--- _id: '55429' abstract: - lang: eng text: A detailed understanding of the cognitive process underlying diagnostic reasoning in medical experts is currently lacking. While high-level theories like hypothetico-deductive reasoning were proposed long ago, the inner workings of the step-by-step dynamics within the mind remain unknown. We present a fully automated approach to elicit, monitor, and record diagnostic reasoning processes at a fine-grained level. A web-based user interface enables physicians to carry out a full diagnosis process on a simulated patient, given as a pre-defined clinical vignette. By collecting the physician’s information queries and hypothesis revisions, highly detailed diagnostic reasoning trajectories are captured leading to a diagnosis and its justification. Four expert epileptologists with a mean experience of 19 years were recruited to evaluate the system and share their impressions in semi-structured interviews. We find that the recorded trajectories validate proposed theories on broader diagnostic reasoning, while also providing valuable additional details extending previous findings. author: - first_name: Dominik full_name: Battefeld, Dominik id: '91864' last_name: Battefeld orcid: 0000-0002-5480-0594 - first_name: Sigrid full_name: Mues, Sigrid last_name: Mues - first_name: Tim full_name: Wehner, Tim last_name: Wehner - first_name: Patrick full_name: House, Patrick last_name: House - first_name: Christoph full_name: Kellinghaus, Christoph last_name: Kellinghaus - first_name: Jörg full_name: Wellmer, Jörg last_name: Wellmer - first_name: Stefan full_name: Kopp, Stefan last_name: Kopp citation: ama: 'Battefeld D, Mues S, Wehner T, et al. Revealing the Dynamics of Medical Diagnostic Reasoning as Step-by-Step Cognitive Process Trajectories. In: Proceedings of the 46th Annual Conference of the Cognitive Science Society. ; 2024.' apa: Battefeld, D., Mues, S., Wehner, T., House, P., Kellinghaus, C., Wellmer, J., & Kopp, S. (2024). Revealing the Dynamics of Medical Diagnostic Reasoning as Step-by-Step Cognitive Process Trajectories. Proceedings of the 46th Annual Conference of the Cognitive Science Society. The Annual Meeting of the Cognitive Science Society, Rotterdam, NL. bibtex: '@inproceedings{Battefeld_Mues_Wehner_House_Kellinghaus_Wellmer_Kopp_2024, title={Revealing the Dynamics of Medical Diagnostic Reasoning as Step-by-Step Cognitive Process Trajectories}, booktitle={Proceedings of the 46th Annual Conference of the Cognitive Science Society}, author={Battefeld, Dominik and Mues, Sigrid and Wehner, Tim and House, Patrick and Kellinghaus, Christoph and Wellmer, Jörg and Kopp, Stefan}, year={2024} }' chicago: Battefeld, Dominik, Sigrid Mues, Tim Wehner, Patrick House, Christoph Kellinghaus, Jörg Wellmer, and Stefan Kopp. “Revealing the Dynamics of Medical Diagnostic Reasoning as Step-by-Step Cognitive Process Trajectories.” In Proceedings of the 46th Annual Conference of the Cognitive Science Society, 2024. ieee: D. Battefeld et al., “Revealing the Dynamics of Medical Diagnostic Reasoning as Step-by-Step Cognitive Process Trajectories,” presented at the The Annual Meeting of the Cognitive Science Society, Rotterdam, NL, 2024. mla: Battefeld, Dominik, et al. “Revealing the Dynamics of Medical Diagnostic Reasoning as Step-by-Step Cognitive Process Trajectories.” Proceedings of the 46th Annual Conference of the Cognitive Science Society, 2024. short: 'D. Battefeld, S. Mues, T. Wehner, P. House, C. Kellinghaus, J. Wellmer, S. Kopp, in: Proceedings of the 46th Annual Conference of the Cognitive Science Society, 2024.' conference: end_date: 2024-07-27 location: Rotterdam, NL name: The Annual Meeting of the Cognitive Science Society start_date: 2024-07-24 date_created: 2024-07-30T08:17:35Z date_updated: 2025-09-23T15:11:19Z ddc: - '000' department: - _id: '660' file: - access_level: closed content_type: application/pdf creator: doba2 date_created: 2024-07-30T08:21:13Z date_updated: 2024-07-30T08:21:13Z file_id: '55430' file_name: Battefeld_2024_Revealing-the-dynamics.pdf file_size: 486513 relation: main_file success: 1 file_date_updated: 2024-07-30T08:21:13Z has_accepted_license: '1' keyword: - Differential Diagnosis - Diagnostic Reasoning - Reasoning Process Analysis - Seizure - Epilepsy language: - iso: eng project: - _id: '128' name: 'TRR 318 - C5: TRR 318 - Subproject C5' publication: Proceedings of the 46th Annual Conference of the Cognitive Science Society publication_status: published quality_controlled: '1' status: public title: Revealing the Dynamics of Medical Diagnostic Reasoning as Step-by-Step Cognitive Process Trajectories type: conference user_id: '91864' year: '2024' ... --- _id: '51343' abstract: - lang: eng text: This paper presents preliminary work on the formalization of three prominent cognitive biases in the diagnostic reasoning process over epileptic seizures, psychogenic seizures and syncopes. Diagnostic reasoning is understood as iterative exploration of medical evidence. This exploration is represented as a partially observable Markov decision process where the state (i.e., the correct diagnosis) is uncertain. Observation likelihoods and belief updates are computed using a Bayesian network which defines the interrelation between medical risk factors, diagnoses and potential findings. The decision problem is solved via partially observable upper confidence bounds for trees in Monte-Carlo planning. We compute a biased diagnostic exploration policy by altering the generated state transition, observation and reward during look ahead simulations. The resulting diagnostic policies reproduce reasoning errors which have only been described informally in the medical literature. We plan to use this formal representation in the future to inversely detect and classify biased reasoning in actual diagnostic trajectories obtained from physicians. author: - first_name: Dominik full_name: Battefeld, Dominik id: '91864' last_name: Battefeld orcid: 0000-0002-5480-0594 - first_name: Stefan full_name: Kopp, Stefan last_name: Kopp citation: ama: 'Battefeld D, Kopp S. Formalizing cognitive biases in medical diagnostic reasoning. In: Proceedings of the 8th Workshop on Formal and Cognitive Reasoning. ; 2022.' apa: Battefeld, D., & Kopp, S. (2022). Formalizing cognitive biases in medical diagnostic reasoning. Proceedings of the 8th Workshop on Formal and Cognitive Reasoning. 8th Workshop on Formal and Cognitive Reasoning (FCR), Trier. bibtex: '@inproceedings{Battefeld_Kopp_2022, title={Formalizing cognitive biases in medical diagnostic reasoning}, booktitle={Proceedings of the 8th Workshop on Formal and Cognitive Reasoning}, author={Battefeld, Dominik and Kopp, Stefan}, year={2022} }' chicago: Battefeld, Dominik, and Stefan Kopp. “Formalizing Cognitive Biases in Medical Diagnostic Reasoning.” In Proceedings of the 8th Workshop on Formal and Cognitive Reasoning, 2022. ieee: D. Battefeld and S. Kopp, “Formalizing cognitive biases in medical diagnostic reasoning,” presented at the 8th Workshop on Formal and Cognitive Reasoning (FCR), Trier, 2022. mla: Battefeld, Dominik, and Stefan Kopp. “Formalizing Cognitive Biases in Medical Diagnostic Reasoning.” Proceedings of the 8th Workshop on Formal and Cognitive Reasoning, 2022. short: 'D. Battefeld, S. Kopp, in: Proceedings of the 8th Workshop on Formal and Cognitive Reasoning, 2022.' conference: end_date: 2022-09-23 location: Trier name: 8th Workshop on Formal and Cognitive Reasoning (FCR) start_date: '2022-09-19 ' date_created: 2024-02-14T09:06:04Z date_updated: 2024-10-31T10:00:01Z ddc: - '000' department: - _id: '660' file: - access_level: closed content_type: application/pdf creator: doba2 date_created: 2024-10-31T09:59:46Z date_updated: 2024-10-31T09:59:46Z file_id: '56846' file_name: paper8.pdf file_size: 261528 relation: main_file success: 1 file_date_updated: 2024-10-31T09:59:46Z has_accepted_license: '1' keyword: - Diagnostic reasoning - Cognitive bias - Cognitive model - POMDP - Bayesian network - Epilepsy - CDSS language: - iso: eng project: - _id: '128' name: 'TRR 318 - C5: TRR 318 - Subproject C5' publication: Proceedings of the 8th Workshop on Formal and Cognitive Reasoning quality_controlled: '1' status: public title: Formalizing cognitive biases in medical diagnostic reasoning type: conference user_id: '91864' year: '2022' ...