TY - JOUR
T1 - Biasing Influence of ‘Mental Shortcuts’ on Diagnostic Decision-Making
T2 - Radiologists Can Overlook Breast Cancer in Mammograms When Prior Diagnostic Information Is Available
AU - Branch, Fallon
AU - Santana, Isabella
AU - Hegdé, Jay
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/1
Y1 - 2022/1
N2 - When making decisions under uncertainty, people in all walks of life, including highly trained medical professionals, tend to resort to using ‘mental shortcuts’, or heuristics. Anchoring-and-adjustment (AAA) is a well-known heuristic in which subjects reach a judgment by starting from an initial internal judgment (‘anchored position’) based on available external information (‘anchoring information’) and adjusting it until they are satisfied. We studied the effects of the AAA heuristic during diagnostic decision-making in mammography. We provided practicing radiologists (N = 27 across two studies) a random number that we told them was the estimate of a previous radiologist of the probability that a mammogram they were about to see was positive for breast cancer. We then showed them the actual mammogram. We found that the radiologists’ own estimates of cancer in the mammogram reflected the random information they were provided and ignored the actual evidence in the mammogram. However, when the heuristic information was not provided, the same radiologists detected breast cancer in the same set of mammograms highly accurately, indicating that the effect was solely attributable to the availability of heuristic information. Thus, the effects of the AAA heuristic can sometimes be so strong as to override the actual clinical evidence in diagnostic tasks.
AB - When making decisions under uncertainty, people in all walks of life, including highly trained medical professionals, tend to resort to using ‘mental shortcuts’, or heuristics. Anchoring-and-adjustment (AAA) is a well-known heuristic in which subjects reach a judgment by starting from an initial internal judgment (‘anchored position’) based on available external information (‘anchoring information’) and adjusting it until they are satisfied. We studied the effects of the AAA heuristic during diagnostic decision-making in mammography. We provided practicing radiologists (N = 27 across two studies) a random number that we told them was the estimate of a previous radiologist of the probability that a mammogram they were about to see was positive for breast cancer. We then showed them the actual mammogram. We found that the radiologists’ own estimates of cancer in the mammogram reflected the random information they were provided and ignored the actual evidence in the mammogram. However, when the heuristic information was not provided, the same radiologists detected breast cancer in the same set of mammograms highly accurately, indicating that the effect was solely attributable to the availability of heuristic information. Thus, the effects of the AAA heuristic can sometimes be so strong as to override the actual clinical evidence in diagnostic tasks.
KW - Anchoring and adjustment
KW - Bias
KW - Cognitive rules of thumb
KW - Diagnostic radiology
KW - Heuristics
KW - Judgement
KW - Medical error
KW - Screening mammography
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U2 - 10.3390/diagnostics12010105
DO - 10.3390/diagnostics12010105
M3 - Article
AN - SCOPUS:85122653672
SN - 2075-4418
VL - 12
JO - Diagnostics
JF - Diagnostics
IS - 1
M1 - 105
ER -