Presentation description

National clinical guidelines are vital to shaping clinician action and patient care in healthcare. Guidelines provide recommendations for diagnosis, screening, treatment, and care involved in the subject of the guideline. Guidelines were created to help advance the treatment of medical conditions and ensure that care, whether a drug, device, or procedure, is not over or under-provided.

When guidelines are created and updated, the evidence gathered must be reviewed consistently and transferred seamlessly to a corresponding recommendation. This evaluation process is guided by methodologies that provide a rating system for evidence quality and recommendation strength but might not eliminate human biases. Despite systemic processes, recommendations are often made (necessarily) with incomplete or low-quality evidence. The uncertainty present in the lack of evidence could be compensated for with the action bias, the tendency to favor action over inaction. While often not a bad thing, there are situations, such as in a clinical setting, where taking a course of action backed by little evidence or associated with potential harm may not be best for a patient. Contrarily, it is difficult to change a method of care that has become routine, and thus social norm bias could influence the development of clinical guidelines by requiring more evidence than necessary to halt or decrease a practice.

Therefore, this study aimed to determine if internal medicine clinical guideline committees exhibit evidence of psychologic biases, such as action bias or social norm bias, when creating national internal medicine clinical guidelines.