Some of the scans showed evidence of disease, which the doctors were required to diagnose. There were also two control conditions, in which the stimuli were still X-rays but with little pictures of either animals or letters embedded in them, instead of diseases.
The image above shows how it worked. As well as pneumonia, one patient has a severe case of Alligator Lung, while the other looks like they've got the Influenza 'B' virus.
Now, the point of all this was to compare the mental process of making a diagnosis to that of seeing an object. The idea is that a trained radiologist sees particular diseases in the scans, in the same way that anyone can see an alligator.
Activity during diagnosis, object-recognition and letter naming was very similar (compared to doing nothing); this presumably represents the visual and language areas involved in looking at the image, recognizing what it is, and saying it out loud:
There were some slight differences, with the left inferior frontal cortex and the posterior cingulate cortex being more activated by diagnosis than animals. But this difference disappeared after controlling for the number of different possible descriptions the radiologists reported thinking about for each image.
The authors conclude that
These results support the hypothesis that medical diagnoses based on prompt visual recognition of clinical signs and naming in everyday life are supported by similar brain systems.Which seems fair enough, although it's important to remember that the diagnoses in this study were quite easy ones. The mean response time was just 1.3 seconds and only 6% of those split-second diagnoses were wrong. Unfortunately diagnosis is not always that easy.
Anyway, this study is all very well, but why stop at chest X-rays? Last year I speculated on the fun neuroscientists could have with a real-time fMRI machine:
You could lie there in the scanner and watch your brain light up. Then you could watch your brain light up some more in response to seeing your brain light up...We really need to scan people while they're looking at brain scans. Only then will we be able to understand the neurological basis of being a neurologist, and find the brain's looking-at-a-blob blob.
Melo M, Scarpin DJ, Amaro E Jr, Passos RB, Sato JR, Friston KJ, and Price CJ (2011). How doctors generate diagnostic hypotheses: a study of radiological diagnosis with functional magnetic resonance imaging. PloS ONE, 6 (12) PMID: 22194902
11 comments:
Hilarious! This reminds me of a story Raymond Smullyan wrote many years ago, about an "experimental epistemologist" who only claimed to know his own experiences after reading them out from a brain-scanning machine. I feel that we are quickly approaching the great day when his vision becomes reality!
Malkovich Malkovich? Malkovich Malkovich Malkovich. MALKOVICH!
What a bunch of nonsense. And it is not much different than the vast majority of BOLD-based functional imaging.
The brain thinks! Who knew?
You could lie there in the scanner and watch your brain light up. Then you could watch your brain light up some more in response to seeing your brain light up...
That's what I thought this would be about thanks to the misleading title! ;)
It's fun to imagine that there could be a neural equivalent to video feedback, but of course we haven't actually reached the level of "mind reading" with the scanners yet…
Still hoping that fRMI do not interfere with one's precious balance of the brain and soul then neuroskeptic?
Anyway, one of my master used to say that what makes somebody a medical specialist was not a diploma but the trained eyes, ears and mind functionning more efficiently when confronted with the material to be diagnosed or cleared of that specialist desease.
NB: This definition of his suppose a strong and clear body of knowledge and do not apply to psychiatry.
Lenoxus: Well, some people are using fMRI to provide real-time feedback now...
28 December 2011 08:33
I wanted also to ask if we were to get fRMI as a laboratory test to give a MD his specialist qualification when he passed an exam about theorical useful knowledge.
It goes like that: you are qualified to become a radiologist when your brain light up in the correct location and at the correct speed before your mouth prononces rightly something like:pneumonia.
It is a common resident vexing experience to stare closely at something who looks just like the image of X-ray lungs, until a senior person comes in ,and in seconds says at a good three meters distance: bronchial dilatation right superior lobe!
Idem when a resident looks at the fRMI image of a brain etc...
You can also imagine laboratory test with the lighting of brains working on a clinical diagnostic (somebody has to read a clinical examination report ) to the specialist candidate in the noisy machinery.
And no cheating possible.
Off topic,
but what do you think of this pieace?
http://blogs.discovermagazine.com/gnxp/2011/12/the-aliens-among-us/
I'd liketo hear you about it...
Neuroskeptic - you left a few comments at the Neuro Times (www.dictionaryofneurology.com) and so I thought I'd pass on a name relevant to this post and a few comments made by Ivana. Amir Raz, at McGill, has demonstrated that this brain-scanning stuff has unusual persuasive abilities. Check out his literature. It will change everything you think you know. Seriously.
Neuro Times: Thanks. I will check it out.
Neuro Times,
Thank for not despising the comment from a middle-aged bitter clinician.
And thanks for your post on the new book (history of neurosurgery):
life is so complicated: I learned from you that the portugese neurosurgeon who get the Nobel prize for the crude lobotomy therapy of chronic pain and disturbing behaviors
also invented the cerebral angiography!
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