Good articles for further reading on the topic:
Diagnostic Failure: A Cognitive and Affective Approach by Pat Croskerry
Cognitive Strategies and Detection of Bias by Pat Croskerry
The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them by (who else?) Pat Croskerry
And for a slightly ‘contrary’ view of the dual processing model and cognitive bias check out this reference to a Geoff Norman article on the topic.
Other relevant links:
Agency for Healthcare Research and Quality (US Dept. of Health and Human Services): Diagnostic Errors
The Clinical Reasoning Toolkit on the Society to Improve Diagnosis in Medicine website
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Thank you GP registrar from Australia
Just a public reflection about framing bias. It’s been on my mind the last few days and I’ve noticed that I sometimes use framing bias to save my pride. There’s such a desire to have perceived the patient in the right way that I unknowingly frame it in a way that will cause the consultant to agree, specifically for when I have a reasonably benign impression of the patient. I think I have enough irresponsible faith in the seniors and the health system that even if my framing is wrong, nothing important will get missed. At times I even think… Read more »
Thanks for your honesty Justin. Framing bias is a tough one because at some point we have to state what we’re thinking diagnostically but one of the things I advise students and junior doctors is to represent the problem when presenting to colleagues in a way that avoids naming a diagnosis, e.g., a 70 yo man presents with acute cough, increased sputum production, and dyspnea on exertion on a background of known severe COPD with an FEV1 of 20% rather than a 70 yo man presenting with an infective exacerbation of COPD. The former framing still leaves the door open… Read more »