University of South Florida, St. Petersburg, FL, USA.
Claremont Graduate University, Upland, CA, USA.
Med Decis Making. 2022 Jan;42(1):94-104. doi: 10.1177/0272989X211011160. Epub 2021 May 8.
Previous research has described physicians' reluctance to use computerized diagnostic aids (CDAs) but has never experimentally examined the effects of not consulting an aid that was readily available. Participants read about a diagnosis made either by a physician or an auto mechanic (to control for perceived expertise). Half read that a CDA was available but never actually consulted; no mention of a CDA was made for the remaining half. For the physician, failure to consult the CDA had no significant effect on competence ratings for either the positive or negative outcome. For the auto mechanic, failure to consult the CDA actually increased competence ratings following a negative but not a positive outcome. Negligence judgments were greater for the mechanic than for the physician overall. Using only a negative outcome, we included 2 different reasons for not consulting the aid and provided accuracy information highlighting the superiority of the CDA over the physician. In neither condition was the physician rated lower than when no aid was mentioned. Ratings were lower when the physician did not trust the CDA and, surprisingly, higher when the physician believed he or she already knew what the CDA would say. Finally, consistent with our previous research, ratings were also high when the physician consulted and then followed the advice of a CDA and low when the CDA was consulted but ignored. Individual differences in numeracy did not qualify these results. Implications for the literature on algorithm aversion and clinical practice are discussed.
先前的研究描述了医生不愿意使用计算机辅助诊断工具(CDA),但从未通过实验检验过不咨询随时可用的辅助工具的效果。参与者阅读了由医生或汽车修理工做出的诊断(以控制感知的专业知识)。一半参与者阅读到 CDA 是可用的,但实际上从未咨询过;另一半参与者没有提到 CDA。对于医生来说,不咨询 CDA 对阳性或阴性结果的能力评估没有显著影响。对于汽车修理工来说,在负面结果后不咨询 CDA 实际上会增加能力评估,但在阳性结果后则不会。对于机械师的疏忽判断总体上大于对医生的判断。仅使用负面结果,我们包含了不咨询辅助工具的 2 个不同原因,并提供了准确性信息,突出了 CDA 相对于医生的优势。在任何情况下,医生的评分都不会低于未提到辅助工具的情况。当医生不信任 CDA 时,评分会降低,而当医生认为自己已经知道 CDA 会说什么时,评分会更高,这令人惊讶。最后,与我们之前的研究一致,当医生咨询并遵循 CDA 的建议时,评分会很高,而当咨询 CDA 但被忽视时,评分会很低。计算能力的个体差异并不能证明这些结果。对算法厌恶和临床实践文献的影响进行了讨论。