Diagnosis is Situated – A New Perspective
A just-released special issue of Diagnosis examines diagnosis from a new, very unique perspective - as a 'situated', social activity. And yes, situativity was a new word for me too ;<)
You can find the special issue here. All articles are free, open access. Details on a situativity Twitter chat -9 PM Eastern on September 15th , and a journal club, October 13, 3-4 PM Eastern, will follow.
Using this lens of social cognitive theory, diagnosis involves not just the clinical reasoning process, but all our interactions with the world around us that play into this. Context is key, and observation of diagnosis in practice is the major research approach used to study the process.
The special issue includes 21 articles, and a set of wonderful illustrations by Michelle Daniel and colleagues. Other highlights include:
Some of my favorite articles also include:
Please share these articles with your colleagues and share your thoughts here:
Mark L Graber, MD FACP
Founder and President Emeritus, SIDM
Professor Emeritus, Stony Brook University, NY
Work 607 305-0050
Cell 919 667-8585
This sounds fascinating. I have downloaded the whole issue and am eager to read this new issue of Diagnosis. Also, for future spelling bees, I will definitely need to know how to spell "situatuity" and use it correctly in a sentence! Also, from what you've mentioned before, I am interested in understanding how Radiology might be a unique example of this, so maybe you address that in your editorial.
Thinking about these concepts kind of reminds me of the discussion that Dr. Bimal Jain and I had last month on this forum - specifically about how Bayesian reasoning is SUPER-important for Radiology as we narrow our range of differential diagnoses to explain what we are seeing on images, but that Bayes theorum may not be so applicable to the internist trying to establish a "final" diagnosis for an individual patient, and thus needing a higher degree of confidence that the diagnosis is correct (and not merely more likely than other possibilities). Perhaps this concept of "situated" diagnosis might be the bridging concept that can unify our two worlds?
All the best,
Michael A. Bruno, M.D., M.S., F.A.C.R. Professor of Radiology & Medicine
Vice Chair for Quality & Patient Safety
Chief, Division of Emergency Radiology
Penn State Milton S. Hershey Medical Center ( (717) 531-8703 | 6 (717) 531-5737
Prof. of Biomedical Informatics, Perelman Sch of Medicine.
Senior Fellow, Wharton's Leonard Davis Institute of Healthcare Economics;
Senior Fellow, Center for Public Health Initiatives, Perelman Sch of Medicine;
Adjunct Professor (full) Sociology Department;
Affil Prof of Medicine, Perelman Sch of Medicine;
Prof. of Biomedical Informatics, SUNY@Buffalo
Thanks Ross – Maybe we should titled the special issue "Lost and Found" – its true that some of the elements falling under situativity have been around for a long time, but they haven't been part of the mainstream discussion. Time to re-visit and re-invigorate this field !