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September 26, 1990

Clinical Decision Making: Theory vs Practice

Author Affiliations

Columbus, Ohio

Columbus, Ohio

JAMA. 1990;264(12):1533. doi:10.1001/jama.1990.03450120045017

To the Editor.—  Since I have been actively participating in educational institutions for the past 56 years and am currently a full professor and practicing ophthalmologist, I completely agree with Dr Eddy's1 thesis that the pathway to professional betterment is through continuing research and education. Always that has been true and has been our sought-after professional goal.However, the illustration that accompanied Dr Eddy's article purports to show that 57 specialists' estimates ranged from 0% to 100% probability of occurrence of a given outcome. This is stated to prove the extreme inaccuracy of the practice of medicine. Since the details of this event were concealed, evaluation of its significance is impossible except by hypothetical approach. I think it does not mean what Dr Eddy assumes and it will be quoted by government to our undeserved detriment.Analysis of the illustrated distribution of the 57 estimates immediately reveals that it