Sunday, December 1, 2013

Moneyball + Cardiogram = Moneygram?

On Friday, Penn's Jason Karlawish wrote in the Times about the American College of Cardiology's recently issued new guidelines about cardiovascular health screening and statins, and its 2013 cardiovascular risk calculator based off of research using the Framingham Heart Study. Karlawish calls it a move away from "nuanced diagnosis and treatment" and toward "Big Data" and medicine's "becoming the science of an insurance actuary."

He references the Oakland Athletics and Moneyball as the parallel in baseball, but I'm not sure the comparison is complete. I like what Karlawish has to say about how people have a hard time understanding qualitative or quantitative assessments of risk. But I think that's an argument for using quantitative assessments rather than against, at least through the lens of the Oakland A's. The argument of Moneyball was precisely the point that subjective judgments tend not to be very good because the beholder sees what he or she wants to see.

It's certainly true that creating a statistical tool does not solve the problem of helping patients and their families understand the risk, just like how giving a laptop and a bunch of Sabermetrics to a baseball front office will not necessarily improve a team's record. But it seems to be a step on the road in the right direction.