Bayesian communication: A clinically significant paradigm for electronic publication

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 th ey also need to make new technology applicable to their local knowledge and circumstances. Availability of the Web has the potential for greatly affec ting the scientific communication process between rescarch and clinician. G oing beyond format changes and hyperlinking, Bayesian communication enables readers to make reported data more relevant by including their prior knowl edge and values. This paper addresses the needs and implications for Bayesi an communication. Formulation: Literature review and development of specifications from reade rs', authors', publishers', and computers' perspectives consistent with for mal requirements for Bayesian reasoning. Results: Seventeen specifications were developed, which included eight fur readers (express prior knowledge, view effect size and variability, express threshold, make inferences, view explanation, evaluate study and statistic al quality, synthesize multiple studies, and view prior beliefs of the comm unity), three for authors (protect the author's investment, publish enough information, make authoring easy), three for publishers (limit liability, s cale up, and establish a business model), and two for computers (incorporat e 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 real ity of readers' needs can meet.