Playing with your mind: between framing and anchoring

This is the X-ray of a 72-year-old man with fever, weight loss, hyporexia, non-productive cough and dyspnea. The oxygen saturation with an oxygen mask and resting was 97%.

What´s your diagnosis?

1. Bronchitis

2. Bronchioloalveolar carcinoma

3. Pulmonary embolism

4. Other

FINAL DIAGNOSIS: SUBCUTANEOUS ABSCESS (right shoulder)

Framing – drawing different conclusions from the same information, depending on how that information is presented

Anchoring: the tendency to rely too heavily, or “anchor,” on one trait or piece of information when making decisions (usually the first piece of information that we acquire on that subject).

COMMENTS: The clinical information is orientated to think about a pulmonary problem. If this happens to you we could speak about anchoring because your clinical reasoning was biased to the lung. Framing is a bias present when the clinical reasoning is deviated because some “emotional” information is attached to the objective information; in this case the possibility of a lung cancer could be enhanced if we add that the patient was a “heavy smoker with some occasional haemoptysis”.