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Eran Eldar

If you don’t let it in, you don’t have to get it out: Thought preemption as a method to control unwanted thoughts

21 July, 2022

Trying to stop thinking unwanted, often repetitive thoughts is a familiar experience. However, being aware of such attempts implies that the thought has already reached consciousness. Can we preempt an unwanted thought from coming to mind in the first place?

Cognitive bias modification of inferential flexibility

Cognitive bias modification of inferential flexibility

5 July, 2022

Are things not going well right now? Having a bad day?

When people experience a negative life event, they tend to make causal inferences about the event. These inferred causes affect the way people experience events and respond to them. Over time, whereas some people revisit events and rethink about them, shift towards more adaptive inferences, others may stay stuck in their initial negative inference.

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Physicians prescribe fewer analgesics during night shifts than day shifts

17 July, 2022
Dr Anat Perry

Adequate pain management is one of the biggest challenges of the modern healthcare system. Physician perception of patient subjective pain, which is crucial to pain management, is susceptible to a host of potential biases. Here we explore the timing of physicians’ work as a previously unrecognized source of systematic bias in pain management. We hypothesized that during night shifts, sleep deprivation, fatigue, and stress would reduce physicians’ empathy for others’ pain, leading to underprescription of analgesics for patient pain relief. In study 1, 67 resident physicians, either following a night shift or not, performed empathy for pain assessment tasks and simulated patient scenarios in laboratory conditions. As predicted, following a night shift, physicians showed reduced empathy for pain. In study 2, we explored this phenomenon in medical decisions in the field. We analyzed three emergency department datasets from Israel and the United States that included discharge notes of patients arriving with pain complaints during 2013 to 2020 (n = 13,482). Across all datasets, physicians were less likely to prescribe an analgesic during night shifts (compared to daytime shifts) and prescribed fewer analgesics than generally recommended by the World Health Organization. This effect remained significant after adjusting for patient, physician, type of complaint, and emergency department characteristics. Underprescription for pain during night shifts was particularly prominent for opioids. We conclude that night shift work is an important and previously unrecognized source of bias in pain management, likely stemming from impaired perception of pain. We consider the implications for hospitals and other organizations employing night shifts.

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