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Recognizing and reducing cognitive bias in clinical and forensic neurology
Open accessAbstract
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.
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“Human cognitive biases can be mitigated through a combination of awareness, education, and structured approaches [20].”
From Mitigating cognitive biases in clinical decision-making through multi-agent conversations using large language models: simulation study (2024) · cites this paper as [20]
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Believing in Overcoming Cognitive Biases
(2020) · AMA Journal of Ethics · doi:10.1001/amajethics.2020.773 · Cited by 80
Ke, Y., Yang, R., Lie, S. A., Lim, T. X. Y., Ning, Y., Li, I., Abdullah, H. R., Ting, D. S. W., & Liu, N. (2024) · Journal of Medical Internet Research · doi:10.2196/59439 · Cited by 64
“Human cognitive biases can be mitigated through a combination of awareness, education, and structured approaches [20].”
Metadata
- Authors
- Satya-Murti, S., & Lockhart, J.
- Affiliations
- Health Policy Consultant (SS-M), Santa Maria, CA; and Forensic Services Division (JL), California Department of State Hospitals, Sacramento.
- ORCID
- Lockhart, Joseph
- Venue
- Neurology Clinical Practice
- Published
- 2015-10
- Volume
- 5
- Issue
- 5
- Pages
- 389-396
- ISSN
- 2163-0402 (ISSN-L)
- 2163-0933
- PMC
- PMC5762024
- OpenAlex
- W2178302034
- Cited by
- 42
- References
- 35
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 5 · 2023: 10 · 2022: 4 · 2021: 5 · 2020: 3 · 2018: 2 · 2017: 1
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- Neurology Clinical Practice (publishedVersion, other-oa)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Keywords
- cognitive biases, confirmation bias, base rate neglect, hindsight bias, bias mitigation, forensic neurology, clinical neurology, diagnostic errors, memory bias
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