How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience

Abstract Understanding the brain mechanisms involved in diagnostic reasoning may contribute to the development of methods that reduce errors in medical practice. In this study we identified similar brain systems for diagnosing diseases, prescribing treatments, and naming animals and objects using wr...

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Autores principales:	Marcio Melo, Gustavo D. F. Gusso, Marcelo Levites, Edson Amaro Jr., Eduardo Massad, Paulo A. Lotufo, Peter Zeidman, Cathy J. Price, Karl J. Friston
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/68b52e29bb9647e1b90bcc9048f59fae
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spelling	oai:doaj.org-article:68b52e29bb9647e1b90bcc9048f59fae2021-12-02T15:04:54ZHow doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience10.1038/s41598-017-01482-02045-2322https://doaj.org/article/68b52e29bb9647e1b90bcc9048f59fae2017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-01482-0https://doaj.org/toc/2045-2322Abstract Understanding the brain mechanisms involved in diagnostic reasoning may contribute to the development of methods that reduce errors in medical practice. In this study we identified similar brain systems for diagnosing diseases, prescribing treatments, and naming animals and objects using written information as stimuli. Employing time resolved modeling of blood oxygen level dependent (BOLD) responses enabled time resolved (400 milliseconds epochs) analyses. With this approach it was possible to study neural processes during successive stages of decision making. Our results showed that highly diagnostic information, reducing uncertainty about the diagnosis, decreased monitoring activity in the frontoparietal attentional network and may contribute to premature diagnostic closure, an important cause of diagnostic errors. We observed an unexpected and remarkable switch of BOLD activity within a right lateralized set of brain regions related to awareness and auditory monitoring at the point of responding. We propose that this neurophysiological response is the neural substrate of awareness of one’s own (verbal) response. Our results highlight the intimate relation between attentional mechanisms, uncertainty, and decision making and may assist the advance of approaches to prevent premature diagnostic closure.Marcio MeloGustavo D. F. GussoMarcelo LevitesEdson Amaro Jr.Eduardo MassadPaulo A. LotufoPeter ZeidmanCathy J. PriceKarl J. FristonNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-13 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Marcio Melo Gustavo D. F. Gusso Marcelo Levites Edson Amaro Jr. Eduardo Massad Paulo A. Lotufo Peter Zeidman Cathy J. Price Karl J. Friston How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience
description	Abstract Understanding the brain mechanisms involved in diagnostic reasoning may contribute to the development of methods that reduce errors in medical practice. In this study we identified similar brain systems for diagnosing diseases, prescribing treatments, and naming animals and objects using written information as stimuli. Employing time resolved modeling of blood oxygen level dependent (BOLD) responses enabled time resolved (400 milliseconds epochs) analyses. With this approach it was possible to study neural processes during successive stages of decision making. Our results showed that highly diagnostic information, reducing uncertainty about the diagnosis, decreased monitoring activity in the frontoparietal attentional network and may contribute to premature diagnostic closure, an important cause of diagnostic errors. We observed an unexpected and remarkable switch of BOLD activity within a right lateralized set of brain regions related to awareness and auditory monitoring at the point of responding. We propose that this neurophysiological response is the neural substrate of awareness of one’s own (verbal) response. Our results highlight the intimate relation between attentional mechanisms, uncertainty, and decision making and may assist the advance of approaches to prevent premature diagnostic closure.
format	article
author	Marcio Melo Gustavo D. F. Gusso Marcelo Levites Edson Amaro Jr. Eduardo Massad Paulo A. Lotufo Peter Zeidman Cathy J. Price Karl J. Friston
author_facet	Marcio Melo Gustavo D. F. Gusso Marcelo Levites Edson Amaro Jr. Eduardo Massad Paulo A. Lotufo Peter Zeidman Cathy J. Price Karl J. Friston
author_sort	Marcio Melo
title	How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience
title_short	How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience
title_full	How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience
title_fullStr	How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience
title_full_unstemmed	How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience
title_sort	how doctors diagnose diseases and prescribe treatments: an fmri study of diagnostic salience
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/68b52e29bb9647e1b90bcc9048f59fae
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How doctors diagnose diseases and prescribe treatments: an fMRI study of diagnostic salience

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