ArticleClinical transplantation2021
Left-digit bias and deceased donor kidney utilization.
Article in Clinical transplantation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed.
- Age-Based Left-Digit Bias in the Treatment of Pancreatic Adenocarcinoma.Journal of gastrointestinal cancer · 2026Article
- Equity and the operational considerations of the kidney transplant allocation system.Current opinion in organ transplantation · 2025Review
- Patient and Provider Attitudes Toward Patient-Facing Kidney Organ Offer Reporting.Kidney international reports · 2025Article
- Article
- Gender bias in pediatric care: Health professionals' opinions and perceptions.Health science reports · 2023Article
- Characterization of Transplant Center Decisions to Allocate Kidneys to Candidates With Lower Waiting List Priority.JAMA network open · 2023Article
- Impact of Extending Eligibility for Reinstatement of Waiting Time After Early Allograft Failure: A Decision Analysis.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- The Influence of the Availability Heuristic on Physicians in the Emergency Department.Annals of emergency medicine · 2021Observational
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
Cognitive biases shown to impact medical decision-making include left-digit bias, the tendency to focus on a continuous variable's leftmost digit. We hypothesized that left-digit bias impacts deceased donor kidney utilization through heuristic processing of donor age and creatinine. We used US registry data to identify 87 019 kidneys recovered (2015-2019) and compared the proportion around thresholds for donor age (69 vs. 70 years) and creatinine (1.9 vs. 2.0 mg/dl), then compared the risk of kidney discard. Kidneys from donors aged 70 vs. 69 years were more frequently discarded (77% vs. 65%, p < .001), with higher risk of discard even after adjusting for KDRI (adjusted RR 1.11, 95% CI 1.02-1.21, p = .018). Similarly, kidneys from donors with final creatinine 2.0 vs. 1.9 mg/dl were more frequently discarded (37% vs. 29%, p < .001), with higher risk of discard after adjusting for KDRI (adjusted RR 1.19, 95% CI 1.07-1.33, p = .001). However, no significant left-digit effect was found when examining other donor age (39/40, 49/50, 59/60 years) or creatinine (0.9/1.0, 2.9/3.0 mg/dl) thresholds. The findings suggest a possible left-digit effect affecting kidney utilization at specific thresholds. Additional investigations of the impact of this and other heuristics on organ utilization are needed to identify potential areas for decision-making interventions aimed at reducing kidney discard.
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