Diagnostic Bias - Eppp Knowledge

1. What is base rate neglect in diagnosis?

   Ignoring prevalence rates and overemphasizing case-specific information. Clinicians fail to incorporate population-level disorder frequencies, leading to overdiagnosis of rare conditions or underdiagnosis of common ones.

2. What is the fundamental attribution error as it can affect diagnosis?

   Overattributing behavior to traits while underweighting situational factors. This error biases diagnosis by emphasizing dispositional causes over environmental influences on behavior.

3. What is the availability heuristic in clinical diagnosis?

   Estimating likelihood by ease of recall of similar cases or media examples. This bias occurs when clinicians assess probability by how readily instances come to mind, influenced by recency or vividness.

4. Which DSM-5 tool is designed to assess cultural identity, stressors, and explanatory models?

   Cultural Formulation Interview (CFI). This structured tool enhances cultural competence by exploring patients' cultural backgrounds and illness perceptions.

5. What is cultural bias in diagnosis (general definition)?

   Systematic diagnostic error due to cultural assumptions, stereotypes, or norms. It introduces errors by applying culturally specific assumptions, misinterpreting symptoms outside the clinician's cultural framework.

6. Which bias best fits: interpreting ambiguous symptoms as supporting the favored diagnosis?

   Confirmation bias. This bias distorts interpretation by favoring information that aligns with hypotheses, potentially leading to diagnostic inaccuracies.

7. Which term describes overestimating a diagnosis after seeing several recent cases?

   Availability heuristic. Recent exposures make certain diagnoses more mentally accessible, inflating perceived likelihood regardless of true prevalence.

8. What is the DSM-5 Cultural Formulation Interview (CFI) primarily used for?

   Eliciting cultural context to improve diagnostic validity and reduce bias. The CFI systematically gathers cultural data to contextualize symptoms and mitigate ethnocentric biases in diagnosis.

9. What is premature closure as a diagnostic error?

   Stopping the diagnostic search after reaching an initial plausible diagnosis. This error truncates the diagnostic process prematurely, risking missed alternative or comorbid conditions.

10. Which error is most likely when clinicians ignore local prevalence and rely only on a striking symptom?

    Base rate neglect. Focusing on salient features without prevalence data violates Bayesian principles, leading to probabilistic errors.

11. What is confirmation bias in diagnostic reasoning?

    Seeking or weighting evidence that supports an initial hypothesis. Clinicians selectively gather or interpret data to affirm preconceived notions, potentially overlooking disconfirming evidence.

12. Which error best fits: selecting a diagnosis because the presentation matches a textbook prototype?

    Representativeness heuristic. It prioritizes similarity to archetypes over probabilistic data, increasing errors in atypical presentations.

13. What is the base rate of a disorder in diagnostic reasoning?

    The disorder prevalence in the relevant population before new case data. It represents the a priori probability of a disorder in a given group, essential for Bayesian diagnostic reasoning.

14. What is the halo effect in clinical judgment?

    A global impression biases ratings of specific symptoms or functioning. Overall perceptions contaminate specific evaluations, leading to skewed diagnostic impressions.

15. Which bias is most consistent with: a likeable patient is judged as less impaired than evidence shows?

    Halo effect. Positive or negative global impressions systematically alter judgments of impairment levels, deviating from objective evidence.

16. What is the category fallacy in cross-cultural diagnosis?

    Assuming Western diagnostic categories apply identically across cultures. It erroneously universalizes diagnostic constructs, ignoring cultural variations in symptom expression and meaning.

17. Which concept best fits: assuming a patient has a disorder because their group is stereotyped as high risk?

    Stereotyping (cultural bias). Cultural stereotypes lead to presumptive diagnoses based on group membership rather than individual presentation.

18. What is anchoring bias during diagnostic assessment?

    Overreliance on initial information, with insufficient adjustment to new data. Initial impressions or data points unduly influence subsequent judgments, resisting revision even with conflicting information.

19. Which bias best fits: clinging to the referral diagnosis despite contradictory evidence?

    Anchoring bias. Initial anchors like referrals create resistance to adjustment, even when new evidence suggests alternative diagnoses.

20. What is ethnocentrism as a source of diagnostic bias?

    Judging other cultures by one's own cultural standards as the norm. This mindset imposes one's cultural norms as universal, distorting cross-cultural diagnostic accuracy.

21. Which diagnostic error best fits: ending assessment once a plausible diagnosis is found?

    Premature closure. Satisficing with the first viable diagnosis halts further exploration, heightening risk of incomplete assessments.

22. What is diagnostic overshadowing?

    Attributing new symptoms to an existing condition, missing a co-occurring disorder. Existing diagnoses eclipse new symptoms, causing underrecognition of additional pathologies.

23. What is a culture-bound syndrome called in DSM-5 terminology?

    Cultural concept of distress. DSM-5 reframes culture-specific idioms of distress to emphasize cultural variability in psychopathology.

24. What is the representativeness heuristic in diagnostic reasoning?

    Judging diagnosis by similarity to a prototype, not true probabilities. This heuristic evaluates diagnostic likelihood based on how closely symptoms match a typical case, disregarding statistical base rates.

25. What is the key corrective principle to reduce base rate neglect in diagnosis?

    Integrate prior probability (prevalence) with case-specific evidence. Applying Bayesian reasoning combines base rates with diagnostic indicators to yield more accurate posterior probabilities.

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