CSI Effect Sends Wrong Signal to Patients
In recent years the legal community has described a phenomenon called the CSI Effect.Based on the popularity of television programs like CSI, jurors as well as the public at large have come to expect that every criminal case can be solved definitively in a short time with clear proof of innocence or guilt. Very often the findings are immediate, dramatic and incontrovertible. Prosecutors have cited the CSI Effect as a major factor in the unexpected outcomes of recent high profile cases. Some have gone so far as to seek to eliminate or "strike" jurors who admit to being avid watchers of shows like CSI.
Not surprisingly, the CSI Effect has bled over into expectations regarding medicine (and medical laboratory science) as well. Patients have come to expect fast, clear-cut, black and white answers; often generated by sophisticated instruments. Not only does this belief set up unrealistic expectations about diagnosis and treatment, it belittles the judgment of professionals who do more than push buttons to generate diagnostic information.
Where does the critical thinking of the clinical laboratorian come in? Rarely in a two hour drama is a laboratorian seen performing instrument maintenance, calibration or even quality control. Sure, story lines abound about specimens that are lost by "lab techs" but never is there any mention of the criteria used to determine acceptable specimens, or the validation of results using delta checks, understanding clinical information or correlation of different results from the same patient.
Patients increasingly want to know what a specific single result means (forget all the nuances, natural variaions, and other clinical information that the laboratory might not have). They wonder why different labs produce different results, or one lab produces results that do not match the patient's expectations or logic. Shouldn't sophisticated instruments always produce predictable easily interpreted results? Doesn't variation mean one lab is better than another ; one is right and the other is wrong?
Shows like House and CSI have really generated a renewed interest in science and medicine but in many ways they have done a disservice to our profession.
With new proposed regulations for laboratories to provide patients with their own results, expectations for simple unambiguous answers will only increase. It will be up to laboratorians to understand and be ready to counter the CSI effect.