On the value of team medical staff: can the “Moneyball” approach be applied to injuries in professional football?

How important is the performance of the medical staff to professional sporting team success? Given that medicine is a science, it is surprising that there is no obvious scientific answer to this question. Achieving success in professional sport has traditionally been considered an “art” of coaching rather than a science. If a scientific revolution ever occurs in sports performance analysis, you can read about its early genesis in Moneyball by Michael Lewis.1 Moneyball details the management strategy behind the Oakland Athletics baseball team for about 5 years from the late 1990s. In that time, they were one of the most successful teams in Major League Baseball (MLB), despite having one of the lowest payrolls. An equivalent achievement in the English Premier League (EPL) would be a team like Bolton or Wigan staying in the top echelon for 5 years straight. How did Oakland do it? The cynics would say that they got lucky. Michael Lewis’s story is that they made their own luck. They statistically analysed (with multifactorial regression analysis for the stats geeks) what the real factors were behind winning a baseball game, not necessarily what the coaches thought were the important factors. After looking at the analyses, they worked out that the baseball market for players was inefficient. There were some players who were particularly undervalued in the market (from Oakland’s perspective, including those batters who were very good at drawing walks and had a high on-base percentage2). Oakland’s philosophy is to buy players that are undervalued statistically and, vice versa, to sell overvalued players. They still punch above their weight but less so than they did in the Moneyball years. The cynics would say that their luck has run out. The Moneyball advocates would say that a side effect of Oakland’s success is that the …