Clinical and actuarial judgement

Question 1

Explain the results of the study on clinical vs actuarial judgement and its implications.

Answer 1

actuarial judgement outperformed clinical judgement.

• data should be drawn from the same sample.
• cross-validation should be required.
• explicit prediction of recidivism, success or recovery.

Question 2

What are clinician strengths?

Answer 2

1. theory-mediated judgement.
2. ability to detect complex predictive cues.
3. ability to use rare events.

Question 3

What are clinician weaknesses?

Answer 3

1. human influences.
2. human judgement and its subjective flaws.
3. overconfidence.

Question 4

Explain calibration and its advantages.

Answer 4

Calibration is the proportion of correct predictions against the level of confidence.

• overconfident raters can be detected.
• raters should be well-trained and well-calibrated.
• more informative than traditional statistical methodology.

Question 5

How can you avoid overconfidence?

Answer 5

1. avoid predictions in unfamiliar domains.
2. adjust down.
3. challenge your own beliefs.
4. use disaggregated, rather than holistic perceptions.

Question 6

What causes the resistance to statistical predictions?

Answer 6

1. fear of unemployment.
2. threatened professional self-image.
3. cognitive dissonance.
4. perception of dehumanizing individuals.
5. uncomfortable with statistical models outperforming clinicians.
6. clinicians may lack empirical thinking skills and be poorly educated.