Laypeople's Views on Decision Making in the Health Professions

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2009-06

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The Ohio State University

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Abstract

Although actuarial judgment (AJ) is often superior to clinical judgment (CJ), it is underused in the health fields for decision making. One potential reason is that people would not like to be treated as statistics. This study investigates laypeople’s views about the use of AJ versus CJ. Manipulations include domain – a medical context or a psychological context – and perceived difficulty of a diagnosis on laypersons’ preference for either method. It is hypothesized that laypeople are biased against AJ in general. However there are many potential effects of varying context and difficulty. Therefore several possibilities are discussed. 82 Research Experience Program students participating for credit were randomly assigned to two groups in which all materials were presented in a medical or psychological context. Participants read unbiased definitions of AJ and CJ, then read scenarios where easy or difficult diagnoses were made by physicians or psychologists. After each scenario, participants indicated how appropriate it was for the professional to use CJ and AJ. Final questions further explored participants’ comfort levels with each method, and their views of health professionals and actuarial tool development. Results indicated significant interactions between style and difficulty on the rated appropriateness of AJ and CJ. After reading the easy scenario, participants were more in favor of CJ, but after the difficult scenario they rated AJ as more appropriate. Significant interactions between style and domain revealed that CJ was perceived as more appropriate in a psychological context, but appropriateness inverted in the medical context. In general, participants were more comfortable with CJ in both the medical and psychological groups. Finally, people perceived physicians as more knowledgeable than psychologists, and their decision making to be more rational. Possible factors influencing these views are discussed in the paper.

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judgment, decision making, psychology, medicine

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