Saturday, November 1, 2025

Visual 3 What is cognition, decision and clinical? GIM November 7

Evolution of clinical decision making 

pre and post AI







What is cognition?


What is dual processing theory of cognition?



What is decision?

Word picture:

Imagine you are "Cutting a vegetable with a knife" and imagine what is the next step in your cooking once cutting is over?

Cision is the process of cutting originated from Proto-Indo-European language as *skh1-ie, *skh1-io, and that is related to the Proto-Indo-European *kh₂eyd- (“to cut, hew”), whence also Latin caedō (“to cut, strike”) in Sanskrit aka खिद्

Looks like Europeans added an s to the beginning of khid in Sanskrit aka caed in Latin and then subsequently removed the d when they used cutting as a metaphor for science!

The word science is derived from Proto-Indo-European language as *skh1-ie, *skh1-io, meaning "to incise". https://en.m.wikipedia.org/wiki/Science

So imagine some of the cutting instruments you know of and check out their names: 

Nouns: scissors, sickle, 

Verbs: incise, size up, cut to size 



Needless to say, not everything ending with cise means cutting such as the words "exercise" and "exorcise" apparently have no connection to cutting: https://www.etymonline.com/word/exorcise


Image with CC licence: https://commons.m.wikimedia.org/wiki/File:Sickle_and_throwing_knife_at_Manchester_Museum.jpg#mw-jump-to-license

And the image of the sickle and science is contained in an important writing tool for science! The question mark is a very important instrument of scientific scepticism:





Creative commons license: https://en.m.wikipedia.org/wiki/Question_mark#/media/File%3AQuestion_opening-closing.svg


To reach a de cision is to stop cutting and stop questioning further! As in de addiction or de escalation, which means to stop addiction or stop escalation!

In other words going with the cutting edge pictorial cooking analogy above, one simply moves to the next phase of cooking once the cutting of it's ingredients is over.

Decision etymology:

https://www.reddit.com/r/etymology/comments/2eujw6/where_did_the_root_cision_come_from_decision/

Clinical etymology:

"Clinical" comes from the Sanskrit Klinna (क्लिन्न) refers to “dripping (clothes) and in general suggests moisture as a result of which it's also used to denote putrefaction due to microorganism action.



https://www.wisdomlib.org/definition/klinna


Greeks took the word to clean their beds and for them it means "kline or  "bed, couch, that on which one lies! 


Europeans took the word to their clinics which were essentially glorified bedsides!


It's a mystery (other than the connotations of slipperiness) as to how klinna also came to mean 'lean' and became used as a suffix for words such as: incline, decline, recline and if you are to believe this link 👇


https://www.etymonline.com/word/clinical, 


Then even the ones below:


acclivity; anticline; clemency; client; climate; climax; cline; clinic; clinical; clino-; clitellum; clitoris; decline; declivity; enclitic; heteroclite; incline; ladder; lean (v.); lid; low (n.2) "small hill, eminence;" matroclinous; patroclinous; polyclinic; proclitic; proclivity; recline; synclinal; thermocline.


Also here:


https://ahdictionary.com/word/indoeurop.html


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Visual 4 What is Intelligence GIM November 7

What is intelligence?





Animal intelligence vs plant cognition?


Speakers thoughts 
and Rhetoric:

Rhetoric:

There is nothing called artificial or real intelligence.

What exists is just "intelligence" that is embedded in all manifest beings in this Earth right from apparently inanimate plants to animate humans including embedded artificial systems that humans appear to be currently developing because of their own intelligence deficiency.

This human intelligence deficiency (requirement) is primarily memory because of which humans have been cursed with their penchant for dimensionality reduction resulting in asynchronous intelligence aka primordial AI. 

This is the reason modern humans have become more and more academic as academics is largely all about communicating and learning through a two dimensional interface, be it early cave paintings or current day xy axis mobile screens!

More thoughts here:


What is artificial intelligence?

The word artificial is from stem of ars "art" (see art (n.)) + -fex "maker," from facere "to do, make" 

from PIE *ar(ə)-ti- (source also of Sanskrit rtih "manner, mode



Facere and facient etymology:

facere "to make" (from PIE root *dhe- "to set, put").

Entries linking to -facient

*dhē-, Proto-Indo-European root meaning "to set, put."

Dheya Sanskrit: to be held 

https://www.wisdomlib.org/definition/dheya

It might also be the source of: Sanskrit dadhati "puts, places;" Avestan dadaiti "he puts;" Old Persian ada "he made;" Hittite dai- "to place;" Greek tithenai "to put, set, place;" Latin facere "to make, do; perform; bring about;" Lithuanian dėti "to put;"




What is natural intelligence?

An embedded intelligence that exists in all of nature's responsive flora and fauna.

What is the difference between artificial and human intelligence?

Artificial intelligence is human intelligence. What commonly passes off as AI is machine intelligence. 

What is it to be human?

To be human is to be vulnerable. 

What is it to be human centered?

It means one is empathic enough toward other individual humans to be able to solve their problems effectively.

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Visual 5 Then and now! What was clinical decision making like in the pre AI LLM era just few years back and now?

What was clinical decision making like in the pre AI LLM era just few years back?


Video demo of our patient centered, clinical decision making lab: 

Recent re-upload:

https://youtu.be/ZKoljY2UBHI?si=UYUfpTD7JGOgoQhA

Original upload:

https://youtu.be/xvE5b8Xk3vM?si=dqDlPQgA_EP2L7zT


Video demo of a single patient's decision making: 


https://youtu.be/csF8VQbOYRo?si=mlbHXIyD5A-29uqf


What is it like now?


Hands on demonstration of human clinical decision making with AI in the loop:




Explaining the user interface for clinical decision making with AI in the loop:

Image above: Current AI driven clinical decision making workflow as well as user interface and medical cognition engine.

Rhetoric : The above interface has essentially evolved from a felt need toward dimensionality reduction leading to what is aka academic flatlands that hides multiple hidden layers, which can pose issues with explainability at a machine level. 


Image CC licence: https://commons.m.wikimedia.org/wiki/File:Rock_Shelter_8,_Bhimbetka_02.jpg#mw-jump-to-license

Rhetoric: Human animals invented AI beginning with asynchronous intelligence through their ability to use cave painting tech to convert multidimensional real life data into two dimensional data in an xy axis cave wall that later evolved to paper and electronic media so that they could eventually manage their lives better as artistic modelling was easier in a two dimensional virtual plane than a multi dimensional real plane!

Let's look at where we have come all the way from primordial AI (aka asynchronous intelligence) to modern AI that models primordial AI to produce some currently interesting results particularly if the data capture is asynchronously hyperlocal.

Unquote: https://userdrivenhealthcare.blogspot.com/2025/08/udlco-crh-reducing-multidimensional.html?m=1


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Visual 6:layered approach to clinical decision making, GIM, November 7

A layered approach to clinical decision making: 


Explainability, trust and layers of clinical decision making in pre and current AI LLM era:

Machine layer and AI dominance with humans in the loop:

How useful is AI in the loop of humans and how crucial are humans if placed in the loop of AI?


Analytical scientific and EBM layer: This layer is where our clinical decision making lab appears to be largely engaged in although the other two layers are no less important.

We have already shared something around this layer in our previous demos particularly our two video links shared above.

Human layer: This is the most important layer where clinical decision making actually happens at multiple human stakeholder levels:


We are all apprentices in a craft where no one ever becomes a master.
Ernest Hemingway, The Wild Years

Human, Scientific and Machine layers :



Anatomy of cognitive layers:









Physiology of cognitive layers in clinical decision making: enter Bloom's taxonomy!


RUAAEC
ApRUAECAp

More here on the bloom game of learning cognition: https://sites.pitt.edu/~super1/lecture/lec54091/001.htm
Bloom's taxonomy image copyright as well as an enlightening write up: https://www.niallmcnulty.com/2019/12/introduction-to-blooms-

Enter decision trees and the machine layers:


Shukratic Conversational dialogue:

[01/11, 19:51]hu1: @⁨hu2 made this decision tree for cough as presenting symptom. While making this chart, I realised how the decision points, point back to other organ system generalised symptoms to go through a similar decision tree to confirm or rule out a differential.

[01/11, 19:53]hu1: @⁨hu2 @⁨hu3 @⁨hu4
If this is something workable, Im planning to make similar decision tree for all other generalised symptoms.


[02/11, 07:17]hu2: Looks very interesting! Well done 👏👏

The only problem with this "yes no," binary,  reductionist , decision making approach is that the patient will end up trying to answer a lot of questions with 50% probability of accuracy and could be very taxing for the patient!

Our approach to decision making is on the other hand synthetic where instead of asking incisive questions (Bloom's level 4) that could be limited by the limitations of current knowledge (aka limited static ontology), we collect all possible event data and try to synthesize a broader picture (Bloom's level 6) after making the necessary reductionist edits using the Bloom's 4 knife!

Apologies if the above appeared inscrutable because currently I'm looking at whatever data flows into me, in the context of my upcoming November 7 presentation that I shall try to share with you ASAP once ready when it could make more sense!

[02/11, 07:18]hu2: A Herculean task, either way, although perhaps could be made more efficient using ML tools but then ML is limited to what currently humans know and that may not be enough, which you may realise if you start sitting in a real OPD and start seeing real patients!

Hu1 is a medical student who is working as our PaJR clinical decision making volunteer and also working as a research assistant in our collaborative project on building a potential "clinical decision making automated user interface" with IIT Hyderabad. He is possibly one of the rare medical students to have presented a clinical decision making scenario in a medical CPD conference within a month of having just entered medical college! More about him here along with our other team members past and present: https://medicinedepartment.blogspot.com/2021/03/medicine-department-training-programs.html?m=1
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