• Iris E Beldhuis, Ramesh S Marapin, You Yuan Jiang, Nádia F Simões de Souza, Artemis Georgiou, Thomas Kaufmann, José Castela Forte, and van der HorstIwan C CICCDepartment of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Intensive Care Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands..
• Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. Electronic address: i.e.beldhuis@umcg.nl.
• J Crit Care. 2021 Aug 1; 64: 144-153.

PurposeCognitive biases and factors affecting decision making in critical care can potentially lead to life-threatening errors. We aimed to examine the existing evidence on the influence of cognitive biases and factors on decision making in critical care.Materials And MethodsWe conducted a scoping review by searching MEDLINE for articles from 2004 to November 2020. We included studies conducted in physicians that described cognitive biases or factors associated with decision making. During the study process we decided on the method to summarize the evidence, and based on the obtained studies a descriptive summary of findings was the best fit.ResultsThirty heterogenous studies were included. Four main biases or factors were observed, e.g. cognitive biases, personal factors, environmental factors, and patient factors. Six (20%) studies reported biases associated with decision making comprising omission-, status quo-, implicit-, explicit-, outcome-, and overconfidence bias. Nineteen (63%) studies described personal factors, twenty-two (73%) studies described environmental factors, and sixteen (53%) studies described patient factors.ConclusionsThe current evidence on cognitive biases and factors is heterogenous, but shows they influence clinical decision. Future studies should investigate the prevalence of cognitive biases and factors in clinical practice and their impact on clinical outcomes.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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