Society for Maternal-Fetal Medicine Special Statement: Cognitive bias and medical error in obstetrics-challenges and opportunities

Am J Obstet Gynecol. 2022 Aug;227(2):B2-B10. doi: 10.1016/j.ajog.2022.04.033. Epub 2022 Apr 27.

Abstract

The processes of diagnosis and management involve clinical decision-making. However, decision-making is often affected by cognitive biases that can lead to medical errors. This statement presents a framework of clinical thinking and decision-making and shows how these processes can be bias-prone. We review examples of cognitive bias in obstetrics and introduce debiasing tools and strategies. When an adverse event or near miss is reviewed, the concept of a cognitive autopsy-a root cause analysis of medical decision-making and the potential influence of cognitive biases-is promoted as part of the review process. Finally, areas for future research on cognitive bias in obstetrics are suggested.

Keywords: decision-making; diagnostic error; disparities; implicit bias; inequity; medical error; racism.

Publication types

  • Review

MeSH terms

  • Bias
  • Cognition*
  • Humans
  • Medical Errors*
  • Obstetrics*
  • Perinatology
  • Societies, Medical
  • United States