Human thinking is based on acquired, processed, and stored knowledge. Personal beliefs, emotions, and experiences are also stored and incorporated into thought processes. Bias is defined as a preference toward or away from an idea or action. It is a personal reality based on perception of available information that includes knowledge and emotional inputs. Cognitive bias is an error in thinking that influences how we make decisions. It can result in a closed-minded or prejudicial approach and may be learned or innate. Biases may lead to distorted perceptions or inaccurate judgment. Both cognitive and implicit biases are innate to human thinking and cannot be eliminated. Consequently, bias is an inevitable and sometimes unwelcome contributor to diagnostic reasoning (Diagnosis 2014;1:23-7).

It has become well established that cognitive biases are a significant problem in medical decision-making. Flaws in judgment, rather than lack of knowledge, are central to diagnostic error (...

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