Rationality in medical decision making: a review of the literature on doctors' decision-making biases

The objectives of this study were to describe ways in which doctors make su boptimal diagnostic and treatment decisions, and to discuss possible means of alleviating those biases, using a review of past studies from the psycho logical and medical decision-making literatures. A number of biases can aff ect the ways in which doctors gather and use evidence in making diagnoses. Biases also exist in how doctors make treatment decisions once a definitive diagnosis has been made. These biases are not peculiar to the medical doma in but, rather, are manifestations of suboptimal reasoning to which people are susceptible in general. None the less, they can have potentially grave consequences in medical settings, such as erroneous diagnosis or patient: m ismanagement. No surefire methods exist for eliminating biases in medical d ecision making, but there is some evidence that the adoption of an evidence -based medicine approach or the incorporation of formal decision analytic t ools can improve the quality of doctors' reasoning. Doctors' reasoning is v ulnerable to a number of biases that can lead to errors in diagnosis and tr eatment, but there are positive signs that means for alleviating some of th ese biases are available.