With the Major League Baseball playoffs now in full swing, the New England Journal of Medicine's piece entitled, "Moneyball and Medicine," provides an admirable comparison of changing approaches in baseball and medicine.
In baseball, Michael Lewis' book, "Moneyball," explained how the Oakland Athletics built playoff teams by using statistical analysis that other teams were not - or at least not until the A's started making the playoffs on regular basis. The A's, who won the American League's West Division this year, took this approach because they did not have the money to try to outspend the New York Yankees (or now the Phillies.).
In the NEJM story, authors Christopher J. Phillips, Ph.D., Jeremy A. Greene, M.D., Ph.D., and Scott H. Podolsky, M.D., point out that the American healthcare system was spending like the Yankees. But now with money tight, more careful analysis and implementation of best practices -- evidence-based medicine - is required. Such approaches often mean better care for patients.
"In both medicine and baseball, advocates of evidence-based approaches argued for the enhanced vision of statistical techniques, which revealed what tradition or habit had obscured," the authors wrote. "The difference between an all-star and an average hitter, for example, works out to about one hit every other week, a distinction that's almost impossible for even a trained scout to recognize. Statistical power can be as relevant as opposite-field hitting power in the assessment of players. Early proponents of controlled medical trials similarly pointed to how difficult it was for an individual practitioner to determine a treatment's efficacy or distinguish real effects from apparent ones after seeing only a small number of clinical cases. Mathematical measurements and calculations were meant to push practitioners away from naive visual biases — a player who 'looks right' or a therapy that seems to work. Walks are far more important than they first appear in baseball; walking is more important than it first appears in medicine."