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September 26, 1990

Clinical Decision Making: Theory vs Practice-Reply

JAMA. 1990;264(12):1534. doi:10.1001/jama.1990.03450120045020

In Reply.—  Dr Havener's basic point is correct—that failure to specify the length of time for the outcome could lead to vastly different estimates. However, in this case that cannot explain the results. The question was formulated with the help of the experts, it was discussed to try to ensure that everyone understood it, a specific period was described, and everything was written down on a blackboard for all to see as they developed their answers. After seeing the results, the participants agreed that there was indeed a wide range of perceptions in the room, and they proceeded to discuss how better information could be obtained.My intention with this example was not to expose the participants as fools or to "prove" extreme inaccuracy in the practice of medicine, but to indicate that in the face of poor information, practitioners can develop widely varying perceptions. In fact, this group of