The combined effect of patient classification systems and availability of resources can bias the judgments of treatment effectiveness

Abstract

Patient classification systems (PCS) support clinical decision-making but may rely on incorrect, outdated, or insufficient data. Doctors can sometimes override errors using their experience. However, certain factors such as scarcity of resources could lead to reliance on incorrect PCS recommendations, with consequences for patients. We conducted two experiments where participants interacted with a PCS that incorrectly classified fictitious patients as more or less sensitive to a treatment. Participants had the opportunity to administer the treatment on a series of patients, and use the feedback to learn that the PCS was wrong and all patients were equally sensitive. This was tested in contexts of abundant and scarce resources. Additionally, the treatment was effective in Experiment 1, but ineffective in Experiment 2. Results indicate that people generally trust the PCS recommendation, to some extent neglecting the information they collect during the task. This can lead to uneven resource allocation, especially in scarcity conditions, and incorrect perceptions of effectiveness, which in Experiment 2 implies believing that an ineffective treatment works. We preregistered the experiments, and all data and materials are public.