Decision Technologies and Evaluation

http://www.york.ac.uk/res/iht/events/HTAiRome2005/romepresent/Dowie.pdf

NHS Knowledge Management Briefing

NHS Knowledge Management Briefing

Junior Doctors' Recommended Reading List

Medical Heuristics: The Silent Adjudicators of Clinical Practice

Clement J. McDonald, MD

The theory and practice of clinical decision-making

Pat Croskerry, MD PhD

peter senge and the learning organization

Peter Senge’s vision of a learning organization as a group of people who are continually enhancing their capabilities to create what they want to create has been deeply influential. We discuss the five disciplines he sees as central to learning organizations and some issues and questions concerning the theory and practice of learning organizations.

Information bias

List of cognitive biases

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.