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Showing posts from April, 2006

Probably incorrect probability

A recent post on the blog Blackademic about the alleged rape of a black woman by white Duke university lacrosse players generated a flurry of comments. One of them anonymously argued: "Unfortunately, statistically a black women is significantly more likely to make a false accusation of rape than to have been raped by a white man. According to the National Crime Victimization Survey ( http://www.ojp.usdoj.gov/bjs/pub/pdf/cvus/current/cv0342.pdf ), less than .0004% of black rape victims were raped by whites. (The NCVS reports the percentage as 0% because there were less than 10 reported cases. I assumed 9 cases, to come up with an actual percentage) Even with the most conservative figure of 2% of rape allegations being false, this means in the case of the Duke Rape Case, the victim is 5000 times more likely to have made a false accusation than to have actually been raped." There were some perplexed responses to this dramatic claim: "yeah, cuz stats and figures are ALWAYS...

The thrust and parry of the evidence-based-medicine debate

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The debate around evidence-based medicine (EBM) makes for fascinating reading, not least because of the prevalence of hyperbole. In a 2004 paper (it's not open access, but here is the reference ), Massimo Porta writes: "Common sense should build upon a body of evidence and experience accrued over the centuries and shared by the medical community. That some members of the community have made it their task to define which parts of the collective experience constitute evidence and which have less title to reach above water has contributed to the current state of affairs. EBM acolytes now perceive practitioners as grubby underlings, hopeless at applying the latest (evidence-based) literature. Clinicians, resentfully, feel watched by nerds who spend their time sipping coffee while talking to computers instead of patients." Ow! He continues: "When it began, it all sounded rather sensible: treatments should be tested for efficacy and trials should be controlled, randomized,...

Pyramid power?

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In my second-last post , I discussed the recent controversy over the term "evidence-based". It was popularized through evidence-based medicine , an enormously influential movement spearheaded in the early 1990's by epidemiologists at McMaster University (see accompanying picture of main campus). It certainly sounds reasonable to suggest that medicine (or healthcare more broadly, or education, or policy ...) should be evidence-based, but what does it mean ? Here, repeating from my last post, is probably the best known definition of evidence-based medicine: "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." Clearly the first step in making sense of this definition is to sort out what evidence is. But is it really important to define evidence? Isn't it just semantics ? Well, I think it does matter—for two reasons. First, there's been a widespread push for evidence-based pr...

A defense of blogs - part 2

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In my first post of this three-part series, I considered the possible origins of negative attitudes about blogs. In this post, I'm going examine the significance of blogging as a form of communication. And what better starting point than Marshall McLuhan ? I can't claim to understand much of what he wrote, but his epigrams are wonderfully insightful. Perhaps most famous is his assertion that "the medium is the message." And when it comes to blogs, what is the medium? Well, it's global personal publishing that's easy, interactive, and effectively free. McLuhan is suggesting that we should focus on the medium rather than the content per se . Critics of blogging miss this point, choosing instead to decry the quality of much of the content. Here is how journalist Ron Steinman saw things, writing in June 2004 : "Reputedly, there are more than a million blogs and still counting. It is scary. Truly, who has the time to read, digest, and make sense of all the wo...

Evidence-based ambiguity

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In the last 15 years, evidence-based medicine has taken the world by storm. According to a famous definition , evidence-based medicine is "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." In this spirit, the evidence supporting many time-honoured practices in medicine has been examined, and in a number of cases found wanting. (For an informative and entertaining look at this, see this slide presentation by former British Medical Journal editor Richard Smith.) The exalted status that expert opinion once enjoyed is waning. Today the cry is "Show me the evidence!" (cf. Jerry Maguire .) If you'll pardon the pun, the success of evidence-based medicine has been infectious . The prefix "evidence-based" is popping up not just in connection with healthcare: today there is evidence-based education, evidence-based software-engineering, evidence-based librarianship, and the list ...