I absolutely agree that it will be interesting to see the results of this experiment in user participation.

Sorry if you thought I was saying you misqouted anyone. What I meant was, it is entirely possible that the Globe in its blog didn’t get things exactly right. When something in a piece like this in a blog or newspaper seems fuzzy it is usually the writer who is unclear and not the subject being quoted.

On the evidence issue, the evidence is not always clear cut for clinicians, and it seems like that is why NEJM is trying to engage readers in weighing evidence in decision making. It will be interesting to watch how the voting and comments build over the next couple weeks.

“By asking people for comments and votes against a scenario people can consider how they came to a decision within this uncertainty compared to how others came to a different one.”

That makes plenty of sense to me. What about the aggregate information presented by NEJM when all respones are tallied? What will be learned from that?

Most content on NEJM is also behind a login and this feature may go that way after a few freebies. This would cut down even further the random types (and unfortunately reduce the accessibility for many who have access to NEJM from another source).

I think the EBM bit is trying to highlight the uncertainty in medicine.

By asking people for comments and votes against a scenario people can consider how they came to a decision within this uncertainty compared to how others came to a different one.

So the gain is not in terms of evidence around the best treatment but evidence around the clinical decision making process.

First, I haven’t misquoted anyone- so I’m not sure from whence you draw the comparison.

Second, I’ve explicitly said that this confuses me. I’m not criticizing (yet). I’ve clearly expressed a hope that someone might help alleviate my confusion.

Third, I have explicitly stated that I think it is a fine thing for NEJM to want to engage readers. In this we appear to agree.

Hey, it might be a poor piece of writing by the author of the article that places a Drazen’s quote in an inappropriate context- I don’t know. I am curious to know, however, if this struck anyone else as strangely as it did me.

I’m far from expert on EBM/EBP. I’m looking to learn something.

Thanks for leaving a comment!

-David

It sounds to me like NEJM is trying to engage readers in a way that draws them into the content, which can’t be a bad thing.