The effect of outcome information on doctors' evaluations of their own diagnostic decisions

Abstract

Outcome bias in medical decisions is discussed in terms of its possible adverse effects on doctors' learning and knowledge revision processes: although sensitivity to outcomes may be desirable in some circumstances, in other circumstances it can cause either the fixing of incorrect knowledge or the improper revision of correct knowledge.

From Beginning to End in Anesthesia

“…The emotional impact felt by anesthesia providers has been shown to impact decision making 8 and can lead to severe depression and destructive behaviors. 9 In some cases, severe emotional distress after an adverse event can cause career changes.…”

Self-reflection on the quality of decisions in health care

“…But then the patient recovered, so everything was okay. This phenomenon was demonstrated systematically in the excellent study by Sacchi and Cherubini, in which, after choosing a diagnosis for a neurological case and receiving feedback on the outcomes of their decisions, doctors were shown to overrate the quality of their decision making process if the outcome had been good and to underrate the quality of their process if the outcome had been poor 1 …”

“…In a world of unclear outcomes, reflective practice that allows one to evaluate one's own performance and adapt on the basis of feedback from the outside world is difficult at best. However, as Sacchi and Cherubini 1 point out with their intriguing paper in this issue, health care providers are also regularly faced with the somewhat paradoxical problem of unambiguous outcomes in a probabilistic world.…”

“…As a result, for an individual practitioner examining her own practice in a particular domain, there may be no apparent contingency between action and outcome. As Sacchi and Cherubini 1 describe, because of the probabilistic nature of patient outcomes, the most appropriate action can be associated with a poor outcome, and a suboptimal action can be associated with a good outcome.…”

The Effect of Hindsight Bias on Psychiatrists’ Clinical Judgment: A Randomized Controlled Trials

“…Numerous studies have been conducted to assess the quality and susceptibility to bias in physicians [11][12][13][14]. LaBine et al [15] and LeBourgious et al [16] investigated whether psychiatrists are also susceptible to hindsight bias in various conditions, knowing about the higher incidence of misdiagnosis in this field.…”