If You Can't Beat It, Join It: Uncertainty and Trust in Medicine
Authors: Katrina Armstrong
Journal: Annals of Internal Medicine (2018)

Ideas and Opinions5 June 2018If You Can't Beat It, Join It: Uncertainty and Trust in MedicineKatrina Armstrong, MD, MSCEKatrina Armstrong, MD, MSCEMassachusetts General Hospital, Boston, Massachusetts (K.A.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-0445 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The quest to eliminate uncertainty in clinical decision making has become central to biomedical research over the past 50 years, driving the emergence of evidence-based medicine, precision medicine, and most recently, biomedical artificial intelligence. This quest is unsurprising given that uncertainty discomforts most humans, who have cognitive and emotional drives to eliminate it from their decisions. When physicians are uncertain about how a condition will progress or respond to treatment, they can feel like they let patients down and fail to have the predictive ability they desire. Paradoxically, however, the very uncertainty that creates this discomfort can have an important ...References1. Hardin R. Conceptions and explanations of trust. In: Cook K, eds. Trust in Society. Vol. 2. New York: Russell Sage Foundation; 2001:3-40. Google Scholar2. Bianco W. Uncertainty, appraisal, and common interest: the roots of constituent trust. In: Braithwaite V, Levi M, eds. Trust and Governance. Vol. 1. New York: Russell Sage Foundation; 1998:245-67. Google Scholar3. Kollock P. The emergence of exchange structures: an experimental study of uncertainty, commitment, and trust. Am J Sociol. 1994;100:313-45. CrossrefGoogle Scholar4. Molm LD, Takahashi N, Peterson G. Risk and trust in social exchange: an experimental test of a classical proposition. Am J Sociol. 2000;105:1396-427. 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[PMID: 17972141] CrossrefMedlineGoogle Scholar10. Nelson W, Reyna VF, Fagerlin A, Lipkus I, Peters E. Clinical implications of numeracy: theory and practice. Ann Behav Med. 2008;35:261-74. [PMID: 18677452] doi:10.1007/s12160-008-9037-8 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Massachusetts General Hospital, Boston, Massachusetts (K.A.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0445.Corresponding Author: Katrina Armstrong, MD, MSCE, Department of Medicine, Massachusetts General Hospital, Grey/Bigelow 7th Floor, 55 Fruit Street, Boston, MA 02114; e-mail, [email protected]harvard.edu.Author Contributions: Conception and design: K. Armstrong.Drafting of the article: K. Armstrong.Critical revision of the article for important intellectual content: K. Armstrong.Final approval of the article: K. Armstrong.Administrative, technical, or logistic support: K. Armstrong.This article was published at Annals.org on 17 April 2018. 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