Decision making and treatment choices Flashcards
What are the three types of decisions?
Certain (know what you’re getting whichever you choose)
Uncertain (chance you will get/not get outcome, probability unknown)
Risky (chance you will get/not get outcome, probability known)
Who created the expected utility theory?
von Neumann and Morgenstern
What is the expected utility theory?
How people ‘should’ make choices
Links choice with values, probability of each option.
Based on mathematical axioms (probability theory)
The choice = option with greatest or maximum value- the correct, accurate or rational choice.
What 4 things does EUT assume about rational decision making?
- People are motivated to follow rules/axioms
- People have complete knowledge of all the options
- People’s representations of options, risks and benefits are accurate
- People know what their values are and their values are stable
What is Bounded Rationality? Who came up with it?
Simon, 1955.
People don’t have processing capacity to calculate EUT.
People use simpler, less effortful strategies: satisficing, elimination by aspects and heuristic.
What is satisficing?
(Simon, 1978) - choose a ‘satisfactory’ criterion and the first option that matches
What is elimiation by aspects?
(Tversky, 1972) – choose an attribute and make trade-offs between options
What is heuristic decision making?
(Chaiken, 1981) – use a rule of thumb, not option information, e.g. friend said X, I’ve done it before.
What are two information processing strategies? Which do we use most?
System 1 (most) and system 2
You are more likely to regret a decision made using which system?
1
Describe system 1
Quick and subconscious, requires little effort. Choice made on a rule of thumb triggered by ‘bit’ of information (heuristic) (e.g. trust the person).
Rules of thumb informed by experience or beliefs.
Describe system 2
Attend to the details of the decision problem.
Evaluate the pros and cons of all options.
Make choice based on trade-offs between evaluations
Conscious, time-consuming, emotionally demanding.
Results in more stable values (changes cognition).
Which decision system do we want patients to use?
2
What did Graber note as 3 types of diagnostic error?
No fault: silent disease, mimics, not known, poor quality data from the patient, etc.
System: culture left too long, missed appointment, unsupervised junior, delays in x-rays, etc.
Cognitive: misdiagnosis from poor data collection, interpretation, flawed reasoning, incomplete knowledge
What is Croskerry’s Dual Process Model of Diagnostic Reasoning?
A flow chart that explains how doctors make diagnostic decisions
