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均衡统治者:一项关于外科医生对手术价值判断的全国调查
Karlie L Zychowski1, Lily N Stalter1, Bethany M Erb1
1Department of Surgery, University of Wisconsin, Madison, WI.
Annals of surgery
|February 8, 2024
概括
手术价值的专业规范存在于连续性上,在外科医生看到同行意见后,共识会得到改善. 这影响了外科手术决策和患者护理.
科学领域:
- 医学伦理 医学伦理
- 在外科手术实践中.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 专业规范可以通过澄清治疗价值来加强外科手术决策.
- 美国外科医生中这种规范的普遍性仍然未得到量化.
研究的目的:
- 调查实践外科医生之间关于手术干预价值的专业规范的存在和性质.
- 确定影响外科医生对特定外科手术程序有用性的判断的因素.
主要方法:
- 对外科医生进行了一项调查,评估了30个手术病例,从"绝对可以"到"绝对不会"的比例.
- 外科医生在初步反应后重新评估病例,采访探讨了他们的推理.
- 分析了响应率和共识水平,以及基于人口和专业的变化.
主要成果:
- 在30个案例中,外科医生在19个案例中就手术的价值达成共识 (≥60%的同意).
- 对同行评价的接触增加了共识,特别是当最初的判断有所不同时.
- 性别和外科专业影响了决策;女性喜欢高死亡率病例的非手术方法,而专家们不太倾向于救援手术.
结论:
- 外科医生对手术价值的看法形成了一个范围,在高度有益的程序上有更大的共识.
- 同行比较有效地提高了对手术价值的共识.
- 外科医生经常将最终的判断推迟到患者身上,尽管他们已经形成了个人评估.
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