Behavioral Heuristics in Coronary-Artery Bypass Graft Surgery
Andrew Olenski, André Zimerman, Stephen Coussens, Anupam B. Jena
Abstract
Behavioral Heuristics in Coronary-Artery Bypass Graft SurgeryTo the Editor: Behavioral heuristics (mental shortcuts that simplify decision making) are common in medicine and can lead to cognitive biases that affect clinical decisions. 1Left-digit bias is the tendency to categorize continuous variables on the basis of the left-most numeric digit. 2 Left-digit bias explains why items are often priced at $4.99 as opposed to $5.00.This bias may affect treatment decisions.For example, patients who are hospitalized with acute myocardial infarction and who are 80 years and 2 weeks of age may be perceived by physicians as being at greater risk for complications -and thus may receive more conservative treatment -than patients who are 79 years and 50 weeks of age, if cognitive biases lead physicians to discretely categorize patients as being "in their 80s" rather than "in their 70s."We used data on Medicare beneficiaries from 2006 through 2012 to evaluate how frequently inpatient coronary-artery bypass grafting (CABG)