Discussion of the Papers by Taylor and Feinbloom

Abstract

Professor Taylor’s paper stimulated a discussion that centred around the question of applicability of this model to other health problems and other users including general practitioners. The same questions relate to the claims made for the probabilistic paradigm described by Feinbloom. Taylor stressed that the value of a model can be measured by the extent to which it helps us to understand complex multifactorial phenomena. Such ill-defined areas pervade the field of primary care and impinge upon many decisions made by doctor and patient alike. If the model has much explanatory power then it may be of use in constructing an agenda for shared decision-making between doctor and patient. However, what became clear in the discussions was the need to measure how far such models did what we thought they ought to do? We need to know where their strengths and weaknesses lie. We also need to study the decisions and problems which fall outside these models, and the frequency with which this occurs. Even when these questions have been answered, more research will have to be done to discover how to use them in the most effective and acceptable way.