Balancing the Tightrope of Cardiac Allograft Rejection: Equations or Experience?
"The only relevant test of the validity of a hypothesis is comparison of prediction with experience." Milton Friedman
Let's face it. We love clinical prediction rules that forecast outcomes in cardiovascular medicine. Our clinical armamentarium is suffused with a variety of scores that seek to predict unique outcomes such as the Framingham risk score for future ischemic events1, the CHADS2 score to ascertain the risk of neurological events in atrial fibrillation2, or clinical decision rules to exclude acute coronary syndromes in patients presenting to the emergency department3. Generally, for a prediction rule to be successfully inserted into our clinical lexicon, it should be highly relevant, easy to employ and exercise sufficient discrimination between extremes to allow for deployment of decisional strategies. This frequently requires an artificial reductionism of the clinical outcome of interest into "yes" or "no" categorical variables. Often, such an over-simplification of an otherwise complex outcome variable can render it to be less informative. (SELECT FULL TEXT TO CONTINUE)
- Received May 17, 2012.
- Accepted May 18, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited