Human Factors in Clinical Judgment: Discussion of Scriven’s ‘Clinical Judgment’

  • Arthur S. Elstein
Part of the Philosophy and Medicine book series (PHME, volume 6)


It would be quite impossible to comment in detail on each of the main points in Scriven’s wide-ranging paper. Much of it is concerned with the issue of clinical versus statistical prediction and with the implications of the well replicated research finding that clinical judgments can be reproduced or even improved upon by simple statistical formulas derived from a representative sample of prior judgments [11]. This appears to be a puzzling, contra-intuitive, controversial research finding. For surely its implications have been only slowly incorporated in clinical practice, and have perhaps been more resisted and avoided than attended to. This discussion, therefore, will focus on one major question: Why do simple formulas for judgment so consistently equal or exceed the accuracy of human inference? I shall answer this question in two ways: first, by offering a critique of human judgment from an information-processing perspective, and second, by critically examining the research model that produced this finding My concern will be, then, with the psychological processes of clinical judgment and with ascertaining what research on clinical judgment has actually studied. The overall thrust of the discussion will be to agree with the main line of Scriven’s argument, while pointing out that there is still an “on the other hand”.


Human Factor Clinical Judgment Clinical Reasoning Research Paradigm Combination Rule 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© D. Reidel Publishing Company, Dordrecht, Holland 1979

Authors and Affiliations

  • Arthur S. Elstein
    • 1
  1. 1.Michigan State UniversityEast LansingUSA

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