I always read your notes with interest. I have practiced EM for almost 28 years y because I was trained before all this high tech mechines, I had to develop my clinical acumen , God only knows how many M.I I send home based only on the history and physical examination but 26 years after I haven't heard from any. EBM is welcome to may armamentarium, but my experience is invaluable. Thanks for all the information . The essay is posted in the soapbox section of my website.
Variability is the law of life.
As no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease. As a result of the influence of the EBM movement, I have become slightly better educated in the mathematical principles underlying Bayesian analysis and I now understand how likelihood ratios can be used to change the pre-test probability of a hypothetical diagnosis. I admire the fundamental principles underlying EBM, and this essay will demonstrate how importantly I regard basic Bayesian analytic thinking. If you think that this topic may interest you, you can read the rest of the essay by going to my website. The essay also contains an appendix section that has EBM definitions, and a practical example of how you can use Bayesian analysis to risk stratify chest pain patients.