Suggestibility of Oncologists’ Clinical Estimates

In JAMA Oncology, David Shalowitz and John Schorge (Massachusetts General Hospital), assess the degree to which oncologists’ clinical estimates might be biased by extraneous information. For their study the authors sent surveys of different clinical scenarios to members of the New England and Mid-Atlantic Association of Gynecological Oncologists. Respondents were asked to assess the scenarios and provide an estimated life expectancy, evaluate other providers’ assessments, and indicate what treatments they would opt for. Results of the study show that clinicians are influenced by anchoring bias, meaning they rely too much on initial pieces of information, irrespective of relevance or reliability. The authors stress that their study was limited by low response rate and small sample size. Nevertheless, the results suggest that extensive training and availability of data may not protect clinicians from non-rational clinical decision-making. The authors caution that awareness of the phenomenon alone will not be enough to avoid bias, as there is potential for cognitive bias whenever there is clinical uncertainty, but it is still important for clinicians to consider potential anchors in making clinical decisions. They point to demonstrated success in asking providers to "consider the opposite" when making decisions.