Junior Faculty review – EuroDEM 2018

CanTest Research Associate Marije Van Melle looks back on a European conference dedicated to diagnostic error…

At the end of August a delegation of CanTest’s Senior and Junior Faculty attended EuroDEM – a conference entirely dedicated to diagnostic error in medicine – in the beautiful, medieval Swiss capital Bern (land of cuckoo clocks, heraldic beasts and gateway to the Alps).

The conference featured two days of interesting and inspired presentations across the whole spectrum of diagnostics: from heuristics and uncertainty in the diagnostic process, radiology testing and machine learning, harm from diagnostic testing and overdiagnosis.

CanTest’s Professor Hardeep Singh showed the complexity of health care, and discussed the challenges and opportunities to understanding and reducing diagnostic error. Associate Director Yoryos Lyratzopoulos provided an overview of recent cancer diagnostics research, as well as a valuable insight in the research that still has to be conducted – something a Junior Faculty member like me prints in her mind.

The most impressive presentation was by Sue Sheridan – a mother and wife of two patients affected by diagnostic error. She told us about multiple ‘what ifs’ that could have positively changed the diagnostic pathway and prevented diagnostic errors in their cases. I think every clinician and diagnostics researcher should hear her story to understand the consequences of the accumulation of the many small errors we might see (or might not even notice anymore) as clinicians resiliently cope with and solve problems on-the-spot on a daily basis. She strongly advocated the need for patient engagement for improving patient safety.

Further inspiring presentations came from Professor Gerd Gigerenzer and Professor Wolfgang Gaissmaier on the usefulness of heuristic reasoning in medical decisions. They discussed the difference between ‘risk’ situations, in which most evidence is present and there is time to use that evidence, vis-a-vis ‘uncertainty’, when the alternatives and consequences are unknown and we rely on heuristics and intuition.

Prof Gassmaier also spoke about communicating risk and uncertainty and the dangers of wrong communications:

Statistics are curious things. They afford one of the few examples in which the use, or abuse, of mathematical methods tends to induce a strong emotional reaction in non-mathematical minds. This is because statisticians apply, to problems in which we are interested, a technique which we do not understand.”Lancet Mathematics, 1937

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