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Emergency Medical Minute


Jun 21, 2019

Contributor: Peter Bakes, MD

Educational Pearls:

  • While there are many different types of medical error, one of the most common errors in emergency medicine is failure to diagnose
  • Systematic error in thinking that negatively affects judgement
  • Medical errors are often driven by cognitive biases, which include anchoring, attribution, and availability  
  • Anchoring bias occurs when early information leads to premature closure on a single diagnosis. There is subsequent failure to consider alternative diagnoses, even in the face of conflicting new data and test results.
  • Attribution bias occurs when assumptions about personal and medical characteristics are made about a specific group of people.
  • Availability bias occurs when recent experiences drive providers to over or under consider diagnoses.


Croskerry P. Cognitive forcing strategies in clinical decisionmaking. Ann Emerg Med. 2003 Jan;41(1):110-20. doi: 10.1067/mem.2003.22. PubMed PMID: 12514691.

Redelmeier DA. Improving patient care. The cognitive psychology of missed diagnoses. Ann Intern Med. 2005 Jan 18;142(2):115-20. doi: 10.7326/0003-4819-142-2-200501180-00010. PubMed PMID: 15657159.

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD