The influence of familiar non‐diagnostic information on the diagnostic decisions of novices
Notice bibliographique
Résumé
CONTEXT: Previous research has demonstrated the influence of familiar symptom descriptions and entire case similarity on diagnostic reasoning. In this paper, we extend the role of familiarity to examine the influence of familiar non-diagnostic patient information (e.g. name and age) on the diagnostic decisions of novices, both immediately following training and after a delay. If an instance model (reliance on similar previously seen cases) has strong explanatory power in clinical reasoning, we should see an influence of familiar patient information on later cases containing similar identifying characteristics even though such information is objectively irrelevant. METHODS: Thirty-six participants (undergraduate psychology students) were trained to competence on four simplified psychiatric diagnoses and allowed to practise their diagnostic skills on 12 prototypical case vignettes, for which feedback was provided. One-third of participants were tested immediately, one-third following a 24-hour delay, and one-third following a 1-week delay; all were tested on novel cases. Test cases were created to have two equiprobable diagnoses, both of which were supported by two novel symptom descriptions. However, one diagnosis was also supported by non-diagnostic patient information similar to information on a patient seen in the training phase. A deviation from an equal assignment of diagnostic probability, in support of the familiar patient information, demonstrates a reliance on the familiar, non-diagnostic information, and therefore indicates an instance model of reasoning. RESULTS: Participants assigned significantly higher diagnostic probability to the diagnosis cued by the familiar patient information (52.6%) than to the plausible alternative diagnosis (38.9%). Participants also reported a higher number of clinically relevant symptoms to support the diagnosis associated with the familiar patient information than to support the plausible alternative diagnosis. The influence of familiar patient identity was consistent across delay periods and cannot be accounted for by the forgetting of diagnostic rules. CONCLUSIONS: Participants were clearly relying on familiar patient identity information as evidenced by their diagnostic conclusions and differential reporting of clinically relevant features. These results support an instance model of reasoning which is not limited by whole case similarity or similarity of diagnostic information.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,663 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».