Heuristics in medical and non-medical decision-making |
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Authors: | Rachael F. Heller Herbert D. Saltzstein William B. Caspe |
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Affiliation: | a Graduate School of the City, University of New York, New York, U.S.A.b The Bronx-Lebanon Hospital and Medical Center, Bronx, NY, U.S.A. |
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Abstract: | Pairs of hypothetical medical and non-medical problems were given to 44 pediatric residents at three levels of hospital training. Each problem was designed to detect a specific heuristic-based bias in making diagnoses. Discounting, disregarding base rate, and over-confidence in contextually embedded redundant information were more evident on medical than on non-medical problems. In particular, a greater number of third-year residents disregarded base-rate information than did first- and second-year residents on medical but not on non-medical problems. On medical problems, a greater number of first-year residents expressed greater confidence in redundant information that was contextually embedded than in information that was presented in a listed format. Over one-third of the residents confused prospective and retrospective probabilities; three-fourths showed evidence of augmentation; virtually all residents expressed greater confidence in a diagnosis based on redundant rather than on non-redundant listed information. These latter effects were consistent across training level and occurred on both medical and non-medical problems. The results are discussed in terms of prototype theory and the nature of medical training. |
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