Human decision -making in medicine: A study of professional characteristics and practices
Abstract
This study investigated how information presentation and professional characteristics/practices alter the selection of medical treatments. A survey and three scenarios were completed by 190 physicians, and 145 psychology students completed one scenario. Scenario one, a replication of Redelmeier and Shafir's (1995) osteoarthritis scenario, examined physicians prescribing a new medication based on the number of medication options available. In contrast to Redelmeier and Shafir's results, these results showed no difference in the likelihood of prescribing a new medication, regardless of whether physicians were deciding about one medication or between two equally attractive medications. Important variables included the supervision of medical students, the number of hours spent supervising medical students, and its interaction with experience. Scenario two, patterned after Levin and Chapman (1990), examined treatment selection based on patient characterization. Treatment selection was similar for their students and this study's physicians. For the hemophilia patient group, a typical framing effect was found; however, for the intravenous drug user patient group, no framing effect was found. For the survival frame, the percentage of physicians selecting the risky choice was significantly different across patient groups. Important variables included experience, and its interaction with number of patients seen per week. Scenario three, patterned after McNeil et al. (1982), combined cumulative probability and life expectancy data of surgery and radiation treatment outcomes for lung cancer. These data were used in conjunction to eliminate a framing effect. Although the students showed a significant framing effect, the physicians did not. Further, the students showed no significant differences from the students or physicians in the original study, whereas the physicians were significantly different from all previous and present groups. Important variables included experience, and its interactions with time spent with outpatients and continuing education. (Abstract shortened by UMI.)
Degree
Ph.D.
Advisors
Proctor, Purdue University.
Subject Area
Cognitive therapy
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