Minué-Lorenzo Sergio, Fernández-Aguilar Carmen, Martín-Martín José Jesús, Fernández-Ajuria Alberto
Integrated Health Services based on Primary Health Care WHO Collaborating Centre. Escuela Andaluza de Salud Pública, Granada, España.
Integrated Health Services based on Primary Health Care WHO Collaborating Centre. Escuela Andaluza de Salud Pública, Granada, España.
Aten Primaria. 2020 Mar;52(3):159-175. doi: 10.1016/j.aprim.2018.11.003. Epub 2019 Jan 31.
To assess the use of representativeness, availability, overconfidence, anchoring and adjustment heuristics in clinical practice, specifically in Primary Care setting.
Panoramic review (scope review).
OvidMedline, Scopus, PsycoINFO, Cochrane Library and PubMed databases. Each one of the selected studies was reviewed applying TIDIER criteria (Template for Description of the Intervention and Replication) to facilitate their understanding and replicability.
A total of 48 studies were selected that analyzed availability heuristics (26), anchoring and adjustment (9), overconfidence (9) and representativeness (8).
From the 48 studies selected, 26 analyzed availability heuristics, 9 anchoring and adjustment, 9 overconfidence; and 8 representativeness. The study population included physicians (35.4%), patients (27%), trainees (20.8%), nurses (14.5%) and students (14.5%). The studies conducted in clinical practice setting were 17 (35.4%). In 33 of the 48 studies (68,7%) it was observed heuristic use in the population studied. Heuristics use on diagnostic process was found in 27 studies (54.1%); 5 of them (18%) were carried out in clinical practice setting. Of the 48 studies, 6 (12,5%) were performed in Primary Care, 3 of which studied diagnostic process: only one of them analyzed the use of heuristics in clinical practice setting, without demonstrating bias as consequence of the use of heuristic.
The evidence about heuristic use in diagnostic process on clinical practice setting is limited, especially in Primary Care.
评估代表性、可得性、过度自信、锚定与调整启发法在临床实践中的应用，特别是在基层医疗环境中的应用。
全景综述（范围综述）。
OvidMedline、Scopus、PsycoINFO、Cochrane图书馆和PubMed数据库。对每项所选研究应用TIDIER标准（干预与复制描述模板）进行综述，以促进对其的理解和可重复性。
共选择了48项研究，这些研究分析了可得性启发法（26项）、锚定与调整（9项）、过度自信（9项）和代表性（8项）。
在所选的48项研究中，26项分析了可得性启发法，9项分析了锚定与调整，9项分析了过度自信，8项分析了代表性。研究人群包括医生（35.4%）、患者（27%）、实习生（20.8%）、护士（14.5%）和学生（14.5%）。在临床实践环境中进行的研究有17项（35.4%）。在48项研究中的33项（68.7%）中，观察到在所研究人群中存在启发法的应用。在27项研究（54.1%）中发现了启发法在诊断过程中的应用；其中5项（18%）是在临床实践环境中进行的。在48项研究中，6项（12.5%）在基层医疗中进行，其中3项研究了诊断过程：其中只有1项分析了启发法在临床实践环境中的应用，未证明因使用启发法而产生偏差。
关于启发法在临床实践环境中诊断过程中的应用证据有限，尤其是在基层医疗中。
