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David D. Woods, PhD; Richard I. Cook, MD
The Ohio State University Department of Industrial and Systems Engineering Columbus

JAMA. 1991;266(6):793-794.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Caplan et al¹ showed an outcome bias in physician evaluations of patient care. In research on error, it is critical to distinguish outcome failures from deficiencies or defects in the decision-making or problem-solving process.

Not all defects in decision processes are associated with bad outcomes; other factors may be necessary for the defect to propagate along a chain of negative consequences.² Conversely, bad outcomes can occur despite good decisions, ie, despite complete and thorough consideration of all of the available information, goals, and contributing factors.³ Appreciating this fundamental aspect of human decision behavior is critical for

Guidelines for Letters

Letters will be published at the discretion of the editor as space permits and subject to editing and abridgment. They should be typewritten double-spaced and submitted in duplicate. They should not exceed 500 words of text. References, if any, should be held to a minimum, . . . [Full Text PDF of this Article]

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