Heuristic decision making in medicine

Marewski, Julian N.; Gigerenzer, Gerd

doi:10.31887/dcns.2012.14.1/jmarewski

Cited by 277 publications

(108 citation statements)

References 59 publications

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“…Heuristics are simple strategies or mental processes and rules that people use to form judgments quickly, make decisions, and find solutions to complex problems. This happens when an individual focuses on the most relevant aspects of a problem or situation to formulate a solution ( Gigerenzer & Gassmeier, 2011 ; Marewski & Gigerenzer, 2012 ).…”

Section: Methodsmentioning

confidence: 99%

Resource allocation decision-making in dementia care with and without budget constraints: a qualitative analysis

Keogh¹,

Pierse²,

O’Shea³

et al. 2020

HRB Open Res

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Introduction: Health systems in many different countries have increasingly been reorienting the delivery of dementia care to home and community care settings. This paper provides information on how health and social care professionals (HSCPs) in Ireland make decisions on resource allocation for people with dementia living at home and how resource constraints affect their decisions and choices. Methods: A balance of care approach was used to assess resource allocation across six dementia case types, from low to high needs. Workshops were held with 24 HSCPs from multiple disciplines. Participants allocated services in two scenarios: allocation with and without a budget constraint. Nominal group technique was used to structure discussions around resource allocation in both scenarios. Thematic analysis was applied to analyse the qualitative data using a general inductive approach. Results: The following themes influenced allocative deliberations: whose needs are being met; what needs are identified; decision making context; decision making process; and allocation outcomes. Participants were proficient in making decisions, using ‘decision rules’ or heuristics to help them make decisions under fixed budget rules and sticking to conventional provision when constraints were in place. Conclusions: Freedom from a budget constraint allowed HSCPs to consider a broader range of services and to take a more expansive view on what needs should be considered, with a particular emphasis on adopting a proactive, preventative approach to the allocation of resources. The effect of the budget constraint overall was to narrow all considerations, using heuristics to limit the type of needs addressed and the range of services and supports provided. The consequences were a largely reactive, less personalised system of care. The findings emphasise the need for an integrated and comprehensive assessment process that is more concerned with individualised responses rather than relying on existing models of care alone.

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Section: Methodsmentioning

confidence: 99%

Resource allocation decision-making in dementia care with and without budget constraints: a qualitative analysis

Keogh¹,

Pierse²,

O’Shea³

et al. 2020

HRB Open Res

View full text Add to dashboard Cite

show abstract

“…These are mental shortcuts that enable them to make decisions and process information more rapidly and based on incomplete, uncertain, or/and peripheral information ( Stroebe, 2011 ). Heuristics have been shown to be part of health practitioners' practice and driven by constraints such as time ( Marewski and Gigerenzer, 2012 ). Moreover, it has been shown that heuristics-based information is less resistant to counter-argument and less predictive of behaviour than systematic processing ( Stroebe, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Cognitions and behaviours of general practitioners in France regarding HPV vaccination: A theory-based systematic review

Escriva–Boulley

Mandrik

Préau

et al. 2021

Preventive Medicine

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Human papillomavirus (HPV) vaccination is safe and efficacious to prevent persistent HPV infection, precancerous anogenital lesions and cervical cancer. However, in countries where vaccination programmes are implemented outside of schools, such as France, reaching high HPV vaccination coverage of the target population is challenging. Many studies have been performed in France to assess cognitions of general practitioners (GPs) regarding HPV vaccination. However, the evidence is not consistent about which cognitions are key. To provide a comprehensive overview, we performed a systematic review of studies conducted in France on GPs' cognitions regarding HPV vaccination and used the reasoned action approach to extract and synthesize data. The systematic search was performed up to July 2020 in Medline via PubMed, PsycINFO, PsycARTICLES, Embase, CINAHL Plus, Web of Science, Pascal and Francis databases. Grey literature was searched for in the French Public Health Database, Cairn. Info, yahoo.fr , and Google Scholar. Twenty-five scientific publications were selected based on eligibility criteria and assessed for quality. Our qualitative synthesis highlights that although 73% of GPs report recommending HPV vaccination, up to 50% would not recommend it because of concerns, including changes in patients' health behaviours and doubts about safety and/or efficacy. GPs' injunctive norms, i.e. trust in institutional information, were shown to be associated positively with GPs' willingness to recommend HPV vaccination. Parents' fears, girls' age, and potential connection with sexuality do not seem to affect GPs' recommendations. These results will inform the development of a professional educational intervention targeting GPs in France.

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“…People, including physicians, often do not use calculated or rational decision strategies, instead relying on heuristics strategies to make decisions ( 1 , 2 ). Heuristics can reduce the time and effort in decision making but may also lead to systematic cognitive biases in medicine settings ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Availability Bias Causes Misdiagnoses by Physicians: Direct Evidence from a Randomized Controlled Trial

Liu

2020

Intern. Med.

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Objective Empirical evidence on the availability bias associated with diagnostic errors is still insufficient. We investigated whether or not recent experience with clinical problems can lead physicians to make diagnostic errors due to availability bias and whether or not reflection counteracts this bias. Methods Forty-six internal medicine residents were randomly divided into a control group (CG) and experimental group (EG). Among the eight clinical cases used in this study, three experimental cases were similar to the disease of dengue fever (DF) but exhibited different diagnoses, one was actually DF, and the other four filler cases were not associated with DF. First, only the EG received information on DF, while the CG knew nothing about this study. Then, six hours later, all participants were asked to diagnose eight clinical cases via nonanalytic reasoning. Finally, four cases were diagnosed again via reflective reasoning. Results In stage 2, the average score of the CG in the diagnosis of experimental cases was significantly higher than that of the filler cases (0.80 vs. 0.59, p<0.01), but the EG's average score in the two types of cases was not significantly different (0.66 vs. 0.64, p=0.756). The EG and CG had significantly different scores for each experimental case, while no difference was observed in the filler cases. The proportion of diseases incorrectly diagnosed as DF among experimental cases ranged from 71% to 100% in the EG. There were no significant differences between the mean diagnostic accuracy scores obtained by nonanalytic reasoning and those obtained by the reflective reasoning in any cases. Conclusion Availability bias led to diagnostic errors. Misdiagnoses cannot always be repaired solely by adopting a reflective approach.

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Heuristic decision making in medicine

Cited by 277 publications

References 59 publications

Resource allocation decision-making in dementia care with and without budget constraints: a qualitative analysis

Resource allocation decision-making in dementia care with and without budget constraints: a qualitative analysis

Cognitions and behaviours of general practitioners in France regarding HPV vaccination: A theory-based systematic review

Availability Bias Causes Misdiagnoses by Physicians: Direct Evidence from a Randomized Controlled Trial

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