tag:blogger.com,1999:blog-9551150.post116499292402207631..comments2024-03-28T01:27:23.408-04:00Comments on Health Care Renewal: Another Post-Modernist Attack on EBM: Because EBM is Not a "Vehicle" for Anyone's Political Program?Roy M. Poses MDhttp://www.blogger.com/profile/00497209843184497847noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-9551150.post-1165184391039908372006-12-03T17:19:00.000-05:002006-12-03T17:19:00.000-05:00Typo in previous link (for some reason a trailing ...Typo in previous link (for some reason a trailing period was added, causing it to fail). The correct link to the aforementioned PLoS article is <A HREF="http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371%2Fjournal.pmed.0020124%20" REL="nofollow">here</A>.InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1165184230999811352006-12-03T17:17:00.000-05:002006-12-03T17:17:00.000-05:00Can't disagree that EBM has its operational flaws....Can't disagree that EBM has its operational flaws. I think, though, that the scientific method's the best we have for maximizing the odds of good outcomes, ideologically speaking. I would not say the scientific method is flawed because there are bullies, criminals, the greedy and others who manage to obtain employment in biomedicine. I do think we need to correct for such issues as Aubrey InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1165125207547269982006-12-03T00:53:00.000-05:002006-12-03T00:53:00.000-05:00Wow, that was fun reading. Training docs to think...Wow, that was fun reading. Training docs to think scientifically (as "fascist" as it may sound) has the potential to get docs to examine evidence more closely before selecting treatments. All the arcane theoretical arguments in the world (and apparently the critics have used most of them) do nothing but attempt to obscure the fact that decisions, especially involving patient welfare, should beCL Psychhttps://www.blogger.com/profile/13990549972520745769noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1165075055428500012006-12-02T10:57:00.000-05:002006-12-02T10:57:00.000-05:00If you dig a bit further, you find that Six Sigma ...If you dig a bit further, you find that Six Sigma splits the problem. First, there is a three sigma (1,000 ppm) on setting the right goals. It explicitly expects that the goals will be imperfect and need both measurement and adjusting. Furthermore, goals include expected variance. For example, the mechanical specification of a part will specify a tolerance. Variances within tolerance are notAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1165005694954167002006-12-01T15:41:00.000-05:002006-12-01T15:41:00.000-05:00Another good book that speaks about these issues i...Another good book that speaks about these issues is Carl Sagan's book "<A HREF="http://www.amazon.com/Demon-Haunted-World-Science-Candle-Dark/dp/0345409469 " REL="nofollow">The Demon-Haunted World: Science as a Candle in the Dark</A>." <BR/><BR/>It has some good chapters on idenitfying and debunking pseudoscience.<BR/><BR/>Also, don't forget physicist <A HREF="http://www.physics.nyu.edu/faculty/InformaticsMDhttps://www.blogger.com/profile/03994321680366572701noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1164997404058309862006-12-01T13:23:00.000-05:002006-12-01T13:23:00.000-05:00Roy, you're absolutely right.However, I think the ...Roy, you're absolutely right.<BR/><BR/>However, I think the scientific community has overcomplicated this issue.<BR/><BR/>Let me articulate how I think this issue will play out in the business and political world:<BR/><BR/>McGlynn, NEJM and a host of other studies suggest that guidelines get followed about 55% of the time in the U.S.<BR/><BR/>The philosophy behind Six Sigma (a major quality Anonymousnoreply@blogger.com