L16 - Applying the research Flashcards
Success stories in aiding and medical decision making
In medical decision making, what are adverse events?
People who get injured while in hospital.
What % of litigation cases are brought against ER physicians are due to delayed or missed diagnosis?
50%
Why might ER physicians make diagnosis errors?
Cognitive load
Diagnosis requires hypothesis formation and testing under time and stress. The cognitive load may lead to error.
What is confirmation bias?
The tendency to seek information consistent with the current hypotheses and avoid the collection of potentially falsifying evidence.
Explain the Wason selection task.
Someone tells you: “if a card has a vowel on the other side then it has an even number on the other”
Which of the cards do you need to turn over to decide whether they are lying?
What did most people choose in the Wason selection task?
E and 4 or just E.
Why did the results of the Wason selection task prove confirmation bias?
What should the answer be?
People would only select the cards which confirmed the rule they are testing when they should instead be tested by looking for exceptions.
Participants should have chosen E and 7 as for both K and 4 every answer would conform to the rule.
How should rules be tested?
By looking for exceptions to the rule.
Trying to falsify, e.g. the scientific method
What are the two faces of confirmation bias in medical diagnosis?
- Failure to look at diagnostic tests which falsify the diagnosis
- Failure to update the diagnosis after disconfirming information is provided.
Which method of learning about disease is better for reducing confirmation bias, independent learning (one after the other) or contrastive learning (diseases presented simultaneously)?
Contrastive learning
What did the results of the Swets et al. (2000) experiment show in regards to the difference training in techniques of decision aids to help diagnosis has?
Very little training in the technique of using a computer package to help diagnosis can help substantially with diagnostic accuracy.
Does warning and education of confirmation bias have a good impact in reducing confirmation bias?
No, it only works well when combined with explicit strategies to improve decision making.
What is clinical judgement?
Using training and experience to make a judgement.
What is actuarial judgment?
Use a statistical model (e.g. linear regression)
Which is more accurate, clinical judgment or actuarial judgment?
Actuarial judgment.
