Medical biases: Diagnosis and treatment are critical to clinical care. Doctors rely on years of education, training, and practice to deduce an evaluation and create a treatment plan.
But what if there is a glitch in this process? Biases touch on myriad aspects of cognition, including those involved in clinical decision making.
Medical biases: Confirmation bias can be detrimental to the patient’s health
Confirmation bias can be detrimental to the health of the patient by sending the doctor into the trap of the wrong treatment. In turn, a misdiagnosis can alter the trajectory of patient care and affect decisions made by other clinicians who may not question the validity of the initial diagnosis.
Confirmation bias can be detrimental to the health of the patient by sending the doctor into the trap of the wrong treatment. In turn, a misdiagnosis can alter the trajectory of patient care. As well as affect the decisions made by other physicians who may not question the validity of the initial diagnosis.
Here’s a closer look at confirmation bias, a type of bias that can affect initial diagnosis, and what to do about it.
What is confirmation bias?
According to the author of a letter published in the Journal of the American Academy of Dermatology (JAAD). Clinical reasoning occurs in two parts. First, an initial diagnostic hypothesis is formed. Second, this hypothesis is tested and a process of elimination occurs that results in confirmation. Confirmation bias refers to a propensity to give more weight to the initial hypothesis and then advance that hypothesis without adequate testing.
An example of intuitive reasoning would be the automatic assumption during the winter season that a feverish patient is fatigued. Just like joint pain he has the flu. Analytical thinking would open the door to other less obvious options, such as meningococcal meningitis.
In clinical practice, common examples of confirmation bias include ignoring laboratory results
Confirmation bias is associated with brain maturation and is more common in adults than in children or adolescents. In clinical practice, common examples of confirmation bias include ignoring laboratory results. Which do not support the preferred diagnosis and do not recognize the possibility of other diagnoses.
Cognitive bias is commonly associated with another form of bias called anchoring bias. The latter refers to bias based on baseline data. Cognitive bias occurs in the following ways:
Availability bias: the propensity to think that the diagnoses that come first to mind are correct.
Response bias: assuming that patients’ responses are inaccurate
Omission bias: the predilection for favoring omission over commission
Sunk cost bias – resolve to stick with a concept because of everything that has been invested thus far
Premature closure: greatly favors the initial diagnosis
Overconfidence: feeling a level of confidence that exceeds the data
Framing effect: semantics in favor of a diagnosis
Medical Biases: Risk Factors for Confirmation Bias
Clinicians face numerous stressors that turn out to be a perfect breeding ground for medical biases and confirmation bias. This, according to the authors of the aforementioned AMA Journal of Ethics article.
“Consideration must be given to the difficulty clinicians face in employing analytical thinking exclusively,” they wrote. “Beyond the limitations of time, information and resources, it is likely that many physicians will also be deprived of sleep. And they work in an environment full of distractions and have to respond quickly while handling heavy cognitive loads. These are working conditions in which analytical thinking strategies are difficult to apply. Especially since they require the cooperation of brain structures that suffer greatly from lack of sleep “
Overcome confirmation bias
Humans are naturally inclined to the confirmation bias. Fortunately, there are ways to overcome confirmation bias and open the doors to a proper diagnosis.
One method involves making a conscious effort to disprove the preferred diagnosis using balanced tests rather than confirmatory tests.
Ironically, reviewing the patient’s medical history and medical history can actually introduce confirmation bias. Furthermore, assigning too much weight to disease prevalence and patient characteristics can also lead to confirmation bias. Although these steps are essential to establishing a correct diagnosis, their potential to mislead should also be considered.
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