Drug therapy decisions. A social judgment analysis

Abstract

Seventy psychiatric staff members at various Veterans Administration hospitals made decisions concerning appropriate medication for 40 hypothetical cases. A profile presented for each case described the patient's status on eight symptom dimensions. The physician-judges examined each profile and specified appropriate drugs and dose levels for the case. Analyses focused on agreement among judges and on prescriptive strategies, the manner in which symptoms were weighted in specific drug decisions. When base rates were taken into account in determining chance levels, the judges failed to agree with each other significantly more than would be expected by change; this was true for their prescriptions of general class of medications, specific drugs, and dose levels. Differences among physicians were traceable to inconsistency in the use of symptom information and individual variations in prescriptive strategies, cue (symptom) weighting strategies of judges being dissimilar and sometimes contradictory.