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将博弈论原理应用于急性中风护理:从囚徒困境、猎鹿博弈及其他策略中学习。

Applying principles from the game theory to acute stroke care: Learning from the prisoner's dilemma, stag-hunt, and other strategies.

作者信息

Saposnik Gustavo, Johnston S Claiborne

机构信息

Stroke Outcomes Research Unit, Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada Neuroeconomics and Social Neuroscience, Department of Economics, University of Zurich, Switzerland

Dell School of Medicine, University of Texas, Austin, TX, USA.

出版信息

Int J Stroke. 2016 Apr;11(3):274-86. doi: 10.1177/1747493016631725. Epub 2016 Feb 11.

Abstract

BACKGROUND

Acute stroke care represents a challenge for decision makers. Decisions based on erroneous assessments may generate false expectations of patients and their family members, and potentially inappropriate medical advice. Game theory is the analysis of interactions between individuals to study how conflict and cooperation affect our decisions.

AIMS

We reviewed principles of game theory that could be applied to medical decisions under uncertainty.

SUMMARY

Medical decisions in acute stroke care are usually made under constrains: short period of time, with imperfect clinical information, limit understanding about patients and families' values and beliefs. Game theory brings some strategies to help us manage complex medical situations under uncertainty. For example, it offers a different perspective by encouraging the consideration of different alternatives through the understanding of patients' preferences and the careful evaluation of cognitive distortions when applying 'real-world' data. The stag-hunt game teaches us the importance of trust to strength cooperation for a successful patient-physician interaction that is beyond a good or poor clinical outcome.

CONCLUSIONS

The application of game theory to stroke care may improve our understanding of complex medical situations and help clinicians make practical decisions under uncertainty.

摘要

背景

急性中风护理对决策者来说是一项挑战。基于错误评估做出的决策可能会让患者及其家属产生不切实际的期望,并可能导致不恰当的医疗建议。博弈论是对个体之间相互作用的分析,旨在研究冲突与合作如何影响我们的决策。

目的

我们回顾了可应用于不确定情况下医疗决策的博弈论原则。

总结

急性中风护理中的医疗决策通常在以下限制条件下做出:时间短、临床信息不完整、对患者及其家属的价值观和信念了解有限。博弈论提供了一些策略,帮助我们在不确定的情况下处理复杂的医疗状况。例如,它通过鼓励在应用“实际”数据时考虑患者偏好并仔细评估认知偏差来考虑不同的选择,从而提供了一个不同的视角。猎鹿博弈让我们明白,信任对于加强合作以实现成功的医患互动至关重要,而这不仅仅关乎临床结果的好坏。

结论

将博弈论应用于中风护理可能会增进我们对复杂医疗状况的理解,并帮助临床医生在不确定的情况下做出实际决策。

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