Timothy M. Smith
American Medical Association
Originally posted 4 Feb 21
Here is an excerpt:
Four to look out for
Cognitive biases are worrisome for physicians because they can affect one’s ability to gather evidence, interpret evidence, take action and evaluate their decisions, the authors noted. Here are four biases that commonly surface in medicine.
Confirmation bias involves selectively gathering and interpretation evidence to conform with one’s beliefs, as well as neglecting evidence that contradicts them. An example is refusing to consider alternative diagnoses once an initial diagnosis has been established, even though data, such as laboratory results, might contradict it.
“This bias leads physicians to see what they want to see,” the authors wrote. “Since it occurs early in the treatment pathway, confirmation bias can lead to mistaken diagnoses being passed on to and accepted by other clinicians without their validity being questioned, a process referred to as diagnostic momentum."
Anchoring bias is much like confirmation bias and refers to the practice of prioritizing information and data that support one’s initial impressions of evidence, even when those impressions are incorrect. Imagine attributing a patient’s back pain to known osteoporosis without ruling out other potential causes.
Affect heuristic describes when a physician’s actions are swayed by emotional reactions instead of rational deliberation about risks and benefits. It is context or patient specific and can manifest when physician experiences positive or negative feelings toward a patient based on prior experiences.
Outcomes bias refers to the practice of believing that clinical results—good or bad—are always attributable to prior decisions, even if the physician has no valid reason to think this, preventing him from assimilating feedback to improve his performance.
“Although the relation between decisions and outcomes might seem intuitive, the outcome of a decision cannot be the sole determinant of its quality; that is, sometimes a good outcome can happen despite a poor clinical decision, and vice versa,” the authors wrote.