Clinical Versus Statistical Prediction

"Clinical versus Statistical Prediction" is Paul Meehl's famous examination of benefits and disutilities related to the different ways of combining information to make predictions. It is a clarifying analysis as relevant today as when it first appeared. A major methodological problem for clinical psychology concerns the relation between clinical and actuarial methods of arriving at diagnoses and predicting behavior. Without prejudging the question as to whether these methods are fundamentally different, we can at least set forth the obvious distinctions between them in practical applications. The problem is to predict how a person is going to behave: What is the most accurate way to go about this task? "Clinical versus Statistical Prediction" offers a penetrating and thorough look at the pros and cons of human judgment versus actuarial integration of information as applied to the prediction problem. Widely considered the leading text on the subject, Paul Meehl's landmark analysis is reprinted here in its entirety, including his updated preface written forty-two years after the first publication of the book. This classic work is a must-have for students and practitioners interested in better understanding human behavior, for anyone wanting to make the most accurate decisions from all sorts of data, and for those interested in the ethics and intricacies of prediction. As Meehl puts it, " "When one is dealing with human lives and life opportunities, it is immoral to adopt a mode of decision-making which has been demonstrated repeatedly to be either inferior in success rate or, when equal, costlier to the client or the taxpayer.""

Clinical versus Statistical Prediction is Paul Meehl's famous examination of benefits and disutilities related to the different ways of combining information to make predictions. It is a clarifying analysis as relevant today as when it first appeared. A major methodological problem for clinical psychology concerns the relation between clinical and actuarial methods of arriving at diagnoses and predicting behavior. Without prejudging the question as to whether these methods are fundamentally different, we can at least set forth the obvious distinctions between them in practical applications. The problem is to predict how a person is going to behave: What is the most accurate way to go about this task? Clinical versus Statistical Prediction offers a penetrating and thorough look at the pros and cons of human judgment versus actuarial integration of information as applied to the prediction problem. Widely considered the leading text on the subject, Paul Meehl's landmark analysis is reprinted here in its entirety, including his updated preface written forty-two years after the first publication of the book. This classic work is a must-have for students and practitioners interested in better understanding human behavior, for anyone wanting to make the most accurate decisions from all sorts of data, and for those interested in the ethics and intricacies of prediction. As Meehl puts it, "When one is dealing with human lives and life opportunities, it is immoral to adopt a mode of decision-making which has been demonstrated repeatedly to be either inferior in success rate or, when equal, costlier to the client or the taxpayer."

This volume explores clinical issues, such as: can we rely on clinical expertise in making decisions about people's lives; when should statistical data be used; and what kind of treatment is best for a particular patient?

This open access book comprehensively covers the fundamentals of clinical data science, focusing on data collection, modelling and clinical applications. Topics covered in the first section on data collection include: data sources, data at scale (big data), data stewardship (FAIR data) and related privacy concerns. Aspects of predictive modelling using techniques such as classification, regression or clustering, and prediction model validation will be covered in the second section. The third section covers aspects of (mobile) clinical decision support systems, operational excellence and value-based healthcare. Fundamentals of Clinical Data Science is an essential resource for healthcare professionals and IT consultants intending to develop and refine their skills in personalized medicine, using solutions based on large datasets from electronic health records or telemonitoring programmes. The book’s promise is “no math, no code”and will explain the topics in a style that is optimized for a healthcare audience.

There is a huge amount of literature on statistical models for the prediction of survival after diagnosis of a wide range of diseases like cancer, cardiovascular disease, and chronic kidney disease. Current practice is to use prediction models based on the Cox proportional hazards model and to present those as static models for remaining lifetime a

Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.

...a comprehensive, empirical investigation of when biases are likely to occur...recommends the use of non-intuitive decision aids to assure the validity of clinical judgements. ..a must read for all helping professionals.