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Biomedical subjects

M E Doherty

Publications and source records attributed to M E Doherty.

10 recordsLinked to original sources
PubMed1999

Is diagnostic judgment influenced by a bias to see pathology?

The clinical judgment literature suggests that clinicians are biased to see psychopathology. The social cognition literature shows that people can be biased to search for information relevant only to the hypothesis under test and to ignore information relevant to the alternative. In light of these biases, we asked practicing clinicians (N = 106 respondents) in three conditions to read 1 of 9 biographical essays. The conditions called for the clinicians to judge the writer of the essay as (a) psychologically healthy or not, (b) psychologically healthy or unhealthy, or (c) experiencing psychopathology or not The latter condition was expected to produce the highest frequency of negative judgments. The opposite result was obtained. To determine if this was due to the extreme wording in the "psychopathology" condition, 30 additional practicing clinicians assessed whether the writer of the essay was psychologically unhealthy or not. A comparison of these data with those from the two less extreme conditions showed no bias. The results were interpreted as an appropriate level of conservativism in clinical judgment with respect to the extreme diagnosis implied by the term psychopathology.

Humans↗
PubMed1996

On people's understanding of the diagnostic implications of probabilistic data.

Two lines of prior research into the conditions under which people seek information are examined in light of two statistical definitions of diagnosticity. Five experiments are reported. In two, subjects selected information in order to test a hypothesis. In the remaining three, they selected information in order to convince someone else of the truth of a known hypothesis. A total of 567 university students served as subjects. The two primary conclusions were as follows: (1) When the task is highly structured by the environment, subjects select information diagnostically, and (2) when the task is less structured, so that subjects must seek relevant information not manifest, they select information pseudodiagnostically. Possible relations to other laboratory inference tasks and to clinical judgment are discussed.

Concept Formation↗
PubMed1982

'Pseudodiagnosticity' in an idealized medical problem-solving environment.

Sixty-five senior medical students chose symptom information that would allow them to assess which of two diagnoses was more appropriate for hypothetical patients. Although Bayes' theorem should have governed their data selection, 83 percent of the subjects did not choose the symptom information required for Bayesian computation. Instead, they showed an overwhelming tendency to seek data relevant to a single disease, while ignoring information related to an equally plausible alternative diagnosis. The tendency for subjects to select diagnostically irrelevant information in such tasks has been labeled "pseudodiagnosticity." The effect result from the difficulty of simultaneously evaluating the relevance of a single symptoms in relation to single diagnosis. Medical educators might incorporate classroom demonstrations of the pseudodiagnosticity effect in order to increase students' accuracy in differential diagnosis.

Bayes Theorem↗
PubMedDate not supplied

Advance directives: a policy-capturing approach.

Policy capturing was used to provide insight into those factors that people consider important in the decision of whether to accept life-sustaining medical treatment. First, open-ended interviews with community-dwelling elderly persons (n = 30) were conducted to determine the factors they would consider when drafting an advance directive. College students (n = 53) then made judgments as to whether they would accept life-sustaining treatment for each of 100 hypothetical vignettes comprising a similar set of factors. Results revealed that 1) students made consistent judgments, 2) there was considerable variability in their mean judgments, 3) the most influential factors were mental and physical functioning, 4) mental and physical functioning had an interactive effect on judgments, and 5) subjective estimates of importance were significantly related to policy-capturing weights. This approach for studying the relationship of individuals' values to their acceptance of life-sustaining therapy may be useful in future studies of patient and surrogate decision making.

Advance Directives↗