Clinicians’ cognitive biases: a potential barrier to implementation of evidence-based clinical practice

Dobler, Claudia C.; Morrow, Allison S.; Kamath, Celia C.

doi:10.1136/bmjebm-2018-111074

Cited by 21 publications

(13 citation statements)

References 25 publications

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“…Clinicians must resist the impulse “to do something” and only use unproven treatments within clinical (ideally adaptive) trials [ 3 ]. The tendency to prefer action over inaction is also known as commission bias and is motivated by avoiding regret about a missed opportunity when a treatment is not given, even if its efficacy is unclear [ 4 ]. Commission bias is a potential barrier to the implementation of evidence-based practice, and drives overtreatment and “low-value care” (care that provides little or no benefit and may cause harm to patients) [ 4 ].…”

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confidence: 99%

Poor quality research and clinical practice during COVID-19

Dobler

2020

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The COVID-19 pandemic has turned our lives upside down. Health services have adapted to the challenges posed by the pandemic at eye-watering speed. Telemedicine has seen a rapid uptake in order for patient–physician encounters to comply with social distancing regulations. Elective surgeries have been put on hold to make room in hospitals for patients with COVID-19 and save valuable personal protective equipment. Many pre-pandemic research projects have been put on hold, and legions of medical researchers are now dedicated to researching COVID-19.

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confidence: 99%

Poor quality research and clinical practice during COVID-19

Dobler

2020

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“…Actively slowing down has been shown to eliminate some of the biases, and it is easy to do [6]. Deliberating on the problem can make us think in a more unbiased way.…”

Section: What Can Be Done To Develop the Ability To Take Unbiased Decmentioning

confidence: 99%

Bias in Clinical Practice

Khadilkar

2020

J Obstet Gynecol India

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Role of bias in errors of decision making is receiving increasing attention. It is turning out to be one of the main sources of mistakes. Hence, it is important to be aware of biases and to design strategies toward an unbiased approach. Biases are of various types, and the potential sources of bias can be related to the consultant, patients and factors related to working conditions. Availability bias, base rate neglect, confirmation bias, conjunction rule, diagnostic momentum bias, framing effect and confirmation bias are the common types, and these have been discussed in this manuscript using a scenario-based format. Two types of human thinking, the rapid intuitive mode and the slow reflective mode, their pros and cons and their role in biases are discussed. Strategies to enhance awareness of biases, tips to improve reasoning, promote freethinking, enhance decision-making skills and resorting to checklists have been deliberated to achieve an unbiased approach.

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“…The limited research in this area indicates that clinicians routinely report misconceptions and anxiety about screening for suicide [7,8]. Research from other areas of medicine suggests that clinicians-like all humans-employ heuristic decision-making and are subject to common behavioral barriers [9]. In the case of clinicians, these behavioral barriers and heuristics may interfere with the uptake of EBPs, but can also be effectively targeted via implementation strategies that seek to improve EBP use [9].…”

Section: Introductionmentioning

confidence: 99%

“…Research from other areas of medicine suggests that clinicians-like all humans-employ heuristic decision-making and are subject to common behavioral barriers [9]. In the case of clinicians, these behavioral barriers and heuristics may interfere with the uptake of EBPs, but can also be effectively targeted via implementation strategies that seek to improve EBP use [9]. However, the specific behavioral barriers that interfere with the implementation of SSAI EBPs across healthcare settings, as well as the most promising strategies to address these barriers, are unknown.…”

Section: Introductionmentioning

confidence: 99%

Implementing nudges for suicide prevention in real-world environments: project INSPIRE study protocol

Davis

Wolk

Jager‐Hyman

et al. 2020

Pilot Feasibility Stud

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Background Suicide is a global health issue. There are a number of evidence-based practices for suicide screening, assessment, and intervention that are not routinely deployed in usual care settings. The goal of this study is to develop and test implementation strategies to facilitate evidence-based suicide screening, assessment, and intervention in two settings where individuals at risk for suicide are especially likely to present: primary care and specialty mental health care. We will leverage methods from behavioral economics, which involves understanding the many factors that influence human decision making, to inform strategy development. Methods We will identify key mechanisms that limit implementation of evidence-based suicide screening, assessment, and intervention practices in primary care and specialty mental health through contextual inquiry involving behavioral health and primary care clinicians. Second, we will use contextual inquiry results to systematically design a menu of behavioral economics-informed implementation strategies that cut across settings, in collaboration with an advisory board composed of key stakeholders (i.e., behavioral economists, clinicians, implementation scientists, and suicide prevention experts). Finally, we will conduct rapid-cycle trials to test and refine the menu of implementation strategies. Primary outcomes include clinician-reported feasibility and acceptability of the implementation strategies. Discussion Findings will elucidate ways to address common and unique barriers to evidence-based suicide screening, assessment, and intervention practices in primary care and specialty mental health care. Results will yield refined, pragmatically tested strategies that can inform larger confirmatory trials to combat the growing public health crisis of suicide.

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Clinicians’ cognitive biases: a potential barrier to implementation of evidence-based clinical practice

Cited by 21 publications

References 25 publications

Poor quality research and clinical practice during COVID-19

Poor quality research and clinical practice during COVID-19

Bias in Clinical Practice

Implementing nudges for suicide prevention in real-world environments: project INSPIRE study protocol

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