Clinical Problem Solving and Diagnostic Decision Making: A Selective Review of the Cognitive Research Literature

The Evidence Base of Clinical Diagnosis: Theory and methods of diagnostic research: Second Edition

Volumn , Issue , 2009, Pages 237-255

  Schwartz, Alan ^a   Elstein, Arthur S ^a  

^a UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

Author keywords

Decision making diagnosis as opinion revision; Hypothesis generation and restructuring errors; Hypothesis generation and selective data collection; Hypothetico deductive method; Pattern recognition or categorization; Probability estimation errors; Problem solving diagnosis as hypothesis selection; Problem solving research and ill structured problem situation; Support theory

Indexed keywords

EID: 73549095592     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1002/9781444300574.ch12     Document Type: Chapter

References (86)

1. Newell A, Simon HA. Human problem solving. Englewood Cliffs (NJ): Prentice-Hall; 1972.
2. Elstein AS, Shulman LS, Sprafka SA. Medical problem solving: an analysis of clinical reasoning. Cambridge (MA): Harvard University Press; 1978.
3. Bordage G, Lemieux M. Semantic structures and diagnostic thinking of experts and novices. Acad Med. 1991;66(9 Suppl):S70-S72.
4. Bordage G, Zacks R. The structure of medical knowledge in the memories of medical students and general practitioners: categories and prototypes. Med Educ. 1984;18:406-16.
5. Schmidt HG, Norman GR, Boshuizen HPA. A cognitive perspective on medical expertise: theory and implications. Acad Med. 1990;65:611-21.
6. Friedman MH, Connell KJ, Olthoff AJ. Medical student errors in making a diagnosis. Acad Med. 1998;73(10 Suppl):S19-S21.
7. Kahneman D, Slovic P, Tversky A, eds. Judgment under uncertainty: heuristics and biases. New York: Cambridge University Press; 1982.
8. Baron J. Thinking and deciding. New York: Cambridge University Press; 1988.
9. Mellers BA, Schwartz A, Cooke ADJ. Judgment and decision making. Annu Rev Psychol. 1998;49:447-77.
10. Hunink M, Glasziou P, Siegel JE, et al. Decision making in health and medicine: integrating evidence and values. Cambridge: Cambridge University Press; 2001.
11. Sox HC, Jr, Blatt MA, Higgins MC, et al. Medical decision making. Stoneham (MA): Butterworths; 1988.
12. Stanovich KE, West RF. Individual differences in reasoning: Implications for the rationality debate? Behav and Brain Sci. 2000;23(5):645-26.
13. Kahneman D. Maps of bounded rationality: a perspective on intuitive judgment and choice. In: Frangsmyr T, ed. Les Prix Nobel. The Nobel Prizes 2002. Stockholm: Almqvist & Wiksell International; 2003.
14. Hogarth RM. Deciding analytically or trusting your intuition? The advantages and disadvantages of analytic and intuitive thought. In: Betsch T, Haberstroh S, eds. The routines of decision making. Mahwah (NJ): Lawrence Erlbaum Associates; 2005. pp. 67-82.
15. Lee TH. Interpretation of data for clinical decisions. In: Goldman L, Ausiello D, eds. Cecil textbook of medicine. 22nd ed. Philadelphia: Saunders; 2004. p 25.
16. Panzer RJ, Black ER, Griner PF. Diagnostic strategies for common medical problems. Philadelphia: American College of Physicians; 1991.
17. Strauss SE, Richardson WS, Glasziou P, et al. Evidence-based medicine: how to practice and teach EBM. 3rd ed. New York: Churchill Livingstone; 2005.
18. Chapman GB, Bergus GR, Elstein AS. Order of information affects clinical judgment. J Behav Decis Making. 1996;9:201-11.
19. Moskowitz AJ, Kuipers BJ, Kassirer JP. Dealing with uncertainty, risks, and tradeoffs in clinical decisions: a cognitive science approach. Ann Intern Med. 1988;108:435-49.
20. Kassirer JP, Kopelman RI. Learning clinical reasoning. Baltimore:Williams &Wilkins, 1991.
21. Joseph GM, Patel VL. Domain knowledge and hypothesis generation in diagnostic reasoning. Med Decis Making. 1990;10:31-46.
22. Patel VL, Groen G. Knowledge-based solution strategies in medical reasoning. Cogn Sci. 1986;10:91-116.
23. Wigton RS, Hoellerich VL, Patil KD. How physicians use clinical information in diagnosing pulmonary embolism: an application of conjoint analysis. Med Dec Making. 1986;6:2-11.
24. Groen GJ, Patel VL. Medical problem-solving: some questionable assumptions. Med Educ. 1985;19:95-100.
25. Brooks LR, Norman GR, Allen SW. Role of specific similarity in a medical diagnostic task. J Exp Psych: Gen. 1991;120:278-87.
26. Eva KW, Neville AJ, Norman GR. Exploring the etiology of content specificity: factors influencing analogic transfer and problem solving. Acad Med. 1998;73(10 Suppl):S1-S5.
27. Elstein AS, Kleinmuntz B, Rabinowitz M, et al. Diagnostic reasoning of high-and low-domain knowledge clinicians: a re-analysis. Med Decis Making. 1993;13:21-9.
28. Davidoff F. Who has seen a blood sugar? Reflections on medical education. Philadelphia: American College of Physicians, 1998.
29. Medin DL, Schaffer MM. A context theory of classification learning. Psychol Rev. 1978;85:207-38.
30. Norman GR, Coblentz CL, Brooks LR, et al. Expertise in visual diagnosis: a review of the literature. Acad Med. 1992;66:S78-S83.
31. Rosch E, Mervis CB. Family resemblances: studies in the internal structure of categories. Cogn Psychol. 1975;7:573-605.
32. Lemieux M, Bordage G. Propositional versus structural semantic analyses of medical diagnostic thinking. Cogn Sci. 1992;16:185-204.
33. Reyna VF, Lloyd FJ, Brainerd CJ. Memory, development, and rationality: an integrative theory of judgment and decision-making. In: Schneider S, Shanteau J, eds. Emerging perspectives on judgment and decision research. Cambridge: Cambridge University Press; 2003. pp. 201-45.
34. Reyna VF. How people make decisions that involve risk. a dual-processes approach. Curr Dir Psychol Sci. 2004;13(2):60-66.
35. Elstein AS. What goes around comes around: the return of the hypotheticodeductive strategy. Teach Learn Med. 1994;6:121-23.
36. Bordage G. Why did I miss the diagnosis? some cognitive explanations and educational implications. Acad Med. 1999;74:S138-S42.
37. Janis IL, Mann L. Decision-making. New York: Free Press; 1977.
38. Anderson RC, Pichert JW. Recall of previously unrecallable information following a shift in perspective. J Verb Learning Verb Behav. 1978;17:1-12.
39. Bartlett FC. Remembering: a study in experimental and social psychology. New York: Macmillan; 1932.
40. Hurwitz B, Greenhalgh T, eds. Narrative based medicine: dialogue and discourse in clinical practice. London: BMJ Books; 1998.
41. Charon R. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA. 2001;286(15):1897-902.
42. Sackett DL, Haynes RB, Guyatt GH, et al. Clinical epidemiology: a basic science for clinical medicine. 2nd ed. Boston: Little, Brown; 1991.
43. Knottnerus JA. Application of logistic regression to the analysis of diagnostic data. Med Decis Making. 1992;12:93-108.
44. Ebell MH. Using decision rules in primary care practice. Prim Care. 1995;22:319-40.
45. Meehl PE. Clinical versus statistical prediction: A theoretical analysis and review of the evidence. Minneapolis: University of Minnesota Press; 1954.
46. James PA, Cowan TM, Graham RP, et al. Family physicians' attitudes about and use of clinical practice guidelines. J Fam Pract. 1997;45:341-47.
47. Cabana MD, Rand CS, Powe NR, et al. Why don't physicians follow clinical practice guidelines? a framework for improvement. JAMA. 1999;282(15):1458-65.
48. Hayward R,Wilson MC, Tunis SR, et al. Users' guides to the medical literature. VIII: how to use clinical practice guidelines, A: are the recommendations valid? JAMA. 1995;274:70-74.
49. Wilson MC, Hayward R, Tunis SR, et al. Users' guides to the medical literature. VIII: how to use clinical practice guidelines, B: what are the recommendations and will they help me in caring for my patient? JAMA. 1995;274:1630-32.
50. Col NF, Eckman MH, Karas RH, et al. Patient-specific decisions about hormone replacement therapy in postmenopausal women. JAMA. 1997;277:1140-47.
51. Kempainen RR, Migeon MB, Wolf FM. Understanding our mistakes: a primer on errors in clinical reasoning. Med Teach. 2003;25(2):177-81.
52. Tversky A, Kahneman D. Judgment under uncertainty: heuristics and biases. Science. 1974;185:1124-31.
53. Elstein AS. Heuristics and biases: selected errors in clinical reasoning. Acad Med. 1999;74:791-94.
54. Eddy DM. Probabilistic reasoning in clinical medicine: problems and opportunities. In: Kahneman D, Slovic P, Tversky A, eds. Judgment under uncertainty: heuristics and biases. New York: Cambridge University Press; 1982. pp. 249-67.
55. Dawes, RM. Rational choice in an uncertain world. New York: Harcourt Brace Jovanovich; 1988.
56. Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science. 1982;211:453-58.
57. Tversky A, Kahneman D. Advances in prospect theory: cumulative representation of uncertainty. J Risk Uncertain. 1992;5:297-323.
58. Fischhoff B, Bostrom A, Quadrell MJ. Risk perception and communication. Annu Rev Pub Health. 1993;14:183-203.
59. Einhorn HJ, Hogarth RM. Decision making under ambiguity. J Bus. 1986;59(Suppl):S225-S50.
60. Dolan JG, Bordley DR, Mushlin AI. An evaluation of clinicians' subjective prior probability estimates. Med Decis Making. 1983;6:216-23.
61. Tversky A, Koehler DJ. Support theory: a nonextensional representation of subjective probability. Psychol Rev. 1994;101:547-67.
62. Rottenstreich Y, Tversky A. Unpacking, repacking, and anchoring: advances in support theory. Psychol Rev. 1997;104:406-15.
63. Redelmeier DA, Koehler DJ, Liberman V, Tversky A. Probability judgment in medicine: discounting unspecified probabilities. Med Decis Making. 1995;15:227-30.
64. Wolf FM, Gruppen LD, Billi JE. Differential diagnosis and the competing hypotheses heuristic: A practical approach to judgment under uncertainty and Bayesian probability. JAMA. 1985;253:2858-62.
65. Gruppen LD, Wolf FM, Billi JE. Information gathering and integration as sources of error in diagnostic decision making. Med Decis Making. 1991;11:233-39.
66. EdwardsW. Conservatism in human information processing. In: Kleinmuntz B, ed. Formal representation of human judgment. New York, Wiley; 1969. pp. 17-52.
67. Kern L, Doherty ME. "Pseudodiagnosticity" in an idealized medical problem-solving environment. J Med Educ. 1982;57:100-104.
68. Hatala R, Norman GR, Brooks LR. Influence of a single example on subsequent electrocardiogram interpretation. Teach Learn Med. 1999;11:110-17.
69. Wason PC, Johnson-Laird PN. Psychology of reasoning: structure and content. Cambridge (MA): Harvard University Press; 1972.
70. Wallsten TS. Physician and medical student bias in evaluating information. Med Decis Making. 1981;1:145-64.
71. Poses RM, Cebul RD, Collins M, et al. The accuracy of experienced physicians' probability estimates for patients with sore throats. JAMA. 1985;254:925-29.
72. Bergus GR, Chapman GB, Gjerde C, et al. Clinical reasoning about new symptoms in the face of pre-existing disease: sources of error and order effects. Fam Med. 1995;27:314-20.
73. Gigerenzer G, Todd PM, ABC Research Group. Simple heuristics that make us smart. Oxford: Oxford University Press; 1999.
74. Barrows HS. Problem-based, self-directed learning. JAMA. 1983;250:3077-80.
75. Barrows HS. A taxonomy of problem-based learning methods. Med Educ. 1986;20:481-86.
76. Schmidt HG. Problem-based learning: rationale and description. Med Educ. 1983;17:11-16.
77. Norman GR. Problem-solving skills, solving problems and problem-based learning. Med Educ. 1988;22:279-86.
78. Gruppen LD. Implications of cognitive research for ambulatory care education. Acad Med. 1997;72:117-20.
79. Gruppen L, Frohna A. Clinical reasoning. In: Norman G, Van Der Vleuten C, Newble D, eds. International handbook of research in medical education. The Netherlands: Kluwer Academic Publishers; 2002. pp. 205-30.
80. Ludmerer KM. Time to heal: American medical education from the turn of the century to the era of managed care. New York: Oxford University Press, 1999.
81. Heneghan C, Badenoch D. Evidence-based medicine toolkit. 2nd ed. London: BMJ Books; 2006.
82. Fagan TJ. Nomogram for Bayes's theorem [letter]. N Engl J Med. 1975;293:257.
83. Schwartz A. Nomogram for Bayes's theorem. Available at: http://araw.mede. uic.edu/cgi-bin/testcalc.pl.
84. Lloyd FJ, Reyna VF. A web exercise in evidence-based medicine using cognitive theory. J Gen Int Med. 2001;16(2):94-99.
85. Eva KW. What every teacher needs to know about clinical reasoning. Med Educ 2005;39(1):98-106.
86. Norman G. Research in clinical reasoning: past history and current trends. Med Educ.2005;39(4):418-27.