BMC Med Inform Decis Mak - Dual processing model of medical decision-making.

Tópicos

{ framework(1458) process(801) describ(734) }
{ decis(3086) make(1611) patient(1517) }
{ error(1145) method(1030) estim(1020) }
{ control(1307) perform(991) simul(935) }
{ can(774) often(719) complex(702) }
{ model(3480) simul(1196) paramet(876) }
{ data(2317) use(1299) case(1017) }
{ treatment(1704) effect(941) patient(846) }
{ howev(809) still(633) remain(590) }
{ imag(1947) propos(1133) code(1026) }
{ research(1085) discuss(1038) issu(1018) }
{ visual(1396) interact(850) tool(830) }
{ ehr(2073) health(1662) electron(1139) }
{ group(2977) signific(1463) compar(1072) }
{ system(1976) rule(880) can(841) }
{ import(1318) role(1303) understand(862) }
{ state(1844) use(1261) util(961) }
{ estim(2440) model(1874) function(577) }
{ motion(1329) object(1292) video(1091) }
{ problem(2511) optim(1539) algorithm(950) }
{ method(1969) cluster(1462) data(1082) }
{ measur(2081) correl(1212) valu(896) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ network(2748) neural(1063) input(814) }
{ take(945) account(800) differ(722) }
{ concept(1167) ontolog(924) domain(897) }
{ method(1557) propos(1049) approach(1037) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ perform(1367) use(1326) method(1137) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ cost(1906) reduc(1198) effect(832) }
{ intervent(3218) particip(2042) group(1664) }
{ use(2086) technolog(871) perceiv(783) }
{ health(1844) social(1437) communiti(874) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ implement(1333) system(1263) develop(1122) }
{ model(3404) distribut(989) bayesian(671) }
{ data(1737) use(1416) pattern(1282) }
{ inform(2794) health(2639) internet(1427) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ studi(2440) review(1878) systemat(933) }
{ assess(1506) score(1403) qualiti(1306) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ care(1570) inform(1187) nurs(1089) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ system(1050) medic(1026) inform(1018) }
{ model(2341) predict(2261) use(1141) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ monitor(1329) mobil(1314) devic(1160) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ result(1111) use(1088) new(759) }
{ survey(1388) particip(1329) question(1065) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Dual processing theory of human cognition postulates that reasoning and decision-making can be described as a function of both an intuitive, experiential, affective system (system I) and/or an analytical, deliberative (system II) processing system. To date no formal descriptive model of medical decision-making based on dual processing theory has been developed. Here we postulate such a model and apply it to a common clinical situation: whether treatment should be administered to the patient who may or may not have a disease.METHODS: We developed a mathematical model in which we linked a recently proposed descriptive psychological model of cognition with the threshold model of medical decision-making and show how this approach can be used to better understand decision-making at the bedside and explain the widespread variation in treatments observed in clinical practice.RESULTS: We show that physician's beliefs about whether to treat at higher (lower) probability levels compared to the prescriptive therapeutic thresholds obtained via system II processing is moderated by system I and the ratio of benefit and harms as evaluated by both system I and II. Under some conditions, the system I decision maker's threshold may dramatically drop below the expected utility threshold derived by system II. This can explain the overtreatment often seen in the contemporary practice. The opposite can also occur as in the situations where empirical evidence is considered unreliable, or when cognitive processes of decision-makers are biased through recent experience: the threshold will increase relative to the normative threshold value derived via system II using expected utility threshold. This inclination for the higher diagnostic certainty may, in turn, explain undertreatment that is also documented in the current medical practice.CONCLUSIONS: We have developed the first dual processing model of medical decision-making that has potential to enrich the current medical decision-making field, which is still to the large extent dominated by expected utility theory. The model also provides a platform for reconciling two groups of competing dual processing theories (parallel competitive with default-interventionalist theories).

Resumo Limpo

ckground dual process theori human cognit postul reason decisionmak can describ function intuit experienti affect system system andor analyt delib system ii process system date formal descript model medic decisionmak base dual process theori develop postul model appli common clinic situat whether treatment administ patient may may diseasemethod develop mathemat model link recent propos descript psycholog model cognit threshold model medic decisionmak show approach can use better understand decisionmak bedsid explain widespread variat treatment observ clinic practiceresult show physician belief whether treat higher lower probabl level compar prescript therapeut threshold obtain via system ii process moder system ratio benefit harm evalu system ii condit system decis maker threshold may dramat drop expect util threshold deriv system ii can explain overtreat often seen contemporari practic opposit can also occur situat empir evid consid unreli cognit process decisionmak bias recent experi threshold will increas relat normat threshold valu deriv via system ii use expect util threshold inclin higher diagnost certainti may turn explain undertreat also document current medic practiceconclus develop first dual process model medic decisionmak potenti enrich current medic decisionmak field still larg extent domin expect util theori model also provid platform reconcil two group compet dual process theori parallel competit defaultinterventionalist theori

Resumos Similares

BMC Med Inform Decis Mak - Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas. ( 0,737777053382552 )
AMIA Annu Symp Proc - An information-centric framework for designing patient-centered medical decision aids and risk communication. ( 0,702991753278082 )
Med Decis Making - Assessing personalized medicines in Australia: a national framework for reviewing codependent technologies. ( 0,695944478316625 )
J. Med. Internet Res. - Web-based virtual patients in nursing education: development and validation of theory-anchored design and activity models. ( 0,687489137651898 )
AMIA Annu Symp Proc - Supporting shared decision making within the MobiGuide project. ( 0,680530608781627 )
AMIA Annu Symp Proc - Revisiting the EBM decision model to formalize non-compliance with computerized CPGs: results in the management of breast cancer with OncoDoc2. ( 0,680382140831328 )
Med Decis Making - Minimal modeling approaches to value of information analysis for health research. ( 0,675100679882265 )
BMC Med Inform Decis Mak - Clarifying values: an updated review. ( 0,673616923013162 )
J Biomed Inform - Opportunistic decision making and complexity in emergency care. ( 0,667550434623812 )
Med Decis Making - All stories are not alike: a purpose-, content-, and valence-based taxonomy of patient narratives in decision aids. ( 0,662742034228165 )
Artif Intell Med - From decision to shared-decision: Introducing patients' preferences into clinical decision analysis. ( 0,662595998817151 )
Med Decis Making - Theoretical foundation of patient v. population preferences in calculating QALYs. ( 0,653464039213071 )
BMC Med Inform Decis Mak - Developing and user-testing Decision boxes to facilitate shared decision making in primary care--a study protocol. ( 0,651336696520742 )
BMC Med Inform Decis Mak - Extensions to regret-based decision curve analysis: an application to hospice referral for terminal patients. ( 0,646037911859673 )
BMC Med Inform Decis Mak - Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards. ( 0,638400638099564 )
Artif Intell Med - Artificial intelligence framework for simulating clinical decision-making: a Markov decision process approach. ( 0,628635427319451 )
Med Decis Making - Expected net present value of sample information: from burden to investment. ( 0,622697358292787 )
BMC Med Inform Decis Mak - Development of a tool to improve the quality of decision making in atrial fibrillation. ( 0,619303541959139 )
Lifetime Data Anal - Case-cohort analysis of clusters of recurrent events. ( 0,605773751906469 )
BMC Med Inform Decis Mak - A new method for determining physician decision thresholds using empiric, uncertain recommendations. ( 0,603664157390112 )
BMC Med Inform Decis Mak - Development and initial evaluation of a treatment decision dashboard. ( 0,602703212395763 )
BMC Med Inform Decis Mak - The design of a low literacy decision aid about rheumatoid arthritis medications developed in three languages for use during the clinical encounter. ( 0,596545491983539 )
Artif Intell Med - Improving structural medical process comparison by exploiting domain knowledge and mined information. ( 0,59040731332714 )
Healthc (Amst) - Incentivizing shared decision making in the USA--where are we now? ( 0,586564185696801 )
Med Decis Making - Looking at patients' choices through the lens of expected utility: a critique and research agenda. ( 0,584693655610174 )
Med Decis Making - Cost-effectiveness on a local level: whether and when to adopt a new technology. ( 0,583156569189811 )
IEEE J Biomed Health Inform - Leveraging social supports for improving personal expertise on ACL reconstruction and rehabilitation. ( 0,581420362956128 )
BMC Med Inform Decis Mak - Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis. ( 0,580498469492575 )
Med Decis Making - What is known about parents' treatment decisions? A narrative review of pediatric decision making. ( 0,57848122084975 )
BMC Med Inform Decis Mak - Visual AIDS for multimodal treatment options to support decision making of patients with colorectal cancer. ( 0,576128060503473 )
BMC Med Inform Decis Mak - Refining a brief decision aid in stable CAD: cognitive interviews. ( 0,574696218936702 )
Med Decis Making - Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions. ( 0,574233215363008 )
J Med Syst - Enhanced UHF RFID tags for drug tracing. ( 0,573725472764268 )
Med Decis Making - Are medical outcomes fungible? A survey of voters, medical administrators, and physicians. ( 0,570493365570953 )
Lifetime Data Anal - The weighted log-rank class under truncated binomial design: saddlepoint p-values and confidence intervals. ( 0,570035597391534 )
Med Decis Making - A model to support shared decision making in electronic health records systems. ( 0,568761390999276 )
Med Decis Making - The impact of a novel computer-based decision aid on shared decision making for colorectal cancer screening: a randomized trial. ( 0,567013484008996 )
BMC Med Inform Decis Mak - Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence. ( 0,566613207238172 )
BMC Med Inform Decis Mak - A regret theory approach to decision curve analysis: a novel method for eliciting decision makers' preferences and decision-making. ( 0,565317204035954 )
BMC Med Inform Decis Mak - Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers. ( 0,564853374567702 )
J Biomed Inform - Managing proposals and evaluations of updates to medical knowledge: theory and applications. ( 0,562577689111507 )
Med Decis Making - Preferences and perceived involvement in treatment decision making among Chinese patients with chronic hepatitis. ( 0,562457202524013 )
BMC Med Inform Decis Mak - Applying the theory of planned behaviour to multiple sclerosis patients' decisions on disease modifying therapy--questionnaire concept and validation. ( 0,561286495124611 )
BMC Med Inform Decis Mak - Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature. ( 0,560486027298154 )
Med Decis Making - When decisions should be shared: a study of social norms in medical decision making using a factorial survey approach. ( 0,558463660538335 )
BMC Med Inform Decis Mak - Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform. ( 0,556540877126755 )
BMC Med Inform Decis Mak - Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol. ( 0,556434159303575 )
Med Decis Making - Framing Options as Choice or Opportunity: Does the Frame Influence Decisions? ( 0,555627650097348 )
Comput Methods Programs Biomed - AngioLab--a software tool for morphological analysis and endovascular treatment planning of intracranial aneurysms. ( 0,555404166076226 )
Med Decis Making - An equity framework for health technology assessments. ( 0,554832365349968 )
BMC Med Inform Decis Mak - Disclosing conflicts of interest in patient decision aids. ( 0,554643447580111 )
BMC Med Inform Decis Mak - Data mining of audiology patient records: factors influencing the choice of hearing aid type. ( 0,554516490725529 )
BMC Med Inform Decis Mak - Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data. ( 0,552184550497031 )
J Med Syst - The reliability of an epilepsy treatment clinical decision support system. ( 0,550592921652627 )
Neural Comput - Integration of reinforcement learning and optimal decision-making theories of the basal ganglia. ( 0,54758628541928 )
Med Decis Making - Breast cancer patients' treatment expectations after exposure to the decision aid program adjuvant online: the influence of numeracy. ( 0,547103506658141 )
IEEE Trans Vis Comput Graph - Empirical Studies in Information Visualization: Seven Scenarios. ( 0,546473670070591 )
J. Med. Internet Res. - Tailored and integrated Web-based tools for improving psychosocial outcomes of cancer patients: the DoTTI development framework. ( 0,543801808904904 )
Wiley Interdiscip Rev Syst Biol Med - Tuneable resolution as a systems biology approach for multi-scale, multi-compartment computational models. ( 0,542759135158502 )
Lifetime Data Anal - Recurrent events and the exploding Cox model. ( 0,540443386344731 )
Med Decis Making - Contributions of Second Opinions, Outcome Forecasts, and Testimonials to Patient Decisions about Knee Replacement Surgery. ( 0,539528618338979 )
Neural Comput - Active inference, evidence accumulation, and the urn task. ( 0,53720896799499 )
J Biomed Inform - Occupational exposome: a network-based approach for characterizing Occupational Health Problems. ( 0,535348105052112 )
Int J Health Geogr - Spatially explicit multi-criteria decision analysis for managing vector-borne diseases. ( 0,532443626253484 )
J Clin Monit Comput - Closed loop mechanical ventilation. ( 0,531875690337658 )
Med Decis Making - The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions. ( 0,531213732439967 )
Med Decis Making - Adherence and decision AIDS: a model and a narrative review. ( 0,531080706665081 )
J Telemed Telecare - Approaches to economic evaluation in telemedicine. ( 0,529693350194687 )
Med Decis Making - Content coding for contextualization of care: evaluating physician performance at patient-centered decision making. ( 0,528459587613806 )
BMC Med Inform Decis Mak - Barriers and facilitators to implementing Decision Boxes in primary healthcare teams to facilitate shared decisionmaking: a study protocol. ( 0,527570412678992 )
AMIA Annu Symp Proc - Using design principles to foster understanding of complex health concepts in consumer informatics tools. ( 0,526183324532736 )
IEEE Trans Vis Comput Graph - Video Snapshots: Creating High-Quality Images from Video Clips. ( 0,526154994157748 )
Med Decis Making - Perceptions of shared decision making and decision aids among rural primary care clinicians. ( 0,525927364640738 )
J. Med. Internet Res. - Cool but counterproductive: interactive, Web-based risk communications can backfire. ( 0,525500418319428 )
Med Decis Making - Decision coaching to prepare patients for making health decisions: a systematic review of decision coaching in trials of patient decision AIDS. ( 0,525380186884499 )
Res Synth Methods - The potential for meta-analysis to support decision analysis in ecology. ( 0,524835918101914 )
Med Decis Making - The context of available options affects health care decisions: a generalization study. ( 0,524589273570492 )
BMC Med Inform Decis Mak - Do personal stories make patient decision aids more effective? A critical review of theory and evidence. ( 0,524041446674437 )
Med Decis Making - The unconscious thought effect in clinical decision making: an example in diagnosis. ( 0,521251335931827 )
IEEE J Biomed Health Inform - Augmenting breath regulation using a mobile driven virtual reality therapy framework. ( 0,519354696651976 )
J Med Syst - Process-oriented integration and coordination of healthcare services across organizational boundaries. ( 0,518297543663098 )
J Med Syst - Comparison of AI techniques for prediction of liver fibrosis in hepatitis patients. ( 0,51735044374707 )
BMC Med Inform Decis Mak - Values clarification in a decision aid about fertility preservation: does it add to information provision? ( 0,516901210443216 )
Med Decis Making - Can Streamlined Multicriteria Decision Analysis Be Used to Implement Shared Decision Making for Colorectal Cancer Screening? ( 0,516091094932064 )
Comput. Biol. Med. - Assessment of cognitive flexibility in real life using virtual reality: a comparison of healthy individuals and schizophrenia patients. ( 0,515977181358573 )
Int J Med Inform - A framework of a patient safety information system for Iranian hospitals: lessons learned from Australia, England and the US. ( 0,515894937107135 )
Med Decis Making - Factors Associated with Informed Decisions and Participation in Bowel Cancer Screening among Adults with Lower Education and Literacy. ( 0,515132641169715 )
Comput Methods Programs Biomed - A SAS macro for direct adjusted survival curves based on Aalen's additive model. ( 0,514839413311679 )
Brief. Bioinformatics - Developing computational model-based diagnostics to analyse clinical chemistry data. ( 0,514146747526135 )
Med Decis Making - What makes a tumor diagnosis a call to action? On the preference for action versus inaction. ( 0,513951500210807 )
Med Decis Making - The impact of explicit values clarification exercises in a patient decision aid emerges after the decision is actually made: evidence from a randomized controlled trial. ( 0,513363451797424 )
Neural Comput - The basal ganglia optimize decision making over general perceptual hypotheses. ( 0,51225071366548 )
J Am Med Inform Assoc - Imaging informatics for consumer health: towards a radiology patient portal. ( 0,512022847297193 )
AMIA Annu Symp Proc - First-order logic theory for manipulating clinical practice guidelines applied to comorbid patients: a case study. ( 0,511473943245206 )
Med Decis Making - Effect of adding a sleep dimension to the EQ-5D descriptive system: a bolt-on experiment. ( 0,511464651189267 )
BMC Med Inform Decis Mak - Development and pilot testing of a decision aid for drivers with dementia. ( 0,510691309396982 )
J. Med. Internet Res. - Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid. ( 0,509951457000796 )
BMC Med Inform Decis Mak - Using value of information to guide evaluation of decision supports for differential diagnosis: is it time for a new look? ( 0,509543804238786 )
Med Decis Making - Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. ( 0,509317361497079 )
Int J Med Inform - Electre Tri-C, a multiple criteria decision aiding sorting model applied to assisted reproduction. ( 0,509276551793728 )