Title |
Risk, diagnostic error, and the clinical science of consciousness
|
---|---|
Published in |
NeuroImage: Clinical, February 2015
|
DOI | 10.1016/j.nicl.2015.02.008 |
Pubmed ID | |
Authors |
Andrew Peterson, Damian Cruse, Lorina Naci, Charles Weijer, Adrian M Owen |
Abstract |
In recent years, a number of new neuroimaging techniques have detected covert awareness in some patients previously thought to be in a vegetative state/unresponsive wakefulness syndrome. This raises worries for patients, families, and physicians, as it indicates that the existing diagnostic error rate in this patient group is higher than assumed. Recent research on a subset of these techniques, called active paradigms, suggests that false positive and false negative findings may result from applying different statistical methods to patient data. Due to the nature of this research, these errors may be unavoidable, and may draw into question the use of active paradigms in the clinical setting. We argue that false positive and false negative findings carry particular moral risks, which may bear on investigators' decisions to use certain methods when independent means for estimating their clinical utility are absent. We review and critically analyze this methodological problem as it relates to both fMRI and EEG active paradigms. We conclude by drawing attention to three common clinical scenarios where the risk of diagnostic error may be most pronounced in this patient group. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 8 | 29% |
United States | 5 | 18% |
Canada | 3 | 11% |
Spain | 1 | 4% |
Turkey | 1 | 4% |
Cayman Islands | 1 | 4% |
Ireland | 1 | 4% |
Mexico | 1 | 4% |
Switzerland | 1 | 4% |
Other | 1 | 4% |
Unknown | 5 | 18% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 19 | 68% |
Scientists | 5 | 18% |
Practitioners (doctors, other healthcare professionals) | 4 | 14% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 1 | <1% |
United States | 1 | <1% |
Sweden | 1 | <1% |
Canada | 1 | <1% |
Unknown | 100 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 18 | 17% |
Student > Ph. D. Student | 15 | 14% |
Student > Bachelor | 15 | 14% |
Researcher | 10 | 10% |
Other | 8 | 8% |
Other | 16 | 15% |
Unknown | 22 | 21% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 24 | 23% |
Psychology | 17 | 16% |
Neuroscience | 11 | 11% |
Agricultural and Biological Sciences | 6 | 6% |
Philosophy | 4 | 4% |
Other | 15 | 14% |
Unknown | 27 | 26% |