EDS & Gut Dysmotility
PodcastDX
This week we will discuss the most common type of Ehlers-Danlos syndrome – the hypermobile type (hEDS, formerly also described as EDS type III or joint hypermobility syndrome), this is the type that most commonly presents to gastroenterology services. As connective tissue is present throughout the body, many different structures around the body including the digestive tract can be affected by EDS. Connective tissue is present in the digestive tract and is essential to the passive mechanical movements needed to complete digestion. It has been suggested that any abnormalities in the...
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Gut Dysmotility & Ehlers Danlos Syndrome
PodcastDX
This week we will discuss the most common type of Ehlers-Danlos syndrome – the hypermobile type (hEDS, formerly also described as EDS type III or joint hypermobility syndrome), this is the type that most commonly presents to gastroenterology services. As connective tissue is present throughout the body, many different structures around the body including the digestive tract can be affected by EDS. Connective tissue is present in the digestive tract and is essential to the passive mechanical movements needed to complete digestion. It has been suggested that any abnormalities in the...
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Ketamine for Depression
PodcastDX
This week we will discuss the use of Ketamine for treating Depression. Our guest for this week's show is Karen DeCocker, DNP, PMHNP, CNM Karen DeCocker is the Director of Advanced Practice Providers at Stella overseeing the assessment team. She helps to identify which innovative biological medical treatments & virtual therapies can help relieve symptoms of anxiety, depression, PTSD & traumatic brain injury. After completing a virtual assessment of each patient, Dr. DeCocker and her team analyze the medical, biological, psychological & social factors to provide...
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Complex Illness
PodcastDX
On this week's show we are speaking once again with Kristine Hoestermann, the founder of "" and she will be explaining how difficult it has been to get a diagnosis for Ehlers Danlos Syndrome and where that diagnosis took her (Brittle Cornea Syndrome & the BRCA Gene for Breast Cancer are the latest two) During our discussion I mentioned how I picture complex diagnoses as being like an over-spooled fishing reel, you don't know where to start to unravel the different aspects of the condition, but you know it's all connected! Heeeeere's Kristine! Allow me to introduce...
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The Microbiome
PodcastDX
Your gut microbiome is like a microscopic ecosystem within your body, housing trillions of microorganisms that interact with each other and their environment in various ways. These microbes also have a significant impact on your overall health, influencing both your digestive system and other bodily functions. A biome is a distinct ecosystem defined by its environment and inhabitants. Your gut, specifically within your intestines, is a miniature biome teeming with trillions of microscopic organisms. This diverse community includes over a thousand species of bacteria, along with viruses,...
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S17E13 Sturge-Weber Syndrome
PodcastDX
This week we will discuss Sturge-Weber syndrome with a wonderful woman we had the pleasure of meeting previously in Chelsey Peat was born with Sturge-Weber syndrome, a rare condition that led to multiple surgeries, including a life-saving brain surgery as an infant. Despite doctors predicting significant limitations, Chelsey has defied these expectations throughout her life. She graduated from high school and college, and she is currently pursuing a degree in sociology alongside a certificate in Diversity, Equity, and Inclusion. With nearly 40 years of personal experience living with a facial...
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BiPolar
PodcastDX
Paris Scobie is a Mental Health Speaker, Host of the top 1% globally ranked podcast, , & Best-Selling Author of her memoir, . Paris launched Live Well Bipolar to use her lived experience to help others overcome the shame, fear and isolation that can so often accompany living with bipolar. She shares how she went from being a patient struggling from inside the walls of a psychiatric hospital newly diagnosed with bipolar to returning to work at this same hospital years later. This unique perspective has allowed Paris to share her experiences on what truly made a difference for her...
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Common Variable Immunodeficiency
PodcastDX
Today, we have the honor of speaking once again with Sheila Ames, a registered nurse in Northern California who has been diagnosed with a rare type of a primary immunodeficiency known as common variable immunodeficiency or CVID for short. How did she fare during the recent Pandemic? Tune in now to find out! At the time of her diagnosis she was working as an ICU nurse and her first doctors order was: no more exposure to infectious patients. This diagnosis not only changed her career dramatically, it led her to following her life's purpose in opening her own health & wellness...
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Ticks & Lyme Disease
PodcastDX
Ticks & Lyme Disease is the topic of the week! Our guest is Dr. Myriah Hinchey, a Naturopathic physician and Fellow of the Medical Academy of Pediatric Special Needs (MAPS), is a recognized expert in the field of Lyme disease and other complex chronic inflammatory conditions, with over 17 years of specialized experience. As a physician and the Medical Director at TAO, an integrative center for healing, she has successfully guided thousands of patients towards recovery from their complex chronic inflammatory conditions. Additionally, she is the founder and owner of LymeCore...
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Ehlers Danlos Syndrome in the age of COVID
PodcastDX
Squeeze a world of passion, goal driven problem solver and an adventurous triathlete into 5 feet of fun and you get Faith Louise Cooper. Faith Louise grew up in a family of 5 with 2 younger sisters. At the 12 she was diagnosed with Juvenile Rheumatoid Arthritis, now known as Juvenile Idiopathic Arthritis. In 2017 she was diagnosed with hypermobility syndrome and was recently changed to Hypermobility Ehlers Danlos Syndrome abbreviated as hEDS. Her younger sister also battles with hEDS on a daily basis. Faith Louise joined the swim team in middle school to help manage...
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This week we will discuss the topic of Diagnostic Radiology. The error rate of radiology is 4% world wide which comes out to be 40 million interpretive errors a year. Errors in diagnostic radiology occur for a variety of reasons related to human error, technical factors and system faults. It is important to recognize that various cognitive biases contribute to these errors.
Cognitive biases have a complex and significant impact on the perception of examinations within diagnostic radiology, with the clear and present danger of diagnostic errors. The following are some of the more common cognitive biases that can affect day-to-day decision making
Alliterative bias
Alliterative bias (sometimes called satisfaction of report) is the tendency for your diagnostic impression to be unduly influenced by the prior interpretation made by another radiologist or clinician. It is a type of confirmation bias and it can result in the same incorrect impression being propagated from one radiologist to the next. Formulating your own interpretation before reviewing any prior imaging reports may help reduce alliterative bias.
Anchoring bias
Anchoring bias is the tendency for your initial impression to unduly influence your evaluation of subsequently collected information. Careful assessment of all imaging findings prior to formulating a diagnosis and consideration of alternate diagnoses may help minimize anchoring bias.
Automation bias
Automation bias is the tendency for reporters using computer-aided decision support to over rely on the software for the diagnosis, and to ignore their own opinions 2. Making your own assessment prior to reviewing the computer-aided findings, and knowing the limitations of the automated software, can help reduce this bias.
Availability bias
Availability bias refers to the tendency for your diagnostic judgements to be unduly influenced by information or experiences that are readily recalled in your mind. Use of information sources beyond your own personal experience, such as publications or an opinion from colleagues, may help to minimize availability bias.
Bandwagon effect
The bandwagon effect (sometimes termed diagnosis momentum) refers to the tendency for you to do or think as others do, simply because that's what others are doing. Applying your own judgment and not dismissing your own opinion can help avoid this bias.
Confirmation bias
Having a predetermined diagnosis in mind, then looking for evidence that supports this predetermined idea. Alliterative errors 3, sometimes referred to as satisfaction of report errors, are caused by the tendency to overvalue previous reports, and can be conceptualised as a type of confirmation bias.
Framing bias
Framing bias refers to the tendency to be unduly influenced by how a clinical question is asked or how the problem is presented. For example, a request form that presents a succinct history that perfectly matches a particular pathology, may influence your interpretation of the imaging. Reviewing the images prior to reading the clinical indication can help avoid any influence. Obtaining more detailed clinical information via the electronic medical record may help provide you with a more balanced assessment of the clinical situation.
Hindsight bias
Hindsight bias is the tendency to overestimate the prior predictability of an event (eg. a diagnosis) after the event is known. In other words, the difficulty of making the correct diagnostic decision initially is retrospectively de-emphasized, after the diagnosis has been proven. It is also informally termed as the “I knew it all along” or "retrospectoscope" bias 5. It is important to be conscious of this bias so that you are not overly critical of yourself or others when quite reasonable errors are made.
Outcome bias
A tendency to favor a less severe diagnosis based on empathy for a patient.
Representativeness bias
Making a judgment on an aspect of an image that is based on one's own perception of what that represents. Representativeness bias as the description suggest can also be heuristic in nature.
Search satisfaction
Search satisfaction is the tendency to prematurely stop searching after early findings satisfy the reader that the diagnosis or symptoms can be explained. Satisfaction of search (SOS) errors have been reported to account for 22% of diagnostic errors 4. A systematic approach to image interpretation and review of check areas and not-to-miss diagnoses can help to reduce this bias.
Zebra retreat bias
A reader will not make a rare diagnosis, which is otherwise supported by the available evidence due to a lack of confidence.
There are businesses that do "second opinion" reads, here are links for two such companies for your use: www.ndximaging.com www.xmri.com
