Park Daniel B, Dobson Joseph V, Losek Joseph D
From the Medical University of South Carolina, Pediatric Emergency Medicine, Charleston, SC.
Pediatr Emerg Care. 2014 Feb;30(2):104-7. doi: 10.1097/PEC.0000000000000065.
The objectives of this study were to highlight the intimate role that cognitive biases play in clinical decision making in the pediatric emergency department and to recommend strategies to limit their negative impact on patient care outcomes.
This was a descriptive study of 3 cases of presumed asthma exacerbation evolving into alternate diagnoses.
The role cognitive biases played in either delay to diagnosis or missed diagnosis contributing to patient morbidity are illustrated in each case.
Common cognitive biases play a role in the unique milieu of the pediatric emergency department. A case series of presumed patients with asthma illustrates how mental shortcuts (heuristics) taken in times of high decision density and uncertainty may lead to diagnostic errors and patient harm. Suggestions to address and prevent cognitive biases are presented.
本研究的目的是强调认知偏差在儿科急诊科临床决策中所起的密切作用，并推荐策略以限制其对患者护理结果的负面影响。
这是一项对3例疑似哮喘加重但最终确诊为其他疾病的病例的描述性研究。
每个病例都说明了认知偏差在导致诊断延迟或漏诊从而致使患者发病方面所起的作用。
常见的认知偏差在儿科急诊科的独特环境中发挥作用。一组疑似哮喘患者的病例系列说明了在决策密度高和不确定性大的情况下采用的心理捷径（启发法）如何可能导致诊断错误和对患者的伤害。文中还提出了应对和预防认知偏差的建议。
