Tokunbo Ajayi; Jerome Okudo

“ Anchoring is defined as bias that describes the common human tendency to rely too heavily on the first piece of information offered (the “anchor”) when making decisions [7] [8] [9] . During decision-making, anchoring occurs when individuals use an initial piece of information to make subsequent judgments [8] . In this case, the initial history of GI bleed with the first laboratory value of significant low hemoglobin and hematocrit led to the belief that the patient’s cardiac arrest was due to hypovolemia from significant blood loss. ”

“ It is also important to know where to draw the line in waiting to make the switch between systems 1 and 2 in anchor heuristics. The emphasis on the application of anchor heuristics should be key in patients because a study has shown that a simple framework of heuristics might not be representative of the trueness and advantages of heuristics such as anchoring. There must be interplay between evidence based medicine and problem based learning. A balance between the two is required in making diagnosis. ”

“ The accuracy of diagnosis is not dependent on the content of the case or mastery of the case but may be dependent on approach. This interplay dependent on the content of the case or mastery of the case but may be dependent on approach. Tools that measure these heuristics are yet to be developed; however, the importance of involving patients in their management cannot be overemphasized especially if they are involved from a cognitive point of view in the diagnostic process. There should be an emphasis on improving heuristic strategies. ”

“ Conclusion Careful evaluation of patients is very important to make an accurate diagnosis. Heuristics are useful tools but they are more effective when a balance between systems 1 and 2 exists, that is, heuristics versus Bayesian methods. ”

“ However, in a top down approach, there is a focus on achieving a goal and this is dependent on the physician’s expected outcomes [1] [2] [3] . It is imperative to have an interplay of both approaches. This interplay depends on the physician’s clinical acumen and experience. ”

“ Initial arrest etiology was thought to be secondary to hypovolemic shock from blood loss because of his initial presentation of hematemesis and laboratory result, but the degree of anemia did not explain his cardiac arrest. However, toxicology report was positive for benzodiazepines and cocaine and his acetaminophen level was greater than 300. ”