Illusion of control

Tom Benzoni benzonit at GMAIL.COM
Sun Apr 3 20:10:04 UTC 2016


There is one important assumption that is implied but, if stated, may
clarify:
What is the likelihood that this patient with this complaint has a disorder
that requires diagnosis and intervention?
I.e., when looking at this question, you must first select those patients
for whom, having made the right diagnosis, there exists a treatment that
makes a difference (and define that difference.)
Then you must select those patients who have a disorder for which no
treatment is needed (it will heal/correct/change on its own) but who are
given a treatment that is ineffective or harmful. Importantly, because they
have been given a diagnosis and treatment, they may be erroneously counted
as a success rather than what they really are, a failure. (Most "pulmonary
emboli" currently being diagnosed by CT and given NOAC are likely in this
group, as are many "cancer survivors.")
I could go on but I'm stop by Voltaire's suggestion that the art of
medicine is amusing the patient while Nature cured the disease.
tom benzoni

On Sat, Apr 2, 2016 at 3:34 PM, robert bell <
0000000296e45ec4-dmarc-request at list.improvediagnosis.org> wrote:

> Dear Xavier,
>
> Could the therapeutic illusion be “real” if the placebo effect was
> stronger in some patients than others?
>
> Also, one would also suspect that certain ineffective treatments
> themselves would have a greater perceived value by some patients than other
> treatments.
>
> And certain providers may be better placebo producers than others?
>
> Isn’t it the placebo effect that drives the $14.4 billion alternative
> medicine market?
>
> Rob
>
> On Apr 2, 2016, at 5:23 AM, Xavier Prida <dr.xavier.prida at GMAIL.COM>
> wrote:
>
> Publication of interest to the society- "The Science of Choosing Wisely-
> Overcoming the Therapeutic Illusion".
> Although framed by the context of "therapeutic illusion", this readily
> translates to "diagnostic illusion"- the cognitive bias of illusion of
> control. Perhaps, best embodied behaviorally by overconfidence.
>
>
> http://www.nejm.org/doi/full/10.1056/NEJMp1516803.
>
>
>
> --
> Xavier E. Prida MD FACC FSCAI
> Assistant Professor of Medicine
> USF Morsani College of Medicine
> Department of Cardiovascular Sciences
> 2 Tampa General Circle
> STC 5 th Floor
> Tampa, Fl 33606
> 813 259 0992(O)
> 813 831 0721(H)
> 813 245 3143(C)
>
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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