Theory about Heuristic Strategies Based on Verbal Protocol Analysis: The Emperor Needs a Shave

Hamm, Robert M.

doi:10.1177/0272989x04271329

Cited by 16 publications

(13 citation statements)

References 39 publications

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“…However, because we did not use ''think-aloud'' protocols or (structured) interviews with the FPs, to avoid interfering with the normal consultation process, our observations alone could not identify the theoretical concepts with which FPs' decisions most closely corresponded. 44 Statistical analyses gave further evidence for a ''simplified'' process. Because there were only a few patients in the sample for whom all of the relevant predictors were identified, using history taking and physical examination, we expected that logistic regression models containing all relevant predictors (saturated model) would be significantly overfitted.…”

Section: Decision Making Regarding Diagnosesmentioning

confidence: 98%

Family Practitioners' Diagnostic Decision-Making Processes Regarding Patients with Respiratory Tract Infections: An Observational Study

Fischer

Himmel

et al. 2008

Med Decis Making

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FPs tended to make their diagnosis based on a few patient symptoms and a limited physical examination. Simple heuristic models were almost as powerful in explaining most diagnoses as saturated models. Direct observation allowed for the study of decision making under real conditions, yielding both quantitative data and "qualitative'' information about the FPs' performance. It is important for investigators to be aware of the specific disadvantages of the method (e.g., a possible observer effect).

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Section: Decision Making Regarding Diagnosesmentioning

confidence: 98%

Family Practitioners' Diagnostic Decision-Making Processes Regarding Patients with Respiratory Tract Infections: An Observational Study

Fischer

Himmel

et al. 2008

Med Decis Making

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“…However, in psychology, there is recognition that heuristics are not something to be expunged, but rather exist in part to provide satisfactory solutions to problems consistent with the constraints of human abilities to process information. This position grew out of the concept of ''bounded rationality' that characterized the field of ''heuristics and biases'' in the 1970's (Hamm 2004). In contrast to the dominant view in the diagnostic error literature, studies in psychology have shown that analytical approaches are often inferior to System 1 methods (Wilson and Schooler 1991;Dijksterhuis et al 2006).…”

Section: Dual Processes Errors and Expertisementioning

confidence: 99%

Dual processing and diagnostic errors

Norman

2009

Adv in Health Sci Educ

205

171

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In this paper, I review evidence from two theories in psychology relevant to diagnosis and diagnostic errors. "Dual Process" theories of thinking, frequently mentioned with respect to diagnostic error, propose that categorization decisions can be made with either a fast, unconscious, contextual process called System 1 or a slow, analytical, conscious, and conceptual process, called System 2. Exemplar theories of categorization propose that many category decisions in everyday life are made by unconscious matching to a particular example in memory, and these remain available and retrievable individually. I then review studies of clinical reasoning based on these theories, and show that the two processes are equally effective; System 1, despite its reliance in idiosyncratic, individual experience, is no more prone to cognitive bias or diagnostic error than System 2. Further, I review evidence that instructions directed at encouraging the clinician to explicitly use both strategies can lead to consistent reduction in error rates.

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“…A recent commentary observes: 'The broader community of medical decision-making researchers has not embraced the topic of heuristics and biases approach with sustained enthusiasm.' 24 More specifically, failure of the theory of heuristic strategies has been attributed to its weak predictive power, its inability to describe the judgement process in sufficient detail or to explain individual differences, and to its failure to assist physicians in improving their decision-making. 25 Thus, in the hands of those who might be best positioned to develop a robust theory and application of heuristic strategies, the work appears to have stalled.…”

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confidence: 99%