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How doctors make diagnoses

PLOS

Doctors use similar brain mechanisms to make diagnoses and to name objects, according to a study published in the Dec. 14 issue of the online journal PLoS ONE and led by Marcio Melo of the University of Sao Paulo in Brazil.

Doctors often make diagnoses within their first moments of interaction with a patient. To investigate the neural processes involved in this quick diagnostic process, the researchers used functional MRI scanning to assess the cerebral activity in doctors while they diagnosed lesions in chest X-rays.

The results showed that the brain areas active during this task were strikingly similar to those activated while naming line drawings of animals embedded in chest X-rays. The doctors were able to begin to verbalize the correct diagnosis in an average of 1.33 seconds, indicating that this type of diagnosis can be very fast.

Understanding the neural basis of medical diagnosis may contribute to the development of better techniques to improve diagnostic expertise and reduce diagnostic errors. This is the first published investigation of the brain mechanisms directly involved in medical diagnosis. Furthermore, the results of this study imply that the vast knowledge obtained from cognitive neuroscience studies on the recognition and naming of objects can be brought to bear on the improvement of diagnostic practices.

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Citation: Melo M, Scarpin DJ, Amaro E Jr, Passos RBD, Sato JR, et al. (2011) How Doctors Generate Diagnostic Hypotheses: A Study of Radiological Diagnosis with Functional Magnetic Resonance Imaging. PLoS ONE 6(12): e28752. doi:10.1371/journal.pone.0028752

Financial Disclosure: This study is part of the Cooperac¸ao Interinstitucional de Apoio a` Pesquisa sobre o Cerebro (CINAPCE) funded by Fundac¸ao de Amparo a` Pesquisa do Estado de Sao Paulo (FAPESP), Brazil. Cathy J. Price and Karl J. Friston are funded by the Wellcome Trust, UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interest Statement: The authors have declared that no competing interests exist.

PLEASE LINK TO THE SCIENTIFIC ARTICLE IN ONLINE VERSIONS OF YOUR REPORT (URL goes live after the embargo ends): http://dx.plos.org/10.1371/journal.pone.0028752

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