Age-Related Cognitive Bias in the Assessment of Lateral Pinch Modulation by Occupational Therapists

Naama Karniel, Eden Shimon, Noam Gemer, Rotem Zivion, Sigal Portnoy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Cognitive bias may appear in occupational therapists’ interpretation of physical examinations. Since different strategies for decision making have been shown to reduce bias, its quantification is an essential first step towards awareness and bias reduction. Our aims: (1) quantify cognitive bias by testing the differences in occupational therapists’ assessment of lateral pinch force modulation between young and older adults, and between women and men; and (2) to test for a correlation between the tendency to bypass an intuitive response and the degree of cognitive bias. Methods: Occupational therapists (n = 37; age 40.3 ± 11.4 years) used a visual analogue scale to rate pre-recorded simulations of the digital output of lateral pinch modulation videos of different levels of abilities coupled with videos of young/old men/woman pressing the force sensor. They filled out the Cognitive Reflection Test and the Rational-Experiential Inventory-40. Results: Subjects showed higher bias towards old individuals compared to young ones (p < 0.001), but with no sex bias (p = 0.119). Rational ability correlated with cognitive bias of assessment of lateral pinch modulation in old individuals (r = 0.537, p < 0.001). Discussion: Occupational therapists might underestimate the physical abilities of older adults. Biased evaluation might cause assignment of redundant exercises and therefore loss of time, effort, and resources.

Original languageEnglish
Article number7747
Issue number18
StatePublished - Sep 2023
Externally publishedYes


  • Rational-Experiential Inventory-40
  • cognitive reflection test
  • occupational therapy


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