CONDITIONAL PREDICTION & THE MANAGEMENT OF DANGEROUSNESS

这项研究测试了临床医生对未来的预测的准确性。 患者暴力使用新的模型来描述临床医生 评估和患者行为。 该模型反映了调查结果 我们目前的研究表明， 诚实并不是一个合乎逻辑的，直接的任务， 可能性估计。 相反，这是一项在内部完成的任务， 需要对暴力案件进行持续的案件管理， 患者 该提案采取的立场是，临床医生 对不诚实的评估与更广泛的模式有关， 关于患者及其情况的脚本。 这些脚本 在本研究中作为对 什么样的暴力会发生在什么样的临床医生 条件 我们假设，当一个人代表临床 判断和病人的行为在这些条件下， 临床医生预测和管理疾病的能力将是 比一般认为的要高。 该研究将收集详细的条件评估， 两个急诊室1600例病人的护理 临床医生对患者进行评估，如果患者入院， 出院时的单位主治医师。 预计400 患者被判定为危险，400名匹配的对照将被 在六个月的时间里进行了三次采访， 将对这些患者的临床和逮捕记录进行审查， 完了 结果将使我们双方能够确定预测 各种临床预测的有效性，并建议其他 可能有助于管理这些患者的条件。 这些结果将促使并集中关于 预测的作用。

This study tests the accuracy of clinicians' predictions of future patient violence using a new model to depict both clinician assessment and patient behavior. This model reflects the findings of our current research showing that the prediction of dangerousness is not a logical, straightforward task of generating a likelihood estimate. It is instead a task that is done within, and shaped by, the need for continuous case management of violent patients. The proposal adopts the position that clinicians assessments of dangerousness are tied to broader schemas or scripts about the patient and his or her situation. These scripts are represented and tested in this study as a judgment of the clinician about what type of violence will occur under what conditions. We hypothesize that when one represents the clinical judgment and patient behavior in these conditional terms clinicians' ability to predict and manage dangerousness will be found to be higher than commonly assumed. The research will collect a detailed conditional assessment of dangerousness on 1600 patients from the two emergency room clinicians who assess the patient and, if the patient is admitted, the unit attending physician at discharge. A projected 400 patients judged dangerous, and 400 matched controls will be followed through three interviews over a six-month period and reviews of clinical and arrest records for these patients will be done. The results will allow us both to determine the predictive validity of various clinical predictions and to suggest other conditions which might aid in the management of these patients. These results will both prompt and focus policy debate about the role of dangerousness predictions.