Telfer School of Management, University of Ottawa, Ottawa, ON, Canada.
Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
BMC Med Inform Decis Mak. 2024 Sep 27;24(1):273. doi: 10.1186/s12911-024-02681-2.
Decision thresholds play important role in medical decision-making. Individual decision-making differences may be attributable to differences in subjective judgments or cognitive processes that are captured through the decision thresholds. This systematic scoping review sought to characterize the literature on non-expected utility decision thresholds in medical decision-making by identifying commonly used theoretical paradigms and contextual and subjective factors that inform decision thresholds.
A structured search designed around three concepts-individual decision-maker, decision threshold, and medical decision-was conducted in MEDLINE (Ovid) and Scopus databases from inception to July 2023. ProQuest (Dissertations and Theses) database was searched to August 2023. The protocol, developed a priori, was registered on Open Science Framework and PRISMA-ScR guidelines were followed for reporting on this study. Titles and abstracts of 1,618 articles and the full texts for the 228 included articles were reviewed by two independent reviewers. 95 articles were included in the analysis. A single reviewer used a pilot-tested data collection tool to extract study and author characteristics, article type, objectives, theoretical paradigm, contextual or subjective factors, decision-maker, and type of medical decision.
Of the 95 included articles, 68 identified a theoretical paradigm in their approach to decision thresholds. The most common paradigms included regret theory, hybrid theory, and dual processing theory. Contextual and subjective factors that influence decision thresholds were identified in 44 articles.
Our scoping review is the first to systematically characterizes the available literature on decision thresholds within medical decision-making. This study offers an important characterization of the literature through the identification of the theoretical paradigms for non-expected utility decision thresholds. Moreover, this study provides insight into the various contextual and subjective factors that have been documented within the literature to influence decision thresholds, as well as these factors juxtapose theoretical paradigms.
决策阈值在医学决策中起着重要作用。个体决策差异可能归因于通过决策阈值捕捉到的主观判断或认知过程的差异。本系统范围综述旨在通过确定常用的理论范式以及告知决策阈值的背景和主观因素，描述医学决策中非期望效用决策阈值的文献。
围绕个体决策者、决策阈值和医学决策这三个概念，在 MEDLINE（Ovid）和 Scopus 数据库中进行了有结构的搜索，检索时间从建库开始到 2023 年 7 月。2023 年 8 月在 ProQuest（论文和学位论文）数据库中进行了搜索。该方案是事先制定的，并在开放科学框架上注册，本研究报告遵循 PRISMA-ScR 指南。两名独立评审员对 1618 篇文章的标题和摘要以及 228 篇纳入文章的全文进行了审查。95 篇文章被纳入分析。一名评审员使用经过试点测试的数据收集工具提取研究和作者特征、文章类型、目标、理论范式、背景或主观因素、决策者和医学决策类型。
在纳入的 95 篇文章中，有 68 篇文章在其决策阈值方法中确定了一个理论范式。最常见的范式包括后悔理论、混合理论和双加工理论。有 44 篇文章确定了影响决策阈值的背景和主观因素。
本范围综述是首次系统地描述医学决策中决策阈值的现有文献。这项研究通过确定非期望效用决策阈值的理论范式，对文献进行了重要的描述。此外，本研究还深入了解了文献中记录的影响决策阈值的各种背景和主观因素，以及这些因素与理论范式的对比。
