Saturday, January 29, 2011

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Biased Reality (Part I): self-fulfilling prophecy. Confirmation Bias

The confirmation bias or confirmation bias is the tendency to investigate and interpret the information so confirming our previous hypothesis or ideas, causing misunderstanding and bias of reality. Give more weight to evidence that confirms the beliefs and underestimate those that disparage or deny.
The effect of the expectant observer (experimenter) or expectant subject (patient) is cognitive bias that occurs in science when a subject expects a given result and therefore unconsciously manipulates an experiment data. Is especially true in medicine where is called the placebo effect or nocebo , depending on whether the handling of the subject has been to include a fact or to omit it. Used to eliminate the double-blind or blind.

The prophecy autocumplia is the conditioning due of an attitude. It is the tendency to infer that something will happen because we think that will happen, and thus or conditioned urge you to pass.

assimilation bias. We understand what we understand, as grandmothers only hear what they want. The brain receives a lot of information and conducts a screening of storing and using that information he considers relevant. Relevance is determined by the vision of reality with predetermined ideas, preconceptions. Opinions, after all, based on our filters and labels.

In a study by Harvard University psychologists Rosenthal and Jacobson, which they called "Pygmalion in the classroom." ( see Pygmalion Effect) Teachers received false information about the achievements they could expect from some of his students (20% of the total, chosen at random). Based on the expectations created by this information, teachers rated with highest scores on tests conducted subsequent to these students.
Wason As concluded in the triple experiment (see link confirmation bias) when establish a hypothesis, we tend to search for evidence to confirm our hypothesis and avoid those who deny it. Instead of trying to deny it, try to confirm this as soon as possible because it makes us feel more secure with what we do.
much to do scientific research to treat a patient prior expectations might affect results or diagnoses.


Depending on the expectations, conditioned observation, diagnosis the treatment, the patient and evolution.
Maitland, in Chapter 3 of his books talks about communication and its difficulties. Makes an important reflection on how easy it is to get false information on the history. Specifically on page 30, discusses bias. It is difficult to formulate an unbiased question. We must always ensure that our issues are neutral.
Are you better than last week? This formulation is more correct, because we are already hinting that should be better, or hope to hear you are better.
What this about last week? This is the correct formula to refer to what we know. The neutral forms often require clarification, and sometimes you need to ask them in various ways to get the answer you want
Are you better, worse or the same last week? not easy to get information and when you practice the collection of unbiased information realizes how extremely easy it is to communicate with bias errors.
Sometimes I like to use a negative bias on purpose, are you a bit worse than last week? Are you sure? or you sure you're better? , because some patients tend to be complacent, we are more comfortable expressing themselves. It is curious to see how easily they sometimes change their minds and inconsistent, and on what we know through the patient. In some cases, communication is practically impossible. Assuming
communication constraints. We must always seek the truth above what we want is the truth. It is very easy to manipulate the history, assessment, examination, diagnosis ... unconsciously.
I strongly recommend reading the first chapters of Maitland. Be critical of ourselves and our treatments. Observe the prejudice of conditioning and try to challenge our assumptions ... All this while conveying confidence and patient safety. An art.


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