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Monday, November 30, 2009

Excellent new blog on "evidence" and medicine

A new medical blog named simply "Evidence" has appeared recently and it is definitely worth reading. The author identifies himself as an academic primary care physician named David Rind.

The following quote was worth the price of admission to the author's latest commentary:

There is no path from evidence to understanding that does not rely on expert interpretation, and, ultimately, no mechanical measure of sufficient evidence or proof outside of what counts as proof to those patients and providers who must make decisions.

Addendum: I neglected to give a link.Here it is.


Michael Kirsch, M.D. said...


I blog quite a bit about evidence, so I was intrigued by your endorsement of this new blog 'Evidence'. I confess that I read the blog's highlighted excerpt on your site 3 times, and I still didn't have a clue. If this is representative of the blog, then I will need the Cliff Notes version. www.MDWhistleblower.blogspot.com

james gaulte said...


The more I look at the quote the less sure I am that I know(knew) what it meant.
I think it meant something very similar to what this quote from Dr.Steven Goodman

"Judgment determines what evidence is admissible and how strongly to weigh different forms of admissible evidence. When there is consensus on these judgments and the data are
strong, an illusion is created that the evidence is speaking for itself and that the methods are objective. But this episode[he refers to a duel of meta-analyses regarding mammograms] should raise awareness that judgment cannot be excised from the process of evidence synthesis and that the variation of this judgment among experts generates uncertainty just as real as the probabilistic uncertainty of statistical calculations."

But maybe I putting words into Dr. Rinds mouth.Perhaps we can hear from him.

David Rind said...

Sorry, didn't mean to create such confusion. I hope the sentence makes more sense in context on the blog post!

I hadn't seen the Steven Goodman quote, but that's very close to what I was trying to say. Proof is a human concept and can only be judged by what individuals count as adequate proof. No p-value or randomized trial determines when something has or has not been proven.

Michael Kirsch, M.D. said...

James, I am not sure that I make more sense out of Steve Goodman's comment. Perhaps, I have a comprehension deficit, although English is my native language. So far, my introduction into your fine blog has not enhanced my self-esteem. www.MDWhistleblower.blogspot.com

james gaulte said...


I apologize.I hit the wrong button and deleted your other comment.


Michael Kirsch, M.D. said...

James, You are forgiven. Regrettably, the comment was teeming with wit and wisdom and I will never be able to recreate it!