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- Page navigation anchor for RE: Deconstructing the diagnostic reasoning of human versus artificial intelligenceRE: Deconstructing the diagnostic reasoning of human versus artificial intelligence
I applaud the authors for clearly articulating the differences between how computers might make a diagnosis versus physicians, whether they be experienced clinicians or trainees. I was disheartened, however, to not see, anywhere in the article, a mention of the value of the physical exam in the early stages of the hypothetico-deductive approach to making a diagnosis. No computer (at least not that I am currently aware of) can pick up the subtleties of focal involuntary guarding in the right lower quadrant in an "ill-looking" 10 year old boy with a 24 hour history of abdominal pain, who, regardless of whether or not an appendix is "seen" on ultrasound or whether or not the WBC or CRP is elevated, more than likely has appendicitis. In the same light, no physician can make that diagnosis either, unless they lay an experienced hand on the child!
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Too often I get a call about an "ultrasound-proven (or, heavens-forbid, a CT-proven!) appendicitis" in the emergency department, with no mention of a history or physical exam let alone an indication that any of these finding belong to an actual patient. Let's not forget the "art of medicine" - the art of the history and physical exam - dying as it may seem(1). Computers have buttons (and so do our young trainees as they carry around phones tied to their hips like conjoined twins)...but is our human senses: hearing, seeing and feeling, using our ears, our eyes and our hands, th...Competing Interests: None declared.