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

Jesus Rivas jesus.rivasce at GMAIL.COM
Sun Nov 12 16:54:43 UTC 2017

I am enjoying this interesting debate and I just wanted to leave my ideas
summarized in three points:

1) It is true that clinicians do not use probabilistic reasoning when doing
dx in our daily practice. We try to identify clues from patient’s story,
clinical examination and tests to suspect diseases.

2) In this setting, there is evidence (I see it everyday too) the cognitive
biases (alone or in combination with system errors - Graber 2005) explain
the most of diagnostic errors in medicine, particularly the premature
closure of diagnosis.

3) Can this situation change via accumulating knowledge and experience?


Jesús Rivas-Ceballos

Servicio de Medicina

Hospital de Emergencias Grau - Lima/Perú

2017-11-07 6:48 GMT-05:00 Jain, Bimal P.,M.D. <BJAIN at>:

> 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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