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Do physicians have a bias toward action? A classic study revisited.
1Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Summary
Pediatricians may exhibit a bias toward action in clinical decisions. When presented with cases where initial inaction was likely, subsequent physicians were more likely to intervene, suggesting a bias toward action in medical decision-making.
Area of Science:
- Medical decision-making
- Pediatric practice
- Clinical judgment
Background:
- Classic studies explored medical decision-making.
- Modern pediatric practice warrants re-evaluation of these decisions.
Purpose of the Study:
- To replicate classic medical decision-making studies in contemporary pediatrics.
- To investigate pediatrician decision patterns for common clinical actions.
Main Methods:
- Developed case scenarios for three common pediatric decisions: tympanostomy tube placement, radiography orders, and emergency room referrals.
- Surveyed pediatricians on their likelihood to take specific clinical actions.
- Assessed subsequent physician actions on scenarios where initial reviewers were least or most likely to act.
Main Results:
- Physicians were more likely to perform tympanostomy tube placement (p=0.004) and consider radiography (p=0.076) in cases where initial reviewers were least likely to act.
- This suggests a potential bias toward action in these pediatric clinical decisions.
- No significant difference in action likelihood was observed when initial reviewers were most likely to act.
Conclusions:
- Pediatricians may demonstrate a bias toward action, intervening more frequently in situations where initial assessment suggested less intervention.
- Understanding this bias is crucial for optimizing clinical decision-making and patient care in pediatrics.