{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:46:25Z","timestamp":1760150785938,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Actinic keratosis (AK) is a pre-cancerous skin condition caused by sun exposure. Number bias, a phenomenon that occurs when meaning other than numerical value is associated with numbers, may influence the reporting of AK removal. The present study aims to determine if number bias is affecting healthcare providers\u2019 documentation of patient-provider encounters. Methods: A single-center retrospective chart review of 1415 patients\u2019 charts was conducted at the University of Cincinnati Medical Center. To determine if there was a significant difference between even and odd-numbered AK removals reported, an exact binomial test was used. The frequency of removals per encounter was fitted to a zero-truncated negative binomial distribution to predict the number of removals expected. All data were analyzed with RStudio. Results: There were 741 odd and 549 even encounters. Odd removals were reported at a significantly greater frequency than even p &lt; 0.001. Age may be contributing to the observed number bias (p &lt; 0.001). One, two, and eight were reportedly removed more frequently, while nine, 13, and 14 were reportedly removed less frequently than expected, respectively. Conclusion: Number bias may be affecting clinicians\u2019 documentation of AK removal and should be investigated in other clinical settings.<\/jats:p>","DOI":"10.3390\/jcm13010202","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T06:18:13Z","timestamp":1703830693000},"page":"202","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Number Bias in Clinicians\u2019 Documentation of Actinic Keratosis Removal"],"prefix":"10.3390","volume":"13","author":[{"given":"Phillip G.","family":"Holovach","sequence":"first","affiliation":[{"name":"Medical School, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7822-0826","authenticated-orcid":false,"given":"Wei-Wen","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8679-3352","authenticated-orcid":false,"given":"Alan B.","family":"Fleischer","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.jaad.2012.09.052","article-title":"Prevalence and awareness of actinic keratosis: Barriers and opportunities","volume":"68","author":"Rosen","year":"2013","journal-title":"J. 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