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Initial diagnostic hypotheses bias analytic information processing in non‐visual domains

2008· article· en· W2061155967 on OpenAlexaff
Kevin McLaughlin, Laura Heemskerk, Robert J. Herman, Martha Ainslie, Remy M. J. P. Rikers, Henk G. Schmidt

Bibliographic record

VenueMedical Education · 2008
Typearticle
Languageen
FieldMedicine
TopicClinical Reasoning and Diagnostic Skills
Canadian institutionsUniversity of Calgary
Fundersnot available
KeywordsMedical diagnosisConfidence intervalSelection (genetic algorithm)DebiasingStatistical hypothesis testingInformation processingAlternative hypothesisMedicinePsychologyCognitive psychologyStatisticsMathematicsSocial psychologyArtificial intelligenceComputer scienceRadiologyInternal medicine

Abstract

fetched live from OpenAlex

CONTEXT: Previous studies have shown that an initial diagnostic hypothesis biases automatic information processing. It is unclear if an initial hypothesis has a similar effect on analytic information processing. Our first objective was to study the effect of an initial diagnostic hypothesis on analytic processing. Our second objective was to assess the effect of clinical experience on analytic processing by evaluating the effect of clinical frequency and urgency of an alternative diagnosis on diagnosis selection. METHODS: During a 12-minute objective structured clinical examination station, 19 subspecialty medical residents diagnosed the cause of 3 clinical presentations: dyspnoea; headache, and chest pain. Subjects were randomly allocated cases for which the suggested initial hypothesis was either correct or incorrect. For cases with an incorrect initial hypothesis, the alternative diagnoses varied in the frequency with which they are encountered in clinical practice, and their clinical urgency, relative to the initial diagnostic hypothesis. RESULTS: All correct initial hypotheses were retained, compared with 10.9% of incorrect hypotheses. All cases with a correct initial hypothesis were diagnosed correctly, compared with 65.2% of cases with an incorrect hypothesis (risk ratio 1.5 [95% confidence interval 1.2-1.9], P = 0.02). Clinical frequency and urgency were not associated with alternative diagnosis selection. DISCUSSION: Our results suggest that an initial diagnostic hypothesis biases analytic processing. The data used to reject an initial hypothesis appear to drive selection of an alternative hypothesis. Further studies aimed at finding strategies for increasing the likelihood of generating a correct initial hypothesis or debiasing an initial hypothesis are needed.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.018
metaresearch head score (Gemma)0.231
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.018
Threshold uncertainty score0.098

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0180.231
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0010.003
Scholarly communication0.0030.003
Open science0.0010.002
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0040.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.034
GPT teacher head0.387
Teacher spread0.352 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations19
Published2008
Admission routes1
Has abstractyes

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