I haven't been following the "Is it worth it?" discussion however I did
open this contribution below from Mike McDowall. Apologies if this has
already been said but I have to disagree with Mike McDowall that there is
is a flaw in using probabistic evidence from analysis of populations to
predict events in individuals. Of course this evidence gives a probability
of an event rather than the certainty of an event but what valid
alternatives do we have? There is a wealth of evidence that the
alternative traditional methods doctors use to apply their eclectic
pathophysiological evidence base to individuals lead to decisions which are
embarrassingly idiosyncratic. We would all like to be certain in our
predictions for individual patients, probabilistic evidence (appropriately
weighted) is the best tool we have at present.
Rod Jackson
>Toby Lipman wrote :
>> we have
>> not adequately addressed the translation of population effects into
>> individual applicability.
>
>This is an issue I queried the list about some time ago (to
>deafening silence). We have developed models for prediction of
>outcome after stroke but are not comfortable that they can easily
>be mis-applied to individuals, where they are only really applicable
>to populations. I am afraid this is a fundamental flaw of statistics in
>general. When using Evidence from statistical analysis, you only
>have a probability (often not defined) that the evidence will be
>applicable in that particular case.
>
>So how will we fulfil Lynda Jackson's dream ?
>
>Yours sincerely,
> Mike McDowall (Mr.).
>
>Stroke Registries Co-ordinator
> University of Edinburgh,
> Department of Clinical Neurosciences,
> Trials Office,
> Western General Hospital,
> Crewe Road,
> Edinburgh, EH4 2XU,
> Scotland.
>
> Telephone ++ 44 (0) 131 537 2926
> Fax ++ 44 (0) 131 332 5150
>
>P.S. those models - papers are in preparation.
Rodney Jackson MBChB PhD FAFPHM
Professor of Epidemiology
Head of Division of Community Health
Faculty of Medical & Health Sciences
University of Auckland
(Grafton Mews, 52-54 Grafton Rd)
Private Bag 92019
Auckland, New Zealand
Phone: +64 (0)9-3737599 ext 6343
Fax: +64 (0)9-3737494
e-mail: [log in to unmask]
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