Exploratory Interaction and Extended Cognition: Redesigning Decision-making Support in Healthcare

Feuz, Martin. 2015. Exploratory Interaction and Extended Cognition: Redesigning Decision-making Support in Healthcare. Doctoral thesis, Goldsmiths, University of London [Thesis]

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Abstract or Description

This thesis presents practice-based research on redesigning decision support within the area of prostate cancer screening. More fundamentally, this research is specifically interested in a politics and practice of supporting exploratory interactivity in healthcare decision-making by non-experts. The motivation for this research stems partly from insights gained from my own empirical research into algorithmic web-search results personalisation as well as issues underlying the biopolitical logic of cancer screening practices, the individualisation of risk and the profound uncertainties inherent in evidencebased medicine which are largely underarticulated in the design of decisionsupport tools for individuals. Taking these conditions as the driver for this research, the first and theoretical part of the thesis analyses models of interactivity and the politics of statistically-derived medical knowledge in evidence-based medicine as well as problematising dominant but narrow conceptions of human decision-making. Following such analysis are the insights that the statistical nature of epidemiological risk information is of limited applicability for individual decision-making and, thus, patient preferences matter to guide decision-making under uncertainty. By introducing cognition understood as socially distributed and extended into and performed
through the environment, this research proposes to rethink how to design for exploratory information interaction in medical decision support. Following a research-through-design method and developing a minimal reserved design approach, a number of prototypes were developed to investigate the potentials
hypothesised in the theoretical part of the thesis. The prototypes assumed a probing function in shedding further light on the thinking and practices of medical professionals, which leads me to suggest repositioning them as probotypes, occupying a middle ground between prototypes and cultural probes. Ultimately, the contribution of this research lies in critically and practically exploring conceptual and methodological potentials for redesigning exploratory interactions in shared medical decision-making processes.

Item Type:

Thesis (Doctoral)

Identification Number (DOI):



Decision-Support, Evidence-based medicine, extended mind, design research, epistemic action, research through design, cancer screening, practice-based research, preventive healthcare

Departments, Centres and Research Units:

Centre for Cultural Studies (1998-2017)


31 August 2015

Item ID:


Date Deposited:

16 Nov 2015 12:11

Last Modified:

08 Sep 2022 13:51



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