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Diagnostic Decision Making in the Face of Uncertainty: COVID-19 and Its Sequalae

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Advances in Human Factors and Ergonomics in Healthcare and Medical Devices (AHFE 2021)

Part of the book series: Lecture Notes in Networks and Systems ((LNNS,volume 263))

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Abstract

The introduction of an unfamiliar disease has added uncertainty to many aspects of the practice of medicine. Evidence-based-guidelines on the recognition, investigation, and treatment of COVID-19 and its sequelae are in early stages. Clinicians are often left making critical diagnostic and treatment decisions in the absence of clear evidence. Operating in the face of uncertainty has brought to light fallibilities in clinical decision-making processes in healthcare systems around the world. A growing body of literature on COVID-19 and its associated Multisystem Inflammatory Syndrome has revealed self-perpetuating cycles of cognitive biases with far-reaching implications on patients, populations, and healthcare systems. We describe the implications of cognitive biases on decision making processes in the context of the COVID-19 pandemic. In an era when even the most experienced of clinicians find themselves navigating unchartered territory, we must rely on tried-and-true diagnostic decision-making processes to mitigate cognitive biases. To address a challenge of such complexity, we incorporate a problem spaces perspective to clinical decision making, encompasses the broader context in which decisions are made, including workplace environment, team dynamics, patient wishes, practitioner perspectives, framing of the problem, and sociocultural factors. By applying evidence from relevant disciplines, we highlight strategies to mitigate cognitive biases during emerging infectious disease pandemics, including optimizing multidisciplinary decision-making, building redundancies, and strengthening decision making processes. Continuous feedback, recalibration, and reflection will provide a better understanding of the art of diagnostic decision making and improve healthcare quality.

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Authors and Affiliations

  1. Northern Medical Program, Faculty of Medicine, University of British Columbia, Prince George, BC, V2N 4Z9, Canada

    Patrick Seitzinger

  2. Royal University Hospital, Saskatchewan Health Authority, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada

    Zoher Rafid-Hamed & Jawahar (Jay) Kalra

  3. Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 0W8, Canada

    Jawahar (Jay) Kalra

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  1. Patrick Seitzinger
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  2. Zoher Rafid-Hamed
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  3. Jawahar (Jay) Kalra
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Corresponding author

Correspondence to Jawahar (Jay) Kalra .

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Editors and Affiliations

  1. Dept.of Pathology, College of Medicine, Univ.of Saskatchewan Royal Univ.Hospital, Saskatoon, SK, Canada

    Jay Kalra

  2. Center for Applied Sys. Engineering, Veterans Affairs, Indianapolis, IN, USA

    Nancy J. Lightner

  3. Campus du Moulin de la Housse, Université de Reims Champagne-Ardenne, Reims Cedex 2, France

    Redha Taiar

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Seitzinger, P., Rafid-Hamed, Z., Kalra, J.(. (2021). Diagnostic Decision Making in the Face of Uncertainty: COVID-19 and Its Sequalae. In: Kalra, J., Lightner, N.J., Taiar, R. (eds) Advances in Human Factors and Ergonomics in Healthcare and Medical Devices. AHFE 2021. Lecture Notes in Networks and Systems, vol 263. Springer, Cham. https://doi.org/10.1007/978-3-030-80744-3_95

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  • DOI: https://doi.org/10.1007/978-3-030-80744-3_95

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-80743-6

  • Online ISBN: 978-3-030-80744-3

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