Art of Progress

As I wrote in my last essay, real world evidence (RWE)  generated from “big” real world data (RWD) is upending the hegemony of traditional randomized controlled trials and the evidence hierarchy. RWE is being used for epidemiological evidence to identify targets for drug development, for safety surveillance of approved medical products, for examining changes in patterns… Continue reading Art of Progress

Shattered Mirrors

Ibn Khaldun, the 15th century North African historian, wrote  “the past resembles the future more than one drop of water resembles another.” Implying that the patterns and lessons of the past are applicable to the present and can be applied to  predict the future.  Explanations and predictions are the outputs of science and the scientific… Continue reading Shattered Mirrors

Evidence of, Evidence for

In the human world, ideas and concepts are more robust and impactful than anything organic or material. Concepts and ideas often outlive their originators. As culture, language and their embedded concepts multiply and diverge, exchange and reconvene, they shape our world in unpredictable ways. One concept that has evolved to loom over all aspects of… Continue reading Evidence of, Evidence for

Intuitions in the Wild

In reality, there are probably no wild places remaining. The watering hole has a water tank and fences, the lions have identification tags, and are largely habituated to the gawking tourists with binoculars. Analogously, the emergency department has protocols, clinical guidelines, and triage scores. Both environments are semi-wild; neither completely open and wild nor fully closed… Continue reading Intuitions in the Wild

The Art of Medicine

David Sackett was widely known as the “father of the evidence-based medicine” movement recently died. He defined evidence based medicine (EBM) as the “conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.” It is a set of best practices based on rigorous experimental data and seeks to… Continue reading The Art of Medicine