SUNY Health Science Center at Brooklyn, Brooklyn, NY, U.S.A.
Kings County Hospital Center, Brooklyn, NY, U.S.A.
Br J Dermatol. 2018 Dec;179(6):1263-1269. doi: 10.1111/bjd.16932. Epub 2018 Sep 25.
Sir William Osler famously, and ironically, stated that 'Medicine is a science of uncertainty and an art of probability'. The processes by which each physician metes out diagnostic uncertainty and navigates probabilities in dermatology is far from uniform. While certain ubiquitous cognitive and visual heuristics can enhance diagnostic speed, they also create pitfalls and thinking traps that introduce significant variation in the diagnostic process. Discussed in this part of a two-part article are various cognitive and visual heuristics as they pertain to skin disease, with an introduction and special attention paid to the heuristic methods classically applied by dermatologists. How to best address error and improve our thought processes will be addressed in part 2.
威廉·奥斯勒爵士曾著名而讽刺地指出,“医学是一门不确定的科学和一门概率的艺术”。每位医生在皮肤科中处理诊断不确定性和驾驭概率的过程远非统一。虽然某些普遍存在的认知和视觉启发法可以提高诊断速度,但它们也会产生陷阱和思维陷阱,从而导致诊断过程中出现显著差异。本文分为两部分,这是其中的一部分,讨论了各种与皮肤疾病相关的认知和视觉启发法,并介绍了皮肤科医生经典应用的启发法方法。在第二部分中,将讨论如何最好地解决错误并改进我们的思维过程。