Proleader and antitrailer information distortion and their effects on choice and postchoice memory

Toward a General Framework of Biased Reasoning: Coherence-Based Reasoning

A considerable amount of experimental research has been devoted to uncovering biased forms of reasoning. Notwithstanding the richness and overall empirical soundness of the bias research, the field can be described as disjointed, incomplete, and undertheorized. In this article, we seek to address this disconnect by offering "coherence-based reasoning" as a parsimonious theoretical framework that explains a sizable number of important deviations from normative forms of reasoning. Represented in connectionist networks and processed through constraint-satisfaction processing, coherence-based reasoning serves as a ubiquitous, essential, and overwhelmingly adaptive apparatus in people's mental toolbox. This adaptive process, however, can readily be overrun by bias when the network is dominated by nodes or links that are incorrect, overweighted, or otherwise nonnormative. We apply this framework to explain a variety of well-established biased forms of reasoning, including confirmation bias, the halo effect, stereotype spillovers, hindsight bias, motivated reasoning, emotion-driven reasoning, ideological reasoning, and more.

The information distortion bias: implications for medical decisions

CONTEXT

Every diagnosis involves an act of decision making, which requires proper evaluation of information. However, even seemingly objective information can require interpretation, often without our conscious awareness. In this cross-cutting edge article we describe the phenomenon of leader-driven information distortion (ID) and its implications for medical education.

INFORMATION DISTORTION

Recent research indicates that one threat to good decisions is a biased interpretation of information to favour one alternative course of action over another. Once an alternative emerges as a leader during a decision there is a strong tendency to evaluate subsequent information as supporting that option. This can occur when deciding between two competing diagnoses. It is particularly a concern if diagnostic tests provide potentially ambiguous results. This leader-driven ID is pre-decisional in nature, in that it develops during a decision and involves the interpretation of information available prior to the final decision or diagnosis, with different interpretations possible depending on whichever alternative is the leader. Studies reveal that the distortion bias is pervasive in decisions, and that awareness of the act of distortion is low in decision makers.

APPLICATION TO MEDICAL EDUCATION

Empirical research has confirmed the presence of leader-driven ID in hypothetical diagnoses made by physicians. ID creates two threats to medical decisions: First, it can make a diagnosis sticky in that it is resistant to being overturned by contradictory information. Second, it can promote unwarranted certainty in a diagnosis. The outcome may be premature closure, unnecessary testing or incorrect treatment, resulting in delayed or missed diagnoses.

METHODS

This paper summarises research related to leader-driven ID in medical and professional decisions and discusses various approaches directed towards reducing ID. A framework and language are provided for thinking about and discussing ID in medical decisions and medical education. Courses of action for mitigating the effects of ID are suggested.

Communicated beliefs about action-outcomes: The role of initial confirmation in the adoption and maintenance of unsupported beliefs

As agents seeking to learn how to successfully navigate their environments, humans can both obtain knowledge through direct experience, and second-hand through communicated beliefs. Questions remain concerning how communicated belief (or instruction) interacts with first-hand evidence integration, and how the former can bias the latter. Previous research has revealed that people are more inclined to seek out confirming evidence when they are motivated to uphold the belief, resulting in confirmation bias. The current research explores whether merely communicated beliefs affect evidence integration over time when it is not of interest to uphold the belief, and all evidence is readily available. In a novel series of on-line experiments, participants chose on each trial which of two options to play for money, being exposed to outcomes of both. Prior to this, they were exposed to favourable communicated beliefs regarding one of two options. Beliefs were either initially supported or undermined by subsequent probabilistic evidence (probabilities reversed halfway through the task, rendering the options equally profitable overall). Results showed that while communicated beliefs predicted initial choices, they only biased subsequent choices when supported by initial evidence in the first phase of the experiment. Findings were replicated across contexts, evidence sequence lengths, and probabilistic distributions. This suggests that merely communicated beliefs can prevail even when not supported by long run evidence, and in the absence of a motivation to uphold them. The implications of the interaction between communicated beliefs and initial evidence for areas including instruction effects, impression formation, and placebo effects are discussed.

Information about expert decision and post-decision distortion of facts of own decision

Cognitive representations of decision problems are dynamic. During and after a decision, evaluations and representations of facts change to support the decision made by a decision maker her- or himself (Svenson, 2003). We investigated post-decision distortion of facts (consolidation). Participants were given vignettes with facts about two terminally ill patients, only one of whom could be given lifesaving surgery. In Study 1, contrary to the prediction, the results showed that facts were distorted after a decision both by participants who were responsible for the decisions themselves and when doctors had made the decision. In Study 2 we investigated the influence of knowledge about expert decisions on a participant's own decision and post-decisional distortion of facts. Facts were significantly more distorted when the participant's decision agreed with an expert's decision than when the participant and expert decisions disagreed. The findings imply that knowledge about experts' decisions can distort memories of facts and therefore may obstruct rational analyses of earlier decisions. This is particularly important when a decision made by a person, who is assumed to be an expert, makes a decision that is biased or wrong.

Choice-Supportive Misremembering: A New Taxonomy and Review

Although the literature on the influence of memory on decisions is well developed, research on the effects of decision making on memory is rather sparse and scattered. Choice-supportive misremembering (i.e., misremembering choice-related information that boosts the chosen option and/or demotes the foregone options) has been observed in several studies and has the potential to affect future choices. Nonetheless, no attempt has been made to review the relevant literature, categorize the different types of choice-supportive misremembering observed, and critically appraise the existing evidence and proposed explanations. Thus, starting from a new theoretically motivated and empirically grounded taxonomy, we review the current research. Our taxonomy classifies choice-supportive misremembering into four conceptually distinct types: misattribution is when information is attributed to the wrong source, fact distortion when the facts are remembered in a distorted manner, false memory when items that were not part of the original decision scenarios are remembered as presented and, finally, selective forgetting is when information is selectively forgotten. After assessing the impact of various potentially moderating factors, we evaluate the evidence for each type of misremembering and conclude that the support for the phenomenon is solid in relation to misattribution when recognition memory is assessed, but significantly weaker for the other three types, and when other memory tests are used to assess memory. Finally, we review the cognitive and emotional explanations proposed for choice-supportive misremembering in the light of the available evidence and identify the main gaps in the current knowledge and the more promising avenues for future research.

Systems Perspective of Amazon Mechanical Turk for Organizational Research: Review and Recommendations

Amazon Mechanical Turk (MTurk) is becoming a prevalent source of quick and cost effective data for organizational research, but there are questions about the appropriateness of the platform for organizational research. To answer these questions, we conducted an integrative review based on 75 papers evaluating the MTurk platform and 250 MTurk samples used in organizational research. This integrative review provides four contributions: (1) we analyze the trends associated with the use of MTurk samples in organizational research; (2) we develop a systems perspective (recruitment system, selection system, and work management system) to synthesize and organize the key factors influencing data collected on MTurk that may affect generalizability and data quality; (3) within each factor, we also use available MTurk samples from the organizational literature to analyze key issues (e.g., sample characteristics, use of attention checks, payment); and (4) based on our review, we provide specific recommendations and a checklist for data reporting in order to improve data transparency and enable further research on this issue.

The Role of Physicians' First Impressions in the Diagnosis of Possible Cancers without Alarm Symptoms

BACKGROUND

First impressions are thought to exert a disproportionate influence on subsequent judgments; however, their role in medical diagnosis has not been systematically studied. We aimed to elicit and measure the association between first impressions and subsequent diagnoses in common presentations with subtle indications of cancer.

METHODS

Ninety UK family physicians conducted interactive simulated consultations online, while on the phone with a researcher. They saw 6 patient cases, 3 of which could be cancers. Each cancer case included 2 consultations, whereby each patient consulted again with nonimproving and some new symptoms. After reading an introduction (patient description and presenting problem), physicians could request more information, which the researcher displayed online. In 2 of the possible cancers, physicians thought aloud. Two raters coded independently the physicians' first utterances (after reading the introduction but before requesting more information) as either acknowledging the possibility of cancer or not. We measured the association of these first impressions with the final diagnoses and management decisions.

RESULTS

The raters coded 297 verbalizations with high interrater agreement (Kappa = 0.89). When the possibility of cancer was initially verbalized, the odds of subsequently diagnosing it were on average 5 times higher (odds ratio 4.90 [95% CI 2.72 to 8.84], P < 0.001), while the odds of appropriate referral doubled (OR 1.98 [1.10 to 3.57], P = 0.002). The number of cancer-related questions physicians asked mediated the relationship between first impressions and subsequent diagnosis, explaining 29% of the total effect.

CONCLUSION

We measured a strong association between family physicians' first diagnostic impressions and subsequent diagnoses and decisions. We suggest that interventions to influence and support the diagnostic process should target its early stage of hypothesis generation.

The Elasticity of Preferences

We explore how preferences for attributes are constructed when people choose between multiattribute options. As found in prior research, we observed that while people make decisions, their preferences for the attributes in question shift to support the emerging choice, thus enabling confident decisions. The novelty of the studies reported here is that participants repeated the same task 6 to 8 weeks later. We found that between tasks, preferences returned to near their original levels, only to shift again to support the second choice, regardless of which choice participants made. Similar patterns were observed in a free-choice task (Study 1) and when the favorableness of options was manipulated (Study 2). It follows that preferences behave in an elastic manner: In the absence of situational pressures, they rest at baseline levels, but during the process of reaching a decision, they morph to support the chosen options. This elasticity appears to facilitate confident decision making in the face of decisional conflict.

What You Find Depends on How You Measure It: Reactivity of Response Scales Measuring Predecisional Information Distortion in Medical Diagnosis

“Predecisional information distortion” occurs when decision makers evaluate new information in a way that is biased towards their leading option. The phenomenon is well established, as is the method typically used to measure it, termed “stepwise evolution of preference” (SEP). An inadequacy of this method has recently come to the fore: it measures distortion as the total advantage afforded a leading option over its competitor, and therefore it cannot differentiate between distortion to strengthen a leading option (“proleader” distortion) and distortion to weaken a trailing option (“antitrailer” distortion). To address this, recent research introduced new response scales to SEP. We explore whether and how these new response scales might influence the very proleader and antitrailer processes that they were designed to capture (“reactivity”). We used the SEP method with concurrent verbal reporting: fifty family physicians verbalized their thoughts as they evaluated patient symptoms and signs (“cues”) in relation to two competing diagnostic hypotheses. Twenty-five physicians evaluated each cue using the response scale traditional to SEP (a single response scale, returning a single measure of distortion); the other twenty-five did so using the response scales introduced in recent studies (two separate response scales, returning two separate measures of distortion: proleader and antitrailer). We measured proleader and antitrailer processes in verbalizations, and compared verbalizations in the single-scale and separate-scales groups. Response scales did not appear to affect proleader processes: the two groups of physicians were equally likely to bolster their leading diagnosis verbally. Response scales did, however, appear to affect antitrailer processes: the two groups denigrated their trailing diagnosis verbally to differing degrees. Our findings suggest that the response scales used to measure information distortion might influence its constituent processes, limiting their generalizability across and beyond experimental studies.

Predecisional Information Distortion and the Self-Fulfilling Prophecy of Early Preferences in Choice

When a decision maker begins to favor a particular choice option, this tentative preference often shifts the evaluation of subsequent information in a manner that benefits the early leader. This ubiquitous bias, called predecisional information distortion, can create a form of self-fulfilling prophecy in which the decision maker is especially likely to choose the initially preferred option. Recent evidence has indicated that information distortion occurs in risky choices as well as riskless choices, that distortion also occurs in choices with more than two options, and that distortion can both enhance the leading option and degrade the trailing option(s). The effects of information distortion on choice and related variables are often sizable and cannot be attributed to individual differences in people’s “undistorted” assessments of the information. Although several issues are not yet resolved, incorporating information distortion into theories and models of the choice process should be a high priority for decision science.

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

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 a month. 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.