Why clinicians are natural bayesians: Is there a bayesian doctor in the house?

doi:10.1136/bmj.330.7504.1390-b

BMJ 2005;330:1390 (11 June), doi:10.1136/bmj.330.7504.1390-b

Letter

Why clinicians are natural bayesians

Is there a bayesian doctor in the house?

The first 150 words of the full text of this article appear below.

EDITOR—According to Gill et al, clinicians are naturalbayesians.¹ Their reasoning about patients is intuitive, probabilistic,and reiterative. Such subjective, context dependent reasoningis integral to clinical judgment and useful when diagnosingrare diseases.

In the same issue, the fictional Dr House is described.² He,too, must be bayesian. He solves rare cases intuitively throughflashes of grim insight, this occurring against a backdrop ofreiteration: obscure diagnoses are hurled back and forth. Heis also likened to fictional detectives, which is interestingbecause the detective model of clinical judgment has alreadybeen described.³ At its core is the collection of evidence aboutthe patient's condition by the clinician, who interprets andreinterprets this in a context dependent way, such evidencebeing given due weight and accepted or rejected according tothe coherence it brings to the diagnostic picture.