What is evidence in diagnosis
blatino at RELIABILITY.COM
Wed Mar 21 17:28:08 UTC 2018
Thank you Bimal.
Tell me if I am making a correct analogy to your point below.
I am in the investigative/RCA business. I see it all the time in healthcare when observing RCA teams, they will use a 'literature search' to validate a hypothesis in any given RCA on some undesirable outcome. I tell them while a literature search may help somewhat determine the probability of that hypothesis occurring overall, it is not a valid form of evidence to conclude it occurred in this particular case. A literature search is representative of experience outside of this case, which cannot conclude anything about this specific case.
I can't imagine a detective doing a literature search to draw a conclusion about how and/or why a certain crime occurred.
Many are not receptive to this perspective of mine as oftentimes literature searches are acceptable forms of evidence in healthcare RCAs.
Am I comparing apples to apples?
Robert J. Latino, CEO
Reliability Center, Inc.
blatino at reliability.com
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From: Jain, Bimal P.,M.D. [mailto:BJAIN at PARTNERS.ORG]
Sent: Wednesday, March 21, 2018 1:00 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] What is evidence in diagnosis
In this attached paper, I discuss how evidence is assessed during diagnosis in practice .I argue that evidence is not assessed by a probability as prescribed because a probability which is a frequency in a population fails to represent evidence for a disease in a given, individual patient in whom diagnosis is performed. Instead evidence is assessed in terms of likelihood ratio and a disease diagnosed from it in practice as we see in all published CPCs and clinical problem solving exercises.
Please review and comment on this paper.
Bimal P Jain MD
Northshore Medical Center
Lynn MA 01904.
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