MedEvidence! Truth Behind the Data

đź•—Exploring the Monty Hall Paradox in Medical Decision Making Ep 136

• Dr. Michael Koren, Kevin Geddings • Episode 136

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What if you could tap into the fascinating world of probability and statistics to make better informed health decisions? This week's MedEvidence Monday Minute, we unravel the intriguing Monty Hall paradox and its surprising implications on medical decision-making. Just as Monty Hall guided contestants towards the best odds without predetermining outcomes, our physicians too lead us towards the most favorable probabilities. Armed with data and statistics, they advise us on the best options without predicting exact results. It's a look into the mind-boggling world of probabilities and how it shapes our everyday health choices. So, gear up for a thrilling ride through the labyrinth of medical research, no lab coat required!

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Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.com

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Music: Storyblocks - Corporate Inspired

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Speaker 1:

Welcome to the MedEvidence Monday Minute Radio Show hosted by Kevin Gettings of WSOS St Augustine Radio and powered by Encore Research Group. Each Monday morning, dr Michael Coran calls in to bring you the latest medical updates with insightful discussions. Medevidence is where we help you navigate the real truth behind medical research, with both a clinical and research perspective. So sit back, relax and get ready to learn about the truth behind the data in medicine and health care. This is MedEvidence.

Speaker 2:

Blue Oyster Colts here on 103.9 WSOS Probably shouldn't have played their other song, right, don't fear the reaper? That would have been more appropriate, dr Coran.

Speaker 3:

Yeah, I think that's my patience, yeah.

Speaker 2:

I would think, before you meet with a patient, that you should be playing in the exam room. Don't fear the reaper. And Dr Michael Coran is with us. He's a big part of our family here at WSOS and of course, he is a medical doctor, cardiologist, research scientist and when we spend time with him we often talk about clinical trials that are going on right here in St John's County in St Augustine. Encore Docs has an office right next door to Flagler Hospital, off of 312. And you can reach them at oncoredocscom to learn about medical trials you can participate in. You can be in the leading edge of medical research and it's really cool stuff, and those of us here at WSOS have participated in this as well Highly recommend it. You can also call I'll give you this number again in just a moment but 904-730-0166. The fun about our audience, dr Coran, is they probably know who Monty Hall is right.

Speaker 3:

Yeah, it's funny. I was just talking about the Monty Hall paradox, which is an interesting puzzle in logic and decision-making. And for those of the listeners that don't know who Monty Hall is, he was the host for many years of a game show called let's Make a Deal, and so some older people remember the actual Monty Hall. I think let's Make a Deal had other hosts over the years, but Monty Hall was the original host.

Speaker 2:

That's right. That's right and a great show. And one of the common things that happened in that show in case you have forgotten or you're of a certain age and you never saw the show was that it always featured three doors and there was something good behind one door and something not so good behind the other two, correct?

Speaker 3:

Yeah, so typically there would be a brand new car behind one of the doors and the other two would have what they called Zonks, which was typically a donkey with some hay.

Speaker 2:

Right, yeah, it wasn't exactly PETA approved, but anyway we enjoyed it back in the day, yeah.

Speaker 1:

So how does?

Speaker 2:

that impact decision-making. It gives us a window into decision-making.

Speaker 3:

So the paradox is this and we can all ask our friends what they would do, Because I've asked a lot of people about this over the years and gotten some interesting answers but in the Monty Hall paradox, Monty Hall asked you to choose a door which has the car and it's a one out of three chance of getting it right, of course.

Speaker 3:

And then, after you say what door you picked, Monty Hall shows you another door, which is always a Zonk. And then he asked you you want to stay with your initial guess or would you like to change your guess? And when you ask that question, most people say well, I'll stick with my initial guess because I trust my instincts. But actually you improve your odds by changing your guess. So statistics show that if you stick with your initial guess, you have a one out of three chance, but if you change your guess, you actually have a two out of three chance of getting the car. And that's confusing to people, but that's actually what the statistics show and I can explain a little bit more. But this gets into the concept of how you take input and make decisions.

Speaker 2:

Explain that a little bit more.

Speaker 3:

Sure. So when you think about this from your standpoint, okay, well, you made a choice, monty Hall shows you a door and now you think your chances are one out of two. But in fact, monty Hall did not show you a door at random. Let's think about what Monty Hall was doing. Monty Hall's job was to show you a door that has a zonk. So if you got it right with your first guess, well then Monty Hall has a choice of two different doors to show you, to show you the zonk. But remember, you have a two out of three chance of getting it wrong initially, and every time you get it wrong initially, monty Hall is going to show you the other door that's wrong. Again, think about that Two out of three chance that you get it wrong. And every time you get it wrong, every time you guess wrong, he shows you the other door. So, by logic, then the door that has not been shown and that you did not pick will be the right answer, two out of three times.

Speaker 2:

That's pretty interesting. If only we had known that back in the day.

Speaker 3:

We could all have brand new AMC Pacers. Well, again, you wouldn't have to have it, and this is why it gets me choosing to people Is that you just improve your odds.

Speaker 2:

All right.

Speaker 3:

So it is true that one out of three times you got it right initially and by switching you'll get it wrong. Right, but two out of three times you'll get it right by switching.

Speaker 2:

So how does that concept play in your world of clinical research?

Speaker 3:

Well, as a physician, we know stuff, we know data and we know the odds, but we can't predict the exact outcome for every patient.

Speaker 3:

So part of our job is to sort of be like Monty Hall and guide people to the place where they have the best odds, without ever saying, well, it's definitely going to happen, or this drug will fix you, or this surgery will make your life better, because we don't know that for sure. We just know the odds of what's going to happen. So doctors can be a little bit cagey in terms of advice. Doctors, at least nowadays, don't say a patient oh, you should definitely do this, don't even think about anything else. What we tend to do is we say well, you have three choices. You can either have a very conservative approach and just take some medication, you can have surgery, or you can do nothing, and so it happens. And so that would be the three doors, and which door you choose depends, of course, on the patient. But the truth is the doctor doesn't know with 100% certainty which is going to be best. The doctor can only give you a little bit of advice and help you make that decision.

Speaker 2:

Well, at least in that scenario, right, the doctor is not giving you any doors that have a goat behind them. Hopefully not, I mean they're all. Ok options. It's not like one of the options is just horrible.

Speaker 3:

Yeah, I guess you should make sure your doctor doesn't like goats.

Speaker 2:

Yeah, that's right. That's a wacky sense of humor.

Speaker 3:

Yeah, exactly so. It's a good metaphor for how we make decisions. And of course, in clinical research we're doing studies where you don't always know what you're on and that sometimes is a little bit concerning for people or makes them make some question whether or not it's a good process. But we happen to know that the process is fabulous, that regardless of what assignment you get in the study, you will probably do better. Again, probably not 100% sure, and because of that we like to help people understand that clinical research is a good choice. There's almost never a downside and there could be an upside.

Speaker 2:

Absolutely. Hey, before we let you go, you've got an event coming up pretty close by over on the west side of Jacksonville, right.

Speaker 3:

We do. We have different offices around northeast Florida and our office on Lane Avenue is having a motels and medicine event. Well, we talked about our latest research in the lipid world and cholesterol problems, particularly LP-Lilay that really really, really bad cholesterol that you've not talked about before and, more broadly, the different things that we're doing in clinical research help people prevent heart attacks and strokes.

Speaker 2:

These events are always great. Just had one last night and Dr Michael Corrin and his team. They really put out some great information. Speaking of that information, you can find it, too, at a different website. I want you to check out medevidencecom. That's medevidencecom. What are they going to find there, dr Corrin?

Speaker 3:

They're going to find the truth behind the data. Obviously, medical information can be very confusing. It's sometimes difficult to sort through, and we help you do exactly that. You have to go through the data and make the decisions so that hopefully, you pick the door that has the car Exactly.

Speaker 2:

Dr Michael Corrin, thanks for your time this morning. We appreciate you Okay.

Speaker 3:

My pleasure, my pleasure, take care.

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Dr. Michael Koren

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