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Antibiotic overprescribing is a global challenge contributing to rising levels of antibiotic resistance and mortality. We test a novel approach to antibiotic stewardship. Capitalising on the concept of "wisdom of crowds", which states that a group's collective judgement often outperforms the average individual, we test whether pooling treatment durations recommended by different prescribers can improve antibiotic prescribing. Using international survey data from 787 expert antibiotic prescribers, we run computer simulations to test the performance of the wisdom of crowds by comparing three data aggregation rules across different clinical cases and group sizes. We also identify patterns of prescribing bias in recommendations about antibiotic treatment durations to quantify current levels of overprescribing. Our results suggest that pooling the treatment recommendations (using the median) could improve guideline compliance in groups of three or more prescribers. Implications for antibiotic stewardship and the general improvement of medical decision making are discussed. Clinical applicability is likely to be greatest in the context of hospital ward rounds and larger, multidisciplinary team meetings, where complex patient cases are discussed and existing guidelines provide limited guidance.

Judging other people is a common and important task. Every day professionals make decisions that affect the lives of other people when they diagnose medical conditions, grant parole, or hire new employees. To prevent discrimination, professional standards require that decision makers render accurate and unbiased judgments solely based on relevant information. Facial similarity to previously encountered persons can be a potential source of bias. Psychological research suggests that people only rely on similarity-based judgment strategies if the provided information does not allow them to make accurate rule-based judgments. Our study shows, however, that facial similarity to previously encountered persons influences judgment even in situations in which relevant information is available for making accurate rule-based judgments and where similarity is irrelevant for the task and relying on similarity is detrimental. In two experiments in an employment context we show that applicants who looked similar to high-performing former employees were judged as more suitable than applicants who looked similar to low-performing former employees. This similarity effect was found despite the fact that the participants used the relevant résumé information about the applicants by following a rule-based judgment strategy. These findings suggest that similarity-based and rule-based processes simultaneously underlie human judgment.