Cognitive guidelines for simplifying medical information: Data framing and perception

In this paper, 1 describe psychological guidelines for simplifying medical information — methods to aid the perception and recognition of abnormalities in medical test reports. These techniques resemble natural human editing strategies outlined in prospect theory. The methods pre-edit data as humans do but to reduce human effort. I review empirical studies assessing these techniques and discuss needs for further research.     

Medicine as business and profession

This paper analyzes one dimension of the frequently alleged contradiction between treating medicine as a business and as a profession, namely the incompatibility between viewing the physician patient relationship in economic and moral terms. The paper explores the utilitarian foundations of economics and the deontological foundations of professional medical ethics as one source for the business/medicine conflict that influences beliefs about the proper understanding of the therapeutic relationship. It, then, focuses on the contrast and distinction between medicine as business and profession by critically analyzing the classic economic view of the moral status of medicine articulated by Kenneth Arrow. The paper concludes with a discussion of some advantages associated with regarding medicine as a business.     

Reflections on segregating and assessing areas of competence

Various complexities that arise in the application of legal and/or clinical criteria to the actual assessment of competence/capacity are discussed, and a particular way of understanding the nature of such criteria is recommended.     

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75 subjects (33 physicians and 42) non-physicians stated their intuitive preferences in 40 (22 published and 18 unpublished) medical dilemmas.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.     

临床决策与疾病发展的“度”

临床决策是十分复杂的专业劳动,良好而科学的临床决策取决于众多因素,包括医师的临床经验、知识水平、医师的爱心与责任心、患者病情的复杂性、医疗水平与条件、患者及家属的条件与配合程度等等,辩证法的“度”在临床的良好应用会帮助医师准确地把握病情,给予更加适度治疗;真正的个体化临床决策必须由医师与患者及家属的密切配合才能实现。     

理性看待微创外科

所谓“微创”,乃是传统外科发展的伸延和提升。微创不等于无创,微创需要科学的决策,同时微创要运用循证医学。微创具有广阔的前景,但它的治疗之路依然很长。它需要进一步的完善。目前,还不是丰收的季节。     

Science, Values and the Human Dimensions

The presented paper substantiates the principle that values are an immanent component of science and any rational cognitive activity. This principle belongs to the European cultural tradition starting from the book of Genesis of the Old Testament, the values of certainty in the antique Greek philosophy and Francis Bacon's coincidence of knowledge and power. Values in science form complicated structures inconnection with different types of knowledge including “the knowledge that”, empirical evidence, various types of generalizations or rules, methods, directions, algorithms, “the knowledge how”, “the knowledge why” or other types of knowledge. Since the assignments of different types of values are the products of a decision-making, it is useful to distinguish many types of decision-making, especially semantic decision-making, information decision-making and decision-making with distinctly pragmatic dimensions. The values assignable to scientific activities and their results also include their social recognition, respect and prestige granted to knowledge and bearers of knowledge by society and social groups or communities. Knowledge generation and the rational and justified application of the achieved and acceptable impacts are also connected with decision-making procedures, values and criteria of social acceptance. This revised version was published online in August 2006 with corrections to the Cover Date.     

选择与坚持:跨期选择与延迟满足之比较

做出选择与坚持选择是决策活动的两个重要阶段。跨期选择源于经济学领域对成人对发生在不同时间点的结果"做出选择"过程的研究;延迟满足则源于心理学领域对儿童为获得未来较大收益而抵制当前诱惑的"坚持选择"过程的研究。二者均致力于研究与时间相关的决策活动,从不同视角关注个体的冲动性与自我控制,但鲜见学者对二者异同的系统比较。本文着重从研究方法、认知机制与神经基础入手探讨了二者的异同,冀为两个研究领域协同发展、共同促进人类远见的培养与实践提供科学的理论支持。