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Cognitive bias and severity of harm following surgery: Plan for workflow debiasing strategy.
Antonacci, Anthony C; Dechario, Samuel P; Rindskopf, David; Husk, Gregg; Jarrett, Mark.
Afiliación
  • Antonacci AC; Northwell Health 2000 Marcus Avenue, Manhasset, NY, 11030, USA. Electronic address: aantonacci@northwell.edu.
  • Dechario SP; Institute for Spine and Scoliosis (ISS), Lawrenceville, NJ 08648, USA. Electronic address: sam@dechario.com.
  • Rindskopf D; City University of New York Graduate School and University Center, New York, NY, USA. Electronic address: drindskopf@gc.cuny.edu.
  • Husk G; Northwell Health 2000 Marcus Avenue, Manhasset, NY, 11030, USA. Electronic address: ghusk@northwell.edu.
  • Jarrett M; Northwell Health 2000 Marcus Avenue, Manhasset, NY, 11030, USA. Electronic address: mjarrett@northwell.edu.
Am J Surg ; 222(6): 1172-1177, 2021 Dec.
Article en En | MEDLINE | ID: mdl-34511201
INTRODUCTION: This study analyzes the relationship between cognitive bias (CB) and harm severity as measured by Clavien-Dindo Scores (CD). METHODS: A prospectively collected series of 655 severity matched general surgical cases with complications were analyzed. Cases were evaluated for CB and assigned harm scores as defined by CD grade. Potentially mitigating "debiasing" strategies were identified for each bias attribution. RESULTS: Among cases with CB, 24% (55/232) were CD(I-II) and 76% (177/232) were CD(III-V). Odds ratio suggests that serious complications occur nearly 60% more frequently when CB is identified. The CBs identified with severe harm were Overconfidence, Commission, Anchoring, Confirmation, and Diagnosis Momentum. Preliminary data on debiasing strategies suggest diagnosis review, linear reasoning and Type II thinking may be relevant in over 85% of complications. CONCLUSION: The incidence of CB is increased in patients sustaining severe harm. Understanding the specific CBs identified and their mitigating debiasing strategies may improve outcomes.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Sesgo / Toma de Decisiones Clínicas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am J Surg Año: 2021 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Sesgo / Toma de Decisiones Clínicas Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am J Surg Año: 2021 Tipo del documento: Article