Medical Education 2009: 43: 721– 728 2006 Mar- Apr;26(2):154-61. • Wegwarth O. Smart strategies for doctors and doctors-in-training: heuristics in medicine. Cognitive bias is increasingly recognised as an important source of medical error, and is both ubiquitous across clinical practice yet incompletely understood. Anchoring bias can cause a clinician to prematurely settle on a diagnostic hypothesis based on initially gathered information and thereafter downplay alternative diagnostic possibilities. For example, we wrote about a case of anchoring in our November 2008 column , “Anchoring errors ensue when diagnoses get lost in translation,” where a patient’s complaint of gas caused clinicians to initially miss an abdominal aneurysm. Like a medical procedure, heuristics can have both risks and benefits. 5-7 Biases in public health medicine have been well recognised. Anchoring bias is closely related to confirmation bias and comes into play when interpreting evidence. 8-12 There are a number of ways in which cognitive bias can be seen to play out in the covid-19 pandemic. Anchoring bias reflects the undue influence that an initial impression has on the evaluation of subsequently collected information. Anchoring bias, limited differential leads to quadriplegia Spinal epidural abscess (SEA) too often overlooked Facts: A 44-year-old male with recent interferon treatment for Hepatitis C and a prior history of neck surgery with hardware sees his PCP for new onset headache, photophobia, and URI symptoms. It refers to physicians’ practices of prioritizing information and data that support their initial impressions, even when first impressions are wrong. cognitive bias: a study of decision making and multiple treatment alternatives in medicine. Anchoring refers to the tendency to latch on, or anchor, to the first symptom or bit of data, leading to misdiagnosis. Example The hospital you are working in as a medical student is short of beds. Authority bias Declining to disagree with an "expert." This increasing awareness of bias has resulted in a surge in clinical and psychological research in the area and development of various ‘debiasing strategies’. Cognitive bias has frequently been discussed in general healthcare environments where it may affect both patient care and staff wellbeing, 2-4 and also in science settings. ... and Pamela Hartzband are staff physicians at Boston’s Beth Israel Deaconess Medical Center. Dr. Amori, who holds a doctorate in counselor education and a master's degree in counseling and human systems, says four types of cognitive bias are most common. Anchoring refers to the tendency to latch on, or anchor, to the first symptom or bit of data, leading to misdiagnosis. Physicians who exhibited information bias, anchoring effects and representativeness bias, were more likely to make diagnostic errors [38, 43, 46, 50]. Psychologists Daniel Kahneman and Amos Tversky studied many of the pitfalls of heuristics, such as these: The base-rate neglect fallacy, explored in my previous post , surfaces when we misuse the anchoring and adjusting heuristic. Discrimination against patients Many types of implicit bias discriminate against patients ( box 1 ). This video explains and illustrates common cognitive biases that affect medical decision-making. Med Decis Making. A physician can anchor on a specific aspect of the history, a physical finding or a laboratory result. This unconscious bias, also known as implicit bias, is important in a medical setting “because it may affect decision making about how care proceeds,” she says. The senior resident sends you to the medical ward to quickly discharge a 67-year- old patient admitted the day before with COPD. Further studies are needed to identify what the most common cognitive biases and the most effective strategies to overcome their potential influence of medical tasks and errors. Anchoring Bias.