Clinical Judgment

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IN RESPONSE:

I thank Dr. Judson and Ms. Jung for their comments, from which I have no real dissent. I doubt, however, that the methods of chaos theory and “fuzzy” logic will work any better than the existing quantitative models. The fundamental problem is in obtaining suitable data, not in finding new models or methods to process the data. The advantage of “clinical judgment” is that it provides suitable data. I agree that autopsies are important and should receive much more attention than they do in an era of major disincentives. With suitable analytic methods, such as the “epidemiologic necropsy” strategy of McFarlane [1], invaluable things can be learned, despite the alleged “selection bias”

Alvan R. Feinstein, MD

The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:

•Include no more than 300 words of text, three authors, and five references

•Type with double-spacing

•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.

Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.

Annals welcomes electronically submitted letters.

References

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