Dear list members
As posted by Jonathan Michaels:
<<<Part of our difficulty may be that most 'scientific' medicine is based on
dichotomous thinking - the entire basis of RCTs is the analysis of a 2 x 2
table. Having struggled to learn (and teach) these relatively simple
statistics it's a daunting thought that perhaps medical diagnosis may be
better modelled using non-linear regression, neural networks or fuzzy logic!
Two comments here.
1) health related knowledge is as well action oriented, and at their
simplest the 'action' issue is 'to to X now' vs. not to do X now', therefore
all relevant knoledge has to be framed as to make it relevant in this
continuum of 'now's'.
2) Clinically relevant knowledge may be layered from a 'deep'post-mortem
molecular pathology up to subjective-intuitive first impresions (which alas
influence attention direction)thus identifying several planes of "truth"
(Feinstein's "Clinical Judgement". This is the inherent limit on diagnostics
research: how deep it is feasible to go in a given moment as per the
evolution of disease, whereas in each plane the rules of evidence differ
Jordi M. Gol Freixa
Agencia de Evaluación de Tecnologías Sanitarias
Instituto de Salud "Carlos III"
Ministerio de Sanidad
WWW.ISCII.es
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