Cognitive bias in diagnostic radiology
Cognitive bias has a complex and significant impact in the perception of examinations within diagnostic radiology. The following are some of the more common cognitive bias that can affect day-to-day decision making 1.
Anchoring bias is the tendency for one to focus on salient evidence upon the initial stages of the diagnosis leading to the diagnosis. Anchoring bias can also be heuristic in nature
Availability bias is the process in which one is to pass judgment more frequency if this information is readily available in the mind
Having a predetermined diagnosis in mind, then looking for evidence that supports this predetermined idea
Making a judgment on an aspect of an image that is based on one's own perception of what that represents. Representativeness bias as the description suggest can also be heuristic in nature
Search satisfaction is ones tendency to cease a search early due to early findings satisfying the reader. Satisfaction of search bias has been reported to account for 22% of diagnostic errors 2.
Framing bias is in which the reader is influenced by the clinical question. For example, a well-written request form detailing the exact pathology expected may influence the reader's decision.
A tendency to favour a less severe diagnosis based on empathy for a patient
Zebra retreat bias
A reader will not make a rare diagnosis albeit supported by evidence due to a lack of confidence.
- 1. Bruno MA, Walker EA, Abujudeh HH. Understanding and Confronting Our Mistakes: The Epidemiology of Error in Radiology and Strategies for Error Reduction. (2015) Radiographics : a review publication of the Radiological Society of North America, Inc. 35 (6): 1668-76. doi:10.1148/rg.2015150023 - Pubmed
- 2. Young W. Kim, Liem T. Mansfield. Fool Me Twice: Delayed Diagnoses in Radiology With Emphasis on Perpetuated Errors. (2014) American Journal of Roentgenology. 202 (3): 465-70. doi:10.2214/AJR.13.11493 - Pubmed
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