tag:blogger.com,1999:blog-4519234397783312626.post5854210113458316822..comments2023-10-09T11:42:57.305-04:00Comments on Healthcare, etc.: Cognitive biases in medicine, part deuxMarya Zilberberghttp://www.blogger.com/profile/16080475886113209344noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-4519234397783312626.post-24537027133750690742010-10-31T18:09:45.955-04:002010-10-31T18:09:45.955-04:00Hi, Eddy, thanks for your considered thoughts. I s...Hi, Eddy, thanks for your considered thoughts. I sometimes wonder if several people might not have come up with these concepts independently -- not impossible, I suppose. I think that we need to be aware of these potential foibles of the mind, so that we can be open to new possibilities.Marya Zilberberghttps://www.blogger.com/profile/16080475886113209344noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-6887097864738565552010-10-31T18:06:02.148-04:002010-10-31T18:06:02.148-04:00Hello, halfbaked, and thanks for your comment. Wou...Hello, halfbaked, and thanks for your comment. Would love to hear from others what they think about your view. Are there other ideas?Marya Zilberberghttps://www.blogger.com/profile/16080475886113209344noreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-36810054670121742652010-10-31T09:22:42.344-04:002010-10-31T09:22:42.344-04:00part 2.....
I've been ambivalent reading disc...part 2.....<br /><br />I've been ambivalent reading discussions about these biases or 'heuristics', at least as when they are used to describe flaws in clinical reasoning (which I realise is a different context to what you discuss). They definitely exist and occur frequently and often unnoticed. But what troubles me is the question of whether merely being aware of their recurring existence is helpful in avoiding their effect; I'm skeptical about that. This is partly because it seems to me that these mental shortcuts which are called biases when they have been shown to lead to wrong conclusions surely must also be part of the mechanics of successful reasoning, especially real-life reasoning like medical work which must be conducted with time constraints and lots of white noise information. So it seems to me there is some hindsight bias about what reasoning has been biased and what has simply been effective. Unless there is a way to tell at the time of the reasoning which of these it is, this self-knowledge doesn't necessarily improve our reasoning ability. It is of course still a very useful idea in discussion between individuals eg. about published research, but some difficulty may apply if one can be accused of suffering one of these biases with regard to a position someone disagrees on, with similar mental leaps being applauded with regard to agreed positions (whether someone's point of reasoning is biased would be a difficult point to falsify with concrete evidence).<br /><br />With regard to clinical reasoning, this old paper stated "One technique that has proven to be absolutely worthless is telling people what a particular bias is and then telling them not to be influenced by it" Impediments to Accurate Clinical Judgment and Possible Ways to Minimize Their Impact, Arkes H, Journal of Consulting and Clinical Psychology 1981, Vol.49, No. 3, 323-330.<br />The approaches they advise include actively considering alternative hypotheses and properly arguing against your own beliefs (similar to the story of the Wright brothers being directed to swap sides mid-argument which one of your wise commenters recounted). They also discuss the importance of understanding Bayesian analysis of probabilities.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-2146701778058715882010-10-31T09:21:53.953-04:002010-10-31T09:21:53.953-04:00sorry but again my comment was rejected so I'l...sorry but again my comment was rejected so I'll break it into 2 halves and see if that works....<br /><br /><br />Thanks, very interesting.<br /><br />The reading I've done about these cognitive biases has been in relation to teaching 'clinical reasoning' ie. bedside problem-solving, and looking at differences in medical vs legal reasoning in court cases where doctors give expert evidence and recurring difficulties occur in how that evidence is interpreted by the court.<br /><br />I'm sure this is no revelation to some but it's striking how much these real-life biases echo difficulties which Popper tried to address in stating demarcation definitions of what science is.<br />-interpretation bias- he rejected the idea of 'objective observation' and stated that all observations are made through the spectrum of preconceived theories<br />-confirmation bias- he rejected the utility of verification of theories as unscientific and advocated attempts to falsify established theories as the path to progress<br />-rescue/auxiliary hypothesis bias- he stated that in the face of evidence in conflict with an established theory the only way to scientifically rescue that theory was with an auxiliary hypothesis which clearly rendered that theory more falsifiable ie. testable with concrete evidence<br /><br />What has struck me when I've read numerous psychology texts and articles is that none have referenced Popper's work which predates theirs by half a century. Popper had a very ambivalent relationship with psychology throughout his career, rejecting it for years after writing a doctorate in the field. Academic psychology reportedly remains quite antipathetic to Popper's work, though I haven't asked psychologists myself if this is true.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4519234397783312626.post-84761640150164707072010-10-31T05:55:27.336-04:002010-10-31T05:55:27.336-04:00It has been a very interesting and thought provoki...It has been a very interesting and thought provoking few days. Thanks for your effort. <br />While plausibility bias might have delayed the interpretation of trials (HRT, H. pylori, etc), but these hypotheses were being tested for the reason that they were plausible. Recognition of plausibility bias should not result in chasing every conceivable thought with an equipoise. This will be fruitless, expensive and perhaps even unethical.Anonymousnoreply@blogger.com