医生的难题:如何避免认知偏见的干扰

2021年1月15日
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大多数人心中,医生是严谨、理性的专业人士,在工作中能控制情绪、屏蔽偏见。但一篇新研究发现,他们在诊断病人时,仍难免受直觉和偏见的影响,从而干扰自己的判断。哪些偏见会影响医生的决策?有什么方法可以帮助医生减少这些干扰呢?

医生的难题:如何避免认知偏见的干扰

How Common Mental Shortcuts Can Cause Major Physician Errors

常见“心理捷径”如何导致医生犯大错?

Bias, which takes many forms, affects how doctors think and the treatment decisions they make.

形式多样的偏见影响着医生思考以及做出治疗决策的过程。

Racial biases in treatment decisions by physicians are well documented. But a growing body of scientific research on physician decision-making shows that doctors exhibit other biases as well — cognitive ones — that influence the way they think and treat patients.

已有充分的证据证明医生在治疗决策中存在种族偏见。此外,越来越多关于医生决策的科学研究表明,医生还会出现认知等方面的偏见,影响着他们思考和治病的方式。

Sometimes these cognitive biases are simple overreactions to recent events, what psychologists term availability bias. One study found that when patients experienced an unlikely adverse side effect of a drug, their doctor was less likely to order that same drug for the next patient whose condition might call for it, even though the efficacy and appropriateness of the drug had not changed.

有时,这些认知偏见只是对近期事件的过度反应,也就是心理学家所说的“可获得性偏见”。一项研究发现,当一种药物对一位医生的多名病人产生意料之外的不良副作用后,这位医生为下一名可能需要该药的病人开出这种药的概率会降低,即使该药物的疗效和适应症状并未改变。

In a new study of physician treatment decisions, published on Thursday in The New England Journal of Medicine, we document signs of left-digit bias.

一项周四发表在《新英格兰医学杂志》上关于医生治疗决策的新研究中,我们发现了“左位偏见”的迹象。

When comparing patients who had a heart attack in the weeks leading up to their 80th birthdays with those who’d recently had an 80th birthday, we found that physicians were significantly less likely to perform a coronary artery bypass surgery for the “older” patients.

我们对比了两组患者,他们分别在80岁生日前几周和刚过完80岁生日后心脏病发作,发现医生给“较老”的病人做冠状动脉搭桥手术的概率要低得多。

Awareness of these cognitive biases has prompted efforts to reduce them in clinical decision-making. Given our growing understanding of the errors that doctors can make, these biases are too costly to ignore.

意识到这一点后,人们已经努力在临床决策中减少这些认知偏见。随着对医生可能犯的错误越来越了解,我们清楚这些偏见代价太大,不容忽视。

推荐书籍:
The Checklist Manifesto 《清单革命》
推荐医疗剧:
The Resident 《驻院医生》(改编自畅销书 Unaccountable)

生词好句
1.mental shortcut 心理捷径
2.physician error 医生错误 misdiagnosis n. 误诊
3.bias UK /ˈbaɪəs/ US /ˈbaɪəs/ n. 偏见 Reporters must be impartial and not show political bias.
新闻记者必须公正,不应该有政治偏见。
4.well documented 记录详实 document vt. 记录,记载
5.a growing body of sth. 越来越多的某物 近义表达:
a growing amount of sth.(不可数)
more and more sth.(可数/不可数)
a growing number of sth.(可数)
6.exhibit UK /ɪɡˈzɪbɪt/ US /ɪɡˈzɪbɪt/ vt. 公开展览,展出,展示(to show sth. publicly) exhibition n. 展览
exhibit n. 展品
7.overreaction UK /ˌəʊvəriˈækʃən/ US /ˌoʊvəriˈækʃən/ n. 过度反应 reaction n. 反应
overreact v. 过度反应
8.term UK /tɜːm/ US /tɜːrm/ vt. 称呼(to give sth. a name)
9.availability bias 可获得性偏见
10.adverse side effect 不良副反应 adverse effect 不良反应
side effect 副作用
11.be less likely to do sth. 做某件事的可能性降低 be more likely to do sth. 做某件事的可能性升高
12.call for sth. 需要,值得(to need or deserve a particular action, remark or quality)
13.efficiency UK /ɪˈfɪʃənsi/ US /ɪˈfɪʃənsi/ n. 功效
14.appropriateness UK /əˈprəʊpriətnəs/ US /əˈproʊpriətnəs/ n. 适应症
15.study UK /ˈstʌdi/ US /ˈstʌdi/ n. 研究(a detailed investigation and analysis of a subject) a study of the relationship between the novel coronavirus and the sales of Corona beer
一项有关新冠病毒和科罗娜啤酒销量之间关系的研究
16.left-digit bias 左位偏见
17.prompt UK /prɒmpt/ US /prɑːmpt/ vt. 引发,引起

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