BMJ  2005;330:781-783 (2 April), doi:10.1136/bmj.330.7494.781

Education and debate

Five pitfalls in decisions about diagnosis and prescribing

¹ INSEAD, 1 Ayer Rajah Avenue, 138676 Singapore jill.klein@insead.edu

Everyone makes mistakes. But our reliance on cognitive processes prone to bias makes treatment errors more likely than we think

The first 150 words of the full text of this article appear below.

Introduction

Psychologists have studied the cognitive processes involved in decision making extensively and have identified many factors that lead people astray. Because doctors' decisions have profound effects on their patients' health, these decisions should be of the best possible quality. All doctors should therefore be aware of possible pitfalls in medical decision making and take steps to avoid these unnecessary errors. In this article, I present five examples of cognitive biases that can affect medical decision making and offer suggestions for avoiding them.

Psychology of decision making

Doctors often have to make rapid decisions, either because of medical emergency or because they need to see many patients in a limited time. Psychologists have shown that rapid decision making is aided by heuristics—strategies that provide shortcuts to quick decisions—but they have also noted that these heuristics frequently mislead us.¹ Good decision making is further impeded by the fact that we often fall prey to various cognitive . . . [Full text of this article]

Pitfall 1: the representativeness heuristic

Pitfall 2: the availability heuristic

Pitfall 3: overconfidence

Pitfall 4: confirmatory bias

Pitfall 5: illusory correlation

Conclusions

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