The appropriateness of confidence ratings in clinical judgment

Abstract

Studies are reviewed in which clinicians made judgments (e.g., diagnoses) and then rated the degree of confidence that they had in each of their judgments. Clinicians are generally thought to be overconfident and unable to specify correctly which of their judgments are most likely to be valid. However, a comprehensive review of the confidence literature reveals little support for the hypothesis that clinicians are overconfident. Also, confidence ratings were related positively to the validity of judgments in a number of studies. Finally, experienced clinicians tended to make more appropriate confidence ratings than did inexperienced judges.

Confidence and accuracy in assessments of short-term risks presented by forensic psychiatric patients

“…Rabinowitz & Garelik-Wyler, 1999). Garb (1986), for example, argued that 'The greater the degree of confidence a clinician has in a judgment, the more heavily that judgment will be weighed when the clinician makes a treatment decision ' (p. 194).…”

Does an Interactive, Teleconference-Delivered, Palliative Care Lecture Series Improve Nursing Home Staff Confidence?

“…It has been shown in previous studies that clinician confidence ratings are related positively to the validity of judgments. 10 Previous work highlighted confidence improvements in staff following ECHO-delivered training. 9 Our research reaffirms this benefit.…”

The (In)visibility of Psychodiagnosticians' Expertise

“…We had also expected calibration to be poorer for experienced clinicians, who we predicted to be overconfident in their choices (Einhorn & Hogarth, ; Friedlander & Phillips, ; Garb, ). In fact, both groups showed the same level of overconfidence (see Supporting Information for details).…”

“…Calculations of diagnostic accuracy on a group level may therefore be misleading (see Limitations in the Supporting Information). We had also expected calibration to be poorer for experienced clinicians, who we predicted to be overconfident in their choices (Einhorn & Hogarth, 1978;Friedlander & Phillips, 1984;Garb, 1986). In fact, both groups showed the same level of overconfidence (see Supporting Information for details).…”