Cognitive Biases in Surgical Practice

This book introduces a practice oriented account of how heuristics and cognitive biases shape clinical reasoning and surgical decision making under uncertainty. Building on behavioral economics and dual process theory, the authors translate foundational constructs such as availability, anchoring, confirmation, overconfidence, loss aversion, framing, and survivorship bias into concrete implications for diagnosis, operative judgment, and multidisciplinary discussions. Drawing on historically grounded clinical narratives, the chapters connect abstract mechanisms to everyday choices in surgery and perioperative care, foregrounding consequences for patient safety and outcomes.

The volume emphasizes awareness, metacognition, and deliberate choice architecture in the operating room and clinic, culminating in general and context specific checklists for bias mitigation. While not a comprehensive taxonomy, the book provides a structured entry point for surgeons and trainees seeking to improve decision quality, reduce diagnostic error, and design safer systems.

The original manuscript of this book was written in Spanish and translated into English with the help of artificial intelligence. A subsequent human revision was done primarily in terms of content.

Chapter 1 Introduction. - Chapter 2 Cognitive biases: history and definition. - Chapter 3 Impact of Cognitive Biases on Clinical Practice. - Chapter 4 Hindsight Bias. The Death of James Garfield. - Chapter 5 Attention Bias. Prefrontal Lobotomy and Mental Illness. - Chapter 6 Availability Bias. The Angelina Jolie effect. - Chapter 7 Negativity bias. Germany and laparoscopic surgery. - Chapter 8 Illusory correlation: Angina and ligation of the internal mammary artery. - Chapter 9 Confirmation bias. Arthroscopy in the treatment of knee osteoarthritis. - Chapter 10 The Law of Triviality. The Keystone Project. - Chapter 11 Anchoring Bias. The Dysphonia of Kaiser Frederick III. - Chapter 12 Loss Aversion Bias. Subspecialization in Vascular Surgery. - Chapter 13 The Halo Effect. The Shah of Iran s Cancer. - Chapter 14 Overconfidence Bias. Benjamin Rush and the Yellow Fever Epidemic of 1793. - Chapter 15 Omission bias. Laparotomy in abdominal trauma. - Chapter 16 Bandwagon Effect. The Rise and Fall of the Adjustable Gastric Band. - Chapter 17 Reactive Devaluation. Ignaz Semmelweis and Handwashing. - Chapter 18 Authority Bias. The Queen s Anesthesia. - Chapter 19 Outcome Bias. The Shead vs Hooley Case. - Chapter 20 Misinformation effect. Peptic ulcer disease and gastric cooling. - Chapter 21 The Framing Effect: Bernard Fisher and the New Paradigm of Mastectomy. - Chapter 22 Survivorship Bias. Battey and Normal Ovariotomy. - Chapter 23 Illusion of Control. The Fastest Knife in the West End.