Availability Bias. The Angelina Jolie Effect
摘要
The availability bias occurs when individuals estimate the frequency, probability, or significance of an event based on how easily similar examples come to mind. This chapter illustrates the bias through the worldwide reaction to Angelina Jolie’s 2013 editorial describing her prophylactic bilateral mastectomy after testing positive for a BRCA1 mutation. Although the mutation is rare and alternative management strategies exist, the celebrity’s highly publicized experience triggered a cascade of emotional, social, and clinical responses: a sharp rise in genetic testing, increased rates of bilateral mastectomy even among women without the mutation, and widespread misconceptions about cancer risk. The chapter reviews the origins of availability bias, including foundational studies by Tversky, Kahneman, Slovic, and Schwarz, and explains how vivid, dramatic, or celebrity-related information disproportionately influences judgment. It also examines the collective effects of availability cascades and provides examples from surgical practice, where recent events, media reports, or personal experiences can distort diagnostic reasoning, treatment selection, and prognostic assessment. Finally, the chapter outlines strategies to mitigate this bias, emphasizing the importance of questioning first impressions, using base rates, seeking high-quality evidence, and deliberately examining whether recalled examples accurately represent true risks.