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Cardiovascular Therapy and Prevention

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Cognitive biases in cardiology practice from the perspective of evolutionary explanation

https://doi.org/10.15829/1728-8800-2024-4311

EDN: CDWCNV

Abstract

The article examines the impact of cognitive biases on decision-making in cardiology practice and their evolutionary explanations. Cognitive biases are systematic thinking errors that, despite their evolutionary adaptiveness in the phylogeny of humans as a species, can lead to serious mistakes in medical diagnosis, treatment, and patient communication. Research indicates that the influence of cognitive biases can be observed across all medical fields. However, the specific types and manifestations of these biases can vary significantly. In cardiology, physicians are particularly prone to biases such as the availability heuristic, anchoring effect, framing effects, and overconfidence bias. Patients exhibit a heightened vulnerability to the affect heuristic and optimism bias. This study, employing an evolutionary descriptive framework, offers some recommendations for overcoming clinical bias in patient interactions and highlights the potential for practice-oriented research on this topic, especially regarding the cultural and institutional specificities of healthcare in Russia.

About the Authors

G. A. Chasovskikh
Pirogov Russian National Research Medical University
Russian Federation

Moscow



E. O. Taratukhin
Pirogov Russian National Research Medical University
Russian Federation

Moscow



References

1. Taratukhin EO. Ethical competence as a component of physician education. Cardiovascular Therapy and Prevention. 2022;21(2): 3208. (In Russ.) doi:10.15829/1728-8800-2022-3208.

2. Blumenthal-Barby JS, Krieger H. Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. Medical Decision Making. 2015;35(4):539-57. doi:10.1177/0272989X14547740.

3. Wilke A, Mata R. Cognitive bias. Encyclopedia of human behaviour. Second edition; 2012; pp. 531-5. ISBN: 978-0-12-415903-7.

4. Saposnik G, Redelmeier D, Ruff CC, Tobler PN. Cognitive biases associated with medical decisions: a systematic review. BMC Med Inform Decis Mak. 2016;16:138. doi:10.1186/s12911-016-0377-1.

5. Wells JCK, Nesse RM, Sear R, et al. Evolutionary public health: introducing the concept. The Lancet. 2017;390(10093):500-9. doi:10.1016/S0140-6736(17)30572-X.

6. Sherbino J, Kulasegaram K, Howey E, Norman G. Ineffectiveness of cognitive forcing strategies to reduce biases in diagnostic reasoning: a controlled trial. Canadian Journal of Emergency Medicine. 2014;16(1):34-40. doi:10.2310/8000.2013.130860.

7. Tversky A, Kahneman D. Judgment under Uncertainty: Heuristics and Biases. Biases in judgments reveal some heuristics of thinking under uncertainty. Science. 1974;185(4157):1124-31. doi:10.1126/science.185.4157.1124.

8. Mamede SÝ, van Gog T, van den Berge K, et al. Effect of availability bias and reflective reasoning on diagnostic accuracy among internal medicine residents. JAMA. 2010;304(11):1198-203. doi:10.1001/jama.2010.1276.

9. Dreiseitl S, Binder M. Do physicians value decision support? A look at the effect of decision support systems on physician opinion. Artificial intelligence in medicine. 2005;33(1):25-30. doi:10.1016/j.artmed.2004.07.007.

10. Friedman CP, Gatti GG, Franz TM, et al. Do physicians know when their diagnoses are correct? Journal of General Internal Medicine. 2005;20(4):334-9. doi:10.1111/j.1525-1497.2005.30145.x.

11. Podbregar M, Voga G, Krivec B, et al. Should we confirm our clinical diagnostic certainty by autopsies? Intensive care medicine. 2001;27:1750-5. doi:10.1007/s00134-001-1129-x.

12. Berner ES, Graber ML. Overconfidence as a cause of diagnostic error in medicine. The American journal of medicine. 2008; 121(5):S10. doi:10.1016/j.amjmed.2008.01.001.

13. Padovani P, Roy A, Guerra A, et al. Cognitive biases in pediatric cardiac care. Frontiers in Cardiovascular Medicine. 2024;11: 1423680. doi:10.3389/fcvm.2024.1423680.

14. Ryan A, Duignan S, Kenny D, McMahon CJ. Decision making in paediatric cardiology. Are we prone to heuristics, biases and traps? Pediatric cardiology. 2018;39:160-7. doi:10.1007/s00246-017-1742-2.

15. McGettigan P, Sly K, O'Connell D, et al. The effects of information framing on the practices of physicians. Journal of general internal medicine. 1999;14(10):633-42. doi:10.1046/j.1525-1497.1999.09038.x.

16. Olenski AR, Zimerman A, Coussens S, Jena AB. Behavioral heuristics in coronary-artery bypass graft surgery. New England Journal of Medicine. 2020;382(8):778-9. doi:10.1056/NEJMc1911289.

17. Holmberg MJ, Granfeldt A, Moskowitz A, et al. Age-related cognitive bias in in-hospital cardiac arrest. Resuscitation. 2021;162:43-6. doi:10.1016/j.resuscitation.2021.01.016.

18. Magid M, McIlvennan CK, Jones J, et al. Exploring cognitive bias in destination therapy left ventricular assist device decision making: A retrospective qualitative framework analysis. American heart journal. 2016;180:64-73. doi:10.1016/j.ahj.2016.06.024.

19. Taratukhin EO. Patient-centered medicine. A new reality. Russian Journal of Cardiology. 2016;(9):79-83. (In Russ.) doi:10.15829/1560-4071-2016-9-79-83.

20. Sharot T. The optimism bias. Current Biology. 2011;21(23): R941-R945. doi:10.1016/j.cub.2011.10.030.

21. Brush JE, Krumholz HM. Clinical decision making in cardiology. British Medical Journal. 2022:376. doi:10.1136/bmj-2021-064389.

22. Haselton MG, Nettle D.The paranoid optimist: An integrative evolutionary model of cognitive biases. Personality and social psychology review. 2006;10(1):52. doi:10.1207/s15327957pspr1001_3.


Review

For citations:


Chasovskikh G.A., Taratukhin E.O. Cognitive biases in cardiology practice from the perspective of evolutionary explanation. Cardiovascular Therapy and Prevention. 2024;23(3S):4311. (In Russ.) https://doi.org/10.15829/1728-8800-2024-4311. EDN: CDWCNV

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)