ArticleEye (London, England)2026
Cognitive heuristics in the operating room: the role of 'left-digit bias' in ophthalmic surgical selection.
Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
introductionLeft-digit bias is a cognitive heuristic in which the leftmost digit of a number disproportionately influences judgment. This study evaluates the impact of perceived patient age on ophthalmic surgical decision-making.
methodsUsing a multicentre federated electronic health record network, patients aged 40-85 years with a routine health visit, followed by at least 1 documented ophthalmic examination and a diagnosis code specific to the surgical outcome under study, were followed for 1 year. Patients were grouped into consecutive 2-year age cohorts and matched 1:1 on demographic characteristics, healthcare utilisation, systemic comorbidities, and ocular diagnoses and procedures. Prespecified decade-boundary comparisons were 48/49 versus 50/51, 58/59 versus 60/61, and 68/69 versus 70/71. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each surgical outcome.
resultsAmong 8,156,608 eligible patients, 218,816 (2.68%) underwent an included ophthalmic procedure, including 201,591 phacoemulsification procedures. The younger cohort had lower odds of phacoemulsification at each decade boundary: 48/49 vs. 50/51 (OR, 0.956; 95% CI, 0.926-0.986), 58/59 vs. 60/61 (OR, 0.935; 95% CI, 0.909-0.961), and 68/69 vs. 70/71 (OR, 0.903; 95% CI, 0.879-0.927; all P < 0.001). No mid-decade phacoemulsification comparisons were significant. The odds of undergoing MIGS were lower at 48/49 vs. 50/51 (OR, 0.876; 95% CI, 0.814-0.940); no decade-boundary differences were observed for GDI or keratoplasty procedures.
conclusionsConsistent with left-digit bias, surgical frequency for phacoemulsification increased at decade transitions. Clinicians should consider the potential influence of age perception in surgical decision-making.
Identifiers
42839088What Socratic holds
Registered trials
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