On 2016 Jun 02, David C. Norris commented:

Kudos to Ms. S., the patient in Dr Rosenbaum’s opening vignette, for having the good sense to dismiss the clinical equivalent of a cheesy pick-up line, "What do you think is the number-one killer of women?" Far from demonstrating that Ms. S's "sense of risk was clearly less about fact than about feeling," her rejection of this population statistic as a decision input may well reflect precisely the opposite. Indeed, the more rational Ms. S's approach to her health care decision-making, the more irrelevant Dr Rosenbaum's population statistics would have seemed to her. In a consultation with a subspecialist, Ms. S. might rightly have hoped the 'denominator' would be 1. She might have hoped for a personalized assessment, conveyed to her in meaningful forms capable of supporting her rational deliberation about her choices, and her rational commitment to those choices.

'Fact resistance' should be regarded as a diagnosis of exclusion. Leaping to this diagnosis undermines effort to fortify the scientific grounds of communication with patients, much as leaping to diagnose malingering or somatizing devitalizes diagnostic effort.

On 2016 Jun 02, David C. Norris commented:

Kudos to Ms. S., the patient in Dr Rosenbaum’s opening vignette, for having the good sense to dismiss the clinical equivalent of a cheesy pick-up line, "What do you think is the number-one killer of women?" Far from demonstrating that Ms. S's "sense of risk was clearly less about fact than about feeling," her rejection of this population statistic as a decision input may well reflect precisely the opposite. Indeed, the more rational Ms. S's approach to her health care decision-making, the more irrelevant Dr Rosenbaum's population statistics would have seemed to her. In a consultation with a subspecialist, Ms. S. might rightly have hoped the 'denominator' would be 1. She might have hoped for a personalized assessment, conveyed to her in meaningful forms capable of supporting her rational deliberation about her choices, and her rational commitment to those choices.

'Fact resistance' should be regarded as a diagnosis of exclusion. Leaping to this diagnosis undermines effort to fortify the scientific grounds of communication with patients, much as leaping to diagnose malingering or somatizing devitalizes diagnostic effort.