The status of heuristics and cognitive biases as a source of diagnostic errors.

Linda M. Isbell lisbell at PSYCH.UMASS.EDU
Thu Nov 9 02:26:05 UTC 2017

Interesting paper, thanks for sharing it; however, I do disagree with
the notion that heuristics and biases are not a significant concern in
diagnosis.  A large body of research demonstrates the pervasive use of
heuristics across pretty much every domain ever investigated over
several decades.  This is not at all controversial in psychology.  So,
it is unclear to me why diagnosis would be exempt from this - ???  I
certainly agree that lack of medical knowledge or experience will
certainly lead to diagnostic errors.  However, how do we explain
diagnostic errors that emerge when a provider has both knowledge and
experience?   One cannot assume, for example, that if an error occurs,
one must not have had the knowledge or experience to reach the correct
diagnosis (though this can be assessed).  Surely very smart and
experienced doctors sometimes rely on the wrong information when
assessing patients and forming a diagnosis - the same doctors who may
well have the necessary information in their heads but, for some reason,
they relied on something other than this information.  



Linda M. Isbell, Ph.D.
 Professor, Psychology
 Department of Psychological and Brain Sciences
 University of Massachusetts
 135 Hicks Way -- 630 Tobin Hall
 Amherst, Massachusetts 01003
 Office Phone:  413-545-5960

On 2017-11-07 06:48, Jain, Bimal P.,M.D. wrote:

> In this attached paper, I point out that heuristics and biases are a source of inferential errors only in a setting in which the normatively correct method of reasoning is probabilistic. 
> I argue that the notion of heuristics and biases as a source of diagnostic errors may not be relevant in diagnosis  which  is not probabilistic in practice as I point out in this paper. 
> I suggest the main sources of diagnostic errors are lack of knowledge and/or experience. 
> Please review and comment on this paper. 
> Thanks. 
> Bimal 
> Bimal P Jain MD 
> Northshore Medical Center 
> Lynn MA 01904. 
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