Departments of Emergency Medicine and Pediatrics, University of Michigan, 1540 East Hospital Drive, CW 2-737, SPC 4260, Ann Arbor, MI 48109-4260, USA.
Departments of Emergency Medicine and Pediatrics, University of Michigan, 1540 East Hospital Drive, CW 2-737, SPC 4260, Ann Arbor, MI 48109-4260, USA.
Crit Care Clin. 2022 Jan;38(1):37-49. doi: 10.1016/j.ccc.2021.07.002.
Critical care settings are unpredictable, dynamic environments where clinicians face high decision density in suboptimal conditions (stress, time constraints, competing priorities). Experts have described two systems of human decision making: one fast and intuitive; the other slow and methodical. Heuristics, or mental shortcuts, a key feature of intuitive reasoning, are often accurate, applied instinctively, and essential for efficient diagnostic decision making. Heuristics are also prone to failures, or cognitive biases, which can lead to diagnostic errors. A variety of strategies have been proposed to mitigate biases; however, current understanding of such interventions to optimize diagnostic safety is still incomplete.
重症监护环境充满不确定性，是动态的，临床医生在不理想的条件（压力、时间限制、优先事项冲突）下需要做出大量决策。专家描述了人类决策的两种系统：一种快速且直观；另一种缓慢且有条理。启发法，或思维捷径，是直观推理的一个关键特征，通常是准确的，本能地应用，并对有效的诊断决策至关重要。启发法也容易出现故障，或认知偏差，这可能导致诊断错误。已经提出了各种策略来减轻偏差；然而，目前对于优化诊断安全性的此类干预措施的理解仍然不完整。
