Improving Fast and Frugal Modeling in Relation to Regression Analysis: Test of 3 Models for Medical Decision Making

Lars G. Backlund, Johan Bring, Ylva Skånér, Lars-Erik Strender and Henry Montgomery
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Lars G. Backlund: Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden
Johan Bring: Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden
Ylva Skånér: Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden
Lars-Erik Strender: Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden
Henry Montgomery: Center for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden

Medical Decision Making, 2009, vol. 29, issue 1, 140-148

Abstract: Background . A matching heuristic (MH) model of decision making has been evaluated previously in a series of studies on medical decision making. The authors' purpose is to evaluate an extended MH model that considers the prevalence of cue values. Methods . Data from 2 previous studies were reanalyzed, one on judgments regarding drug treatment of hyperlipidemia and the other on diagnosing heart failure. The original MH model and the extended MH model were compared with logistic regression (LR) in terms of fit to actual judgments, number of cues, and the extent to which the cues were consistent with clinical guidelines. Results . There was a slightly better fit with LR compared with MH. The extended MH model gave a significantly better fit than the original MH model in the drug treatment task. In the diagnostic task, the number of cues was significantly lower in the MH models compared to LR, whereas in the therapeutic task, LR could be less or more frugal than the matching heuristic models depending on the significance level chosen for inclusion of cues. For the original MH model, but not for the extended MH model or LR, the most important cues in the drug treatment task were often used in a direction contrary to treatment guidelines. Conclusions . The extended MH model represents an improvement in that prevalence of cue values is adequately taken into account, which in turn may result in better fit and in better agreement with medical guidelines in the evaluation of cues.

Keywords: Key words: medical decision making; fast and frugal; matching heuristic; judgment analysis. (Med Decis Making 2009; 29:140—148) (search for similar items in EconPapers)
Date: 2009
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:29:y:2009:i:1:p:140-148

DOI: 10.1177/0272989X08326091

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