Evidence map›Paper›PMID 34997906›Full record

ArticleInternal and emergency medicine2022

Clinical reasoning in dire times. Analysis of cognitive biases in clinical cases during the COVID-19 pandemic.

Matteo Coen, Julia Sader, Noëlle Junod-Perron, Marie-Claude Audétat, Mathieu Nendaz

Abstract read
In one paragraph

Article in Internal and emergency medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Matteo Coen *Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland. matteo.coen@hcuge.ch.ORCID 0000-0002-6156-1691
Julia Sader *Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Noëlle Junod-PerronUnit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Marie-Claude AudétatUnit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Mathieu Nendaz

Funding

Edmond J. Safra Philanthropic Foundation HERO (CGR 75976)
6 · The paper itself

Abstract

Cognitive biases are systematic cognitive distortions, which can affect clinical reasoning. The aim of this study was to unravel the most common cognitive biases encountered in in the peculiar context of the COVID-19 pandemic. Case study research design. Primary care. Single centre (Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland). A short survey was sent to all primary care providers (N = 169) taking care of hospitalised adult patients with COVID-19. Participants were asked to describe cases in which they felt that their clinical reasoning was "disrupted" because of the pandemic context. Seven case were sufficiently complete to be analysed. A qualitative analysis of the clinical cases was performed and a bias grid encompassing 17 well-known biases created. The clinical cases were analyzed to assess for the likelihood (highly likely, plausible, not likely) of the different biases for each case. The most common biases were: "anchoring bias", "confirmation bias", "availability bias", and "cognitive dissonance". The pandemic context is a breeding ground for the emergence of cognitive biases, which can influence clinical reasoning and lead to errors. Awareness of these cognitive mechanisms could potentially reduce biases and improve clinical reasoning. Moreover, the analysis of cognitive biases can offer an insight on the functioning of the clinical reasoning process in the midst of the pandemic crisis.

Indexed as

COVID-19BiasClinical ReasoningCognitionHumansPandemicsClinical decision-makingCognitive dissonanceDiagnostic errorsEmergency medicineMetacognition

Identifiers

PMID34997906
PMCPMC8742156

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.