Fwd: [IMPROVEDX] Fifty Cognitive and Affective biases.

Annalese Bolton a.bolton at NEURA.EDU.AU
Tue Sep 10 00:04:55 UTC 2013

A good way of simplifying the list of biases is to classify them according to the underlying psychological mechanisms responsible for producing the biases. There have been several attempts to do this. I particularly like Arkes, H. (1991). Cost and Benefits of Judgment Errors: Implications for Debiasing. Psychological Bulletin, 110 (3) , 486-498. He classifies them into 3 groups. 

Others papers are 

Haselton & Nettle (2006). The paranoid optimist: An integrative Evolutionary Model of Cognitive Biases. Personality and Social Psychology Review, 10 (1), 47-66 

Oreg & Bayazit (2009). Prone to bias: Development of a bias taxonomy from an Individual Differences Perspective. Review of General Psychology, 13 (3), 175-195 


Annalese Bolton 

(Previously Prince of Wales Medical Research Institute) 

Barker Street Randwick Sydney NSW 2031 Australia 
PO Box 1165 Randwick Sydney NSW 2031 Australia 
T +61 2 9399 1842 

----- Original Message -----

From: "John Brush" <jebrush at ME.COM> 
Sent: Sunday, 8 September, 2013 10:46:25 PM 
Subject: Re: [IMPROVEDX] Fifty Cognitive and Affective biases. 

I agree that it would be good to simplify the list, to make it easier to double check our thinking quickly in our heads. 

Seems like many of the biases are variants of over-generalization or hasty generalization. 
The anchoring and adjusting heuristic may be unique since it is a two part process. Each part is subject to hasty generalization (i.e. anchoring and base rate neglect). 

In addition to a shorter list of subcategories, it would be good to have a better idea of the relative frequencies of the types mistakes. Which ones are most common? Maybe we could focus on one or two that would catch a substantial proportion of potential mistakes. 

Some biases like stereotyping seem to be more subconscious than others, and those will be particularly hard to address. Those are probably only addressed by creating a better general awareness of their potential effects, but harder for someone to catch at the time. 

Sent from my iPad 

On Sep 7, 2013, at 9:31 AM, "Graber, Mark" <Mark.Graber at VA.GOV> wrote: 

> I agree - it would be very valuable to somehow improve how we present the biases. The idea of grouping them is excellent, and many of the heuristics and CDR's (cognitive dispositions to respond, Pat's term) ARE related. 
> I'd also like to see each one illustrated by a real-world, every day examples outside medicine so learners would recognize that these are all just part of normal cognition. How about a contest -"Submit Your Best Example". 
> There is a very little data on prevalence, but in our study it seemed like two were at the top of the list: 
> * Premature closure 
> * Context errors/framing/diagnostic inertia (all related). 
> ________________________________ 
> From: "co1881 at gmail.com" <co1881 at gmail.com> 
> Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, "co1881 at gmail.com" <co1881 at gmail.com> 
> Date: Fri, 6 Sep 2013 17:11:35 -0400 
> Subject: Re: [IMPROVEDX] Fifty Cognitive and Affective biases. 
> I wonder if Dr. Croskerry would re-publish the list with the ones that are most prevalent/cause the most damage, to the lesser ones, less damaging ones (a hierarchy of damage caused). If he would make the list of phrases, I would be glad to re-make the list in that order with the explanations included. I'd like to learn them one at a time, with the most important learned first. Also, this would make a great list for medical school/residency directors to use and distribute. 
> Cari Oliver, M.D., J.D. 
> Cautious Patient Foundation 
> Oliver Center for Patient Safety and Quality Healthcare, University of Texas Medical Branch 
> On Thu, Sep 5, 2013 at 5:17 PM, robert bell <rmsbell at esedona.net> wrote: 
> Dear all, 
> I have really appreciated Pat Croskerry's list of 50 biases that physicians can have when making diagnoses. And have sent to others by e-mail to create discussion and thought. 
> I wondered if this list could be made more useful? Personally, I would never remember the whole 50 biases on the list. 
> Could the descriptors more accurately describe the biases to perhaps remember more easily; could similar issues be grouped together; perhaps could there be an attempt to rank the biases in terms of which are more likely to to be present in the average practice situation? 
> Which brings up the issue of would the types of biases be different for PCPs versus Specialists? And yet again how would you know which are the most important without research? If the biases were ranked would you need different lists for specialists and PCPs or even different lists for different specialities? 
> And how would you design a study to pick the biases up? Is there bias research in other areas that could perhaps be extrapolated the the medical diagnostic arena? e.g. Airline industry? 
> And finally, would the list be more useful if there were 5 to 10 main biases? 
> Rob Bell, M.D., Ph.C. 

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