldacre’s framework is the accessible version; Heneghan’s EBM framework is the formal version. Both reach the same conclusion on the Letby evidence.
The Bad Science framework applied to the Letby case
Dr Goldacre’s book Bad Science (2008) and its successorI Think You’ll Find It’s a Bit More Complicated Than That(2014) set out a framework for identifying unreliable medical claims based on seven warning signs: retrospective pattern-matching, absence of control, hypothesis-first reasoning, non-peer-reviewed methodology, narrative heaviness, confident inference from weak evidence, and selective reporting. His public-commentary application of this framework to the Letby trial evidence identifies all seven warning signs in the Crown’s case methodology.
The Bad Science framework is a popular-audience version of what Prof. Carl Heneghan’s Oxford CEBM framework articulates in formal evidence-based medicine terms. The two frameworks reach the same conclusion on the Letby case methodology: it does not meet the modern UK clinical-evidence standard for medical claims used in criminal proceedings. The institutional weight is twofold: formal academic-EBM endorsement (Heneghan, Oxford) and public-audience EBM endorsement (Goldacre, Oxford DataLab, Bennett Institute).
The Bennett Institute for Applied Data Science
Dr Goldacre is Director of the Bennett Institute for Applied Data Science at the University of Oxford. The Bennett Institute’s research programme includes the OpenSAFELY platform for NHS data analysis, the OpenPrescribing and TrialsTracker projects, and substantial peer-reviewed work on evidence-based-medicine methodology. The institutional weight of the Bennett Institute as a leading UK applied-data-science centre means Dr Goldacre’s public-commentary engagement with the Letby case carries Oxford institutional standing as well as his personal-research authority.
Why this voice matters for the conviction-safety question
A Court of Appeal weighing the Panel finding under the ‘real possibility’ test will look at whether the Crown’s methodology met the modern standard for medical-evidence claims used in criminal proceedings. Dr Goldacre’s and Prof. Heneghan’s evidence-based-medicine critique provides one of the institutional methodological frameworks against which that question can be assessed. Their combined Oxford institutional weight is part of the post-conviction evidential picture the CCRC review engages.