Kahneman interview - putting a premium on error detection

Bruno, Michael mbruno at PENNSTATEHEALTH.PSU.EDU
Tue Feb 5 17:40:45 UTC 2019


Yes, thanks, Art!

It seems to me that while some errors are preventable, others may well be inevitable. The perceptual errors we were talking about at that session at DEM are probably biologically rooted (i.e., secondary to neurocognitive brain network functions) and are thus essentially outside of our conscious control. They are an example of an entire class of errors that flow from “how we are made,” our biology and our evolution, and so they will not respond to the usual interventions, such as cognitive de-biasing, adult learning/CME, or even mindfulness.

So it seems to me that, for these types of errors at least, there needs to be a premium placed on early error detection, so that errors can be more promptly detected and corrected before any patient harm is done.  That is the value of double-reading in radiology, and it may be an avenue where AI turns out to be particularly helpful in the years ahead.

All the best,

[cid:image004.png at 01D112FF.F77F98B0]
Michael A. Bruno, M.D., M.S., F.A.C.R.
Professor of Radiology & Medicine
Vice Chair for Quality & Patient Safety
Chief, Division of Emergency Radiology
Penn State Milton S. Hershey Medical Center
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[inspired to keep patient safe]

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From: Art Papier [mailto:apapier at VISUALDX.COM]
Sent: Sunday, February 03, 2019 2:34 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Kahneman interview

Thanks for sharing!   Great interview with many fascinating threads, and some new thoughts on the randomness of error, and how all error is not due to cognitive bias.  Towards the conclusion we hear that Dr. Kahneman in not a believer in cognitive debiasing…. saying essentially we are too busy making errors to recognize that we are making errors.  He asserts we should be thinking about how we recognize other peoples errors.  In made me think of the session at DEM on perceptual errors in diagnostic imaging and the very positive role of second reads in radiology….whether by humans or AI to recognize errors.  Perhaps either co-decision making, or AI “second opinions” is an area we should all be further exploring.
Best
Art

Art Papier MD
CEO VisualDx
Associate Professor of Dermatology and Medical Informatics
University of Rochester College of Medicine

________________________________

From: Xavier Prida <dr.xavier.prida at GMAIL.COM>
Sent: Sunday, February 03, 2019 8:59 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] Kahneman interview

On "thinking again"- not changing your mind, error, and bias - the latter two are not always linked.

https://onbeing.org/programs/daniel-kahneman-why-we-contradict-ourselves-and-confound-each-other-jan2019/<https://urldefense.proofpoint.com/v2/url?u=https-3A__onbeing.org_programs_daniel-2Dkahneman-2Dwhy-2Dwe-2Dcontradict-2Dourselves-2Dand-2Dconfound-2Deach-2Dother-2Djan2019_&d=DwMGaQ&c=_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0&r=XZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ&m=UrbAzwfML-iEIuCykgw2Fqn20pE6WrN96IDUMbiOHMs&s=3X_IjCf1rsQokLp5q2wzaZqF1pXrJky5MKUV2tVppnQ&e=>

XEP

 praesent superare odio  (rise above)

Xavier E. Prida MD FACC FSCAI
Assistant Professor of Medicine
Program Director Cardiology Fellowship Training
USF Morsani College of Medicine
Department of Cardiovascular Sciences
2 Tampa General Circle
STC 5 th Floor
Tampa, Fl 33606
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