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Bayesian Communication

A Clinically Significant Paradigm for Electronic Publication

Affiliation of the authors: Johns Hopkins School of Medicine, Baltimore, Maryland.

Correspondence and reprints: Harold P. Lehmann, MD, PhD, Johns Hopkins, Blalock 407, 600 N. Wolfe Street, Baltimore, MD 21287-4461; e-mail: <Lehmann{at}jhmi.edu>.

Abstract Objective: To develop a model for Bayesian communication to enable readers to make reported data more relevant by including their prior knowledge and values.

Background: To change their practice, clinicians need good evidence, yet they also need to make new technology applicable to their local knowledge and circumstances. Availability of the Web has the potential for greatly affecting the scientific communication process between research and clinician. Going beyond format changes and hyperlinking, Bayesian communication enables readers to make reported data more relevant by including their prior knowledge and values. This paper addresses the needs and implications for Bayesian communication.

Formulation: Literature review and development of specifications from readers', authors', publishers', and computers' perspectives consistent with formal requirements for Bayesian reasoning.

Results: Seventeen specifications were developed, which included eight for readers (express prior knowledge, view effect size and variability, express threshold, make inferences, view explanation, evaluate study and statistical quality, synthesize multiple studies, and view prior beliefs of the community), three for authors (protect the author's investment, publish enough information, make authoring easy), three for publishers (limit liability, scale up, and establish a business model), and two for computers (incorporate into reading process, use familiar interface metaphors). A sample client-only prototype is available at http://omie.med.jhmi.edu/bayes .

Conclusion: Bayesian communication has formal justification consistent with the needs of readers and can best be implemented in an online environment. Much research must be done to establish whether the formalism and the reality of readers' needs can meet.

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