Saturday, March 03, 2007

Lean Learning

This is borrowed from Lean Manufacturing or just-in-time manufacturing: no inventory. It is just-in-time learning as opposed to just-in-case learning, the premise being that know-why (judgement) is most important and that know-how is next and that know-what can always be looked up.

Many years ago, I was surprised to learn that Einstein did not know the mass of the earth. It wasn’t necessary to know it because it was referenced. It took more time and effort then to look up something like that than it does today. Knowing it remains unnecessary.

In medicine practice is supposed to be informed by the evidence, but for most of medicine there is no evidence. Where cause and effect are proximate, common-sense serves; where they are not it does not. We have already picked all the low hanging fruit of proximate effects. We are in uncharted territory with huge numbers of patients and small effects and a severely constrained cognitive biology.

What is the solution? More data and more sophisticated data mining and a more pervasively statistical perspective. Never, of course, forgetting human and humane engagement.

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