University of Wisconsin–Madison Medical College of Wisconsin

Pausing During the Pandemic: Addressing Cognitive Biases in Providers’ Medical Decision-Making During the COVID-19 Era

Sarah Yale, MD; Jacqueline Lee, MD; Natalya Beneschott, MD; Amanda Rogers, MD

WMJ. 2021;120(3):241-243.

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Introduction: The COVID-19 pandemic has not only exacerbated traditional cognitive biases but also created new cognitive biases specific to the pandemic that contribute to diagnostic errors. Cases of suspected multisystem inflammatory syndrome in children (MIS-C)—one of the more clinically significant manifestations of COVID-19 in children—need to be reported and reviewed by clinicians as they have varied presentations and lack definitive confirmatory testing, presenting challenges to effective diagnosis.

Case Presentation: We present 3 cases of pediatric patients initially diagnosed with COVID-19/MIS-C who were ultimately found to have alternative diagnoses.

Discussion: For each case, we describe conventional and COVID-19-related cognitive biases to enhance awareness of their role in diagnostics and promote strategies to support diagnostic accuracy and timeliness.

Conclusion: With rapidly changing knowledge about COVID-19 and MIS-C, providers must remain diligent to counteract heuristic thinking and provide timely and accurate diagnostic evaluations.

Author Affiliations: Children’s Wisconsin, Milwaukee, Wisconsin (Yale, Rogers); Medical College of Wisconsin, Milwaukee, Wisconsin (Yale, Lee, Beneschott, Rogers).
Corresponding Author: Sarah Yale, MD, Department of Pediatrics, Medical College of Wisconsin, Children’s Corporate Center, Suite 560, 999 North 92nd Street, Milwaukee, WI 53226; phone 414.337.7050; email; ORCID ID 0000-0002-2954-4808.
Acknowledgments: Michelle Mourad, MD, for innovation and support of adaptation and use of the diagnostic timeout in the pediatric inpatient setting.
Funding/Support: None declared.
Financial Disclosures: None declared.
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