Clinical Decision Making Flashcards
Describe the effect of extraneous factors on clinical decision-making using an example.
Junior-senior (e.g. nurse-doctor) relationship may lead to the wrong decision being made
Define heuristics
Heuristics are the strategies derived from previous experiences with similar problems. These strategies depend on using readily accessible, though loosely applicable, information to control problem solving, where an optimal solution is impossible or impractical.
e.g. rules of thumb, educated guesses, or mental shortcuts
Describe the two systems for decision making
System 1 = fast, intuitive, automatic reactions and instantaneous decisions that govern most of our lives
System 2 = slow, deliberate type of thinking involved in focus, deliberation, reasoning or analysis
What is Confirmatory Bias?
The tendency to search for or interpret information in a way that confirms one’s preconceptions, often leading to errors
What is the Sunk Cost Fallacy?
Rationally, the only factor affecting future action should be future cost/benefit ratio BUT humans do not always act rationally
Often, the more we have invested in the past (in irretrievable costs), the more we are prepared to invest in a problem in the future
What is the Anchoring Effect?
A psychological heuristic;
dAnchoring occurs when, during decision making, an individual depends heavily on an initial piece of information to make subsequent judgments. This bias occurs when interpreting future information using this anchor.
Explain what is meant by the representativeness heuristic, and how this might lead to errors
Subjective probability that a stimulus belongs to a particular class based on how ‘typical’ of that class it appears to be (regardless of base rate probability)
When people rely on representativeness to make judgments, they are likely to judge wrongly because the fact that something is more representative does not actually make it more likely.
Explain what is meant by the availability heuristic, and how this might lead to errors
Probabilities/frequencies are estimated on the basis of how easily and/or vividly they can be called to mind.
When an infrequent event can be brought easily and vividly to mind, this heuristic overestimates its likelihood.
What is Gambler’s Fallacy?
logical fallacy involving the mistaken belief that past events will affect future events when dealing with random activities
Define conditional probability.
Measures the probability of an event happening given that another event has occurred
State some strategies for improving clinical decision-making.
- Recognise that heuristics and biases may be affecting our judgement even though we may not be conscious of them
- When evaluating a diagnosis be sure to test for alternatives rather than just looking for evidence that confirms our preferred theory
- Understand and employ statistical principles
- Use of algorithms and decision support systems (more useful where the problem is well defined)
