Information search and information distortion in the diagnosis of an ambiguous presentation
Journal Title: Judgment and Decision Making - Year 2009, Vol 4, Issue 5
Abstract
Physicians often encounter diagnostic problems with ambiguous and conflicting features. What are they likely to do in such situations? We presented a diagnostic scenario to 84 family physicians and traced their information gathering, diagnoses and management. The scenario contained an ambiguous feature, while the other features supported either a cardiac or a musculoskeletal diagnosis. Due to the risk of death, the cardiac diagnosis should be considered and managed appropriately. Forty-seven participants (56%) gave only a musculoskeletal diagnosis and 45 of them managed the patient inappropriately (sent him home with painkillers). They elicited less information and spent less time on the scenario than those who diagnosed a cardiac cause. No feedback was provided to participants. Stimulated recall with 52 of the physicians revealed differences in the way that the same information was interpreted as a function of the final diagnosis. The musculoskeletal group denigrated important cues, making them coherent with their representation of a pulled muscle, whilst the cardiac group saw them as evidence for a cardiac problem. Most physicians indicated that they were fairly or very certain about their diagnosis. The observed behaviours can be described as coherence-based reasoning, whereby an emerging judgment influences the evaluation of incoming information, so that confident judgments can be achieved even with ambiguous, uncertain and conflicting information. The role of coherence-based reasoning in medical diagnosis and diagnostic error needs to be systematically examined.
Authors and Affiliations
Olga Kostopoulou, Christos Mousoulis and Brendan Delaney
Keywords
Related Articles
- EP ID EP677696
- DOI -
- Views 182
- Downloads 0
Testing the ability of the surprisingly popular method to predict NFL games
We consider the recently-developed “surprisingly popular” method for aggregating decisions across a group of people (Prelec, Seung and McCoy, 2017). The method has shown impressive performance in a range of decision-maki...
Downside financial risk is misunderstood
The mathematics of downside financial risk can be difficult to understand: For example a 50% loss requires a subsequent 100% gain to break-even. A given percentage loss always requires a greater percentage gain to break-...
How the public, and scientists, perceive advancement of knowledge from conflicting study results
Science often advances through disagreement among scientists and the studies they produce. For members of the public, however, conflicting results from scientific studies may trigger a sense of uncertainty that in turn l...
Coping strategies and immune neglect in affective forecasting: Direct evidence and key moderators
Affective forecasting skills have important implications for decision making. However, recent research suggests that immune neglect—the tendency to overlook coping strategies that reduce future distress—may lead to affec...
Developing expert political judgment: The impact of training and practice on judgmental accuracy in geopolitical forecasting tournaments
The heuristics-and-biases research program highlights reasons for expecting people to be poor intuitive forecasters. This article tests the power of a cognitive-debiasing training module (“CHAMPS KNOW”) to improve probab...