治疗决策中的后期偏见
Donald A Redelmeier1,2,3,4,5, Eldar Shafir6,7
1Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
JAMA network open
|September 4, 2024
概括
在可疑的治疗方法后,一小部分症状改善会鼓励继续使用,即使在无效的情况下. 这种后期偏见可能会导致自满,并阻碍有效的医疗保健选择.
科学领域:
- 认知心理学 认知心理学
- 医疗服务研究 医疗服务研究
- 临床决策的过程
背景情况:
- 持续的无效治疗可以导致自满,阻止寻找替代方案,并导致护理短缺.
- 了解治疗延续方面的偏见对于改善医疗保健结果至关重要.
研究的目的:
- 调查后期偏差,在一个可疑的治疗后边际症状改善影响继续使用.
- 评估这种偏见是否影响社区成员和医疗保健专业人员.
主要方法:
- 通过在线和面对面的调查,向社区成员和药剂师展示了假设的患者场景.
- 受访者被随机分配到症状稍微改善或在可疑的治疗后保持不变的版本.
- 测量的主要结果是继续治疗的建议.
主要成果:
- 与会者更有可能建议继续使用可疑的治疗方法 (抗生素,铜手,维生素B12),当症状显示微小的改善相比没有变化.
- 这种效应在多种场景中观察到,包括医疗保健专业人员.
- 继续治疗的几率比率从3.98到16.19不等,P值<.001.1.
结论:
- 在可疑的治疗后,边际症状的改善可能会导致它们的延续,这表明存在显著的后期偏差.
- 临床医生应该意识到这种偏见并警告患者,以防止使用无效和可能昂贵的治疗方法.
- 解决这种认知偏见对于促进基于证据的医疗保健和预防护理缺陷至关重要.
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