Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano (Università della Svizzera italiana), Lugano, Switzerland (RL, PJS).
Med Decis Making. 2018 Jan;38(1):3-13. doi: 10.1177/0272989X17716672. Epub 2017 Jun 25.
Being confronted with uncertainty in the context of health-related judgments and decision making can give rise to the occurrence of systematic biases. These biases may detrimentally affect lay persons and health experts alike. Debiasing aims at mitigating these negative effects by eliminating or reducing the biases. However, little is known about its effectiveness. This study seeks to systematically review the research on health-related debiasing to identify new opportunities and challenges for successful debiasing strategies.
A systematic search resulted in 2748 abstracts eligible for screening. Sixty-eight articles reporting 87 relevant studies met the predefined inclusion criteria and were categorized and analyzed with regard to content and quality. All steps were undertaken independently by 2 reviewers, and inconsistencies were resolved through discussion.
The majority of debiasing interventions ( n = 60) was at least partially successful. Optimistic biases ( n = 25), framing effects ( n = 14), and base rate neglects ( n = 10) were the main targets of debiasing efforts. Cognitive strategies ( n = 36) such as "consider-the-opposite" and technological interventions ( n = 33) such as visual aids were mainly tested. Thirteen studies aimed at debiasing health care professionals' judgments, while 74 interventions addressed the general population. Studies' methodological quality ranged from 26.2% to 92.9%, with an average rating of 68.7%.
In the past, the usefulness of debiasing was often debated. Yet most of the interventions reviewed here are found to be effective, pointing to the utility of debiasing in the health context. In particular, technological strategies offer a novel opportunity to pursue large-scale debiasing outside the laboratory. The need to strengthen the transfer of debiasing interventions to real-life settings and a lack of conceptual rigor are identified as the main challenges requiring further research.
在与健康相关的判断和决策背景下，面对不确定性可能会导致系统偏差的发生。这些偏差可能会对非专业人士和健康专家造成不利影响。去偏旨在通过消除或减少偏差来减轻这些负面影响。然而，对于其有效性知之甚少。本研究旨在系统地回顾与健康相关的去偏研究，以确定成功的去偏策略的新机会和挑战。
系统搜索产生了 2748 个符合筛选条件的摘要。有 68 篇文章报告了 87 项相关研究符合预先设定的纳入标准，并根据内容和质量进行了分类和分析。所有步骤均由 2 名评审员独立进行，如果出现意见不一致，则通过讨论解决。
大多数去偏干预措施（n=60）至少部分成功。乐观偏见（n=25）、框架效应（n=14）和基数忽略（n=10）是去偏努力的主要目标。认知策略（n=36），如“考虑相反”，和技术干预（n=33），如视觉辅助，主要进行了测试。有 13 项研究旨在去偏医疗保健专业人员的判断，而 74 项干预措施针对一般人群。研究的方法学质量从 26.2%到 92.9%不等，平均评分为 68.7%。
过去，去偏的有用性经常受到争议。然而，这里审查的大多数干预措施都被发现是有效的，这表明去偏在健康背景下的实用性。特别是，技术策略为在实验室外进行大规模去偏提供了新的机会。需要加强将去偏干预措施转移到现实环境中，以及缺乏概念严谨性被确定为需要进一步研究的主要挑战。
