Siddhartha Mukherjee on Strong Intuition vs Weak Tests


December 23, 2015

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Editor's Note: In this One-on-One interview, Medscape Editor-in-Chief Eric J. Topol, MD, talks to Siddhartha Mukherjee, MD, author of The Emperor of All Maladies (Scribner, 2010), about his new book, The Laws of Medicine: Field Notes From an Uncertain Science (Simon & Schuster/TED Books, 2015).

Dr Topol: What was the stimulus for you to do The Laws of Medicine?

Dr Mukherjee: I wanted to ask the question: "How do we imagine what principles hold true for the future?" The framework that I used (and that is important here) was that, colloquially, we hear about the "science of medicine." If there is a science of medicine, then science has laws. Physics has laws. Chemistry has laws. Biology has laws. If that's the case, then what are the laws of medicine? These were not meant to be universal commandments. These were meant to be explorations about principles that might hold true about medicine today and about medicine in the future. That was the framework for this book.

Dr Topol: The first law is about priors. "A strong intuition is much more powerful than a weak test." Tell us about that.

Dr Mukherjee: Tests have false negatives. They have false positives. That's why the medical data sheet begins with history, not tests. It begins with history and physical, not test and physical or conclusion and then physical. That's the first law.

Watch the full interview with Dr Mukherjee here.


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