The roles of evidence and the baseline in dental decision making.
Decisions are courses of action that exclude other actions and are based on information that is subject to error. Sometimes that information is evidence gathered about a particular situation; sometimes it is general knowledge about similar situations. A very simple example is used to show that the best decision making strategy is to consistently favor the most likely outcome based on previous experience if one is using baseline information. This is more effective than probability matching or dividing resources evenly. The same advantage of "sticking with the winner" applies when one is making a decision based on evidence. When both baseline information and evidence are available, only one should be used--the one with the highest accuracy. They cannot be combined. The evidence-based dentistry controversy is analyzed from this perspective. It is shown that evidence has the highest accuracy for the controlled circumstances that researchers investigate and that the baseline has the highest accuracy for the natural circumstances that dentists encounter. The relative roles of the baseline and of evidence in decision making are applied to investing in the stock market and for showing that both examination-based relicensure and the current practice of testing for initial licensure are indefensible because they ignore the baseline.
Chambers
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DW
D003748:Dental Equipment; D018865:Dental Research; D003813:Dentistry; D003933:Diagnosis; D003951:Diagnostic Errors; D019317:Evidence-Based Medicine; D006801:Humans