Evidence-based medicine (EBM) has been embraced as the best approach to practising medicine, providing clinicians with ‘objective’ evidence from clinical research. However, for presentations with complex pathophysiology or from complex social environments, sometimes there remains no evidence, and no amount of research will obtain it. 

This paper examines the role of research that seeks to obtain evidence to support EBM, using a case study of research into ear disease in Aboriginal populations, and suggested that in complex situations, perhaps randomised controlled trials are not the answer. Instead, clinicians could apply empirical evidence, tailoring treatments to individuals while taking into account the complexities of their life circumstances.