2014
DOI: 10.1515/dx-2014-0017
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The bias of the question posed: a diagnostic “invisible gorilla”

Abstract: Posing a question can introduce a powerful bias into the diagnostic process. A clinical case is presented to demonstrate how a colleague's diagnostic question can focus the clinicians' attention on one detail, distracting and blinding them even to the most obvious and important clinical findings. This "inattentional blindness" is similar to the phenomenon demonstrated by Simons in the famous "invisible gorilla" psychological experiment. As much as practical, clinicians should attempt to assess referred patient… Show more

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Cited by 4 publications
(2 citation statements)
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“…For example, when pilots focus on information projected onto the windshield during landing, they sometimes completely overlook other airplanes on the runway [ 2 ]. Also, radiologists looking for lung nodules in CT scans failed to notice much larger, yet unexpected alterations in the image [ 3 ] (see also[ 4 ]).…”
Section: Introductionmentioning
confidence: 99%
“…For example, when pilots focus on information projected onto the windshield during landing, they sometimes completely overlook other airplanes on the runway [ 2 ]. Also, radiologists looking for lung nodules in CT scans failed to notice much larger, yet unexpected alterations in the image [ 3 ] (see also[ 4 ]).…”
Section: Introductionmentioning
confidence: 99%
“…For example, a person who had been diagnosed with tuberculosis died from undiagnosed lymphoma, possibly because the cancerous cells looked similar to a typical presentation of tuberculosis in a lymph node biopsy (Owattanapanich et al, 2017 ). Similarly, 11 out of 12 ophthalmologists missed signs of iron toxicity from a metallic object when asked to look for and rule out malignant melanoma (Zamir, 2015 ), and only about 25% of radiological reports mentioned the presence of an additional rib during their initial read of a CT scan taken for other purposes (Viertel et al, 2012 ). In an analysis of initial readings of radiological images that resulted in delayed diagnosis, approximately 42% of the errors were attributed to “underreading” or missing the finding, and 82% of the examined cases had an instance of underreading (Kim & Mansfield, 2014 ).…”
Section: Introductionmentioning
confidence: 99%