Optimism bias in understanding neonatal prognoses

Objective: Discrepancies between physician and parent neonatal prognostic expectations are common. Optimism bias is a possible explanation. Study design: Parents interpreted hypothetical neonatal prognoses in an online survey. Results: Good prognoses tended to be interpreted accurately, while poor prognoses were interpreted as less than the stated value. One-third of participants consistently overstated survival for the three lowest prognoses, compared to the sample as a whole. Three significant predictors of such optimistic interpretations were single-parent status (OR 0.39; 95% CI 0.2–0.75; p = 0.005), African-American descent (OR 3.78; 95% CI 1.63–8.98; p = 0.002) and the belief that physicians misrepresented prognoses (OR 3.11; 95% CI 1.47–6.65; p = 0.003). Participants’ explanations echoed research on optimism bias in clinical and decision science studies. Conclusion: Participants accepted positive prognoses for critically ill neonates, but reinterpreted negative ones as being unduly pessimistic demonstrating optimism bias.