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我不是适合你的医生:认知偏差、复杂疾病与道德责任。

I'm Not the Doctor for You: Cognitive Bias, Complex Illness, and a Moral Imperative.

作者信息

Kuon Carla P

机构信息

Department of Hospital Medicine, Osher Center for Integrative Medicine, University of California, San Francisco, CA, USA.

出版信息

Glob Adv Integr Med Health. 2025 Jan 8;14:27536130241311594. doi: 10.1177/27536130241311594. eCollection 2025 Jan-Dec.

DOI:10.1177/27536130241311594
PMID:39790367
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11713959/
Abstract

Cognitive Bias and the Treatment of Complex Illnesses: A Reflection on Substance Use Disorder and Long COVID. Physicians use anchoring and confirmation bias every day to make snap decisions about patient care. However, in the case of poorly understood complex illness, cognitive bias can lead to poor outcomes for the patient. This article explores how recognizing and overcoming cognitive bias leads to increased personal career satisfaction, and improved patient outcomes. In an era where health disparities are increasingly recognized, and in the post-COVID era in particular, there's a need to recognize cognitive bias against complex illnesses such as Long COVID and Chronic Fatigue Syndrome. It may even be a moral imperative.

摘要

认知偏差与复杂疾病的治疗

对物质使用障碍和长新冠的思考。医生每天都会运用锚定效应和确认性偏差对患者护理做出快速决策。然而,在对复杂疾病了解不足的情况下,认知偏差可能会给患者带来不良后果。本文探讨了认识并克服认知偏差如何能提高个人职业满意度,并改善患者治疗效果。在一个健康差距日益受到重视的时代,尤其是在后新冠时代,有必要认识到针对长新冠和慢性疲劳综合征等复杂疾病的认知偏差。这甚至可能是一项道德义务。

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本文引用的文献

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NIH Study Provides Long-Awaited Insight Into Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.美国国立卫生研究院的研究为肌痛性脑脊髓炎/慢性疲劳综合征提供了期待已久的见解。
JAMA. 2024 Apr 9;331(14):1169-1171. doi: 10.1001/jama.2024.3603.
2
Why the Psychosomatic View on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Is Inconsistent with Current Evidence and Harmful to Patients.为什么躯体化视角下的肌痛性脑脊髓炎/慢性疲劳综合征与当前证据不一致,且对患者有害。
Medicina (Kaunas). 2023 Dec 31;60(1):83. doi: 10.3390/medicina60010083.
3
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Adults: United States, 2021-2022.成人肌痛性脑脊髓炎/慢性疲劳综合征:美国,2021 - 2022年
NCHS Data Brief. 2023 Dec(488):1-8.
4
Postacute/Long COVID in Pediatrics: Development of a Multidisciplinary Rehabilitation Clinic and Preliminary Case Series.儿科的新冠后/长期新冠:多学科康复诊所的发展和初步病例系列。
Am J Phys Med Rehabil. 2021 Dec 1;100(12):1140-1147. doi: 10.1097/PHM.0000000000001896.
5
Gender Disparity in the Funding of Diseases by the U.S. National Institutes of Health.美国国立卫生研究院资助疾病的性别差异。
J Womens Health (Larchmt). 2021 Jul;30(7):956-963. doi: 10.1089/jwh.2020.8682. Epub 2020 Nov 27.
6
Teaching Critical Thinking: A Case for Instruction in Cognitive Biases to Reduce Diagnostic Errors and Improve Patient Safety.教授批判性思维:以认知偏差教学减少诊断错误和提高患者安全的案例。
Acad Med. 2019 Feb;94(2):187-194. doi: 10.1097/ACM.0000000000002518.
7
Curiosity. Are you curious enough to read on?好奇心。你是否有足够的好奇心继续读下去?
J R Soc Med. 2015 May;108(5):160-4. doi: 10.1177/0141076815585057.
8
Seen through their eyes: residents' reflections on the cognitive and contextual components of diagnostic errors in medicine.从他们的视角看问题:住院医师对医学诊断错误的认知和背景因素的反思。
Acad Med. 2012 Oct;87(10):1361-7. doi: 10.1097/ACM.0b013e31826742c9.
9
The importance of cognitive errors in diagnosis and strategies to minimize them.认知错误在诊断中的重要性以及将其最小化的策略。
Acad Med. 2003 Aug;78(8):775-80. doi: 10.1097/00001888-200308000-00003.