title: Confidence and Information Access in Clinical Decision-Making: An Examination of the Cognitive Processes that affect the Information-seeking Behavior of Physicians.
abstract: Clinical decision-making involves the interplay between cognitive processes and physicians' perceptions of confidence in the context of their information-seeking behavior. The objectives of the study are: to examine how these concepts interact, to determine whether physician confidence, defined in relation to information need, affects clinical decision-making, and if information access improves decision accuracy. We analyzed previously collected data about resident physicians' perceptions of information need from a study comparing abstracts and full-text articles in clinical decision accuracy. We found that there is a significant relation between confidence and accuracy (φ=0.164, p<0.01). We also found various differences in the alignment of confidence and accuracy, demonstrating the concepts of underconfidence and overconfidence across years of clinical experience. Access to online literature also has a significant effect on accuracy (p<0.001). These results highlight possible CDSS strategies to reduce medical errors.
authors.affiliation: National Library of Medicine, Bethesda, MD 20894.
authors.forename: Raymonde Charles
authors.initials: RC
authors.lastname: Uy
authors.affiliation: National Library of Medicine, Bethesda, MD 20894.
authors.forename: Raymond Francis
authors.initials: RF
authors.lastname: Sarmiento
authors.affiliation: National Library of Medicine, Bethesda, MD 20894.
authors.forename: Alex
authors.initials: A
authors.lastname: Gavino
authors.affiliation: National Library of Medicine, Bethesda, MD 20894.
authors.forename: Paul
authors.initials: P
authors.lastname: Fontelo
mesh_terms: D002983:Clinical Competence; D003071:Cognition; D003657:Decision Making; D006801:Humans; D057226:Information Seeking Behavior; D007396:Internship and Residency; D019300:Medical Errors / Q000517:prevention & control; D009862:Online Systems / Q000706:statistics & numerical data; D010820:Physicians / Q000523:psychology