Diagnostic Bias in the COVID-19 Pandemic: A Series of Short Cases

  • Anete Zieda Milton Keynes University Hospital, Milton Keynes, UK
  • Silvia Sbardella Milton Keynes University Hospital, Milton Keynes, UK
  • Malika Patel Milton Keynes University Hospital, Milton Keynes, UK
  • Richard W. Smith Milton Keynes University Hospital, Milton Keynes, UK

Keywords

COVID-19, availability heuristic, cognitive bias, diagnostic bias

Abstract

During the COVID-19 pandemic, healthcare systems have faced unprecedented pressures. One challenge has been to promptly recognise non-COVID-19 conditions. Cognitive bias due to the availability heuristic may cause difficulties in reaching the correct diagnosis. Confirmation bias may also affect imaging interpretation. We report three cases with an alternative final diagnosis in whom COVID-19 was initially suspected: (a) Pneumocystis jirovecii pneumonia with unrecognised HIV infection; (b) pulmonary lymphangitis carcinomatosis; and (c) ST elevation myocardial infarction causing acute pulmonary oedema. To help mitigate bias, there is no substitute for thoughtful clinical assessment and critical appraisal when evaluating new information and formulating the differential diagnosis

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References

  • World Health Organization. Rapid assessment of service delivery for NCDs during the COVID-19 pandemic. 29 May 2020. https://www.who.int/who-documents-detail/rapid-assessment-of-service-delivery-for-ncds-during-the-covid-19-pandemic (accessed 8 February 2021).
  • Aldujeli A, Hamadeh A, Briedis K, Tecson KM, Rutland J, Krivckas Z, et al. Delays in presentation in patients with acute myocardial infarction during the COVID-19 pandemic, Cardiol Res 2020;11(6):386–391.
  • Published: 2021-05-11

    Issue: 2021: Vol 8 No 5 (view)

    Section: Articles

    How to cite:
    1.
    Zieda A, Sbardella S, Patel M, Smith R. Diagnostic Bias in the COVID-19 Pandemic: A Series of Short Cases. EJCRIM 2021;8 doi:10.12890/2021_002575.