A Theory of Medical Decision Making and Health: Fuzzy Trace Theory

ArticleinMedical Decision Making 28(6):850-65 · November 2008with16 Reads
DOI: 10.1177/0272989X08327066 · Source: PubMed
Abstract
The tenets of fuzzy trace theory are summarized with respect to their relevance to health and medical decision making. Illustrations are given for HIV prevention, cardiovascular disease, surgical risk, genetic risk, and cancer prevention and control. A core idea of fuzzy trace theory is that people rely on the gist of information, its bottom-line meaning, as opposed to verbatim details in judgment and decision making. This idea explains why precise information (e.g., about risk) is not necessarily effective in encouraging prevention behaviors or in supporting medical decision making. People can get the facts right, and still not derive the proper meaning, which is key to informed decision making. Getting the gist is not sufficient, however. Retrieval (e.g., of health-related values) and processing interference brought on by thinking about nested or overlapping classes (e.g., in ratio concepts, such as probability) are also important. Theory-based interventions that work (and why they work) are presented, ranging from specific techniques aimed at enhancing representation, retrieval, and processing to a comprehensive intervention that integrates these components.
    • "We begin by examining the reliability and coherence of the Delay-of-gratification Gist Scale (DG-Gist) in each of three studies with large samples by subjecting the scale items to principal components analyses. Then, again for these three studies plus another smaller community sample, we report correlations of DG-Gist scores with other potentially related scales, such as Future Orientation (Webley & Nyhus, 2006), Propensity to Plan (Lynch, Netemeyer, Spiller, & Zammit, 2010 ), Time Perspectives Inventory (Morsanyi & Fogarasi, 2014; Zimbardo & Boyd, 1999, 2008, Spendthrift-Tightwad (Rick, Cryder, & Loewenstein, 2008), Barratt Impulsiveness (Patton et al., 1995), and delay discounting using the Monetary Choice Questionnaire because it has high test–retest reliability over a year for the target population of college students (Kirby, 2009). Each of these measures has been shown to be associated with real-world outcomes and behavioral measures such as saving and spending money, Fair Isaac Company (FICO) credit scores, grade point average, and credit card debt. "
    [Show abstract] [Hide abstract] ABSTRACT: Delay of gratification captures elements of temptation and self-denial that characterize real-life problems with money and other problem behaviors such as unhealthy risk taking. According to fuzzy-trace theory, decision makers mentally represent social values such as delay of gratification in a coarse but meaningful form of memory called “gist.” Applying this theory, we developed a gist measure of delay of gratification that does not involve quantitative trade-offs (as delay discounting does) and hypothesize that this construct explains unique variance beyond sensation seeking and inhibition in accounting for problem behaviors. Across four studies, we examine this Delay-of-gratification Gist Scale by using principal components analyses and evaluating convergent and divergent validity with other potentially related scales such as Future Orientation, Propensity to Plan, Time Perspectives Inventory, Spendthrift-Tightwad, Sensation Seeking, Cognitive Reflection, Barratt Impulsiveness, and the Monetary Choice Questionnaire (delay discounting). The new 12-item measure captured a single dimension of delay of gratification, correlated as predicted with other scales, but accounted for unique variance in predicting such outcomes as overdrawing bank accounts, substance abuse, and overall subjective well-being. Results support a theoretical distinction between reward-related approach motivation, including sensation seeking, and inhibitory faculties, including cognitive reflection. However, individuals' agreement with the qualitative gist of delay of gratification, as expressed in many cultural traditions, could not be reduced to such dualist distinctions nor to quantitative conceptions of delay discounting, shedding light on mechanisms of self-control and risk taking. Copyright
    Article · Aug 2016
    • "If verbatim and gist representations form the basis of independent systems of encoding, storing, and retrieving memories, then it follows that they could develop independently across the lifespan (Reyna, 2008 ). In other words, verbatim and gist memories need not develop in lockstep or at similar rates. "
    [Show abstract] [Hide abstract] ABSTRACT: Fuzzy-trace theory posits independent verbatim and gist memory processes, a distinction that has implications for such applied topics as eyewitness testimony. This distinction between precise, literal verbatim memory and meaning-based, intuitive gist accounts for memory paradoxes including dissociations between true and false memory, false memories outlasting true memories, and developmental increases in false memory. We provide an overview of fuzzy-trace theory, and, using mathematical modeling, also present results demonstrating verbatim and gist memory in true and false recognition of narrative sentences and inferences. Results supported fuzzy-trace theory's dual-process view of memory: verbatim memory was relied on to reject meaning-consistent, but unpresented, sentences (via recollection rejection). However, verbatim memory was often not retrieved, and gist memory supported acceptance of these sentences (via similarity judgment and phantom recollection). Thus, mathematical models of words can be extended to explain memory for complex stimuli, such as narratives, the kind of memory interrogated in law.
    Article · Jan 2016
    • "The approaches of fuzzy multi-criteria decision making have been tested successfully in many real life applications, including health sciences and sustainable human well-being. For example, the fuzzy approach has been applied in medical decision making (Reyna 2008; Toress & Nieto 2006; Phuonga & Kreinovich 2001) and also in measuring quality of life (Abdullah & Md Tap 2008; Abdullah & Md Tap 2009). The method of fuzzy decision making fuzzy simple additive weight was employed by Abdullah and Jamal (2011) to weight dimensions of HRQoL. "
    [Show abstract] [Hide abstract] ABSTRACT: Health Related Quality of Life (HRQoL) is one of the escalating subjects used for assessing health condition among patients who suffer specific diseases or ailments. It has been known that dimensions of HRQoL are able to mirror one’s overall health condition using mainly standard statistical technique. However, devising the extent of contribution of multiple dimensions towards overall health conditions is not straight forward as the arbitrary nature of HRQoL dimensions. Therefore this paper aims to propose a model to explain the relationship between HRQoL dimensions and overall health condition using a matrix driven fuzzy linear regression. An experiment was conducted to measure the strength of the relationship among elderly people via judgment provided by ten decision makers. The health condition linguistic data and scaled data of regularity of experiencing health-related problems among elderly people were given by the decision makers. The five stepwise computations based on matrix-driven fuzzy linear regression were proposed to describe the relationship. It is found that nearly forty six percent variations in overall health condition of elder people were explained by the eights HRQoL dimensions. The employment of matrix-driven multivariate fuzzy linear regression model has successfully identified the strength of the relationship between multi dimensions of HRQoL and overall health condition in the case of elderly people.
    Full-text · Article · Dec 2015
Show more