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Clinical Reasoning and Cognitive Processes

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  • John C. Hershey
  • Jonathan Baron

Abstract

Expected utility theory, and the Bayesian probability theory on which it is based, form the normative basis of most work in medical decision analysis. Recent work in the psychology of judgments and decisions indicates that people do not conform to the axioms of this theory and that these deviations occur in clinical reasoning as well as in the psychology laboratory. At issue is what to do now. The authors argue that the important next steps lie at the interface between descriptive, prescriptive, and normative accounts, all of which affect each other. They point to examples in which the simplest application of supposedly normative theory seems inappropriate, and suggest ways in which the tension between normative and de scriptive models may be resolved. Key words: decision analysis; expected utility theory; clinical reasoning; cognitive processes. (Med Decis Making 7:203-211, 1987)

Suggested Citation

  • John C. Hershey & Jonathan Baron, 1987. "Clinical Reasoning and Cognitive Processes," Medical Decision Making, , vol. 7(4), pages 203-211, December.
    • Handle: RePEc:sae:medema:v:7:y:1987:i:4:p:203-211
    DOI: 10.1177/0272989X8700700402
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    References listed on IDEAS

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    1. Jonathan Baron & Gerald B. Holzman & Jay Schulkin, 1998. "Attitudes of Obstetricians and Gynecologists toward Hormone Replacement Therapy," Medical Decision Making, , vol. 18(4), pages 406-411, October.
    2. David Faro & Yuval Rottenstreich, 2006. "Affect, Empathy, and Regressive Mispredictions of Others' Preferences Under Risk," Management Science, INFORMS, vol. 52(4), pages 529-541, April.
    3. Zeelenberg, M., 1999. "The use of crying over spilled milk : A note on the rationality and functionality of regret," Other publications TiSEM 66ac04be-d1ee-4a0e-9e97-7, Tilburg University, School of Economics and Management.
    4. Han Bleichrodt & Jose Luis Pinto & Peter P. Wakker, 2001. "Making Descriptive Use of Prospect Theory to Improve the Prescriptive Use of Expected Utility," Management Science, INFORMS, vol. 47(11), pages 1498-1514, November.
    5. Chen Li & Zhihua Li & Peter Wakker, 2014. "If nudge cannot be applied: a litmus test of the readers’ stance on paternalism," Theory and Decision, Springer, vol. 76(3), pages 297-315, March.
    6. Raisa B. Deber & Vivek Goel, 1990. "Using Explicit Decision Rules to Manage Issues of Justice, Risk, and Ethics in Decision Analysis," Medical Decision Making, , vol. 10(3), pages 181-194, August.
    7. Gurmankin Levy, Andrea & Hershey, John C., 2006. "Distorting the probability of treatment success to justify treatment decisions," Organizational Behavior and Human Decision Processes, Elsevier, vol. 101(1), pages 52-58, September.

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