Rational decision making in medicine: Implications for overuse and underuse

Journal of Evaluation in Clinical Practice

Volumn 24, Issue 3, 2018, Pages 655-665

  Djulbegovic, Benjamin ^a   Elqayam, Shira ^b   Dale, William ^a  

^a CITY OF HOPE NATIONAL MEDICAL CENTER   (United States)

^b DE MONTFORT UNIVERSITY   (United Kingdom)

Author keywords

clinical decision making; health policy; overtreatment; overuse; practice; rationality; undertreatment; underuse

Indexed keywords

ARTICLE; CAUSE OF DEATH; CLINICAL DECISION MAKING; CLINICAL PRACTICE; EVIDENCE BASED MEDICINE; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH CARE UTILIZATION; HEALTH SERVICE; HUMAN; PATIENT CARE; PRACTICE GUIDELINE; PRIORITY JOURNAL; DECISION THEORY; UTILIZATION;

CLINICAL DECISION-MAKING; DECISION THEORY; EVIDENCE-BASED MEDICINE; HEALTH POLICY; HEALTH SERVICES; HEALTH SERVICES MISUSE; HUMANS;

EID: 85036580333     PISSN: 13561294     EISSN: 13652753     Source Type: Journal    
DOI: 10.1111/jep.12851     Document Type: Article

References (103)

1. IOM (Institute of Medicine). Delivering High-Quality Cancer Care: Charting A New Course for A System in Crisis. Washington, DC: The National Academies Press; 2013.
2. IOM (Institute of Medicine). Variation in Health Care Spending: Target Decision Making, Not Geography. Washington, DC: The National Academies Press; 2013.
3. Berwick DM, Hackbarth AD. Eliminating waste in US health care. JAMA. 2012;307(14):1513-1516. https://doi.org/10.1001/jama.2012.362
4. Keeney R. Personal decisions are the leading cause of death. Oper Res. 2008;56(6):1335-1347. https://doi.org/10.1287/opre.1080.0588
5. Djulbegovic B. A framework to bridge the gaps between evidence-based medicine, health outcomes, and improvement and implementation science. J Oncol Pract. 2014;10(3):200-202. https://doi.org/10.1200/JOP.2013.001364
6. Cassel CK, Guest JA. Choosing wisely: helping physicians and patients make smart decisions about their care. JAMA. 2012;307(17):1801-1802. https://doi.org/10.1001/jama.2012.476
7. Djulbegovic B, Elqayam S. Many faces of rationality: implications of the great rationality debate for clinical decision-making. J Eval Clin Pract. 2017;23(5):915-922. https://doi.org/10.1111/jep.12788
8. Evans JSTBT, Over DE. Rationality and Reasoning. Hove: Psychology Press; 1996.
9. Stanovich KE. Rationality and the Reflective Mind. Oxford: Oxford University Press; 2011.
10. Baron J. Thinking and Deciding. 4th ed. Cambridge: Cambridge University Press; 2007.
11. Djulbegovic B, Guyatt GH, Ashcroft RE. Epistemologic inquiries in evidence-based medicine. Cancer Control. 2009;16(2):158-168. https://doi.org/10.1177/107327480901600208
12. Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet. 2017;390(10092):415-423. https://doi.org/10.1016/S0140-6736(16)31592-6
13. Guyatt GH, Oxman AD, Kunz R, et al. Going from evidence to recommendations. BMJ. 2008;336(7652):1049-1051. https://doi.org/10.1136/bmj.39493.646875.AE
14. Evans JSTBT. Thinking Twice. Two Minds in One Brain. Oxford: Oxford University Press; 2010.
15. Oaksford M, Chater N. Précis of Bayesian rationality: the probabilistic approach to human reasoning. Behav Brain Sci. 2009;32(1):69-84. discussion 85-120, https://doi.org/10.1017/S0140525X09000284
16. US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149(9):627-637. https://doi.org/10.7326/0003-4819-149-9-200811040-00243
17. Schwartz B. What does it mean to be a rational decision maker? J Market Behav. 2015;1(2):113-145. https://doi.org/10.1561/107.00000007
18. Schwartz B. What is rationality? J Market Behav. 2015;1(2):175-185. https://doi.org/10.1561/107.00000011
19. Elqayam S, Evans JSBT. Subtracting ‘ought’ from ‘is’: descriptivism versus normativism in the study of human thinking. Behav Brain Sci. 2011;34(05):233-248. https://doi.org/10.1017/S0140525X1100001X
20. Gigerenzer G, Brighton H. Homo heuristicus: why biased minds make better inferences. Top Cogn Sci. 2009;1(1):107-143. https://doi.org/10.1111/j.1756-8765.2008.01006.x
21. Gigerenzer G, Hertwig R, Pachur T, eds. Heuristics. The Foundation of Adaptive Behavior. New York: Oxford University Press; 2011, https://doi.org/10.1093/acprof:oso/9780199744282.001.0001.
22. Stanovich KE. Who Is Rational? Studies of Individual Differences in Reasoning. Mahway, NJ: Lawrence Elrbaum Associates; 1999.
23. Mercier H, Sperber D. Why do humans reason? Arguments for an argumentative theory. Behav Brain Sci. 2011;34(2):57-74. discussion 74-111, https://doi.org/10.1017/S0140525X10000968
24. Mercier H, Sperber D. The Enigma of Reason. Cambridge, MA: Harvard University Press; 2017.
25. Simon HA. A behavioral model of rational choice. Quart J Econom. 1955;69(1):99-118. https://doi.org/10.2307/1884852
26. Simon HA. Information processing models of cognition. Ann Review Psychol. 1979;30:263-296.
27. Katsikopoulos KV, Gigerenzer G. One-reason decision-making: modeling violations of expected utility theory. J Risk Uncert. 2008;37(1):35-56. https://doi.org/10.1007/s11166-008-9042-0
28. Baron J. Rationality and Intelligence. New York, NY: Cambridge University Press.; 1985, https://doi.org/10.1017/CBO9780511571275.
29. Elqayam S, Thompson VA, Wilkinson MR, Evans JS, Over DE. Deontic introduction: a theory of inference from is to ought. J Exp Psychol Learn Mem Cogn. 2015;41(5):1516-1532. https://doi.org/10.1037/a0038686
30. Gorawara-Bhat R, O'Muircheartaigh S, Mohile S, Dale W. Patients' perceptions and attitudes on recurrent prostate cancer and hormone therapy: qualitative comparison between decision-aid and control groups. J Geriatr Oncol. 2017;8(5):368-373. https://doi.org/10.1016/j.jgo.2017.05.006
31. Van den Bruel A, Thompson M, Buntinx F, Mant D. Clinicians' gut feeling about serious infections in children: observational study. BMJ. 2012;345:e6144(sep25 2). https://doi.org/10.1136/bmj.e6144
32. Stanovich KE. The Robot's Rebellion: Finding Meaning in The Age of Darwin. Chicago: Chicago University Press.; 2004, https://doi.org/10.7208/chicago/9780226771199.001.0001.
33. Elqayam S. Grounded rationality: descriptivism in epistemic context. Synthese. 2012;189(S1):39-49. https://doi.org/10.1007/s11229-012-0153-4
34. Stanovich KE. Meta-rationality in cognitive science. J Market Behav. 2015;1(2):147-156. https://doi.org/10.1561/107.00000009
35. Stanovich KE. Higher order preference and the master rationality motive. Think Reason. 2008;14(1):111-127. https://doi.org/10.1080/13546780701384621
36. Stanovich KE. Why humans are (sometimes) less rational than other animals: cognitive complexity and the axioms of rational choice. Think Reason. 2013;19(1):1-26. https://doi.org/10.1080/13546783.2012.713178
37. Zeelenberg M. Robust satisficing via regret minimization. J Market Behav. 2015;1(2):157-166. https://doi.org/10.1561/107.00000010
38. Zeelenberg M, Pieters R. A theory of regret regulation 1.0. J Consum Psychol. 2007;17(1):3-18. https://doi.org/10.1207/s15327663jcp1701_3
39. Zeelenberg M, Pieters R. A theory of regret regulation 1.1. J Consum Psychol. 2007;17:29-35.
40. Djulbegovic B, Tsalatsanis A, Mhaskar R, Hozo I, Miladinovic B, Tuch H. Eliciting regret improves decision making at the end of life. Eur J Cancer. 2016;68:27-37. https://doi.org/10.1016/j.ejca.2016.08.027
41. Hozo I, Djulbegovic B. When is diagnostic testing inappropriate or irrational? Acceptable regret approach. Med Decis Making. 2008;28(4):540-553. https://doi.org/10.1177/0272989X08315249
42. Hozo I, Djulbegovic B. Clarification and corrections of acceptable regret model. Med Decis Making. 2009;29:323-324.
43. Gigerenzer G. Full disclosure about cancer screening. BMJ. 2016;352:h6967. https://doi.org/10.1136/bmj.h6967
44. Djulbegovic B, Lyman G. Screening mammography at 40-49 years: regret or no regret? Lancet. 2006;368(9552):2035-2037. https://doi.org/10.1016/S0140-6736(06)69816-4
45. Djulbegovic B, van den Ende J, Hamm RM, Mayrhofer T, Hozo I, Pauker SG. When is rational to order a diagnostic test, or prescribe treatment: the threshold model as an explanation of practice variation. Eur J Clin Invest. 2015;45(5):485-493. https://doi.org/10.1111/eci.12421
46. Pauker SG, Kassirer J. The threshold approach to clinical decision making. N Engl J Med. 1980;302(20):1109-1117. https://doi.org/10.1056/NEJM198005153022003
47. Pauker SG, Kassirer JP. Therapeutic decision making: a cost-benefit analysis. N Engl J Med. 1975;293(5):229-234. https://doi.org/10.1056/NEJM197507312930505
48. Djulbegovic B, Hozo I, Beckstead J, Tsalatsanis A, Pauker SG. Dual processing model of medical decision-making. BMC Med Inform Decis Mak. 2012;12(1):94. https://doi.org/10.1186/1472-6947-12-94
49. Djulbegovic B, Hamm RM, Mayrhofer T, Hozo I, Van den Ende J. Rationality, practice variation and person-centred health policy: a threshold hypothesis. J Eval Clin Pract. 2015;21(6):1121-1124. https://doi.org/10.1111/jep.12486
50. Basinga P, Moreira J, Bisoffi Z, Bisig B, Van den Ende J. Why are clinicians reluctant to treat smear-negative tuberculosis? An inquiry about treatment thresholds in Rwanda. Med Decis Making. 2007;27(1):53-60. https://doi.org/10.1177/0272989X06297104
51. Elshaug AG, Rosenthal MB, Lavis JN, et al. Levers for addressing medical underuse and overuse: achieving high-value health care. Lancet. 390(10090):191-202. https://doi.org/10.1016/S0140-6736(16)32586-7
52. Djulbegovic B, Guyatt G. EBM and the theory of knowledge. In: Guyatt G, Meade M, Cook D, eds. Users' Guides to the Medical Literature: A Manual for Evidence-Based Clinical Practice. Boston: McGraw-Hill; 2014.
53. Djulbegovic B, Trikalinos TA, Roback J, Chen R, Guyatt G. Impact of quality of evidence on the strength of recommendations: an empirical study. BMC Health Serv Res. 2009;9(1):120. https://doi.org/10.1186/1472-6963-9-120
54. Djulbegovic B, Kumar A, Kaufman RM, Tobian A, Guyatt GH. Quality of evidence is a key determinant for making a strong GRADE guidelines recommendation. J Clin Epidemiol. 2015;68(7):727-732. https://doi.org/10.1016/j.jclinepi.2014.12.015
55. Alexander PE, Bero L, Montori VM, et al. World Health Organization recommendations are often strong based on low confidence in effect estimates. J Clin Epidemiol. 2014;67(6):629-634. https://doi.org/10.1016/j.jclinepi.2013.09.020
56. Fiedler K. Meta-cognitive myopia and the dilemmas of inductive-statistical inference. Psychol Learn Motivat - Adv Res Theory. 2012;57:1-55. https://doi.org/10.1016/B978-0-12-394293-7.00001-7
57. Djulbegovic B, Loughran TP Jr, Hornung CA, et al. The quality of medical evidence in hematology-oncology. Am J Med. 1999;106(2):198-205. https://doi.org/10.1016/S0002-9343(98)00391-X
58. Ebell MH, Sokol R, Lee A, Simons C, Early J. How good is the evidence to support primary care practice? Evid Based Med. 2017;22(3):88-92. https://doi.org/10.1136/ebmed-2017-110704
59. Altman D, Bland M. Absence of evidence is not evidence of absence. BMJ. 1995;311(7003):485. https://doi.org/10.1136/bmj.311.7003.485
60. US Preventive Service Task Force. Screening for breast cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:716-726.
61. Hozo I, Djulbegovic B. Will insistence on practicing medicine according to expected utility theory lead to an increase in diagnostic testing? Med Dec Making. 2009;29(3):320-322. https://doi.org/10.1177/0272989X09334370
62. Fontanarosa P, Bauchner H. Conflict of interest and medical journals. JAMA. 2017;317(17):1768-1771. https://doi.org/10.1001/jama.2017.4563
63. Alexander PE, Gionfriddo MR, Li SA, et al. A number of factors explain why WHO guideline developers make strong recommendations inconsistent with GRADE guidance. J Clin Epidemiol. 2016;70:111-122. https://doi.org/10.1016/j.jclinepi.2015.09.006
64. Djulbegovic B, Hozo I, Greenland S. Uncertainty in clinical medicine. In: Gifford F, ed. Philosophy of Medicine (Handbook of the Philosophy of Science). London: Elsevier; 2011:299-356.
65. Slovic P, Finucane ML, Peters E, MacGregor DG. Risk as analysis and risk as feelings: some thoughts about affect, reason, risk, and rationality. Risk Anal. 2004;24(2):311-322. https://doi.org/10.1111/j.0272-4332.2004.00433.x
66. Sunstein CR. Probability neglect: emotions, worst cases, and law. Yale Law J. 2002;112(1):61-107. https://doi.org/10.2307/1562234
67. Hsee CK, Rottenstreich Y. Music, pandas and muggers: on the affective psychology of value. J Exp Psychol. 2004;133(1):23-30. https://doi.org/10.1037/0096-3445.133.1.23
68. Pachur T, Hertwig R, Wolkewitz R. The affect gap in risky choice: affect-rich outcomes attenuate attention to probability information. Decision. 2013;1:64-78.
69. Hemmerich JA, Elstein AS, Schwarze ML, Moliski EG, Dale W. Risk as feelings in the effect of patient outcomes on physicians' subsequent treatment decisions: a randomized trial and manipulation validation. Soc Sci Med. 2012;75(2):367-376. https://doi.org/10.1016/j.socscimed.2012.03.020
70. Inman J. Regret regulation: disentagling self-reproach from learning. J Consum Psychol. 2007;17:19-24.
71. Connolly T, Zeelenberg M. Regret in decision making. Curr Dir Psychol Sci. 2002;11(6):212-216. https://doi.org/10.1111/1467-8721.00203
72. Djulbegovic B, Hozo I, Schwartz A, McMasters K. Acceptable regret in medical decision making. Med Hypotheses. 1999;53(3):253-259. https://doi.org/10.1054/mehy.1998.0020
73. Djulbegovic B, Paul A. From efficacy to effectiveness in the face of uncertainty indication creep and prevention creep. JAMA. 2011;305(19):2005-2006. https://doi.org/10.1001/jama.2011.650
74. Stanovich KE, West RF. Evolutionary Versus Instrumental Goals. How Evolutionary Psychology Misconceives Human Rationality. Hove, UK: Psychological Press; 2003.
75. Djulbegovic M, Beckstead J, Elqayam S, et al. Thinking styles and regret in physicians. PLoS One. 2015;10(8):e0134038):e0134038. https://doi.org/10.1371/journal.pone.0134038
76. Djulbegovic B, Elqayam S, Reljic T, et al. How do physicians decide to treat: an empirical evaluation of the threshold model. BMC Med Inform Decis Mak. 2014;14(1):47. https://doi.org/10.1186/1472-6947-14-47
77. Hume D. A Treatise on Human Nature (Original publication date 1739-1740). Oxford: Clarendon; 2000.
78. Djulbegovic B, Beckstead J, Nash DB. Human judgment and health care policy. Popul Health Manag. 2014;17(3):139-140. https://doi.org/10.1089/pop.2014.0027
79. Djulbegovic B, Lyman GH, Ruckdeschel J. Why evidence-based oncology. Evid-Based Oncol. 2000;1(1):2-5. https://doi.org/10.1054/ebon.1999.0003
80. https://www.nlm.nih.gov/pubs/factsheets/medline.html. MEDLINE fact sheet. 2016; https://www.nlm.nih.gov/pubs/factsheets/medline.html. Accessed April 20. 2016.
81. Bastian H, Glasziou P, Chalmers I. Seventy-five trials and eleven systematic reviews a day: how will we ever keep up? PLoS Med. 2010;7(9):e1000326):e1000326. https://doi.org/10.1371/journal.pmed.1000326
82. Hozo I, Djulbegovic B, Luan S, Tsalatsanis A, Gigerenzer G. Towards theory integration: threshold model as a link between signal detection theory, fast-and-frugal trees and evidence accumulation theory. J Eval Clin Pract. 2017;23(1):49-65. https://doi.org/10.1111/jep.12490
83. Kassirer JP. Our stubborn quest for diagnostic certainty. A cause of excessive testing. N Engl J Med. 1989;320(22):1489-1491. https://doi.org/10.1056/NEJM198906013202211
84. Tsalatsanis A, Hozo I, Djulbegovic B. Acceptable regret model in the end-of-life setting: patients require high level of certainty before forgoing management recommendations. Eur J Cancer. 2017;75:159-166. https://doi.org/10.1016/j.ejca.2016.12.025
85. Wentlandt K, Krzyzanowska MK, Swami N, Rodin GM, Le LW, Zimmermann C. Referral practices of oncologists to specialized palliative care. J Clin Oncol. 2012;30(35):4380-4386. https://doi.org/10.1200/JCO.2012.44.0248
86. Elqayam S, Wilkinson MR, Thompson VA, Over DE, Evans J. Utilitarian moral judgment exclusively coheres with inference from is to ought. Front Psychol. 2017;8:1042. https://doi.org/10.3389/fpsyg.2017.01042
87. Pirolli P. Rational analyses of information foraging on the web. Cognit Sci. 2005;29(3):343-373. https://doi.org/10.1207/s15516709cog0000_20
88. Pirolli P, Card S. Information foraging. Psychol Rev. 1999;106(4):643-675. https://doi.org/10.1037/0033-295X.106.4.643
89. IOM (Institute of Medicine). Dying in America: Improving Quality and Honoring Individual Preferences Near The End of Life. Washington, DC: The National Academies Press; 2015.
90. Gomes B, Higginson IJ, Calanzani N, et al. Preferences for place of death if faced with advanced cancer: a population survey in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. Ann Oncol. 2012;23(8):2006-2015. https://doi.org/10.1093/annonc/mdr602
91. Neumann PJ, Cohen JT, Weinstein MC. Updating cost-effectiveness—the curious resilience of the $50,000-per-QALY threshold. N Engl J Med. 2014;371(9):796-797. https://doi.org/10.1056/NEJMp1405158
92. Marseille E, Larson B, Kazi DS, Kahn JG, Rosen S. Thresholds for the cost-effectiveness of interventions: alternative approaches. Bull World Health Organ. 2015;93(2):118-124. https://doi.org/10.2471/BLT.14.138206
93. Djulbegovic B. Value-based cancer care and the excessive cost of drugs. JAMA Oncol. 2015;1(9):1301-1302. https://doi.org/10.1001/jamaoncol.2015.3302
94. Elqayam S. Grounded rationality: descriptivism in epistemic context. Synthese. 2012;189(S1):39-49. https://doi.org/10.1007/s11229-012-0153-4
95. Stich SP. The Fragmentation of Reason: Preface to A Pragmatic Theory of Cognitive Evaluation. Cambridge, Mass: MIT Press; 1990.
96. Institute of Medicine. Vital Signs: Core Metrics for Health and Health Care Progress. Washington, DC: The National Academies Press; 2015.
97. Brownlee S, Chalkidou K, Doust J, et al. Evidence for overuse of medical services around the world. Lancet. 390(10090):156-168. https://doi.org/10.1016/S0140-6736(16)32585-5
98. Glasziou P, Straus S, Brownlee S, et al. Evidence for underuse of effective medical services around the world. Lancet. 390(10090):169-177. https://doi.org/10.1016/S0140-6736(16)30946-1
99. Saini V, Brownlee S, Elshaug AG, Glasziou P, Heath I. Addressing overuse and underuse around the world. Lancet. 390(10090):105-107. https://doi.org/10.1016/S0140-6736(16)32573-9
100. Saini V, Garcia-Armesto S, Klemperer D, et al. Drivers of poor medical care. Lancet. 390(10090):178-190. https://doi.org/10.1016/S0140-6736(16)30947-3
101. Hammond KR. Human Judgment and Social Policy. Irreducible Uncertainty, Inevitable Error, Unavoidable Injustice. Oxford: Oxford University Press; 1996.
102. Hammond KR. Beyond rationality. The search for wisdom in a troubled time. Oxford: Oxford University Press; 2007.
103. Nickel B, Barratt A, Copp T, Moynihan R, McCaffery K. Words do matter: a systematic review on how different terminology for the same condition influences management preferences. BMJ Open. 2017;7(7):e014129. https://doi.org/10.1136/bmjopen-2016-014129