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Physicians' Diagnostic Judgments and Treatment Decisions for Acute Otitis Media in Children

Author

Listed:
  • Claudia González-Vallejo
  • Paul C. Sorum
  • Thomas R. Stewart
  • John B. Chessare
  • Jeryl L. Mumpower

Abstract

Physicians' diagnoses of acute otitis media (AOM) and their treatment choices were investigated using judgment and decision-making analyses. Thirty-two pediatricians in the Albany, New York, area provided probability judgments of the presence of AOM and made treatment decisions for 32 patient vignettes, each described in terms of historical and examination variables. Their probability judgments were well predicted by linear combinations of the patient variables (R 2 s ranged from 0.76 to 0.97). Information about the observed condition of the eardrum proved to be most critical to the physicians' diagnoses. They demonstrated good levels of agreement on diagnoses. They varied, however, in their tendencies to treat with amoxicillin rather than another antibiotic. Case vagueness was related to the rate of antibiotic treatment. The rate of antibiotic treatment was higher for vague than for non-vague cases when the mean judged probability of AOM was low. In combination, the findings highlight the importance of performing and interpreting ear examinations and the role that consistent training may have in improving management of AOM.

Suggested Citation

  • Claudia González-Vallejo & Paul C. Sorum & Thomas R. Stewart & John B. Chessare & Jeryl L. Mumpower, 1998. "Physicians' Diagnostic Judgments and Treatment Decisions for Acute Otitis Media in Children," Medical Decision Making, , vol. 18(2), pages 149-162.
    • Handle: RePEc:sae:medema:v:18:y:1998:i:2:p:149-162
    DOI: 10.1177/0272989X9801800203
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    Citations

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    Cited by:

    1. Paul Clay Sorum, 1999. "Measuring Patient Preferences by Willingness to Pay to Avoid," Medical Decision Making, , vol. 19(1), pages 27-37, January.
    2. Mandeep K. Dhami & Jeryl L. Mumpower, 2018. "Kenneth R. Hammond’s contributions to the study of judgment and decision making," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 13(1), pages 1-22, January.
    3. repec:cup:judgdm:v:9:y:2014:i:2:p:114-128 is not listed on IDEAS
    4. Jeryl L. Mumpower & Gary H. McClelland, 2014. "A signal detection theory analysis of racial and ethnic disproportionality in the referral and substantiation processes of the U.S. child welfare services system," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 9(2), pages 114-128, March.
    5. repec:cup:judgdm:v:13:y:2018:i:1:p:1-22 is not listed on IDEAS

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