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Bias in judgement - Coggle Diagram
Bias in judgement
impediments to accurate clinical judgement
lack of awareness of judgemental processes
overconfidence
influence of preconceived notions
hindsight bias
inability to assess covariation
strategies
increased attention to types of usually ignored data
minimisation of the role of memory
active considerations of alternative outcomes
clinical vs actuarial judgement
clinical judgement
human decision-maker
actuarial judgement
conclusions based on empirically establish relations between data
comparing both methods
avoid conditions that artificially inflate accuracy of actuarial methods
judgements on the same data
results from comparative studies
Goldberg: neurosis or psychosis
Goldberg's rule outperforming judgements of expert and non expert judges
Leli & Filskov: diagnosis of progressive brain disease
Einhorn: prediction of survival time following diagnosis of Hodgkin's disease
advantage of the actuarial over the clinical method - also found in a large number of other studies
factors for the superiority of actuarial methods
actuarial procedures always lead to the same conclusions when repeated on a given dataset
clinical judgements might lead to differing results (factors being fatigue, recency, order effects)
mathematical rules ensure that in actuarial methods variables are weighted and contribute based on their actual predictive power and relation to criterion of interest
human judgements have difficulty distinguishing valid and invalid variables and develop false beliefs about associations between variables
clinical judgements produce 'self-fulfilling prophecies' - prediction of outcomes that actually influence the outcome
skewed exposure - a clinician is more likely to evaulate individuals with sig problems - hinders comparisons
overconfidence in clinical judgements
subjective appraisal of a judgement
conclusion
failure to accept large and consistent body of evidence over unvalidated personal observation?
but actuarial methods are obviously also not infallible
need for critical reevaluation
when developed and evaluated properly, actuarial methods have various benefits
higher accuracy
even when accuracy is equal, save time and costs
explicit, objective procedure
sources of bias
heuristics
availability
adjustment
representativeness
anchoring
specific types of biases
diagnostic overshadowing
hindsight bias
response bias
confirmatory bias
bias though patient characteristics
impact of biases on judgement
sins of imprecision
judgements deviate systematically from conclusions that would be reached when assessed within a form al logic system
sins of commission
consideration of information not relevant to the decision
sins of omission
neglecting or overlooking data
recommendation for improving clinical judgement
education/training about bias
and more ...