{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:00Z","timestamp":1783509300533,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Given that excess opioid prescriptions contribute to the US opioid epidemic and there are few national opioid-prescribing guidelines for the management of acute pain, it is pertinent to determine whether prescribers can sufficiently assess their own prescribing practice. We investigated podiatric surgeons\u2019 ability to evaluate whether their own opioid-prescribing practice is less than, near, or above that of an \u201caverage\u201d prescriber.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We administered a scenario-based, voluntary, anonymous, online questionnaire consisting of five surgery-based scenarios commonly performed by podiatric surgeons. Respondents were asked the quantity of opioids they would prescribe at the time of surgery. Respondents were also asked to rate their prescribing practice compared with the average (median) podiatric surgeon. We compared self-reported behavior to self-reported perception (\u201cI prescribe less than average,\u201d \u201cI prescribed about average,\u201d and \u201cI prescribe more than average\u201d). Analysis of variance was used for univariate analysis among the three groups. We used linear regression to adjust for confounders. Data restriction was used to account for restrictive state laws.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    One hundred fifteen podiatric surgeons completed the survey in April 2020. Less than half of the time, respondents accurately identified their own category. Consequently, there were no statistically significant differences among podiatric surgeons who reported that they \u201cprescribe less,\u201d \u201cprescribe about average,\u201d and \u201cprescribe more.\u201d Paradoxically, there was a flip in scenario 5: respondents who reported they \u201cprescribe more\u201d actually prescribed the least and respondents who believed they \u201cprescribe less\u201d actually prescribed the most.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Cognitive bias, in the form of a novel effect, occurs in postoperative opioid-prescribing practice; in the absence of procedure-specific guidelines or an objective standard, podiatric surgeons, more often than not, were unaware of how their own opioid-prescribing practice measured up to that of other podiatric surgeons.\n                  <\/jats:p>","DOI":"10.7547\/21-215","type":"journal-article","created":{"date-parts":[[2022,4,28]],"date-time":"2022-04-28T11:15:25Z","timestamp":1651144525000},"source":"Crossref","is-referenced-by-count":3,"title":["Cognitive Bias in Postoperative Opioid-Prescribing Practice"],"prefix":"10.3390","volume":"113","author":[{"given":"Bradley M.","family":"Brooks","sequence":"first","affiliation":[{"name":"University of South Alabama Health, Mobile, AL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Ding","family":"Shih","sequence":"additional","affiliation":[{"name":"California School of Podiatric Medicine at Samuel Merritt University, Oakland, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reed W. R.","family":"Bratches","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison S.","family":"Arp","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard J.","family":"Coughlin","sequence":"additional","affiliation":[{"name":"California School of Podiatric Medicine at Samuel Merritt University, Oakland, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina B.","family":"Wolff","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon M.","family":"Brooks","sequence":"additional","affiliation":[{"name":"The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH."},{"name":"William Jennings Bryan Dorn Veterans Affairs Medical Center, Columbia, SC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"MMWR Morb Mortal Wkly Rep","first-page":"202","article-title":"Trends and geographic patterns in drug and synthetic opioid overdose deaths\u2014United States, 2013\u20132019","volume":"70","author":"Mattson CL","year":"2021","unstructured":"Mattson CL: Trends and geographic patterns in drug and synthetic opioid overdose deaths\u2014United States, 2013\u20132019. MMWR Morb Mortal Wkly Rep 70: 202, 2021."},{"key":"B2","series-title":"Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health","year":"2020","unstructured":"Substance Abuse and Mental Health Services Administration: Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD, 2020. 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Arthrosc Sports Med Rehabil 2: e481, 2020."},{"key":"B11","series-title":"J Surg Educ","first-page":"413","article-title":"Targeted intervention to increase awareness of opioid overprescribing significantly reduces narcotic prescribing within an academic orthopaedic practice","volume":"77","author":"King C","year":"2020","unstructured":"King C, Curran J, Devanagondi S, : Targeted intervention to increase awareness of opioid overprescribing significantly reduces narcotic prescribing within an academic orthopaedic practice. J Surg Educ 77: 413, 2020."},{"key":"B12","series-title":"Ann Surg","first-page":"457","article-title":"Results of a prospective, multicenter initiative aimed at developing opioid-prescribing guidelines after surgery","volume":"268","author":"Thiels CA","year":"2018","unstructured":"Thiels CA, Ubl DS, Yost KJ, : Results of a prospective, multicenter initiative aimed at developing opioid-prescribing guidelines after surgery. 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BMJ 330: 781, 2005."},{"key":"B15","series-title":"Br J Clin Pharmacol","first-page":"310","article-title":"Exploring the causes of junior doctors\u2019 prescribing mistakes: a qualitative study","volume":"78","author":"Lewis PJ","year":"2014","unstructured":"Lewis PJ, Ashcroft DM, Dornan T, : Exploring the causes of junior doctors\u2019 prescribing mistakes: a qualitative study. Br J Clin Pharmacol 78: 310, 2014."},{"key":"B16","series-title":"J Psychiatr Pract","first-page":"15","article-title":"Biases in medication prescribing: the case of second-generation antipsychotics","volume":"16","author":"Makhinson M","year":"2010","unstructured":"Makhinson M: Biases in medication prescribing: the case of second-generation antipsychotics. J Psychiatr Pract 16: 15, 2010."},{"key":"B17","series-title":"JAC Antimicrob Resist","first-page":"dlaa107","article-title":"Cognitive bias: how understanding its impact on antibiotic prescribing decisions can help advance antimicrobial stewardship","volume":"2","author":"Langford BJ","year":"2020","unstructured":"Langford BJ, Daneman N, Leung V, : Cognitive bias: how understanding its impact on antibiotic prescribing decisions can help advance antimicrobial stewardship. JAC Antimicrob Resist 2: dlaa107, 2020."},{"key":"B18","series-title":"J Pers Soc Psychol","first-page":"1121","article-title":"Unskilled and unaware of it: how difficulties in recognizing one\u2019s own incompetence lead to inflated self-assessments","volume":"77","author":"Kruger J","year":"1999","unstructured":"Kruger J, Dunning D: Unskilled and unaware of it: how difficulties in recognizing one\u2019s own incompetence lead to inflated self-assessments. 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