Gotlieb R, Abitbol J, How J A, Ben-Brith I, Abenhaim H A, Lau S K, Basik M, Rosberger Z, Geva N, Gotlieb W H, Mintz A
Division of Experimental Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Canada.
Gynecol Oncol Rep. 2019 Jan 2;27:50-53. doi: 10.1016/j.gore.2018.12.008. eCollection 2019 Feb.
There is an absence of information on how physicians make surgical decisions, and on the effect of gender on the processing of information. A novel web based decision-matrix software was designed to trace experimentally the process of decision making in medical situations. The scenarios included a crisis and non-crisis simulation for endometrial cancer surgery. Gynecologic oncologists, fellows, and residents (42 male and 42 female) in Canada participated in this experiment. Overall, male physicians used more heuristics, whereas female physicians were more comprehensive in accessing clinical information (p < 0.03), utilized alternative-based acquisition processes in the non-crisis scenario (p = 0.01), were less likely to consider procedure-related costs (p = 0.04), and overall allocated more time to evaluate the information (p < 0.01). Further experiments leading to a better understanding of the cognitive processes involved in medical decision making could influence education and training and impact on patient outcome.
关于医生如何做出手术决策以及性别对信息处理的影响，目前缺乏相关信息。设计了一种新型的基于网络的决策矩阵软件，用于通过实验追踪医疗情境中的决策过程。场景包括子宫内膜癌手术的危机和非危机模拟。加拿大的妇科肿瘤学家、研究员和住院医师（42名男性和42名女性）参与了该实验。总体而言，男性医生更多地使用启发式方法，而女性医生在获取临床信息方面更全面（p<0.03），在非危机场景中使用基于替代方案的获取过程（p=0.01），不太可能考虑与手术相关的成本（p=0.04），并且总体上分配更多时间来评估信息（p<0.01）。进一步的实验有助于更好地理解医疗决策中涉及的认知过程，这可能会影响教育和培训，并对患者的治疗结果产生影响。
