Clinical Decision Making

Question 1

Algorithmic decision making

Answer 1

flow chart
simplify process
limit independent thinking

Question 2

pattern recognition decision making

Answer 2

recognise presentation and apply a label or diagnosis

prone to anchoring - ignoring info not confirming diagnosis

Question 3

worst case scenario decision making

Answer 3

consider a list of not to miss life threatening diagnosis

good for patient safety

Question 4

event driven decision making

Answer 4

if THIS then THAT
don’t need precis diagnosis
reactive to symptoms

Question 5

hypothetico-deductive decision making

Answer 5

empirical observation - theory formulation - hypothesis generation - hypothesis testing

Question 6

data aquisition

Answer 6

pertinent positives and negatives
focused physical exam
targeted investigations

Question 7

cognitive biases

Answer 7

predicatable, systematic errors in cognition

tendency to think in favour of one perspective over others

Question 8

Dual process theory

Answer 8

system 1 represents intuitive, unconscious reasoning that relies on heuristics or mental shortcuts
system 2 represents conscious, analytic though

Question 9

heuristics

Answer 9

mental shortcuts that ease the cognitive load of making a decision

Question 10

affective error

Answer 10

tendency to convince yourself that what you want to be true it true

Question 11

aggregate bias

Answer 11

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

Question 12

ambiguity effect

Answer 12

tendency to select options for which the probability is known, instead of selecting options for which is probabiltiy is unknown

Question 13

anchoring

Answer 13

prematurely settling on a single diagnosis based on a few important feautres and failing to adjust based on new information

Question 14

ascertainment bias

Answer 14

when your thinking is shaped by prior expectations

you see what you expect to see

Question 15

availability bias

Answer 15

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

Question 16

base rate neglect

Answer 16

failure to incorporate the true prevalence of a disease into diagnostic reasoning

Question 17

belief bias

Answer 17

tendency to accept or reject data based on one’s personal beliefs

Question 18

blind spot bias

Answer 18

fail to recognise our own weaknesses or conitive errors,

Question 19

commission and omission biases

Answer 19

commission : tendency towards action rather than inaction

omission: tendency towards inaction rather than action

Question 20

confirmation bias

Answer 20

once you have formed an opinion you have a tendency to evidence that supports you and ignore contrary evidence

Question 21

feedback sanction

Answer 21

there may be a signifcant delay until one sees the consequences of a cognitive error, therefore behaviour is reinforced

Question 22

framing effect

Answer 22

decisions are affected by how you frame your question

Question 23

fundamental attribution error

Answer 23

overweighting of an individual’s personality as the cause od their problems rather than considering potential external factors

Question 24

Gambler’s fallacy

Answer 24

belief that chance is self correcting i.e. get a number of conditions, you belief that the next one won’t be that condition

Question 25

hindsight bias

Answer 25

knowing the outcome can affect our perception of past events

Question 26

information bias

Answer 26

tendency to believe that the more info one can gather to support a diagnosis, the bettwe

Question 27

order effects

Answer 27

info transfer occurs as a u shaped function

we remember info from the beginning and end but not in th emiddle

Question 28

playing the odds

Answer 28

tendency to assume a benign diagnosis when faced with an ambiguous presentation

Question 29

posterior probabiltiy error

Answer 29

the probability of a diagnosis is overly influenced bby prior event
opposite to gambler’s fallacy

Question 30

premature closure

Answer 30

tendency to stop too early in a diagnositc process, accepting a diagnosis before gathering all the necessary info

Question 31

representativeness restraint

Answer 31

tendency to judge the likelihood of a diagnosis based on a typical prototype of the diagnosis

Question 32

search satisfaction

Answer 32

tendency to stop dearching once you have found something

Question 33

sunk cost fallacy

Answer 33

once one is invested in comething, it is difficult to let it go

Question 34

triage cueing

Answer 34

when diagnostic decisions are influenced by the original triage category

Question 35

ying yang bias

Answer 35

the belief that a pt cannot possible have a diagnosis because they have already been subjected to a multitude of negative tests

Question 36

zebra retreat

Answer 36

backing away from a rare diagnosis only because it is rare

Question 37

SPIT differential diagnosis

Answer 37

Serious diagnosis
Probable diagnosis
Interesting diagnosis
Treatable diagnosis