Table 2 TWED checklist and the cognitive errors addressed

T = life or limb Threat (What are the life or limb threatening conditions in this patient?)

Cognitive errors due to failure to consider alternative diagnoses (worst-case scenarios)

This domain encapsulates the rule-out-worse-case scenarios (ROWS) heuristics as a form of cognitive forcing strategy

W = Wrong? (What if I am wrong? What else could it be?)

Cognitive errors due to overattachment to a particular diagnosis and cognitive errors due to failure to consider alternative diagnoses

This domain is to reduce the risk of committing cognitive errors such as search satisficing, anchoring, confirmation, availability biases, etc.

E = evidences (Do I have sufficient evidences for or against this diagnose?)

Cognitive errors due to inheriting someone else’s thinking and cognitive errors due to erroneous estimation or perception of prevalence

This domain is to minimize cognitive errors such as anchoring, confirmation bias, blind spot, myside bias, ego bias, etc.

D = dispositional factors (What are the environmental & emotional (2es) dispositions influencing my decision?)

Environment influences are not explicitly listed as one of the categories but discussed in this paper as error-producing conditions (EPC). These are high-pressured conditions that often exist by necessity, but are prone to cognitive errors because of the expectation to shorten the decision making process

These are the factors that may increase the risk of committing cognitive errors. These can be further divided into 2 ‘E’s: the environmental factors—e.g., chaotic, busy working place; and the ‘emotional factors’. These emotional factors can come from the physician or from the patient