Budowski Alexandra D, Bergauer Lisa, Castellucci Clara, Braun Julia, Nöthiger Christoph B, Spahn Donat R, Tscholl David W, Roche Tadzio R
Department of Anesthesiology, University of Zurich, University Hospital Zurich, 8091 Zurich, Switzerland.
Department of Epidemiology and Biostatistics, University of Zurich, 8006 Zurich, Switzerland.
Diagnostics (Basel). 2022 Jul 29;12(8):1835. doi: 10.3390/diagnostics12081835.
Decision confidence—the subjective belief to have made the right decision—is central in planning actions in a complex environment such as the medical field. It is unclear by which factors it is influenced. We analyzed a pooled data set of eight studies and performed a multicenter online survey assessing anesthesiologists’ opinions on decision confidence. By applying mixed models and using multiple imputation to determine the effect of missing values from the dataset on the results, we investigated how task performance, perceived workload, the utilization of user-centered medical diagnostic devices, job, work experience, and gender affected decision confidence. The odds of being confident increased with better task performance (OR: 1.27, 95% CI: 0.94 to 1.7; p = 0.12; after multiple imputation OR: 3.19, 95% CI: 2.29 to 4.45; p < 0.001) and when user-centered medical devices were used (OR: 5.01, 95% CI: 3.67 to 6.85; p < 0.001; after multiple imputation OR: 3.58, 95% CI: 2.65 to 4.85; p < 0.001). The odds of being confident decreased with higher perceived workload (OR: 0.94, 95% CI: 0.93 to 0.95; p < 0.001; after multiple imputation, OR: 0.94, 95% CI: 0.93 to 0.95; p < 0.001). Other factors, such as gender, job, or professional experience, did not affect decision confidence. Most anesthesiologists who participated in the online survey agreed that task performance (25 of 30; 83%), perceived workload (24 of 30; 80%), work experience (28 of 30; 93%), and job (21 of 30; 70%) influence decision confidence. Improved task performance, lower perceived workload, and user-centered design in medical equipment enhanced the decision confidence of anesthesia providers.
决策信心——做出正确决策的主观信念——在诸如医疗领域这样的复杂环境中进行行动规划时至关重要。目前尚不清楚它受哪些因素影响。我们分析了八项研究的汇总数据集，并开展了一项多中心在线调查，评估麻醉医生对决策信心的看法。通过应用混合模型并使用多重填补法来确定数据集中缺失值对结果的影响，我们研究了任务表现、感知工作量、以用户为中心的医疗诊断设备的使用、工作、工作经验和性别如何影响决策信心。随着任务表现的提高（比值比：1.27，95%置信区间：0.94至1.7；p = 0.12；多重填补后比值比：3.19，95%置信区间：2.29至4.45；p < 0.001）以及使用以用户为中心的医疗设备（比值比：5.01，95%置信区间：3.67至6.85；p < 0.001；多重填补后比值比：3.58，95%置信区间：2.65至4.85；p < 0.001），感到有信心的几率会增加。随着感知工作量的增加，感到有信心的几率会降低（比值比：0.94，95%置信区间：0.93至0.95；p < 0.001；多重填补后，比值比：0.94，95%置信区间：0.93至0.95；p < 0.001）。其他因素，如性别、工作或专业经验，并不影响决策信心。参与在线调查的大多数麻醉医生都认为任务表现（30人中有25人；83%）、感知工作量（30人中有24人；80%）、工作经验（30人中有28人；93%）和工作（30人中有21人；70%）会影响决策信心。任务表现的改善、感知工作量的降低以及医疗设备的以用户为中心设计增强了麻醉提供者的决策信心。
