Faculty of Health, Southern Cross University, Lismore, Australia.
National Coalition of Independent Scholars, Canberra, Australia.
JMIR Hum Factors. 2023 Dec 20;10:e46490. doi: 10.2196/46490.
Humans currently dominate decision-making in both clinical health services and complex health services such as health policy and health regulation. Many assumptions inherent in health service models today are underpinned by Ramsey's Expected Utility Theory, a prominent theory in the field of economics that is rooted in rationality. Rational, evidence-based metrics currently dominate the culture of decision-making in health policy and regulation. However, as the COVID-19 pandemic has shown, rational metrics alone may not suffice in making better policy and regulatory decisions. There are ethical and moral considerations and other complex factors that cannot be reduced to evidence-based rationality alone. Therefore, this scoping review was undertaken to identify and map the attributes that influence human decision-making in complex health services.
The objective is to identify and map the attributes that influence human decision-making in complex health services that have been reported in the peer-reviewed literature.
This scoping review was designed to answer the following research question: what attributes have been reported in the literature that influence human decision-making in complex health services? A clear, reproducible methodology is provided. It is reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) standards and a recognized framework. As the topic of interest merited broad review to scope and understand literature from a holistic viewpoint, a scoping review of literature was appropriate here. Inclusion and exclusion criteria were developed, and a database search undertaken within 4 search systems-ProQuest, Scopus, PubMed, and Web of Science.
The results span 46 years, from 1976 to 2022. A total of 167 papers were identified. After removing duplicates, 81 papers remained. Of these, 77 papers were excluded based on the inclusion and exclusion criteria. The remaining 4 papers were found to be relevant. Citation tracking was undertaken, identifying 4 more relevant papers. Thus, a total of 8 papers were included. These papers were reviewed in detail to identify the human attributes mentioned and count the frequency of mentions. A thematic analysis was conducted to identify the themes.
The results highlight key themes that underline the complex and nuanced nature of human decision-making. The results suggest that rationality is entrenched and may influence the lexicon of our thinking about decision-making. The results also highlight the counter narrative of decision-making underpinned by uniquely human attributes. This may have ramifications for decision-making in complex health services today. The review itself takes a rational approach, and the methods used were suited to this.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/42353.
目前，在临床卫生服务和复杂卫生服务（如卫生政策和卫生监管）中，人类主导着决策。当今卫生服务模式中存在许多假设，这些假设都以理性为基础，建立在经济学领域中著名的期望效用理论之上。基于理性和循证的指标目前主导着卫生政策和监管决策的文化。然而，正如 COVID-19 大流行所表明的那样，单凭理性指标可能不足以做出更好的政策和监管决策。在做出决策时，还存在伦理道德考量以及其他无法简化为基于证据的理性的复杂因素。因此，进行了本次范围界定审查，以确定并绘制在同行评议文献中报告的影响复杂卫生服务中人类决策的属性。
本研究旨在确定并绘制在同行评议文献中报告的影响复杂卫生服务中人类决策的属性。
本范围界定审查旨在回答以下研究问题：在同行评议文献中，哪些属性被报道会影响复杂卫生服务中的人类决策？本研究提供了一个清晰、可重现的方法。它是根据 PRISMA-ScR（系统评价和荟萃分析扩展的首选报告项目）标准和公认的框架报告的。由于所关注的主题需要广泛审查，从整体角度理解文献，因此在这里进行了文献范围界定审查。制定了纳入和排除标准，并在 4 个检索系统-ProQuest、Scopus、PubMed 和 Web of Science 中进行了数据库检索。
结果跨越 46 年，从 1976 年到 2022 年。共确定了 167 篇论文。去除重复项后，剩余 81 篇。其中，根据纳入和排除标准，有 77 篇被排除。其余 4 篇论文与研究相关。进行了引文追踪，确定了另外 4 篇相关论文。因此，共有 8 篇论文被纳入。详细审查了这些论文，以确定提到的人类属性并计算提及的频率。进行了主题分析以确定主题。
结果突出了强调人类决策复杂和微妙性质的关键主题。结果表明，理性根深蒂固，可能会影响我们对决策的思维词汇。结果还强调了基于人类独特属性的决策的反叙事。这可能对当今复杂卫生服务中的决策产生影响。审查本身采用了理性方法，所使用的方法适合这种方法。
