The proposed research explores and characterizes expert and novice intensive care decision making within a clinical setting.
The aims are to construct process tracing models of the knowledge structure and heuristics of clinicians, to develop statistical models of their judgment and to compare these with process tracing models, to evaluate framing effects and other biases on decisions, and to study the calibrations of clinicians as a function of experience.
These aims are addressed in four studies whose objectives are related to the longer term goals of studying the knowledge structure and basis of human judgment in general and clinical reasoning in particular. The first set of two studies, on process tracing and statistical modeling, describes the subjects' decision strategies and weighting schemes; the second set of studies detects how these strategies and weightings are discrepant with normative theory. The proposed research has practical, methodological and theoretical implications for human judgment as well as for critical care decision making in that it addresses real-world problem solving activities using a multi-method approach that is generalizable to other decision and clinical choice environments.

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Research Project (R01)
Project #
5R01LM004583-03
Application #
3373840
Study Section
Biomedical Library Review Committee (BLR)
Project Start
1986-08-01
Project End
1989-07-31
Budget Start
1988-08-01
Budget End
1989-07-31
Support Year
3
Fiscal Year
1988
Total Cost
Indirect Cost
Name
University of Illinois at Chicago
Department
Type
Schools of Education
DUNS #
121911077
City
Chicago
State
IL
Country
United States
Zip Code
60612
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Bernstein, L M; Chapman, G B; Elstein, A S (1999) Framing effects in choices between multioutcome life-expectancy lotteries. Med Decis Making 19:324-38
Chapman, G B; Elstein, A S; Hughes, K K (1995) Effects of patient education on decisions about breast cancer treatments: a preliminary report. Med Decis Making 15:231-9
Bergus, G R; Chapman, G B; Gjerde, C et al. (1995) Clinical reasoning about new symptoms despite preexisting disease: sources of error and order effects. Fam Med 27:314-20
Chapman, G B; Elstein, A S (1995) Valuing the future: temporal discounting of health and money. Med Decis Making 15:373-86
Elstein, A S; Kleinmuntz, B; Rabinowitz, M et al. (1993) Diagnostic reasoning of high- and low-domain-knowledge clinicians: a reanalysis. Med Decis Making 13:21-9
Elstein, A S (1993) Beyond multiple-choice questions and essays: the need for a new way to assess clinical competence. Acad Med 68:244-9
Christensen, C; Cottrell, J J; Murakami, J et al. (1993) Forecasting survival in the medical intensive care unit: a comparison of clinical prognoses with formal estimates. Methods Inf Med 32:302-8
Elstein, A S; Holzman, G B; Belzer, L J et al. (1992) Hormonal replacement therapy: analysis of clinical strategies used by residents. Med Decis Making 12:265-73
Kleinmuntz, B (1992) Computers as clinicians: an update. Comput Biol Med 22:227-37

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