Do medical decision analyses' largest gains grow from the smallest trees?

Some decision analysts recommend reserving their models for careful, complete study of complex problems. Others believe simple problem analyses provide the greatest gains. To clarify these issues, I tested: (1) whether simple published analyses compared to complex ones, produced results as non-intuitive; and (2) whether non-intuitiveness represented analytic gain (or equivalently, intuitive loss). Very limited data also examined (3) the gain from adding model intricacy for a given problem vs. selecting more complex problems for analysis. To assess two non-intuitiveness measures, 75 subjects (33 physicians and 42) non-physicians stated their intuitive preferences in 40 (22 published and 18 unpublished) medical dilemmas. For both physicians and non-physicians, simpler models (those with lees than 30 terminal branches in the decision tree) had about one third the non-intuitiveness of more complex ones. Three tests also supported the premise that analyses outperform intuition, therefore that on average the formers' non-intuitiveness reflects less analytic gain. In addition, for different models of the same problem, tree complexity did not correlate with gain. Thus, simpler trees may not generally gain less because they inadequately describe problems. Instead, simpler analyses may represent simpler problems, with more similar intuitive and formal solutions. If so, these findings may help us avoid some costly but unnecessary simple analyses.     

Microsecond resolution timing with Sun workstations

A high-resolution clock is often indispensable for the accurate measurement of millisecond or microsecond resolution intervals, and it is impossible to measure the probability distribution of short intervals without one. This paper describes a microsecond clock for Sun 3 and 4 workstations that we designed, built, and have made publicly available. It also explains how to measure intervals shorter than a computer’s clock resolution, and derives confidence intervals for such measurements.     

Tachistoscopic display using color-lookup-table display devices

In this article, I describe a method for presenting multiple bit-mapped images on video displays under precise temporal control. The method makes use of the color-table animation technique that can be used with color-lookup-table display devices. The principal challenge in applying this technique to the display of multiple stimuli lies in dealing efficiently with the problem of overlapping displays. The solution described here is to allocate separate bit slices of screen memory to stimuli that overlap and to allocate sequential color-table indices to stimuli that are disjoint. Software is described that automatically computes the location of a stimulus on the screen, allocates color indices appropriately, transfers bit images to screen memory efficiently, and manipulates the color lookup table to present a given stimulus to the viewer. These operations are handled transparently; the user simply draws the stimuli and then turns them on or off under program control.     

The fear potentiated startle effect

A differential conditioning study examined whether an acoustic startle probe, presented during extinction of an aversively conditioned visual stimulus, potentiated the reflex eyeblink response in humans and whether this potentiation varied with the change in affective valence of the conditioned stimulus. Sixty college students were randomly assigned to view a series of two slides, depicting either unpleasant/highly arousing, unpleasant/moderate arousing, neutral/calm, pleasant/moderate arousing or pleasant/highly arousing scenes and objects (duration: 8 sec). During preconditioning (8 trials) and extinction (24 trials) acoustic startle probes (white noise bursts [50 ms; 95 dBA] were administered during and between slide presentation). During acquisition (16 trials) CS+ was reinforced by an electric shock. Startle response magnitudes significantly increased from preconditioning to extinction and were substantially larger to CS+. Conditioned startle reflex augmentation linearly increased with the pleasantness of the slides. Furthermore, subjects showed a greater post-conditioning increase of judged aversiveness to slides that they had previously reported to be more pleasant, exactly paralleling the startle reflex results.

     

Cerebral lateralization in individuals diagnosed as autistic in early childhood

Early infantile autism was found to be associated with an atypical pattern of cerebral lateralization. Based on EEG measures of hemispheric activation during cognitive processing, it was found that 7 of the 10 autistic individuals tested showed a pattern of hemispheric specialization rarely seen in the normal population; namely, a “reversal” in lateralization reflective of a lack of left-hemisphere specialization for linguistic functions. Furthermore, the autistic individuals' pattern of cognitive strengths and weakness is suggestive of a selective impairment of the left cerebral hemisphere.     

Vocal changes in stutterers and nonstutterers when speaking to children

Within the last few years, considerable attention has been devoted to the possibility that the amelioration of stuttering in many novel speaking conditions is a function of vocal changes with or without accompanying modifications in prosodic expression. These formulations have made reference primarily to conditions in which stutterers were induced into one or another novel speech pattern by an external stimulus such as masking noise, a rhythmic cue, or by instructions to sing, or read in unison with another speaker. In contrast, far less attention has been paid to other ameliorative conditions that lack a novel external stimulus or special instructions that direct the stutterer to speak in some unique manner. Speaking or reading to a child is an example of this latter type of condition. The present study was conducted to see if nine adult stutterers and a matched group of nonstutterers would evince vocal changes as they read aloud to another adult, a child, and a child and adult together. There was also a fourth control condition wherein the subjects read to one of the experimenters. Dependent measures of disfluency and stuttering, fundamental frequency, fundamental frequency deviation, fluent reading rate, and peak vocal sound pressure level were made and treated statistically. The major findings of this study indicated that, relative to the control condition, both subject groups exhibited several vocal changes when reading to a child alone and to a child and adult together. In addition, the stutterers experienced a reduction in disfluency, but only when reading to the child alone. The normal speakers exhibited too few disfluencies in the control condition for any meaningful change to occur in that dependent variable. The fact that the stutterers evinced vocal changes in both experimental conditions but a significant drop in disfluency in just one bears importantly on hypotheses that emphasize vocal changes in conditions that ameliorate stuttering.     

Response-contingent stimulation as a treatment for developmental failure in infancy

An 8-month-old infant with a developmental quotient of $\text{1}\text{1}\text{2}$ months was given response-contingent stimulation using a pressure-sensitive pillow which turned an overhead mobile. The subject learned to control the mobile by kicking the pillow, and concurrently began smiling at both the mobile and her mother for the first time. After mastering three contingencies on arm, head, and leg movement, she displayed what appeared to be a Piagetian coordinated secondary circular reaction, in which one response provided 4 seconds of access to another contingency. Although the subject remains severely retarded, the results suggest that some forms of developmental delay may be treated at least in part as a failure to develop contingency awareness.