Clinical Decision Making Flashcards
Algorithmic decision making
flow chart
simplify process
limit independent thinking
pattern recognition decision making
recognise presentation and apply a label or diagnosis
prone to anchoring - ignoring info not confirming diagnosis
worst case scenario decision making
consider a list of not to miss life threatening diagnosis
good for patient safety
event driven decision making
if THIS then THAT
don’t need precis diagnosis
reactive to symptoms
hypothetico-deductive decision making
empirical observation - theory formulation - hypothesis generation - hypothesis testing
data aquisition
pertinent positives and negatives
focused physical exam
targeted investigations
cognitive biases
predicatable, systematic errors in cognition
tendency to think in favour of one perspective over others
Dual process theory
system 1 represents intuitive, unconscious reasoning that relies on heuristics or mental shortcuts
system 2 represents conscious, analytic though
heuristics
mental shortcuts that ease the cognitive load of making a decision
affective error
tendency to convince yourself that what you want to be true it true
aggregate bias
belief that aggregate data, such as the data involved in the validation of clinical decision instruments, does not apply to the patient in front of you
ambiguity effect
tendency to select options for which the probability is known, instead of selecting options for which is probabiltiy is unknown
anchoring
prematurely settling on a single diagnosis based on a few important feautres and failing to adjust based on new information
ascertainment bias
when your thinking is shaped by prior expectations
you see what you expect to see
availability bias
tendency to judge the likelihood of a disease by the ease with wohich relevant examples come to mind
i.e. recent experience with a particular diagnosis may cause you to use the same ddiagnosis
base rate neglect
failure to incorporate the true prevalence of a disease into diagnostic reasoning
belief bias
tendency to accept or reject data based on one’s personal beliefs
blind spot bias
fail to recognise our own weaknesses or conitive errors,
commission and omission biases
commission : tendency towards action rather than inaction
omission: tendency towards inaction rather than action
confirmation bias
once you have formed an opinion you have a tendency to evidence that supports you and ignore contrary evidence
feedback sanction
there may be a signifcant delay until one sees the consequences of a cognitive error, therefore behaviour is reinforced
framing effect
decisions are affected by how you frame your question
fundamental attribution error
overweighting of an individual’s personality as the cause od their problems rather than considering potential external factors
Gambler’s fallacy
belief that chance is self correcting i.e. get a number of conditions, you belief that the next one won’t be that condition
hindsight bias
knowing the outcome can affect our perception of past events
information bias
tendency to believe that the more info one can gather to support a diagnosis, the bettwe
order effects
info transfer occurs as a u shaped function
we remember info from the beginning and end but not in th emiddle
playing the odds
tendency to assume a benign diagnosis when faced with an ambiguous presentation
posterior probabiltiy error
the probability of a diagnosis is overly influenced bby prior event
opposite to gambler’s fallacy
premature closure
tendency to stop too early in a diagnositc process, accepting a diagnosis before gathering all the necessary info
representativeness restraint
tendency to judge the likelihood of a diagnosis based on a typical prototype of the diagnosis
search satisfaction
tendency to stop dearching once you have found something
sunk cost fallacy
once one is invested in comething, it is difficult to let it go
triage cueing
when diagnostic decisions are influenced by the original triage category
ying yang bias
the belief that a pt cannot possible have a diagnosis because they have already been subjected to a multitude of negative tests
zebra retreat
backing away from a rare diagnosis only because it is rare
SPIT differential diagnosis
Serious diagnosis
Probable diagnosis
Interesting diagnosis
Treatable diagnosis
