The diversity effect in diagnostic reasoning

Abstract

Diagnostic reasoning draws on knowledge about effects and their potential causes. The causal-diversity effect in diagnostic reasoning normatively depends on the distribution of effects in causal structures, and thus, a psychological diversity effect could indicate whether causally structured knowledge is used in evaluating the probability of a diagnosis, if the effect were to covary with manipulations of causal structures. In four experiments, participants dealt with a quasimedical scenario presenting symptom sets (effects) that consistently suggested a specified diagnosis (cause). The probability that the diagnosis was correct had to be rated for two opposed symptom sets that differed with regard to the symptoms' positions (proximal or diverse) in the causal structure that was initially acquired. The causal structure linking the diagnosis to the symptoms and the base rate of the diagnosis were manipulated to explore whether the diagnosis was rated as more probable for diverse than for proximal symptoms when alternative causations were more plausible (e.g., because of a lower base rate of the diagnosis in question). The results replicated the causal diversity effect in diagnostic reasoning across these conditions, but no consistent effects of structure and base rate variations were observed. Diversity effects computed in causal Bayesian networks are presented, illustrating the consequences of the structure manipulations and corroborating that a diversity effect across the different experimental manipulations is normatively justified. The observed diversity effects presumably resulted from shortcut reasoning about the possibilities of alternative causation.

Clinical Reasoning in Physical Therapy: A Concept Analysis

“…Related terms in psychology include clinical decision-making, 122 diagnosis. [123][124][125][126][127][128][129][130] Related concepts and antecedents directed at cues, 122,123,131 key features, 132 hypothesis testing [127][128][129]133 and statements made or a situation presented. 126,133,134 The consequence was a formed judgement 125,127,[135][136][137] and attributes included critical thinking, 122,134,136,[138][139][140][141][142][143] reflection, 141 weighing information, 132 flexibility in thinking.…”

“…[124][125][126][127][128][129]133,[143][144][145] Many of the psychology articles were primarily discussing medical reasoning related to physician diagnoses and problem solving. 124,125,129,130 Those articles that focused specifically on psychology related clinical reasoning to critical thinking and logical problem solving. 122,138,140,144 Related terms in the health professions (PT, OT) literature included critical thinking and decision-making.…”

“…56,[61][62][63] Psychology similarly used the term cognitive thinking to refer to clinical decision-making as the reasoning process to determine a formed judgment/diagnosis. [122][123][124][125][126][127][128][129][130] Nursing primarily focused on critical thinking, particularly related to recognizing changes in signs and symptoms that would change a plan of care. [97][98][99][100][101][102][103][104][105] The ability to critically think was directly related to competencies in nursing practice.…”

Tracing current explanations in memory: A process analysis based on eye-tracking

“…The sequential integration of information enables the retrieval of critical information from memory to generate and evaluate the best causal explanation. Recent research on this subject has shown that this generation and evaluation process depends on the activation of information from long-term memory (Mehlhorn et al, 2011; Rebitschek et al, 2016; Thomas et al, 2008). In a study by Mehlhorn et al (2011), participants first learned associations between medical symptoms and potential chemicals that caused them (and therefore act as their explanations).…”

Information stored in memory affects abductive reasoning

“…To form a correct situation model, is it necessary to have all previous information active in memory, according to research showing that the generation of explanations is influenced by the knowledge currently activated in memory (Mehlhorn, Taatgen, Lebiere, & Krems, 2011;Rebitschek, Krems, & Jahn, 2016;Thomas, Dougherty, Sprenger, & Harbison, 2008). Based on the situation model, the reasoner forms explanations of the observation.…”