Cognitive and Human Factors in Expert Decision Making: Six Fallacies and the Eight Sources of Bias

Root cause analysis of cases involving diagnosis

Diagnostic errors comprise the leading threat to patient safety in healthcare today. Learning how to extract the lessons from cases where diagnosis succeeds or fails is a promising approach to improve diagnostic safety going forward. We present up-to-date and authoritative guidance on how the existing approaches to conducting root cause analyses (RCA's) can be modified to study cases involving diagnosis. There are several diffierences: In cases involving diagnosis, the investigation should begin immediately after the incident, and clinicians involved in the case should be members of the RCA team. The review must include consideration of how the clinical reasoning process went astray (or succeeded), and use a human-factors perspective to consider the system-related contextual factors in the diagnostic process. We present detailed instructions for conducting RCA's of cases involving diagnosis, with advice on how to identify root causes and contributing factors and select appropriate interventions.

Which diagnoses and arguments regarding severe mental disorder do forensic psychiatric experts in Sweden consider in different cases? A qualitative vignette study

The decision-making process of experts in forensic psychiatric investigations (FPI) is complex and reasoning regarding psychiatric diagnosis and severe mental disorder (SMD, the judicial concept central to legal exemption in Swedish law) has severe ramifications. Nevertheless, the qualitative aspects of FPI experts' decision-making process have seldom been studied systematically.

METHOD

The participants (N = 41) were FPI experts: forensic psychiatrists (n = 15), forensic psychologists (n = 15) and forensic social workers (n = 11). Using three case vignettes and qualitative content analysis, it was explored how case-specific characteristics could affect which hypotheses FPI experts generated regarding a) psychiatric diagnosis and b) severe mental disorder and c) which information sources they required. Each case vignette described a diagnostically ambiguous case but indicated emphasis on: psychotic symptoms (case 1); personality disorder symptoms (case 2) and neurodevelopmental disorder symptoms (case 3).

RESULTS

Experts reasoned in a similar manner regarding generating hypotheses and required information, but also in a case-adapted manner. Experts considered various diagnostic alternatives, and some (e.g. psychosis) were mentioned for all three cases. Other diagnoses were only suggested as hypotheses in certain cases (e.g. case 3: intellectual disability).

DISCUSSION

In Sweden, a core basis for SMD is psychotic-like functioning, and psychosis was suggested as a hypothesis for all three cases. Experts reasoned in similar ways regarding SMD in all cases, considering various perspectives for and against SMD. Some case-specific arguments for and against SMD adapted to the psychopathological circumstances were found. These could be related to aspects of the SMD concept that become important to ascertain when the type of psychopathology indicated in the case vignette was present; for example, ascertaining reality monitoring for a person with potential delusions of being followed by a criminal gang requires investigation of criminal history and related conflicts. Taken together, FPI-experts considered a broad range of psychiatric diagnoses in various cases. Their reasoning regarding SMD was both based on general and case-specific (or psychopathology-specific) factors.

The effects of cognitive bias, examiner expertise, and stimulus material on forensic evidence analysis

Forensic examiners have come under scrutiny due to high-profile exonerations, highlighting the consequences that contextual bias can have on investigations. Researchers have proposed solutions to reduce the effects of bias including blind testing and redacting task-irrelevant information. Practitioners have concerns over the limitations of some of this research that uses untrained students to examine complex pieces of forensic evidence (e.g., fingerprints) (1; but see 2 for studies including trained experts and/or actual casework). This study sought to (a) examine the effect of contextual bias on examiners' evaluation of forensic evidence by varying the amount of pre-comparison information available to participants, (b) compare student and expert examiners' performance and their vulnerability to contextual bias, and (c) examine the effects of contextual bias on examiners' evaluation of different types of forensic evidence. Expert fingerprint examiners and student participants were presented with varying amounts of pre-comparison case information and compared matching and non-matching fingerprint and footwear impression evidence. Results suggest no effects of blinding examiners from case information or redacting task-irrelevant information. As expected, expert fingerprint examiners were more likely to correctly identify matching fingerprints and correctly exclude non-matching fingerprints than students. However, expert fingerprint examiners were no better than student participants at comparing footwear impression evidence. These findings suggest that sample, stimulus selection, and discipline-specific training matter when investigating bias in forensic decision making. These findings suggest caution when using forensic stimuli with student samples to investigate forensic decision-making and highlight the need for more research on redaction procedures.

A global survey of the attitudes and perspectives of cognitive bias in forensic anthropology

It is now well established that decision making can be susceptible to cognitive bias in a broad range of fields, with forensic science being no exception. Previously published research has revealed a bias blind spot in forensic science where examiners do not recognise bias within their own domain. A survey of 101 forensic anthropology practitioners (n = 52) and students (n = 38) was undertaken to assess their level of awareness of cognitive bias and investigate their attitudes towards cognitive bias within forensic anthropology. The results revealed that the forensic anthropology community (∼90%) had a high level of awareness of cognitive bias. Overall ∼89% expressed concerns about cognitive bias in the broad discipline of forensic science, their own domain of forensic anthropology, and in the evaluative judgments they made in reconstruction activities, identifying a significant reduction in the bias blind spot. However, more than half of the participants believed that bias can be reduced by sheer force of will, and there was a lack of consensus about implementing blinding procedures or context management. These findings highlight the need to investigate empirically the feasibility of proposed mitigating strategies within the workflow of forensic anthropologists and their capabilities for increasing the transparency in decision making.

Contextual bias in forensic toxicology decisions: A follow-up empirical study from China

The impact of contextual bias has been demonstrated repeatedly across forensic domains; however, research on this topic in forensic toxicology is very limited. In our previous study, experimental data from only one context version were compared with the actual forensic biasing casework. As a follow-up, this controlled experiment with 159 forensic toxicology practitioners was conducted, to test whether knowledge of different contextual information influenced their forensic decision-making. Participants in different context groups were tasked to identify testing strategies for carbon monoxide and opiate drugs. The results of chi-squared tests for their selections and two context groups exhibited statistically significant differences (p < 0.05 or p < 0.01). These findings show contextual information can bias forensic toxicology decisions about testing strategies, despite it is a relatively objective domain in forensic science.

Contextual bias by Forensic Document Examination trainees: An empirical study from China

The impact of contextual bias has been repeatedly demonstrated across forensic domains; however, research on this topic in China is scarce. To examine the prevalence of contextual bias in pattern feature-comparison disciplines, we conducted an experiment involving 24 forensic document examination students. The aim was to determine whether knowledge of different contextual information influenced their forensic decision-making. Participants were divided into different context groups and tasked with examining whether questioned signatures with ambiguous features matched reference signatures. The results of independent-samples t-tests for their decision score data in the two context groups exhibited a statistically significant difference (p < 0.05, Cohen's d > 0.8). Moreover, the submitted forensic reports by participants disclosed a biased evaluation of handwriting features. These findings show how contextual information can bias forensic decision-making in handwriting examination. Context management with complementary strategies such as case triage, cognitive training and decision-making transparency must be implemented to minimize bias in handwriting examination.

Unpacking workplace stress and forensic expert decision-making: From theory to practice

Workplace stress can affect forensic experts' job satisfaction and performance, which holds financial and other implications for forensic service providers. Therefore, it is important to understand and manage workplace stress, but that is not simple or straightforward. This paper explores stress as a human factor that influences forensic expert decision-making. First, we identify and highlight three factors that mitigate decisions under stress conditions: nature of decision, individual differences, and context of decision. Second, we situate workplace stress in forensic science within the Challenge-Hindrance Stressor Framework. We argue that stressors in forensic science workplaces can have a positive or a negative impact, depending on the type, level, and context of stress. Developing an understanding of the stressors, their sources, and their possible impact can help forensic service providers and researchers to implement context-specific interventions to manage stress at work and optimize expert performance.

Inconsistencies in rater-based assessments mainly affect borderline candidates: but using simple heuristics might improve pass-fail decisions

INTRODUCTION

Research in various areas indicates that expert judgment can be highly inconsistent. However, expert judgment is indispensable in many contexts. In medical education, experts often function as examiners in rater-based assessments. Here, disagreement between examiners can have far-reaching consequences. The literature suggests that inconsistencies in ratings depend on the level of performance a to-be-evaluated candidate shows. This possibility has not been addressed deliberately and with appropriate statistical methods. By adopting the theoretical lens of ecological rationality, we evaluate if easily implementable strategies can enhance decision making in real-world assessment contexts.

METHODS

We address two objectives. First, we investigate the dependence of rater-consistency on performance levels. We recorded videos of mock-exams and had examiners (N=10) evaluate four students' performances and compare inconsistencies in performance ratings between examiner-pairs using a bootstrapping procedure. Our second objective is to provide an approach that aids decision making by implementing simple heuristics.

RESULTS

We found that discrepancies were largely a function of the level of performance the candidates showed. Lower performances were rated more inconsistently than excellent performances. Furthermore, our analyses indicated that the use of simple heuristics might improve decisions in examiner pairs.

DISCUSSION

Inconsistencies in performance judgments continue to be a matter of concern, and we provide empirical evidence for them to be related to candidate performance. We discuss implications for research and the advantages of adopting the perspective of ecological rationality. We point to directions both for further research and for development of assessment practices.

Towards a forensic semiotics

For years, forensic science has been criticized for its lack of scientific foundations, explaining its methodological drawbacks. Notwithstanding recommendations to upgrade quality management and counter cognitive biases, the ontology of the trace and the very nature of forensic science amplified by its decision context is rarely invoked as sources of inescapable errors. Understanding what (forensic) science is could even reconcile the prescriptive approach and the descriptive cognitive reality, through an unexplored pathway, Peirce's semiotics. The implementation of a semiotic line of arguments could concur to the transparency of scientific opinions for security and justice purposes, with rich potentialities in sight.

Assessing physical fit examinations of stabbed and torn textiles through a large dataset of casework-like items and interlaboratory studies

Several organizations have outlined the need for standardized methods for conducting physical fit comparisons. This study answers this call by developing and evaluating a systematic and transparent approach for examining, documenting, and interpreting textile physical fits, using qualitative feature descriptors and a quantitative metric (Edge Similarity Score, ESS) for the physical fit examination of textile materials. Here, the results from 1027 textile physical fit comparisons are reported. This includes the evaluation of inter and intraanalyst variation when using this method for hand-torn and stabbed fabrics. ESS higher than 80% and ESS lower than 20%, respectively, support fit and nonfit conclusions. The results show that analyst accuracy ranges from 88% to 100% when using this criterion. The estimated false-positive rate for this dataset (2% false positives, 10 of 477 true nonfit pairs) demonstrates the importance of assessing the quality of a physical fit during an examination and reveals that potential errors are low, but possible in textile physical fit examinations. The risk of error must be accounted for in the interpretation and verification processes. Further analysis shows that factors such as the separation method, construction, and design of the samples do not substantially influence the ESS values. Additionally, the proposed method is independently evaluated by 15 practitioners in an interlaboratory exercise that demonstrates satisfactory reproducibility between participants. The standardized terminology and documentation criteria are the first steps toward validating approaches to streamline the peer review process, minimize bias and subjectivity, and convey the probative value of the evidence.

Experimental results on data analysis algorithms for extracting and interpreting edge feature data for duct tape and textile physical fit examinations

A physical fit is an important observation that can result from the forensic analysis of trace evidence as it conveys a high degree of association between two items. However, physical fit examinations can be time-consuming, and potential bias from analysts may affect judgment. To overcome these shortcomings, a data analysis algorithm using mutual information and a decision tree has been developed to support practitioners in interpreting the evidence. We created these tools using data obtained from physical fit examinations of duct tape and textiles analyzed in previous studies, along with the reasoning behind the analysts' decisions. The relative feature importance is described by material type, enhancing the knowledge base in this field. Compared with the human analysis, the algorithms provided accuracies above 90%, with an improved rate of true positives for most duct tape subsets. Conversely, false positives were observed in high-quality scissor cut (HQ-HT-S) duct tape and textiles. As such, it is advised to use these algorithms in tandem with human analysis. Furthermore, the study evaluated the accuracy of physical fits when only partial sample lengths are available. The results of this investigation indicated that acceptable accuracies for correctly identifying true fits and non-fits occurred when at least 35% of a sample length was present. However, lower accuracies were observed for samples prone to stretching or distortion. Therefore, the models described here can provide a valuable supplementary tool but should not be the sole means of evaluating samples.

Experts' decision-making processes in Swedish forensic psychiatric investigations: A case vignette study

It has previously been demonstrated that decisions made by forensic experts can suffer from issues with both bias and poor reliability. The outcome of Swedish forensic psychiatric investigations can have a major impact on the courts' choice of sanction for a mentally disordered offender. These investigations are performed by multi-professional teams of experts, where each expert is obliged to state their opinion on whether the client has a severe mental disorder (SMD) or not. In the present study, a case vignette design was used to simulate the decision-making process of forensic psychiatric investigations. Of the 73 Swedish experts working with forensic psychiatric investigations, a total of 27 (37%) participated in the study. The results showed that the Swedish experts formulated multiple diagnostic hypotheses about cases throughout the process and revised these hypotheses when presented with new information. There was substantial variation between the experts in which hypotheses were seen as most relevant. While the experts grew more certain of their opinions on SMD during the simulated investigation, there was considerable variation in their opinions both throughout and at the end of the process. Although low statistical power and the sample not being randomized limit generalizations, the results indicate no idiosyncratic patterns in the decision-making processes of Swedish experts or signs of confirmation bias. If used properly, the variation in both process and outcome could be used to safeguard and possibly increase the reliability and validity of the final decision of Swedish forensic psychiatric investigations.

The most consistent finding in forensic science is inconsistency

The most consistent finding in many forensic science domains is inconsistency (i.e., lack of reliability, reproducibility, repeatability, and replicability). The lack of consistency is a major problem, both from a scientific and a criminal justice point of view. Examining forensic conclusion data, from across many forensic domains, highlights the underlying cognitive issues and offers a better understanding of the issues and challenges. Such insights enable the development of ways to minimize these inconsistencies and move forward. The aim is to highlight the problem, so that it can be minimized and the reliability of forensic science evidence can be improved.

Shifting decision thresholds can undermine the probative value and legal utility of forensic pattern-matching evidence

Forensic pattern analysis requires examiners to compare the patterns of items such as fingerprints or tool marks to assess whether they have a common source. This article uses signal detection theory to model examiners' reported conclusions (e.g., identification, inconclusive, or exclusion), focusing on the connection between the examiner's decision threshold and the probative value of the forensic evidence. It uses a Bayesian network model to explore how shifts in decision thresholds may affect rates and ratios of true and false convictions in a hypothetical legal system. It demonstrates that small shifts in decision thresholds, which may arise from contextual bias, can dramatically affect the value of forensic pattern-matching evidence and its utility in the legal system.

Cognitive bias in pathology, as exemplified in dermatopathology

Cognitive bias refers to human thinking patterns, as well as pitfalls, that are reproducible. Importantly, cognitive bias is not intentionally discriminatory and is necessary to properly interpret the world around us, including microscopic slides. Thus, it is a useful exercise to examine cognitive bias in pathology, as exemplified in dermatopathology.

The interpretation of forensic conclusions by professionals and students: Does experience matter?

Are professionals better at assessing the evidential strength of different types of forensic conclusions compared to students? In an online questionnaire 96 crime investigation and law students, and 269 crime investigation and legal professionals assessed three fingerprint examination reports. All reports were similar, except for the conclusion part which was stated in a categorical (CAT), verbal likelihood ratio (VLR) or numerical likelihood ratio (NLR) conclusion with high or low evidential strength. The results showed no significant difference between the groups of students and professionals in their assessment of the conclusions. They all overestimated the strength of the strong CAT conclusion compared to the other conclusion types and underestimated the strength of the weak CAT conclusion. Their background (legal vs. crime investigation) did have a significant effect on their understanding. Whereas the legal professionals performed better compared to the crime investigators, the legal students performed worse compared to crime investigation students.

Toward Personalized Medicine Approaches for Parkinson Disease Using Digital Technologies

Parkinson disease (PD) is a complex neurodegenerative disorder that afflicts over 10 million people worldwide, resulting in debilitating motor and cognitive impairment. In the United States alone (with approximately 1 million cases), the economic burden for treating and caring for persons with PD exceeds US $50 billion and myriad therapeutic approaches are under development, including both symptomatic- and disease-modifying agents. The challenges presented in addressing PD are compounded by observations that numerous, statistically distinct patient phenotypes present with a wide variety of motor and nonmotor symptomatic profiles, varying responses to current standard-of-care symptom-alleviating medications (L-DOPA and dopaminergic agonists), and different disease trajectories. The existence of these differing phenotypes highlights the opportunities in personalized approaches to symptom management and disease control. The prodromal period of PD can span across several decades, allowing the potential to leverage the unique array of composite symptoms presented to trigger early interventions. This may be especially beneficial as disease progression in PD (alongside Alzheimer disease and Huntington disease) may be influenced by biological processes such as oxidative stress, offering the potential for individual lifestyle factors to be tailored to delay disease onset. In this viewpoint, we offer potential scenarios where emerging diagnostic and monitoring strategies might be tailored to the individual patient under the tenets of P4 medicine (predict, prevent, personalize, and participate). These approaches may be especially relevant as the causative factors and biochemical pathways responsible for the observed neurodegeneration in patients with PD remain areas of fluid debate. The numerous observational patient cohorts established globally offer an excellent opportunity to test and refine approaches to detect, characterize, control, modify the course, and ultimately stop progression of this debilitating disease. Such approaches may also help development of parallel interventive strategies in other diseases such as Alzheimer disease and Huntington disease, which share common traits and etiologies with PD. In this overview, we highlight near-term opportunities to apply P4 medicine principles for patients with PD and introduce the concept of composite orthogonal patient monitoring.

Millennia of legal content criteria of lies and truths: wisdom or common-sense folly?

Long before experimental psychology, religious writers, orators, and playwrights described examples of lie detection based on the verbal content of statements. Legal scholars collected evidence from individual cases and systematized them as "rules of evidence". Some of these resemble content cues used in contemporary research, while others point to working hypotheses worth exploring. To examine their potential validity, we re-analyzed data from a quasi-experimental study of 95 perjury cases. The outcomes support the fruitfulness of this approach. Travelling back in time searching for testable ideas about content cues to truth and deception may be worthwhile.

Teaching old presumptive tests new digital tricks with computer vision for forensic applications

Presumptive (or 'spot') tests have served forensic scientists, law enforcement, and legal practitioners for over a hundred years. Yet, the intended design of such tests, enabling quick identification of drugs by-eye, also hides their full potential. Here, we report the development and application of time-resolved imaging methods of reactions attending spot tests for amphetamines, barbiturates, and benzodiazepines. Analysis of the reaction videos helps distinguish drugs within the same structural class that, by-eye, are judged to give the same qualitative spot test result. It is envisaged that application of these results will bridge the existing suite of field and lab-based confirmatory forensic tests, and support a broader range of colorimetric sensing technologies.

Reducing the impact of cognitive bias in decision making: Practical actions for forensic science practitioners

Previously published methods for reducing the impact of cognitive bias in forensic decision making have focused primarily on actions at the laboratory or organizational levels. This paper presents generalized and specific actions that forensic science practitioners can take to reduce the impact of cognitive bias in their work. Practical examples illustrating ways that practitioners can implement many of the specific actions are also provided, along with some suggestions for handling court testimony about cognitive bias. The actions presented in this paper provide a means through which individual practitioners can take ownership for minimizing cognitive bias in their work. Such actions can provide supporting evidence to stakeholders that forensic practitioners acknowledge the existence of cognitive bias and its potential influence on their work, and they can also stimulate implementation of methods that focus on solutions at the laboratory and organizational levels.

Forensic odontology: Wrong convictions, "bad apples" and "the innocence files"

Forensic odontology (FO) provides expert testimony; however, new criticism has identified FO as one of the fields that must strengthen its scientific foundations. The recent Netflix documentary titled "The Innocence Files", featuring wrongful convictions, dedicates three of its nine episodes almost exclusively to bite mark identification (BMI), one of the most questioned tests performed by FO. Although most of the FO fields have an undoubted utility in forensic and juridical context, only BMI has been questioned in recent years; the derogatory expression "Junk science" is used continuously in the documentary almost as a synonym for FO. We present a scoping review of cases reported in the US National Registry of Exonerations in which FO was false or misleading forensic evidence (F/MFE) leading to wrongful convictions. Although in the 26 cases identified the only declared F/MFE was the BMI (excluding any other type of dental expertise), only in 2 cases (7.69%) was F/MFE the sole contributing factor, and in 4 cases (15.38%) there was F/MFE plus three additional factors. Official misconduct was detected in 19 cases (73.08%) and perjury or false accusation in 16 cases (61.54%). It has already been mentioned how dangerous it is to consider FO as synonymous with "bite mark identification", or even to publicly provide incorrect or decontextualized information. This review shows that erroneous convictions have been exclusively in the field of BMI, and that FO encompasses much more than just BMI. The relationship between the media and forensic sciences has been strained. The perspective of the new culture of risk management in forensics is also discussed.

Associations between emotions and psychophysiological states and confirmation bias in question formulation in ongoing simulated investigative interviews of child sexual abuse

Introduction

In forensic settings interviewers are advised to ask as many open-ended questions as possible. However, even experts may have difficulty following this advice potentially negatively impacting an investigation. Here, we sought to investigate how emotions and psychophysiological parameters are associated with question formulation in real time in an ongoing (simulated) child sexual abuse (CSA) interview.

Method

In a experimental study, psychology students (N = 60, Mage = 22.75) conducted two interviews with child avatars, while their emotions (anger, sadness, disgust, surprise and relief), GSR and heart rate (HR) were registered.

Results

First, we found that general emotionality related to CSA and perceived realness of the avatars was associated with stronger overall emotional reactions. Second, we found that closed (vs. open) questions were preceded by more facially observable anger, but not disgust, sadness, surprise or relief. Third, closed (vs. open) questions were preceded by higher GSR resistance and lower heart rate.

Discussion

Results suggest for the first time that emotions and psychophysiological states can drive confirmation bias in question formulation in real time in CSA.

A comparative analysis of human and AI performance in forensic estimation of physical attributes

Human errors in criminal investigations have previously led to devastating miscarriages of justice. For example, flaws in forensic identification based on physical or photographic evidence are notoriously unreliable. The criminal justice system has, therefore, started to turn to artificial intelligence (AI) to improve the reliability and fairness of forensic identification. So as not to repeat history, it is critical to evaluate the appropriateness of deploying these new AI forensic tools. We assess the feasibility of measuring basic physical attributes in a photo using a state-of-the-art AI system, and compare performance with human experts and non-experts. Our results raise concerns as to the use of current AI-based forensic identification.

Wrongful convictions and claims of false or misleading forensic evidence

The results are reported of a study to examine case factors associated with 732 wrongful convictions classified by the National Registry of Exonerations as being associated with "False or Misleading Forensic Evidence." A forensic error typology has been developed to provide a structure for the categorization and coding of factors relating to misstatements in forensic science reports; errors of individualization or classification; testimony errors; issues relating to trials and officers of the court; and evidence handling and reporting issues. This study, which included the analysis of 1391 forensic examinations, demonstrates that most errors related to forensic evidence are not identification or classification errors by forensic scientists. When such errors are made, they are frequently associated with incompetent or fraudulent examiners, disciplines with an inadequate scientific foundation, or organizational deficiencies in training, management, governance, or resources. More often, forensic reports or testimony miscommunicate results, do not conform to established standards, or fail to provide appropriate limiting information. Just as importantly, actors within the broader criminal justice system-but not under the purview of any forensic science organization-may contribute to errors that may be related to the forensic evidence. System issues include reliance on presumptive tests without confirmation by a forensic laboratory, use of independent experts outside the administrative control of public laboratories, inadequate defense, and suppression or misrepresentation of forensic evidence by investigators or prosecutors. In approximately half of wrongful convictions analyzed, improved technology, testimony standards, or practice standards may have prevented a wrongful conviction at the time of trial.

Mind the gap: The challenges of sustainable forensic science service provision

Recent worldwide humanitarian and security efforts reflect the growth of forensic science as a global practice supporting peace, prosperity, and justice. While the dominance of the Global North in published research and public attention may suggest that this practice is universally well-developed, many Global South jurisdictions are at a stark disadvantage in resourcing and technological capabilities. Continued development of forensic science as an international endeavour requires a narrowing of inequalities between jurisdictions, in line with the United Nations Sustainable Development Goals. Here we propose a framework of principles for the sustainable provision of transparent, high-quality forensic services meeting jurisdictional needs and limitations. We illustrate how this concept of 'frugal forensics' can be applied in the context of latent fingermark detection in two Global South jurisdictions, and how quality assurance frameworks can be developed to support this service.

Measuring base-rate bias error in workplace safety investigators

INTRODUCTION

This study explored the magnitude of professional industrial investigators' bias to attribute cause to a person more readily than to situational factors (i.e., human error bias). Such biased opinions may relieve companies from responsibilities and liability, as well as compromise efficacy of suggested preventative measures.

METHOD

Professional investigators and undergraduate participants were given a summary of a workplace event and asked to allocate cause to the factors they found causal for the event. The summary was crafted to be objectively balanced in its implication of cause equally between two factors: a worker and a tire. Participants then rated their confidence and the objectivity of their judgment. We then conducted an effect size analysis, which supplemented the findings from our experiment with two previously published research studies that used the same event summary.

RESULTS

Professionals exhibited a human error bias, but nevertheless believed that they were objective and confident in their conclusions. The lay control group also showed this human error bias. These data, along with previous research data, revealed that, given the equivalent investigative circumstances, this bias was significantly larger with the professional investigators, with an effect size of d_unb = 0.97, than the control group with an effect size of only d_unb = 0.32.

CONCLUSIONS

The direction and strength of the human error bias can be quantified, and is shown to be larger in professional investigators compared to lay people.

PRACTICAL APPLICATIONS

Understanding the strength and direction of bias is a crucial step in mitigating the effects of the bias. The results of the current research demonstrate that mitigation strategies such as proper investigator training, a strong investigation culture, and standardized techniques, are potentially promising interventions to mitigate human error bias.

Assessing significant factors that can influence physical fit examinations - Part I. Physical fits of torn and cut duct tapes

This study expands upon a previously developed method that quantifies the similarity of the compared tape edges by systematically studying the effect of several separation methods and tape grades on the quality of a fit. Analysts examined more than 3300 pairs of hand-torn or scissor-cut duct tapes from three different tape grades while they were kept blind from the ground truth to minimize bias. The samples were examined following a three-step methodology: 1) qualitative assessment of the overall edge alignment and description of edge pattern, 2) macroscopic evaluation of the edges' features, 3) bin by bin subunit assessment of tape edges and estimation of the edge similarity score. A report template was designed to maintain records of the decision-making process. In the second and third steps, eight comparison features were defined and documented using auto-populated cell options. Generally, misidentification rates were low, with no false positives reported. Coinciding with previous research, low scores (under 20%) provided the most support for a non-fit conclusion, while high scores (80% or higher) supported a fit conclusion. A statistical analysis of the separation method and quality of tape revealed a potential interaction between these factors and showed that they significantly impact the edge scores for true fitting pairs, but not the true non-fits' scores. The developed comparison and documentation criteria can assist practitioners with a more straightforward, consistent, and transparent interpretation and reporting approach.

Experiment protocols for brain-body imaging of locomotion: A systematic review

Introduction

Human locomotion is affected by several factors, such as growth and aging, health conditions, and physical activity levels for maintaining overall health and well-being. Notably, impaired locomotion is a prevalent cause of disability, significantly impacting the quality of life of individuals. The uniqueness and high prevalence of human locomotion have led to a surge of research to develop experimental protocols for studying the brain substrates, muscle responses, and motion signatures associated with locomotion. However, from a technical perspective, reproducing locomotion experiments has been challenging due to the lack of standardized protocols and benchmarking tools, which impairs the evaluation of research quality and the validation of previous findings.

Methods

This paper addresses the challenges by conducting a systematic review of existing neuroimaging studies on human locomotion, focusing on the settings of experimental protocols, such as locomotion intensity, duration, distance, adopted brain imaging technologies, and corresponding brain activation patterns. Also, this study provides practical recommendations for future experiment protocols.

Results

The findings indicate that EEG is the preferred neuroimaging sensor for detecting brain activity patterns, compared to fMRI, fNIRS, and PET. Walking is the most studied human locomotion task, likely due to its fundamental nature and status as a reference task. In contrast, running has received little attention in research. Additionally, cycling on an ergometer at a speed of 60 rpm using fNIRS has provided some research basis. Dual-task walking tasks are typically used to observe changes in cognitive function. Moreover, research on locomotion has primarily focused on healthy individuals, as this is the scenario most closely resembling free-living activity in real-world environments.

Discussion

Finally, the paper outlines the standards and recommendations for setting up future experiment protocols based on the review findings. It discusses the impact of neurological and musculoskeletal factors, as well as the cognitive and locomotive demands, on the experiment design. It also considers the limitations imposed by the sensing techniques used, including the acceptable level of motion artifacts in brain-body imaging experiments and the effects of spatial and temporal resolutions on brain sensor performance. Additionally, various experiment protocol constraints that need to be addressed and analyzed are explained.

Cognitive bias in workplace investigation: Problems, perspectives and proposed solutions

Psychological research demonstrates how our perceptions and cognitions are affected by context, motivation, expectation, and experience. A mounting body of research has revealed the many sources of bias that affect the judgments of experts as they execute their work. Professionals in such fields as forensic science, intelligence analysis, criminal investigation, medical and judicial decision-making find themselves at an inflection point where past professional practices are being questioned and new approaches developed. Workplace investigation is a professional domain that is in many ways analogous to the aforementioned decision-making environments. Yet, workplace investigation is also unique, as the sources, magnitude, and direction of bias are specific to workplace environments. The workplace investigation literature does not comprehensively address the many ways that the workings of honest investigators' minds may be biased when collecting evidence and/or rendering judgments; nor does the literature offer a set of strategies to address such happenings. The current paper is the first to offer a comprehensive overview of the important issue of cognitive bias in workplace investigation. In it I discuss the abilities and limitations of human cognition, provide a framework of sources of bias, as well as, offer suggestions for bias mitigation in the investigation process.

Contextual information in medicolegal death investigation decision-making: Manner of death determination for cases of a single gunshot wound

To explore the role of contextual information in determining manner of death, four cases involving single gunshot wounds were presented to participants (n = 252) involved in medicolegal death investigation. The participants received identical autopsy information but different contextual information. The data demonstrated that participants tended to rely on contextual information more than autopsy information: In the suicide context, participants across the four cases reached 153 final decisions of suicide (and 25 of homicide), whereas in the homicide context, participants reached only 10 final decisions of suicide (and 181 of homicide) --all while examining identical autopsy information. The impact of the contextual information was so powerful that many participants changed initial autopsy-based conclusions to align with the contextual information. Given the significant role and impact that contextual information has on expert decision making, one must consider what, how, and when contextual information should be used.

Break the Cycle of Collusion: Simulation to Influence Mechanism of Cognitive Bias on To-Collude Decision Making

Collusion is an all-pervading illegal market behavior that can undermine the sustainable development of the construction industry. It is acknowledged that collusive bidding decision making is influenced by conspirators’ cognitive bias. Nevertheless, the understanding of such an influence mechanism remains vague in the literature. This study aims to examine the mechanism of conspirators’ to-collude decision making by establishing a system dynamic model. The model development is based on the theories of cognitive biases, collusive bidding, and complex adaptive system. Multiple scenarios were simulated in the context of the Chinese construction industry. Three most influential cognitive bias are overconfidence, the illusion of control, and cognitive dissonance. The simulation results reveal conspirators’ intrinsic mechanisms to decide whether they deserve to participate in collusive bidding. The evolution of to-collude decision making is characterized by nonlinearity, multiplier, and stimulus enhancement effects. Collusion motivation and enterprise network relationships expand conspirators’ to-collude decision making. The increase of government regulation intensity and enterprise performance inhibit conspirators’ to-collude decision making. This study provides an insight into the cycle of collusion emergence from a complex system perspective and implies that antitrust authorities can launch carrot-and-stick measures for better regulation.

Sources of bias in death determination: A research note articulating the need to include systemic sources of biases along with cognitive ones as impacting mortality data

There are structural and organizational factors that impact how and what mortality data are collected. There are individual decision-making processes and implicit cognitive biases that influence how and what mortality data are collected. Yet there seems to be a disconnect between how and why these two broad sources of bias may collide and how both need to be understood in order to be able to approach solutions aimed at strengthening the accuracy of mortality data. Using results from a mixed-method, long-term research project at four medicolegal offices in two countries, France and the United States, this research note proposes that truly understanding the sources of implicit cognitive bias in forensic pathologists and other medicolegal actors requires knowledge of legal, cultural, and organizational structures that shape medicolegal systems and in turn constrain individual actors' decision-making processes. The goal is to advocate for multilevel and multi-methods approaches to propose systemic solutions to the issue of implicit cognitive biases in forensic pathologists and other medicolegal actors' decision-making processes. For this purpose, the author outlines a series of specific issues to be integrated in future research.

See Change: Overcoming Anti-Black Racism in Health Systems

Anti-Black racism embedded in contemporary health systems harms Black and Indigenous People of Color (BIPoC) in concert with various diseases. Seemingly unrelated at first, the COVID-19 pandemic is a recent example that reveals how the combined manifestations of anti-Black racism in disease governance, course, and burden exacerbate the historic and still present subjugation of Black people. Thus, such conditions highlight a biosocial network that intricately propagates and consolidates systems of oppression since the birth of the United States of America. In this article, we show how anti-Black racism in conjunction with past and ongoing epidemics exemplify intertwined conditions embodying and perpetuating racial inequities in the North American country. Through schematic visualizations and techniques of progressive disclosure, we situate disease governance, course, and burden as action spaces within a design model that alternates views of organizational strategies, operations, offerings, and people's experiences, supporting an action-oriented discussion in each of these spaces. We utilize insights from this analysis to recommend that public health moves forward, considering more holistic, solution-oriented questions that embrace systemic complexity and people-centered perspectives when seeking to improve health outcomes for all.

The Current State of Subjective Training Load Monitoring: Follow-Up and Future Directions

This article addresses several key issues that have been raised related to subjective training load (TL) monitoring. These key issues include how TL is calculated if subjective TL can be used to model sports performance and where subjective TL monitoring fits into an overall decision-making framework for practitioners. Regarding how TL is calculated, there is conjecture over the most appropriate (1) acute and chronic period lengths, (2) smoothing methods for TL data and (3) change in TL measures (e.g., training stress balance (TSB), differential load, acute-to-chronic workload ratio). Variable selection procedures with measures of model-fit, like the Akaike Information Criterion, are suggested as a potential answer to these calculation issues with examples provided using datasets from two different groups of elite athletes prior to and during competition at the 2016 Olympic Games. Regarding using subjective TL to model sports performance, further examples using linear mixed models and the previously mentioned datasets are provided to illustrate possible practical interpretations of model results for coaches (e.g., ensuring TSB increases during a taper for improved performance). An overall decision-making framework for determining training interventions is also provided with context given to where subjective TL measures may fit within this framework and the determination if subjective measures are needed with TL monitoring for different sporting situations. Lastly, relevant practical recommendations (e.g., using validated scales and training coaches and athletes in their use) are provided to ensure subjective TL monitoring is used as effectively as possible along with recommendations for future research.

A practical tool for information management in forensic decisions: Using Linear Sequential Unmasking-Expanded (LSU-E) in casework

Forensic analysts often receive information from a multitude of sources. Empirical work clearly demonstrates that biasing information can affect analysts' decisions, and that the order in which task-relevant information is received impacts human cognition and decision-making. Linear Sequential Unmasking (LSU; Dror et al., 2015) and LSU-Expanded (LSU-E; Dror & Kukucka, 2021) are examples of research-based procedural frameworks to guide laboratories' and analysts' consideration and evaluation of case information. These frameworks identify parameters—such as objectivity, relevance, and biasing power—to prioritize and optimally sequence information for forensic analyses. Moreover, the LSU-E framework can be practically incorporated into any forensic discipline to improve decision quality by increasing the repeatability, reproducibility, and transparency of forensic analysts’ decisions, as well as reduce bias. Future implementation of LSU and LSU-E in actual forensic casework can be facilitated by concrete guidance. We present here a practical worksheet designed to bridge the gap between research and practice by facilitating the implementation of LSU-E.

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Contextual information can influence how forensic analysts perceive, interpret, and evaluate evidence.

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Proper information sequencing can reduce bias and improve the repeatability and reproducibility of forensic decisions.

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Linear Sequential Unmasking–Expanded (LSU-E) prioritizes objective, relevant, and non-suggestive information.

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To close the gap between research and practice, we developed a worksheet to help laboratories and analysts implement LSU-E.

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This worksheet aims to optimize information sequencing and promote transparency in forensic decisions.

Public R&D Projects-Based Investment and Collaboration Framework for an Overarching South Korean National Strategy of Personalized Medicine

Since the South Korean government designated personalized medicine (PM) as a national strategic task in 2016, it has spared no investment to achieve its goals, which were recently accelerated by the COVID-19 pandemic. This study analyzed investment trends in 17 regions and eight technology clusters related to PM, consisting of 5727 public R&D projects worth USD 148.5 million, from 2015 to 2020. We also illustrated the level of investment for different PM-related technology clusters in each region; various research organizations explicitly verified comparable innovation capabilities for all eight technology fields in 17 regions, showing individual differences in technology areas per region. Our framework provided information to allow implementation of two goals: administering successful PM and improving regional equality in public health and healthcare according to technical and organizational levels. This study empirically demonstrates that it can provide a precise overarching innovation scheme with regional, technical, and organizational dimensions to establish collaboration among different stakeholders, thereby creating a foundation for an overarching national PM strategy.

The logic of forensic pathology opinion

Evaluating evidence and providing opinions are at the heart of forensic science, and forensic experts are expected to provide opinions that are based on logically sound and transparent scientific reasoning, and that honour the boundaries of their area of expertise. In order to meet these objectives, many fields of science explicitly apply Bayes' theorem, which describes the logically correct way to update probabilities on the basis of observations. Making a distinction between 'investigative' and evaluative' modes of operating helps to implement the theorem into daily casework. Use of these principles promotes the logic and transparency of the reasoning that leads to expert's opinion and helps the expert to stay within her remit. Despite these important benefits, forensic pathology seems slow to adopt these principles. In this article, we explore this issue and suggest a way forward. We start with a short introduction to Bayes' theorem and its benefits, followed by a discussion of why its application is actually second nature to medical practitioners. We then discuss the difference between investigative and evaluative opinions, and how they enable the forensic pathologist to reconcile Bayes' theorem with the different phases of a forensic investigation. Throughout the text, practical examples illustrate the various ways in which the logically correct way of evidence interpretation can be implemented, and how it may help the forensic pathologist to provide an appropriate and relevant opinion.

Decision-Making Within Forensic Psychiatric Investigations: The Use of Various Information Sources by Different Expert Groups to Reach Conclusions on Legal Insanity

BACKGROUND

Which type of information experts use to make decisions regarding legal insanity within forensic psychiatric investigations (FPI) is relatively unknown, both in general and when considering variations due to case context. It is important to explore this area to be able to counteract the effects of various kinds of cognitive bias.

METHOD

The aim was to explore whether FPI expert groups differed regarding case-specific as well as general use of information types required to make decisions on severe mental disorder (SMD). Three FPI case vignettes were presented to three professional groups involved in FPIs in Sweden (n = 41): forensic psychiatrists (n = 15), psychologists (n = 15), and social workers (n = 11). The participants reported which types of information they required to reach conclusions regarding SMD in each case. They also reported which types of information they had used within general FPI praxis during the previous year and the information types' perceived usefulness.

RESULTS

The expert groups differed somewhat regarding what type of information they required for the cases (e.g., results from cognitive testing), but some information was required in all cases (e.g., client's self-report). Regarding the preliminary assessment of SMD in the three cases, minor differences were found. Within the general FPI praxis, experts reported using several information types, while the general perceived usefulness of these sources varied.

DISCUSSION

The professional groups relied partly on a "core" of information sources, but some case-specific adaptations were found. The professional groups' inclination to suspect SMD also varied somewhat. This indicates a need to explore the potential consequences of these similarities and differences.

The decision-making process in Swedish forensic psychiatric investigations

Forensic psychiatric investigations in Sweden can have a major impact on the choice of sentence in criminal cases. Previous research shows that the decisions in several forensic fields, including forensic psychiatry, can be affected in a negative way by factors not relevant to the case. In the present study, the decision-making process of forensic psychiatric investigations was explored by using semi-structured interviews with experts (n = 38) and analyzing these interviews thematically. The results showed that the decision-making process is both complex and iterative, where the experts use and shape a substantial amount of information to reach their decisions. The experts work in teams, which add both benefits and risks to the process, and feel that particularly time constraints may reduce the quality of their decisions. In summary, the decision-making process of Swedish forensic psychiatric investigations creates a potential for high validity, but also contains risks for bias effects that could warrant further mitigation.

Human and machine similarity judgments in forensic firearm comparisons

It is unclear whether humans assess similarity differently than automated algorithms in firearms comparisons. Human participants (untrained in firearm examination) were asked to assess the similarity of pairs of images (from 0 to 100). A sample of 40 pairs of cartridge casing 2D-images was used. The images were divided into 4 groups according to their similarity as determined by an algorithm. Humans were able to distinguish between matches and non-matches (both when shown the 2 middle groups, as well as when shown all 4 groups). Thus, humans are able to make high-quality similarity judgments in firearm comparisons based on two images. The humans' similarity scores were superior to the algorithms' scores at distinguishing matches and non-matches, but inferior in assessing similarity within groups. This suggests that humans do not have the same group thresholds as the algorithm, and that a hybrid human-machine approach could provide better identification results than humans or algorithms alone.

Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study

Ultrasound (US) has an emerging evidence base for the assessment of swallowing and laryngeal function. Accessibility and technological advances support the use of US as a clinical assessment tool; however, there is insufficient evidence to support its translation into clinical practice. This study aimed to establish consensus on the priorities for translation of US into clinical practice for the assessment of swallowing and laryngeal function. Nominal Group Technique (NGT) was used as a formal method of consensus development. Clinicians and academics, all members of an international US working group, were invited to participate in the study. Two NGT meetings were held, where participants silently generated and then shared ideas. Participants anonymously ranked items. Rankings were aggregated before participants re-ranked items in order of priority. Discussions regarding rankings were recorded and transcribed to inform analysis. Member-checking with participants informed the final analysis. Participants (n = 15) were speech and language pathologists, physiotherapists and sonographers representing six countries. Fifteen items were identified and prioritised 1-13 (including two equally ranked items). Reliability, validity and normative data emerged as key areas for research while development of training protocols and engagement with stakeholders were considered vital to progressing US into practice. Analysis revealed common themes that might be addressed together in research, in addition to the ranked priority. A measured approach to the translation of US into clinical practice will enable effective implementation of this tool. Priorities may evolve as clinical and professional contexts shift, but this study provides a framework to advance research and clinical practice in this field.

Challenges to reasoning in forensic science decisions

The success of forensic science depends heavily on human reasoning abilities. Although we typically navigate our lives well using those abilities, decades of psychological science research shows that human reasoning is not always rational. In addition, forensic science often demands that its practitioners reason in non-natural ways. This article addresses how characteristics of human reasoning (either specific to an individual or in general) and characteristics of situations (either specific to a case or in general in a lab) can contribute to errors before, during, or after forensic analyses. In feature comparison judgments, such as fingerprints or firearms, a main challenge is to avoid biases from extraneous knowledge or arising from the comparison method itself. In causal and process judgments, for example fire scenes or pathology, a main challenge is to keep multiple potential hypotheses open as the investigation continues. Considering the contributions to forensic science judgments by persons, situations, and their interaction, reveals ways to develop procedures to decrease errors and improve accuracy.