Department of Social Work, School of Primary and Allied Health Care, Faculty of Medicine Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia.
Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
PLoS One. 2020 Oct 20;15(10):e0240716. doi: 10.1371/journal.pone.0240716. eCollection 2020.
Cognitive and other biases can influence the quality of healthcare decision making. While substantial research has explored how biases can lead to diagnostic or other errors in medicine, fewer studies have examined how they impact the decision making of other healthcare professionals. This scoping review aimed to identify and synthesise a broad range of research investigating whether decisions made by allied health professionals are influenced by cognitive, affective or other biases.
A systematic literature search was conducted in five electronic databases. Title, abstract and full text screening was undertaken in duplicate, using prespecified eligibility criteria designed to identify studies attempting to demonstrate the presence of bias when allied healthcare professionals make decisions. A narrative synthesis was undertaken, focussing on the type of allied health profession, type of decision, and type of bias reported within the included studies.
The search strategy identified 149 studies. Of these, 119 studies came from the field of psychology, with substantially fewer from social work, physical and occupational therapy, speech pathology, audiology and genetic counselling. Diagnostic and assessment decisions were the most common decision types, with fewer studies assessing treatment, prognostic or other clinical decisions. Studies investigated the presence of over 30 cognitive, affective and other decision making biases, including stereotyping biases, anchoring, and confirmation bias. Overall, 77% of the studies reported at least one outcome that represented the presence of a bias.
This scoping review provides an overview of studies investigating whether decisions made by allied health professionals are influenced by cognitive, affective or other biases. Biases have the potential to seriously impact the quality, consistency and accuracy of decision making in allied health practice. The findings highlight a need for further research particularly in professional disciplines outside of psychology, using methods that reflect real life healthcare decision making.
认知和其他偏见会影响医疗保健决策的质量。虽然大量研究探讨了偏见如何导致医学中的诊断或其他错误，但很少有研究研究它们如何影响其他医疗保健专业人员的决策。本范围综述旨在确定并综合广泛研究，以调查是否由辅助医疗专业人员做出的决策受到认知，情感或其他偏见的影响。
在五个电子数据库中进行了系统的文献检索。使用专门设计的资格标准，对标题，摘要和全文进行了双重筛选，旨在确定研究尝试证明辅助医疗保健专业人员做出决策时存在偏见的研究。进行了叙述性综合，重点是所包括研究中的辅助卫生专业类型，决策类型以及报告的偏见类型。
该搜索策略确定了 149 项研究。其中，119 项来自心理学领域，而来自社会工作，物理和职业治疗，言语病理学，听力学和遗传咨询的研究则要少得多。诊断和评估决策是最常见的决策类型，而评估治疗，预后或其他临床决策的研究较少。研究调查了 30 多种认知，情感和其他决策偏见的存在，包括刻板印象偏见，锚定和确认偏见。总体而言，77％的研究报告了至少一项代表偏见存在的结果。
本范围综述提供了对研究的概述，该研究调查了辅助医疗保健专业人员做出的决策是否受到认知，情感或其他偏见的影响。偏见有可能严重影响辅助卫生实践中的决策质量，一致性和准确性。研究结果强调需要进一步研究，特别是在心理学以外的专业学科中，使用反映现实生活中医疗保健决策的方法。
