Gillis J S, Lipkin J O, Moran T J
J Nerv Ment Dis. 1981 Jul;169(7):439-47. doi: 10.1097/00005053-198107000-00005.
Seventy psychiatric staff members at various Veterans Administration hospitals made decisions concerning appropriate medication for 40 hypothetical cases. A profile presented for each case described the patient's status on eight symptom dimensions. The physician-judges examined each profile and specified appropriate drugs and dose levels for the case. Analyses focused on agreement among judges and on prescriptive strategies, the manner in which symptoms were weighted in specific drug decisions. When base rates were taken into account in determining chance levels, the judges failed to agree with each other significantly more than would be expected by change; this was true for their prescriptions of general class of medications, specific drugs, and dose levels. Differences among physicians were traceable to inconsistency in the use of symptom information and individual variations in prescriptive strategies, cue (symptom) weighting strategies of judges being dissimilar and sometimes contradictory.
七十名来自不同退伍军人管理局医院的精神科工作人员针对40个假设病例做出了关于适当用药的决定。为每个病例呈现的一份概况描述了患者在八个症状维度上的状况。医生评审员检查了每份概况，并为病例指定了适当的药物和剂量水平。分析集中在评审员之间的一致性以及处方策略上，即在特定药物决策中对症状进行加权的方式。在确定概率水平时考虑基础比率时，评审员之间的意见不一致程度明显高于随机预期；在他们对一般药物类别、特定药物和剂量水平的处方方面都是如此。医生之间的差异可追溯到症状信息使用的不一致以及处方策略的个体差异，评审员的线索（症状）加权策略各不相同，有时甚至相互矛盾。
