Availability Bias

  • Kahneman and Thaler – Should I Go in the Water?

    By Marjorie Stiegler on August 19, 2015
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    I’ve often used the illustration of a shark attack to explain the Availability Bias (Kahneman and Tversky) – in a nutshell, the mental illusion that memorable events are more likely than their their statistical rarity predicts. Although shark attacks are vivid, make incredible headlines, are gruesome, and therefore are memorable, we are much more likely to die from the mundane - a fall, lighting strike, pig attack, and so on. Therefore, rationally speaking, imagery from the Discovery Channel's "Shark Week" should not stop us from enjoying the waves. This Saturday, I’m heading to the same NC beaches that boast no less than 8 (!!) shark attacks in the past several weeks - the highest number in over 80 years. What is happening? Are we under siege? According to some expert reports, these shark attacks are "extraordinary," represent "incredible odds" and a "perfect storm". And so I ask Drs. Kahneman and Thaler - what would you do?
  • Why Can’t We Fix the Diagnostic Error Epidemic?

    By Marjorie Stiegler on March 9, 2015
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    It is estimated that the volume of knowledge is doubling at least every 8 years. This rate of expansion overwhelms our capacity to stay abreast of emerging knowledge, even in the ever-narrowing micro-specialization of medical practice. New careers are created while other fields die out. Rapid access and effective delivery of information becomes paramount to both patient safety and professional success. It is not surprising, then, that the potential for delayed or incorrect diagnosis exists. Cognitive psychology theory also tells us it is not surprising that modern decision support systems are ineffective are reducing this problem. Why?
  • Memory, Cognition, and the Acquisition of Medical Expertise

    By Marjorie Stiegler on December 3, 2014
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    This video is part of the Stanford MedicineX series and the MOOC Medical Education in the New Millennium. In it, we explore cognitive and memory-related pitfalls that lead to diagnostic error, even among experts.
  • Never Be Wrong (Or At Least, Catch Yourself Sooner!)

    By Marjorie Stiegler on November 15, 2014
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    My last post discussed how the building blocks of expertise and experience - stored memory collections of events and ideas - are the repository from which we make diagnostic and therapeutic decisions. Now, let’s consider three key strategies that may assist us in counterbalancing availability bias (confusing memorability with probability). This post is intended to address cases in which expert intuition lead us to a cognitive error called “premature closure” – selecting the first plausible diagnosis that comes to mind and seems to match the contextual information. Strategies to prevent premature closure hinge upon...
  • Are Our Memories Accurate? How Experience and Expertise Can Cause Error

    By Marjorie Stiegler on November 3, 2014
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    Are our memories true histories, or just stories? Experience is critical to acquisition of expertise, and yet memories of our experiences are often incomplete and sometimes incorrect. Let’s consider experience, and how the same processes that lead to expertise may also lead to error. (Note: this post is intended to compliment my upcoming lecture at the Stanford University School of Medicine course “Medical Education in the New Millennium” )...
  • Anticipated Regret and Medical Decisions

    By Marjorie Stiegler on July 18, 2014
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    Is this quote true? Versions of this sentiment abound, and seem like motivation for living life to the fullest. But what does it really mean to regret, and how can we measure regret over a choice not made, or perhaps even a choice we didn't know existed? In medical decision making, the phenomenon of anticipated regret is a powerful influencer on choice...
  • Nonrational Cognitive Processes in Medical Decision Making

    By Marjorie Stiegler on November 22, 2013
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    What are the processes that contribute to errors in medical decision making?  Certainly, medical decision making is complex,  and simple knowledge gaps could be to blame.  But very often, experienced physicians make medical decision errors in the form of cognitive errors.  Cognitive errors are thought process mistakes  frequently rooted in nonrational decision processes, rather than knowledge gaps.  What is a […]
  • Will Algorithms Replace Doctors? Not So Elementary, Watson.

    By Marjorie Stiegler on May 6, 2013
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    Are doctors necessary? Just how far might the automation of medicine go? These are questions posed by Jonathon Cohn in his article “The Robot Will See You Now” recently published in the Atlantic magazine and online. The article is about the computer Watson – yep, the same one set a record playing Jeopardy and earned the first $1,000,000 in winnings. […]
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