bias in meta-decisions
Bias affect the conceptualization of research questions, conduction of research, aggregating of evidence, publication, and the point of decision-making. A common bias affecting meta-decision’s process is cognitive bias. It is the systematic deviation of people’s thinking from rational thought. It affects how questions are asked, aims are determined, alternative decisions are developed, and whether there is rationalization in decision-making. Therefore, cognitive bias is negatively related to the quality of meta-decisions. Moreover, a type of cognitive bias is the outcome bias, wherein a decision is judged as a failure or responsible for one when it leads to undesirable consequences, even if the decision was considered as acceptable prior.37 This is different from hindsight bias, where a decision outcome seems inviable retrospectively. 38
Another relevant cognitive bias is confirmation bias, which is the tendency to search for, interpret, favor, and recall information in a way that confirms one’s prior personal beliefs/ hypotheses. Here, the process starts with a decision and not with a performance gap or need. Moreover, in searching for alternatives, only those matching the decision-maker’s agenda are sought, and the same applies when rationalizing choices based on the criteria if this stage is reached.
Political bias has an important influence on meta-decision processes. Although it is a very common influential factor, it may negatively affect decisions because it restricts and distorts information flow and draws decision-makers attention from patients, population, or institution goals to their own preferences and self-interests.39 It is noteworthy that a combination of these biases can occur.