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Showing results for tags 'Confirmation bias'.
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News ArticleDeeply ingrained medical misogyny and racial biases are routinely putting people in need of treatment at risk, the government’s patient safety commissioner in England has warned. Dr Henrietta Hughes was appointed in 2022 in response to a series of scandals in women’s health. She outlined a “huge landscape” of biases in need of levelling, citing examples ranging from neonatal assessment tools and pulse oximeters that work less well for darker skin tones to heart valves, mesh implants and replacement hip joints that were not designed with female patients in mind. Hughes said: “I don’t see this as blaming individual healthcare professionals – doctors and nurses – for getting it wrong. It’s pervasive in the systems we have – the training, the experience, the resources. “Anatomy books are very narrow in their focus. Even the resuscitation models are of pale males – we don’t have female resuscitation models, we don’t have them in darker skin tones. This is deeply ingrained in the way that we assess and listen to patients.” She described the realisation that pulse oximeters, used to measure blood oxygen levels, work less well for darker skin tones as a “real shock to the system” when the problem was highlighted during the pandemic. More recently, the NHS Race and Health Observatory highlighted concerns about neonatal assessments. Bilirubinometers, widely used to assess jaundice in newborn babies, are less reliable for darker skin tones and some guidelines for the assessment of cyanosis (caused by a shortage of blood oxygen) refer to “pink”, “blue” or “pale” skin, without reference to skin changes in minority ethnic babies. The Apgar score, a quick test given to newborns that was rolled out in the 1950s, traditionally includes checking whether a baby is “pink all over”. “Even the names of those conditions – jaundice and cyanosis – suggest a colour. The Apgar score includes P for pink all over,” said Hughes. “There are systemic biases in that if you have a darker skin tone those conditions may not be so apparent.” Read full story Source: The Guardian, 4 February 2024
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- Race
- Discrimination
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Content ArticleCan anti-bias training help to reduce inequities in health care? A range of stakeholders share their recommendations for how implicit bias training could improve Black maternity outcomes.
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- Unconscious bias
- Confirmation bias
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Content ArticleUnconscious bias, which is deeply ingrained and often hard to recognise, impacts decisions in ways we may not realise. Implicit bias, shaped by repeated exposure to real-world interactions, also plays a significant role in this phenomenon. As such, in healthcare, intuitive decision-making can be a double-edged sword. It can help during emergencies but can also lead to discrimination and biases, especially in complex situations. In addition, hidden and automatic biases, which are further strengthened by unquestioned repeated practices, have a significant impact on daily healthcare interactions. Historically, gynaecology occupied a marginalised position within the realm of surgical care, often relegated to the status of a ‘Cinderella service’. This perception stemmed from societal attitudes and gender biases, which influenced how gynaecological surgeries were viewed in comparison with other surgical specialties. Gynaecology, being predominantly focused on women's reproductive health, was sometimes considered less prestigious or less prioritised than other surgical fields such as orthopaedic surgery or general surgery.
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- Unconscious bias
- Confirmation bias
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Content ArticleIn the wake of the Covid-19 pandemic, we are all too aware of the urgent health inequalities that plague our world. But these inequalities have always been urgent: modern medicine has a colonial and racist history. Here, in an essential and searingly truthful account, Annabel Sowemimo unravels the colonial roots of modern medicine. Tackling systemic racism, hidden histories and healthcare myths, Sowemimo recounts her own experiences as a doctor, patient and activist. Divided exposes the racial biases of medicine that affect our everyday lives and provides an illuminating - and incredibly necessary - insight into how our world works, and who it works for.
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- Health inequalities
- Health Disparities
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Content ArticleThis systematic review in the British Journal of Surgery aimed to describe types of cognitive bias in surgery, their impact on surgical performance and patient outcomes, their source, and the mitigation strategies used to reduce their effect. The authors concluded that cognitive biases have a negative impact on surgical performance and patient outcomes across all points of surgical care. This review highlights the scarcity of research investigating the sources that give rise to cognitive biases in surgery and the mitigation strategies that target these factors.
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- Safety culture
- Cognitive tasks
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Content Article“Medical gaslighting” is a controversial term that has emerged to describe a phenomenon some people – women in particular – may recognise. It refers to a patient’s feeling that their symptoms are not taken seriously, or are being misdiagnosed by healthcare professionals. When she was 37, Eleanor presented at a hospital emergency department with severe chest pain. She was diagnosed with slightly high cholesterol and sent home. Three days later, she suffered excruciating pain and was taken to hospital in an ambulance. There, she was asked if she had suffered from panic attacks and was left overnight in a cubicle, before doctors realised she was having a heart attack. She needed eight cardiac stents. “I am sure no man would be asked if they suffer from panic attacks while they’re having a heart attack,” she says. This article in the Irish Times asks why women are more likely to feel their symptoms are not being taken seriously by doctors. Further reading on the hub: ‘Women are being dismissed, disbelieved and shut out’ Gender bias: A threat to women’s health Dangerous exclusions: The risk to patient safety of sex and gender bias
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- Womens health
- Gaslighting
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Content ArticleIn this article for the Byline Times, Consultant David Oliver analyses claims by media and political commentators about spending, waste and inefficiency in healthcare and proposes a ten point plan to restore services to their 2010 level.
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- Communication
- Confirmation bias
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Content ArticleWomen are 50% more likely to receive a wrong initial diagnosis; when they are having a heart attack, such mistakes can be fatal. People who are initially misdiagnosed have a 70% higher risk of dying. The latest studies have similarly shown that women have worse outcomes for heart operations such as valve replacements and peripheral revascularisation. As well as being misdiagnosed, women are less likely to be treated quickly, less likely to get the best surgical treatment and less likely to be discharged with the optimum set of drugs. None of this is excusable, but is it understandable? What is behind this bias and how can how it be fixed? Sian Harding, emeritus professor of cardiac pharmacology at Imperial College London, looks at the evidence in this Guardian article. Related reading Dangerous exclusions: The risk to patient safety of sex and gender bias Gender bias: A threat to women’s health Medicines, research and female hormones: a dangerous knowledge gap
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- Health inequalities
- Health Disparities
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Content ArticleA handful of immunologists are pushing the field to take attributes such as sex chromosomes, sex hormones, and reproductive tissues into account.
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- Health inequalities
- Health Disparities
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Content ArticleIn this blog for Psychology Today, Gary Klein looks at the psychological causes of diagnostic errors, arguing that being clear about the exact causes of these errors is the only way to reduce them. Drawing on physical causes of diagnostic error identified in an Institute of Medicine report in 2015, he highlights the need to go further in understanding the explanations the report offers for diagnostic errors.
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- Diagnosis
- Diagnostic error
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Content ArticleGender bias in healthcare is a well-recognised issue. From diagnosis to drug development and treatment, the modern healthcare system has been shown to advantage men over women. Responsibly designed artificial intelligence (AI) and machine learning algorithms have the potential to overcome gender bias in medicine. However, if machine learning methods are implemented without careful thought and consideration they can lead to the perpetuation and even accentuation of existing biases. How can we develop technology in a way that prevents rather than perpetuates bias? This blog from Babylon highlights 4 key principles that can help.
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- Womens health
- Confirmation bias
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Content Article
ECRI: Top 10 Patient Safety Concerns 2022
Patient Safety Learning posted an article in International patient safety
ECRI's annual Top 10 list helps organisations identify imminent patient safety challenges. The 2022 edition features many first-time topics, and emphasis is on potential risks that could have the biggest impact on patient health across all care settings. The number one topic on this year’s list has been steadily growing throughout the COVID-19 pandemic and impacts patients and staff on all levels: staffing shortages. Prior to 2021, there was a growing shortage of both clinical and non-clinical staff, but the problem has grown exponentially. In early January 2022, it was estimated that 24% of US hospitals were critically understaffed, while 100 more facilitates anticipated facing critical staff shortages within the following week. The list includes diagnostic and vaccine-related errors that can impact patient outcomes. In addition, several topics on this year's list reflect challenges that have arisen as a result of the stresses associated with delivering care during a global pandemic.- Posted
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- Safe staffing
- Staff factors
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News Article
Miscarriage: 'I was in pain and they did not listen'
Patient Safety Learning posted a news article in News
Research shows black women are at a 40% higher risk of pregnancy loss than white women. It is an urgent problem, which the Royal College of Obstetricians and Gynaecologists says needs greater attention, with many complex reasons driving this higher risk. These include a lack of quality research involving all ethnicities - but RCOG head Dr Edward Morris says implicit racial bias is also affecting some women's experience of care. Isabel Gomes Obasi and her husband, Paulson, from Coventry, are expecting a baby boy in March. They are extremely anxious as almost a year ago their baby boy Andre died four months into Isabel's pregnancy. Giving birth to Andre was extremely traumatic, Isabel says, but how she was treated when in severe pain and bleeding, in the days before her loss, made the experience worse. "We knew something was wrong, so we went into hospital and waited five hours to be seen by a doctor," she says. "I remember being laughed at by one of the nurses, who said, 'Just go home. Why do you keep coming in?'" Isabel was checked over and told the baby was fine but says her intuition and pain were belittled and ignored. Within 48 hours of going home, Isabel began bleeding heavily. There is little doctors can do at this relatively early stage of pregnancy to save a baby's life. But the feeling of not being listened to has stayed with Isabel ever since. "I just shut down," she says. "The experience made me anxious and depressive, if not suicidal." Asked why she was not listened to, she said: "The colour of my skin," the attitude of some staff was: "'You have black skin - you are not from here - you can wait.'" Dr Morris says it is "unacceptable" women belonging to ethnic minorities face worse outcomes than white women - especially in maternity care. "Implicit racial bias from medical staff can hinder consultations and negatively influence treatment options," he says. This can stop some women engaging with healthcare. Read full story Source: BBC News, 8 February 2022 -
Content ArticleWhen Joe Fassler's wife was struck by mysterious, debilitating symptoms, their trip to the ER revealed the sexism inherent in emergency treatment.
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- Womens health
- Pain
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Content Article
Every single cognitive bias in one infographic
Patient Safety Learning posted an article in Barriers
Humans have a tendency to think in particular ways that can lead to systematic deviations from making rational judgements. Here's all 188 cognitive biases in existence, grouped by how they impact our thoughts and actions. Produced by DesignHacks.co.- Posted
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- Unconscious bias
- Confirmation bias
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Content ArticleIn the previous blog in the 'Why investigate' series, we heard from Professor Martin Langham about the error trap being an error trap in itself, and about changing our focus in investigations to look wider than simplistic ideas and models of causation. In this blog, Professor Alex Stedmon considers how we might make the wrong decision when we think it’s the right decision.
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- Investigation
- Confirmation bias
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Content ArticleThis guidance from the Chartered Institute of Ergonomics and Human Factors (CIEHF) is aimed at early career pharmacists, especially those in foundation pharmacist positions managing the transition from education to the workplace environment. Support in clinical decision-making is recognised as an educational development need for early career pharmacists, making the transition from a university education where there is very little exposure to the clinical environment into the work environment. This situation is compounded by a policy landscape which puts the pharmacist in a central role for clinical management of long-term complex morbidities, making clinical decision making and taking responsibility for patient outcomes increasingly important. The guidance will also be of use to those involved in the education and mentorship of early career pharmacist.
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- Pharmacy / chemist
- Health education
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Content ArticleDisparities in healthcare exist because of socioeconomic factors, structural racism and implicit bias. The panelists in this video identify the problems and discuss what solutions are in place that could improve health disparities such as medical education, more training for underrepresented minority physicians, more funding for research, and fast-tracking publication of research. Furthermore, the panelists explore how the field of dermatology and other medical specialties can address these issues.
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- Diagnosis
- Dermatological
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Content ArticleBy understanding how physicians make clinical decisions, and examining how errors due to cognitive biases occur, cognitive bias awareness training and debiasing strategies may be developed to decrease diagnostic errors and patient harm. Studies of the impact of teaching critical thinking skills have mixed results but are limited by methodological problems. The authors of this paper, published in Academic Medicine, argue that explicit instruction in metacognition in medical education, including awareness of cognitive biases, has the potential to reduce diagnostic errors and thus improve patient safety.
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- Unconscious bias
- Confirmation bias
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Content ArticleCognition is the mental process of knowing, including awareness, perception, reasoning and judgement, and is distinct from emotion and volition. Cognitive processes include mental shortcuts, which speed up decision making. However, cognitive bias occurs when the shortcut causes inferences about other people and/or situations to be drawn in an illogical fashion. There is a tendency to display bias in judgements that are made in everyday life, indeed this is a natural element of the human psyche. Jumping to a conclusion, tunnel vision, only seeing what is expected/wanted, being influenced by the views of others, all are recognisable behaviours. However, whilst such biases may be commonplace and part of human nature, it is essential to guard against these in forensic science, where many processes require subjective evaluations and interpretations. The consequences of cognitive bias may be far-reaching; investigators may be influenced to follow a particular line of enquiry or interpretation of a finding that may be incomplete, or even wrong. Simply because there is a risk of a cognitive bias does not imply that it occurs. The problem is that as it is a subconscious bias it is unlikely that an individual will know either way and therefore it is wise that all practitioners understand the issue and take proportionate steps to mitigate against it.
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- Investigation
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Content ArticleThis report by the World Health Organization, draws attention to gender as a powerful determinant of health care access and outcomes. By analysing universal health coverage (UHC) indicators from a gender perspective, including indicators dis-aggregated by sex, the report exposes how people’s gender intersects with their socioeconomic backgrounds and other aspects of their identities and circumstances to produce health inequities. It applies gender and equity perspectives to service coverage and financial protection, two key dimensions of UHC. It concentrates on the policies and services of health systems, while acknowledging that breaking gender- and equity-related barriers requires a multisectoral approach. It shows how health systems and UHC policies, by increasing gender responsiveness, can improve equity. And it recommends ways to incorporate gender in the UHC framework for monitoring country progress.
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- Confirmation bias
- Public health
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Content ArticleHuman factors and ergonomics (HFE) approaches to patient safety have addressed five different domains: usability of technology; human error and its role in patient safety; the role of healthcare worker performance in patient safety; system resilience; and HFE systems approaches to patient safety.
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- Ergonomics
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Content ArticleA blog from Dr Linda Dykes. "Bryn was my patient. He died. He may have stood a better chance of survival had I been aware of the risk of small bowel volvulus in an adult. I produced this reflective learning resource with some colleagues - and with Bryn's widow, whom we call Fiona. Please read it... it may help you save a life one day."
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- Accident and Emergency
- Patient death
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Content ArticleBen Tipney and Vikki Howarths' presetation on Human Factors in practice. This presentation covers: an introduction to human factors human factors training implementation of human factors in practice new initiatives.
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- Confirmation bias
- Decision making
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Content ArticleHindSight is a magazine produced by the Safety Improvement Sub-Group (SISG) of EUROCONTROL. It is produced for Air Traffic Controllers and is issued by the Agency twice a year. Its main function is to help operational air traffic controllers to share in the experiences of other controllers who have been involved in ATM-related safety occurrences. The current Editor in Chief is Dr Steven Shorrock.
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- Confirmation bias
- Decision making
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