ACTUARIAL VS. CLINICAL
JUDGEMENT QUESTIONS AND
VERIFIED ANSWERS|100%
CORRECT|GRADE A+
Clinical Method vs Actuarial Method - Dawes et al., 1989 - ANSWER • Clinic method: "decision-maker
combines or processes information in their head"
• Actuarial method: utilizes empirically established relations between data and the condition
Goldberg Rule and MMPI - Dawes et al., 1989 - ANSWER o Judging between neurosis and psychosis -
"Goldberg Rule": a calculation that adds the relevant subscales and subtracts them from each other -> if
the sum is 45+ the patient is psychotic"
o Across seven setting and over 800 cases, Goldberg's rule was compared to 29 clinical judges ->
averages of judges = 62%, actuarial program = 70%
o Conclusion: Over multiple studies, EVERY judge would have done better by following Goldberg's rule.
The model was even more reliable than the actual judges it was based on
• Other tests/conditions: Decision rules/models also performed better in intellectual tests, survival
predictions for disease severity (Hodgkin's Disease)
Advantage of Clinical Judgment - ANSWER "Broken leg" problem - rare phenomena that are not included
in the model, sometimes you need a human to decide when to override the formula
o However, making "exceptions" actually appears to happen TOO often, leading correct modifications to
be outnumbered by the incorrect
Limits of actuarial methods: Results are still modest at best, cannot simply apply to new settings
mindlessly
o But actuarial saves time and money
Meehl et al., 1973 - ANSWER Actuarial did equal/better than clinical judgment across 27 studies in
predicting anything from success in military training to recovery from psychosis - no studies showed
clinical judgment to be better
JUDGEMENT QUESTIONS AND
VERIFIED ANSWERS|100%
CORRECT|GRADE A+
Clinical Method vs Actuarial Method - Dawes et al., 1989 - ANSWER • Clinic method: "decision-maker
combines or processes information in their head"
• Actuarial method: utilizes empirically established relations between data and the condition
Goldberg Rule and MMPI - Dawes et al., 1989 - ANSWER o Judging between neurosis and psychosis -
"Goldberg Rule": a calculation that adds the relevant subscales and subtracts them from each other -> if
the sum is 45+ the patient is psychotic"
o Across seven setting and over 800 cases, Goldberg's rule was compared to 29 clinical judges ->
averages of judges = 62%, actuarial program = 70%
o Conclusion: Over multiple studies, EVERY judge would have done better by following Goldberg's rule.
The model was even more reliable than the actual judges it was based on
• Other tests/conditions: Decision rules/models also performed better in intellectual tests, survival
predictions for disease severity (Hodgkin's Disease)
Advantage of Clinical Judgment - ANSWER "Broken leg" problem - rare phenomena that are not included
in the model, sometimes you need a human to decide when to override the formula
o However, making "exceptions" actually appears to happen TOO often, leading correct modifications to
be outnumbered by the incorrect
Limits of actuarial methods: Results are still modest at best, cannot simply apply to new settings
mindlessly
o But actuarial saves time and money
Meehl et al., 1973 - ANSWER Actuarial did equal/better than clinical judgment across 27 studies in
predicting anything from success in military training to recovery from psychosis - no studies showed
clinical judgment to be better
