The potential of collective intelligence in emergency medicine. Pooling medical students' independent decisions improves diagnostic performance.

Autor/inn/en	Kämmer, Juliane; Hautz, Wolf; Herzog, Stefan M.; Kunina-Habenicht, Olga; Kurvers, Ralf
Titel	The potential of collective intelligence in emergency medicine. Pooling medical students' independent decisions improves diagnostic performance.
Quelle	In: Medical decision making, 37 (2017) 6, S. 715-724 PDF als Volltext Link als defekt meldenVerfügbarkeit
Beigaben	Illustrationen
Sprache	englisch
Dokumenttyp	online; gedruckt; Zeitschriftenaufsatz
ISSN	0272-989X; 1552-681X
DOI	10.1177/0272989X17696998
Schlagwörter	Kompetenz; Entscheidung; Intelligenz (Psy); Diagnose; Computersimulation; Medizin; Kollektiv; Student
Abstract	Background: Evidence suggests that pooling multiple independent diagnoses can improve diagnostic accuracy in well-defined tasks. We investigated whether this is also the case for diagnostics in emergency medicine, an ill-defined task environment where diagnostic errors are rife. Methods: A computer simulation study was conducted based on empirical data from 2 published experimental studies. In the computer experiments, 285 medical students independently diagnosed 6 simulated patients arriving at the emergency room with dyspnea. Participants' diagnoses (n = 1,710), confidence ratings, and expertise levels were entered into a computer simulation. Virtual groups of different sizes were randomly created, and 3 collective intelligence rules (follow-the-plurality rule, follow-the-most-confident rule, and follow-the-most-senior rule) were applied to combine the independent decisions into a final diagnosis. For different group sizes, the performance levels (i.e., percentage of correct diagnoses) of the 3 collective intelligence rules were compared with each other and against the average individual accuracy. Results: For all collective intelligence rules, combining independent decisions substantially increased performance relative to average individual performance. For groups of 4 or fewer, the follow-the-most-confident rule outperformed the other rules; for larger groups, the follow-the-plurality rule performed best. For example, combining 5 independent decisions using the follow-the-plurality rule increased diagnostic accuracy by 22 percentage points. These results were robust across case difficulty and expertise level. Limitations: Our findings are based on simulated patients diagnosed by medical students. Whether results generalize to clinical practice is currently unknown. Conclusion: Combining independent decisions may substantially improve the quality of diagnoses in emergency medicine and may thus enhance patient safety. (DIPF/Orig.).
Erfasst von	DIPF \| Leibniz-Institut für Bildungsforschung und Bildungsinformation, Frankfurt am Main
Update	2020/2