Predecisional information distortion in physicians’ diagnostic judgments: Strengthening a leading hypothesis or weakening its competitor?

© 2014.Decision makers have been found to bias their interpretation of incoming information to support an emerging judgment (predecisional information distortion). This is a robust finding in human judgment, and was recently also established and measured in physicians’ diagnostic judgments (Kostopoulou et al. 2012). The two studies reported here extend this work by addressing the constituent modes of distortion in physicians. Specifically, we studied whether and to what extent physicians distort information to strengthen their leading diagnosis and/or to weaken a competing diagnosis. We used the “stepwise evolution of preference” method with three clinical scenarios, and measured distortion on separate rating scales, one for each of the two competing diagnoses per scenario.In Study 1, distortion in an experimental group was measured against the responses of a separate control group. In Study 2, distortion in a new experimental group was measured against participants’ own, personal responses provided under control conditions, with the two response conditions separated by amonth. The two studies produced consistent results. On average, we found considerable distortion of information to weaken the trailing diagnosis but little distortion to strengthen the leading diagnosis. We also found individual differences in the tendency to engage in either mode of distortion. Given that two recent studies found both modes of distortion in lay preference (Blanchard, Carlson & Meloy, 2014; DeKay, Miller, Schley & Erford, 2014), we suggest that predecisional information distortion is affected by participant and task characteristics. Our findings contribute to the growing research on the different modes of predecisional distortion and their stability to methodological variation

Information search and information distortion in the diagnosis of an ambiguous presentation

Physicians often encounter diagnostic problems with ambiguous and conflicting features. What are they likely to do in such situations? We presented a diagnostic scenario to 84 family physicians and traced their information gathering, diagnoses and management. The scenario contained an ambiguous feature, while the other features supported either a cardiac or a musculoskeletal diagnosis. Due to the risk of death, the cardiac diagnosis should be considered and managed appropriately. Forty-seven participants (56%) gave only a musculoskeletal diagnosis and 45 of them managed the patient inappropriately (sent him home with painkillers). They elicited less information and spent less time on the scenario than those who diagnosed a cardiac cause. No feedback was provided to participants. Stimulated recall with 52 of the physicians revealed differences in the way that the same information was interpreted as a function of the final diagnosis. The musculoskeletal group denigrated important cues, making them coherent with their representation of a pulled muscle, whilst the cardiac group saw them as evidence for a cardiac problem. Most physicians indicated that they were fairly or very certain about their diagnosis. The observed behaviours can be described as coherencebased reasoning, whereby an emerging judgment influences the evaluation of incoming information, so that confident judgments can be achieved even with ambiguous, uncertain and conflicting information. The role of coherence-based reasoning in medical diagnosis and diagnostic error needs to be systematically examined

The Role of Coherence in Text Approaching and Comprehension: Applications in Translation Didactics

The communicative text-linguistic approach to the study of texts and their theoretical and methodological problems plays an important role in Translation Studies and in Translation Didactics. The need to use and utilise the textual factors in the translation process and teaching is apparent in various linguistic and translational theories given that Translation, an act of speech and communication, is not performed at the level of language, but at the level of the text and discourse, utilising both linguistic and extralinguistic devices. This paper examines one of the seven textual factors, according to the basic theory of de Beaugrande and Dressler, i.e., the factor of coherence. Given that coherence expresses the logical consistency of utterances in terms of content – and therefore the construction of meaning – concepts such as knowledge, patterns and types of knowledge, frames and scripts, memory, are crucial for describing and examining this factor when approaching and understanding a text. Moreover, the interconnection of text linguistics, translation and cognition is evident, considering de Beaugrande’s argument (1999) that “text linguistics has always had a resolutely cognitive orientation because the text must be described as both product and process.” Furthermore, we shall examine how teachers of translation courses may take into account these concepts and elements when choosing texts for translation purposes, and utilise the theory of high-coherence and low-coherence texts (D. McNamara) in order to assist translator trainees in enhancing their extralinguistic knowledge and in using their prior knowledge during the comprehension/decoding phase of the translation act.L’approche de la linguistique communicative du texte des études de textes et de leurs problèmes théoriques et méthologiques jouent un rôle important dans la traductologie et dans la didactique de la traduction. Le besoin d’utiliser des facteurs textuels dans le processus de la translation et de l’enseignement est visible dans les diverses théories linguistiques et translationnelles, étant entendu que la translation, acte de parole et de communication, ne se déroule pas au niveau de la langue, mais à celui du texte et du discours en utilisant à la fois le linguistique et l’extralinguistique. Cet article étudie l’un des sept facteurs textuels selon la théorie de base de Beaugrande et Dressler, c’est-à-dire le facteur de cohérence. Étant donné que la cohérence exprime la constante logique des énoncés en terme de contenu – et par conséquent la construction du sens – les concepts de connaissance, de modes et de types de savoir, des cadres et scénarios, mémoire, sont importants pour décrire et examiner ce facteur dans l’approche de la compréhension du texte. De plus, l’interconnexion de la linguistique du texte de la translation et de la cognition est évidente en prenant en compte l’argument de Beaugrande (1999) que « la linguistique du texte a toujours eu une orientation résolument cognitive parce que le texte doit être décrit à la fois comme produit et processus ». Par ailleurs, nous examinons comment les enseignants de la translation intègrent ces concepts et ces éléments dans leurs choix de textes à traduire, et comment ils utilisent la théorie de la haute et la faible cohérences textuelles (D. McNamara) pour servir aux apprentis translateurs à mettre en valeur leurs connaissances extralinguistiques et à utiliser leurs connaissances préalables lors de la phase de compréhension, décodage de l’acte de translation