Recognizing and reducing cognitive bias in clinical and forensic neurology

Abstract

In medicine, cognitive errors form the basis of bias in clinical practice. Several types of bias are common and pervasive, and may lead to inaccurate diagnosis or treatment. Forensic and clinical neurology, even when aided by current technologies, are still dependent on cognitive interpretations, and therefore prone to bias. This article discusses 4 common biases that can lead the clinician astray. They are confirmation bias (selective gathering of and neglect of contradictory evidence); base rate bias (ignoring or misusing prevailing base rate data); hindsight bias (oversimplification of past causation); and good old days bias (the tendency for patients to misremember and exaggerate their preinjury functioning). We briefly describe strategies adopted from the field of psychology that could minimize bias. While debiasing is not easy, reducing such errors requires awareness and acknowledgment of our susceptibility to these cognitive distortions. Neurol Clin Pract 2015;5:389-396

Global Cognitive Impairment Prevalence and Incidence in Community Dwelling Older Adults—A Systematic Review

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Predictors of poor health and functional recovery following road trauma: protocol of a British Columbian inception cohort study

“…The 'good-old-days' bias, where patients knowingly or unknowingly exaggerate Open access their preinjury HRQoL, is common following injury. [49][50][51] To minimise 'good-old-days' and recall bias, baseline interviews were conducted as soon as possible following the crash, ideally within 7 days. 12 Administrative health records, including calculated chronic disease score, will be used as an objective measure of preinjury health.…”

“…12 Administrative health records, including calculated chronic disease score, will be used as an objective measure of preinjury health. 49 Participants are assured their responses are confidential, and identifying as health researchers strengthens rapport and improves response rate and quality. 52 Another limitation is sampling bias or non-respondent bias which may occur if those who are missed or decline to participate differ in important ways from participants.…”

Believing in Overcoming Cognitive Biases

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