Profiles in patient safety: confirmation bias in emergency medicine

Acad Emerg Med. 2006 Jan;13(1):90-4. doi: 10.1197/j.aem.2005.07.028. Epub 2005 Dec 19.


Confirmation bias is a pitfall in emergency care and may lead to inaccurate diagnoses and inappropriate treatments and care plans. Because of the increasing severity and volume of emergency care, emergency physicians often must rely on heuristics, such as rule-out protocols, as a guide to diagnosing and treating patients. The use of heuristics or protocols can be potentially misleading if the initial diagnostic impression is incorrect. To minimize cognitive dissonance, clinicians may accentuate confirmatory data and ignore nonconfirmatory data. Clinicians should recognize confirmation bias as a potential pitfall in medical decision making in the emergency department. Reliance on the scientific method, Bayesian reasoning, metacognition, and cognitive forcing strategies may serve to improve diagnostic accuracy and improve patient care.

Publication types

  • Case Reports

MeSH terms

  • Attitude of Health Personnel
  • Bias
  • Decision Support Techniques
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / urine
  • Diagnostic Errors / prevention & control*
  • Emergency Medicine / methods*
  • Epidural Abscess / complications
  • Epidural Abscess / diagnosis
  • Epidural Abscess / surgery
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / etiology
  • Low Back Pain / therapy
  • Male
  • Middle Aged
  • Patient Selection
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / therapy
  • Triage / methods*