Sunday, October 26, 2008

Evidence Based Healthcare and Baseball

Love the Op Ed piece in the Friday New York Times entitled "How to take American Healthcare from Worst to First."  First, one reason I love this article is it is discussing how we need to move to more "Evidence Based" medicine.  You may be amazed to know that much of medicine is not evidence based but that is the sad truth.  When I first heard about how not all medicine was evidence based medicine (in a talk by David Cox when I was a grad. student) I was blown away.  Anyway, the article is worth a read from this point of view.  

More amazingly is the author list -- Billy Beane (general manager of the Oakland A's), Newt Gingrich, and John Kerry.  What a combination.  They make the argument that medicine needs a wholesale change in the way it is done just like baseball is shifting to more evidence based decisions.  It is a nice analogy.  Too bad the current administration believes that simply thinking about something is the equivalent to evidence.  And also too bad that McCain-Palin seem to be following in the trend of Bush to not hold "evidence" in high regard.  I wonder what Newt (who is a big science and technology advocate) thinks of the recent anti-science push of the Republicans in power.

4 comments:

  1. Newt has always been on the surface into science more than other Republicans but in practice he's more into quick-fix simplistic answers verging on crank science. In the 1990s he was into "bionomics", which as Paul Krugman wrote was the combination of pseudo-economics with pseudo-evolutionary biology. Now the (mis-) application of simple "Moneyball" statistics seems to be Newt's thing.

    Statistics are of course important to medicine, but that's not like that's earth shattering news -- biomedical statistics is a hot field right now (much like bioinformatics was circa 2000).

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  2. I am not sure I buy your comment that they are misapplying simple moneyball statistics. I think what they are advocating is different than biomedical statistics in the way I know it. I think they are hinting at collecting massive amounts of data on medical treatments much like baseball statistics are collected and then this will in turn allow all the medical equivalents of sabermatricians to find new patterns. I know they do not specifically say this, but given that Billy Beane is involved, they must be thinking this.

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  3. There is no science in a private medical practice. Most antibiotic prescriptions are given for viral infections, b/c it is much easier to send a patient home with a script than an explanation. You can see more patients = more money.
    At the end everything, including baseball is money oriented...

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  4. Well, as in baseball, in private practice and HMOs there seems to a science of how to make more money. Doctor's offices seem incredibly elegant about how to stream through the largest numbers of people and how to squeeze every dollar out of them. And in baseball, there is now rigor being applied to how to field a team with the least amount of money spent so that profits are highest. So they get science. Unforutnately it is usually applied to the wrong things.

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