Note to users. If you're seeing this message, it means that your browser cannot find this page's style/presentation instructions -- or possibly that you are using a browser that does not support current Web standards. Find out more about why this message is appearing, and what you can do to make your experience of our site the best it can be.

Site Tools

  • AAAS
  • Subscribe
  • Feedback

Site Search

Search Advanced

Science 31 March 1989:
Vol. 243. no. 4899, pp. 1668 - 1674
DOI: 10.1126/science.2648573

Articles

Science, Vol 243, Issue 4899, 1668-1674
Copyright © 1989 by American Association for the Advancement of Science


articles

Clinical versus actuarial judgment

RM Dawes, D Faust, and PE Meehl

Department of Social and Decision Sciences, Carnegie Mellon University, Pittsburgh, PA 15213.

Professionals are frequently consulted to diagnose and predict human behavior; optimal treatment and planning often hinge on the consultant's judgmental accuracy. The consultant may rely on one of two contrasting approaches to decision-making--the clinical and actuarial methods. Research comparing these two approaches shows the actuarial method to be superior. Factors underlying the greater accuracy of actuarial methods, sources of resistance to the scientific findings, and the benefits of increased reliance on actuarial approaches are discussed.


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES:
Using Information to Optimize Medical Outcomes.
J. R. Duncan and R. G. Evens (2009)
JAMA 301, 2383-2385
   Full Text »    PDF »
Aging Versus Stable Enduring Traits as Explanatory Constructs in Sex Offender Recidivism: Partitioning Actuarial Prediction Into Conceptually Meaningful Components.
H. E. Barbaree, C. M. Langton, R. Blanchard, and J. M. Cantor (2009)
Criminal Justice and Behavior 36, 443-465
   Abstract »    PDF »
How to make good-enough risk decisions.
A. Carroll (2009)
Advan. Psychiatr. Treat. 15, 192-198
   Abstract »    Full Text »    PDF »
A gluco-metabolic risk index with cardiovascular risk stratification potential in patients with coronary artery disease.
M. Anselmino, K. Malmberg, L. Ryden, and J. Ohrvik (2009)
Diabetes and Vascular Disease Research 6, 62-70
   Abstract »    PDF »
The Meta-Analysis of Clinical Judgment Project: Effects of Experience on Judgment Accuracy.
P. M. Spengler, M. J. White, S. Aegisdottir, A. S. Maugherman, L. A. Anderson, R. S. Cook, C. N. Nichols, G. K. Lampropoulos, B. S. Walker, G. R. Cohen, et al. (2009)
The Counseling Psychologist 37, 350-399
   Abstract »    PDF »
Evidence-Based Practice in Social Work: Lessons from Judgment and Decision-Making Theory.
G. M. J. van de Luitgaarden (2009)
Br. J. Soc. Work 39, 243-260
   Abstract »    Full Text »    PDF »
Hoping for A to Z While Rewarding Only A: Complex Organizations and Multiple Goals.
S. K. Ethiraj and D. Levinthal (2009)
Organization Science 20, 4-21
   Abstract »    PDF »
Depression Screening and Patient Outcomes in Cardiovascular Care: A Systematic Review.
B. D. Thombs, P. de Jonge, J. C. Coyne, M. A. Whooley, N. Frasure-Smith, A. J. Mitchell, M. Zuidersma, C. Eze-Nliam, B. B. Lima, C. G. Smith, et al. (2008)
JAMA 300, 2161-2171
   Abstract »    Full Text »    PDF »
A Meta-Analysis of Juvenile Justice Risk Assessment Instruments: Predictive Validity by Gender.
C. S. Schwalbe (2008)
Criminal Justice and Behavior 35, 1367-1381
   Abstract »    PDF »
Health Decision Making: Lynchpin of Evidence-Based Practice.
B. Spring (2008)
Med Decis Making 28, 866-874
   Abstract »    PDF »
Science and Pseudoscience in Law Enforcement: A User-Friendly Primer.
S. O. Lilienfeld and K. Landfield (2008)
Criminal Justice and Behavior 35, 1215-1230
   Abstract »    PDF »
Converting the Informed Consent From a Perfunctory Process to an Evidence-Based Foundation for Patient Decision Making.
S. V. Arnold, C. Decker, H. Ahmad, O. Olabiyi, S. Mundluru, K. J. Reid, G. E. Soto, S. Gansert, and J. A. Spertus (2008)
Circ Cardiovasc Qual Outcomes 1, 21-28
   Abstract »    Full Text »    PDF »
From Meehl to Fast and Frugal Heuristics (and Back): New Insights into How to Bridge the Clinical--Actuarial Divide.
K. V. Katsikopoulos, T. Pachur, E. Machery, and A. Wallin (2008)
Theory Psychology 18, 443-464
   Abstract »    PDF »
Performance-Based Assessment in Schools: A Comment on Hojnoski, Morrison, Brown, and Matthews (2006).
S. R. Smith (2007)
Journal of Psychoeducational Assessment 25, 248-256
   Abstract »    PDF »
Directions for Violence and Sexual Risk Assessment in Correctional Psychology.
D. G. Kroner, J. F. Mills, L. R. Reitzel, E. Dow, D. H. Aufderheide, and M. G. Railey (2007)
Criminal Justice and Behavior 34, 906-918
   Abstract »    PDF »
Performance Characteristics of Depression Screening Instruments in Survivors of Acute Myocardial Infarction: Review of the Evidence.
B. D. Thombs, G. Magyar-Russell, E. B. Bass, K. J. Stewart, K. K. Tsilidis, D. E. Bush, J. A. Fauerbach, U. D. McCann, and R. C. Ziegelstein (2007)
Psychosomatics 48, 185-194
   Abstract »    Full Text »    PDF »
The Massachusetts Youth Screening Instrument as a Predictor of Institutional Maladjustment in Severe Male Juvenile Offenders.
M. A. Butler, B. R. Loney, and J. Kistner (2007)
Criminal Justice and Behavior 34, 476-492
   Abstract »    PDF »
Predictive Validity of the Joint Risk Matrix With Juvenile Offenders: A Focus on Gender and Race/Ethnicity.
C. S. Schwalbe, M. W. Fraser, and S. H. Day (2007)
Criminal Justice and Behavior 34, 348-361
   Abstract »    PDF »
Development and Field Test of a Gender-Informed Security Reclassification Scale for Female Offenders.
K. Blanchette and K. N. Taylor (2007)
Criminal Justice and Behavior 34, 362-379
   Abstract »    PDF »
Patients Derogate Physicians Who Use a Computer-Assisted Diagnostic Aid.
H. R. Arkes, V. A. Shaffer, and M. A. Medow (2007)
Med Decis Making 27, 189-202
   Abstract »    PDF »
Measuring Foster Parent Potential: Casey Foster Applicant Inventory-Worker Version (CFAI-W).
G. S. Cuddeback, C. Buehler, J. G. Orme, and N. S. Le Prohn (2007)
Research on Social Work Practice 17, 93-109
   Abstract »    PDF »
.
G. A. Aarons (2006)
Psychiatr Serv 57, 1656
   Full Text »    PDF »
Regions of Rationality: Maps for Bounded Agents.
R. M. Hogarth and N. Karelaia (2006)
Decision Analysis 3, 124-144
   Abstract »    PDF »
To Bayes or Not to Bayes? A Comparison of Two Classes of Models of Information Aggregation.
D. V. Budescu and H.-T. Yu (2006)
Decision Analysis 3, 145-162
   Abstract »    PDF »
Projective Test Use Among School Psychologists: A Survey and Critique.
R. L. Hojnoski, R. Morrison, M. Brown, and W. J. Matthews (2006)
Journal of Psychoeducational Assessment 24, 145-159
   Abstract »    PDF »
Drug Benefit Decisions among Older Adults: A Policy-Capturing Analysis.
R. R. Cline and K. Gupta (2006)
Med Decis Making 26, 273-281
   Abstract »    PDF »
The Meta-Analysis of Clinical Judgment Project: Fifty-Six Years of Accumulated Research on Clinical Versus Statistical Prediction.
S. Aegisdottir, M. J. White, P. M. Spengler, A. S. Maugherman, L. A. Anderson, R. S. Cook, C. N. Nichols, G. K. Lampropoulos, B. S. Walker, G. Cohen, et al. (2006)
The Counseling Psychologist 34, 341-382
   Abstract »    PDF »
Should I Pack My Umbrella? Clinical Versus Statistical Prediction of Mental Health Decisions.
S. Aegisdottir, P. M. Spengler, and M. J. White (2006)
The Counseling Psychologist 34, 410-419
   Abstract »    PDF »
EAPC Abstracts.
(2006)
Palliative Medicine 20, 229-379
   PDF »
The Effectiveness of Simple Decision Heuristics: Forecasting Commercial Success for Early-Stage Ventures.
T. Astebro and S. Elhedhli (2006)
Management Science 52, 395-409
   Abstract »    PDF »
Response to "Competing Views: A Dialogue on Response to Intervention".
T. E. Scruggs and M. A. Mastropieri (2006)
Assessment for Effective Intervention 32, 62-64
   Abstract »    PDF »
Book Review: Configural Frequency Analysis: Methods, Models, and Applications.
E. Y. Mun (2006)
Applied Psychological Measurement 30, 72-74
   PDF »
Physician Evaluation after Medical Errors: Does Having a Computer Decision Aid Help or Hurt in Hindsight?.
M. V. Pezzo and S. P. Pezzo (2006)
Med Decis Making 26, 48-56
   Abstract »    PDF »
Another Look at Interpreting Risk Categories.
D. Mossman (2006)
Sexual Abuse: A Journal of Research and Treatment 18, 41-63
   Abstract »    PDF »
Local Applicability of Clinical and Model-Based Probability Estimates.
E. W. Steyerberg (2005)
Med Decis Making 25, 678-680
   PDF »
Comparative Validity Analysis of Multiple Measures of Violence Risk in a Sample of Criminal Offenders.
K. S. Douglas, M. Yeomans, and D. P. Boer (2005)
Criminal Justice and Behavior 32, 479-510
   Abstract »    PDF »
Assessing the Likelihood of an Important Clinical Outcome: New Insights from a Comparison of Clinical and Actuarial Judgment.
T. Rakow, C. Vincent, K. Bull, and N. Harvey (2005)
Med Decis Making 25, 262-282
   Abstract »    PDF »
Evidence-based toxicology: a comprehensive framework for causation.
P. S Guzelian, M. S Victoroff, N C. Halmes, R. C James, and C. P Guzelian (2005)
Human and Experimental Toxicology 24, 161-201
   Abstract »    PDF »
Predicting Wife Assault: A Critical Review and Implications for Policy and Practice.
N. Z. Hilton and G. T. Harris (2005)
Trauma Violence Abuse 6, 3-23
   Abstract »    PDF »
Using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) to Detect Psychological Distress and Dysfunction in a State Correctional Setting.
M. S. Black, J. D. Forbey, Y. S. Ben-Porath, J. R. Graham, J. L. McNulty, S. V. Anderson, and A. K. Burlew (2004)
Criminal Justice and Behavior 31, 734-751
   Abstract »    PDF »
A Review of Clinical Characteristics and Residential Treatments for Adolescent Delinquents with Mental Health Disorders: A Promising Residential Program.
L. A. Underwood, L. Barretti, T. L. Storms, and N. Safonte-Strumolo (2004)
Trauma Violence Abuse 5, 199-242
   Abstract »    PDF »
Learning from samples of one or fewer.
J G March, L S Sproull, and M Tamuz (2003)
Qual. Saf. Health Care 12, 465-471
   Abstract »    Full Text »    PDF »
Holistic Thinking is not the Whole Story: Alternative or Adjunct Approaches for Increasing the Accuracy of Legal Evaluations.
D. Faust (2003)
Assessment 10, 428-441
   Abstract »    PDF »
Evaluation of a Model of Violence Risk Assessment Among Forensic Psychiatric Patients.
K. S. Douglas, J. R. P. Ogloff, and S. D. Hart (2003)
Psychiatr Serv 54, 1372-1379
   Abstract »    Full Text »    PDF »
Actuarial Risk Assessment: Commentary on Berlin et al.
S. D. Hart (2003)
Sexual Abuse: A Journal of Research and Treatment 15, 383-388
   Abstract »    PDF »
Men in His Category Have a 50% Likelihood, But Which Half Is He In? Comments on Berlin, Galbreath, Geary, and McGlone.
G. Harris (2003)
Sexual Abuse: A Journal of Research and Treatment 15, 389-392
   PDF »
Setting Performance Standards: Concepts, Methods, and Perspectives.
Y. M. Thum (2003)
Applied Psychological Measurement 27, 305-307
   PDF »
The Science and Practice of Empirically Supported Treatments.
J. D. Herbert (2003)
Behav Modif 27, 412-430
   Abstract »    PDF »
The Foster Parent Potential Scale.
J. G. Orme, C. Buehler, M. McSurdy, K. W. Rhodes, and M. E. Cox (2003)
Research on Social Work Practice 13, 181-207
   Abstract »    PDF »
Computer-Based Test Interpretation in Career Assessment: Ethical and Professional Issues.
J. P. Sampson Jr., M. P. Purgar, and J. D. Shy (2003)
Journal of Career Assessment 11, 22-39
   Abstract »    PDF »
A Comparison of Predictors of General and Violent Recidivism Among High-Risk Federal Offenders.
A. J. J. Glover, D. E. Nicholson, T. Hemmati, G. A. Bernfeld, and V. L. Quinsey (2002)
Criminal Justice and Behavior 29, 235-249
   Abstract »    PDF »
Decision support and safety of clinical environments.
A H Morris (2002)
Qual. Saf. Health Care 11, 69-75
   Abstract »    Full Text »    PDF »
Statistical Prediction Models, Artificial Neural Networks, and the Sophism "I Am a Patient, Not a Statistic".
M. Kattan (2002)
J. Clin. Oncol. 20, 885-887
   Full Text »    PDF »
Automated Measurement of Bulbar Redness.
P. Fieguth and T. Simpson (2002)
Invest. Ophthalmol. Vis. Sci. 43, 340-347
   Abstract »    Full Text »    PDF »
The Empirical Validation of an Instrument to Predict Risk of Recidivism Among Juvenile Offenders.
J. Krysik and C. W. LeCroy (2002)
Research on Social Work Practice 12, 71-81
   Abstract »    PDF »
Do we under utilise actuarial judgement and decision analysis?.
J. D Hamilton (2001)
Evid. Based Ment. Health 4, 102-103
   Full Text »    PDF »
The Clinical Application of Risk Assessment in the Treatment-Planning Process.
M. J. Moran, M. G. Sweda, M. R. Fragala, and J. Sasscer-Burgos (2001)
Int J Offender Ther Comp Criminol 45, 421-435
   Abstract »    PDF »
Predicting Violence by Serious Wife Assaulters.
N. Z. HILTON, G. T. HARRIS, and M. E. RICE (2001)
J Interpers Violence 16, 408-423
   Abstract »    PDF »
Advance Directives as Acts of Communication: A Randomized Controlled Trial.
P. H. Ditto, J. H. Danks, W. D. Smucker, J. Bookwala, K. M. Coppola, R. Dresser, A. Fagerlin, R. M. Gready, R. M. Houts, L. K. Lockhart, et al. (2001)
Arch Intern Med 161, 421-430
   Abstract »    Full Text »    PDF »
From Death to Life: Prison Behavior of Former Death Row Inmates in Indiana.
T. J. REIDY, M. D. CUNNINGHAM, and J. R. SORENSEN (2001)
Criminal Justice and Behavior 28, 62-82
   Abstract »    PDF »
Classifying Child Abusers: Its Relevance to Theory and Clinical Practice.
J. Bickley and A. R. Beech (2001)
Int J Offender Ther Comp Criminol 45, 51-69
   Abstract »    PDF »
Problems for clinical judgement: introducing cognitive psychology as one more basic science.
D. A. Redelmeier, L. E. Ferris, J. V. Tu, J. E. Hux, and M. J. Schull (2001)
Can. Med. Assoc. J. 164, 358-360
   Full Text »    PDF »
Conceptions of depressive disorder and its treatment among 17 Swedish GPs. A qualitative interview study.
S. J Andersson, M. Troein, and G. Lindberg (2001)
Fam. Pract. 18, 64-70
   Abstract »    Full Text »    PDF »
Recurrent Issues and Recent Advances in Scoring Performance Assessments.
B. E. Clauser (2000)
Applied Psychological Measurement 24, 310-324
   Abstract »    PDF »
Factors Associated With Completion of the Restraining Order Process in Female Victims of Partner Violence.
L. A. ZOELLNER, N. C. FEENY, J. ALVAREZ, C. WATLINGTON, M. L. O'NEILL, R. ZAGER, and E. B. FOA (2000)
J Interpers Violence 15, 1081-1099
   Abstract »    PDF »
Determinants of Student Evaluations of Global Measures of Instructor and Course Value.
R. B. Marks (2000)
Journal of Marketing Education 22, 108-119
   Abstract »    PDF »
Modal Preferences Predict Elderly Patients' Life-sustaining Treatment Choices as Well as Patients' Chosen Surrogates Do.
W. D. Smucker, R. M. Houts, J. H. Danks, P. H. Ditto, A. Fagerlin, and K. M. Coppola (2000)
Med Decis Making 20, 271-280
   Abstract »    PDF »
Dementia diagnoses from clinical and neuropsychological data compared: The Cache County study.
J. T. Tschanz, K. A. Welsh-Bohmer, I. Skoog, N. West, M. C. Norton, B. W. Wyse, R. Nickles, and J. C. S. Breitner (2000)
Neurology 54, 1290-1296
   Abstract »    Full Text »    PDF »
Actuarial Assessment of Risk for Violence: Predictive Validity of the VRAG and the Historical Part of the HCR-20.
M. GRANN, H. BELFRAGE, and A. TENGSTROM (2000)
Criminal Justice and Behavior 27, 97-114
   Abstract »    PDF »
The Loss of the Romantic: Gain for the Science.
K. Salzinger (1999)
Journal of Humanistic Psychology 39, 30-37
   Abstract »    PDF »
Don't Confuse me with the Facts: Common Errors in Violence Risk Assessment at Capital Sentencing.
M. D. CUNNINGHAM and T. J. REIDY (1999)
Criminal Justice and Behavior 26, 20-43
   Abstract »    PDF »
Getting research findings into practice: Decision analysis and the implementation of research findings.
R J Lilford, S G Pauker, D A Braunholtz, and J. Chard (1998)
BMJ 317, 405-409
   Full Text »
Information Integration in Child Welfare Cases: An Introduction to Statistical Decision Making.
J. Ruscio (1998)
Child Maltreat 3, 143-156
   Abstract »
Proof Positive: Pornography in a Day-Care Center.
P. R. Abramson, M. Y. Cloud, R. Keese, and J. A. Girardi (1997)
Sexual Abuse: A Journal of Research and Treatment 9, 75-86
   Abstract »    PDF »
The Impact of Direct Marketing Appeals on Charitable Marketing Effectiveness.
G. E. Smith and P. D. Berger (1996)
Journal of the Academy of Marketing Science 24, 219-231
   Abstract »
Weighing Evidence in Sexual Abuse Evaluations: An Introduction to Bayes's Theorem.
J. M. Wood (1996)
Child Maltreat 1, 25-36
   Abstract »
Prevalence of Parkinsonian Signs and Associated Mortality in a Community Population of Older People.
D. A. Bennett, L. A. Beckett, A. M. Murray, K. M. Shannon, C. G. Goetz, D. M. Pilgrim, and D. A. Evans (1996)
N. Engl. J. Med. 334, 71-76
   Abstract »    Full Text »    PDF »
Predictors of General and Violent Recidivism among Mentally Disordered Inmates.
D. B. VILLENEUVE and V. L. QUINSEY (1995)
Criminal Justice and Behavior 22, 397-410
   Abstract »
Judging Development Control Decisions.
K.G. Willis (1995)
Urban Stud 32, 1065-1079
   Abstract »    PDF »
The Juncture of Intrapersonal and Interpersonal Knowledge: Self-Certainty and Interpersonal Congruence.
B. W. Pelham and W. B. Swann Jr. (1994)
Pers Soc Psychol Bull 20, 349-357
   Abstract »
Doctorates by Action Research for Senior Practising Managers.
C. Perry and O. Zuber-Skerritt (1994)
Management Learning 25, 341-364
   Abstract »
A National Program for the Assessment and Treatment of Sex Offenders in the English Prison System.
D. GRUBIN and D. THORNTON (1994)
Criminal Justice and Behavior 21, 55-71
   Abstract »
Risk Assessment in Child Protective Services: An Evaluation of the Child at Risk Field System.
H. J. DOUECK, M. LEVINE, and D. E. BRONSON (1993)
J Interpers Violence 8, 446-467
   Abstract »    PDF »
Nontraditional Validity Calculations and Differential Interviewer Experience: Implications for Selection Interviews.
T. M. Gehrlein, R. L. Dipboye, and C. Shahani (1993)
Educational and Psychological Measurement 53, 457-469
   Abstract »
Some Thoughts On Basic Concepts and Future Directions In The Study of Inter-Group Conflict.
S. G. Levy (1993)
Conflict Management and Peace Science 13, 1-27
   PDF »
Diagnosis of Dementia in a Heterogeneous Population: A Comparison of Paradigm-Based Diagnosis and Physician's Diagnosis.
J. Pittman, H. Andrews, T. Tatemichi, B. Link, E. Struening, Y. Stern, and R. Mayeux (1992)
Arch Neurol 49, 461-467
   Abstract »    PDF »
Short-term mortality predictions for critically ill hospitalized adults: science and ethics.
W. Knaus, D. Wagner, and J Lynn (1991)
Science 254, 389-394
   Abstract »    PDF »
Cognitive Psychology and Medical Judgment: Some Downfalls of Studying Pitfalls.
D. A. Redelmeier (1991)
Med Decis Making 11, 169-170
   PDF »
A Convergent Validity Model of Emergent Leadership in Groups.
S. D. Anderson and K. W. Wanberg (1991)
Small Group Research 22, 380-397
   Abstract »
Buddy, Can You Paradigm?.
G. W. Brown (1991)
Arch Pediatr Adolesc Med 145, 725
   Abstract »    PDF »
Do objectiue Estimates of chances for Survival Influence Decisions to Withhold or Withdraw Treatment?.
W. A. Knaus, A. Rauss, A. Alperovitch, J.-R. Le Gall, P. Loirat, E. Patois, and S. E. Marcus (1990)
Med Decis Making 10, 163-171
   Abstract »    PDF »
Clinical Judgment : an Overview.
N. L. Records and A. L. Weiss (1990)
Communication Disorders Quarterly 13, 153-165
   Abstract »    PDF »



To Advertise     Find Products


Science. ISSN 0036-8075 (print), 1095-9203 (online)