[roenxi]

> I get the impression that much of medicine is one of those strange practices that looks kinda like science, but really isn't.

It is very hard to escape from the fact that there are patients who are so difficult to keep alive that the rational choice is probably to let them die. The exact circumstances will depend on your value structure, but once that is settled any scientific approach that optimises for greatest net good or quality of life will involve letting some patients go without really trying to save them.

There is a pretty substantial lobby (no particular affiliation) who just won't accept that attitude being out in public.

I watch the struggles of data science to take root in our medical system with great interest in light of this. Anyone using a statistical argument to justify inaction when confronted with a patient is running a risk of being pilloried. Pictures of ancient grandmas on the front page of a newspaper style stuff. And that is if they get the stats right - get something wrong and then you feel like a loser on top of running that risk.

Between that and the serious privacy concerns, I can believe that the medical world will be mysteriously disorganised and ad-hoc in their decision making no matter what statistics available. I don't see what the real incentive is to look at and use the numbers, without having a statesman like dedication to the greater good, come what may. Such persons combined with leadership and statistical knowhow are rare.