---
title: "Book review: Beyond Belief"
date: "2026-07-30T06:34:00+01:00"
modified: "2026-06-08T20:47:55+01:00"
url: "https://newhumanist.org.uk/articles/book-review-beyond-belief/"
post_id: 10637
---

# Book review: Beyond Belief

![A 1950s illustration of Scottish physician James Lind feeding a sick sailor a piece of fruit](https://newhumanist.org.uk/wp-content/uploads/sites/2/2026/07/FG891A-1-1200x920.jpg)Scottish physician James Lind (1716-1794). Illustration by Robert Thom, circa 1958. Credit: Alamy **Beyond Belief: How Evidence Shows What Really Works (Princeton)** by Helen Pearson

Helen Pearson’s *Beyond Belief: How Evidence Shows What Really Works* tells a story that is at once reassuring and faintly uncomfortable. Reassuring, because it charts the eventual triumph of evidence over intuition. Uncomfortable, because it highlights the recurring human tendency to privilege experience, authority and gut instinct over carefully collected and curated data.

The early chapters focus on the now almost unbelievable state of mid-20th-century clinical practice. Doctors, highly trained and deeply committed, nonetheless often relied on what might politely be called experience or, less politely, guesswork. The example of Iain Chalmers is telling. As a young obstetrician in the 1970s, he noticed that colleagues would prescribe entirely different treatments for the same condition, whilst giving way to what the most senior person in the room happened to believe. It was, as Pearson notes, a time of “eminence-based medicine.”

What makes this more surprising is that the tools to resolve such disagreements had existed for centuries. Pearson highlights this by revisiting what is generally accepted to be the first clinical trial, conducted by James Lind in 1747. Lind, a Scottish naval physician, had a hunch that scurvy could be treated by including acids in the diet of sailors. Lind’s sample size consisted of just 12 sailors, split into pairs, each given a different treatment, including dilute sulfuric acid, vinegar and citrus fruit. The result was clear: citrus treats and prevents scurvy.

And yet, knowing something and acting on it are not the same thing. Despite increasingly sophisticated clinical trials, such as the landmark 1948 streptomycin study demonstrating an effective treatment for tuberculosis, medicine was slow to abandon tradition and authority. Meanwhile, we lacked the legal, ethical and evidence hierarchies to adequately use the knowledge that we had collected. It took the thalidomide tragedy to force change in the regulatory approach, leading the US Congress to pass legislation in 1962 requiring drug companies to rigorously demonstrate, through randomised control trials, that their treatments were both safe and effective.

From here, Pearson traces the development of more sophisticated evidence hierarchies, leading to what we now recognise as evidence-based medicine. Central to this is the idea that individual studies, however well designed, are only part of the picture. What matters is the totality of evidence. This is where systematic reviews and meta-analyses, sitting at the top of the evidence hierarchy, emerge.

Chalmers was one of several pioneers in this area. Whilst others were beginning to review the evidence for specific treatments, Chalmers set about something extraordinary: reviewing every procedure relating to childbirth and pregnancy. In the pre-digital era, this meant physically locating, reading and evaluating thousands of papers, a task that relied on teams of volunteers and an extraordinary degree of persistence. A decade of work led to the publication, in 1989, of a two-volume tome (along with a more digestible paperback aimed at parents-to-be) which shattered many commonly held practices, from shaving women’s pubic hair to pre-labour enemas.

So far, so reassuring. Evidence, eventually, wins. Meta-analysis and systematic reviews became the gold standard for evidence synthesis. But Pearson’s real message is that this victory is far from complete. While evidence-based practice is now embedded in medicine, other sectors lag far behind. The latter half of the book broadens the scope, examining how similar struggles are unfolding in education, policing, conservation and business management.

The management chapter lands with a certain sting. Pearson points out that the vast majority of business leaders have never engaged with peer-reviewed research. I recognise myself here. As a scientist, I am trained to interrogate data, to weigh evidence, to be sceptical of unsupported claims. Yet, as a manager, I am far more likely to rely on eminent colleagues, received wisdom, or the latest bestselling business book (although I do at least check that they include a good set of references) than a systematic review. It was uncomfortable to recognise that I apply critical thinking rigorously in some areas of my professional practice but not in others.

Pearson is sympathetic to this. The issue is not wilful ignorance but structural constraint. Busy professionals do not have the time to trawl through academic literature, and more often than not that literature is not written with the practitioner in mind. This is where organisations translating dense research into accessible, actionable insights come in – from the Cochrane Collaboration working on medicine, to the UK’s College of Policing and the Centre for Evidence-Based Management.

What makes *Beyond Belief* particularly effective is its tone. Pearson avoids both evangelism and cynicism. Instead, she offers a measured, evidence-led account of how change happens, slowly and unevenly. Pearson also leaves us with a simple lingering question: If we now fully expect decisions about our health to be grounded in the best available evidence, why are we so willing to accept anything less in other, equally important, areas of our lives?