Cognitive bias and decision aid use under stressful conditions
Abstract
Stressful environments encapsulate factors such as time pressure and information overload that act as inhibitors to intention to use decision aids. In this study, we investigate a stressful environment in a hospital and explore factors that are positively and negatively associated with the intention to use a decision aid. We then develop a theoretical model based on the literature and employ survey data from healthcare experts together with structural equation modelling to investigate the model. In addition to the expected factors from the Technology Acceptance Model, we uncover three additional constructs: information quality, perceived risk, and environment. Our analysis suggests that the perceived personal risk to the decision maker is positively related to attitude toward the decision aid, and that environment is an inhibitor and negatively related. Information quality was not significantly related in our analysis. We also uncover overconfidence bias as an inhibitor to intention to use decision aids.
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Confidence in the initial decision is a key factor influencing decision-making in high-stakes environments such as medical diagnosis.
“In addition to these psychological factors and medical experience, confidence in the initial decision is a key factor influencing decision-making processes in high-stakes environments, such as medical diagnosis [ 23 - 25 ].”
From Psychological Factors Influencing Appropriate Reliance on AI-enabled Clinical Decision Support Systems: Experimental Web-Based Study Among Dermatologists (2025) · cites this paper as [25]
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- Authors
- Phillips-Wren, G., Jefferson, T., & McKniff, S.
- Affiliations
- Loyola University Maryland (US)
- WellSpan Health (US)
- Corresponding author
- Phillips-Wren, Gloria
- ORCID
- Jefferson, Theresa
- Venue
- Journal of Decision Systems
- Publisher
- Informa UK Limited
- Published
- 2019-04-03
- Volume
- 28
- Issue
- 2
- Pages
- 162-184
- ISSN
- 1246-0125 (ISSN-L)
- 2116-7052
- OpenAlex
- W2962923323
- Cited by
- 22
- References
- 90
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 1 · 2020: 1 · 2019: 2
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Decision System (publishedVersion)
- Topics
- Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Keywords
- decision aids, intention to use, cognitive biases, overconfidence, stress, time pressure, information overload, risk perception, information quality, environment, technology acceptance model, healthcare decision-making
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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