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Scientific article
Open access
English

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

Publication date2022-01-08
First online date2022-01-08
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.

eng
Keywords
  • Clinical decision-making
  • Cognitive dissonance
  • Diagnostic errors
  • Emergency medicine
  • Metacognition
Funding
  • Edmond J SAFRA foundation for clinical research in internal medicine - [CGR 75976/ME-HERO]
Citation (ISO format)
COEN, Matteo et al. Clinical reasoning in dire times. Analysis of cognitive biases in clinical cases during the COVID-19 pandemic. In: Internal and emergency medicine, 2022. doi: 10.1007/s11739-021-02884-9
Main files (1)
Article (Published version)
accessLevelPublic
Identifiers
ISSN of the journal1828-0447
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79downloads

Technical informations

Creation01/10/2022 10:20:00 AM
First validation01/10/2022 10:20:00 AM
Update time03/16/2023 2:23:47 AM
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