TY - JOUR
T1 - Age-related cognitive bias in in-hospital cardiac arrest
AU - For the American Heart Association's Get With The Guidelines – Resuscitation Investigators
AU - Holmberg, Mathias J.
AU - Granfeldt, Asger
AU - Moskowitz, Ari
AU - Andersen, Lars W.
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/5
Y1 - 2021/5
N2 - Aims: Cognitive bias has been recognized as a potential source of medical error as it may affect clinical decision making. In this study, we explored how cognitive bias, specifically left-digit bias, may affect patient outcomes in in-hospital cardiac arrest. Methods: Using the Get With The Guidelines® – Resuscitation registry, we included adult patients with an in-hospital cardiac arrest from 2011 to 2019. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation, favorable neurological outcome, and duration of resuscitation. Using a regression discontinuity design, we explored whether there was a sudden change in survival at the age threshold of 80 years which would indicate left-digit bias. Additional analyses were performed at age thresholds of 60, 70, and 90 years. Results: A total of 26,784 patients were included for the primary analysis. The overall survival was 22% in this cohort. There was no discontinuity of survival below and above the age of 80 years (risk difference, 0.47%; 95%CI, −1.61% to 2.56%). Similar results were estimated for the secondary outcomes and for the age thresholds of 60, 70, and 90 years. The results were consistent in sensitivity analyses. Conclusions: There was no indication that cognitive bias based on age affected outcomes in in-hospital cardiac arrest in these data.
AB - Aims: Cognitive bias has been recognized as a potential source of medical error as it may affect clinical decision making. In this study, we explored how cognitive bias, specifically left-digit bias, may affect patient outcomes in in-hospital cardiac arrest. Methods: Using the Get With The Guidelines® – Resuscitation registry, we included adult patients with an in-hospital cardiac arrest from 2011 to 2019. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation, favorable neurological outcome, and duration of resuscitation. Using a regression discontinuity design, we explored whether there was a sudden change in survival at the age threshold of 80 years which would indicate left-digit bias. Additional analyses were performed at age thresholds of 60, 70, and 90 years. Results: A total of 26,784 patients were included for the primary analysis. The overall survival was 22% in this cohort. There was no discontinuity of survival below and above the age of 80 years (risk difference, 0.47%; 95%CI, −1.61% to 2.56%). Similar results were estimated for the secondary outcomes and for the age thresholds of 60, 70, and 90 years. The results were consistent in sensitivity analyses. Conclusions: There was no indication that cognitive bias based on age affected outcomes in in-hospital cardiac arrest in these data.
KW - Cognitive bias
KW - Heart arrest
KW - In-hospital cardiac arrest
KW - Left-digit bias
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U2 - 10.1016/j.resuscitation.2021.01.016
DO - 10.1016/j.resuscitation.2021.01.016
M3 - Article
C2 - 33582254
AN - SCOPUS:85101924225
SN - 0300-9572
VL - 162
SP - 43
EP - 46
JO - Resuscitation
JF - Resuscitation
ER -