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Horses and zebras: probabilities, uncertainty, and cognitive bias in clinical diagnosis

Emmet Hirsch1

  • 1Department of Obstetrics and Gynecology, NorthShore University Health System. Evanston, IL; Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL.

American Journal of Obstetrics and Gynecology
|January 20, 2020
PubMed

Insights

Cognitive bias can lead to medical misdiagnosis. This study reviews specific biases and strategies to improve diagnostic accuracy and patient outcomes.

Area of Science:

  • Medical diagnosis
  • Cognitive science
  • Clinical decision-making

Background:

  • Medical diagnosis is an iterative process involving data integration and synthesis.
  • Diagnostic errors can occur due to factors beyond factual information.
  • Systematic cognitive biases are implicated in medical misdiagnosis.

Purpose of the Study:

  • To present a case study of medical misdiagnosis attributed to cognitive bias.
  • To identify and cite specific cognitive biases that contribute to diagnostic errors.
  • To review strategies for mitigating the impact of cognitive bias in medical diagnosis.

Main Methods:

  • Case study analysis of a medical misdiagnosis.
  • Literature review of cognitive biases in clinical practice.
  • Synthesis of evidence on bias mitigation techniques.

Main Results:

  • A specific case illustrating the role of cognitive bias in diagnostic error is detailed.
  • Several common cognitive biases influencing medical diagnosis are identified.
  • Practical measures to reduce cognitive bias in clinical decision-making are discussed.

Conclusions:

  • Cognitive bias is a significant factor contributing to medical misdiagnosis.
  • Awareness and specific interventions can help minimize diagnostic errors.
  • Improving diagnostic accuracy requires addressing both data and cognitive processes.
Keywords:
cognitive biasdiagnostic processmedical errorovarian ectopic pregnancy

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