Psychological cue use and implications for a clinical decision support system

Christopher Buckingham*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Effective clinical decision making depends upon identifying possible outcomes for a patient, selecting relevant cues, and processing the cues to arrive at accurate judgements of each outcome's probability of occurrence. These activities can be considered as classification tasks. This paper describes a new model of psychological classification that explains how people use cues to determine class or outcome likelihoods. It proposes that clinicians respond to conditional probabilities of outcomes given cues and that these probabilities compete with each other for influence on classification. The model explains why people appear to respond to base rates inappropriately, thereby overestimating the occurrence of rare categories, and a clinical example is provided for predicting suicide risk. The model makes an effective representation for expert clinical judgements and its psychological validity enables it to generate explanations in a form that is comprehensible to clinicians. It is a strong candidate for incorporation within a decision support system for mental-health risk assessment, where it can link with statistical and pattern recognition tools applied to a database of patients. The symbiotic combination of empirical evidence and clinical expertise can provide an important web-based resource for risk assessment, including multi-disciplinary education and training.

Original languageEnglish
Pages (from-to)237-251
Number of pages15
JournalMedical Informatics and the Internet in Medicine
Volume27
Issue number4
DOIs
Publication statusPublished - Dec 2002

Fingerprint

Clinical Decision Support Systems
Cues
Psychology
Psychological Models
Suicide
Mental Health
Databases
Education

Keywords

  • base-rates
  • classification
  • clinical decision support systems
  • cues
  • mental health
  • risk assessment

Cite this

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