在急性医疗保健中对医疗诊断的信心和确定性:范围审查
Sriraj Aiyer1, Helen Higham2,3, Nick Yeung4
1Experimental Psychology, University of Oxford, Oxford, UK rajagain925@gmail.com.
BMJ quality & safety
|December 3, 2025
概括
临床医生对医疗诊断的过度信心是常见的,并影响患者的护理. 提高信心校准对于医学教育和实践至关重要.
科学领域:
- 医学教育 医学教育
- 临床决策 - 临床决策
- 认知偏见是一种认知偏见.
背景情况:
- 对医疗诊断的过度信心是导致医疗错误的一个重要因素.
- 了解影响诊断信心的因素对于改善患者护理结果至关重要.
研究的目的:
- 审查临床医生对医学诊断的信心的实验研究.
- 确定影响诊断信心的因素及其对患者护理的影响.
- 分析信心如何影响临床决策和行动.
主要方法:
- 对医学和心理学文献进行了全面的范围审查.
- 搜索包括SCOPUS,MEDLINE,PsycINFO和全球健康,并补充了引用跟踪.
- 包括的研究报告了经验诊断决策研究的定量结果.
主要成果:
- 77篇文章符合纳入标准,这表明诊断信心在经验水平上往往准确度不佳.
- 确定的主要主题是信心的决定因素 (例如,病例复杂性,环境) 和其对临床行动的影响 (例如,测试,处方).
- 影响信心但不影响准确性的因素突出显示了导致过度/不足信心的脱.
结论:
- 提高诊断信心的校准是医学教育和临床实践的优先事项.
- 提出了一个理论模型来指导未来的研究,以促进适当的诊断信心.
- 决策辅助工具和有针对性的教育策略可以帮助减轻因信任误差而产生的诊断错误.
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