When there is noise, one physician may be clearly right and the other may be clearly wrong (and may suffer from some kind of bias). As might be expected, skill matters a lot. A study of pneumonia diagnoses by radiologists, for instance, found significant noise. Much of it came from differences in skill. More specifically, “variation in skill can explain 44% of the variation in diagnostic decisions,” suggesting that “policies that improve skill perform better than uniform decision guidelines.” Here as elsewhere, training and selection are evidently crucial to the reduction of error, and to the
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