Download PDF
J Am Acad Audiol 2020; 31(02): 158-167
DOI: 10.3766/jaaa.18096
Reviews
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Systematic Review of Interventions to Reduce the Effects of Cognitive Biases in the Decision-Making of Audiologists

Karyn L. Galvin
*   Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Australia
,
Rebecca J. Featherston
†   Department of Social Work, The University of Melbourne, Melbourne, Australia
1   Current affiliation: Department of Social Work, Monash University, Melbourne, Australia
,
Laura E. Downie
‡   Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
,
Adam P. Vogel
§   Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Australia
‖   Redenlab, Melbourne, Australia
¶   Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
‡   Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
,
Bridget Hamilton
**   Department of Nursing, The University of Melbourne, Melbourne, Australia
,
Catherine Granger
††   Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
,
Aron Shlonsky
†   Department of Social Work, The University of Melbourne, Melbourne, Australia
1   Current affiliation: Department of Social Work, Monash University, Melbourne, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
25 May 2020 (online)

Also available at
   Permissions and Reprints

Abstract

Background:

Audiologists are constantly making decisions that are key to optimizing client/patient outcomes, and these decisions may be vulnerable to cognitive biases.

Purpose:

The purpose was to determine the present state of knowledge within the field of audiology regarding the potential impact of cognitive biases on clinical decision-making and the use of interventions to reduce such impact.

Research Design:

A systematic review was conducted to identify and consider the outcomes of all studies in which an intervention, strategy, or procedure was implemented with the aim of reducing the impact of cognitive biases on the decision-making of audiologists.

Data Collection:

The review was part of a larger scale search which included the broader disciplines of health science and medicine. Electronic database searches were supplemented by citation searches of relevant reviews and a gray literature search. Following title and abstract screening, 201 full-text studies were considered for inclusion.

Results:

No studies were found which fulfilled the eligibility criteria.

Conclusions:

Despite initial calls to respond to these types of cognitive biases being made three decades ago, no peer-reviewed scientific studies testing strategies to reduce the impact of cognitive biases on the decision-making of audiologists were found. There is a clear need for a more concerted research effort in this area if audiologists are to consistently deliver truly evidence-based care.

Key Words

audiology - audiologists - clinical decision-making - cognitive bias

This work was supported by a Collaborative Seed Funding Grant awarded by the Melbourne School of Health Sciences at The University of Melbourne.


 

  • REFERENCES

  • Boisvert I, Clemesha J, Lundmark E, Crome E, Barr C, McMahon CM. 2017; Decision-making in audiology: balancing evidence-based practice and patient-centered care. Trends Hear 21: 1-14
    Search in Google Scholar
  • Burgess DJ. 2010; Are providers more likely to contribute to healthcare disparities under high levels of cognitive load? How features of the healthcare setting may lead to biases in medical decision making. Med Decis Making 30: 246-257
    CrossrefPubMedSearch in Google Scholar
  • Crowley RS, Legowski E, Medvedeva O, Reitmeyer K, Tseytlin E, Castine M, Jukic D, Mello-Thoms C. 2013; Automated detection of heuristics and biases among pathologists in a computer-based system. Adv Health Sci Educ Theory Pract 18: 343-363
    CrossrefPubMedSearch in Google Scholar
  • Demorest ME. 1986; Problem solving: stages, strategies, and stumbling blocks. J Acad Rehabilitative Audiol 19: 13-26
    Search in Google Scholar
  • Doyle J. 1987; Audiologists, the audiogram and the perception of hearing-impaired children’s speech. Aust J Audiol 9 (01) 1-6
    Search in Google Scholar
  • Doyle J. 1989; A survey of Australian audiologists’ clinical decision-making. Aust J Audiol 11: 75-88
    Search in Google Scholar
  • Doyle J, Thomas SA. 1988; Clinical decision-making in audiology: the case for investigating what we do. Aust J Audiol 10: 45-56
    Search in Google Scholar
  • Doyle J, Thomas SA. 1995; Capturing policy in hearing-aid decisions by audiologists. Med Decis Making 15: 58-64
    CrossrefPubMedSearch in Google Scholar
  • Gans DP, Flexer C. 1982; Observer bias in the hearing testing of profoundly involved multiply handicapped children. Ear Hear 3: 309-313
    CrossrefPubMedSearch in Google Scholar
  • Gigerenzer G, Gaissmaier W. 2011; Heuristic decision making. Annu Rev Psychol 62: 451-482
    CrossrefPubMedSearch in Google Scholar
  • Johnson E, Mueller HG, Ricketts TA. 2009; Statistically derived factors of varied importance to audiologists when making a hearing aid brand preference decision. J Am Acad Audiol 20: 40-48
    Thieme ConnectPubMedSearch in Google Scholar
  • Johnson E, Ricketts T. 2010; Dispensing rates of four common hearing aid product features: associations with variations in practice among audiologists. Trends Amplif 14: 12-45
    CrossrefPubMedSearch in Google Scholar
  • Kostopoulou O, Porat T, Corrigan D, Mahmoud S, Delaney BC. 2017; Diagnostic accuracy of GPs when using an early-intervention decision support system: a high-fidelity simulation. Br J Gen Pract 67: e201-e208
    CrossrefPubMedSearch in Google Scholar
  • Liberati A, Altman D, Tetzlaff J, Mulrow C, Gøtzsche P, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D. 2009; The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6: e1000100
    CrossrefPubMedSearch in Google Scholar
  • Ludolph R, Schulz PJ. 2017; Debiasing health-related judgments and decision making: a systematic review. Med Decis Making 38: 3-13
    PubMedSearch in Google Scholar
  • Meyer C, Barr C, Khan A, Hickson L. 2017; Audiologist-patient communication profiles in hearing rehabilitation appointments. Patient Educ Couns 100: 1490-1498
    CrossrefPubMedSearch in Google Scholar
  • Moodie ST, Kothari A, Bagatto MP, Seewald R, Miller LT, Scollie SD. 2011; Knowledge translation in audiology: promoting the clinical application of best evidence. Trends Amplif 15: 5-22
    CrossrefPubMedSearch in Google Scholar
  • Norman G. 2014; The bias in researching cognitive bias. Adv Health Sci Educ 19: 291-295
    CrossrefPubMedSearch in Google Scholar
  • Oswald ME, Grosjean S. 2004. Confirmation bias. In: Pohl RF. Cognitive Illusions: A Handbook on Fallacies and Biases in Thinking, Judgement and Memory. New York: Psychology Press;
    Search in Google Scholar
  • Phua DH, Tan NC. 2013; Cognitive aspect of diagnostic errors. Ann Acad Med Singapore 42: 33-41
    PubMedSearch in Google Scholar
  • Redelmeier D, Shafir E. 1995; Medical decision making in situations that offer multiple alternatives. JAMA 273: 302-305
    CrossrefPubMedSearch in Google Scholar
  • Richards MS, Wierzbicki M. 1990; Anchoring errors in clinical-like judgments. J Clin Psychol 46: 358-365
    CrossrefPubMedSearch in Google Scholar
  • Saposnik G, Redelmeier D, Ruff CC, Tobler PN. 2016; Cognitive biases associated with medical decisions: a systematic review. BMC Med Inf Decis Mak 16: 138
    Search in Google Scholar
  • Schwarz N, Vaughn LA. 2002. The availability heuristic revisited: ease of recall and content of recall as distinct sources of information. In: Gilovich T, Griffin D, Kahneman D. Heuristics and Biases: the Psychology of Intuitive Judgment. New York: Cambridge University Press;
    Search in Google Scholar
  • Shah AK, Oppenheimer DM. 2008; Heuristics made easy: an effort-reduction framework. Psychol Bull 134: 207-222
    CrossrefPubMedSearch in Google Scholar
  • Snowden LR. 2003; Bias in mental health assessment and intervention: theory and evidence. Am J Public Health 93: 239-243
    CrossrefPubMedSearch in Google Scholar
  • Trowbridge RL, Dhaliwal G, Cosby KS. 2013; Educational agenda for diagnostic error reduction. BMJ Qual Saf 22: ii28-ii32
    CrossrefPubMedSearch in Google Scholar
  • Tversky A, Kahneman D. 1973; Availability: a heuristic for judging frequency and probability. Cogn Psychol 5: 207-232
    CrossrefSearch in Google Scholar
  • Tversky A, Kahneman D. 1974; Judgment under uncertainty—heuristics and biases. Science 185: 1124-1131
    CrossrefPubMedSearch in Google Scholar
  • Valente M, Abrams H, Benson D, Chisolm T, Citron D, Hampton D. 2006; Guidelines for the audiological management of adult hearing impairment. Audiol Today 18: 32-36
    Search in Google Scholar
  • van Ryn M, Burgess DJ, Dovidio JF, Phelan SM, Saha S, Malat J, Griffin JM, Fu SS, Perry S. 2011; The impact of racism on clinician cognition, behavior, and clinical decision making. Du Bois Rev 8: 199-218
    CrossrefPubMedSearch in Google Scholar