Dual processing model of medical decision-making.

Area of Science:

• Cognitive Psychology
• Medical Decision-Making
• Behavioral Economics

Background:

• Dual processing theory describes cognition via intuitive (system I) and analytical (system II) systems.
• No formal model of medical decision-making based on dual processing theory existed.
• This study addresses treatment decisions for patients with uncertain disease status.

Purpose of the Study:

• To develop and apply a formal descriptive model of medical decision-making using dual processing theory.
• To explain variations in clinical treatment practices.
• To integrate psychological models of cognition with medical decision-making thresholds.

Main Methods:

• Developed a mathematical model linking a psychological model of cognition with the threshold model of medical decision-making.
• Applied the model to analyze physician treatment decisions.
• Investigated the influence of system I and system II processing on treatment thresholds.

Main Results:

• Physician treatment decisions are moderated by system I and the ratio of benefits to harms.
• System I can lead to lower thresholds, potentially explaining overtreatment.
• System I can also lead to higher thresholds, explaining undertreatment when evidence is unreliable or biased.

Conclusions:

• The first dual processing model for medical decision-making has been developed.
• This model enriches the field beyond traditional expected utility theory.
• It offers a framework for reconciling competing dual processing theories.