Pezzo Mark V, Pezzo Stephanie P
Psychological Sciences Program, University of South Florida, St. Petersburg, FL 33701, USA.
Med Decis Making. 2006 Jan-Feb;26(1):48-56. doi: 10.1177/0272989X05282644.
The authors examined whether physicians' use of computerized decision aids affects patient satisfaction and/or blame for medical outcomes.
Experiment 1: Fifty-nine undergraduates read about a doctor who made either a correct or incorrect diagnosis and either used a decision aid or did not. All rated the quality of the doctor's decision and the likelihood of recommending the doctor. Those receiving a negative outcome also rated negligence and likelihood of suing. Experiment 2: One hundred sixty-six medical students and 154 undergraduates read negative-outcome scenarios in which a doctor either agreed with the aid, heeded the aid against his own opinion, defied the aid in favor of his own opinion, or did not use a decision aid. Subjects rated doctor fault and competence and the appropriateness of using decision aids in medicine. Medical students made judgments for themselves and for a layperson.
Experiment 1: Using a decision aid caused a positive outcome to be rated less positively and a negative outcome to be rated less negatively. Experiment 2: Agreeing with or heeding the aid was associated with reduced fault, whereas defying the aid was associated with roughly the same fault as not using one at all. Medical students were less harsh than undergraduates but accurately predicted undergraduate's responses.
Agreeing with or heeding a decision aid, but not defying it, may reduce liability after an error. However, using an aid may reduce favorability after a positive outcome.
作者研究了医生使用计算机化决策辅助工具是否会影响患者满意度和/或对医疗结果的指责。
实验1：59名本科生阅读了一篇关于一位医生的文章，该医生做出了正确或错误的诊断，并且要么使用了决策辅助工具，要么没有使用。所有人都对医生决策的质量以及推荐该医生的可能性进行了评分。那些得知负面结果的人还对疏忽和起诉的可能性进行了评分。实验2：166名医学生和154名本科生阅读了负面结果的情景，其中医生要么同意辅助工具的意见，要么不顾自己的意见听从辅助工具的意见，要么不顾辅助工具的意见而坚持自己的意见，要么没有使用决策辅助工具。受试者对医生的过错和能力以及在医学中使用决策辅助工具的适当性进行了评分。医学生为自己和外行做出判断。
实验1：使用决策辅助工具导致对积极结果的评分不那么积极，对消极结果的评分不那么消极。实验2：同意或听从辅助工具的意见与过错减少有关，而不顾辅助工具的意见与根本不使用辅助工具的过错大致相同。医学生比本科生宽容，但准确预测了本科生的反应。
同意或听从决策辅助工具的意见，而不是违抗它，可能会减少错误后的责任。然而，使用辅助工具可能会降低积极结果后的好感度。
