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Determining Whether a Patient is Feeling Better: Pitfalls from the Science of Human Perception

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Abstract

Human perception is fallible and may lead patients to be inaccurate when judging whether their symptoms are improving with treatment. This article provides a narrative review of studies in psychology that describe misconceptions related to a patient's comprehension, recall, evaluation and expression. The specific misconceptions include the power of suggestion (placebo effects), desire for peace-of-mind (cognitive dissonance reduction), inconsistent standards (loss aversion), a flawed sense of time (duration neglect), limited perception (measurement error), declining sensitivity (Weber's law), an eagerness to please (social desirability bias), and subtle affirmation (personal control). An awareness of specific pitfalls might help clinicians avoid some mistakes when providing follow-up and interpreting changes in patient symptoms.

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Acknowledgements

This project was supported by the Canada Research Chair in Medical Decision Sciences, the Physician Services Incorporated Foundation of Ontario, and the Sunnybrook Research Institute. We thank the following individuals for helpful comments on earlier drafts of this article: Chaim Bell, William Chan, Nick Daneman, Edward Etchells, Daniel Hackam, David Henry, David Juurlink, Christopher Kandel, Fred Leavitt, Anne Matlow, Lee Ross, Damon Scales, Michael Schull, and Steven Shumak.

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Correspondence to Donald A. Redelmeier MD, FRCPC, MS(HSR), FACP.

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Redelmeier, D.A., Dickinson, V.M. Determining Whether a Patient is Feeling Better: Pitfalls from the Science of Human Perception. J GEN INTERN MED 26, 900–906 (2011). https://doi.org/10.1007/s11606-011-1655-3

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