人类因素和定量数据:在紧急肠道手术中对ICG使用的不同观点 - 一个系统的文献综述
Ankita Kulkarni1, Camy Sheth2, Nikhil Pawa2
1West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK. ankita.kulkarni2@nhs.net.
Updates in surgery
|January 12, 2026
概括
在紧急手术中,印ocyanine Green (ICG) 成像容易出现由于人为因素导致的解释错误. 认知偏见和系统性问题往往加强外科医生的现有决定,而不是提供客观数据.
科学领域:
- 手术创新 在外科创新.
- 医疗成像医学成像
- 人类因素在医学中的作用
背景情况:
- 印ocyanine Green (ICG) 光成像被广泛采用,用于在紧急肠道手术期间评估肠道输液.
- 尽管技术成功率很高,但ICG光成像的术内解释显示出显著的变化.
- 人类因素,包括认知和系统因素,被怀疑会影响ICG成像的有效性.
研究的目的:
- 系统地审查和分析认知和系统的人类因素如何影响ICG光成像在紧急肠道手术中的解释和感知效果.
- 将这些人类因素的影响与ICG成像报告的定量结果进行比较.
- 确定影响临床实践中ICG解释的常见偏见和系统限制.
主要方法:
- 在PubMed和Embase进行了系统的文献搜索,从266篇选文章中确定了31项原始研究.
- 定性合成遵循ENTREQ原则,使用基于认知偏差类别的主题分析进行偏差识别.
- 数据使用一篇文章一篇文章的偏见矩阵进行分析,根据领域和情绪进行总结.
主要成果:
- 在308例中,ICG在302例中影响了手术决策,但光发现和临床行动之间的差异发生在38.3%的病例中.
- 常见的认知偏见包括确认偏见,定偏见,过度自信以及使用ICG来支持先前存在的决策.
- 系统性限制包括缺乏跨学科投入,病例报告偏见以及缺乏标准化解释协议.
结论:
- 术内ICG光成像功能作为一种由人类解释,时间压力和决策势头影响的认知接口,而不是纯粹客观的诊断工具.
- ICG经常强化外科医生的预先存在的临床判断,强调需要解决偏见意识的问题.
- 提高解释的一致性和患者结果需要解决认知偏见,并整合跨学科框架,以在紧急手术中标准化ICG使用.
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