Optimism bias in understanding neonatal prognoses

• Published in: Journal of perinatology Vol. 41; no. 3; pp. 445 - 452
• Main Authors: Nayak, Babina, Moon, Jee-Young, Kim, Mimi, Fischhoff, Baruch, Haward, Marlyse F
• Format: Journal Article
• Language: English
• Published: United States Nature Publishing Group 01.03.2021
• Subjects: Bias; Diseases; Infants (Newborn); Medical prognosis; Neonatal intensive care; Neonates; Newborn babies; Optimism; Parents; Pediatric research; Physicians; Prognosis; Psychological aspects; Surveys; United States
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-020-00773-1

Discrepancies between physician and parent neonatal prognostic expectations are common. Optimism bias is a possible explanation. Parents interpreted hypothetical neonatal prognoses in an online survey. Good prognoses tended to be interpreted accurately, while poor prognoses were interpreted as less than the stated value. One-third of participants consistently overstated survival for the three lowest prognoses, compared to the sample as a whole. Three significant predictors of such optimistic interpretations were single-parent status (OR 0.39; 95% CI 0.2-0.75; p = 0.005), African-American descent (OR 3.78; 95% CI 1.63-8.98; p = 0.002) and the belief that physicians misrepresented prognoses (OR 3.11; 95% CI 1.47-6.65; p = 0.003). Participants' explanations echoed research on optimism bias in clinical and decision science studies. Participants accepted positive prognoses for critically ill neonates, but reinterpreted negative ones as being unduly pessimistic demonstrating optimism bias.