众筹一个诊断? 探索小组诊断的大小和类型的准确性:一项实验性研究
Jonathan Sherbino1, Matt Sibbald2, Geoffrey Norman3
1Department of Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada sherbino@mcmaster.ca.
BMJ quality & safety
|March 19, 2024
概括
与个人评估相比,组诊断可以提高诊断准确度. 然而,增加小组规模超过3个并没有进一步提高准确性,互动讨论也没有显示任何额外的好处.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 临床决策的过程
- 医疗保健研究的研究.
背景情况:
- 咨询过程在医学中是基本的,但小组诊断的有效性仍未得到充分研究.
- 这项研究解决了了解群体动态如何影响诊断准确性的差距.
研究的目的:
- 将个人诊断与群体诊断进行比较.
- 评估组大小 (3对6) 和组过程 (交互式对人工组) 对诊断准确性的影响.
主要方法:
- 36名内科/急诊医生通过视频会议,单独或分组 (n=3,n=6) 诊断出书面病例.
- 通过汇总个人数据进行比较,创建了人工组.
- 诊断准确度以正确诊断的存在和列出的诊断数量来衡量.
主要成果:
- 与个人诊断相比,组诊断显著提高了初级和差异诊断的准确性.
- 当从3个增加到6个时,没有观察到诊断准确度的显著改善.
- 交互式和人工组显示出相当的诊断准确度.
结论:
- 组诊断是提高临床诊断准确性的宝贵工具.
- 诊断的最佳群体规模似乎是三个人左右,较大的群体没有额外的好处.
- 交互式小组讨论在本研究的方法论中没有产生更高的诊断准确性.
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