Abstract

While collective intelligence (CI) is a powerful approach to increase decision accuracy, few attempts have been made to unlock its potential in medical decision-making. Here we investigated the performance of three well-known collective intelligence rules (“majority”, “quorum”, and “weighted quorum”) when applied to mammography screening. For any particular mammogram, these rules aggregate the independent assessments of multiple radiologists into a single decision (recall the patient for additional workup or not). We found that, compared to single radiologists, any of these CI-rules both increases true positives (i.e., recalls of patients with cancer) and decreases false positives (i.e., recalls of patients without cancer), thereby overcoming one of the fundamental limitations to decision accuracy that individual radiologists face. Importantly, we find that all CI-rules systematically outperform even the best-performing individual radiologist in the respective group. Our findings demonstrate that CI can be employed to improve mammography screening; similarly, CI may have the potential to improve medical decision-making in a much wider range of contexts, including many areas of diagnostic imaging and, more generally, diagnostic decisions that are based on the subjective interpretation of evidence.

Highlights

  • Beliefs in individual experts and genius are deeply engrained in western societies yet research on collective intelligence has shown that groups can often outperform individuals when solving cognitive problems [1,2,3,4]

  • As group size increases, all three CIrules achieve both increases in true positives (Fig 1A) and decreases in false positives (Fig 1B)

  • We find that groups employing any of the collective intelligence (CI) rules outperform the best-performing radiologist in that group, achieving more true positives (Fig 1A), fewer false positives (Fig 1B) and higher overall accuracy (Fig 1C)

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Summary

Introduction

Beliefs in individual experts and genius are deeply engrained in western societies yet research on collective intelligence has shown that groups can often outperform individuals when solving cognitive problems [1,2,3,4]. Impressive feats of collective intelligence (CI) have been described in a wide range of animal species including microbes, insects, fish, birds and humans [6,7,8,9,10,11,12]. Collective Intelligence Meets Medical Decision-Making (SAW-2013-IGB-2); by the American Cancer Society using a donation from the Longaberger Company’s Horizon of Hope Campaign (SIRSG-07-271, SIRSG07-272, SIRSG-07-273, SIRSG-07-274-01, SIRSG07-275, SIRSG-06-281, SIRSG-09-270-01, SIRSG09-271-01, SIRSG-06-290-04); by the Breast Cancer Stamp Fund; and by the National Cancer Institute Breast Cancer Surveillance Consortium (U01CA63740, U01CA86076, U01CA86082, U01CA70013, U01CA69976, U01CA63731, U01CA70040, HHSN261201100031C). For a full description of these sources, please see www.breastscreening.cancer.gov/work/ acknowledgement.html

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