Cognitive Shortcut Research Articles

Clinical Reasoning Unveiled: Demystifying Heuristics and Hermeneutics in Neurological Clinical Practice

Introduction: Medical practice, particularly in Neurology, is often influenced by cognitive biases that can compromise diagnostic and therapeutic accuracy, leading to significant patient consequences. Clinical reasoning strategies are fundamental, yet the complexity of these processes is frequently underestimated. Understanding these strategies is crucial to ensure accurate diagnoses and effective treatments, thereby reducing clinical errors and optimizing patient outcomes. Despite extensive literature on cognitive biases, there is a need for a systematic synthesis addressing the peculiarities of neurological clinical reasoning, considering heuristics (mental shortcuts or rules of thumb that simplify decision-making) and hermeneutics (the theory and methodology of interpretation, especially of textual and symbolic content). Objectives: To review and systematize the main clinical reasoning strategies in Neurology, highlighting common biases and proposing methods to improve diagnostic and therapeutic accuracy. Methodology: A comprehensive literature review focusing on familiarity biases, Dual Process Theory, and heuristics (anchoring, availability, and representativeness). Additionally, the application of hermeneutics in hypothesis formulation and the importance of understanding the patient as a complex system were analyzed. Results: Specialized neurologists often rely on heuristics, which means a cognitive shortcut. Recognizing this process can mitigate anchoring and availability biases. The hermeneutic approach, on the other hand, is essential for interpreting variables in the patient’s context, integrating historical and social aspects. Conclusion: Understanding clinical reasoning processes and systematically teaching these strategies are crucial to enhancing the efficiency and effectiveness of clinical decision-making, reducing diagnostic errors, and improving patient outcomes.

Explain Breathlessness: Could 'Usual' Explanations Contribute to Maladaptive Beliefs of People Living with Breathlessness?

Explanations provided by healthcare professionals contribute to patient beliefs. Little is known about how healthcare professionals explain chronic breathlessness to people living with this adverse sensation. A purpose-designed survey disseminated via newsletters of Australian professional associations (physiotherapy, respiratory medicine, palliative care). Respondents provided free-text responses for their usual explanation and concepts important to include, avoid, or perceived as difficult to understand by recipients. Content analysis coded free text into mutually exclusive categories with the proportion of respondents in each category reported. Respondents (n = 61) were predominantly clinicians (93%) who frequently (80% daily/weekly) conversed with patients about breathlessness. Frequent phrases included within usual explanations reflected breathlessness resulting from medical conditions (70% of respondents) and physiological mechanisms (44%) with foci ranging from multifactorial to single-mechanism origins. Management principles were important to include and phrases encouraging maladaptive beliefs were important to avoid. The most frequent difficult concept identified concerned inconsistent relationships between oxygenation and breathlessness. Where explanations included the term 'oxygen', a form of cognitive shortcut (heuristic) may contribute to erroneous beliefs. This study presents examples of health professional explanations for chronic breathlessness as a starting point for considering whether and how explanations could contribute to adaptive or maladaptive breathlessness beliefs of recipients.

Family members use superficial justice information to evaluate performance of sheltered workshops: A warning about “cognitive shortcuts”

ABSTRACT Background A growing number of services are focused on people with intellectual disabilities. Our study investigates interpersonal justice (interpersonal treatment families receive from service professionals) perceived by family members as a heuristic (cognitive shortcut) they can use to evaluate service performance directed towards improving the quality of life of their relatives with intellectual disability. Method Using a sample of 86 family members, we tested a within-person model. Interpersonal justice and service performance were measured four times (T1–T4). Results Over time, changes in interpersonal justice were positively related to changes in service performance. Family members use the treatment they receive from professionals to superficially draw inferences (heuristic) about service performance. Conclusions Our study warns about the use of superficial justice information based on a heuristic to evaluate service performance. More active participation of families in the organizational life is suggested to avoid the use of these types of cognitive shortcuts.

The role of anthropomorphism and racial homophily of virtual influencers in encouraging low‐ versus high‐cost pro‐environmental behaviors

AbstractVirtual influencers have great potential to shape the audience's perception and motivate behavioral change. Drawing upon anthropomorphism theory and social identity theory, this paper examined the interaction effect of anthropomorphism and racial homophily of virtual influencers in shaping audiences' trust and subsequently pro‐environmental behaviors in low‐ and high‐cost contexts. Two online studies employing experimental materials generated by artificial intelligence were conducted. Study 1 revealed that high anthropomorphism (human‐like virtual influencers) and high racial homophily (local‐like virtual influencers) are more effective for eliciting trust in the context of low‐cost pro‐environmental behaviors. The findings also showed that low racial homophily (foreign‐like virtual influencers) would further weaken the trust level of a virtual influencer in low anthropomorphism (animate‐like virtual influencers). Study 2 aimed to replicate the findings from Study 1 in the context of high‐cost pro‐environmental behaviors. The findings showed that low racial homophily (foreign‐like virtual influencers) enhanced the trust in a high anthropomorphism (human‐like virtual influencers) virtual influencer. The moderated mediation analyses confirmed the hypothesized relationships in the proposed research model. This research advanced our understanding on the moderating role of racial homophily that serves as a cognitive shortcut for low‐cost and quick decisions. However, a low racial homophily (foreign‐like) virtual influencer would be more effective for high‐cost and symbolic pro‐environmental behaviors. These insights provide valuable guidance to businesses, marketers, and environmental advocates aiming to leverage virtual influencers for encouraging sustainability practices.

Heuristics in sport: A scoping review

Judgement and decision-making under uncertainty often rely on simplistic” rules of thumb”, known as “heuristics”. The purpose of this scoping review is to explore the extant literature focussed on heuristics and sport. This study employed a five-stage scoping review methodology. The databases searched were Scopus, Web of Science, SPORTDiscus, and PsycInfo. The search terms were sport*, heuristic* (and its synonyms: cognitive shortcut, shortcut, rule of thumb, mental rule, cognitive rule) plus cognitive bias. The search identified 2019 studies, of which 38 were included in the analysis. Studies based in USA and Germany were most common. The use of heuristics by players were most common, while football (soccer) and basketball were the most frequently researched sport contexts. Both males and females were commonly included in most studies, but there were no studies with an explicit focus on females. The research was contextualized within several academic disciplines (e.g., psychology, forecasting, JDM, organization behavior, sports marketing and sponsorship, coaching science, risk analysis and sociology). Approximately 80 % of the studies were quantitative. Sixteen studies examined the fast and frugal heuristics approach (i.e., take-the-first heuristic (n = 8), recognition heuristic (n = 7), or gut instinct (n = 1), whereas eleven articles embraced the heuristics and biases approach. Future research should pursue a greater variety of heuristics, investigate the use of heuristics by selectors and boards of directors, and how best to design, implement, and evaluate heuristic education programs.

Aging a Decade in a Day: Age Cutoff Bias in Adjuvant Therapy Allocation for Early-Stage Breast Cancer

Physicians may expedite interpretation of data presented as a continuous variable by binning the data into "high" and "low" subgroups (cutoff heuristic). Use of this cognitive shortcut with age may lead to fewer nuanced or inappropriate decisions. We hypothesized an age cutoff heuristic may lead to non-evidence-based adjuvant treatment allocation among patients with early-stage breast cancer. Two cohorts with strong indications for adjuvant treatment regardless of age that underwent lumpectomy for early-stage breast cancer between 2004 and 2017 were identified in the National Cancer Database. Cohort 1 had higher-risk features (estrogen receptor negative, endocrine therapy not planned, final margins positive, or size >3 cm; n=160,990) and was appropriate for radiation. Cohort 2 had hormone receptor positivity with tumors >5 mm (n=394,946) and was appropriate for endocrine therapy. Multivariable logistic regressions with odds ratios (ORs) and 99.8% confidence intervals (CIs) were performed to determine whether any single year-over-year age difference was independently associated with a difference in likelihood of adjuvant therapy recommendation. In cohort 1, radiation recommendation decreased sharply at age 70, ranging from 90% to 92% between the ages of 50 and 69 years to 81% for those aged 70 years. Multivariable logistic regressions showed year-over-year age difference was an independent predictor for adjuvant radiation recommendation at only age 70 versus 69 (OR, 0.47; CI, 0.39-0.57; P < .001). For cohort 2, endocrine therapy recommendation showed a small decline at age 70, and year-over-year age difference was a predictor of endocrine therapy recommendation at only age 70 versus 69 (OR, 0.86; CI, 0.74-0.99; P=.001). We observed a unique decline in appropriate adjuvant therapy recommendation between ages 69 and 70. This suggests use of an age cutoff heuristic to process patient age in this population as a categorical, binary variable. This is a previously undescribed phenomenon in early-stage breast cancer.

Dichotomous thinking about social groups: Learning about one group can activate opposite beliefs about another group

Across three studies (N = 607), we examined people’s use of a dichotomizing heuristic—the inference that characteristics belonging to one group do not apply to another group—when making judgments about novel social groups. Participants learned information about one group (e.g., “Zuttles like apples”), and then made inferences about another group (e.g., “Do Twiggums like apples or hate apples?”). Study 1 acted as a proof of concept: Eight-year-olds and adults (but not 5-year-olds) assumed that the two groups would have opposite characteristics. Learning about the group as a generic whole versus as specific individuals boosted the use of the heuristic. Study 2 and Study 3 (sample sizes, methods, and analyses pre-registered), examined whether the presence or absence of several factors affected the activation and scope of the dichotomizing heuristic in adults. Whereas learning about or treating the groups as separate was necessary for activating dichotomous thinking, intergroup conflict and featuring only two (versus many) groups was not required. Moreover, the heuristic occurred when participants made both binary and scaled decisions. Once triggered, adults applied this cognitive shortcut widely—not only to benign (e.g., liking apples) and novel characteristics (e.g., liking modies), but also to evaluative traits signaling the morals or virtues of a social group (e.g., meanness or intelligence). Adults did not, however, extend the heuristic to the edges of improbability: They failed to dichotomize when doing so would attribute highly unusual preferences (e.g., disliking having fun). Taken together, these studies indicate the presence of a dichotomizing heuristic with broad implications for how people make social group inferences.

When to (or not to) trust intelligent machines: Insights from an evolutionary game theory analysis of trust in repeated games

The actions of intelligent agents, such as chatbots, recommender systems, and virtual assistants are typically not fully transparent to the user. Consequently, users take the risk that such agents act in ways opposed to the users’ preferences or goals. It is often argued that people use trust as a cognitive shortcut to reduce the complexity of such interactions. Here we formalise this by using the methods of evolutionary game theory to study the viability of trust-based strategies in repeated games. These are reciprocal strategies that cooperate as long as the other player is observed to be cooperating. Unlike classic reciprocal strategies, once mutual cooperation has been observed for a threshold number of rounds they stop checking their co-player’s behaviour every round, and instead only check it with some probability. By doing so, they reduce the opportunity cost of verifying whether the action of their co-player was actually cooperative. We demonstrate that these trust-based strategies can outcompete strategies that are always conditional, such as Tit-for-Tat, when the opportunity cost is non-negligible. We argue that this cost is likely to be greater when the interaction is between people and intelligent agents, because of the reduced transparency of the agent. Consequently, we expect people to use trust-based strategies more frequently in interactions with intelligent agents. Our results provide new, important insights into the design of mechanisms for facilitating interactions between humans and intelligent agents, where trust is an essential factor.

How to improve the Triage: A dashboard to assess the quality of nurses’ decision-making

This paper presents a dashboard for assessing the quality of Triage decision-making process in the assignment of the priority code to patients arriving at an emergency department. The quality is assessed through performance indexes aimed at measuring both the nurses’ accuracy and the presence of nurses’ shared behavior in the Triage assignment process. The theoretical perspective of the cognitive heuristic, that is a cognitive shortcut strategy to make decisions, is the framework to design performance indexes of the dashboard. The dashboard has been tested in two Emergency Departments. We gather the data input through the submission to 54 nurses of a questionnaire, simulating 25 patients’ scenarios. The dashboard reveals a disparity between nurses in priority level assignment. This disparity depends on nurses’ capacity in disregarding some information and in considering the right cue. We find the presence of sharing behaviors and inclination to over or under assessment by nurses. This performance analysis, integrated with the nurses’ reasoning in assigning the priority code, can address the management in designing improvement actions at individual level and at the organizational one. In addition, the application to two Emergency Department confirms the influence of organizational aspects in the individual decision process.

Psychological Cues to Political Stands: An Experiment with Italians on Regional Autonomy

The human mind is not necessarily willing to assess costs and benefits every time it faces a decision. It often prefers to rely on cognitive shortcuts (i.e., heuristics) enabling it to decide rapidly and satisfactorily. Most literature on heuristics and biases suggests that a common cognitive shortcut individuals take is looking at what is close to judge what is far. An experiment involving 300 Italian citizens used a questionnaire to test whether it may work the other way around when it comes to politics. This paper investigated whether citizens might use mere exposure to information on a foreign issue as a heuristic to express an opinion on a similar issue at the domestic level. Furthermore, it strived to test whether this occurs more frequently when the individual considers the two cultures involved to be relatively close to each other. Results show data can only partially confirm the expectations.

Privacy, Values and Machines: Predicting Opposition to Artificial Intelligence

ABSTRACT In this study we identify, for the first time, social determinants of opposition to artificial intelligence, based on the assessment of its benefits and risks. Using a national survey in Spain (n = 5200) and linear regression models, we show that common explanations regarding opposition to artificial intelligence, such as competition and relative vulnerability theories, are not confirmed or have limited explanatory power. Stronger effects are shown by social values and general attitudes to science. Those expressing egalitarian values and privacy concerns, as well as those less predisposed to innovation in a general sense, are more prone to oppose both technological applications. Lastly, we found evidence that, as in other complex technological applications, a new cognitive shortcut is produced. In this case, we found a strong correlation (0.652, p < .001) between public attitudes toward robotization in the workplace and toward artificial intelligence. We discuss the implications of this new cognitive schema, the “intelligent machine”, as a new threatening or beneficial element.

Cognitive Shortcuts and Public Support for Intervention

Scholars of public opinion on military intervention agree that survey respondents make judgments from limited information. Yet researchers still question whether ordinary Americans reflect elite attitudes or instead reach their own “pretty prudent” conclusions from the stated principal policy objective (PPO). This article adjudicates the debate while incorporating lessons from the study of bounded rationality. Evidence comes from an original data set of aggregate US public opinion, covering 1,080 nationally representative survey items about launching operations, across thirty-five countries, during 1981 to 2016. Tests show that PPO matters: pursuing “internal policy change” is less popular than restraining international aggression. However, language reflecting White House cues and one prominent cognitive shortcut (the “availability heuristic”) statistically and substantively outperforms PPO at predicting intervention support. The results indicate that when ordinary Americans are polled about using force against salient foes (Saddam Hussein, al-Qaeda, Islamic State in Iraq and Syria), elements of bounded rationality can overtake the prudence expressed toward less vivid problems.

Poliheuristic Theory and Germany’s (Non-)Participation in Multinational Military Interventions. The Non-compensatory Principle, Coalition Politics and Political Survival

This article employs the poliheuristic theory of decision-making (PHT) to analyse German decisions to participate in, or abstain from, multinational military operations. PHT represents one of the leading theoretical efforts at bridging the cognitive-rationalist divide in foreign policy analysis. The theory posits a two-stage model of foreign policy-making: in the first stage, actors rely on a non-compensatory strategy as a cognitive shortcut to eliminate unacceptable alternatives and to reduce the choice set. In the second stage, actors switch to a compensatory mode of information-processing and select the alternative which maximises expected utility. While there is broad agreement that the non-compensatory dimension at the first stage of PHT concerns the domestic repercussions of foreign policy, it is less clear how this ‘domestic politics’ dimension should be operationalised. This article contributes to this debate by specifying the operationalisation of the non-compenstaory principle in the context of coalition foreign policy making in parliamentary democracies. Specifically, it suggests that the non-compensatory dimension in coalition foreign policy consists of the expected impact of foreign policy on coalition survival. Empirically, the article argues that PHT sheds important new light on arguably some of the most controversial military deployment decisions (Democratic Republic of Congo, Lebanon, Libya) of post-unification Germany.

Public responses to scientific research: Does disciplinary attribution matter?

Research has shown that the form and content of science communications can influence individuals' responses. This study examines whether individuals' perceptions of scientific research are influenced by the discipline to which the research is attributed. Two vignette experiments find that neither the perceived scientific-ness nor trustworthiness of a study originating from sociology is affected by attributing the study to a different social science or to a natural or medical science. These null findings contrast with surveys showing sizable disciplinary differences in public attitudes. It is possible that disciplinary attribution is a less salient cognitive shortcut when presented in longer communications as compared to survey questions that only provide the name of a discipline. We conclude with suggestions for further research on the role of disciplinary attribution on public perceptions of science.

FFAB—The Form Function Attribution Bias in Human–Robot Interaction

People seem to miscalibrate their expectations and interactions with a robot. When it comes to robot design, the anthropomorphism level of the robot form (appearance) has become an increasingly important variable to consider. It is argued here that people base their expectations and perceptions of a robot on its form and attribute functions which do not necessarily mirror the true functions of the robot. The term form function attribution bias (FFAB) refers to the cognitive bias which occurs when people are prone to perceptual errors, leading to a biased interpretation of a robot’s functionality. We argue that rather than objectively perceiving the robot’s functionalities, people take a cognitive shortcut using the information available to them through visual perception. FFAB intends to outline the implications the design of a robot has on the human predisposition to interact socially with robots. In this theoretical review, we examined the results of several studies suggesting an FFAB. We outline future directions of experimental paradigms and robot design implications.

The psychology of beach users: importance of confirmation bias, action, and intention to improving rip current safety

The rip current hazard on beaches is a global public health issue. While physical controls on rip current formation and flow behavior are relatively well understood, there has been a recent increase in studies examining the less-understood social dimensions of the hazard. This paper reviews how these studies provide insight into beach safety practices and rip current knowledge among beach users, their ability to spot a rip, and their ability to understand and heed posted warnings. However, we identify how these studies are hindered by methodological limitations and problematic sample choices. It is argued that beach user behavior is affected by confirmation bias, a cognitive shortcut by which a person selectively attends to evidence confirming their preexisting beliefs and ignores disconfirming evidence, and to make decisions in accordance with this bias. Evidence is presented to suggest that there is a potential for beach-going behaviors to be influenced by other beach users and past observations, whether the behavior of others conforms to warnings about the dangers posed by rips in general or at a specific time and place. We also suggest that beach users’ self-reported intentions and beliefs about beach safety may not correspond to their actions at the beach. This suggests a need for active intervention and creation of social norms that address cognitive errors associated with unsafe beach behavior, which in turn requires that coastal scientists and beach safety practitioners should collaborate with social scientists and psychologists for more effective safety outcomes.

The reinforcement heuristic in normal form games

We analyze simple reinforcement-based behavioral rules in 3 × 3 games through choice data and response times. We argue that there is a large overlap between reinforcement-based heuristics (win-stay, lose-shift) and the more “rational” behavioral rule of myopic best reply. However, evidence from response times shows that choices in agreement with the common prescription of those rules are comparatively fast, and choices of the form “lose-shift” occur more frequently for larger differences with bygone payoffs. Both observations speak in favor of reinforcement processes as a cognitive shortcut for apparent myopic best reply, and advise caution when interpreting behavioral results in favor of optimizing behavior.

Remarkable Reframing

This paper arises from a presentation at the International Mediation and Restorative Practice Conference held at the National University of Ireland, Maynooth on 5th September 2014. The topic is the technique known as reframing. To reframe is to bring about a change in someone’s mental perspective by altering their tacit underlying viewpoint to create different meaning. It is an attempt to release the parties from a blame and counter-blame cycle, and to focus on more useful ways of viewing the conflict. It is not about over-looking or evading some negative sentiment - this needs to be included to maintain the context. What reframing does, however, is to introduce new meaning, co-existent with the negative perspective, which shifts the mind-set towards a more constructive future. A ‘frame’ is a cognitive shortcut that people use to make sense of the world. It is a complex mental structure of unquestioned beliefs, values and ideas that is used to simplify our understanding of the world around us and thus to infer meaning. If a part of that frame is changed – for example through self-reflection, education or reframing - then the inferred meaning may also change. When parties are in conflict their frames help them to interpret what has happened, what the intentions of the other party are, and their own role in what has taken place. This is usually positively disposed to the self and negatively disposed to the other. This lens, or frame, provides meaning for the conflict. Reframing upsets this frame and introduces a different, and potentially more helpful way to look at the conflict so that the parties will work on resolution rather than being stuck on set, negative, unproductive or toxic ways of viewing matters, or being defensive and closed-minded.

Effects of meal variety on expected satiation: Evidence for a ‘perceived volume’ heuristic

Meal variety has been shown to increase energy intake in humans by an average of 29%. Historically, research exploring the mechanism underlying this effect has focused on physiological and psychological processes that terminate a meal (e.g., sensory-specific satiety). We sought to explore whether meal variety stimulates intake by influencing pre-meal planning. We know that individuals use prior experience with a food to estimate the extent to which it will deliver fullness. These ‘expected satiation’ judgments may be straightforward when only one meal component needs to be considered, but it remains unclear how prospective satiation is estimated when a meal comprises multiple items. We hypothesised that people simplify the task by using a heuristic, or ‘cognitive shortcut.’ Specifically, as within-meal variety increases, expected satiation tends to be based on the perceived volume of food(s) rather than on prior experience. In each trial, participants (N = 68) were shown a plate of food with six buffet food items. Across trials the number of different foods varied in the range one to six. In separate tasks, the participants provided an estimate of their combined expected satiation and volume. When meal variety was high, judgments of perceived volume and expected satiation ‘converged.’ This is consistent with a common underlying response strategy. By contrast, the low variety meals produced dissociable responses, suggesting that judgments of expected satiation were not governed solely by perceived volume. This evidence for a ‘volume heuristic’ was especially clear in people who were less familiar with the meal items. Together, these results are important because they expose a novel process by which meal variety might increase food intake in humans.

Over-confidence and Low-cost Heuristics: An Experimental Investigation of Choice Behavior

Abstract This paper extends choice theory by allowing for the interaction between cognitive costs and imitative dynamics. The authors experimentally investigate the role of imitation when participants face a task which is costly in cognitive terms. In order to disentangle different choice dynamics, they devise a laboratory experiment with a novel experimental task in which they model the choice of different alternatives through high or low cognitive costs and feedback information provided to subjects. Their results provide evidence for imitative behavior driven by under-confidence about own skills and by the beliefs regarding others’ performance. They also find a temporal pattern in the distribution of choices, both in the highcost and low-cost cognitive conditions, that may represent another cognitive shortcut.