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Ideas and the origin of evidence during the COVID-19 pandemic
  1. Mike Wells
  1. Division of Emergency Medicine, University of the Witwatersrand Faculty of Health Sciences, Johannesburg 2050, South Africa
  1. Correspondence to Professor Mike Wells, Division of Emergency Medicine, University of the Witwatersrand Faculty of Health Sciences, Johannesburg 2050, South Africa; profmikewells{at}

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COVID-19 has exposed the limits of evidence-based medicine. We are faced with a new emergency, for which no evidence exists to guide us. So then how do we deal with the pressing need for new information?

This question highlights the three types of research (and researchers) that are urgently needed. The first is the inventor and innovator: these researchers are the ‘Heston Blumenthals’ of emergency medicine. They generate new ideas. They create a new concept or an idea that can solve a particular problem. They are responsible for paradigm shifts and new ways of thinking. The second researcher is the applied scientist. These researchers take an idea and improve it or make it more practical. The applied scientist may synthesise two ideas and create a new model or idea. The final researcher is the sceptic. The sceptic researchers are the critics who see the problems in the new ideas or models. They may attempt to test the novel ideas and ensure that they are better than previously used methodologies. In order for medical science to advance there needs to be a balance between these three types of research. If there are no new ideas, there can be no advancement. If there is no optimisation of ideas, advancement is too slow. If there is no scepticism, something that appears to be an advancement may lead to patient harm. On the other hand, too much scepticism …

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  • Handling editor Ellen J Weber

  • Twitter @docmikewells

  • Contributors I was the sole author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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