I have found this discussion very interesting showing the complexity of applying an evidence-based model of clinical practice - as I teach my clinical students finding the best evidence increases their chance of making better clinical decisions, but they still have to make decisions without perfect knowledge or evidence and that in this model of clinical care their judgment is more impotent - not less.
But what I have not seen in this discussion is that the planning and response to the H1N1 threat was based on worst possible outcome. Even if the probability of a 1918 scale outbreak was low did you still not have to base the world response to that possibility. For example in the US the possibility of an oil rig bowing up and releasing 20 to 50 thousand barrel of oil in the environment was considered so low that real planning was not done.
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Michael Kronenfeld, Director
Learning Resource Center
A.T. Still U. of the Health Sciences - AZ
5850 E. Still Circle
Mesa, AZ 85206
(480) 219-6091
Http://www.atsu.edu/atsu/lrc
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