Age-related cognitive bias in in-hospital cardiac arrest

for the American Heart Association's Get With The Guidelines-Resuscitation Investigators

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Aims: Cognitive bias has been recognized as a potential source of medical error as it may affect clinical decision making. In this study, we explored how cognitive bias, specifically left-digit bias, may affect patient outcomes in in-hospital cardiac arrest. Methods: Using the Get With The Guidelines® – Resuscitation registry, we included adult patients with an in-hospital cardiac arrest from 2011 to 2019. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation, favorable neurological outcome, and duration of resuscitation. Using a regression discontinuity design, we explored whether there was a sudden change in survival at the age threshold of 80 years which would indicate left-digit bias. Additional analyses were performed at age thresholds of 60, 70, and 90 years. Results: A total of 26,784 patients were included for the primary analysis. The overall survival was 22% in this cohort. There was no discontinuity of survival below and above the age of 80 years (risk difference, 0.47%; 95%CI, −1.61% to 2.56%). Similar results were estimated for the secondary outcomes and for the age thresholds of 60, 70, and 90 years. The results were consistent in sensitivity analyses. Conclusions: There was no indication that cognitive bias based on age affected outcomes in in-hospital cardiac arrest in these data.

Original languageEnglish (US)
Pages (from-to)43-46
Number of pages4
StatePublished - May 2021


  • Cognitive bias
  • Heart arrest
  • In-hospital cardiac arrest
  • Left-digit bias

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine


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