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Probability judgement in medicine: discounting unspecified possibilities
D A Redelmeier1, D J Koehler, V Liberman
1University of Toronto, Ontario, Canada.
Summary
Physicians tend to underestimate the probability of unspecified possibilities in medical diagnoses. Support theory explains this cognitive bias, suggesting awareness can improve medical decision-making.
Area of Science:
- Cognitive Psychology
- Medical Decision Making
- Behavioral Economics
Background:
- Cognitive psychology research shows event descriptions influence probability judgments.
- Support theory posits explicit event descriptions yield higher probability judgments than implicit ones.
Purpose of the Study:
- To investigate the applicability of support theory to physicians' diagnostic and prognostic probability judgments.
- To determine if physicians discount unspecified possibilities in clinical scenarios.
Main Methods:
- Physicians were presented with clinical scenarios.
- Diagnostic and prognostic probability judgments were elicited.
- Judgments were analyzed in the context of support theory's predictions.
Main Results:
- Physicians' probability judgments were consistent with support theory.
- Evidence suggests physicians tended to discount unspecified diagnostic and prognostic possibilities.
- This indicates a systematic bias in medical probability assessment.
Conclusions:
- Physicians exhibit a tendency to underweight unspecified possibilities, aligning with support theory.
- Awareness of this discrepancy between intuitive judgment and probability theory can enhance medical decision-making.
- Interventions may be developed to mitigate this bias and improve clinical judgment accuracy.