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The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients

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Dual processing model of medical decision-making.

Benjamin Djulbegovic¹, Iztok Hozo, Jason Beckstead

¹Center for Evidence-based Medicine and Health Outcomes Research, Tampa, FL, USA. bdjulbeg@health.usf.edu

BMC Medical Informatics and Decision Making

|September 5, 2012

Summary

This study introduces a dual processing model for medical decision-making, explaining treatment variations by integrating intuitive (system I) and analytical (system II) thinking. It helps understand overtreatment and undertreatment in clinical practice.

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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.