Center for Vulnerable Populations, University of California, San Francisco, USA.
Zuckerberg San Francisco General Hospital Library, University of California, San Francisco, San Francisco, CA, USA.
BMC Med Inform Decis Mak. 2019 Aug 9;19(1):158. doi: 10.1186/s12911-019-0882-0.
Collective intelligence, facilitated by information technology or manual techniques, refers to the collective insight of groups working on a task and has the potential to generate more accurate information or decisions than individuals can make alone. This concept is gaining traction in healthcare and has potential in enhancing diagnostic accuracy. We aim to characterize the current state of research with respect to collective intelligence in medical decision-making and describe a framework for diverse studies in this topic.
For this systematic scoping review, we conducted a systematic search for published literature using PubMed, Embase, Web of Science, and CINAHL on August 8, 2017. We included studies that combined the insights of two or more medical experts to make decisions related to patient care. Studies that examined medical decisions such as diagnosis, treatment, and management in the context of an actual or theoretical patient case were included. We include studies of complex medical decision-making rather than identification of a visual finding, as in radiology or pathology. We differentiate between medical decisions, in which synthesis of multiple types of information is required over time, and studies of radiological scans or pathological specimens, in which objective identification of a visual finding is performed. Two reviewers performed article screening, data extraction, and final inclusion for analysis.
Of 3303 original articles, 15 were included. Each study examined the medical decisions of two or more individuals; however, studies were heterogeneous in their methods and outcomes. We present a framework to characterize these diverse studies, and future investigations, based on how they operationalize collective intelligence for medical decision-making: 1) how the initial decision task was completed (group vs. individual), 2) how opinions were synthesized (information technology vs. manual vs. in-person), and 3) the availability of collective intelligence to participants.
Collective intelligence in medical decision-making is gaining popularity to advance medical decision-making and holds promise to improve patient outcomes. However, heterogeneous methods and outcomes make it difficult to assess the utility of collective intelligence approaches across settings and studies. A better understanding of collective intelligence and its applications to medicine may improve medical decision-making.
集体智慧是指通过信息技术或手动技术促进的群体工作任务的集体洞察力，它有可能比个人单独做出更准确的信息或决策。这个概念在医疗保健领域越来越受到关注，并有可能提高诊断准确性。我们旨在描述当前在医学决策中的集体智慧研究现状，并描述该主题中各种研究的框架。
为了进行这项系统的范围界定综述，我们于 2017 年 8 月 8 日在 PubMed、Embase、Web of Science 和 CINAHL 上进行了系统文献检索。我们纳入了将两名或更多名医学专家的见解结合起来以做出与患者护理相关的决策的研究。纳入了研究在实际或理论患者病例背景下检查诊断、治疗和管理等医学决策的研究。我们纳入了需要随着时间的推移综合多种类型信息的复杂医学决策研究，而不是纳入在放射学或病理学中需要识别视觉发现的研究。我们将医学决策与需要随着时间的推移综合多种类型信息的研究区分开来，而将放射学扫描或病理标本的研究与需要识别视觉发现的研究区分开来。两名评审员进行了文章筛选、数据提取和最终纳入分析。
在 3303 篇原始文章中，有 15 篇被纳入。每项研究都检查了两名或更多人的医学决策；然而，研究在方法和结果上存在异质性。我们根据他们如何为医学决策实施集体智慧提出了一个框架来描述这些不同的研究和未来的研究：1）初始决策任务是如何完成的（小组与个人），2）意见是如何综合的（信息技术与手动与面对面），以及 3）参与者是否可以获得集体智慧。
医学决策中的集体智慧越来越受欢迎，以推进医学决策，并有可能改善患者的治疗结果。然而，不同的方法和结果使得难以评估集体智慧方法在不同环境和研究中的实用性。更好地了解集体智慧及其在医学中的应用可能会改善医学决策。
