Ryan Aedin, Duignan Sophie, Kenny Damien, McMahon Colin J
Paediatric Cardiology Department, Our Lady's Hospital for Sick Children, Dublin, Ireland.
School of Medicine, University College Dublin, Belfield, Dublin, 4, Ireland.
Pediatr Cardiol. 2018 Jan;39(1):160-167. doi: 10.1007/s00246-017-1742-2. Epub 2017 Oct 4.
Hidden traps in decision making have been long recognised in the behavioural economics community. Yet we spend very limited, if any time, analysing our decision-making processes in medicine and paediatric cardiology. Systems 1 and 2 thought processes differentiate between rapid emotional thoughts and slow deliberate rational thoughts. For fairly clear cut medical decisions, in-depth analysis may not be needed, but in our field of paediatric cardiology it is not uncommon for challenging cases and occasionally 'simple' cases to generate significant debate and uncertainty as to the best decision. Although morbidity and mortality meetings frequently highlight poor outcomes for our patients, they often neglect to analyse the process of thought which underlined those decisions taken. This article attempts to review commonly acknowledged traps in decision making in the behavioural economics world to ascertain whether these heuristics translate to decision making in the paediatric cardiology environment. We also discuss potential individual and collective solutions to pitfalls in decision making.
行为经济学界早就认识到决策中的隐藏陷阱。然而，在医学和儿科心脏病学领域，我们花在分析决策过程上的时间（如果有的话）非常有限。系统1和系统2的思维过程区分快速的情感思维和缓慢的深思熟虑的理性思维。对于相当明确的医疗决策，可能不需要深入分析，但在我们儿科心脏病学领域，具有挑战性的病例，偶尔还有“简单”病例，就最佳决策产生重大争论和不确定性的情况并不少见。虽然发病率和死亡率会议经常强调我们患者的不良结局，但它们往往忽略分析做出这些决策的思维过程。本文试图回顾行为经济学领域公认的决策陷阱，以确定这些启发式方法是否适用于儿科心脏病学环境中的决策。我们还讨论了决策陷阱的潜在个人和集体解决方案。
