By Paul O’Byrne
Paul O’Byrne is vice-president of the faculty of health sciences and dean of the Michael G. DeGroote School of Medicine at McMaster University.
The op-ed was published in The Hamilton Spectator on Apr 11, 2026.
As McMaster’s faculty of health sciences classes of 2026 prepare to graduate and I prepare my final convocation address as dean, I have been reflecting on an important lesson learned during my 40 years at the university: clinical evidence matters most when it is both understood and trusted.
McMaster University led the way in establishing the concept of evidence-based medicine. The term was coined by faculty member Gordon Guyatt, in an influential 1991 paper published in the American College of Physicians Journal. As difficult as it may be to believe today, many clinicians did not initially embrace the idea of using established evidence as a compass to guide clinical decisions.
Even at McMaster, the home of problem-based learning, clinicians were reluctant because they had well-established standards of care. Change was hard, but evidence-based medicine has become widely adopted and understood.
I am very proud that the methods now used worldwide to establish the quality and impact of clinical evidence are McMaster innovations, originating here in Hamilton. The British Medical Journal recognized this as one of the 10 most impactful medical discoveries of the 20th century, together with other brilliant innovations, such as the structure of DNA, the discovery of insulin and the development of pacemakers.
We changed the world of clinical medicine, but experience taught us that evidence is not enough if it is not understood and trusted.
The lack of trust in clinical evidence became most obvious in 2020, when as a result of the COVID-19 pandemic, society seemed to shut down overnight. Of course, our hospitals did not. Our students and faculty were essential members of health-care teams working in strained environments during the pandemic. It was vital that we continued to train and graduate health-care students. McMaster’s deep integration within our hospital systems reflects our responsibility to this region.
During the pandemic, the level of distrust in evidence-based treatment approaches was so high that the U.S. Surgeon General issued an urgent health advisory on the severe harms of medical disinformation. While this was a particularly difficult period, I remain concerned today about how easy it has become to misunderstand and misuse health information generated on AI platforms and propagated on social media.
AI will be an immense benefit to medicine. It is improving diagnostic skills in some areas and enhancing our ability to discover and develop new drugs, such as antibiotics to fight drug-resistant bacteria, as recently demonstrated by McMaster scientist Jon Stokes. AI is also a risk. The information it provides is only as good as the information it can access, and unfortunately, some of this information is fraudulent or misleading.
A good example of what we need to address is vaccine hesitancy.
Measles rates are rising because misinformation has eroded public confidence in highly effective vaccines. Vaccines remain one of humanity’s greatest medical achievements, eradicating diseases such as smallpox and polio. Despite these ongoing challenges, McMaster experts such as Dawn Bowdish work tirelessly to counter misinformation that drives vaccine hesitancy.
Another recent McMaster innovation which has become subject to misinformation is an inhaled COVID-19 vaccine, created by McMaster researchers Fiona Smaill and Zhou Xing. Vaccines undergo rigorous clinical trials before being approved for use, and this inhaled vaccine is currently in testing and is proving to be safe and effective.
We are all responsible for building confidence in medical decision-making, grounded in the best available clinical evidence. The health-care professionals graduating from McMaster are well prepared and deeply committed, but combating misinformation depends on more than the knowledge of well-trained health-care professionals. It is a community challenge.
We can all help address it in our everyday conversations by being curious, asking questions, and sharing credible resources.
