What does confirmation bias describe in clinical thinking?

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Confirmation bias in clinical thinking is the tendency to seek out and give greater weight to information that supports your initial diagnostic impression while discounting data that could disprove it. This trap leads to premature closure, where you settle on a diagnosis too soon and fail to adequately explore other possibilities. For example, if you think a patient has pneumonia, you might focus on findings that fit that diagnosis, such as fever and crackles, and overlook signs that suggest alternative causes like bronchitis, a rib injury, or heart-related chest pain. The key is to actively look for disconfirming evidence and maintain a broad differential, testing hypotheses rather than just collecting confirming data. Develop this by formulating multiple possible diagnoses and intentionally seeking information that could disprove each one, using structured data gathering, checklists, and, when helpful, a second opinion. This helps counteract the natural pull toward confirmation and improves diagnostic accuracy and patient safety.