Abstract
Background
Cognitive bias can lead to systematic errors in judgment.
Objective
We sought to assess cognitive bias in emergency physicians and compare the results
to a sample of nonphysicians.
Methods
Selected emergency physicians were invited to take the Rationality Quotient (RQ) test,
which measures cognitive biases. Control subjects were nonphysicians selected randomly
from individuals who had taken the RQ test contemporaneously. We compared RQ scores
overall and by bias and assessed the relationship between self-reported statistical
knowledge and familiarity with decision-making biases and RQ scores.
Results
Of 150 physicians invited, 95 (63%) completed the RQ test. There was less bias in
physicians compared with control subjects (RQ scores were 51.1 for physicians and
43.3 for control subjects, p < 0.001). There was less bias among physicians for both bias blind spot (15 vs. 14.3,
p < 0.001) and for representative bias (10.4 vs. 5.2, p < 0.001). Anchoring bias, confirmation bias, projection bias, and attribution error
were not significantly different. Emergency physicians with greater self-reported
statistical familiarity (either 6 of 7 or 7 of 7 on a Likert scale) had higher RQ
scores by 7.7 points (95% confidence interval 3.1–12.3)—i.e., they were less biased.
There was no association between self-reported knowledge of decision biases and RQ
scores.
Conclusion
Cognitive biases were common in this sample of emergency physicians, and physicians
demonstrated less bias than control subjects. Variability was mostly attributed to
2 biases: bias blind spot and representative bias.
Keywords
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Article info
Publication history
Published online: May 21, 2019
Accepted:
March 30,
2019
Received in revised form:
March 20,
2019
Received:
January 17,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
