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Ego bias, reverse ego bias, and physicians' prognostic
R M Poses1, D K McClish, C Bekes
1Department of Internal Medicine, Medical College of Virginia, Richmond.
Critical Care Medicine
|December 1, 1991
Summary
Physicians' prognostic judgments are influenced by ego bias. Attending physicians showed reverse ego bias, while house officers exhibited ego bias, impacting their patient survival predictions.
Area of Science:
- Medical Decision Making
- Cognitive Bias in Healthcare
- Critical Care Medicine
Background:
- Physician prognostic judgments are crucial for critical care.
- Cognitive biases, such as ego bias, can influence these judgments.
- Ego bias involves overestimating one's own patients' prognosis compared to population data.
Purpose of the Study:
- To investigate the presence and direction of ego bias in physicians' prognostic assessments.
- To compare the prognostic judgments of attending physicians and house officers for critically ill patients.
Main Methods:
- Prospective study of critically ill patients in ICU and intermediate care units.
- Collected prognostic survival predictions from attending physicians and house officers.
- Compared individual patient predictions with overall survival rate assessments and actual outcomes.
Main Results:
- Attending physicians demonstrated a 'reverse ego bias,' underestimating individual prognoses compared to overall survival rates (79.8% vs. 88.0%).
- House officers exhibited 'ego bias,' overestimating individual prognoses compared to overall survival rates (73.5% vs. 68.9%).
- Significant variations in bias magnitude and direction were observed among both attending physicians and house officers.
Conclusions:
- Attending physicians' reverse ego bias stemmed from optimism regarding overall critical care survival rates.
- House officers' ego bias was linked to pessimism about overall critical care survival rates.
- Cognitive biases significantly impact physician prognostic accuracy in critical care settings.