Ongoing project: Patient centred user driven learning community ontology development through conversational learning transcripts--Ontology development (level 6 in blooms taxonomy) over existing ones in the area of subclinical hypothyroidism, leucorrhea, overdiagnosis, overtreatment, pure impure placebos and study design to adjudge pure placebo efficacies over impure expensive placebos (real but non evidence based medicines)
Summary : A woman comes with leucorrhea and wants a thyroid test as her friend adviced her to get it done as treating her presumably subclinical hypothyroidism made her leucorrhea disappear! Ontology development (level 6 in blooms taxonomy) over existing ones in the area of subclinical hypothyroidism, leucorrhea, overdiagnosis, overtreatment, pure impure placebos and study design to adjudge pure placebo efficacies over impure expensive placebos (real but non evidence based medicines)! Medical cognition also needs to focus on patient cognition other than health professional cognition.
Conversational transcripts :
[9/23, 9:07 PM] Rakesh Biswas: Please share your questions around this patient to trigger the discussion that may help everyone to learn how to provide better care to this patient
[9/23, 9:29 PM] Medicine 2021 UG : good evng sir
sir, do there is any relation between hyperthyroidism with happening of white discharge
[9/23, 10:36 PM] Rakesh Biswas: Can you share the first and last thyroid function test values of the patient?
[9/24, 6:50 AM] Medicine 2021 UG : sir actually the patient told that she came for thyroid test because there is similar history for her neighbour and she told she did thyroid test and there are variations in it and used tablets for thyroid and white discharge stopped so she came for thyroid test on basis of that
[9/24, 7:41 AM] Rakesh Biswas: Good potential bloom level 6 insights 👏
Looks like she may have had a placebo response to low dose thyroxine tablets some one may have given her unnecessarily and the patient herself wanted to pursue this placebo effect (unknowingly off course) in the hope that it may eventually cure her leucorrhea!
I guess any causal relationship between thyroxine deficiency and leucorrhea is perhaps currently not well known and one may always pursue a search engine to see if anyone has tried to look earlier in this direction!
However what were the variations in her thyroid test and what was the dose of thyroxine she used earlier? Please call her up and clarify this with the images of the earlier reports and earlier doses adviced.
[9/24, 7:53 AM] 2021 Medical UG: sir actually the patient came for the first time for thyroid test on advice of her neighbour because her neighbour used thyroid tablets due to variations in her thyroid levels and cured leucorrhea after taking those tablets
[9/24, 7:54 AM] 2021 Medical UG: patient is thinking that variation in thyroid levels also may cause leucorrhea
[9/24, 7:55 AM] Rakesh Biswas: We need to also trace the neighbor by phone and find out the vital information around what were her thyroid function tests trends since she began taking thyroxine tablets and what were her thyroxine doses
[9/24, 7:56 AM] 2021 Medical UG: ok sir
[9/24, 7:57 AM] Rakesh Biswas: This could be a breakthrough lead in our focus area of medical cognition where we largely focus on health professional cognition but also need to focus on patient cognition! 👏
[9/24, 8:00 AM] Rakesh Biswas: There's this interesting study I just saw that actually experimented with using real cheaper placebos.
Most of our current many patient's healthcare options consists of using non evidence based expensive placebos given by their non evidence based bloom level 1-2 practitioners. That could change with more studies such as these👇
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