“Evidence Based Medicine” is a movement in crisis according to a recent BMJ article by doctors who want to improve it. Many of the responses to the article call for better statistics, more effectively communicated, and one in particular makes a plea for less but better protocols. One doctor talks about a friend who worked as a sailor in command of a nuclear submarine. He said the crew had to learn and consistently apply a small number of protocols and suggests that doctors should do the same.
There is a confusion at the heart of this comment, and in some of the assumptions behind statistics based medicine.
The confusion is that human beings are just complicated machines.
One way to clear up some of this confusion is to think about the differences between the terms complicated and complex.
Machines can be complicated. Technology can be complicated. Anything which is made…
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