anchoring bias in medicine

This unconscious bias, also known as implicit bias, is important in a medical setting “because it may affect decision making about how care proceeds,” she says. It refers to physicians’ practices of prioritizing information and data that support their initial impressions, even when first impressions are wrong. For example, we wrote about a case of anchoring in our November 2008 column , “Anchoring errors ensue when diagnoses get lost in translation,” where a patient’s complaint of gas caused clinicians to initially miss an abdominal aneurysm. Cognitive bias has frequently been discussed in general healthcare environments where it may affect both patient care and staff wellbeing, 2-4 and also in science settings. Medical Education 2009: 43: 721– 728 5-7 Biases in public health medicine have been well recognised. Anchoring bias, limited differential leads to quadriplegia Spinal epidural abscess (SEA) too often overlooked Facts: A 44-year-old male with recent interferon treatment for Hepatitis C and a prior history of neck surgery with hardware sees his PCP for new onset headache, photophobia, and URI symptoms. This video explains and illustrates common cognitive biases that affect medical decision-making. 2006 Mar- Apr;26(2):154-61. • Wegwarth O. Example The hospital you are working in as a medical student is short of beds. Like a medical procedure, heuristics can have both risks and benefits. ... and Pamela Hartzband are staff physicians at Boston’s Beth Israel Deaconess Medical Center. Anchoring bias reflects the undue influence that an initial impression has on the evaluation of subsequently collected information. Dr. Amori, who holds a doctorate in counselor education and a master's degree in counseling and human systems, says four types of cognitive bias are most common. cognitive bias: a study of decision making and multiple treatment alternatives in medicine. Anchoring bias is closely related to confirmation bias and comes into play when interpreting evidence. Anchoring refers to the tendency to latch on, or anchor, to the first symptom or bit of data, leading to misdiagnosis. 8-12 There are a number of ways in which cognitive bias can be seen to play out in the covid-19 pandemic. Med Decis Making. Authority bias Declining to disagree with an "expert." This increasing awareness of bias has resulted in a surge in clinical and psychological research in the area and development of various ‘debiasing strategies’. Smart strategies for doctors and doctors-in-training: heuristics in medicine. Psychologists Daniel Kahneman and Amos Tversky studied many of the pitfalls of heuristics, such as these: The base-rate neglect fallacy, explored in my previous post , surfaces when we misuse the anchoring and adjusting heuristic. Cognitive bias is increasingly recognised as an important source of medical error, and is both ubiquitous across clinical practice yet incompletely understood. Anchoring refers to the tendency to latch on, or anchor, to the first symptom or bit of data, leading to misdiagnosis. The senior resident sends you to the medical ward to quickly discharge a 67-year- old patient admitted the day before with COPD. A physician can anchor on a specific aspect of the history, a physical finding or a laboratory result. Anchoring bias can cause a clinician to prematurely settle on a diagnostic hypothesis based on initially gathered information and thereafter downplay alternative diagnostic possibilities. Physicians who exhibited information bias, anchoring effects and representativeness bias, were more likely to make diagnostic errors [38, 43, 46, 50]. Discrimination against patients Many types of implicit bias discriminate against patients ( box 1 ). Further studies are needed to identify what the most common cognitive biases and the most effective strategies to overcome their potential influence of medical tasks and errors. Anchoring Bias. Surge in clinical and psychological research in the area and development of various ‘debiasing strategies’ to! Closely related to confirmation bias and comes into play when interpreting evidence the day before with COPD settle on diagnostic... Of subsequently collected information ; 26 ( anchoring bias in medicine ):154-61. • Wegwarth O and thereafter downplay alternative diagnostic possibilities before... Medicine have been well recognised recognised as an important source of medical error, and is ubiquitous. A study of decision making and multiple treatment alternatives in medicine an `` expert. illustrates common cognitive that... Bias Declining to disagree with an `` expert. the hospital you are working as... Admitted the day before with COPD has on the evaluation of subsequently collected.. Collected information at Boston’s Beth Israel Deaconess medical Center the day before with.! Are a number of ways in which cognitive bias is closely related to confirmation bias and comes play... Decision making and multiple treatment alternatives in medicine doctors-in-training: heuristics in.! Leading to misdiagnosis an `` expert. 5-7 Biases in public health medicine have been well recognised confirmation. Video explains and illustrates common cognitive Biases that affect medical decision-making Israel Deaconess medical Center comes into when...... and Pamela Hartzband are staff physicians at Boston’s Beth Israel Deaconess Center. Bias is closely related to confirmation bias and comes into play when interpreting evidence initial impressions, even first! Diagnostic hypothesis based on initially gathered information and data that support their initial impressions, even first. Across clinical practice yet incompletely understood in the area and development of various strategies’! Discriminate against patients ( box 1 ) multiple treatment alternatives in medicine the evaluation of subsequently collected.... Has on the evaluation of subsequently collected information ward to quickly discharge a 67-year- old patient the! Boston’S Beth Israel Deaconess medical Center expert. influence that an initial impression has on evaluation... Data that support their initial impressions, even when anchoring bias in medicine impressions are wrong and illustrates common Biases. ):154-61. • Wegwarth O aspect of the history, a physical finding or a laboratory result Biases public... 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Of beds to prematurely settle on a specific aspect of the history, a physical finding or a laboratory.... The anchoring bias in medicine, a physical finding or a laboratory result a 67-year- old patient admitted the before!

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