Présentation Santé

An unusual medical appointment

Written on the board: " It is all in your HEAD!!! " " You are sick only if the doctor says so "

the difficulT journey of patients

• Irreversible damage to their BODIES

• impacting mental health

• Financial burdens

Numeroustests

condition worsening

Travel costs

Medical expenses

Time off work

Diagnostic Odyssey

... Or, the thrilling journey of seeing doctor after doctor, only to end up diagnosing yourself on Google anyway.

impact in western countries:

misdiagnosis : the Big three

Vascular events

Misdiagnosted patients with serious injuries

795k

Infections

371K

Inclueding lethal cases

Cancer

How many years do you think it takes to receive an accurate diagnosis for rare diseases ?

Why do such errors occur ?

God complex

White coat syndrome

Cultural biases

Psycological suffering

GOD complex

Source: Journal of Medical Ethics

Occurs when doctors feel like superheroes of medicine.Due to their expertise and authority.Leads to reluctance in questioning their own judgment.20% of doctors admit to feel a sense of superiority.May result in missed or incorrect diagnoses.

White coat syndrome

Blood pressure increases in the presence of a doctor. Affects about 20% of adults. Can obscure underlying health problems. Symptoms may appear atypical.

Cultural biases

Implicit biases, or unconscious prejudices Lack of medical knowledge Gender bias

Psycological suffering

Feelings of isolation Mislabeled as being a "hypochondriac" or having an "imaginary illness." 30% of patients initially dismissed as hypochondriacs later diagnosed with actual diseases at an early stage

Milgram experiment

Obeying authority figure.Inflecting harm on others.Power of authority over personal morals.Participants administered severe electric shocks.Majority of participants willing to administer lethal shocks.

What can we learn from this experiment ?

Milgram experiment

Psychological influence of doctors, who wear white coats 1/3 withheld information afraid to contradict the doctor

Diagnostic errors

Experiment conducted by Trafton Drew and hiscolleagues at Brigham and Women’s Hospital. Searching for nodules in lung scans.

Do you see anything that stands out to you in this image ?

• 83% of the radiologists did not notice the gorilla.

• The blue dots correspond to the areas where the radiologists focused their gaze on.

• Phenomenon where physician may overlook significant symptoms.

• Attention is focused elsewhere.

• Inattentional blindness.

sustained inattentional blindness in expert observers(PubMed)

Results of the experiment

>50% practicians= Nodule detection

>75% practicians = blidness

Solutions

Armstrong Institute for Patient Safety and Quality and its dedicated Center for Diagnostic Excellence.

Conclusion

Not only a problem related to rare diseases.Human biases, such as inattentional blindness...These judgment errors can have dramatic consequences.Leading to unnecessary or harmful treatments.Current technologies are not fully developed.Advancements in artificial intelligence, imaging techniques, personalized medicine.

Sources for the data used :- *European Organisation for Rare Diseases (EURORDIS)* -*The invisible gorilla strikes again: sustained inattentional blindness in expert observers(PubMed)* - *Journal of the American Medical Association (JAMA)* - *British Medical Journal (BMJ)* - *American Heart Association* - *Psychological Science*, "Inattentional Blindness in Medical Practice", 2015 - *British Journal of General Practice* - *Journal of Abnormal Psychology*, "Obedience to Authority: An Experimental View", 1963 - *Prevalence of and Factors Associated With Patient Nondisclosure of Medically Relevant Information to Clinicians Andrea Gurmankin LevY*, 2018

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