A UCLA-led study has found evidence of anchoring bias in the emergency department, specifically related to patients with congestive heart failure experiencing shortness of breath. The research suggests that when the initial check-in process notes the reason for the visit as congestive heart failure instead of the broader “shortness of breath,” patients are less likely to be tested for pulmonary embolism, a potentially fatal blood clot in the lung. The study found that mentioning a patient’s known congestive heart failure reduced the likelihood of testing for pulmonary embolism by one-third, despite it being a possible cause of the shortness of breath. Surprisingly, rates of pulmonary embolism within 30 days were equal between patients with visit reasons mentioning congestive heart failure and those without, indicating that anchoring bias may have caused delays in diagnosis. Anchoring bias is a cognitive bias that influences physician decision-making by focusing on initial information without considering subsequent information about the patient’s condition. The researchers analyzed data from 108,000 patients with congestive heart failure who visited emergency departments with shortness of breath between 2011 and 2018. This study highlights the potential consequences of anchoring bias, which can lead to delays in crucial testing and diagnosis of life-threatening medical conditions such as pulmonary embolism.

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