Westen Drew, Weinberger Joel
Emory University.
Adelphi University.
Am Psychol. 2004 Oct;59(7):595-613. doi: 10.1037/0003-066X.59.7.595.
This article reconsiders the issue of clinical versus statistical prediction. The term clinical is widely used to denote 1 pole of 2 independent axes: the observer whose data are being aggregated (clinician/expert vs. lay) and the method of aggregating those data (impressionistic vs. statistical). Fifty years of research suggests that when formulas are available, statistical aggregation outperforms informal, subjective aggregation much of the time. However, these data have little bearing on the question of whether, or under what conditions, clinicians can make reliable and valid observations and inferences at a level of generality relevant to practice or useful as data to be aggregated statistically. An emerging body of research suggests that clinical observations, just like lay observations, can be quantified using standard psychometric procedures, so that clinical description becomes statistical prediction.
本文重新审视了临床预测与统计预测的问题。“临床”一词被广泛用于表示两个独立轴中的一极:数据被汇总的观察者(临床医生/专家与外行)以及汇总这些数据的方法(印象式与统计式)。五十年的研究表明,当有公式可用时,统计汇总在很多时候优于非正式的主观汇总。然而,这些数据与临床医生是否能够,或在何种条件下,在与实践相关的一般性水平上做出可靠且有效的观察和推断,或者作为统计汇总的数据是否有用这一问题几乎没有关联。一项新兴的研究表明,临床观察,就像外行观察一样,可以使用标准的心理测量程序进行量化,从而使临床描述成为统计预测。