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A cognitive model of converting scientific evidence on treatment effects into prognostic information in clinical practice

Levente Kriston


Rationale, aims and objectives: Little is known about the cognitive processes of how population-based scientific evidence is utilized in the treatment of individual patients. The present work aims to outline a formalized framework of converting scientific evidence on treatment effects into prognostic information in clinical practice and describes a pilot study for illustration of how the framework can be used in research.

Method:The proposed theoretical framework considers the human mind as a limited capacity information processing system. This system codes external stimuli into internal inputs, which are then processed through several steps towards an evidence-informed clinical output. A small-scale pilot study including 130 laypersons was performed. Participants were asked to make probabilistic prognostic statements based on a fictional study (“evidence”) and a fictional case vignette (“clinical context”).

Results: Several cognitive processes were defined, including coding of the attributes of the evidence and the clinical context, integration of the information in a similarity-dissimilarity matrix and calculating the prognostic output. Frequently required operations, such as extrapolation, individualization, particularization, generalization and absolutization of the information were outlined. The presented framework was shown to be useful in analyzing and interpreting the pilot study data.

Conclusions:The postulated model holds great potential for investigating cognitive processes included in evidence-informed clinical care.


Absolutization, applicability, clinical context, clinical knowledge, cognitive psychology, decision-making, empirical knowledge, evidence-based medicine, external validity, extrapolation, generalizability, individualization, particularization

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