Cognitive errors in clinical decision making

[Mary Mallozziberg]

Although quantitative mathematical models can guide clinical decision making, clinicians rarely use formal computations to make patient care decisions in day-to-day practice. Rather, an intuitive understanding of probabilities is combined with cognitive processes called heuristics to guide clinical judgment.
Heuristics are often referred to as rules of thumb, educated guesses, or mental shortcuts. Heuristics usually involve pattern recognition and rely on a subconscious integration of somewhat haphazardly gathered patient data with prior experience rather than on a conscious generation of a rigorous differential diagnosis that is formally evaluated using specific data from the literature.
Such informal reasoning is often fallible because heuristics may cause several types of unconscious errors (cognitive errors). Studies suggest that more medical errors involve cognitive error than lack of knowledge or information.