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When, more than 2500 years ago, Thales of Milet (624–547 BC) claimed that nature was ruled by laws and not by gods, he changed the world.1 Such a concept allowed for the discovery and mathematical proof of impersonal causation of what, until then, had been a mystery ruled by unpredictable gods. Indeed, ever since then the understanding of nature—today we would call it the natural sciences—has become a major activity of mankind. With this strategy, we have come a long way. Initially, it allowed us to use the position of stars and planetary motion for navigation and the discovery of new continents; next, it set the basis for the development of engines and technologies; and finally, it led to the discovery of the human body. Eventually, this allowed for the rise of modern medicine, among many other achievements.As a consequence, theology and philosophy, the dominant disciplines of ancient times, were increasingly challenged and, to a great extent, replaced by scientifically based knowledge about the world, about nature, mankind, and disease. Such knowledge produced pratically useful consequences, such as pumps, steam, and later, petrol-driven engines, trains, cars, aeroplanes, and rockets, allowing us to fly to New York or to the moon. In life sciences, it brought about hygiene, anaesthesia, and in turn, aseptic surgery, antibiotics, vaccination, rescucitation, cardiac surgery, and interventional cardiology;2,3 an impressive and unanticipated achievement indeed.What is evidence? At the beginning of any discovery stands an individual with curiosity; an initial observation is the first step in the process. When Columbus sat at the beach—as the famous movie by Ridley Scott leads us to believe—watching ships leaving the harbour with his son Diego, he asked him, ‘Look!’‘Half of the ship has gone’, replied Diego.‘And now?’‘It's gone.’‘What does it tell …

The bumpy road to evidence: why many research findings are lost in translation