Health psychology/Cognitive biases · Clinical reasoning

Anchoring

What it means

Locking onto an initial diagnostic impression and failing to adjust it as new, discordant information arrives.

Worked example

Fixing on "ALL" in a child and dismissing the short stature and absent radius that point to Fanconi anaemia.

In the exam

A child is presented as classic leukaemia; the clinician settles on ALL and disregards the noted short stature and congenital radial anomaly that would have redirected the diagnosis.

What settles it

Anchoring is failing to REVISE from the first impression. Premature closure is stopping the workup too EARLY; confirmation bias is selectively gathering supporting evidence.

Classically confused with

Premature closure

Source: Croskerry; AAFP 2011