Anita Chandran reviews Beyond Belief: How Evidence Shows What Really Works by Helen Pearson
How do we make good, well-informed decisions? This is the central question of author Helen Pearson’s new book Beyond Belief: How Evidence Shows What Really Works. It examines evidence-based decision-making and compares it with “conventional wisdom and questionable opinion”. Pearson is interested in how we can use scientific reasoning to empower decision-making using empirical evidence, rather than choices based on opinion or public sentiment.
Pearson uses human stories and historical narratives to outline “the evidence revolution”, in which academics, policy-makers and civilians have tried to embed evidence into decision-making. She tackles disciplines where evidence is seldom used, such as people management, or where its absence is surprising, like environmental conservation. Throughout Beyond Belief, Pearson asks us to understand what makes for good evidence, and how evidence can be better used in daily life.
An award-winning science journalist and editor at the journal Nature, Pearson is particularly good at establishing clear narratives based on a host of different scientific studies. She begins with the field of medicine, focusing on Iain Chalmers, one of the founders of the Cochrane Collaboration. Formed in 1993, it is considered to be a trailblazer in evaluating evidence-based healthcare. Indeed, the institution has influenced important changes to treatment, including the use of corticosteroids to save the lives of premature babies.
It seems obvious, Pearson suggests, that doctors would choose treatments based on rigorous evidence. Instead, she shows us that evidence-based medicine is a young field that only emerged in the 1970s. One particularly personal example she gives is the standard practice of shaving knee cartilage in meniscal tears – a procedure I nearly underwent in 2015 – which was shown to be no better than exercise therapy after a landmark trial in 2016. Beyond Belief offers a glimpse into how recent, and as-yet fragile, our reliance on evidence-based treatment is; as well as how much opposition it has faced from institutional inertia and scepticism.
The book is not just about medicine. It includes examples ranging from the roll-out of the pioneering Mexican social welfare scheme, PROGRESA, which helped to decrease poverty and improve health and education in the country; to the ineffective use of bat bridges over the UK’s A11 dual-carriageway. She also discusses using evidence to make management decisions, as opposed to relying on corporate wisdom or management consultancy. The examples are often surprising, underscoring Pearson’s central argument that evidence allows for better decisions, but getting people to use good evidence consistently is challenging.
Throughout the book, Pearson is engaging and often witty, while still discussing the complexities of implementing evidence-based best practice. Beyond Belief is highly readable too – even when navigating difficult concepts in meta-analyses. Pearson outlines the difficulties of teaching people how to use evidence, how to design studies well, and how studies can easily be misleading. She presents the enormous challenge of encouraging institutions to use evidence correctly, while remaining hopeful about our direction of travel.
There are places where tensions arise, one being in the chapter on policing. Pearson describes how evidence can be used in effective policing, for example, to support increasing patrols or stop-and-search in crime hot-spots. This reveals an interesting question about what the role of successful policing is – crime reduction, retributive justice or rehabilitation – and whose definition of justice that evidence is being used to support.
In these cases, the author’s arguments would have been strengthened if she had engaged more with the central premise of the book: that evidence always makes for better decisions. There are nuances that arise between evidence-based policy and harm reduction, and broader questions of trust that cause people to rebuke evidence entirely. A more serious conversation about these reservations might have deepened the argument in favour of empirical evidence, particularly in questions of social policy.
This discussion is not entirely absent. One particular strength of Beyond Belief is Pearson’s examination of COVID, drawn from her experience as a Nature editor during the pandemic. In this chapter, close to the book’s end, Pearson presents the difficulties of using evidence-based trials in acutely developing crises, in which scientists and public-health bodies have to adapt quickly to minimize harm. At a time when discussions about public health responses to COVID are so polarized, Beyond Belief provides a nuanced analysis of how we can arrive at a scientific conclusion under immense pressure.
At the heart of this book is Pearson’s passion and advocacy for a scientific approach to decision-making. She includes a call to action, empowering readers to be champions of evidence in their lives. Although only present in the short chapters towards the book’s end, her anecdotes about childcare, artificial intelligence and using your vote to support evidence through democracy, are useful reference tools. She also succeeds in her goal of starting a conversation about how we can best use evidence.
Ultimately, Beyond Belief sets out to demonstrate the ways in which evidence enters our lives and improves them. Pearson asks us to advocate for science in a world of increasing misinformation, and to challenge conventional wisdom while equipping us with the tools to do so. For that alone, her book is well worth reading.
- 2026 Princeton University Press 368pp £25 hb
