手术后认知偏差和伤害严重程度：制定工作流程去偏策略计划。

Cognitive bias and severity of harm following surgery: Plan for workflow debiasing strategy.

机构信息

Northwell Health 2000 Marcus Avenue, Manhasset, NY, 11030, USA.

Institute for Spine and Scoliosis (ISS), Lawrenceville, NJ 08648, USA.

出版信息

Am J Surg. 2021 Dec;222(6):1172-1177. doi: 10.1016/j.amjsurg.2021.08.035. Epub 2021 Sep 6.

DOI:10.1016/j.amjsurg.2021.08.035

PMID:34511201

Abstract

INTRODUCTION

This study analyzes the relationship between cognitive bias (CB) and harm severity as measured by Clavien-Dindo Scores (CD).

METHODS

A prospectively collected series of 655 severity matched general surgical cases with complications were analyzed. Cases were evaluated for CB and assigned harm scores as defined by CD grade. Potentially mitigating "debiasing" strategies were identified for each bias attribution.

RESULTS

Among cases with CB, 24% (55/232) were CD(I-II) and 76% (177/232) were CD(III-V). Odds ratio suggests that serious complications occur nearly 60% more frequently when CB is identified. The CBs identified with severe harm were Overconfidence, Commission, Anchoring, Confirmation, and Diagnosis Momentum. Preliminary data on debiasing strategies suggest diagnosis review, linear reasoning and Type II thinking may be relevant in over 85% of complications.

CONCLUSION

The incidence of CB is increased in patients sustaining severe harm. Understanding the specific CBs identified and their mitigating debiasing strategies may improve outcomes.

摘要

简介

本研究分析了认知偏差（CB）与 Clavien-Dindo 评分（CD）所测伤害严重程度之间的关系。

方法

对 655 例严重程度匹配的普外科并发症病例进行前瞻性收集分析。对病例进行 CB 评估，并根据 CD 分级分配伤害评分。为每个偏差归因确定了潜在的减轻“偏差”策略。

结果

在有 CB 的病例中，24%（55/232）为 CD（I-II），76%（177/232）为 CD（III-V）。比值比表明，当出现 CB 时，严重并发症的发生率增加近 60%。与严重伤害相关的 CB 为过度自信、决策、锚定、确认和诊断势头。关于减轻偏差策略的初步数据表明，诊断复查、线性推理和第二型思维在超过 85%的并发症中可能相关。