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Updated: Dec 12, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Optimism bias in understanding neonatal prognoses
Babina Nayak1,2, Jee-Young Moon3, Mimi Kim3
1Harlem Hospital Medical Center, Columbia University, New York, NY, USA.
Objective:
Discrepancies between physician and parent neonatal prognostic expectations are common. Optimism bias is a possible explanation.
Study Design:
Parents interpreted hypothetical neonatal prognoses in an online survey.
Results:
Good prognoses tended to be interpreted accurately, while poor prognoses were interpreted as less than the stated value. One-third of participants consistently overstated survival for the three lowest prognoses, compared to the sample as a whole. Three significant predictors of such optimistic interpretations were single-parent status (OR 0.39; 95% CI 0.2-0.75; p = 0.005), African-American descent (OR 3.78; 95% CI 1.63-8.98; p = 0.002) and the belief that physicians misrepresented prognoses (OR 3.11; 95% CI 1.47-6.65; p = 0.003). Participants' explanations echoed research on optimism bias in clinical and decision science studies.
Conclusion:
Participants accepted positive prognoses for critically ill neonates, but reinterpreted negative ones as being unduly pessimistic demonstrating optimism bias.
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