How doctors diagnose and prescribe treatments: a functional magnetic ressonance imaging study of primary care physicians

Abstract

Physicians generate diagnostic hypotheses in response to symptoms, clinical signs or other information obtained while assessing patients. There are several studies showing that this process can be fast and the accuracy of these hypotheses have a decisive influence on the final diagnosis. We conceptualize that the generation of diagnostic hypotheses is a lexical semantic association process in which diagnostic information evoke the name of associated diseases. Our hypothesis is that the neurocognitive mechanisms involved in medical diagnosis based on pattern recognition are similar to those used in the identification and naming of objects and concepts in everyday life. This hypothesis was tested in the visual domain using radiological diagnosis as an experimental model. The results supported the hypothesis. We intend with the present investigation to test the proposal in the verbal domain, using diagnostic information presented verbally to primary care physicians. Brain activations will be assessed while participants make diagnoses during a session of functional magnetic resonance imaging. In addition we want to test the proposal that prescription of treatments to specific diseases has a neural substrate similar to the generation of diagnostic hypotheses. (AU)