Exam 3

Question 1

Diagnostic Errors are _____

Answer 1

Diagnostic errors are the leading type of paid medical malpractice claim

Most people will experience at least one diagnostic error in their lifetime

Question 2

Clinical Decision Making

Answer 2

Doctors must heal and serve diagnosis

Question 3

Polyamory Diagnosis

Answer 3

Pre commit to diagnosis then undergo all relevant information to find actual diagnosis

Question 4

The 5 Common Diagnostic Errors

Answer 4

Anchoring Bias
Confirmation Bias
Prevalence Bias
Outcome Bias 
Availability Bias

Question 5

Anchoring Bias

Answer 5

Rendering diagnosis based on things patients say on first two to 3 sentences –> bassically commit to pre diagnosis

Question 6

Confirmation Bias

Answer 6

Confirm diseases you have instead of treat.

Thus confirming hypothesis/ pre diagnosis instead of seeking evidence that might disprove it.

Question 7

Search Satisficing

Answer 7

Uses information from previous diagnosis to fix a person –> differ from confirmative since doctors are fixing the issue at hand
Calling off search for other abnormalities (bc found satisfaction in first diagnosis –> similar to confirmative diagnosis

Question 8

Availability Bias

Answer 8

what is available in your head based on intuitions on the world
Ex) Covid is more available in our head thus we have more intuition if you have a runny nose now then you have a bacterial infection –> this will happen because you just diagnosis –> Which leads to error

Question 9

Prevalence Bias

Answer 9

The tendency to misjudge the true base rate of a disease

Ex) If you physician treats breast cancer your physician is more than likely to believe you have breast cancer

Question 10

Outcome bias

Answer 10

The expectation to do something
Ex) Preference of an action –> to eliminate cancer is to have surgery –> does not think about the outcome if there weren’t an outcome –> because doctors are known to to heal, diagnosis, and treat

Question 11

Results of Availability Bias

Answer 11

Confidence increases the more you diagnosis and the longer you been a doctor
Renne Fox: more experience you have the less likely you are to diagnosis heavily creating conjugative bias –> more confidence in second year medical residents then first year medical residents
Second year residents have more errors than first year residents because they tend to form the availability bias

Question 12

When was there a sharp drop in life expectancy

Answer 12

Sharp drop in life expectancy due to flu pandemic –> 1980
In men world war 2 during –> 1940-50 soldiers died
Idea of: Crisis Morality –> sharp declines in morality

Question 13

The Standard of Living Debate

Answer 13

Argument 1: Standard of living as the causal engine

Argument 2: Purposeful action as the causal engine

Question 14

Argument 1: Standard of living as the causal engine is

Answer 14

If we improve developing countries ECONOMY than improve life expectancy and standard of living
Ex) Incomes improved, which lead to an improved diet
Market is beneficent

Question 15

Argument 2: Purposeful action as the causal engine is

Answer 15

Its not just economy its about general health knowledge –> gains a educated population
market is not beneficent

Question 16

The McKeown Thesis

Answer 16

The growth of population can be attributed to a decline in mortality from infectious diseases by turning into chronic dieases

Question 17

Fixing Morality

Answer 17

Decline in organism virulence (harmfulness of diseases)

Immunization

Urban hygiene improvements

(1-3 –> neg findings don’t work)

Nutritional improvements –> improving in standard of living and economy to improve diet –> postive finding but hard to provde

Question 18

Sweden vs Kazahkstan

Answer 18

The death rate in 1992:
Sweden:  10.55 per 1,000 
Longer life expectancy
Lower fertility
More older age groups
Kazahkstan:  7.42 per 1,000
Far more younger people and infants due to higher fertility
Thus longer life expectancy

But the age-specific mortality rate in Kazahkstan is higher for every age group thus this is NOT a paradox

Question 19

Tuberculosis

Answer 19

Specific medical innovations mattered little

Improvements started well before municipal hygiene became important  definitely wasn’t medicine that dropped the morality rate

Thus disagrees with Mckowen thesis

In wales (England) Tuberculosis was main disease

Question 20

When does Medicine Matter

Answer 20

When it takes most of the morality
–> Vaccines are helpful and drop mortality rates but wasn’t needed to drop rates –> SO yes medicine matters but not always used to drop rates In morality

Question 21

Diet & Height

Answer 21

Height is responsive to nutritional improvements but increase in height is only weakly correlated with increases in life expectancy

Question 22

The Preston Curve: the improvement in life expectancy is driven by two factors which are ____

Answer 22

GDP

Technological change –> productively controlling a disease –> is sort of like the mckeown thesis

Question 23

***Sweden has really good

Answer 23

records in morality :D
Lower fertility in Sweden more older people thus their is more older problems than baby problems like cancer over puberty
–> Thus as morality increase birthrate decrease

Question 24

Urban-Rural Differences

Answer 24

You are better living on a farm then in a urban area

People move to city where deficit is the greatest which have lower life expectancy but its good for the economy

Question 25

The Importance of Institutions and Knowledge

Answer 25

Controlling disease requires new institutions –> that the economy cannot always do
Shifting focus from external causes (e.g., God) to internal ones (e.g., how I prepare my food)
In absence of this, everyone suffers

Question 26

External Vs Internal

Answer 26

Shifting focus from external causes (e.g., God) to internal ones (e.g., how I prepare my food)

Question 27

The Epidemiological Transition

Answer 27

In progressing from HIGH to LOW mortality, all populations experience a shift in the major causes of illness (of death).
These changes are associated with socioeconomic improvements—as total mortality declines and income rises, communicable disease mortality declines

Question 28

The Epidemiological Transition shift from

Answer 28

Infectious disease to Chronic Diseases

Ex) Nutritional and Reproductive health to degenerative and Man made diseases

Question 29

Four Transitions –> Of how disease became chronic

Answer 29

External injuries to infectious disease –> Larger Populations, in urbans areas and long periods in the same location

Infectious to degenerative disease  Unpredictable
–> population ages

Cardiovascular to cancer –> diet and overall health improves

Cancer to something else  Mystery
- Overall decline in cancer mortality

Question 30

Morality Vs Mortality

Answer 30

Morality –> People Infected

Mortality –> Peopled killed

Question 31

Women vs Men

Answer 31

Women Outlive men –> especially in older ages but females have higher probability of death at low life expectancy levels because they are susceptible to infection.

Shown alot in japan

Question 32

Caveats of shifting causes of death very fast

Answer 32

Deviations in PACE –> Some developing countries have yet to fully move through them
Deviations from linear and unidirectional change
Some reverse transitions ex) chronic to infectious

Question 33

The 5 Models of Doctor Patient Relationship

Answer 33

Instrumental
Paternalistic 
Informative
Interpretive 
Deliberative

Question 34

Instrumental model →

Answer 34

patient values are irrelevant – physicians acts on patients only as an instrument of science (cruelty)

Question 35

Paternalistic Model →

Answer 35

Patient values are objective thus pshs yasin convinces the patent to do something

Question 36

Informative Model →

Answer 36

Convinced gap between doctor and patient thus, patient is not safetied and does not know how to make a good decision and rather feels pressure – emphasis on knowledge of medicine is hard to quire and physician must care as much as they inform

Question 37

Intervention model →

Answer 37

Patient values are conflicted thus, phsyains is of authority to persuade patients into doing certain treatments but must not over power

Question 38

Deliberate model →

Answer 38

think of as an discussion, there is a balancing between choice and biased information, discussing alternate and different treatments – more confidence however than the interpretive model – most consistent with the public expectations of physicians