Decision-making and treatment choices Flashcards
What are the different types of decisions?
Certain - know what getting
Uncertain - chance will get/not get the outcome, probablilty unknown
Risky - chance will get/not get the outcome, probability known
What kind of decisions are treatment choices?
Risky/uncertain
What is Expected Utility Theory (von Neumann and Morgenstern)?
Normative theory - how people should act.
Links choice with values, probability of each option.
What is the maximum expected utility choice?
Choice based on evaluating all options. The choice = option with greatest maximum value
What is satisficing (Simon)?
Choose a ‘satisfactory’ criterion and the first option that matches, e.g. must have 5 rooms, choose 1st house with 5 rooms.
What is elimination by aspects (Tversky)?
Choose an attribute and make trade-offs between options eg compare all houses with 5 rooms.
What is heuristics?
Attend to part of the decision problem or decision context (e.g. who gave the information).
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 (e.g. trust ‘mum’).
Sub-conscious, quick, little effort or emotion.
Satisfactory: more likely to regret or make ‘wrong’ choice
What is a systematic strategy?
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).
Happier with choice made, less likely to regret choice.
What are potential biases in decision making?
•Presentation of information biases how we make choices.
•The context ‘leaks information’, cues.
•People pick up on cues and it affects their decision representation, and judgment:
•Framing – direct.
•Perceptions risk and values – in-direct.
Our judgments not stable, always changing.
Why might bad decisions be made?
Decision making goes wrong because:
We miss information in our search and/or are over-confident after a limited search of information
Our judgments or inferences are biased
We think too much and find counter-evidence that does not add more to the decision representation.
What are the three types of errors in diagnosis that may occur according to Graber?
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
