Don’t Let Anchoring Bias Sink Sound Decision-Making

Evidence is mounting that anchoring bias—getting “stuck” on patient-reported reasons for a visit to the extent that it affects decision-making or narrows the provider’s consideration of actual etiologies—is not only real but also a serious concern in clinical care. A study just published by JAMA Internal Medicine reveals that when patients presenting to an emergency room with shortness of breath included congestive heart failure on their self-reported history, physicians were less likely to assess for pulmonary embolism. Patients doing so “was associated with delayed workup and diagnosis of PE,” according to the authors. The study reflected the care of 108,019 patients with CHF who presented to an emergency room with SOB. The phenomenon of anchoring bias is not specific to the ED, of course. In fact, JUCM published a case report in which it played a significant role. Read A ‘Red Herring’ Chief Complaint to see its effects in the urgent care center.