Clinical reasoning in dire times. Analysis of cognitive biases in clinical cases during the COVID-19 pandemic.
Clinical decision-making
Cognitive dissonance
Diagnostic errors
Emergency medicine
Metacognition
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
received:
18
09
2021
accepted:
01
11
2021
pubmed:
9
1
2022
medline:
31
5
2022
entrez:
8
1
2022
Statut:
ppublish
Résumé
Cognitive biases are systematic cognitive distortions, which can affect clinical reasoning. The aim of this study was to unravel the most common cognitive biases encountered in in the peculiar context of the COVID-19 pandemic. Case study research design. Primary care. Single centre (Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland). A short survey was sent to all primary care providers (N = 169) taking care of hospitalised adult patients with COVID-19. Participants were asked to describe cases in which they felt that their clinical reasoning was "disrupted" because of the pandemic context. Seven case were sufficiently complete to be analysed. A qualitative analysis of the clinical cases was performed and a bias grid encompassing 17 well-known biases created. The clinical cases were analyzed to assess for the likelihood (highly likely, plausible, not likely) of the different biases for each case. The most common biases were: "anchoring bias", "confirmation bias", "availability bias", and "cognitive dissonance". The pandemic context is a breeding ground for the emergence of cognitive biases, which can influence clinical reasoning and lead to errors. Awareness of these cognitive mechanisms could potentially reduce biases and improve clinical reasoning. Moreover, the analysis of cognitive biases can offer an insight on the functioning of the clinical reasoning process in the midst of the pandemic crisis.
Identifiants
pubmed: 34997906
doi: 10.1007/s11739-021-02884-9
pii: 10.1007/s11739-021-02884-9
pmc: PMC8742156
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
979-988Subventions
Organisme : Edmond J. Safra Philanthropic Foundation
ID : HERO (CGR 75976)
Informations de copyright
© 2021. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).
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