Illness Scripts and Flaws in Clin Med DSA Flashcards
What is an illness script?
mental cue cards used to represent individual diseases
Why are illness scripts important?
enable pattern recognition
inform hx taking based on patterns identified
enhance the integration of new knowledge w/ prior knowledge
improve diagnostic efficiency and accuracy
How does an expert’s illness script differ from a novice’s?
novice = detailed biomedical knowledge
expert = clinical features; weigh biomedical stuff w/ pt presentation
What is the basic organization of an illness script?
epidemiology: who gets it?
temporal course: how does the dz present w/ respect to time?
pathophysiology: what are the biomedical causes of this dz?
clinical presentation
What should be included in your minset of an expected clinical presentation?
key and differentiating features
must include rejecting features
What is an anchoring bias and how do you prevent it?
sticking with a diagnosis even if its not really working
corrective strategy: examine the impact of nonresponse or new info on the original diagnosis
What is availability bias and how do you correct it?
referring to what comes to mind most easily, often based on a previous pt with similar sx
corrective strategy: know baseline prevalence and stat likelihoods of the condition diagnosed
What is confirmation bias and how do you correct it?
assigning preference to findings that confirm a diagnosis or strategy
corrective strategy: use an objective source (diagnosis checklist, etc) to evaluate whether the diagnosis correlates w/ technical findings
What is framing bias and how do you correct it?
assembling elements that support a diagnosis (assuming sx are malarial in someone who was just in africa)
corrective strategy: elicit different perspectives by broadening the hx to search for other causes or associations
What is premature closure bias?
failing to seek additional info after reaching a diagnostic conclusion
corrective strategy: review the case, seek other opinions, and consult objective resources
What is the bias of groupthink?
agreement is reached based on an authoritative source (lab and imaging test results) w/out sufficient examination