Diagnostic Habituation Error and Spotting Those Who Fall Its Prey

Diagnostic methods do not lend themselves to discovery goals; only to conclusions. The wise skeptic understands the difference in mindset of either approach, its value in application, and can spot those who fall prey to diagnostic habituation; hell bent on telling the world what is and what is not true.
Linear diagnostic thinkers tend to regard that one must ‘believe’ in or have scientific proof of their idea prior to conducting any research on it in the first place. They will not state this, however – watch carefully their illustration of applied scientific methodology. A bias towards prescriptive conclusions, obsession over beliefs, enemies and wanting proof as the first step of the scientific method will eventually broach in their worn out examples of poorly researched 1972 Skeptic’s Handbook bunk exposé.

When Lab Coats Serve to Deceive Self

There's no such thing as...

Nickell plating is the method of twisted thinking wherein one adorns lab coats and the highly visible implements of science in order to personally foist a display of often questionable empirical rigor. In a similar fashion, lab coats can also be used to deceive self, if one does not “live the examined life” as cited in the Socratic Apology 38a path context. Diagnostic Habituation Error is a very common judgement error in scientific methodology, often committed by professionals who work in very closed set domains, realms which involve a high degree of linear thinking, or matching of observation (or symptom) to prescriptive conclusion. The medical field is one such discipline set inside of which many professionals become blinded by protocols to such an extent that they fail to discern the more complex and asymmetrical demands of science in other disciplines.

For instance, medical diagnosticians use a term called a SmartPhrase in order to quickly communicate and classify a patient medical record entry for action or network flagging. A SmartPhrase is an a priori diagnostic option, a selection from cladistic clinical language, used in patient Electronic Health Record (EHR) documentation. While its intent was originally to compress and denote frequently used language, it has emerged as a defacto diagnostic option set as well. Wittgenstein would be nodding his aged head to this natural evolution. The nomenclature and diagnostic option set afforded makes life immersed inside Electronic Health Records easier for physicians. It makes science easier – but comes at a cost as well. A cost which the diagnostician must constantly bear in mind.

Not all sciences are like diagnostic medicine and astronomy. Most are vastly more complex in their deontologically reductive landscape. Diagnostician’s Error – is the failure to grasp this.

It would not constitute a far stretch of the imagination to understand why a clinical neurologist might not understand the research complexity or sequencing entailed in scientifically identifying a new species, assessing the impact of commodities on economics and poverty or the discovery of a new material phase state.  Despite their scientific training, they will habitually conclude that no such new species/state exists, because the traps we set for them are empty, our observations must have come from flawed observational memory, or that the textbook doctrine on ‘supply and demand’/’elastic and inelastic’ demand curves apply to our situation. Diagnostics in the end, do not lend themselves to discovery.  This is why it is all to common to observe clinical diagnosticians in Social Skeptic roles, denying the existence of this or that or pooh-poohing the latest efforts to use integrative medicine on the part of the public. These ‘skeptics’ comprehend only an abbreviated and one dimensional, linear version of the scientific method; if they apply any at all. In diagnostics, and in particular inside of medicine, the following compromises to the scientific method exist: (diagnostic and clinical medicine and not medical research):

  • symptom eventually equals previously known resolution
  • only the ‘most likely’ or ‘most risk bearing’ alternatives need be tested
  • very little need for discovery research
  • absence of evidence always equals evidence of absence
  • only lab experimental testing is valid
  • single parameter measure judgements are employed with abandon
  • the first question asked is an experiment, little advance thought is required
  • the first question presumes an whole domain of familiar ‘known’
  • the intelligence research has already been completed by others – and is assumed comprehensive
  • necessity observation is done by the patient (but is discounted in favor of experiment)
  • Ockham’s Razor involves fixed pathways
  • the set of possible outcomes is fixed and predetermined
  • an answer must be produced at the end of the deliberative process

The key, for The Ethical Skeptic, is to be able to spot those individuals who not only suffer from forms of Diagnostic Habituation, but also have a propensity to enforce the conclusions from such errant methodology and thinking on the rest of society.  Not all subjects can be resolved by diagnostics and linear thinking. This form of thinking usually involves avoiding a rigor called a logical calculus, in favor of something called abductive (or simplest explanation) reasoning.  If one is not absolutely sure that the domain inside of which they are working is truly abductive (disease is 98% abductive – the rest of our reality is not) – then it would be an error to use this type of reasoning universally as one’s approach to broader science. One does not research anomalous phenomena by using abductive reason for instance; because abductive logical inference was what kept the world locked in religious and Dark Age understandings of our realm for so long.

Reasoning Types†

Abductive Reason (Diagnostic Inference) – a form of precedent based inference which starts with an observation then seeks to find the simplest or most likely explanation. In abductive reasoning, unlike in deductive reasoning, the premises do not guarantee the conclusion. One can understand abductive reasoning as inference to the best known explanation.

Strength – quick to the answer. Usually a clear pathway of delineation. Leverages strength of diagnostic data.

Weakness – Uses the simplest answer (ergo most likely). Does not back up its selection with many key mechanisms of the scientific method. If an abductive model is not periodically tested for its predictive power, such can result in a state of dogmatic axiom.

Inductive Reason (Logical Inference) – is reasoning in which the premises are viewed as supplying strong evidence for the truth of the conclusion. While the conclusion of a deductive argument is certain, the truth of the conclusion of an inductive argument may be probable, based upon the evidence given combined with its ability to predict outcomes.

Strength – flexible and tolerant in using consilience of evidence pathways and logical calculus to establish a provisional answer (different from a simplest answer, however still imbuing risk into the decision set). Able to be applied in research realms where deduction or alternative falsification pathways are difficult to impossible to develop and achieve.

Weakness – can lead research teams into avenues of provisional conclusion bias, where stacked answers begin to become almost religiously enforced until a Kiuhn Paradigm shift or death of the key researchers involved is required to shake science out of its utility blindness on one single answer approach. May not have examined all the alternatives, because of pluralistic ignorance or neglect.

Deductive Reason (Reductive Inference) – is the process of reasoning from one or more statements (premises) to reach a logically certain conclusion. This includes the instance where the elimination of alternatives (negative premises) forces one to conclude the only remaining answer.

Strength – most sound and complete form of reason, especially when reduction of the problem is developed, probative value is high and/or alternative falsification has helped select for the remaining valid understanding.

Weakness – can be applied less often than inductive reason.

Diagnostic Habituation Error

/philosophy : science : method : linear diagnostics : unconscious habituation/ : the tendency of medical professionals and some linear thinkers to habitually reduce subjects of discourse inside protocols of diagnosis and treatment, when not all, or even most fields of discourse can be approached in this manner. Diagnosis must produce an answer, is performed inside a closed set of observational data domain, constrained fields of observation (eg. 1500 most common human maladies), are convergent in model nature, tend to increasing simplicity as coherency is resolved and develop answers which typically select from a closed field of prescriptive conclusions. All of these domain traits are seldom encountered in the broader realms of scientific research.

DIAGNOSTICIANS

Detecting a Linear Diagnostic Thinker – Habituated into Selecting From a Prescriptive Answer Inventory
They tend to think that one must ‘believe’ in or have scientific proof of their idea prior to conducting any research on it in the first place. They will not state this, however – watch carefully their illustration of applied scientific method. They will rarely grasp an Ockham’s Razor threshold of plurality, nor understand its role; obsessively clinging to the null hypothesis until ‘proof’ of something else arrives. Gaming method, knowing full well that ‘proof’ seldom arrives in science.

The determination of a diagnosis of inherited static encephalopathy may be a challenging endeavor at first, and indeed stands as a process of hypothesis reduction and science.  However, this reduction methodology differs from the broader set of science and in particular, discovery science in that it features the following epignosis characteristics. The problem resides when fake skeptics emulate the former process and advertise that its method applies to their ability to prescriptively dismiss what they do not like.

your deceptive practicesA key example of applied Diagnostic Habituation Error can be found here. An elegant demonstration of how well-applied diagnostic methodology inside a clinical technical role can serve to mislead its participant when applied in the broader realms of science. This treatise exhibits a collegiate level dance through repetitious talk about method, parlaying straight into sets of very familiar, poorly researched canned conclusions, excused by high school level pop-skeptic dogma. Worn out old propaganda about about how memory is fallible if we don’t like its evidence, and if you research anything forbidden, your mind is therefore ‘believing’ and playing tricks on its host.

Diagnosis Based Science (How it differs from the broader set of science reduction and discovery)

the diagnostic habituation errorObservational Domain is Set, Experimental Only and Controlled – the human body is the domain and the set of observable parameters is well established, known and relatively easily and only measured.

Example:  Observable parametrics in the human body consist of blood measures, skin measures, neurological signals, chemical signatures and hormone levels, physical measures and those measures which can be ascertained through bacteriology and virology. In medicine, the scientific method starts there.  In discovery science, method does not start with an experiment, it starts with observation, necessity and intelligence. Despite the complexity which is inherent inside these observational domains, still the set is highly restricted and the things observed-for, well known for the most part. In contrast, examining the galaxy for evidence of advanced life will be a long, poorly understood and failure laden pathway. We cannot begin this process with simply the Drake Equation and an experiment and hope to have success.

Field of Observation is Constrained and Well Established with Gnosis Background – there are only a few subset disciplines inside which observations can be made. Each is well documented and for which is published a guiding set of protocols, advisement, and most recent knowledge base regarding that discipline.

Example:  There exist only a closed set of systems inside the human body, which are for the most part well understood in terms of dysfunction and symptom. Integumentary, skeletal, nervous, cardiovascular, endocrine and muscular systems. Compare this to the energy systems which regulate our planetary environment. Most are not well understood in terms of impact, and we are not even sure how many constitute the major contributors to climate impact, or even how to measure them. I am all behind science on Climate Change, but in no way do I regard the discipline as a diagnostic field. I am wary of those who treat it as such.  And they are many.

Fixed Ockham’s Razor Mandate, Single Hypothesis and Extreme Null Evidence Standards – The protocols of diagnosis always dictate that the most likely or danger-entailing explanation be pursued in earnest, first and only. Once this hypothesis has been eliminated, only then can the next potential explanation be pursued. Absence of evidence is always taken as evidence of absence. This is not how discovery or asymmetric science works. Very rarely is diagnostic science challenged with a new medical discovery.

Example:  When a 55 year old patient is experiencing colon pain, the first response protocol in medicine is to order a colonoscopy. But in research regarding speciation for instance, or life on our planet, one does not have to solely pursue classic morphology studies to establish a phylogeny reduction. One can as well simultaneously pursue DNA studies and chemical assay studies which take a completely different tack on the idea at hand, and can be used to challenge the notion that the first phylogeny classification was a suitable null hypothesis to begin with. Real research can begin with several pathways which are in diametric opposition.

Diagnoses are Convergent in Nature – the methods of reduction in a diagnosis consistently converges on one, or maybe two explanatory frameworks inside a well known domain of understanding. In contrast, the broader world of modeling results in convergent models very rarely; moreover, often in non-discriminating or divergent models which require subjective reasoning in order to augment in terms of a decision process (if a decision is chosen at all).

Example:  If I have a patient complaining of tinnitus, my most complex challenge exists on the first day (in most cases). I am initially faced with the possible causes of antibiotics effects, hearing loss, intestinal infection, drug use, excessive caffeine intake, ear infections, emotional stress, sleep disorder or neurological disorder. From there evidence allows our models to converge on one optimal answer in short order in most cases.  Compare in contrast an attempt to discern why the level of poverty in a mineral rich country continues to increase, running counter to the growing GDP derived through exploitation of those minerals. The science and models behind the economics which seek to ascertain the mechanisms driving this effect can become increasingly divergent and subjective as research continues.

Tendency is Towards Increasing Simplicity as Coherency is Resolved – medical diagnoses tend to reduce information sets as coherency is attained and focus on one answer.  Please note that this is not the same as reducing complexity.  The reduction of complexity is not necessarily a scientific goal – as many correct solutions are indeed also inherently complex.

Example:  As I begin to diagnose and treat a case of Guillain–Barré syndrome, despite the initial chaos which might be entailed in symptom and impact mitigation, or the identification of associated maladies – eventually the patient and doctor are left with a few reduced and very focused symptomatic challenges which must be addressed.  CNS impacts, nerve damage, allergies and any residual paralysis, eventually the set of factors reduces to a final few.  In contrast, understanding why the ecosystem of the upper Amazon is collapsing, despite the low incidence of human encroachment, is a daunting and increasingly complex challenge. Its resolution may require much out-of-the-box thinking on the part of researchers who constantly exhaust multiple explanatory pathways and cannot wait for each one-by-one, prescriptive solution or explanation or a null hypothesis to ‘work itself out’ over 25 years.

Selects from Solutions Inside a Closed Field of Prescriptive Options – Almost all medical diagnoses are simply concluded from a well or lesser, but known set of precedent solutions from which decisions can be made and determinations drawn.  This is not the case with broader scope or discovery science.

Example:  In the end, there are only a set of about 1500 primary diseases from which we (most of the time) can regularly choose to diagnose a set of symptoms, most with well established treatment protocols. Contrast this with the World Health Organization’s estimate that over 10,000 monogenic disorders potentially exist.¹ The research task entailed inside monogenic nucleotide disorders is skyrocketing and daunting.  This is discovery science. The diagnosis of the primary human 1500 diseases, is not. Different mindsets will be needed to approach these very different research methodologies.

An Answer Must be Produced or We Fail – 100% of diagnostic processes involve the outcome of a conclusion. In fake skepticism, of course the participants are rife with ‘answer which as the greatest likelihood of being true’ type baloney.  To the Diagnostic Habituated fake skeptic, an answer has to be produced – NOW. But in a discovery process, we do not necessarily have to have an answer or disposition on a subject.  Be very wary of those who seem to force answers and get angry when you do not adopt their conclusion immediately. Be wary of those who have an answer for all 768 entries in The Skeptic’s Dictionary (including those who wrote the material). They are not conducting a scientifically reliable or honest exercise, rather are simply propping up a charade which seeks to alleviate the mental dissonance stress from something larger which disturbs them greatly. See Corber’s Burden. As one claims to be an authority on all that is bunk, their credibility declines in hyperbolic inverse proportion to the number of subjects in which authority is claimed.

Example:  If one is experiencing pain, for the most part both the patient and the researcher will not stop until they have an answer.  A conclusive finish to the pain itself is the goal after all, and not some greater degree of human understanding necessarily.  Contrast this with grand mysteries of the cosmos. We do not yet have an answer to the Sloan Digital Sky Survey “Giant Blob” Quasar Cluster² observation and how it could easily exist under current understandings of classical cosmology or M-theory. We have to await more information. No one has even suggested forcing a ‘answer which has the greatest likelihood of being true.’ To do so would constitute pseudoscience.

It is from this constrained mindset which the Ethical Skeptic must extract himself/herself, in order to begin to grasp why so many subjects are not well understood, and why we must think anew in order to tackle the grander mysteries of our existence. The more we continue to pepper these subjects with prescripted habituated diagnoses, the more those who have conducted real field observation will object. We have well observed the falling back on the same old ‘conspiracy theorist’ pejorative categorization of everyone who disagrees with the diagnoses proffered by these linear thinkers. It is not that a diagnostic approach to science always produces an incorrect answer. But if we follow simply the error of diagnosis habituation, then let’s just declare that mind Ξ brain right now, and we can close up shop and all go home. And while I might not bet against the theory were it on the craps table in Vegas and I were forced to make a selection now, neither am I in an ethical context ready to reject its antithesis simply because some diagnostic linear thinkers told me to.

I am an Ethical Skeptic, I don’t reject your idea as false, but I await more information. As a discovery researcher I refuse to simply accept your diagnostically habitual ‘critical thinking;’ nor its identifying which answer the constrained set has shown ‘is most likely true.’

That is not how real skepticism and real science work.


¹  World Health Organization, “Genes and Human Disease,” Genomic Resource Center, Spring 2015; http://www.who.int/genomics/public/geneticdiseases/en/index2.html.

² The Biggest Thing in the Universe, National Geographic; January 11, 2013, National Geographic Society;  http://news.nationalgeographic.com/news/2013/01/130111-quasar-biggest-thing-universe-science-space-evolution/.

† Abductive, Inductive, and Deductive Reason definitions – are modified from their approximate definitions provided by Wikipedia, in its series on reasoning and logical inference.

https://en.wikipedia.org/wiki/Abductive_reasoning

https://en.wikipedia.org/wiki/Inductive_reasoning

https://en.wikipedia.org/wiki/Deductive_reasoning

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