Errors in Surgical Neuropathology and the Influence of Cognitive Biases: The Psychology of Intelligence Analysis

2006 ◽  
Vol 130 (5) ◽  
pp. 613-616 ◽  
Author(s):  
Roger E. McLendon
Keyword(s):  
Decision Making ◽  
Cognitive Psychology ◽  
Medical Decision Making ◽  
Cognitive Biases ◽  
Correct Diagnosis ◽  
Data Sources ◽  
Medical Decision ◽  
Intelligence Analysis ◽  
First Impression ◽  
Decision Making Processes

Abstract Context.—A significant difficulty that pathologists encounter in arriving at a correct diagnosis is related to the way information from various sources is processed and assimilated in context. Objective.—These issues are addressed by the science of cognitive psychology. Although cognitive biases are the focus of a number of studies on medical decision making, few if any focus on the visual sciences. Data Sources.—A recent publication authored by Richards Heuer, Jr, The Psychology of Intelligence Analysis, directly addresses many of the cognitive biases faced by neuropathologists and anatomic pathologists in general. These biases include visual anticipation, first impression, and established mindsets and subconsciously influence our critical decision-making processes. Conclusions.—The book points out that while biases are an inherent property of cognition, the influence of such biases can be recognized and the effects blunted.

scholarly journals P140: Emergency department decision-making for incapacitated and unrepresented patients: a comprehensive review of the literature

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S124-S125
Author(s):  
J.L. Willinsky ◽  
I. Hyun
Keyword(s):  
Decision Making ◽  
Emergency Department ◽  
Medical Decision Making ◽  
Hospital Setting ◽  
Ethics Committees ◽  
Medical Decision ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Patient Cohort ◽  
Decision Making Processes

Introduction: Incapacitated patients who lack substitute decision-makers (SDM) are commonly encountered in the emergency department (ED). The number of these patients will rise dramatically as the Baby Boomers age. We can expect an influx of elderly patients who lack decisional capacity due to dementia and other illnesses, and who present without family. It is estimated that 3 to 4 percent of U.S. nursing home residents have no SDM or advance directives. Medical decision-making for this cohort poses an ethical challenge, particularly in the ED setting. Methods: A comprehensive review of the literature was conducted surrounding decision-making for incapacitated and unrepresented patients in the hospital setting. Articles were identified using MEDLINE (1946-October 2015) and Embase (1974-October 2015). The reference lists of relevant articles were hand searched. Articles describing decision-making processes that have been proposed, tested or applied in practice were chosen for full review. The aim of this review was to outline recognized medical decision-making processes for incapacitated and unrepresented patients, and to identify areas for future research. Results: The search yielded 20 articles addressing decision-making for incapacitated and unrepresented patients in the hospital setting. All of these articles focus on the intensive care unit and other hospital wards; no literature on the ED setting was found. Five types of formal consulting bodies exist to assist physicians in applying the best interest standard for this patient cohort: internal hospital ethics committees, external ethics committees, public guardians, court-appointed guardians, or judges. The majority of decisions for these patients, however, are made informally by a single physician or by a healthcare team, although it is well recognized that this approach lacks appropriate safeguards. There is no consensus surrounding the optimal approach to decision-making in these cases, and as such there is significant inconsistency in how medical decisions are made for these patients. Conclusion: There are several articles describing decision-making processes for incapacitated and unrepresented patients, none of which focus on the ED. These processes are not practical for use in the ED. Further inquiry is needed into the most ethical and respectful method of decision-making for this patient cohort in the ED.

Medicine and heuristics: cognitive biases and medical decision-making

2020 ◽  
Vol 189 (4) ◽  
pp. 1477-1484 ◽  
Author(s):  
Dale F. Whelehan ◽  
Kevin C. Conlon ◽  
Paul F. Ridgway
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Cognitive Biases ◽  
Medical Decision

scholarly journals Understanding the Role of Numeracy in Health: Proposed Theoretical Framework and Practical Insights

2009 ◽  
Vol 36 (6) ◽  
pp. 1065-1081 ◽  
Author(s):  
Isaac M. Lipkus ◽  
Ellen Peters
Keyword(s):  
Decision Making ◽  
Risk Communication ◽  
Medical Decision Making ◽  
Theoretical Framework ◽  
Medical Decision ◽  
Mathematical Concepts ◽  
Health Numeracy ◽  
Targeted Interventions ◽  
Decision Outcomes ◽  
Decision Making Processes

Numeracy—that is, how facile people are with mathematical concepts and their applications—is gaining importance in medical decision making and risk communication. This article proposes six critical functions of health numeracy. These functions are integrated into a theoretical framework on health numeracy that has implications for risk communication and medical decision-making processes. The authors examine practical underpinnings for targeted interventions aimed at improving such processes as a function of health numeracy. They hope that the proposed functions and theoretical framework will spur more research to determine how an understanding of health numeracy can lead to more effective communication and decision outcomes.

Rational Adaptation: Contextual Effects in Medical Decision Making

2020 ◽  
Vol 14 (2) ◽  
pp. 112-131
Author(s):  
Frank Eric Robinson ◽  
Markus A. Feufel ◽  
Valerie L. Shalin ◽  
Debra Steele-Johnson ◽  
Brian Springer
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Context Effects ◽  
Theoretical Perspective ◽  
Work Practice ◽  
Contextual Effects ◽  
Medical Decision ◽  
Decision Making Processes ◽  
Quantitative Analyses ◽  
The Impact

Research and practice in medical decision making value consistency with standardized intervention, potentially neglecting the impact of various environmental features such as workload or the constraints of local work practice. This study presents both qualitative and quantitative analyses of emergency physicians’ decision-making processes in their natural work setting to examine the impact of contextual features. We study contextual effects on two separable decision-making processes identified in quantified observational data: goal enactment and goal establishment. Whereas goal enactment responds to hospital differences and patient difficulty as main effects, goal establishment responds to their interaction. Our emphasis on goal establishment expands the scope of a medical decision-making literature focused on diagnosis, and extends to other professions and the more general conceptualization of expertise. From a theoretical perspective, we emphasize the importance of accounting for contextual variability within the bounds of expert behavior. Practically, we provide real-world examples of context effects that bear on the standardization of care, cost differences between hospitals, and the conceptualization of quality medical care.

scholarly journals "Doctor Knows Best"

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Dylan Mirek Popowicz
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Evidence Based ◽  
Patient Relationship ◽  
Medical Practitioners ◽  
Making Sense ◽  
Decision Making Processes ◽  
Based Medicine

We often consider medical practitioners to be epistemic authorities: “Doctor knows best,” as the saying goes. The place of expert judgment in evidence-based medicine hierarchies, and the crucial role of patient preferences and values in medical decision-making, however, pose problems for making sense of such authority. I argue that there is an account of such medical epistemic authority that does justice to the complexities of the doctor–patient relationship, while maintaining that medical practitioners hold an epistemically privileged position. Such a view can better inform medical practice by clearly illuminating the distinct roles of patients and doctors in decision-making processes.

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