Michelle A. Garlin Politis retweetledi
Cognitive Biases in Multimodal Diagnostic Interpretation:
I find this fascinating, and I'll confess that I had an LLM help me with this. I hadn't thought of biases in pathology before, but I think this should be required reading for all pathologists. I'll confess that I've been sucked into each one of these biases over time. I particularly wanted to highlight incorporation bias, where you try to use somebody else's results, such as those from radiology or molecular testing, to interpret our own cytology or histopathology results.
👉Anchoring Bias
Definition: Overreliance on the first piece of information encountered.
Example: A pathologist may be influenced by a radiology report labeling a lesion as "suspicious," leading to an overly aggressive interpretation of borderline cellular atypia.
👉Confirmation Bias
Definition: The tendency to interpret findings in a way that confirms preexisting assumptions.
Example: A pathologist may favor a malignant interpretation in the presence of a clinical diagnosis suggesting carcinoma, even when features are equivocal.
👉Diagnostic Overshadowing
Definition: A dominant clinical context obscures alternative explanations.
Example: A known malignancy may bias interpretation of new findings, with benign lesions misclassified as metastases.
👉Incorporation Bias
Definition: Integrating the results of one diagnostic modality into the interpretation of another, compromising independent assessment.
Example: Pathologic interpretation is skewed by prior knowledge of a positive KRAS mutation, resulting in upstaging of an indeterminate smear.
👉Framing Effect
Definition: Diagnostic interpretation shifts based on how the case is presented.
Example: Labeling a specimen as “rule out malignancy” may prime the interpreter toward a malignant diagnosis.
👉Premature Closure
Definition: Halting diagnostic deliberation after an early conclusion is reached.
Example: A diagnosis of low-grade IPMN may lead to under-recognition of subsequent evidence suggesting high-grade atypia.
👉Availability Bias
Definition: Overestimation of a diagnosis based on recent or memorable cases.
Example: Recently, encountering a rare pancreatic neuroendocrine tumor may lead to overdiagnosis in future ambiguous cases. @smlungpathguy
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