Cognitive biases and debiasing strategies

Cognitive bias	Comments	Risk reduction strategies
Availability heuristic	Linking the current situation to the most memorable prior events (emotionally charged) rather than to the most alike	Identify at least 3 possibilities and do not use only the first that comes to mind
Confirmation	A tendency to focus on data that support and ignoring further details that would refute the initial assessment	Physically or mentally list all aspects of the case, even those that appear irrelevant; present to a colleague and ask for their assessment
Anchoring or fixation	Focusing on a single aspect of a case (often the initial one) rather than the complete picture	As above
Overconfidence	Inaccurate overly positive self-assessment	Recognize this tendency, ask "how could I have gone wrong?"
Visceral or emotional	Allowing feelings about a patient to influence the assessment ("high maintenance," "drug seeking," "VIP patient")	Be cognizant of personal positive or negative emotional response to patient; consider if diagnosis would be different if the patient were of a different race or socio-economic class
Reconstruction	"Filling in the blanks" when the current situation lacks certain features of the perceived most likely diagnosis	Ask "what do I know for sure, and what is missing that is typically seen in this condition?"

Adapted from: Stiegler MP, Tung A. Cognitive processes in anesthesiology decision making. Anesthesiology 2014; 120:204.

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