No abstract

In the past 30 years researchers have examined the impact of heightened stress on the fidelity of eyewitness memory. Meta-analyses were conducted on 27 independent tests of the effects of heightened stress on eyewitness identification of the perpetrator or target person and separately on 36 tests of eyewitness recall of details associated with the crime. There was considerable support for the hypothesis that high levels of stress negatively impact both types of eyewitness memory. Meta-analytic Z-scores, whether unweighted or weighted by sample size, ranged from −5.40 to −6.44 (high stress condition-low stress condition). The overall effect sizes were −.31 for both proportion of correct identifications and accuracy of eyewitness recall. Effect sizes were notably larger for target-present than for target-absent lineups, for eyewitness identification studies than for face recognition studies and for eyewitness studies employing a staged crime than for eyewitness studies employing other means to induce stress.

The objectives of this study were to describe ways in which doctors make suboptimal diagnostic and treatment decisions, and to discuss possible means of alleviating those biases, using a review of past studies from the psychological and medical decision-making literatures. A number of biases can affect the ways in which doctors gather and use evidence in making diagnoses. Biases also exist in how doctors make treatment decisions once a definitive diagnosis has been made. These biases are not peculiar to the medical domain but, rather, are manifestations of suboptimal reasoning to which people are susceptible in general. None the less, they can have potentially grave consequences in medical settings, such as erroneous diagnosis or patient mismanagement. No surefire methods exist for eliminating biases in medical decision making, but there is some evidence that the adoption of an evidence-based medicine approach or the incorporation of formal decision analytic tools can improve the quality of doctors' reasoning. Doctors' reasoning is vulnerable to a number of biases that can lead to errors in diagnosis and treatment, but there are positive signs that means for alleviating some of these biases are available.

More than 25 years of research has accumulated concerning the possible biasing effects of mugshot exposure to eyewitnesses. Two separate metaanalyses were conducted on 32 independent tests of the hypothesis that prior mugshot exposure decreases witness accuracy at a subsequent lineup. Mugshot exposure both significantly decreased proportion correct and increased the false alarm rate, the effect being greater on false alarms. A mugshot commitment effect, arising from the identification of someone in a mugshot, was a substantial moderator of both these effects. Simple retroactive interference, where the target person is not included among mugshots and no one in a mugshot is present in the subsequent lineup, did not significantly impair target identification. A third metaanalysis was conducted on 19 independent tests of the hypothesis that failure of memory for facial source or context results in transference errors. The effect size was more than twice as large for "transference" studies involving mugshot exposure in proximate temporal context with the target than for "bystander" studies with no subsequent mugshot exposure.

We assessed the relative importance healthcare consumers attach to various factors in choosing a primary care doctor (PCD) in a cross-sectional, in-person survey. Three survey locations were used: doctors' offices, a public shopping area, and meetings of a women's organization. A total of 636 community residents, varying across major demographic categories, participated. Participants completed a 23-item survey, designed to assess which factors consumers perceive as most relevant in choosing a PCD. Participants perceived professionally relevant factors (e.g. whether the doctor is board certified, office appearance) and management practices (e.g. time to get an appointment, evening and weekend hours) as more important than the doctor's personal characteristics (race, age, gender, etc.). Participants' own characteristics bore little relationship to the perceived importance of doctor characteristics. Factors patients perceive as most important to their choice of a PCD are also those that have the greatest effect on the quality of healthcare they will receive. However, they do not always have access to this information. A better understanding of the factors that influence people's choice of a PCD can contribute to efforts to provide them with the resources to make well-informed decisions in selecting among healthcare options.