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

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art_MELO_How_doctors_diagnose_diseases_and_prescribe_treatments_an_2017.PDF (1.62 MB)
Citações na Scopus
5
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
NATURE PUBLISHING GROUP
Autores
MELO, Marcio
ZEIDMAN, Peter
PRICE, Cathy J.
FRISTON, Karl J.
Citação
SCIENTIFIC REPORTS, v.7, article ID 1304, 13p, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
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URI
https://observatorio.fm.usp.br/handle/OPI/19951
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - FM/MLS
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/01
Artigos e Materiais de Revistas Científicas - LIM/20
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