An interesting twist on EBM and evaluation. If we’re making decisions the right way, why wouldn’t we get the best results? I disagree with DB’s rant – I don’t think we can always expect the best outcome – even though we make good decisions.
We’re not in complete control – the patients, the system, environmental and social concerns – all these dilute the effectiveness (and certainly proof of effectiveness) of any medical care – even that based on the highest evidence. It may be that the BEST we can hope for is to analyze our decisions – our “intentions to treat.”
Addressing the other factors that impact upon outcome is still our concern – but more on a socio-political front – not as an aspect of clinical care…
DB’s Medical Rants ? Poker and medical decision making

Poker and medical decision making