The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
How clinical decisions are made
Open accessAbstract
There is much variation in the implementation of the best available evidence into clinical practice. These gaps between evidence and practice are often a result of multiple individual decisions. When making a decision, there is so much potentially relevant information available, it is impossible to know or process it all (so called ‘ bounded rationality ’). Usually, a limited amount of information is selected to reach a sufficiently satisfactory decision, a process known as satisficing . There are two key processes used in decision making: System 1 and System 2. System 1 involves fast, intuitive decisions; System 2 is a deliberate analytical approach, used to locate information which is not instantly recalled. Human beings unconsciously use System 1 processing whenever possible because it is quicker and requires less effort than System 2. In clinical practice, gaps between evidence and practice can occur when a clinician develops a pattern of knowledge, which is then relied on for decisions using System 1 processing, without the activation of a System 2 check against the best available evidence from high quality research. The processing of information and decision making may be influenced by a number of cognitive biases, of which the decision maker may be unaware. Interventions to encourage appropriate use of System 1 and System 2 processing have been shown to improve clinical decision making. Increased understanding of decision making processes and common sources of error should help clinical decision makers to minimize avoidable mistakes and increase the proportion of decisions that are better .
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“In clinical settings, clinicians often tackle tasks using System 1 thinking, particularly in time-sensitive or high-pressure situations [91].”
From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [91]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Evidence based medicine: what it is and what it isn't
Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996) · BMJ · doi:10.1136/bmj.312.7023.71 · Cited by 15,769
Decision aids for people facing health treatment or screening decisions
Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., Holmes-Rovner, M., Llewellyn-Thomas, H., Lyddiatt, A., Thomson, R., et al. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001431.pub5 · Cited by 6,685
Predictably Irrational: The Hidden Forces That Shape Our Decisions
Ariely, D. (2008) · Choice Reviews Online · doi:10.5860/choice.46-0969 · Cited by 2,164
The Importance of Cognitive Errors in Diagnosis and Strategies to Minimize Them
Croskerry, P. (2003) · Academic Medicine · doi:10.1097/00001888-200308000-00003 · Cited by 1,675
A cognitive perspective on medical expertise
Schmidt, H. G., Norman, G. R., & Boshuizen, H. P. A. (1990) · Academic Medicine · doi:10.1097/00001888-199010000-00001 · Cited by 1,135
A Universal Model of Diagnostic Reasoning
Croskerry, P. (2009) · Academic Medicine · doi:10.1097/acm.0b013e3181ace703 · Cited by 1,016
Gabbay, J., & May, A. L. (2004) · BMJ · doi:10.1136/bmj.329.7473.1013 · Cited by 986
Achieving Quality in Clinical Decision Making: Cognitive Strategies and Detection of Bias
Croskerry, P. (2002) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2002.tb01574.x · Cited by 938
Information Needs in Office Practice: Are They Being Met?
Covell, D. G., UMAN, G. C., & MANNING, P. R. (1985) · Annals of Internal Medicine · doi:10.7326/0003-4819-103-4-596 · Cited by 852
Decision aids for people facing health treatment or screening decisions
O'Connor, A. M. C., Bennett, C. L., Stacey, D., Barry, M. J., Col, N. F., Eden, K., Entwistle, V. A., Fiset, V., Holmes-Rovner, M. M., Khangura, S. D., et al. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001431.pub2 · Cited by 715
Flagged first, then by citations
Research works printed but not linked: 2
- Croskerry P, 2005, Advances in Patient Safety: From Research to Implementation, 240
- 10.1197/aemj.9.11.1184 · DOI · Paper page
Cited by
Sorted by citations
Items 101–131 of 131
Rutter, J. (2020) · Wolverhampton Intellectual Repository and E-Theses (University of Wolverhampton)
(2015) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9780890426760.pe01
Paramedic decision-making and the influence of bias: a case study
Tory, D., & Darby, I. (2022) · Journal of Paramedic Practice · doi:10.12968/jpar.2022.14.6.226
Chahda, M., & Amro, A. S. A. (2022) · International Journal of Health Sciences · doi:10.53730/ijhs.v6ns9.13430
Niemitz, L., van der Stel, S. D., Sørensen, S. T., Messina, W., Sekar, S. K. V., Sterenborg, H. J. C. M., Andersson‐Engels, S., Ruers, T. J. M., & Burke, R. (2023) · doi:10.1364/opticaopen.22285822
Niemitz, L., van der Stel, S. D., Sørensen, S. T., Messina, W., Sekar, S. K. V., Sterenborg, H. J. C. M., Andersson‐Engels, S., Ruers, T. J. M., & Burke, R. (2023) · doi:10.1364/opticaopen.22285822.v1
Decision Making Approaches in Aviation and Medicine
Eichstedt, S. (2024) · Mechanisms and machine science · doi:10.1007/978-3-031-63755-1_21
Co-morbidity Representation in Artificial Intelligence: Tapping into Unused Clinical Knowledge
Bolton, W. J., Georgiou, P., Holmes, A. H., & Rawson, T. M. (2024) · Studies in computational intelligence · doi:10.1007/978-3-031-63592-2_14
Regulation in Health – A Brief History
Peter Donnelly MBBCh, B., & Katie Webb MSc, P. (2021) · doi:10.1002/9781394322305.ch2
Byra, K., Kipfmiller, K. J., & Santus, I. (2024) · Autism and child psychopathology series · doi:10.1007/978-3-031-64499-3_12
Valles-Coral, M. A., Pinedo, L., Navarro-Cabrera, J. R., Valverde-Iparraguirre, J., Injante, R., Saavedra, S., Quintanilla-Morales, L. K., & Espinosa, A. A. (2025) · Iberoamerican Journal of Science Measurement and Communication · doi:10.47909/ijsmc.181
InfEHR: Resolving Clinical Uncertainty through Deep Geometric Learning on Electronic Health RecordsPreprint
Kauffman, J., Holmes, E., Vaid, A., Charney, A. W., Kovatch, P., Lampert, J., Sakhuja, A., Žitnik, M., Glicksberg, B. S., Hofer, I. S., et al. (2025) · medRxiv · doi:10.1101/2025.01.31.25321471
Birkemeyer, R., & Tatur, K. (2025) · Aktuelle Kardiologie · doi:10.1055/a-2515-8280
Kadambi, A., Eftekhar, P., Wang, R. H., & Zariffa, J. (2025) · Research Square · doi:10.21203/rs.3.rs-7852937/v1
Changes in diagnostic evaluation of patients with lung cancer symptoms
Sætre, L. M. S., Balasubramaniam, K., Wehberg, S., Laursen, C. B., Søndergaard, J., & Jarbøl, D. E. (2025) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-025-00464-4
Stroster, J. A. (2013) · UA Campus Repository (The University of Arizona)
Jenkins, H. J., Downie, A., Wong, J. J., Young, J. J., Roseen, E. J., Nim, C. G., McNaughton, D., Øverås, C. K., Hartvigsen, J., Mior, S. A., et al. (2023) · Figshare · doi:10.6084/m9.figshare.24181064
Nguyen, Q. H., Ming, D. K. Y., Luu, A. P., Chanh, H. Q., Tam, D. T. H., Thanh, T. N., Huy, V. X., Hernandez, B., Nuil, J. I. V., Paton, C., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26565821
Jenkins, H. J., Downie, A., Wong, J. J., Young, J. J., Roseen, E. J., Nim, C. G., McNaughton, D., Øverås, C. K., Hartvigsen, J., Mior, S. A., et al. (2023) · Figshare · doi:10.6084/m9.figshare.24181058
Jenkins, H. J., Downie, A., Wong, J. J., Young, J. J., Roseen, E. J., Nim, C. G., McNaughton, D., Øverås, C. K., Hartvigsen, J., Mior, S. A., et al. (2023) · Figshare · doi:10.6084/m9.figshare.24181061
Saxer, F., Jansen, G., Bierma-Zeinstra, S. M. A., Holzhauer, B., Demanse, D., Melnick, J., Greetham, D. V., Rall, T., Mesenbrink, P. G., & Schieker, M. (2025) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2025.12.021
Zarbá, M., O’Sullivan, D., Maj, D., Cheung, W. Y., Ludwig, L., Wells, C., Ferrier, E., Chehade, R. E. H., Donskov, F. N., Eid, M., et al. (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1827686
Understanding cognitive errors in clinical decision-making: a Q methodology approach
Zangooeidovvom, S., Jokar, F., & Omid, A. (2026) · BMC Medical Education · doi:10.1186/s12909-026-09375-5
Tan, J. M., Chai, W. C., Ailabouni, N. J., Proudman, S., Wiese, M. D., & Reeve, E. (2026) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-026-02183-3
Wu, D., Lookingbill, V., Vuruma, S. K. R., Aust, L., Yaddanapalli, B. S., Zhang, J., Markanti, R., Zhang, J., Li, X., Weissman, S., et al. (2026) · Journal of Medical Internet Research · doi:10.2196/91620
Pensée algorithmique, modalités et exemples
Peyskens, L., & Detrait, M. (2025) · Elsevier eBooks · doi:10.1016/b978-2-294-78233-6.00005-9
Towards patient-centered HIV drug resistance testing services in China: A discrete choice experiment
Song, Q., Shen, Q., Long, T., Yu, Y., & Su, S. (2026) · International Journal of STD & AIDS · doi:10.1177/09564624261480307
Brookfield, C., Hover, Q. R. M., Lewis, D. A., Perry, J., Howard, A., Gerada, A., & Hope, W. W. (2026) · Clinical Infection in Practice · doi:10.1016/j.clinpr.2026.100729
Malhotra, R. (2026) · Frontiers in Health Services · doi:10.3389/frhs.2026.1833920
Metadata
- Authors
- Bate, L., Hutchinson, A., Underhill, J., & Maskrey, N.
- Affiliations
- National Institute for Health and Care Excellence (GB)
- Corresponding author
- Bate, Louise
- ORCID
- Maskrey, Neal
- Venue
- British Journal of Clinical Pharmacology
- Publisher
- Wiley
- Published
- 2012-09-05
- Volume
- 74
- Issue
- 4
- Pages
- 614-620
- ISSN
- 0306-5251 (ISSN-L)
- 1365-2125
- PMC
- PMC3477329
- OpenAlex
- W1599764279
- Cited by
- 131
- References
- 32
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 11 · 2023: 18 · 2022: 12 · 2021: 7 · 2020: 12 · 2019: 9 · 2018: 12 · 2017: 5 · 2015: 13 · 2014: 3 · 2013: 4 · 2012: 1
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- British Journal of Clinical Pharmacology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Keywords
- clinical decision-making, knowledge-practice gap, bounded rationality, satisficing, cognitive biases, clinical reasoning, decision errors, implementation of evidence
- MeSH terms
- Clinical Competence, Decision Making, Humans, Models, Psychological, Evidence-Based Medicine
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 ›
Are you an author, or do you see a problem with this page? Request a review
