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PubMed2003

Temporal judgments, hemispheric equivalence, and interhemispheric transfer in adolescents with attention deficit hyperactivity disorder.

This study investigated temporal processing abilities, hemispheric asymmetry, interhemispheric transfer, and stimulant medication effects in adolescents with attention deficit hyperactivity disorder (ADHD). Pairs of light emitting diodes in a visual half-field display (i.e., bilateral and unilateral presentations) were presented to examine medication effects, temporal judgments, hemispheric asymmetry, and interhemispheric transfer in male adolescents with ADHD and matched controls on age and gender. Participants responded (YES/NO) whether pairs of spatially separated diodes were illuminated simultaneously. Stimulant medication did not have an affect on temporal judgments, hemispheric equivalence, or interhemispheric transfer. No group differences in temporal judgments in any of the paired conditions were revealed. Both the ADHD and control groups demonstrated hemispheric equivalence for temporal judgments. Unexpectedly, the ADHD group demonstrated significantly faster interhemispheric transfer times when compared to the control group. The overall findings indicate that the reported deficit in time perception among individuals with ADHD may be restricted to tasks that involve response inhibition, reaction time, and/or motor movements (e.g., replicate durations of stimuli by pressing a lever).

Adolescent↗
PubMed2000

Effects of visible and invisible cueing procedures on perceptual judgments in young and elderly subjects.

Healthy subjects were tested in two experiments to examine the effects of lateralized cues on line bisection and landmark judgments. The studies were designed to investigate whether bisection and landmark biases induced by cueing are simply a result of a direct perceptual lengthening of the cued part of the line caused by the fact that the cue is visible, thus creating a composite 'line plus cue' or whether cueing induces an attentional bias operating on judgments of spatial extent by either reducing the magnitude of the parts of the stimulus receiving 'less' attention or magnifying those parts receiving 'more'. Lateralized cues were either visible letter cues or invisible marks drawn with a leadless pencil either by the subject him/herself (Experiment 1) or the experimenter (Experiment 2). Comparable to a previous study (Mattingley, Pierson, Bradshaw, Phillips and Bradshaw, 1993, Neuropsychologia, 31, 1201-1215), the first experiment showed that only visible cues affected line bisection and landmark judgments thus favouring the perceptual explanation. The second study, however, revealed bisection and judgment biases for invisible as well as visible cues with the attended part of the line appearing subjectively longer. These results indicate that attentional modulations can increase the salience of a line in a similar vein to physical changes. It seems likely that the requirement of a motor response in Experiment 1 cancelled out all attentional properties supposedly induced by placing that invisible cue.

Adult↗
PubMed2003

The Canadian C-spine rule performs better than unstructured physician judgment.

STUDY OBJECTIVES: We compare the predictive accuracy of emergency physicians' unstructured clinical judgment to the Canadian C-Spine rule. METHODS: This prospective multicenter cohort study was conducted at 10 Canadian urban academic emergency departments. Included in the study were alert, stable, adult patients with a Glasgow Coma Scale score of 15 and trauma to the head or neck. This was a substudy of the Canadian C-Spine and CT Head Study. Eligible patients were prospectively evaluated before radiography. Physicians estimated the probability of unstable cervical spine injury from 0% to 100% according to clinical judgment alone and filled out a data form. Interobserver assessments were done when feasible. Patients underwent cervical spine radiography or follow-up to determine clinically important cervical spine injuries. Analyses included comparison of areas under the receiver operating characteristic (ROC) curve with 95% confidence intervals (CIs) and the kappa coefficient. RESULTS: During 18 months, 6265 patients were enrolled. The mean age was 36.6 years (range 16 to 97 years), and 50.1% were men. Sixty-four (1%) patients had a clinically important injury. The physicians' kappa for a 0% predicted probability of injury was 0.46 (95% CI 0.28 to 0.65). The respective areas under the ROC curve for predicting cervical spine injury were 0.85 (95% CI 0.80 to 0.89) for physician judgment and 0.91 (95% CI 0.89 to 0.92) for the Canadian C-Spine rule (P <.05). With a threshold of 0% predicted probability of injury, the respective indices of accuracy for physicians and the Canadian C-Spine rule were sensitivity 92.2% versus 100% (P <.001) and specificity 53.9% versus 44.0% (P <.001). CONCLUSION: Interobserver agreement of unstructured clinical judgment for predicting clinically important cervical spine injury is only fair, and the sensitivity is unacceptably low. The Canadian C-Spine rule was better at detecting clinically important injuries with a sensitivity of 100%. Prospective validation has recently been completed and should permit widespread use of the Canadian C-Spine rule.

Adolescent↗
PubMedDate not supplied

Assessing same/different judgments in individuals with severe intellectual disabilities: a status report.

This report summarizes state-of-the-art approaches for assessing visual stimulus same/different judgments in individuals with severe intellectual disabilities. Methods are described that permit one to conduct assessments on a population-wide basis, excluding few if any participants due to failure to acquire necessary baseline performances. Methodological investigations summarized here indicate that one can obtain reliable same/different judgments with a variety of stimuli in virtually anyone for whom a basal score on the Peabody Picture Vocabulary Test can be obtained. This approach includes judgments involving not only familiar, readily nameable stimuli, but also abstract two-dimensional forms of the type commonly used to minimize extraexperimental influences on performance. Taken together, recent findings lead to the conclusion that past studies have significantly under-estimated the capacity of participants with low MA scores to make same/different judgments. They also suggest a more general methodological approach that can potentially lead to more sensitive assessment of other behavioral capacities in this difficult-to-test population.

Attention↗
PubMed2002

Effects of testimonial inconsistencies and eyewitness confidence on mock-juror judgments.

This study examined the interaction between testimonial consistency and eyewitness confidence on mock-jurors' judgments of probability that the defendant committed the crime and verdicts. In a 2 (testimonial consistency) x 2 (confidence) between-groups design, 130 mock-jurors listened to an audio-taped trial of a person charged with armed robbery. Manipulations were contained in the prosecution witness's responses to detailed questioning by prosecution and defense attorneys. Although consistency is considered to be a key marker of accuracy, its impact on judgments was weak and nonsignificant. Witness confidence had a strong influence on judgments, whether testimony was consistent or inconsistent. We suggested that witness confidence may be more likely to emerge as a dominant influence on juror judgments when the testimony is wide ranging rather than relatively brief and concerned only with a specific issue (e.g., identification confidence).

Adult↗
PubMed1997

The effects of medical evidence and pain intensity on medical student judgments of chronic pain patients.

This study examined symptom judgments made by medical students of hypothetical chronic low back pain patients. Eight vignettes were varied as to the pain intensity reported by the hypothetical patient (low vs. moderate vs. high vs. very high) and the availability of medical evidence supportive of the pain report (present vs. absent). Ninety-five subjects read vignettes and made judgments of patient emotional distress, pain intensity, and pain-related disability. Subjects significantly discounted pain level when intensity was high but slightly augmented pain level when intensity was low. Judgments of pain and disability were higher for patients for whom medical evidence was present compared to those for whom it was absent. The results support and extend previous research on the effects of situational and patient variables on observer pain judgments. Future research should examine the influence of these biasing variables on the assessment and treatment of chronic pain patients.

Adult↗
PubMed2003

The impact of confidence on the accuracy of structured professional and actuarial violence risk judgments in a sample of forensic psychiatric patients.

Some previous research indicates that confidence affects the accuracy of probabilistic clinical ratings of risk for violence among civil psychiatric inpatients. The current study investigated the impact of confidence on actuarial and structured professional risk assessments, in a forensic psychiatric population, using community violence as the outcome criteria. Raters completed the HCR-20 violence risk assessment scheme for a sample of 100 forensic psychiatric patients. Results showed that accuracy of both actuarial judgments (HCR-20 total scores) and structured professional judgments (of low, moderate, and high risk) were substantially more accurate when raters were more confident about their judgments. Findings suggest that confidence of ratings should be studied as a potentially important mediator of structured professional and actuarial risk judgments.

Adult↗
PubMed2004

Explaining sexual harassment judgments: looking beyond gender of the rater.

In two decades of research on sexual harassment, one finding that appears repeatedly is that gender of the rater influences judgments about sexual harassment such that women are more likely than men to label behavior as sexual harassment. Yet, sexual harassment judgments are complex, particularly in situations that culminate in legal proceedings. And, this one variable, gender, may have been overemphasized to the exclusion of other situational and rater characteristic variables. Moreover, why do gender differences appear? As work by Wiener and his colleagues have done (R. L. Wiener et al., 2002; R. L. Wiener & L. Hurt, 2000; R. L. Wiener, L. Hurt, B. Russell, K. Mannen, & C. Gasper, 1997), this study attempts to look beyond gender to answer this question. In the studies reported here, raters (undergraduates and community adults), either read a written scenario or viewed a videotaped reenactment of a sexual harassment trial. The nature of the work environment was manipulated to see what, if any, effect the context would have on gender effects. Additionally, a number of rater characteristics beyond gender were measured, including ambivalent sexism attitudes of the raters, their judgments of complainant credibility, and self-referencing that might help explain rater judgments. Respondent gender, work environment, and community vs. student sample differences produced reliable differences in sexual harassment ratings in both the written and video trial versions of the study. The gender and sample differences in the sexual harassment ratings, however, are explained by a model which incorporates hostile sexism, perceptions of the complainants credibility, and raters' own ability to put themselves in the complainant's position (self-referencing).

Adult↗
PubMed1987

Judgment of contingency: cognitive biases in depressed and nondepressed subjects.

In this research I investigated whether the use of relevant affective outcomes influences depressed and nondepressed subjects' judgment of contingency. Similar to previous studies (Alloy & Abramson, 1979, Experiments 1 and 2), Experiments 1 and 2 confirmed that when the outcome is affectively neutral (i.e., the onset of a light) depressed subjects make accurate judgments of contingency, whereas nondepressed subjects show (in noncontingent situations) a significant illusion of control. In Experiments 3 and 4 (a contingency situation and a noncontingency situation, respectively) different types of sentences (negative self-referent, negative other-referent, positive self-referent, positive other-referent) were used as outcomes. Although depressed subjects were more reluctant to show biased judgments than were the nondepressed subjects, in noncontingency situations depressed subjects made overestimated judgments of contingency when the outcomes were negative self-referent sentences. Results are discussed with regard to current cognitive theories of depression, particularly the learned helplessness model.

Adult↗
PubMed1986

Perceptual plane geometry: collinearity judgments probe the perceived orientation of an angle's sides.

The task was to position a dot to lie one line length beyond the vertex of an angle by mentally extending one line segment forming the angle (and later the other line segment). Eight angles, variously oriented, provided judgmental errors attributable to the size of the subtended angle and line orientation. Collinearity errors are consistent with the hypothesis that the sizes of all subtended angles are underestimated. Horizontal-vertical assimilation describes the line-orientation effect. The largest error component is associated with the interaction of the two independent variables. Judgmental errors were modeled by a set of theoretically meaningful additive terms. Modeling was facilitated by symmetry assumptions (associated with odd and even mathematical functions) about the absolute magnitude and sign of judgmental errors that lead to the comparison of judgments derived from "interesting pairs" of stimuli.

Humans↗
PubMed2000

A feature-sampling account of the time course of old-new recognition judgments.

This article describes the feature-sampling theory of recognition (FESTHER), a new model of the time course of recognition judgments based on a model of the time course of perceptual processing in categorization (K. Lamberts, 1995, 1998). FESTHER is applied to previous results and to data from 4 old-new recognition experiments. Experiments 1 and 2 provided a preliminary test of the model's ability to explain recognition judgments of simple objects under response deadlines. Experiments 3 and 4 involved a response-signal procedure to elicit recognition judgments at different time lags after presentation of a stimulus. Simple objects and words were used as stimuli in Experiments 3 and 4, respectively. The new model accounts well for the data from the 4 experiments and offers a parsimonious account of the time course of recognition judgments based on the time-dependent availability of stimulus information.

Adult↗
PubMed1998

Age-related priming effects in social judgments.

Two experiments investigated adult age differences in the impact of previously activated (and thus easily accessible) trait-related information on judgments about people. The authors hypothesized that age-related declines in the efficiency of controlled processing mechanisms during adulthood would be associated with increased susceptibility to judgment biases associated with such information. In each study, different-aged adults made impression judgments about a target, and assimilation of these judgments to trait constructs activated in a previous, unrelated task were examined. Consistent with the authors' hypotheses, older adults were likely to form impressions that were biased toward the primed trait constructs. In contrast, younger adults exhibited greater awareness of the primed information and were more likely to correct for its perceived influence, especially when distinctive contextual cues regarding the source of the primes were available.

Adolescent↗
PubMed1988

Grammaticality judgments and sentence comprehension in agrammatic aphasia.

The relationship between sentence comprehension and grammaticality judgment was examined for both neurologically intact and agrammatic aphasic subjects. Aphasic subjects were able to make grammaticality judgments and comprehension judgments, but were less accurate than healthy control subjects. However, the tasks appeared dissociated for the aphasic subjects: Both the effects of semantic cues and the hierarchy of difficulty of sentence types differed across the two tasks. Further, the findings suggest that not all aspects of morpho-syntactic processing may be equally disrupted in aphasia. The results argue against both a central deficit view of agrammatic aphasia, and a view suggesting that syntactic processing is intact whereas semantic or thematic mapping is not. Instead, the results indicate that the respective performance domains of comprehension and grammaticality judgment may draw on different processes and/or operate on different aspects of the language input.

Adult↗
PubMed1990

Reliability and validity of judgments of the integrity of the anterior cruciate ligament of the knee using the Lachman's test.

This study assessed the intratester and intertester reliability and the validity of judgments of the integrity of the anterior cruciate ligament (ACL) based on the use of the Lachman's test. End-feel and tibial translation judgments made during the Lachman's test were also assessed. Patients with unilateral knee problems (N = 32), 13 of whom had documented ACL damage, were examined by two physical therapists and two orthopedic surgeons. Intratester Kappa values for whether the test was positive or negative were .44 for physical therapists, .60 for orthopedic surgeons, and .51 for all examiners. Intertester Kappa values were .69 for the therapists, .61 for the surgeons, and .42 for all examiners. The predictive value of a positive test was 47% for all examiners, whereas the predictive value of a negative test was 70%. Results indicate that Lachman's test judgments have limited reliability and may be more useful for predicting that a patient does not have an ACL injury than for predicting that the ACL is injured. [Cooperman JM, Riddle, DL, Rothstein JM: Reliability and validity of judgments of the integrity of the anterior cruciate ligament of the knee using the Lachman's test.

Adolescent↗
PubMed1979

Surgical decision making. The reliability of clinical judgment.

Elective surgery second opinion programs are predicted on strict acceptance of the accuracy of the consultant's surgical judgment. The reliability and reproducibility of clinical judgment, therefore, become basic to the effectiveness of such programs. This aspect, however, has received little attention. We report a randomized and controlled survey of surgical specialists which defines agreement/disagreement patterns in surgical decision-making for seven elective surgical procedures. For each disease process, four case histories, including at least one control, were developed by specialty panels of physicians. The case summaries described fictional patients who were seeking professional consultation. The histories were mailed to a random sample of Board-certified specialists from the State of Maryland and the District of Columbia. The response rate was approximately 80% for all five specialties. The respondents were asked to indicate whether they would (Yes) or would not (No) perform the surgical procedure in question. Factual knowledge was not sought, but instead the application of that knowledge and experience to decide on the need for surgical intervention. By comparing the responses for each case history, the agreement/disagreement patterns of inter-observer surgical judgment were determined. Analysis of the data revealed a marked divergence of opinion concerning the need for surgery. The significant point of this study is that surgical judgment differs to a major degree from one surgeon to the next. In a second-opinion program the number of consultants needed to provide a reliable clinical decision probably exceeds the number who are logistically available and that the patient would be willing to visit. Surgical decision-making is a semi-exact scientific process, and it is unreasonable to expect exact answers to clinical problems.

Certification↗
PubMed1981

Intraoperative determination of small intestinal viability following ischemic injury: a prospective, controlled trial of two adjuvant methods (Doppler and fluorescein) compared with standard clinical judgment.

Two adjuvant techniques for the intraoperative assessment of small intestinal viability were compared with standard clinical judgment in a prospective, controlled study of 71 ischemic bowel segments in 28 consecutive patients operated on for acute intestinal ischemic disease. Each segment was independently assessed 15 minutes after surgical correction of the underlying lesion by: 1) standard clinical judgment; 2) Doppler-detected pulsatile mural blood flow; and 3) fluorescein ultraviolet fluorescence pattern. Viability endpoint for each segment was determined objectively by patient follow-up or "blinded" microscopic evaluation of histologically unequivocal resection specimens using criteria established by previous animal studies. Seventeen histologically equivocal specimens were excluded from the final results. Standard clinical judgment proved moderately accurate overall (89%) but would have led to a relatively high rate (46%) of unnecessary bowel resection. The Doppler technique did not increase accuracy in any category of evaluation. The fluorescein fluorescent pattern was correct in all 54 determinant bowel segments, and proved more sensitive specific, predictive, and significantly more accurate overall than either standard clinical judgment or the Doppler method. This controlled study suggests that the fluorescein technique is the method of choice for the prediction of small intestinal recovery following ischemic injury.

Adolescent↗
PubMed2003

The privileged status of prestigious terminology: impact of "medicalese" on clinical judgments.

PURPOSE: Health professionals frequently use medical terminology like dyspnea or nasopharyngitis. These two studies examine how the use of medical terms affects the judgments of seriousness, prevalence, and disease; and diagnostic judgments. METHOD: In study 1, a survey containing the names of 22 diseases with either a medical or lay description was completed by 47 undergraduate psychology students and 25 medical students, who were asked to judge seriousness, prevalence, and how "disease-like" it was. In study 2, undergraduate students learned four "pseudopsychiatry" conditions, each with four associated features. Features were presented in lay or medical versions. They were then tested with 18 new cases with two medical features from one condition and two lay terms from the other. RESULTS: In study 1, the medical students rated conditions as more disease-like, more serious, and less prevalent than did the psychology students. Medical descriptions were seen as significantly less common and somewhat more serious and more disease-like. In study 2, the participants rated the condition with medical features consistently more likely than the alternative, regardless of training condition. CONCLUSIONS: The specific words used to describe a feature or condition can have an impact on judgments of likelihood of disease, and, to a lesser extent, judgments of seriousness.

Diagnosis↗
PubMed1978

Priority setting in quality assurance: reliability of staff judgments in medical institutions.

A structured procedure using the judgments of a representative group of local providers for establishing priorities for quality assurance activity in diverse medical institutions was tested for reliability. Two independent matched teams of phy sicians, nurses, administrators, and other staff in eight separate medical facilities generated 320 topics which encompassed areas where quality assurance efforts would have either considerable or little impact in terms of improving health outcomes within reasonable costs. Concordance of judgment between teams in each facility was determined by analyzing the similarity of topics content, the agreement in scaling the health impact of similar topics generated by both teams independently, and the agreement by one team in scaling the health impact of topics generated by the other team. The findings revealed 44 per cent content agreement on topics independently generated, 93 per cent agreement on dichotomous scaling of similar topics, and 87 per cent agreement on five-point scaling of similar topics. Concordance of judgment by one team in scaling the other team's topics was highly significant (p less than .001). Preliminary analysis of topic content and scaling agreement among different facilities indicated low agreement both on the content areas and on the health impact of similar topics. It is concluded that the judgments of local providers in identifying cost-effective quality assurance priorities is highly relaible in the medical institutions studied.

Cost-Benefit Analysis↗