Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

Area of Science:

• Cognitive Psychology
• Medical Decision Making
• Behavioral Economics

Background:

• Dual Processing Theories (DPT) posit two cognitive systems: intuitive (type 1) and deliberative (type 2).
• The Dual Processing Model (DPM) extends DPT to medical decision-making, where treatment is initiated if benefits outweigh harms, exceeding a threshold probability.
• Previous models, like Expected Utility Theory (EUT), primarily focus on objective probabilities and utilities.

Observation:

• This study extends the DPM to incorporate diagnostic testing decisions.
• A clinical scenario involving prostate cancer management is used to illustrate the model's application.
• Two decision thresholds were calculated and compared: one based on EUT and another based on DPM.

Findings:

• The DPM threshold provided a better explanation for decisions to order diagnostic tests compared to EUT.
• Diagnostic test decisions are influenced by objective data on benefits/harms and subjective type 1 cognitive assessments.
• The DPM threshold is individualized due to the unique nature of type 1 cognitive processes in each decision-maker.

Implications:

• The DPM framework can elucidate variations in clinical diagnostic and treatment patterns.
• Understanding the interplay of objective evidence and subjective cognition is crucial for improving medical decision-making.
• This model highlights the importance of considering individual cognitive differences in clinical practice.