26 Jun Cognitive Biases Can Influence Doctors’ Decisions
MedicalResearch.com Interview with:
Dan P. Ly, MD, PhD, MPP
Physician and an Assistant Professor
Division of General Internal Medicine and Health Services Research
David Geffen School of Medicine at UCLA
MedicalResearch.com: What is the background for this study?
Response: Cognitive biases, or ways of thinking that may deviate from rationality, are thought to influence physician decision-making, but there has been little large-scale evidence of their existence clinically. There is some large-scale evidence of the availability heuristic, under which the likelihood of an event is affected by how easily it comes to mind, but there’s little large scale evidence of other cognitive biases affecting physicians.
MedicalResearch.com: What are the main findings? Would you briefly explain what is meant by anchoring bias?
Response: Anchoring bias is the focus on a single—often first—piece of information when making decisions without sufficiently adjusting to later information. One study in the 1970s had participants spin a wheel and guess how many countries in Africa were in the U.N. When participants spun a low number, their guesses were much lower than those who spun a high number.
In our study, we found that, among patients who all had a condition called congestive heart failure, when the visit reason that was put down during the emergency department check-in process mentioned congestive heart failure, physicians were more likely to test for an exacerbation of congestive heart failure and less likely to test for the deadly, can’t-miss condition of pulmonary embolism, or blood clots in the lung. This occurred even though mention of congestive heart failure had no association with likelihood of pulmonary embolism.
MedicalResearch.com: What should readers take away from your report?
Response: That cognitive biases can influence even physicians, and those on the medical team need to work on not promoting anchoring when relaying information about patients.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Future research should not only examine the influence of other cognitive biases but also how to combat such biases.
Response: No, I have nothing to disclose. I am a physician in the VA, and these views are mine only and do not necessarily represent the views of the US Department of Veterans Affairs or the US government
Ly DPShekelle PG Song Z. Evidence for Anchoring Bias During Physician Decision-Making. JAMA Intern Med. Published online June 26, 2023. doi:10.1001/jamainternmed.2023.2366
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