Outcome bias and cognitive dissonance in evaluating treatment decisions

Gruppen, Larry D.; Margolin, Jonathan; Wisdom, Kimberlydawn; Grum, Cyril M.

doi:10.1097/00001888-199410000-00042

Cited by 50 publications

(25 citation statements)

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“…Therefore, continuing medical education programs focusing in statistical concepts and reasoning may mitigate the probability judgment biases of residents (34, 35). Furthermore, specific instruction aimed at increasing awareness of the gambler’s fallacy may reduce residents’ susceptibility to this bias (35–37). …”

Section: Discussionmentioning

confidence: 99%

Assessment of cognitive biases and biostatistics knowledge of medical residents: a multicenter, cross-sectional questionnaire study

Msaouel

Kappos

Tasoulis

et al. 2014

Medical Education Online

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PurposeThe aim of this study is to determine the perceived familiarity of medical residents with statistical concepts, assess their ability to integrate these concepts in clinical scenarios, and investigate their susceptibility to the gambler’s fallacy and the conjunction fallacy.MethodsA multi-institutional, cross-sectional survey of Greek medical residents was performed. Participants were asked to indicate their familiarity with basic statistical concepts and answer clinically oriented questions designed to assess their biostatistics knowledge and cognitive biases. Univariate, bivariate, and multivariate statistical models were used for the evaluation of data.ResultsOut of 153 respondents (76.5% response rate), only two participants (1.3%) were able to answer all seven biostatistics knowledge questions correctly while 29 residents (19%) gave incorrect answers to all questions. The proportion of correct answers to each biostatistics knowledge question ranged from 15 to 51.6%. Residents with greater self-reported familiarity were more likely to perform better on the respective knowledge question (all p<0.01). Multivariate analysis of the effect of individual resident characteristics on questionnaire performance showed that previous education outside Greece, primarily during medical school, was associated with lower biostatistics knowledge scores (p<0.001). A little more than half of the respondents (54.2%) answered the gambler’s fallacy quiz correctly. Residents with higher performance on the biostatistics knowledge questions were less prone to the gambler’s fallacy (odds ratio 1.38, 95% confidence intervals 1.12–1.70, p=0.003). Only 48 residents (31.4%) did not violate the conjunction rule.ConclusionsA large number of medical residents are unable to correctly interpret crucial statistical concepts that are commonly found in the medical literature. They are also especially prone to the gambler’s fallacy bias, which may undermine clinical judgment and medical decision making. Formalized systematic teaching of biostatistics during residency will be required to de-bias residents and ensure that they are proficient in understanding and communicating statistical information.

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Section: Discussionmentioning

confidence: 99%

Assessment of cognitive biases and biostatistics knowledge of medical residents: a multicenter, cross-sectional questionnaire study

Msaouel

Kappos

Tasoulis

et al. 2014

Medical Education Online

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“…It is not uncommon to study decision making by haying participants evaluate others' behavior, in both non-medical (Baron, 1994) and medical domains (Gruppen et al, 1994). The sunk cost literature has failed to fi nd differences in participants' judgments depending on whether they are asked to make decisions themselves or to evaluate another's decisions (Arkes and Blumer, 1985;Bornstein and Chapman, 1994).…”

Section: Materials and Designmentioning

confidence: 99%

“…Medical decision making research has sought to uncover some of the parallels between cognitive biases which exist in the non-medical world and in the medical world (Detmer et al, 1978;Elstein et al, 1978;Dawson and Arkes, 1987;Elstein, 1988; for an inventory of medical decision-making biases, see Hershberger et al, 1994). Some of the biases that have been shown to infl uence medical judgment include the omission bias (Asch et al, 1994), availability bias (Poses and Anthony, 1991), hindsight bias (Arkes et al, 1981;Dawson et al, 1988), a bias to ignore negative evidence when attempting to synthesize information (Mazur and Hickam, 1990), framing effects (McNeil et al, 1984) and outcome bias (Gruppen et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

Rationality in medical treatment decisions: is there a sunk-cost effect?

Bornstein

Emler

Chapman

1999

Social Science & Medicine

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“…In most circumstances, the degree of this unwanted experience will further increase as most healthcare seekers will subsequently encounter a situation of ambiguity, whereby information on the suitable treatment is not available to them. This is supported by Gruppen et al (1994) 17 as it was found that for many treatment choices, consumers often confront a lack of accessible and medically sound information that would enable them to rationally weigh the benefits and drawback of medical procedures, causing them to be in a state of ambiguity or uncertainty and thereby resulting in higher levels of cognitive dissonance. Nevertheless, Gates (1996) 18 suggests that patients may be more exposed to the benefits of medical procedures.…”

Section: The Salient Issuesmentioning

confidence: 98%

Healthcare marketing: Contemporary salient issues and future research directions

Lim

Ting

2012

International Journal of Healthcare Management

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The purpose of this paper is to discern the current salient issues in healthcare marketing by looking at the perspective of healthcare consumers and providers, and providing a scope of marketing prospects and opportunities for healthcare improvement as an avenue for future research, as well as guiding how scholars could obtain relevant healthcare data which may be useful for future write-ups on the subject. A review of existing journals in the healthcare and marketing scholarship under the ERA 2010 List of Journals was conducted. We examine the salient issues in healthcare marketing from the patient and healthcare provider perspective. Following the review, we examine what future research is required to solve these issues. Notably, salient issues concerning patients revolve around healthcare quality, dissatisfaction, cognitive dissonance, anxiety, ambiguity or uncertainty, and the lack of control, and the concerns of healthcare providers were in terms of mutation of medical focus, rising cost of medical procedures, and escalading numbers of healthcare providers. Our findings indicate six areas of future research to overcome the identified salient issues -improving patient satisfaction, identifying trends in satisfaction-loyalty relations, effective targeting, health promotion, medical tourism, and looking beyond the brick and mortar context for possible healthcare marketing solutions.

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Outcome bias and cognitive dissonance in evaluating treatment decisions

Cited by 50 publications

References 0 publications

Assessment of cognitive biases and biostatistics knowledge of medical residents: a multicenter, cross-sectional questionnaire study

Assessment of cognitive biases and biostatistics knowledge of medical residents: a multicenter, cross-sectional questionnaire study

Rationality in medical treatment decisions: is there a sunk-cost effect?

Healthcare marketing: Contemporary salient issues and future research directions

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