Dataset Information

Categorizing patients in a forced-choice triad task: the integration of context in patient management.

ABSTRACT:

Background

Studies of experts' problem-solving abilities have shown that experts can attend to the deep structure of a problem whereas novices attend to the surface structure. Although this effect has been replicated in many domains, there has been little investigation into such effects in medicine in general or patient management in particular.

Methodology/principal findings

We designed a 10-item forced-choice triad task in which subjects chose which one of two hypothetical patients best matched a target patient. The target and its potential matches were related in terms of surface features (e.g., two patients of a similar age and gender) and deep features (e.g., two diabetic patients with similar management strategies: a patient with arthritis and a blind patient would both have difficulty with self-injected insulin). We hypothesized that experts would have greater knowledge of management categories and would be more likely to choose deep matches. We contacted 130 novices (medical students), 11 intermediates (medical residents), and 159 experts (practicing endocrinologists) and 15, 11, and 8 subjects (respectively) completed the task. A linear mixed effects model indicated that novices were less likely to make deep matches than experts (t(68) = -3.63, p = .0006), while intermediates did not differ from experts (t(68) = -0.24, p = .81). We also found that the number of years in practice correlated with performance on diagnostic (r = .39, p = .02), but not management triads (r = .17, p = .34).

Conclusions

We found that experts were more likely than novices to match patients based on deep features, and that this pattern held for both diagnostic and management triads. Further, management and diagnostic triads were equally salient for expert physicians suggesting that physicians recognize and may create management-oriented categories of patients.

SUBMITTER: Devantier SL

PROVIDER: S-EPMC2690657 | biostudies-literature | 2009 Jun

REPOSITORIES: biostudies-literature

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Publications

Categorizing patients in a forced-choice triad task: the integration of context in patient management.

Devantier Sarah L SL Minda John Paul JP Goldszmidt Mark M Haddara Wael W

PloS one 20090611 6

<h4>Background</h4>Studies of experts' problem-solving abilities have shown that experts can attend to the deep structure of a problem whereas novices attend to the surface structure. Although this effect has been replicated in many domains, there has been little investigation into such effects in medicine in general or patient management in particular.<h4>Methodology/principal findings</h4>We designed a 10-item forced-choice triad task in which subjects chose which one of two hypothetical patie ...[more]

PMID: 19516910

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Project description:This pilot study aimed at implementing a new food picture database in the context of functional magnetic resonance imaging (fMRI) cognitive food-choice task, with an internal conflict or not, in healthy normal-weight adults. The database contains 170 photographs including starters, main courses, and desserts; it presents a broad-spectrum of energy content and is provided with portion weight and nutritional information. It was tested in 16 participants who evaluated the energy density and gave a liking score for all food pictures via numerical scales. First, volunteers were segregated into two groups according to their eating habits according to a food consumption frequency questionnaire (FCFQ) to assess whether the database might elicit different appreciations according to individual eating habits. Second, participants underwent fMRI cognitive food-choice task (van der Laan et al., 2014), using our picture database, in which they had to choose between high-energy (HE) and low-energy (LE) foods, under a similar liking (SL, foods with similar hedonic appraisals) condition or a different liking (DL, foods with different hedonic appraisals) condition. Participants evaluated correctly the caloric content of dishes (from r = 0.72 to r = 0.79, P < 0.001), confirming a good perception of the caloric discrepancies between food pictures. Two subgroups based on FCFQ followed by a principal component analysis (PCA) and a hierarchical ascendant classification (HAC) were defined, that is, Prudent-type (PTc, N = 9) versus Western-type (WTc, N = 7) consumers, where the WTc group showed higher consumption of HE palatable foods than PTc (P < 0.05). The WTc group showed a higher correlation between liking and caloric evaluation of the food pictures as compared to PTc (r = 0.77 and r = 0.36, respectively, P < 0.001), confirming that food pictures elicited variable responses according to contrasted individual eating habits. The fMRI analyses showed that the DL condition elicited the activation of dorsal anterior cingulate cortex (dACC), involved in internal conflict monitoring, whereas SL condition did not, and that LE food choice involved high-level cognitive processes with higher activation of the hippocampus (HPC) and fusiform gyrus compared to HE food choice. Overall, this pilot study validated the use of the food picture database and fMRI-based procedure assessing decision-making processing during a food choice cognitive task with and without internal conflict.

Dataset Information

Categorizing patients in a forced-choice triad task: the integration of context in patient management.

Background

Methodology/principal findings

Conclusions

Publications

Categorizing patients in a forced-choice triad task: the integration of context in patient management.

Similar Datasets

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