REDUCING VARIABILITY IN TREATMENT DECISION-MAKING - EFFECTIVENESS OF EDUCATING CLINICIAN ABOUT UNCERTAINTY

The objective of this study was to investigate whether or not educatio n about the concept of uncertainty reduced variability in treatment de cision-making. Three small groups of dentists in North York, Canada we re asked to make restorative treatment decisions about simulated bitew ing radiographs. They subsequently took part in a seminar about variat ions in perception and judgement and were given explanations of sensit ivity, specificity and receiver operating characteristic (ROC) curve a nalysis. A repeat reading of the radiographs was then performed by bot h test and control groups. Results indicated that the intervention inc reased the accuracy, and decreased the variability of dentists' restor ative treatment decisions. Kappa statistics were 0.33, 0.34 and 0.31 b efore the seminar, and 0.40, 0.43 and 0.41 after the seminar. Standard errors for kappas were 0.06, 0.05 and 0.05 before the seminar, and 0. 02, 0.02 and 0.05 after the seminar. The area under the ROC curve was 0.7136 before the seminar and 0.7835 after the seminar. The data demon strate that the dentists' decisions were less variable and more accura te following the educative intervention. This study suggests that ther e is potential for improving consistency and accuracy in clinical deci sionmaking through education in probabilistic reasoning.