Human judgment and decision making/Medical decision making

In 1954, Dr. Paul Meehl summarized a number of findings which demonstrated that the diagnosis of a trained expert judgment did not outperform the prediction of a mathematical model.  This “clinical versus actuarial” decision making distinction has influenced my interest in comparing holistic decision making with decompositional or disaggregated decision making.


Holistic decision making occurs when you are trying to weigh the advantages and disadvantages of a decision and make those tradeoffs in your head.  Decompositional decision making occurs when you take a systematic approach to weighing the pros and cons of a decision.  For example, you may want to simply write the number of pros and cons of each option and take the difference between the number of pros and cons for each option and select the option with largest difference.  While there are more complex forms of decompositional decision making, it has been shown to lead to more accurate judgments.  Decompositional judgments are also more temporally consistent than their holistic counterparts.


I have an interest in applying the principle of decompositional decision making in medical settings.  For example, when you go to the doctor’s office, you may be presented with information about two treatment options for a health condition.  How should you go about making this decision?  I would argue that using a decision aid or informal decompositional techniques allows you to make the necessary tradeoffs in a simple fashion.

  Representative publications (underlined authors represent student authors)
  • Morera, O.F. & Dawes, R.M. (2006).  Clinical and Statistical Prediction after Fifty Years: A Dedication to Paul Meehl.  Journal of Behavioral Decision Making, 19, 409-412.
  • Morera, O.F., Maydeu-Olivares, A., Nygren, T.E., White, R. J, Fernandez, N.P. & Skewes, M.C. (2006). Social Problem Solving Predicts Decision Making Styles in a U.S. Hispanic sample.  Personality and Individual Differences, 41, 307-317.
  • Morera, O.F. & Budescu, D.V.  (2001). Random Error Reduction in Analytic Hierarchies: A Comparison of Holistic and Decompositional Decision Strategies.   Journal of Behavioral Decision Making, 14, 223-242.
  • Walker, M. E., Morera, O. F., Vining, J. & Orland, B. (1999).  Disparate WTA-WTP Disparities: The Influence of Human vs. Natural Causes.  Journal of Behavioral Decision Making, 12, 219-232.
  • Morera, O. F. & Budescu, D. V.  (1998). A Psychometric Analysis of the “Divide and Conquer” Principle in Multi-Criteria Decision Making. Organizational Behavior and Human Decision Processes, 75(3), 187-206.
Published Abstracts
  • Morera, O.F., Kim, L.K., Fernandez, N.P., Urquidi, U., de la Torre, M. & Dolan, J.G. (2005).  Decision aids and colorectal cancer screening interest among Hispanic patients. Abstract published in the 27th Annual Meetings of the Society for Medical Decision Making.  San Francisco, CA.
External Subproject Funded
  • Decision Aids and Colorectal Cancer Screening Decisions in a Hispanic Population.”  2 R24 MH47167-11 Funding Organization: National Institutes of Mental Health/Minority Research Infrastructure and Support Program. Author:  Morera, O.F and Kim, L.  Role: Project Director.  Amount: $282,128.  Funding period: July 2003- June 2006.