Building the James Lind Library

What are the objectives of The James Lind Library?
The James Lind Library has been created to increase general knowledge about how fair tests can help us to distinguish helpful from harmful effects of treatments.

What are the origins of The James Lind Library?
The James Lind Library was built on the foundations of a website called Controlled Trials from History. This was launched by the Library of the Royal College of Physicians of Edinburgh in 1998, to mark the 50th anniversary of the publication of the British Medical Research Council’s celebrated randomized trial of streptomycin for pulmonary tuberculosis (MRC 1948).  The website was redesigned and relaunched in 2003 as The James Lind Library to mark the 250th anniversary of the publication of James Lind’s Treatise of the Scurvy. Lind was a Fellow and Treasurer of the Royal College of Physicians of Edinburgh, and his Treatise contained a systematic review of what had been written about scurvy, and an account of a controlled trial showing that oranges and lemons were dramatically better than the other supposed treatments for the disease.

In 2003, 'Scientific American' awarded The James Lind Library a 2003 Sci/Tech Web Award. Judges representing the journal considered 1000 websites across all of science, and selected 50 for awards. Five of these were in the 'Medicine' category. The James Lind Library was the only one of these five sites to have been created outside the United States.

What’s in The James Lind Library?
The Library contains a series of short essays introducing the characteristics of fair tests. These essays draw on hundreds of records - texts from books, articles and other documents - showing how current ideas about fair tests of treatments reflect principles and practices that have evolved over the past millennium. The Library also contains a wealth of other material linked to these essays and records – commentaries, biographies, portraits and other images, audio and video recordings, and so on.

How do we decide which records to include in The James Lind Library?
The records on the James Lind Library relate mainly to fair tests of treatments in patients, although some records relate to tests of measures intended to prevent healthy people becoming patients. We select records for inclusion in the Library both to illustrate the evolution of principles of fair tests of treatments, and to illustrate the application of these principles, in practice.

We include records to illustrate the application of principles, up to the point at which the principles appear to have become widely accepted.  For example, by the 1960s, there was wide acceptance of the need to generate comparison groups using alternation or random allocation - so that like would be compared with like. Biases in assessing treatment outcomes had also been recognised, and the steps needed to reduce these, sometimes by using placebos. 

By the end of the 20th century, people had realised how important it is to assess treatment effects using systematic reviews of all the relevant evidence, published and unpublished.  At the beginning of the 21st century, there is increasing awareness of various biases associated with commercial sponsorship of tests of treatments. It is clear that the principles of fair tests of treatments continue to evolve, and we try to reflect this continuing evolution in The James Lind Library.  

Can you help us improve The James Lind Library?
Although we do not attempt to be comprehensive, we are constantly assessing additional material for possible inclusion in the James Lind Library. We welcome suggestions for additional ‘candidate’ records, and other comments.  Let us know about these through feedback@jameslindlibrary.org.