Clinical decision making Flashcards
what are sunk costs?
any costs that have been spent on a project that are irretrievable ranging including anything from money spent from building a house to expensive drugs.
what is the Sunk Cost Fallacy or Concorde Effect?
The only factor affecting future action should be the future cost/benefits ratio but humans do not always act rationally and often the more we have invested in the past, the more we are prepared to invest in a problem in the future
what is anchoring and adjustment?
a psychological heuristic (cognitive shortcut that may result in a suboptimal outcome) that influences the way people intuitively assess probabilities.
anchor- reference point
adjustment- estimate from there
what is heuristics?
- rule of thumb
- mental short cut
- pattern recognition
- educated guesses
- subconscious integration of patient data with prior experience
fast and frugal approaches to thinking
what is Gambler’s Fallacy aka Sunken Cost’s Fallacy?
a logical fallacy involving the mistaken belief that past events will affect future events when dealing with random activities, such as with gambling games
the more we have invested in a problem in the past, the more we will invest in the future
rationally, the costs and benefits of the problem presenting at the time should be considered rather than what happened in the past
what are the methods for improving decision making?
- Recognise that heuristics and biases may affect our judgement (even subconsciously).
- Counteract the effect of top-down information processing by generating alternate theories and looking for evidence to support them rather than evidence that confirms out preferred theory.
- Employ statistical principles – e.g. larger sample size = greater confidence in our judgements.
Use of algorithms.
what is an algorithm?
a logical series of steps to take to decide most effectively, but not necessarily most efficiently.
what types of medical error is most common?
both system-related and cognitive factors
what is confirmation bias?
the tendency to search or interpret information in a way which confirms one’s own preconceptions
how can decision making be improved?
1) education
2) feedback
3) accountability
4) generating alternatives
5) consultations
how are older adults likely to respond to treatment?
Older adults – more likely to agree to treatment described in positive terms as opposed to neutrally or negative.
what is a framing effect?
When presented with treatment descriptions, described in positive, negative or neutral terms
what is representativeness heuristic?
"The thing belongs in this group because it is typical of that group": the subjective probability that a stimulus belongs to a certain class based on how ‘typical’ of that class it appears to be regardless of the base rate probability.
E.G. Fit and young 60yo man with vague chest pain that goes away. You should NOT dismiss him in case of MI as its common in that age category.
what is availability heuristic?
probabilities are estimated based on how easily and/or vividly they can be called to mind.
E.G. the patient has whatever your last patient who looked like this had.
how can one reduce making rushed, inaccurate decisions in a group?
- playing devil’s advocate
- encouraging participation
- use of algorithms
