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Use of Heuristics during the clinical decision process in Primary Care physicians in real conditions.
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  • Carmen Fernández Aguilar,
  • José-Jesús Martín-Martín,
  • Sergio Minué-Lorenzo,
  • Miquel Farres
Carmen Fernández Aguilar
Isabel I of Castile International University
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José-Jesús Martín-Martín
University of Granada
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Sergio Minué-Lorenzo
Andalusian School of Public Health
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Miquel Farres
Andalusian Health Service District Sur de Granada
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Abstract

Rationale, aims and objectives: The available evidence on the existence and consequences of the use of heuristics in the clinical decision process is very scarce. The purpose of this study is to measure the use of the Representativeness, Availability and Overconfidence heuristics in real conditions with Primary Care physicians in cases of dyspnea and to study the possible correlation with diagnostic error. Methods: A prospective cohort study was carried out in 4 Primary Care centers in which 371 new cases or dyspnea were registered. The use of the three heuristics in the diagnostic process is measured through an operational definition of the same. Subsequently, the statistical correlation with the identified clinical errors is analyzed. Results: In 9.97% of the registered cases a diagnostic error was identified. In 49.59% of the cases, the physicians used the representativeness heuristic in the diagnostic decision process. The availability heuristic was used by 82.38% of the doctors and finally, in more than 50% of the cases the doctors showed excess confidence. None of the heuristics showed a statistically significant correlation with diagnostic error. Conclusion: The three heuristics have been used as mental shortcuts by Primary Care physicians in the clinical decision process in cases of dyspnea, but their influence on the diagnostic error is not significant. New studies based on the proposed methodology will allow confirming both its importance and its association with diagnostic error.

Peer review status:IN REVISION

23 Feb 2021Submitted to Journal of Evaluation in Clinical Practice
25 Feb 2021Assigned to Editor
25 Feb 2021Submission Checks Completed
25 Feb 2021Reviewer(s) Assigned
30 Mar 2021Review(s) Completed, Editorial Evaluation Pending
30 Mar 2021Editorial Decision: Revise Major
08 Jun 20211st Revision Received