Fwd: Why Facts Don=?UTF-8?Q?=E2=80=99t_?=Change Our Minds - The New Yorker

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Thu Feb 23 18:25:21 UTC 2017

Re the facts not changing one's mind:  At my first SIDM conference, I was
fascinated to hear of the study--briefly stated here--made a diagnosis on
the basis of initial information.  Given additional objective test/lab
information which should have triggered a change in the diagnosis, that
just did not happen with a majority of the doctors.  Another round of
objective info which should have further undermined the initial diagnosis
was deemed to have 'proven' the initial diagnosis.  Anchoring bias!

This was pretty unsettling to me as a patient, as it paralleled my own
initial diagnostic errors, in which a severe anemia was found, with the
cause/diagnosis to be that of a 'tiny, scabbed-over stomach ulcer".  The
pathology report denied any such ulcer, and no evidence of H. pylori.  More
endoscopes which lacked any such ulcer followed, but 'striations' were
found, which again established the ulcer as the cause--and the doubling of
meds, etc.  The anemia was eventually found--after an ultrasound to prep
for a liver biopsy to prove the new diagnosis of cirrhosis (now carefully
enshrined as diagnosis in my records)--to have been caused by a 10 x 9x 6
cm kidney tumor.

Seems that there are other things than scabbed-over ulcers which could
account for a 6.6 hemoglobin.

My editorial note here is that patients need to see immediately all their
labs and reports.  Had I seen the pathology report saying I had no ulcer,
that would certainly have caused me, if not the GI doc, to ask, "What else
could it be?".

Peggy--13 years after the Stage IV kidney cancer diagnosis and grateful to
be alive.

Peggy Zuckerman

On Thu, Feb 23, 2017 at 8:16 AM, David Meyers <dm0015 at icloud.com> wrote:

> This article may be of interest. Spoiler alert, the author makes a few
> political comments.
> http://www.newyorker.com/magazine/2017/02/27/why-facts-
> dont-change-our-minds
> David
> David L Meyers, MD FACEP
> Listserv Moderator/Board member
> Society to Improve Diagnosis in Medicine
> Save the Date: Australiasia DEM, May 24-25, 2017, Melbourne Australia
> Save the Date: Diagnostic Error in Medicine, October 8-10, 2017, Boston, MA
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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