Uncertainty is inherent in actions, which are always consequences of decisions. Whether it’s deciding which restaurant to go to for dinner or the decision about further therapy after a wrist CT. There is always a certain level of risk involved in deciding. I worked as a surgeon for 42 years, 33 of them in hand surgery. I had to decide every day.
During my career, the art of decision-making underwent a transformation. At the beginning decisions based on „experience“ and heuristics. Then scores developed. We got more devices: CT, MRI, Ultrasound, Arthroscopy. Scientific papers were more and more evidence based, not eminence based. Now we are entering the age of Machine Learning, Artificial Intelligence and Generative AI. It will become more complex to decide and act upon the decisions.
My life also involves mathematics, statistics, and artificial intelligence — to the extent a driven surgeon can grasp them. In addition to my teachers, books, and papers, I always tried to look behind the scenes of decisions. I am influenced by „fuzzy logic“ and Gerd Gigerenzers risk management and heuristics, the books of Dubben and Beck-Bornholdt et al. In the 90th, my interest focused on chaos theory and the interpretation of signals (ECG). Then, at starting my PhD-thesis 1997, I discovered self-organizing maps (SOM) and the field of artificial intelligence. 2017 I…
