Will Twitter Ruin Your Diagnostic Abilities?

Medical errors, by some estimates, are associated with cognitive biases up to 75% of the time.  Given the oft-quoted 98,000 deaths per year as a result of medical error, recognition of these biases seems prudent.  Knowing is, after all, half the battle.

One of these is “availability bias”, the tendency to conflate the likelihood of disease depending on whether the details are readily present in memory.  Essentially, if you don’t think of it – you’ll never diagnose it – but if you think of it too frequently, you might test or treat for it with greater frequency than appropriate.

These authors subjected 38 internal medicine residents to a simulation where they read Wikipedia entries on two diseases.  Six hours later, they were asked to review and submit diagnoses for eight cases – two of which superficially resembled the disease descriptions from Wikipedia.  Finally, the residents were asked to use a structured methodology evaluating signs and symptoms in order to systematically create and winnow a list of potential diagnoses.

I’ve probably already clued you into the end result – but, basically, in the initial case review, residents had a 56% correct diagnosis rate for the “availability bias” cases and a 70% correct diagnosis rate for the others.  Then, by simply re-reading the cases in a systematic fashion, they subsequently were able to bring their rate of correct diagnosis up to 71% on the bias cases.

So, the next time you discover something novel and interesting on Twitter – try not to take it with you to work unchecked ….

“Exposure to Media Information About a Disease Can Cause Doctors to Misdiagnose Similar-Looking Clinical Cases”
http://www.ncbi.nlm.nih.gov/pubmed/24362387