The EBM framework — Crown's methodology does not meet evidence-based standards
Prosecution claim
The Crown's expert evidence at trial was appropriate medical evidence, given by qualified clinicians applying clinical judgment to the casebook.
Counter-evidence
Evidence-based medicine (EBM) is the formal UK framework for evaluating clinical evidence on methodological quality. The Oxford Centre for Evidence-Based Medicine, directed by Prof. Carl Heneghan, is its flagship UK institution. Applied to the Crown's trial evidence, the EBM framework identifies four specific failures: retrospective pattern-matching without pre-registration; absence of a control group of similar-acuity preterm collapses on comparable NICUs; hypothesis-first reasoning (the Crown's expert worked from the suspect hypothesis toward confirming findings); absence of peer-reviewed methodology. Prof. Ben Goldacre's Bad Science framework identifies the same failures. Heneghan and Goldacre — the UK's leading EBM voices — have each publicly stated the Crown's evidence does not meet EBM standards.
EBM is the canonical UK framework for evaluating clinical claims. Applied to the Letby trial evidence, it identifies four specific methodological failures. Where independent methodologically-sound replication reaches the opposite conclusion, the original result is not reproducible.
What the jury heard
The Crown's expert evidence was presented as authoritative clinical opinion. The EBM framework for evaluating expert-evidence reliability was not systematically walked through.
What the Panel says
The Panel methodology is explicitly aligned with modern EBM standards: blinded review, structured differential diagnosis, cross-specialist consensus, peer-reviewable framework. The Panel's conclusions reflect what an EBM-standards expert review of the casebook produces.
What independent experts add
- EBM is the canonical UK methodology for evaluating clinical evidence.
- The Oxford CEBM under Heneghan is its flagship institution.
- Goldacre's Bad Science framework is the popular-reference version.
- Both frameworks identify the same four failures in the Crown's methodology.
- The Panel methodology is the modern-standards version of what the trial should have had.
- Peer-reviewed literature does not defend the Crown's methodology against the EBM critique.