Society for Maternal-Fetal Medicine, 409 12 St. SW, Washington, DC 20024, USA.
Am J Obstet Gynecol. 2022 Aug;227(2):B2-B10. doi: 10.1016/j.ajog.2022.04.033. Epub 2022 Apr 27.
The processes of diagnosis and management involve clinical decision-making. However, decision-making is often affected by cognitive biases that can lead to medical errors. This statement presents a framework of clinical thinking and decision-making and shows how these processes can be bias-prone. We review examples of cognitive bias in obstetrics and introduce debiasing tools and strategies. When an adverse event or near miss is reviewed, the concept of a cognitive autopsy-a root cause analysis of medical decision-making and the potential influence of cognitive biases-is promoted as part of the review process. Finally, areas for future research on cognitive bias in obstetrics are suggested.
诊断和管理过程涉及临床决策。然而,决策往往受到认知偏差的影响,这可能导致医疗错误。本陈述提出了临床思维和决策的框架,并展示了这些过程如何容易受到偏差的影响。我们回顾了产科认知偏差的例子,并介绍了去偏工具和策略。当审查不良事件或险些发生的事件时,提倡将认知尸检(对医疗决策的根本原因分析以及认知偏差的潜在影响)的概念作为审查过程的一部分。最后,提出了产科认知偏差未来研究的领域。