Nangia Ritika, Sethi Chetna Arvind, Dhiman Niharika
Department of Anaesthesia, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
Department of Obstetrics and Gynaecology, Lok Nayak Hospital, New Delhi, India.
J Family Med Prim Care. 2022 Nov;11(11):7466-7468. doi: 10.4103/jfmpc.jfmpc_833_22. Epub 2022 Dec 16.
The coronavirus pandemic has put an unprecedented strain on our health care system. An urgent need for timely and accurate diagnosis coupled with an inordinate caseload and myriad overlapping signs and symptoms with other differentials is leaving physicians fatigued. This often leads to the use of mental shortcuts - "heuristics" by the strained mind and the inadvertent use of intuitive thought processes rather than the more controlled analytical thinking to cope and speed up the decision-making process. - making a recent or vivid patient diagnosis more readily accessible to the mind - and - relying too heavily on a single symptom for deducing diagnosis - are among the most prevalent cognitive biases. Therefore, it is not unexpected that any new cases of acute onset respiratory illness may be mis-diagnosed as coronavirus disease 2019 during the pandemic, significantly impacting the morbidity and mortality of true diagnosis. To reduce the risk of patient harm, it is therefore imperative that medical practitioners be aware of the existence and influence of cognitive bias in clinical decision making and maintain sight of a variety of differential diagnoses to ensure that no adverse condition is overlooked.
新冠疫情给我们的医疗系统带来了前所未有的压力。对及时准确诊断的迫切需求，加上病例数量过多以及与其他病症有大量重叠的体征和症状，让医生疲惫不堪。这常常导致思维紧张的医生使用心理捷径——“启发法”，不经意地运用直观思维过程，而非更可控的分析性思维来应对并加快决策过程。最常见的认知偏差包括：——使脑海中更容易浮现近期或印象深刻的患者诊断情况；——过于依赖单一症状来推断诊断。因此，在疫情期间，任何急性起病的呼吸道疾病新病例都有可能被误诊为2019冠状病毒病，这对准确诊断的发病率和死亡率产生重大影响，也就不足为奇了。为降低对患者造成伤害的风险，医生必须意识到认知偏差在临床决策中的存在及其影响，同时要考虑到各种鉴别诊断，以确保不遗漏任何不良病症。
