背景:临床决策支持(CDS)警报和提醒旨在影响临床决策,然而,它们的设计往往没有考虑人类的决策行为。虽然这种行为是由行为经济学(BE)全面描述的,BE文献的绝对数量对设计师提出了挑战,当识别具有提醒和提醒设计的效用的行为效果时。本研究通过关注行为改变的MINDSPACE框架来应对这一挑战,它整理了九种深刻影响人类决策行为的行为效应:信使,奖励,规范,默认值,显著性,灌注,影响,承诺,和自我。
方法:系统综述搜索MEDLINE,Embase,PsycINFO,和CINAHLPlus探讨(i)在警报和提醒设计中使用MINDSPACE效果,以及(ii)这些警报和提醒在影响临床决策中的功效。搜索查询包括十个布尔搜索,其中9个专注于思维空间效应,一个专注于思维空间。
结果:从1970年至2022年的1791篇英文同行评审期刊文章中选择了50项研究。除了自我,九种MINDSPACE效果中的八种被用来设计警报和提醒,默认和规范在警报和提醒中使用最多,分别。总的来说,由MINDSPACE效果通知的警报和提醒显示影响临床决策的平均成功率为71%(警报73%,提醒69%)。大多数研究在设计中使用了单一效果,警报(64%)比提醒(41%)更有效。其他人利用了多种效果,对提醒(28%)的效力高于警报(9%)。
结论:本综述提供了充分的证据,证明了MINDSPACE框架在设计CDS警报和提醒时要考虑人类决策的优点。该框架可以充分解决在识别与CDS警报和提醒的有效设计相关的行为影响方面的挑战。审查还确定了未来研究其他相关影响的机会(例如,框架)。
BACKGROUND: Clinical decision support (CDS) alerts and reminders aim to influence clinical decisions, yet they are often designed without considering human decision-making behaviour. While this behaviour is comprehensively described by behavioural economics (BE), the sheer volume of BE literature poses a challenge to designers when identifying behavioural effects with utility to alert and reminder designs. This study tackles this challenge by focusing on the MINDSPACE framework for behaviour change, which collates nine behavioural effects that profoundly influence human decision-making behaviour: Messenger, Incentives, Norms, Defaults, Salience, Priming, Affect, Commitment, and Ego.
METHODS: A systematic
review searching MEDLINE, Embase, PsycINFO, and CINAHL Plus to explore (i) the usage of MINDSPACE effects in alert and reminder designs and (ii) the efficacy of those alerts and reminders in influencing clinical decisions. The search queries comprised ten Boolean searches, with nine focusing on the MINDSPACE effects and one focusing on the term mindspace.
RESULTS: 50 studies were selected from 1791 peer-reviewed journal articles in English from 1970 to 2022. Except for ego, eight of nine MINDSPACE effects were utilised to design alerts and reminders, with defaults and norms utilised the most in alerts and reminders, respectively. Overall, alerts and reminders informed by MINDSPACE effects showed an average 71% success rate in influencing clinical decisions (alerts 73%, reminders 69%). Most studies utilised a single effect in their design, with higher efficacy for alerts (64%) than reminders (41%). Others utilised multiple effects, showing higher efficacy for reminders (28%) than alerts (9%).
CONCLUSIONS: This
review presents sufficient evidence demonstrating the MINDSPACE framework\'s merits for designing CDS alerts and reminders with human decision-making considerations. The framework can adequately address challenges in identifying behavioural effects pertinent to the effective design of CDS alerts and reminders. The
review also identified opportunities for future research into other relevant effects (e.g., framing).