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In decision making under uncertainty one studies how the single case (the decision maker, e.g., a radiologist) chooses between alternatives (e.g., presence or absence of a tumor on an X-ray) when the information presented is uncertain or incomplete. By evaluating two possible types of errors that the decision maker can make, false positives and false negatives, estimates of two independent characteristics of the decision maker are obtained. One characteristic is the decision maker's sensitivity, which is his or her ability to detect the presence of the “signal” (e.g., tumor). The second is the decision maker's response bias, which is his or her tendency to favor one of the possible alternatives (e.g., a higher willingness to err on the side of caution). In decision contexts where the two types of errors have differential payoffs or costs, or where the two alternatives are not equally likely to occur, the decision maker's decision process can be evaluated in more detail with the receiver operating characteristics (ROC) curve (also called the relative operating characteristics curve). Assessing these separate characteristics of the decision maker provides a more informative alternative to simply assessing his or her accuracy rate (e.g., overall percentage-correct decisions) and is one way of studying a single case, an individual, who is in the process of making a binary decision.

Conceptual Overview and Discussion

The simplest decision-making situation is when a decision maker must choose between two possible alternatives (e.g., disease or no disease). To assess the decision maker's sensitivity and response bias, the researcher uses two types of errors that the decision maker can make: a false alarm (false positive, or Type I error in statistical hypothesis testing) and a miss (false negative, or Type II error). Data for the estimates of these two probabilities are the relative frequencies of the decision maker's responses to each of the two alternative scenarios over repeated trials. Table 1 shows the possible situations that may arise. The stimulus presented to the decision maker is one of two, either containing a signal or not. The decision maker can make one of two responses, either signal present or not. This creates four possible outcomes, but note that because for a given stimulus the decision maker must give one of the two responses the probabilities within each row must add up to 1.0.

Table 1 Four possible outcomes in a two-choice decision task

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Theoretical Basis: Signal Detection Theory

The theoretical basis for obtaining estimates of the decision maker's sensitivity and response bias is known as signal detection theory (SDT). SDT was developed and introduced into psychological research in the 1950s and is a direct application of statistical hypothesis testing to the tasks of detecting “signals” in noisy stimuli and of discriminating between two confusable stimuli. As in statistical hypothesis testing, there are two distributions, the noise-alone (analogous to the null) distribution and the signal + noise (alternative) distribution (see Figure 1). In SDT, the two distributions represent the probabilities of the various strength of evidence that the decision maker has for each of the two possible situations. The two distributions overlap, and there is one point, the decision criterion, along the evidence–strength axis that represents the decision maker's critical decision point for his or her decision rule. The rule applies on each trial and is stated thus: If the evidence received is stronger than the decision criterion, then respond “signal”; if the evidence is weaker, then respond “noise.” The evidence, however, can come from either of the two situations. So, if the strength of evidence falls above the criterion but was from the noise stimulus, fn distribution, then the decision maker has made an error of the false positive type (a false alarm). Alternatively, if it had in fact been from the signal distribution, fs, then the decision maker's response was correct and is referred to as a hit. The areas under the two curves to the right of the criterion are estimated by the proportions of P(hit) and P(false alarm) in Table 1.

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