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Journal articles on the topic 'Clinical judgements'

Author: Grafiati

Published: 4 June 2021

Last updated: 13 February 2022

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1

Lewis, Glyn, and Paul Williams. "Clinical judgement and the standardized interview in psychiatry." Psychological Medicine 19, no. 4 (November 1989): 971–79. http://dx.doi.org/10.1017/s0033291700005699.

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SYNOPSISThere has been little discussion of the advantages and disadvantages of allowing a psychiatrist to make clinical judgements about the presence or absence of symptoms in administering currently used standardized psychiatric interviews. This paper reports an examination of the value of clinical judgements in defining cases of minor psychiatric disorder, by studying existing data in which the Clinical Interview Schedule (CIS) was used. This comparison can be made because the first section of the CIS is largely self-report while interviewers are also instructed to use clinical judgement in the second section to decide on ratings. The results indicate that in the context of identifying minor psychiatric disorder the ratings requiring clinical judgement add little information to those based on self-report, may be less reliable and may lead to the biased assessment of anxiety and depression.

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BELL, IAN, and DAVID MELLOR. "Clinical judgements: Research and practice." Australian Psychologist 44, no. 2 (June 2009): 112–21. http://dx.doi.org/10.1080/00050060802550023.

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3

Slavney, P. R., and G. A. Chase. "Clinical Judgements of Self-Dramatisation." British Journal of Psychiatry 146, no. 6 (June 1985): 614–17. http://dx.doi.org/10.1192/bjp.146.6.614.

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SummaryIt has been claimed that the diagnosis of histrionic personality disorder is inherently sexist. To estimate the extent to which psychiatrists are influenced by sexist prejudice in their judgements about self-dramatisation (the central trait in the histrionic cluster), we conducted a study in which male and female subjects rated the degree of self-dramatisation portrayed in videotaped vignettes. The results did not support the sexist hypothesis that dramatic behaviour would more often be attributed to a woman than to a man, especially by male raters.

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4

Faisal, Muhammad, Binish Khatoon, Andy Scally, Donald Richardson, Sally Irwin, Rachel Davidson, David Heseltine, et al. "A prospective study of consecutive emergency medical admissions to compare a novel automated computer-aided mortality risk score and clinical judgement of patient mortality risk." BMJ Open 9, no. 6 (June 2019): e027741. http://dx.doi.org/10.1136/bmjopen-2018-027741.

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ObjectivesTo compare the performance of a validated automatic computer-aided risk of mortality (CARM) score versus medical judgement in predicting the risk of in-hospital mortality for patients following emergency medical admission.DesignA prospective study.SettingConsecutive emergency medical admissions in York hospital.ParticipantsElderly medical admissions in one ward were assigned a risk of death at the first post-take ward round by consultant staff over a 2-week period. The consultant medical staff used the same variables to assign a risk of death to the patient as the CARM (age, sex, National Early Warning Score and blood test results) but also had access to the clinical history, examination findings and any immediately available investigations such as ECGs. The performance of the CARM versus consultant medical judgement was compared using the c-statistic and the positive predictive value (PPV).ResultsThe in-hospital mortality was 31.8% (130/409). For patients with complete blood test results, the c-statistic for CARM was 0.75 (95% CI: 0.69 to 0.81) versus 0.72 (95% CI: 0.66 to 0.78) for medical judgements (p=0.28). For patients with at least one missing blood test result, the c-statistics were similar (medical judgements 0.70 (95% CI: 0.60 to 0.81) vs CARM 0.70 (95% CI: 0.59 to 0.80)). At a 10% mortality risk, the PPV for CARM was higher than medical judgements in patients with complete blood test results, 62.0% (95% CI: 51.2 to 71.9) versus 49.2% (95% CI: 39.8 to 58.5) but not when blood test results were missing, 50.0% (95% CI: 24.7 to 75.3) versus 53.3% (95% CI: 34.3 to 71.7).ConclusionsCARM is comparable with medical judgements in discriminating in-hospital mortality following emergency admission to an elderly care ward. CARM may have a promising role in supporting medical judgements in determining the patient’s risk of death in hospital. Further evaluation of CARM in routine practice is required.

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5

Munford, Mary-Ann. "Clinical Judgements c Rayner Clinical Judgements Published by Michael Joseph 388pp £12.95 0-7181-3251-3." Nursing Standard 3, no. 43 (July 22, 1989): 48–49. http://dx.doi.org/10.7748/ns.3.43.48.s56.

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6

Ylva Skånér, Lars-Erik Strender, Jo. "How do GPs use clinical information in their judgements of heart failure?: A Clinical Judgement Analysis study." Scandinavian Journal of Primary Health Care 16, no. 2 (January 1998): 95–100. http://dx.doi.org/10.1080/028134398750003241.

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7

Cairns, Ruth, Clementine Maddock, Alec Buchanan, Anthony S. David, Peter Hayward, Genevra Richardson, George Szmukler, and Matthew Hotopf. "Reliability of mental capacity assessments in psychiatric in-patients." British Journal of Psychiatry 187, no. 4 (October 2005): 372–78. http://dx.doi.org/10.1192/bjp.187.4.372.

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BackgroundPrevious work on the reliability of mental capacity assessments in patients with psychiatric illness has been limited.AimsTo describe the interrater reliability of two independent assessments of capacity to consent to treatment, as well as assessments made by a panel of clinicians based on the same interview.MethodFifty-five patients were interviewed by two interviewers 1–7 days apart and a binary (yes/no) capacity judgement was made, guided by the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). Four senior clinicians used transcripts of the interviews to judge capacity.ResultsThere was excellent agreement between the two interviewers for capacity judgements made at separate interviews (kappa=0.82). A high level of agreement was seen between senior clinicians for capacity judgements of the same interview (mean kappa=0.84)ConclusionsIn combination with a clinical interview, the MacCAT–T can be used to produce highly reliable judgements of capacity.

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Bech, P., A. Haaber, and C. R. B. Joyce. "Experiments on clinical observation and judgement in the assessment of depression: profiled videotapes and Judgement Analysis." Psychological Medicine 16, no. 4 (November 1986): 873–83. http://dx.doi.org/10.1017/s0033291700011880.

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SynopsisVariations within and between observer-judges reduce the accuracy of clinical research. Judgement Analysis allows strategies to be developed and applied which reduce variation in judgement. The prediction that the removal of important sources of error variance by this means would reduce the likelihood of committing a Type 2 Error was supported by the application of Judgement Analysis to assessments by 15 psychiatrists of 92 patients in a clinical trial of 2 antidepressive treatments. The statistical significance of differences between the effect of the treatments on the severity of depression was increased, and significant differences appeared earlier. Ten stimulated patient profiles were also converted into narrative case histories, enacted by experienced psychiatrists or psychologists and videotaped. The participants' judgements of the overall severity of the depression were in good agreement with those they had made on the original cases. Videotapes so prepared help training to reduce variation in observation, just as Judgement Analysis can lead to reductions in the variation of judgement.

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9

Westbrook, David. "Can Therapists Predict Length of Treatment from Referral Letters? A Pilot Study." Behavioural and Cognitive Psychotherapy 19, no. 4 (October 1991): 377–82. http://dx.doi.org/10.1017/s0141347300014087.

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Seven experienced clinicians were asked to judge how many sessions patients in a clinical psychology out-patient clinic would take to complete treatment, using patient referral letters as their only data. Results showed the clinicians were very poor at making this judgement and generally did no better than chance. Their clinical predictions were compared with statistical data using a regression analysis of initial questionnaire measures. The regression equation did a little better on some judgements, but still failed to predict long-term treatment.

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10

Mason, Geraldine, and Christine Webb. "Researching children's nurses' clinical judgements about assessment data." Clinical Effectiveness in Nursing 1, no. 1 (March 1997): 47–54. http://dx.doi.org/10.1016/s1361-9004(97)80037-4.

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11

Rudoy, A. S., A. A. Bova, and T. A. Nekhaichik. "Atrial septal aneurysm: Evolution of diagnostic and clinical judgements." Terapevticheskii arkhiv 89, no. 9 (September 15, 2017): 104–8. http://dx.doi.org/10.17116/terarkh2017899104-108.

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The article discusses anatomical and clinical judgements on atrial septal aneurysm (ASA) as a primary cardiac structural abnormality. It presents current approaches to the classification of ASA and its echocardiographic diagnosis. Special attention is focused on the clinical significance of ASA as an isolated anomaly and concurrent with other structural abnormalities of the heart, especially from the standpoint of a risk of cardioembolic stroke.

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12

Galloghly, Dylan P., and Greg E. Dear. "Factors underlying clinicians’ judgements of patient insight and confidence in using clinical judgement in psycho-legal settings." Psychiatry, Psychology and Law 27, no. 1 (January 2, 2020): 95–109. http://dx.doi.org/10.1080/13218719.2019.1687046.

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Dowding, Dawn, Russell Gurbutt, Monica Murphy, Margaret Lascelles, Alan Pearman, and Barbara Summers. "Conceptualising decision making in nursing education." Journal of Research in Nursing 17, no. 4 (July 2012): 348–60. http://dx.doi.org/10.1177/1744987112449963.

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The ability to exhibit sound judgement and decision-making skills is a fundamental requirement of undergraduate nursing curricula. In order to acquire such skills, students need to develop critical thinking ability, as well as an understanding of how judgements and decisions are reached in complex healthcare environments. The use of techniques such as problem-based learning, simulation and feedback has been hypothesised to help with the development of critical thinking skills. In addition, a curriculum that incorporates teaching on different ways in which judgements and decisions are reached can potentially help students identify how to avoid errors and mistakes in their clinical practice. Feedback has been shown to be a powerful tool to help with developing decision-making skills; evidence for other approaches to teaching critical thinking and decision-making skills is currently limited. This paper reviews theoretical concepts that provide a framework for decision making in nursing, as well as methods by which it can be taught.

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Galloghly, Dylan P., Greg E. Dear, and Assen Jablensky. "Reliability of clinical judgements of insight in patients with psychoses." Psychiatry Research 208, no. 3 (August 2013): 291–92. http://dx.doi.org/10.1016/j.psychres.2013.03.016.

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15

Baeroe, K. "Priority-setting in healthcare: a framework for reasonable clinical judgements." Journal of Medical Ethics 35, no. 8 (July 30, 2009): 488–96. http://dx.doi.org/10.1136/jme.2007.022285.

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Scarff, Catherine E., Margaret Bearman, Neville Chiavaroli, and Steve Trumble. "Keeping mum in clinical supervision: private thoughts and public judgements." Medical Education 53, no. 2 (October 16, 2018): 133–42. http://dx.doi.org/10.1111/medu.13728.

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17

Demarquay, G., JP Royet, P. Giraud, G. Chazot, D. Valade, and P. Ryvlin. "Rating of Olfactory Judgements in Migraine Patients." Cephalalgia 26, no. 9 (September 2006): 1123–30. http://dx.doi.org/10.1111/j.1468-2982.2006.01174.x.

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The aim of this study was to evaluate olfactory hypersensitivity (OHS) between attacks in migraine patients. Seventy-four migraine patients and 30 controls were enrolled. The presence of OHS was evaluated using an oral questionnaire and a chemical odour intolerance index. Subjects had to rate the intensity and hedonicity of 12 odourants using a linear rating scale. Twenty-six patients (35.2±) but no control subjects reported an interictal OHS ( P < 0.001). Logistic regression analysis showed that patients with OHS presented a greater attack frequency, a higher number of odour-induced migraines and visual hypersensitivity when compared with other patients. Disease duration, age, gender and auditory hypersensitivity were not associated with OHS. OHS patients judged odours less pleasant than did other patients and controls, whereas the intensity scores were identical in both groups. OHS between attacks was significantly associated with odour-triggered migraine and an alteration of hedonic judgement.

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18

Blackburn, Ronald. "On Moral Judgements and Personality Disorders." British Journal of Psychiatry 153, no. 4 (October 1988): 505–12. http://dx.doi.org/10.1192/bjp.153.4.505.

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Psychopathic personality has always been a contentious concept, but it continues to be used in clinical practice and research. It also has its contemporary synonyms in the categories of antisocial personality disorder in DSM–III (American Psychiatric Association, 1980) and “personality disorder with predominantly asocial or sociopathic manifestations” in ICD–9 (World Health Organization, 1978), and some overlap between these and the legal category of psychopathic disorder identified in the English Mental Health Act 1983 is commonly assumed. Although the literal meaning of ‘psychopathic’ is nothing more specific than psychologically damaged, the term has long since been transmogrified to mean socially damaging, and as currently used, it implies a specific category of people inherently committed to antisocial behaviour as a consequence of personal abnormalities or deficiencies.

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19

Szawarski, Piotr. "Classic cases revisited: Of hurricanes, cyanide and moral courage." Journal of the Intensive Care Society 21, no. 1 (July 12, 2018): 2–6. http://dx.doi.org/10.1177/1751143718787755.

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All decisions made by doctors have a moral dimension. When a moral judgement demands a different course of action to one that represents the usual practice, many doctors do struggle. The inability to embrace such decisions can represent moral negligence, as often the consequence is greater suffering for the individual in question or loss of utility for the population. On the other hand, it takes courage to make such decisions as the society fails to accept them, even though decisions made are rational and morally valid. Clinical practice that does not conform to moral judgements can result in moral distress, burn out and job-leave. Reflective practice evaluating moral dimensions of clinical decision making is an important aspect of nurturing humanity, empathy and professionalism in the therapeutic endeavour.

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20

Groenier, Marleen, Jules M. Pieters, Casper D. Hulshof, Pascal Wilhelm, and Cilia L. M. Witteman. "Psychologists' judgements of diagnostic activities: deviations from a theoretical model." Clinical Psychology & Psychotherapy 15, no. 4 (July 2008): 256–65. http://dx.doi.org/10.1002/cpp.587.

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21

Roberts, Andrew B., Mark Mon-Williams, James R. Tresilian, and Robin Burgess-Limerick. "Kinaesthetic judgements and refinement of striking action." Developmental Medicine & Child Neurology 42, no. 8 (February 13, 2007): 518–24. http://dx.doi.org/10.1111/j.1469-8749.2000.tb00707.x.

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22

Lord, Richard, and Charles Hulme. "PERCEPTUAL JUDGEMENTS OF NORMAL AND CLUMSY CHILDREN." Developmental Medicine & Child Neurology 29, no. 2 (November 12, 2008): 250–57. http://dx.doi.org/10.1111/j.1469-8749.1987.tb02143.x.

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23

Peretz, Isabelle, and Lise Gagnon. "Dissociation between recognition and emotional judgements for melodies." Neurocase 5, no. 1 (January 1999): 21–30. http://dx.doi.org/10.1080/13554799908404061.

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24

Watling, Christopher, Erik Driessen, Cees P. M. van der Vleuten, and Lorelei Lingard. "Learning from clinical work: the roles of learning cues and credibility judgements." Medical Education 46, no. 2 (January 12, 2012): 192–200. http://dx.doi.org/10.1111/j.1365-2923.2011.04126.x.

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25

Alexander, Helen A. "Physiotherapy Student Clinical Education: the influence of subjective judgements on observational assessment." Assessment & Evaluation in Higher Education 21, no. 4 (December 1996): 357–66. http://dx.doi.org/10.1080/0260293960210406.

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26

Fordham, Ann Scott, B. May, M. Boyle, R. P. Bentall, and P. D. Slade. "Good and bad clinicians: Supervisors' judgements of trainees' competence." British Journal of Clinical Psychology 29, no. 1 (February 1990): 113–14. http://dx.doi.org/10.1111/j.2044-8260.1990.tb00856.x.

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27

Coulter Smith, Margaret A., Pam Smith, and Rosemary Crow. "A critical review: a combined conceptual framework of severity of illness and clinical judgement for analysing diagnostic judgements in critical illness." Journal of Clinical Nursing 23, no. 5-6 (December 27, 2013): 784–98. http://dx.doi.org/10.1111/jocn.12463.

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28

Cairns, Ruth, Penelope Brown, Hugh Grant-Peterkin, Mizanur R. Khondoker, Gareth S. Owen, Genevra Richardson, George Szmukler, and Matthew Hotopf. "Judgements about deprivation of liberty made by various professionals: comparison study." Psychiatrist 35, no. 9 (September 2011): 344–49. http://dx.doi.org/10.1192/pb.bp.110.033241.

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Aims and methodA group of lawyers, psychiatrists, best interest assessors and independent mental capacity advocates were asked to make binary judgements about whether real-life situations in 12 vignettes amounted to deprivation of liberty. Kappa coefficients were calculated to describe the level of agreement within each professional group and for the total group of professionals.ResultsThere was total agreement between all professionals about deprivation of liberty in only 1 of the 12 cases. The overall level of agreement for judgements made by all professionals was ‘slight’ (κ=0.16, P < 0.01).Clinical implicationsThere are practical difficulties involved in making reliable deprivation of liberty judgements within the Deprivation of Liberty Safeguards (DoLS) legislation. A clear interpretation of deprivation of liberty is necessary to facilitate professionals' decision-making in this area.

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Callender, John S. "Cognitive ethical therapy? The role of moral judgements in cognitive therapy." Clinical Psychology & Psychotherapy 9, no. 3 (2002): 177–86. http://dx.doi.org/10.1002/cpp.326.

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30

Cropley, Mark, Andrew K. MacLeod, and Phillip Tata. "Memory retrieval and subjective probability judgements in control and depressed participants." Clinical Psychology & Psychotherapy 7, no. 5 (2000): 367–78. http://dx.doi.org/10.1002/1099-0879(200011)7:5<367::aid-cpp249>3.0.co;2-h.

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Swe, Derek C., Romina Palermo, O. Scott Gwinn, Gillian Rhodes, Markus Neumann, Shanèle Payart, and Clare A. M. Sutherland. "An objective and reliable electrophysiological marker for implicit trustworthiness perception." Social Cognitive and Affective Neuroscience 15, no. 3 (March 2020): 337–46. http://dx.doi.org/10.1093/scan/nsaa043.

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Abstract Trustworthiness is assumed to be processed implicitly from faces, despite the fact that the overwhelming majority of research has only involved explicit trustworthiness judgements. To answer the question whether or not trustworthiness processing can be implicit, we apply an electroencephalography fast periodic visual stimulation (FPVS) paradigm, where electrophysiological cortical activity is triggered in synchrony with facial trustworthiness cues, without explicit judgements. Face images were presented at 6 Hz, with facial trustworthiness varying at 1 Hz. Significant responses at 1 Hz were observed, indicating that differences in the trustworthiness of the faces were reflected in the neural signature. These responses were significantly reduced for inverted faces, suggesting that the results are associated with higher order face processing. The neural responses were reliable, and correlated with explicit trustworthiness judgements, suggesting that the technique is capable of picking up on stable individual differences in trustworthiness processing. By demonstrating neural activity associated with implicit trustworthiness judgements, our results contribute to resolving a key theoretical debate. Moreover, our data show that FPVS is a valuable tool to examine face processing at the individual level, with potential application in pre-verbal and clinical populations who struggle with verbalization, understanding or memory.

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32

Furlong, Allannah, and Michèle S. Lefebvre. "Psychotherapy and Disclosure: Recent Court Decisions." Canadian Journal of Psychiatry 43, no. 7 (September 1998): 731–36. http://dx.doi.org/10.1177/070674379804300708.

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Objective: To encourage mental health professionals concerned about the practice of psychotherapy to add their voices to the legal debate on disclosure. Method: Analysis of recent court decisions, in particular 2 Supreme Court of Canada judgements, R. v. O'Connor and R. v. Carosella, and 1 United States Supreme Court judgement, Jaffee v. Redmond. Results: The lack of a common definition of psychotherapy may, in part, have made it awkward for mental health professionals to mount a concerted defence of psychotherapy dossiers. Conclusions: Unless mental health professionals develop a more robust justification and delimitation for privilege, in Canadian courts possible relevance of clinical material is likely to override concern for the patient's privacy interest. Future research might evaluate the impact of loss of privilege upon different types of psychotherapy.

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33

Knight, Carolyn. "The Impact of a Client's Diagnosis of AIDS on Social Worker's Clinical Judgements:." Social Work in Health Care 23, no. 4 (August 26, 1996): 35–50. http://dx.doi.org/10.1300/j010v23n04_04.

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34

Waller, Glenn, Angela Ruddock, and Christopher Pitts. "When is sexual abuse relevant to bulimic disorders? The validity of clinical judgements." European Eating Disorders Review 1, no. 3 (December 1993): 143–51. http://dx.doi.org/10.1002/erv.2400010303.

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Samuriwo, Ray, and Dawn Dowding. "Nurses’ pressure ulcer related judgements and decisions in clinical practice: A systematic review." International Journal of Nursing Studies 51, no. 12 (December 2014): 1667–85. http://dx.doi.org/10.1016/j.ijnurstu.2014.04.009.

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Peña, Elizabeth D., María Reséndiz, and Ronald B. Gillam. "The role of clinical judgements of modifiability in the diagnosis of language impairment." Advances in Speech Language Pathology 9, no. 4 (January 2007): 332–45. http://dx.doi.org/10.1080/14417040701413738.

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37

Courbalay, A., T. Deroche, M. Descarreaux, E. Prigent, J. O'Shaughnessy, and M. A. Amorim. "Facial Expression Overrides Lumbopelvic Kinematics for Clinical Judgements about Low Back Pain Intensity." Pain Research and Management 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/7134825.

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Background.Through real-time behavioral observation systems, pain behaviors are commonly used by clinicians to estimate pain intensity in patients with low back pain. However, little is known about how clinicians rely on pain-related behaviors to make their judgment. According to the Information Integration Theory (IIT) framework, this study aimed at investigating how clinicians value and integrate information from lumbopelvic kinematics (LK), a protective pain behavior, and facial expression intensity (FEI), a communicative pain behavior, to estimate pain in patients with chronic low back pain (cLBP).Methods.Twenty-one experienced clinicians and twenty-one novice clinicians were asked to estimate back pain intensity from a virtual character performing a trunk flexion-extension task.Results.Results revealed that both populations relied on facial expression and that only half of the participants in each group integrated FEI and LK to estimate cLBP intensity. Among participants who integrated the two pain behaviors, averaging rule predominated among others. Results showed that experienced clinicians relied equally on FEI and LK to estimate pain, whereas novice clinicians mostly relied on FEI.Discussion.The use of additive rule of integration does not appear to be systematic when assessing others’ pain. When assessing pain intensity, communicative and protective pain behaviors may have different relevance.

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Pentzek, Michael, Michael Wagner, Heinz-Harald Abholz, Horst Bickel, Hanna Kaduszkiewicz, Birgitt Wiese, Siegfried Weyerer, et al. "The value of the GP’s clinical judgement in predicting dementia: a multicentre prospective cohort study among patients in general practice." British Journal of General Practice 69, no. 688 (October 8, 2019): e786-e793. http://dx.doi.org/10.3399/bjgp19x706037.

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BackgroundClinical judgement is intrinsic to diagnostic strategies in general practice; however, empirical evidence for its validity is sparse.AimTo ascertain whether a GP’s global clinical judgement of future cognitive status has an added value for predicting a patient’s likelihood of experiencing dementia.Design and settingMulticentre prospective cohort study among patients in German general practice that took place from January 2003 to October 2016.MethodPatients without baseline dementia were assessed with neuropsychological interviews over 12 years; 138 GPs rated the future cognitive decline of their participating patients. Associations of baseline predictors with follow-up incident dementia were analysed with mixed-effects logistic and Cox regression.ResultsA total of 3201 patients were analysed over the study period (mean age = 79.6 years, 65.3% females, 6.7% incident dementia in 3 years, 22.1% incident dementia in 12 years). Descriptive analyses and comparison with other cohorts identified the participants as having frequent and long-lasting doctor–patient relationships and being well known to their GPs. The GP baseline rating of future cognitive decline had significant value for 3-year dementia prediction, independent of cognitive test scores and patient’s memory complaints (GP ratings of very mild (odds ratio [OR] 1.97, 95% confidence intervals [95% CI] = 1.28 to 3.04); mild (OR 3.00, 95% CI = 1.90 to 4.76); and moderate/severe decline (OR 5.66, 95% CI = 3.29 to 9.73)). GPs’ baseline judgements were significantly associated with patients’ 12-year dementia-free survival rates (Mantel–Cox log rank test P<0.001).ConclusionIn this sample of patients in familiar doctor–patient relationships, the GP’s clinical judgement holds additional value for predicting dementia, complementing test performance and patients’ self-reports. Existing and emerging primary care-based dementia risk models should consider the GP’s judgement as one predictor. Results underline the importance of the GP-patient relationship.

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Bergus, George R., and Clarence D. Kreiter. "The reliability of summative judgements based on objective structured clinical examination cases distributed across the clinical year." Medical Education 41, no. 7 (July 2007): 661–66. http://dx.doi.org/10.1111/j.1365-2923.2007.02786.x.

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40

Lovett, P. A., M. B. Halstead, A. R. Hill, D. A. Palmer, T. S. Sonnex, and M. R. Pointer. "The effect on clinical judgements of new types of fluorescent lamp: I Experimental arrangements and clinical results." Lighting Research & Technology 23, no. 1 (March 1991): 35–51. http://dx.doi.org/10.1177/096032719102300101.

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41

Dave, Subodh, Roshelle Ramkisson, Chelliah R. Selvasekar, and Indranil Chakravorty. "The Case for Integrating Multi-Source Data for a Fairer and Holistic Judgement of Competence in Medical Education & Training." Sushruta Journal of Health Policy & Opinion 14, no. 1 (November 10, 2020): 1–9. http://dx.doi.org/10.38192/14.1.1.

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Being a doctor in the 21st Century requires a diverse range of skills, a broad base of knowledge and a suite of professional values and attitudes that enable the clinical practice to be safe, effective and caring. Doctors, irrespective of their speciality, need to be knowledgeable and skilful not just in their area of expertise but also need a range of generic skills and capabilities such as communication, leadership, academic scholarship and research, teaching, quality improvement, advocacy, digital literacy to name a few. These capabilities, all relevant to clinical practice, are assessed routinely in clinical settings. This rich information about trainees, available from their formative assessments, does not inform high-stakes judgements about progression. Instead, these judgements are usually made on the basis of summative examinations conducted in simulated settings. Unfortunately, these summative assessments have consistently delivered results with a large magnitude of the differential between the outcomes of candidates, based on factors such as ethnicity, gender, other protected characteristics and also the country of primary medical qualification. Formative assessment during training, however, is individualised and tends not to show this level of difference; leading to a situation where failure in summative examinations comes as a surprise to both trainees and to training programme directors. There is evidence that periodic assessment of trainees’ acquisition of core capabilities can help make balanced, informed judgements about readiness for progression. The move from a pass/fail categorisation to a yet/not yet categorisation when coupled with appropriate remedial measures can improve, both the validity, as well as the fairness of assessments. The large magnitude of the differential in outcomes of high-stakes assessments cannot be fixed by tweaking current assessment systems. Instead, there needs to be a recognition that high-level of capabilities consistently demonstrated in the workplace need to play a role in judgements about progression. Failure to do so is unfair, wasteful of public finances, and in breach of the trust places by the public, in training safe and competent clinicians.

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Gruber, Ronald P., and Richard A. Block. "Effect of caffeine on prospective and retrospective duration judgements." Human Psychopharmacology: Clinical and Experimental 18, no. 5 (2003): 351–59. http://dx.doi.org/10.1002/hup.501.

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Takakura, Nobuari, Miho Takayama, Akiko Kawase, Ted J. Kaptchuk, and Hiroyoshi Yajima. "Double Blinding with a New Placebo Needle: A Further Validation Study." Acupuncture in Medicine 28, no. 3 (September 2010): 144–48. http://dx.doi.org/10.1136/aim.2009.001230.

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Background The masking properties of a new, non-penetrating, double-blind placebo acupuncture needle were demonstrated. Practitioners correctly identified some of the needles; if they were confident in this opinion, they would be unblinded. Objective To investigate the clues that led to correct identification, and the confidence in this decision. Methods Ten acupuncture practitioners, blindly and randomly, applied 10 each of three types of needle to the shoulder: blunt, non-penetrating needles that pressed the skin (‘skin-touch placebo needle’); new non-penetrating needles that penetrated soft material (stuffing) but did not reach the skin (‘non-touch control needle’); matching penetrating needles. Afterwards, practitioners were asked to judge the type of needle, their confidence in their decision and what clues led them to their judgements. Results Of the 30 judgements made by each practitioner, the mean number of correct, incorrect and unidentifiable answers were 10.4 (SD 3.7), 15.2 (SD 4.9) and 4.4 (SD 6.1), respectively. There was no significant difference in the confidence scores for 104 correct (mean, 54.0 (SD 20.2)%) and 152 incorrect (mean, 50.3 (SD 24.3)%) judgements. Twelve needles were identified with 100% confidence—three correct, and nine incorrect. For needles correctly identified, the proportions of non-touch (p = 0.14) and skin-touch (p = 0.17), needles were no greater than chance, but the proportion of penetrating needles correctly identified exceeded chance (p < 0.01). 53% of judgements were made from the “feeling of needle insertion”, but 57% of these were wrong. Conclusion Practitioners had a slight tendency to guess the penetrating needles correctly, but were uncertain about most of their judgments, posing only a very small risk to double blinding.

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Reekie, Lilian-Jean, and Finy Josephine Hansen. "The Influence of Client Age on Clinical Judgements of Male and Female Social Workers." Journal of Gerontological Social Work 19, no. 2 (October 29, 1992): 67–82. http://dx.doi.org/10.1300/j083v19n02_05.

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Vetter, Norman. "What is a clinical review?" Reviews in Clinical Gerontology 13, no. 2 (May 2003): 103–5. http://dx.doi.org/10.1017/s0959259803013212.

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Traditional clinical review articles, also known as updates, differ from systematic reviews and meta-analyses. Systematic reviews comprehensively examine the medical literature, seeking to identify and synthesize all relevant information to formulate the best approach to diagnosis or treatment. Meta-analyses, sometimes known as quantitative systematic reviews seek to answer a narrow clinical question, often about the specific treatment of a condition, using rigorous statistical analysis of pooled research studies. Updates review the medical literature almost as carefully as a systematic review but discuss the topic under question more broadly and make reasoned judgements where there is little hard evidence, based upon the expertise of the reviewer. It may not include evidence from foreign language journals or look for unpublished data on a topic, so will tend to be more applicable to the local situation than a systematic review, as it may take into account local shortages of equipment or personnel.

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James, Ian A., Paul S. Smith, and Derek Milne. "Teaching Visual Analysis of Time Series Data." Behavioural and Cognitive Psychotherapy 24, no. 3 (July 1996): 247–61. http://dx.doi.org/10.1017/s1352465800015101.

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Visual analysis, or “eyeballing”, of single subject (N=l) data is the commonest technique for analysing time series data. The present study examined firstly, psychologists' abilities to determine significant change between baseline (A) and therapeutic (B) phases, and secondly, the decision making process in relation to the visual components of such graphs. Thirdly, it looked at the effect that a training programme had on psychologists' abilities to identify significant A−B change. The results revealed that the participants were poor at identifying significant effects from non-significant changes. In particular, the study found a high rate of false alarms (Type 1 errors), and a low rate of misses (Type 2 errors), i.e. high sensitivity but poor specificity. The only visual components to significantly alter decisions were the degree of serial dependency and the mean shift component. The teaching influenced the participants' judgements. In general, participants became more conservative, but there was limited evidence of a significant improvement in their judgements following the teaching.

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Yang, Huiqin, and Carl Thompson. "The effects of clinical experience on nurses’ critical event risk assessment judgements in paper based and high fidelity simulated conditions: A comparative judgement analysis." International Journal of Nursing Studies 48, no. 4 (April 2011): 429–37. http://dx.doi.org/10.1016/j.ijnurstu.2010.09.010.

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Cramer, P., J. Bowen, and M. O'Neill. "Schizophrenics and Social Judgement." British Journal of Psychiatry 160, no. 4 (April 1992): 481–87. http://dx.doi.org/10.1192/bjp.160.4.481.

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Videotaped social interactions were shown to a population of schizophrenics and controls who were asked to comment on the emotional state of the principal protagonist. Their free responses were subjected to a content analysis to examine which of three possible explanations of known schizophrenic inaccuracies on this task were responsible: formal thought disorder, selective avoidance of psychological factors, or perceptual/attentional deficits. Neither selective avoidance nor marked thought disorder were found to explain these errors. The schizophrenics as a group rated much the same, irrespective of clinical profile. Their judgements of personality were less clear-cut than the controls.

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Stafleu, Frans R., F. Robert Heeger, and Anton C. Beynen. "A Case Study on the Impact of Clinically-Observed Abnormalities in Mice with Gallstones on the Ethical Admissibility of a Projected Experiment with Gallstone-Bearing Mice." Alternatives to Laboratory Animals 17, no. 2 (December 1989): 101–8. http://dx.doi.org/10.1177/026119298901700206.

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An attempt was made to study the impact of clinically-observed abnormalities in mice with gallstones on the ethical admissibility of a proposed experiment using gallstone-bearing mice. Three groups of respondents completed a questionnaire based on a hypothetical protocol of a proposed experiment using gallstone-bearing mice. Differing information was given in the protocols concerning abnormalities in gallstone-bearing mice. Respondents were asked to judge, using a scoring system, the ethical admissibility of the proposed experiment and the degree of discomfort for the mice. Respondents were also asked to defend their admissibility judgements and discomfort scores. Respondents given clinical information considered the degree of discomfort to be more serious than respondents without such information. Respondents given information indicated that their estimate of discomfort was based principally on the clinical information provided. Respondents without clinical information mentioned the lack of such information as a handicap to assessing discomfort properly. Scores on ethical admissibility of the proposed experiment were found to be unaltered by the clinical information. Judgement of the ethical admissibility was based mainly on the anticipated human benefits to be gained by performing the experiment. It is stressed that the specific character of the present study does not allow generalisation of its outcome.

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DOYLE, M., and M. DOLAN. "Violence risk assessment: combining actuarial and clinical information to structure clinical judgements for the formulation and management of risk." Journal of Psychiatric and Mental Health Nursing 9, no. 6 (December 2002): 649–57. http://dx.doi.org/10.1046/j.1365-2850.2002.00535.x.

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