Signal detection theory offers a powerful model to explain decision-making processes in the laboratory, and it can also be applied to the setting of clinical consultationSignal becomes harder to distinguish from noise when we are tired or trying to hold too much information in our working memoryThe way in which patients present information might make important symptoms harder to distinguish from less clinically relevant onesPatients in neurology might be 'noisier' than average, owing to the often long-standing duration of their condition and the greater proportion that have medically unexplained symptomsStrategies to reduce noise include writing down key facts as they emerge, getting patients to self-filter their symptoms, and asking the patients to focus on one presenting complaint at a time
Every doctor carries around a highly sophisticated piece of signal detection apparatus—the human brain. Powerful as it is, however, the brain is still far from perfect and is prone to errors of judgment. What can the theory underlying signal detection tell us about the cognitive processes that lead to such mistakes? And how can an understanding of signal detection theory (SDT) hone our brain function for use in clinical situations and improve our interactions with patients? This Review seeks to address these key questions.
