Evidence‐informed person‐centered healthcare part I: Do ‘cognitive biases plus’ at organizational levels influence quality of evidence?

Abstract

'Cognitive biases plus' are hard wired, primarily at the unconscious level, and the resulting behaviours are not easily corrected. Social behavioural researchers advocate multi-pronged measures in similar situations: (i) abolish incentives that spawn self-serving bias; (ii) enforce severe deterrents for breaches of conduct; (iii) value integrity; (iv) strengthen self-awareness; and (v) design curricula especially at the trainee level to promote awareness of consequences to society. Virtuous professionals and organizations are essential to fulfil the vision for high-quality individualized health care globally.

‘Cognitive biases plus’: covert subverters of healthcare evidence

“…The ‘unintended consequences’ may be explained by: (1) limitations in the tenets of EBM, and (2) flawed or unethical decisions and actions (‘misuses of EBM’2) by several distinct yet interconnected healthcare-related organisations 4 5. At the core of both is the covert cognitive syndrome we have termed ‘cognitive biases plus’ 4.…”

“…At the core of both is the covert cognitive syndrome we have termed ‘cognitive biases plus’ 4. Qualitative information is summarised and up-dated from a more detailed review,4 5 to support the hypothesis.…”

“…There is considerable literature on conflicts of interest (CoIs), biases, fallacies and ethical violations (table 1); generally, these have been discussed in a silo fashion 4. We have suggested grouping them syndromically as ‘cognitive biases plus’ for the following reasons: (1) the four entities frequently co-occur in various combinations, (2) they share neurobiological processes (especially related to system 1), (3) many have evolutionary roots and (4) all are potentially influenced by prevailing organisational and sociocultural values.…”

“…The table and figure supplement each other. The contents are substantially condensed and revised from (1) table 1 in Seshia et al 4. and (2) table 1 in Seshia et al 5.…”

“…The achievements of EBM testify to the contributions made by EBM expert groups to evidence-informed healthcare. At the same time, the potential for scientific inbreeding and groupthink increases the risk of shared intellectual CoIs and replication biases 4 5 7…”