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在重症监护室的人类判断错误:关于偏见和噪音的观点
I P Peringa1, E G M Cox2,3, R Wiersema4
1Faculty of Behavioral and Social Sciences, Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands. i.p.peringa@rug.nl.
Critical care (London, England)
|February 25, 2025
概括
了解和减少临床决策中的随机错误或噪音对于改善重症监护室 (ICU) 患者的治疗结果至关重要. 使用算法和平均独立判断等策略可以减轻这种变化.
科学领域:
- 医疗决策的制定 医疗决策的制定
- 关键护理医学 关键护理医学
- 医疗保健中的人类因素
背景情况:
- 重症监护病房 (ICU) 涉及复杂的,高风险的临床判断,对患者的结果有重大影响.
- 人类判断错误,包括偏见 (系统错误) 和噪音 (随机错误),在重症监护机构中很普遍.
- 虽然偏见已被广泛研究,但噪音在临床决策中的作用和减轻需要进一步探索.
研究的目的:
- 研究噪音对重症监护室 (ICU) 临床判断准确性的影响.
- 探索在临床决策中减轻噪音的策略,以改善患者的治疗结果.
主要方法:
- 定义系统噪声及其组件:平面噪声,稳定模式噪声和偶发噪声.
- 确定减少噪音的策略,包括使用算法和平均独立判断.
主要成果:
- 系统噪声代表了临床判断中的不必要的变化,这些判断应该是一致的.
- 噪音源于临床医生平均判断的差异,对特定患者因素的反应,以及临床医生内部的随机变化.
- 算法和平均独立判断被提出为减少噪音的方法.
结论:
- 在临床决策中解决噪音对于提高重症监护的判断准确性至关重要.
- 实施有效的降噪策略可以减少错误并改善患者的治疗结果.
- 减少噪音最终提高了重症监护病房的护理质量.
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