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Medical Error and Patient Safety in Surgery
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Cognitive disposition to respond Anchoring AvAilAbility biAs Commission biAs ConfirmAtion biAs DiAgnosis momentum FundAmentAl Attribution error Hindsight biAs omission biAs order effects overconfidence biAs PremAture closure seArch sAtisfying ViscerAl biAs Description tendency to weigh initiAl dAtA too heAvily And fAilure to AdApt the diAgnosis once more informAtion is AvAilAble, sticking with the diAgnosis. tendency to judge diAgnosis more likely if one hAs been recently seen or experienced. tendency to promote pAtient beneficence through Action rAther thAn inAction, performing A treAtment or procedure becAuse the pAtient is ill. tendency to look for evidence thAt confirms A diAgnosis rAther thAn look for evidence to refute. tendency to lAbel A diAgnosis for gAining trAction with the pAtient And heAlth-cAre workers so thAt it is perceived As definite rAther thAn possible. tendency to blAme pAtients for their situAtion or illness rAther thAn exAmine their ActuAl circumstAnces. being AwAre of the outcome influences the perception of pAst events such thAt the role of An individuAl is under- or overestimAted. tendency to Avoid doing something wrong through inAction rAther thAn Action. tendency to remember the beginning And end during informAtion trAnsfer, neglecting dAtA exchAnged in the middle. tendency of An individuAl to believe themselves to be more knowledgeAble thAn they reAlly Are, leAding to Action bAsed on inAdequAte informAtion or intuition without AppropriAte supporting evidence. tendency to Accept A diAgnosis As true before it hAs been fully verified. tendency to stop looking for other problems once one is identified, leAding to missed diAgnosis or injuries. tendency to hAve decisions influenced by An emotionAl or Affectively lAbile stAte; countertrAnsference, negAtive or positive feelings towArd A pAtient, leAding to missed diAgnosis or injuries.
The Three Types of PPG
Published in Robin Stevenson, Learning and Behaviour in Medicine, 2022
There are now more than 30 documented biases. They include the following: anchoring bias when physicians may lock on to features in the initial presentation and be reluctant to adjust this impression in the light of later information.availability bias makes physicians think of diagnoses that come readily to mind because of recent experience of similar cases.confirmation bias encourages physicians uncritically to accept information that supports their first diagnosis rather than looking for evidence against it.omission bias is the tendency towards inaction because physicians should do no harm.overconfidence bias induces physicians to act on inadequate data, intuition or hunches.premature closure bias is the temptation to curtail the decision-making process before the diagnosis has been verified.search satisficing bias is the universal tendency to call off a search once something has been found. Satisficing is a portmanteau word comprising satisfy and suffice [15].bias of sunk costs makes physicians who have invested heavily in one diagnosis very reluctant to consider an alternative.
Withholding and Withdrawing Life-Sustaining Treatment: Ethically Equivalent?
Published in The American Journal of Bioethics, 2019
Ethicists, however, heavily challenge the intuitive difference between acts and omissions as initially compelling, but ultimately confused. We again “seem faced with a conflict between theory and intuitions about cases” (Woollard and Howard-Snyder 2016). Ethicists argue that if we take a closer look at the ethics of allowing versus acting, we will see that our intuitive judgements are based on an “omission bias”: Because acts stand out more prominently than omissions to act, acts are judged to be morally different from omissions, even if the outcome of the act and omission is the same.
Identification of diabetes risk in dental settings: Implications for physical and mental health
Published in International Journal of Mental Health, 2018
Mary T. Rosedale, Shiela M. Strauss, Navjot Kaur, Ann Danoff, Dolores Malaspina
It is certain that diabetes progression and complications can be mitigated by early detection coupled with lifestyle modification and therapeutic interventions to optimize glycemic control (ADA, 2015a), so suboptimal provider responses are a missed opportunity with significant consequences for individuals and society. These findings are consistent with reports that clinicians systematically downgrade the severity of patients’ symptoms and self-reports, leading to preventable adverse events (Basch, 2010; Pakhomov, Jacobsen, Chute, & Roger, 2008). The tendency to downgrade symptoms may be based on the clinician’s thought that persons are still well at the early stages of an illness, perhaps making mental comparisons to sicker patients: (e.g., “You think your HbA1c reading is high, but I have patients with much more elevated readings.”). As described elsewhere, the cognitive errors of clinicians include “omission bias” and “feedback sanction” (Grady, 2010; Croskerry, 2003). Omission bias is the tendency toward inaction and is rooted in the principle of nonmaleficence (e.g., “It will upset the patient if I say the screening is consistent with prediabetes, so I will reassure the patient because a prediabetes reading is not very concerning.”). Feedback sanction implies that there is no immediate consequence for failure to make a diagnosis or recommending a treatment change (i.e., the progression of prediabetes to diabetes could take years.) Clinicians may also be reluctant to describe a problem in a chart because this creates a record that the health care provider needs to act on, and there may be fears of potential litigation (Grady, 2010). Such clinician actions constitute critical missed opportunities for patients, especially in interrupting the progression from prediabetes to diabetes. Clearly, prevention is secondary to treatment in this approach.