On this episode Neal Christopher, DO, interviews Mark Ard, MD, about the problematic role of anchoring bias in emergency psychiatric evaluations and medical diagnoses, and we review lessons learned from auto immune encephalitis cases. Don't miss the links and references for a ton of helpful follow up information.
LINKS:
Cognitive biases associated with medical decisions: a systematic review
Catalogue of Bias
REFERENCES:
Abboud, Hesham, John C Probasco, Sarosh Irani, Beau Ances, David R Benavides, Michael Bradshaw, Paulo Pereira Christo, et al. 2021. “Autoimmune Encephalitis: Proposed Best Practice Recommendations for Diagnosis and Acute Management.” Journal of Neurology, Neurosurgery & Psychiatry 92 (7): 757–68.
Al-Diwani, Adam, Adam Handel, Leigh Townsend, Thomas Pollak, M Isabel Leite, Paul J Harrison, Belinda R Lennox, David Okai, Sanjay G Manohar, and Sarosh R Irani. 2019. “The Psychopathology of NMDAR-Antibody Encephalitis in Adults: A Systematic Review and Phenotypic Analysis of Individual Patient Data.” The Lancet Psychiatry 6 (3): 235–46.
Berg SA, Moss JH. Anchoring and Judgment Bias: Disregarding Under Uncertainty. Psychol Rep. 2022;125(5):2688-2708. doi:10.1177/00332941211016750
Dalmau, Josep, Thais Armangué, Jesús Planagumà, Marija Radosevic, Francesco Mannara, Frank Leypoldt, Christian Geis, et al. 2019. “An Update on Anti-NMDA Receptor Encephalitis for Neurologists and Psychiatrists: Mechanisms and Models.” The Lancet Neurology 18 (11): 1045–57.
Endres, Dominique, Frank Leypoldt, Karl Bechter, Alkomiet Hasan, Johann Steiner, Katharina Domschke, Klaus- Peter Wandinger, et al. 2020. “Autoimmune Encephalitis as a Differential Diagnosis of Schizophreniform Psychosis: Clinical Symptomatology, Pathophysiology, Diagnostic Approach, and Therapeutic Considerations.” European Archives of Psychiatry and Clinical Neuroscience 270 (7): 803–18.
Graus, Francesc, Maarten J Titulaer, Ramani Balu, Susanne Benseler, Christian G Bien, Tania Cellucci, Irene Cortese, et al. 2016. “A Clinical Approach to Diagnosis of Autoimmune Encephalitis.” The Lancet Neurology 15 (4): 391– 404.
Hemmat S, Santhosh L. Diagnostic Error and Anchoring Bias in a Patient with Schizophrenia. Am J Med. 2020;133(3):e98-e99. doi:10.1016/j.amjmed.2019.08.030
Lieder F, Griffiths TL, M Huys QJ, Goodman ND. The anchoring bias reflects rational use of cognitive resources. Psychon Bull Rev. 2018;25(1):322-349. doi:10.3758/s13423-017-1286-8
Rocker JA, Oestreicher J. Focused Medical Assessment of Pediatric Behavioral Emergencies. Child Adolesc Psychiatr Clin N Am. 2018;27(3):399-411. doi:10.1016/j.chc.2018.02.003
Saposnik G, Redelmeier D, Ruff CC, Tobler PN. Cognitive biases associated with medical decisions: a systematic review. BMC Med Inform Decis Mak. 2016;16(1):138. Published 2016 Nov 3. doi:10.1186/s12911-016-0377-1
