Vignette-based methodologies are frequently used to examine judgments and decision-making processes, including clinical judgments made by health professionals. Concerns are sometimes raised that vignettes do not accurately reflect “real world” phenomena, and that this affects the validity of results and conclusions of these studies. This article provides an overview of the defining features, design variations, strengths, and weaknesses of vignette studies as a way of examining how health professionals form clinical judgments (e.g., assigning diagnoses, selecting treatments). As a “hybrid” of traditional survey and experimental methods, vignette studies can offer aspects of both the high internal validity of experiments and the high external validity of survey research in order to disentangle multiple predictors of clinician behavior. When vignette studies are well designed to test specific questions about judgments and decision-making, they can be highly generalizable to “real life” behavior, while overcoming the ethical, practical, and scientific limitations associated with alternative methods (e.g., observation, self-report, standardized patients, archival analysis). We conclude with methodological recommendations and a description of how vignette methodologies are being used to investigate clinicians’ diagnostic decisions in case-controlled field studies for the ICD-11 classification of mental and behavioural disorders, and how these studies illustrate the preceding concepts and recommendations
Children with autism spectrum disorder (ASD) may be at increased risk for overweight and obesity, but little information is known about correlates of overweight and obesity in this population. This study compared prevalence rates of parent-reported overweight and obesity and specific health behaviors (i.e., parent report of child sleep, family meal patterns, child screen time, and child physical activity) among children with ASD (N = more than 900 [weighted to represent 690,000; age 10-17]) compared with children without ASD using data from a nationally representative sample. Additionally, the relationship between specific health behaviors (i.e., child sleep, family meals, screen time, and physical activity) and weight status was examined in the ASD population. Data were from the National Survey of Children's Health 2011-2012. Results indicate that children with ASD were more likely to be obese but not more likely to be overweight than non-ASD youth. Children with ASD engaged in physical activity less than children without ASD, but no differences were found on sleep, most measures of screen time, and mealtimes. However, parent perceived poorer sleep was associated with increased weight status, and fewer family meals were associated with normal weight status among children with ASD.
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