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

• Main Authors: Anete Zieda, Silvia Sbardella, Malika Patel, Richard Smith
• Format: Article
• Language: English
• Published: SMC MEDIA SRL 2021-05-01
• Series: European Journal of Case Reports in Internal Medicine
• Subjects: covid-19; availability heuristic; cognitive bias; diagnostic bias
• Online Access: https://www.ejcrim.com/index.php/EJCRIM/article/view/2575

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