Heuristics and biases in medical decision-making under uncertainty: The case of neuropronostication for consciousness disorders.

Autor: Lakhlifi C; Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Paris, France; Université Paris Cité, Paris, France., Rohaut B; Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, APHP, Hôpital de la Pitié Salpêtrière, Paris, France; AP-HP, Hôpital de la Pitié Salpêtrière, MIR Neuro, DMU Neurosciences, Paris, France. Electronic address: benjamin.rohaut@icm-institute.org.
Jazyk: angličtina
Zdroj: Presse medicale (Paris, France : 1983) [Presse Med] 2023 Jun; Vol. 52 (2), pp. 104181. Date of Electronic Publication: 2023 Oct 10.
DOI: 10.1016/j.lpm.2023.104181
Abstrakt: Neuropronostication for consciousness disorders can be very complex and prone to high uncertainty. Despite notable advancements in the development of dedicated scales and physiological markers using innovative paradigms, these technical progressions are often overshadowed by factors intrinsic to the medical environment. Beyond the scarcity of objective data guiding medical decisions, factors like time pressure, fatigue, multitasking, and emotional load can drive clinicians to rely more on heuristic-based clinical reasoning. Such an approach, albeit beneficial under certain circumstances, may lead to systematic error judgments and impair medical decisions, especially in complex and uncertain environments. After a brief review of the main theoretical frameworks, this paper explores the influence of clinicians' cognitive biases on clinical reasoning and decision-making in the challenging context of neuroprognostication for consciousness disorders. The discussion further revolves around developing and implementing various strategies designed to mitigate these biases and their impact, aiming to enhance the quality of care and the patient safety.
Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests.
(Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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