Models, methods, and goals

Abstract

To receive this award is itself a delightful honor. To share it in the company of Peter Armitage and David Sackett increases the honor and the pleasure. The joy is further heightened by the presence of Jacques Genest, as chairman of the ceremony, and by the distinguished guests who have come as colleagues and commentators. I am grateful to the Robarts Research Institute and the other sponsors for making it all possible, and to the selection committee for this tangible public demonstration of admiration and approval. The recipients of the Taylor Prize this year have been chosen because of contributions in methodology. All three of us have helped develop or improve methods that can be used for the diverse challenges of evaluation that occur in modern medicine. Instead of recapitulating those accomplishments, however, I should like to contemplate the future rather than review the past. I want to speak to our younger colleagues who may be asking, “Have those old guys done it all? Is there still some good stuff left for us? Are the fundamental concepts and paradigms all permanently established, so that our work will consist mainly of filling in the gaps-or do important basic challenges still exist?” To reassure those younger colleagues, I want to point out some outstanding, exciting, basic methodologic challenges that are still available for imaginative thought, creative research, cogent concepts, and new paradigms. As in many other fields of science, the new problems arise because of what was revealed or produced by the successful solution of old problems. As the development of excellent methodologic