Arnold Kling on EBM and the role of guidelines in today’s clinical decision making:
It is absurd to think that a baseball statistician, operating at a distance in time and space from a player being scouted, is able to make a better decision about the player’s likelihood of major league success than a local scout. Except that it happens.
It is absurd to think that credit scoring models are better predictors of default than human underwriters. Except they are.
Today, we are in between two images of the doctor. One image is the heroic personal savior, who uses his own experience and intimate knowledge of the patient to make the best decisions. The other image is the trained technician, who gathers data, feeds it into a decision tree, and implements that recommended course of action.