Cognitive bias and decision making

Eye-tracking is emerging as a tool for researchers to better understand cognition and behavior. However, it is possible that experiment participants adjust their behavior when they know their eyes are being tracked. This potential change would be considered a type of Hawthorne effect, in which participants alter their behavior in response to being watched and could potentially compromise the outcomes and conclusions of experimental studies that use eye tracking. We examined whether eye-tracking produced Hawthorne effects in six commonly used psychological scales and five behavioral tasks...

OBJECTIVE: There is a growing concern about the sustainability of healthcare and the impacts of 'overuse' on patients and systems. Quaternary prevention (P4), a concept promoting the protection of patients from medical interventions in which harms outweigh benefits, is well positioned to stimulate reflection and inspire solutions, yet has not been widely adopted. We sought to identify enablers and barriers to a P4 approach, according to field experts and advocates in one health system...

BACKGROUND CONTEXT: Left-digit bias is a behavioral heuristic or cognitive "shortcut" in which the leftmost digit of a number, such as patient age, disproportionately influences surgical decisions. PURPOSE: To determine if left-digit bias in patient age influences the decision to perform arthrodesis with instrumentation vs. decompression in lumbar spinal stenosis (LSS). DESIGN: Retrospective cohort. PATIENT SAMPLE: Patients with an ICD-10 diagnosis of lumbar stenosis or spondylolisthesis identified in the 2017-2021 National Surgical Quality Improvement Program (NSQIP) database...

BACKGROUND: Patient involvement in goals of care decision-making has shown to enhance satisfaction, affective-cognitive outcomes, allocative efficiency, and reduce unwarranted clinical variation. However, the involvement of patients in goals of care planning within hospitals remains limited, particularly where mismatches in shared understanding between doctors and patients are present. AIM: To identify and critically examine factors influencing goals of care conversations between doctors and patients during acute hospital illness...

Monitoring errors consumes limited cognitive resources and can disrupt subsequent task performance in multitasking scenarios. However, there is a dearth of empirical evidence concerning this interference with prospective estimation of time. In this study, we sought to investigate this issue through a serial multitasking experiment, employing a temporal bisection task as the primary task. We introduced two task contexts by implementing two different concurrent tasks. In one context, participants were tasked with discriminating the size difference between two visual items, while in the other context, they were required to judge the temporal order of similar visual items...

So far, little is known about the ability to contrast contextual bias as a protective factor in an ever-changing organizational environment. This study assessed whether professionals with different seniority can resist the reframing and the decoy effect under decision-making conditions and whether decision-making styles can predict the resistance to such covert influence tactics. To reach this aim, two groups of professionals divided into senior and junior professionals performed two novel tasks, a Resistance to Reframe Task (RRT) and a Resistance to Alternatives Task (RAT), which, by including ecological scenarios that represent typical decision situations that could arise in the company, can measure the resistance to such covert influence tactics...

Intertemporal choice refers to the decision-making process involving trade-offs between rewards available at different points in time (such as choosing between smaller immediate rewards versus larger rewards later on). Empirical evidence often deviates from the exponential preferences predicted by the normative model. A hyperbolic discount function better mirrors individual behavior, explaining temporal inconsistency - whereby preferences vary over time by applying a higher discount in the present. Hyperbolic preferences are associated with addictive behaviors, such as smoking and alcohol consumption, as well as depression or attention deficit hyperactivity disorder...

The Multidimensional Forced Choice (MFC) test is frequently utilized in non-cognitive evaluations because of its effectiveness in reducing response bias commonly associated with the conventional Likert scale. Nonetheless, it is critical to recognize that the MFC test generates ipsative data, a type of measurement that has been criticized due to its limited applicability for comparing individuals. Multidimensional item response theory (MIRT) models have recently sparked renewed interest among academics and professionals...

Should we keep doing what we know works for us, or should we risk trying something new as it could work even better? The exploration-exploitation dilemma is ubiquitous in daily life decision-making, and balancing between the two is crucial for adaptive behavior. Yet, we only have started to unravel the neurocognitive mechanisms that help us to find this balance in practice. Analyzing BOLD signals of healthy young adults during virtual foraging, we could show that a behavioral tendency for prolonged exploitation was associated with weakened signaling during exploration in central node points of the frontoparietal attention network, plus the frontopolar cortex...

People with serious mental illness have challenged self-awareness, including momentary monitoring of performance. A core feature of this challenge is in the domain of using external information to guide behavior, an ability that is measured very well by certain problem-solving tasks such as the Wisconsin Card Sorting Test (WCST) . We used a modified WCST to examine correct sorts and accuracy decisions regarding the correctness of sort. Participants with schizophrenia (n = 99) or bipolar disorder (n = 76) sorted 64 cards and then made judgments regarding correctness of each sort prior to feedback...

Excessive avoidance is characteristic for anxiety disorders, even when approach would lead to positive outcomes. The process of how such approach-avoidance conflicts are resolved is not sufficiently understood. We examined the temporal dynamics of approach-avoidance in intense fear of spiders. Highly fearful and non-fearful participants chose repeatedly between a fixed no spider/low reward and a spider/high reward option with varying fear (probability of spider presentation) and reward information (reward magnitude)...

BACKGROUND: Mild cognitive impairment (MCI) is the stage between cognitive decline due to physiological aging and the severity of decline seen in neurodegenerative disorders like Alzheimer disease (AD), which is among the most prevalent neurodegenerative disorders characterized by cognitive impairment. People with MCI are at increased risk of developing AD. Although MCI and AD are incurable, nutritional interventions can potentially delay or prevent their onset. Consequently, effective interventions used to decelerate or alleviate the progress of cognitive impairment in older people are a significant focus in geriatric care...

BACKGROUND: Non-technical skills (NTS) are essential for safe surgical patient management. However, assessing NTS involves observer-based ratings, which can introduce bias. Eye tracking (ET) has been proposed as an effective method to capture NTS. The purpose of the current study was to determine if ET metrics are associated with NTS performance. METHODS: Participants wore a mobile ET system and participated in two patient care simulations, where they managed a deteriorating patient...

BACKGROUND: Literature suggest that physicians' high level of confidence has a negative impact on medical decisions, and this may lead to medical errors. Experimental research is lacking; however, this study investigated the effects of high confidence on diagnostic accuracy. METHODS: Forty internal medicine residents from different hospitals in Saudi Arabia were divided randomly into two groups: A high-confidence group as an experimental and a low-confidence group acting as a control...

The entrustment framework redirects assessment from considering only trainees' competence to decision-making about their readiness to perform clinical tasks independently. Since trainees and supervisors both contribute to entrustment decisions, we examined the cognitive and affective factors that underly their negotiation of trust, and whether trainee demographic characteristics may bias them. Using a document analysis approach, we adapted large language models (LLMs) to examine feedback dialogs (N = 24,187, each with an associated entrustment rating) between medical student trainees and their clinical supervisors...

OBJECTIVES: Lung cancer is the leading cause of cancer-related death and poses significant challenges in diagnosis and management. Although muscle metastases are exceedingly rare and typically not the initial clinical manifestation of neoplastic processes, their recognition is crucial for optimal patient care. METHODS: We present a case report in which we identify the unique scenario of a 60-year-old man with shoulder pain and a deltoid muscle mass, initially suggestive of an undifferentiated pleomorphic sarcoma...

Algorithms are a ubiquitous part of modern life. Despite being a component of medicine since early efforts to deploy computers in medicine, clinicians' resistance to using decision support and use algorithms to address cognitive biases has been limited. This resistance is not just limited to the use of algorithmic clinical decision support, but also evidence and stochastic reasoning and the implications of the forcing function of the electronic medical record. Physician resistance to algorithmic support in clinical decision making is in stark contrast to their general acceptance of algorithmic support in other aspects of life...

Personality traits drive individual differences in behaviour that are consistent across time and context. Personality limits behavioural plasticity, which could lead to maladaptive choices if animals cannot adapt their behavior to changing conditions. Here, we assessed consistency and flexibility in one personality trait, boldness, across non-social and social contexts in eastern gartersnakes (Thamnophis sirtalis sirtalis). Snakes explored a novel open arena either alone or in a pair. Pairs were assigned based on the data from the solo trials, such that each snake was paired once with a bolder and once with a less bold partner...

OBJECTIVE/BACKGROUND: The Consensus Sleep Diary (CSD) is widely used to assess subjective sleep. Psychometric evaluations and focus-groups support its validity and clinical usefulness, but further research into its validity is needed. The aim of the study was to evaluate a Swedish translation of the CSD regarding test content and response processes in patients with insomnia. PATIENTS/METHODS: In connection with translating the CSD into Swedish, we used cognitive interviewing to evaluate test content and the response process, that is, how people make decisions when responding to survey items...

BACKGROUND: Diagnostic errors have been attributed to reasoning flaws caused by cognitive biases. While experiments have shown bias to cause errors, physicians of similar expertise differed in susceptibility to bias. Resisting bias is often said to depend on engaging analytical reasoning, disregarding the influence of knowledge. We examined the role of knowledge and reasoning mode, indicated by diagnosis time and confidence, as predictors of susceptibility to anchoring bias. Anchoring bias occurs when physicians stick to an incorrect diagnosis triggered by early salient distracting features (SDF) despite subsequent conflicting information...