Development of a test of cognitive bias in medical decision making

Abstract

The rather poor performances of the students and residents and the faculty on the ICBM suggest that cognitive biases constitute an important detraction from reliance on logical and statistical strategies. The ICBM shows promise for use as a tool in both instructional and research endeavors attempting to minimize and elucidate this phenomenon.

Rationality in medical treatment decisions: is there a sunk-cost effect?

“…Although previous research has documented a number of cognitive biases in medical decision makers (e.g., Elstein et al, 1978;Dawson and Arkes, 1987;Hershberger et al, 1994), the present fi ndings do not provide much additional support for the notion that physicians are poor reasoners. Most notably, residents' evaluations of treatment decisions were not infl uenced by the amount of time and/or money that had already been invested in treating a particular patient; in other words, they did not fall prey to the sunk cost effect when judging different treatment options.…”

“…Medical decision making research has sought to uncover some of the parallels between cognitive biases which exist in the non-medical world and in the medical world (Detmer et al, 1978;Elstein et al, 1978;Dawson and Arkes, 1987;Elstein, 1988; for an inventory of medical decision-making biases, see Hershberger et al, 1994). Some of the biases that have been shown to infl uence medical judgment include the omission bias (Asch et al, 1994), availability bias (Poses and Anthony, 1991), hindsight bias (Arkes et al, 1981;Dawson et al, 1988), a bias to ignore negative evidence when attempting to synthesize information (Mazur and Hickam, 1990), framing effects (McNeil et al, 1984) and outcome bias (Gruppen et al, 1994).…”

Regulating impurities in pharmaceutical products: a tolerability of risk approach?

“…In areas where the public has shown low acceptance for an activity, the HSE suggests the combination of probabilistic estimates of individual risks with a societal acceptance criterion. The figure is based on psychometric studies of the extent to which potentially affected people accept or refuse a specific risk [51]. The producers and controllers of the risk may be interested to invest in a scoping exercise defining in which therapeutic areas the presence of genotoxic impurities could constitute a dread.…”

Instruments for Evaluating Shared Medical Decision Making

“…Another related concept is locus of control in health care, which addresses the broader concept of self-care or control of health or health care (Consumer Health Education Institute 2005). A number of instruments also address aspects of health care professionals' decision making, such as cognitive biases (Hershberger et al 1994) or ethical reasoning or values (McAlpine, Kristjanson, and Poroch 1997) but have not been evaluated in the context of shared decisions with patients.…”