Soru

A 42-year-old woman is evaluated in the emergency department for progressive shortness of breath and a dry cough over the past week. She has a history of poorly controlled asthma and obesity. Over the past month, the region has experienced unprecedented wildfires, and the evaluating physician has managed dozens of severe asthma exacerbations. Upon initial assessment, the physician notes bilateral wheezing, immediately diagnoses an asthma exacerbation, and prescribes systemic corticosteroids and continuous bronchodilator nebulization.

Two hours later, the patient's hypoxia worsens despite therapy. The physician returns to the bedside and specifically questions the patient about her recent compliance with home inhalers and whether she has been keeping her windows open at home. During this conversation, the physician disregards the patient's new complaint of sharp, right-sided pleuritic chest pain, attributing it to muscle strain from forceful coughing. A subsequent CT pulmonary angiogram, ordered by a different physician during shift change, reveals a large saddle pulmonary embolism.

Which of the following cognitive biases best explains the initial physician's persistent focus on an asthma exacerbation despite the patient's worsening clinical trajectory and new symptoms?