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

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.

[1]  M. Fishbein A Reasoned Action Approach to Health Promotion , 2008, Medical decision making : an international journal of the Society for Medical Decision Making.

[2]  J. Prochaska Decision Making in the Transtheoretical Model of Behavior Change , 2008, Medical decision making : an international journal of the Society for Medical Decision Making.

[3]  Angela Fagerlin,et al.  Clinical Implications of Numeracy: Theory and Practice , 2008, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[4]  Valerie F Reyna,et al.  Explaining Contradictory Relations Between Risk Perception and Risk Taking , 2008, Psychological science.

[5]  V. Reyna,et al.  Risk Taking Under the Influence: A Fuzzy-Trace Theory of Emotion in Adolescence. , 2008, Developmental review : DR.

[6]  N. Ford Learning: Individual Differences , 2008 .

[7]  V. Reyna,et al.  Numeracy, Ratio Bias, and Denominator Neglect in Judgments of Risk and Probability. , 2008 .

[8]  Herbert Simon,et al.  Current theories of risk and rational decision making , 2008 .

[9]  V. Reyna,et al.  Converging evidence supports fuzzy-trace theory's nested sets hypothesis, but not the frequency hypothesis , 2007 .

[10]  C J Brainerd,et al.  Explaining Developmental Reversals in False Memory , 2007, Psychological science.

[11]  P. Klaczynski,et al.  The development of judgement and decision making in children and adolescents , 2007 .

[12]  Charles J. Brainerd,et al.  The importance of mathematics in health and human judgment: Numeracy, risk communication, and medical decision making , 2007 .

[13]  M. Brundage,et al.  Further Insight into the Perception of Quantitative Information: Judgments of Gist in Treatment Decisions , 2007, Medical decision making : an international journal of the Society for Medical Decision Making.

[14]  V. Reyna,et al.  A web exercise in evidence-based medicine using cognitive theory , 2001, Journal of General Internal Medicine.

[15]  Valerie F. Reyna,et al.  Interference processes in fuzzy-trace theory: Aging, Alzheimer's disease, and development. , 2007 .

[16]  Colin M. Macleod,et al.  Inhibition in Cognition , 2007 .

[17]  Jessica S. Ancker,et al.  The Practice of Informatics: Design Features of Graphs in Health Risk Communication: A Systematic Review , 2006, J. Am. Medical Informatics Assoc..

[18]  V. Reyna,et al.  Physician decision making and cardiac risk: effects of knowledge, risk perception, risk tolerance, and fuzzy processing. , 2006, Journal of experimental psychology. Applied.

[19]  V. Reyna,et al.  Risk and Rationality in Adolescent Decision Making , 2006, Psychological science in the public interest : a journal of the American Psychological Society.

[20]  D. Kumaran,et al.  Frames, Biases, and Rational Decision-Making in the Human Brain , 2006, Science.

[21]  C. K. Mertz,et al.  PSYCHOLOGICAL SCIENCE Research Article Numeracy and Decision Making , 2022 .

[22]  S. Frederick Journal of Economic Perspectives—Volume 19, Number 4—Fall 2005—Pages 25–42 Cognitive Reflection and Decision Making , 2022 .

[23]  Valerie F. Reyna,et al.  Coherence and Correspondence Criteria for Rationality: Experts' Estimation of Risks of Sexually Transmitted Infections. , 2005 .

[24]  P. Ubel,et al.  How making a risk estimate can change the feel of that risk: shifting attitudes toward breast cancer risk in a general public survey. , 2005, Patient education and counseling.

[25]  V. Reyna,et al.  Risky decision making in childhood and adolescence: A fuzzy-trace theory approach , 2005 .

[26]  C. Krumhansl Concerning the Applicability of Geometric Models to Similarity Data : The Interrelationship Between Similarity and Spatial Density , 2005 .

[27]  V. Reyna CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE How People Make Decisions That Involve Risk A Dual-Processes Approach , 2022 .

[28]  Valerie F Reyna,et al.  Fuzzy‐Trace Theory, Risk Communication, and Product Labeling in Sexually Transmitted Diseases , 2003, Risk analysis : an official publication of the Society for Risk Analysis.

[29]  Charles J. Brainerd,et al.  Emerging Perspectives on Judgment and Decision Research: Memory, Development, and Rationality: An Integrative Theory of Judgment and Decision Making , 2003 .

[30]  J. Shanteau,et al.  Emerging Perspectives on Judgment and Decision Research: List of Contributors , 2003 .

[31]  Kimihiko Yamagishi,et al.  Facilitating normative judgments of conditional probability: frequency or nested sets? , 2003, Experimental psychology.

[32]  James Shanteau,et al.  Emerging Perspectives on Judgment and Decision Research , 2003 .

[33]  Winston R. Sieck,et al.  Foreground:background salience: Explaining the effects of graphical displays on risk avoidance , 2003 .

[34]  K. Stanovich,et al.  Heuristic and analytic processing: age trends and associations with cognitive ability and cognitive styles. , 2002, Journal of experimental child psychology.

[35]  P. Windschitl,et al.  Context and the interpretation of likelihood information: the role of intergroup comparisons on perceived vulnerability. , 2002, Journal of personality and social psychology.

[36]  V F Reyna,et al.  Accuracy and ambiguity in counseling patients about genetic risk. , 2001, Archives of internal medicine.

[37]  V F Reyna,et al.  Genetic testing and medical decision making. , 2001, Archives of internal medicine.

[38]  Kirby Bd Understanding what works and what doesn't in reducing adolescent sexual risk-taking. , 2001 .

[39]  V F Reyna,et al.  The Importance of Memory in Informed Consent for Surgical Risk , 2001, Medical decision making : an international journal of the Society for Medical Decision Making.

[40]  P R Bell,et al.  The role of risk and benefit perception in informed consent for surgery. , 2001, Medical decision making : an international journal of the Society for Medical Decision Making.

[41]  T. Kealey,et al.  More is less , 2000, Nature.

[42]  J. Neuschatz,et al.  Recall accuracy and illusory memories: when more is less. , 1999, Memory.

[43]  J. G. Hollands,et al.  The visual communication of risk. , 1999, Journal of the National Cancer Institute. Monographs.

[44]  V. Reyna,et al.  Fuzzy-trace theory and false memory: new frontiers. , 1998, Journal of experimental child psychology.

[45]  R. Greene,et al.  False recognition of associates: How robust is the effect? , 1997 .

[46]  V. Reyna,et al.  Theories of false memory in children and adults , 1997 .

[47]  Albert N. Katz,et al.  Metaphor: Implications and Applications , 2018 .

[48]  Jason M. Blackwell,et al.  Memory Illusions: Recalling, Recognizing, and Recollecting Events that Never Occurred , 1996 .

[49]  L D Cohn,et al.  Risk-perception: differences between adolescents and adults. , 1995, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[50]  C. Del Mar,et al.  Aid to diagnosis of melanoma in primary medical care , 1995, BMJ.

[51]  C. J. Brainerd,et al.  Autosuggestibility in Memory Development , 1995, Cognitive Psychology.

[52]  D. Redelmeier,et al.  Medical decision making in situations that offer multiple alternatives. , 1995, JAMA.

[53]  V. Reyna,et al.  Fuzzy-trace theory: An interim synthesis , 1995 .

[54]  V. Reyna,et al.  Fuzzy-trace theory: Some foundational issues , 1995 .

[55]  F. N. Dempster,et al.  Interference and inhibition in cognition: An historical perspective , 1995 .

[56]  V. Reyna Interference effects in memory and reasoning , 1995 .

[57]  Eric R. Stone,et al.  Risk communication: absolute versus relative expressions of low-probability risks , 1994 .

[58]  Valerie F. Reyna,et al.  Fuzzy-Trace Theory and Framing Effects in Children's Risky Decision Making , 1994 .

[59]  Douglas H. Wedell,et al.  Contemplating Single versus Multiple Encounters of a Risky Prospect , 1994 .

[60]  Charles J. Brainerd,et al.  The origins of probability judgment: A review of data and theories. , 1994 .

[61]  P. Johnson-Laird,et al.  PSYCHOLOGICAL SCIENCE Research Article HOW DIAGRAMS CAN IMPROVE REASONING , 2022 .

[62]  G. W. Fischer,et al.  Strategy compatibility, scale compatibility, and the prominence effect. , 1993 .

[63]  V. Reyna,et al.  Chapter 3 Fuzzy Memory and Mathematics in The Classroom , 1993 .

[64]  Robert H. Logie,et al.  Memory in everyday life , 1993 .

[65]  V. Reyna,et al.  Development of Long-Term Retention , 2011, Springer New York.

[66]  V. Reyna Reasoning, Remembering, and Their Relationship: Social, Cognitive, and Developmental Issues , 1992 .

[67]  V. Reyna Class inclusion, the conjunction fallacy, and other cognitive illusions , 1991 .

[68]  V. Reyna,et al.  Fuzzy-trace theory and framing effects in choice: Gist extraction, truncation, and conversion , 1991 .

[69]  V. Reyna,et al.  Inclusion illusions: Fuzzy-trace theory and perceptual salience effects in cognitive development , 1990 .

[70]  V. Reyna,et al.  Fuzzy processing in transitivity development , 1990 .

[71]  M. Gail,et al.  Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. , 1989, Journal of the National Cancer Institute.

[72]  A. Tversky,et al.  Rational choice and the framing of decisions , 1990 .

[73]  A. Tversky,et al.  Extensional versus intuitive reasoning: the conjunction fallacy in probability judgment , 1983 .

[74]  A. Tversky,et al.  On the elicitation of preferences for alternative therapies. , 1982, The New England journal of medicine.

[75]  A. Tversky,et al.  The framing of decisions and the psychology of choice. , 1981, Science.

[76]  H. H. Clark,et al.  Psychology and language : an introduction to psycholinguistics , 1979 .

[77]  C. Krumhansl Concerning the applicability of geometric models to similarity data: The interrelationship between similarity and spatial density. , 1978 .