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Clinical Decision Making RU

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Notes of Clinical Decision Making classes. Period 3. 2023. SOW-PWB3020. Includes exercises useful for the exam!

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Uploaded on
April 8, 2023
Number of pages
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Written in
2022/2023
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Eliana and leontien
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Course Book: Judgment and Decision Making by Nancy S. Kim

Ch 1.
Decision making: why study it?
Judging and deciding:
- impacts our lives and our deaths.
And how about Clinical Desicion Making?
Judging and deciding:
- is part of the core business of a clinician.
- is generally rather difficult, because decision problems can be complex
and decision processes are complicated.
- can have far-reaching consequences.
Heuristics and Biases:
- “bounded rationality” (to decide under uncertainty, not selecting and weighing all
relevant information).
- heuristics: short-cut strategies that give reasonable solutions but may come with
systematic errors or biases. they evolve in contexts and are based on learning in
environments.
- study of heuristics & biases
- tversky & kahneman
- availability heuristic
- ideas/ elements that immediately come to mind when
evaluating a topic
- representativeness heuristic
- we estimate the probability of an event based on how similar it
is to another situation. we compare it to smt else that we
already have in mind.
- affect heuristic (new one suggested)
- based on the emotions present.
- anchoring and adjustment heuristic
- malleable every time new information is presented.
- NO LONGER A HEURISTIC BECAUSE: it does not
influence judgment when people try to answer a hard question
by instead answering an easier one. This no-longer-heuristic
involves no attribute substitution.
- fast and frugal heuristics
- learning how cognition works
- gigerezner - aims to show how heuristics are adaptive
- environmental cues - are retrieved from memory and serve as a
basis for intelligent guesses
- descriptive viewpoint: empirical research, cognitive psychology
- descriptive models: what people actually do, how they proceed

, - normative viewpoint: ideals or standards that if followed infallibly lead to the best
decisions
- normative models: objective criteria for judging an answer
- prescriptive viewpoint: rules or procedures to bridge actual and ideal decision
making
- prescriptive models: tell you how you should proceed


Ch 2 & 3 + Witterman, C. L.
http://www.tandfonline.com/doi/pdf/10.1080/09515070.2012.655419
Availability and Representatives
- with frequency and probability people often use availability heuristic
- judgment of category membership based on resemblance to a prototype or stereotype:
- how representative is the to-be-judged person/object of the category
- how likely is it that this person/object belongs to that category
Prototypes
- is a specific type of example - a representative of a category
- prototypes depend on personal experiences and are subjective
Anchoring and adjustment
- Kahneman & Tversky
- people “anchor” to their initial choice/idea and these affect quantitive
judgments
- then they adjust away from that, but those adjustments are usually insufficient
- happens in frequency, value and magnitude judgments as well as casual
attributions
- insufficient adjustment: are made away from the anchor but anchor is
still weighted
- selective accessibility account: anchor and anchor-like examples are
more accessible than other information
- why are adjustments insufficient?
- adjustments require cognitive resources and there may
be competing demands for these
- individual differences in disposition for effortful
thinking
Ch 4 & 12 + Munro
http://www.sciencedirect.com/journal/child-abuse-and-neglect/vol/23/issue/8
Hindsight bias:
Being wise after the event.
- Uncertain outcomes often seem more likely after it is known that the outcome
occurred. (fictitious data)
- In hindsight, people believe to have estimated probabilities better than they did/would
have.
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