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Dear All,
another name for it is 'tacit knowledge'
If we do not know how to measure it, how to acquire it, how to use it,
how we can rely on it?
VVV
[log in to unmask]">...Dear Ben and Joseph
I published these findings about combining System 1 and 2 in my MD (I have been calling them transparent and ‘non-transparent). The data was given to me to illustrate that in order to model differential diagnostic reasoning it was necessary to use a theorem derived from the extended version Bayes rule proven by me. The lenders of the data were perplexed by what I was able to show.
The data had been collected originally to assess feasibility and hopefully the superiority of ‘computer diagnosis’ (now called ‘AI’ I suppose) so my finding undermined this (ie combining Systems 1 and 2 or non-transparent gut feeling with evidence based transparent reasoning was superior to computer diagnosis / AI alone). Because of this I had trouble getting permission to use the data in my MD (but I did eventually) but was not given permission to publish widely what I had found because of ‘commercial confidentiality’.
The Oxford Handbook of Clinical Diagnosis is based on the above reasoning process by probabilistic elimination and it’s Chapter 13 describes the maths. It also shows that Bayes unextended rule with a single prior, sensitivity and false positive rates (or likelihood ratios) with statistical independence does not provide an adequate model for differential diagnosis. (It is important to use the priors of all the differential diagnoses in the calculation and ratios of sensitivities or ratios of false negative rates). Referees are reluctant to accept this as it undermines current EBM dogma.
I will scan some of the pages from my MD and send them to you shortly (or anyone else who would like to see them). I am revising and adding to Chapter 13 of the next 4th edition of the Oxford Handbook of Clinical Diagnosis at present. However Chapter 13 of the 3rd edition is ‘open access’ online: http://oxfordmedicine.com/view/10.1093/med/9780199679867.001.0001/med-9780199679867-chapter-13
Best wishes
Huw
-- \/.\/.\/. Vasiliy V. Vlassov, MD Professor, National Research University Higher School of Economics e-mail: vlassov[a t]cochrane.ru Web page https://www.hse.ru/en/org/persons/14527416 snail mail: P.O.Box 13 Moscow 109451 Russia Phone Russia +7(965)2511021
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