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Use of Linear Models to Analyze Physicians' Decisions

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  • Robert S. Wigton

Abstract

Linear models of judgment are powerful tools for studying medical decision making. The recent increase in applications of these models to medicine reflects more available computing resources and the parallel development of clinical prediction rules derived from multivariate analysis of patient data. Psychological research into expert and novice decision making shows that linear models derived from judges' decisions usually predict future decisions more accurately than either the judge or a mechanical application of the judge's stated policies. Studies of medical decision making have shown similar results, as well as marked variation among experts in how they appear to use clinical information. Cognitive feedback, which is feedback to the learner of the judgment model derived from previous decisions, is highly effective for teaching complex judgment tasks. Many technical problems remain to be mastered in constructing linear models of medical judgment. These include how to select the correct variables, how to provide a selection of variables broad enough to accommodate individual variations in strategy, how to model intercorrelated variables, and how to char acterize and aggregate individual strategies. Despite the methodologic challenges, linear models remain a powerful method for studying how physicians combine multiple items of imperfect information to make a judgment. These techniques may provide important insights into variation in physician judgments. In addition, they hold promise in teaching the appro priate integration of complex data in the day-to-day practice of medicine. Key words: linear models; medical judgment; diagnosis; prognosis. (Med Decis Making 8:241-252, 1988)

Suggested Citation

  • Robert S. Wigton, 1988. "Use of Linear Models to Analyze Physicians' Decisions," Medical Decision Making, , vol. 8(4), pages 241-252, December.
    • Handle: RePEc:sae:medema:v:8:y:1988:i:4:p:241-252
    DOI: 10.1177/0272989X8800800404
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    References listed on IDEAS

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    1. Robert S. Wigton & Vincent L. Hoellerich & Kashinath D. Patil, 1986. "How Physicians Use Clinical Information in Diagnosing Pulmonary Embolism," Medical Decision Making, , vol. 6(1), pages 2-11, February.
    2. Robert M.. Centor & John M. Witherspoon & Harry P. Dalton & Charles E. Brody & Kurt Link, 1981. "The Diagnosis of Strep Throat in Adults in the Emergency Room," Medical Decision Making, , vol. 1(3), pages 239-246, August.
    3. G. Anderson & C. Bombardier, 1984. "Estimating Disease Activity in Rheumatoid Arthritis," Medical Decision Making, , vol. 4(4), pages 469-487, December.
    4. Hans-Ulrich Fisch & John S. Gillis & Romano Daguet, 1982. "A Cross-National Study of Drug Treatment Decisions in Psychiatry," Medical Decision Making, , vol. 2(2), pages 167-177, June.
    5. Thomas R. Stewart & C.R.B. Joyce, 1988. "Increasing the Power of Clinical Trials Through Judgment Analysis," Medical Decision Making, , vol. 8(1), pages 33-38, February.
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    Cited by:

    1. Randall D. Cebul, 1988. "Decision Making Research at the Interface Between Descriptive and Prescriptive Studies," Medical Decision Making, , vol. 8(4), pages 231-232, December.
    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:13:y:2018:i:1:p:1-22 is not listed on IDEAS
    4. Stewart, Thomas R. & Roebber, Paul J. & Bosart, Lance F., 1997. "The Importance of the Task in Analyzing Expert Judgment," Organizational Behavior and Human Decision Processes, Elsevier, vol. 69(3), pages 205-219, March.

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