Discussion
I have Symptom X. Symptom X is a very likely predictor of Condition A, so much that Condition A is often presumed diagnosed *only* with direct observation of Symptom X. I observed Symptom X thirteen months ago.
I also have Symptom Y. When we know Condition A, Symptom Y is clearly established to be a direct result of Condition A in many cases. But Symptom Y also results from many other causes.
@yvonnezlam do they say why they think there's evidence against it?
@yvonnezlam (I just find that a useful question to force clarity)
@grimalkina My friend reports that they say, "You have a lot going on, but I don't think it's Complex Condition."
Nevertheless, the probability of Condition A given BOTH Symptom Y and Symptom Y is, well. Different from the probability of Condition A given only Symptom Y.
Want to guess how many separate different doctors appointments it took to get from my raising Symptom X, while having an appointment about Symptom Y, to get to Condition A?
@JeffGrigg oh yes thanks!
@JeffGrigg the word "symptom" stopped being meaningful as some point writing those lol
It took EIGHT appointments, over $1000 (that's after insurance), and loads of time and stress.
And I raised the thing we needed to look at in the very first appointment and every subsequent one.
Now, I don't dispute the need to not leap to assumptions. Perhaps there really are many drivers of Symptom Y.
But not even *considering* Condition A? A real failure.
Doctors' appointments are subject to anchoring effects, perhaps worse than any single high-stakes reasoning moment I've ever seen.
This sounds eerily like my daughter's current & ongoing experience with US health care.
@Benhm3 I hope she gets care :(
Famously, doctors struggle with base rates and similar cognitive biases around likelihood
(
see: https://www.researchgate.net/publication/247373134_Physicians_neglect_base_rates_and_it_matters
or
https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2753.2001.00284.x
)
Really, we all struggle with base rates
We are trained to think about population level averages. Our minds like to anchor on large known patterns.
But most moments of detective work are about winnowing through conditional probabilities
@grimalkina Thanks for that reminder about anchoring. It helps me feel a little better about the doctor who neglected to read my history, because absent that history, her advice was for the most likely remedy for causes of Symptom X: exercise, bronchodilation; useless for me.
I have been going back through the last two years of my experience here and trying to write something out of it. A few large points are resolving
@grimalkina shiiiiiit, I'm so sorry. Ugh.
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@grimalkina I have a friend who is being told by doctors "you have a lot of awful symptoms, but you don't have Complex Condition That We Have Not Tried to Diagnose."
Me: "Isn't having a lot of awful symptoms in itself a complex condition? Even if it's not the one you think you might have that they don't think you do so they aren't trying to diagnose?"