Illusion of control

Xavier Prida dr.xavier.prida at GMAIL.COM
Sun Apr 3 22:30:17 UTC 2016


Peter,
It is all about context and satisfaction(diagnostician and patient).
Patient satisfaction which is now being universally measured does in some
diagnostic categories(e.g. acute MI) correlate with outcome.

Read this beautiful reflection of the anthropological necessity of care
deliver and that which is meaningful to patients.

http://www.mayoclinicproceedings.org/article/S0025-6196(11)65233-6/fulltext

Xavier

On Sun, Apr 3, 2016 at 5:19 PM, Elias Peter <pheski69 at gmail.com> wrote:

> There is another distinction to be made. Care != diagnosis/treatment.
>
>
>    - We can - and often do - treat people appropriately despite having no
>    diagnosis, or a diagnosis that has no effective treatment.
>    - The diagnosis that causes the symptoms may be less distressing or
>    dangerous than the anxiety or confusion that exists alongside - whether or
>    not the diagnosis is made, made correctly, made incorrectly.
>
>
> I am not suggesting that accurate diagnosis is not important and that
> diagnostic error should not be minimized. I only want to remind us that
> making the correct (pathologic) diagnosis and identifying a treatment may
> not be all that a patient wants or needs.
>
>
> Peter
>
>
> On 2016.04.03, at 4:10 PM, Tom Benzoni <benzonit at GMAIL.COM> wrote:
>
> 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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>>
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-- 
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)






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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