当谨慎变得有害时:了解过度调查的心理学
1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Rheumatology Fellowship Program, Department of Rheumatic and Immunologic Diseases, Medical Specialty Institute, Cleveland Clinic, Cleveland, Ohio, USA.
The American journal of medicine
|October 17, 2025
概括
过度调查,订购太多的诊断测试,伤害患者,增加成本而没有改善护理. 解决这一问题需要专注于临床推理,共享决策和系统性改革,以合理使用测试.
科学领域:
- 医学实践 医学实践
- 卫生经济学 卫生经济学
- 患者安全 患者安全
背景情况:
- 过度调查,在伤害超过益处时订购诊断测试,在现代医学中很普遍.
- 这种做法导致不必要的患者风险,如假阳性,过度诊断,痛苦和可避免的程序,而不会改善结果.
- 导致过度调查的因素包括心理,文化和系统因素.
研究的目的:
- 检查导致过度调查的心理,文化和系统因素.
- 了解导致过度测试的医生和患者的认知决定因素.
- 识别导致问题恶化的系统性问题,并提出解决方案.
主要方法:
- 这是一个审查审查过度调查的因素.
- 它分析了认知偏见,防御医学,患者的期望,专业压力和文化规范.
- 还考虑了系统因素,如时间限制,服务费用模式和资源可用性.
主要成果:
- 认知因素包括对模糊性和佣金偏见的不适.
- 防御医学,患者的期望和文化规范都有很大的贡献.
- 系统性问题,如时间压力,财务激励和容易获得测试,加剧了这个问题,并加剧了实验室流程问题.
结论:
- 过度调查侵蚀了患者的信任,膨胀了医疗保健成本,并导致临床医生倦怠.
- 需要一种文化转变,强调临床推理,基于证据的指导方针和共享决策.
- 系统性改革至关重要,以促进对诊断测试的深思熟虑和明智使用.
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