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Understand the barriers and bottlenecks which limit desired behaviors of patients and HCPs in the pharmaceutical industry and how messaging boosted by heuristic science can effectively influence any stakeholder audience.

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Defending Our Decision

Michael Hayden
10 FEB, 2020

Accountability Bias in a decision is seen when a person thinks he might have to justify that decision to another person or group. This concept is closely linked to defensive decision making, wherein a person knowingly chooses a suboptimal course of action because he will be better protected in an event where something goes wrong. Consider prostate interventions. Most prostate cancers will remain nonprogressive throughout the lifetime of most men. While screening may detect prostate cancers, the cancers detected are most likely benign. In other words, men are more likely to die with prostate cancer than as a result of it.1

Physicians however, often err on the side of over-intervention. Why? A primary reason is that they don’t want to risk being put in a position where they detected a potential cancer and didn’t act on it; this can become particularly hazardous because they open themselves up to liability in the event of a lawsuit. A case in point is a physician telling his friend not to get a prostate screening but advises a patient to get the screening done. A simple case of Accountability Bias coming into play since the physician might have to justify his decision to a group of doctors or in court.

[1] 1 in 5 American men in their 50s, about will have prostate cancer. When these men are in their 60s and 70s, two to three are anticipated to have prostate cancer. This number jumps to 4 out of 5 men in their 80s. Yet the lifetime risk of dying from prostate cancer is 3%. For more information, see https://www.stat.berkeley.edu/~aldous/157/Papers/health_stats.pdf