Cognitive bias: Its influence on clinical diagnosis
In a busy practice, it’s helpful to be aware of specific psychological tendencies that influence diagnostic reasoning and can lead to error.
PRACTICE RECOMMENDATIONS
› Acquire a basic understanding of key cognitive biases to better appreciate how they could interfere with your diagnostic reasoning. C
› Consider using a differential diagnosis generator as a safeguard if you suspect an increased risk of diagnostic error in a particular patient. C
Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
Looking forward
More research will hopefully lead to corrective solutions. But it is also likely that solutions will require additional time and resources on the part of already overburdened providers. Thus, new challenges will arise in applying remedies to the current model of health care management and reimbursement.
Despite clinically useful advances in technology and science, family physicians are left with the unsettling conclusion that the most common source of error may also be the most difficult to change: physicians themselves. Fortunately, history has shown that the field of medicine can overcome even the most ingrained and harmful tendencies of the human mind, including prejudice and superstition.16,17 This next challenge will be no exception.
CORRESPONDENCE
Thomas Yuen, MD, Crozer Keystone Family Medicine Residency, 1260 East Woodland Avenue, Suite 200, Philadelphia, PA 19064; thomas.yuen@crozer.org.
