I may be more qualified than most to review this book since I work in Clinical Trial Disclosure and Transparency doing the very work in the pharmaceutical industry that Goldacre focuses on here; disclosing clinical trial results to the public. In fact the discipline I work in has developed considerably as a direct result of this book. Entire laws, registries, standard operating procedures, and the culture around transparency have changed. I joined industry in 2015, 3 years after its publication. There are the old guard that remember the 'fuss' this book caused and have ill feelings towards the author, then there are the new guard such as myself that feel this was an important and welcomed turning point and support his assertions.

I could write an essay but will keep it short. This book was at the time, and remains today, incredibly important. All the salient points about the various factors limiting the ability to practice good quality medicine such as: poorly designed and analysed clinical trials, transparency of clinical trials, lack of RWE, publication bias, the purpose and effects of marketing etc. are spot on. In 2025 they remain as relevant as ever. Some chapters are long, but they had sub divisions within them which I think are helpful. I also deeply appreciate the summary list at the end of each chapter specifically calling out what the reader can do to help the situation. I think this is so important to give agency back to the people.

I docked 0.5 stars for two reasons; first there were a few obvious factual errors which I found surprising in such a well researched book with copious substantiated evidence. (One easy one: AstraZeneca was referred to as a Swiss company, when it is British-Swedish.) Secondly I think Goldacre repeated himself and often fell into a self indulgent ramble that I see men do on podcasts who like to antagonise others. He himself in the book did say that he enjoys that role, I just don't think the reader benefits from large swathes of it. The facts and impact are severe enough, the text could have benefitted from an editor cutting these bits down. I found i could skip entire paragraphs as it was a rehashing of the same points and moral outrage as before.

Overall - a little dated now but only because of the enormous impact this book has had on legislation and industry operations. I am yet to see the same level of impact within general practice. The main points of the book remain relevant and I recommend this to the public, patients, health care professionals, and pharmaceutical industry professionals.