客观关于与诊断错误相关的可用性偏差的经验证据仍然不足。我们调查了最近的临床问题经验是否会导致医生由于可用性偏差而导致诊断错误,以及反思是否抵消了这种偏差。方法将46例内科住院医师随机分为对照组(CG)和实验组(EG)。在这项研究中使用的8例临床病例中,三个实验病例与登革热(DF)疾病相似,但表现出不同的诊断,一个实际上是DF,其余4例与DF无关。首先,只有EG收到关于DF的信息,而CG对这项研究一无所知。然后,六小时后,所有参与者被要求通过非分析推理诊断8例临床病例.最后,4例通过反思性推理再次诊断。结果在第2阶段,实验病例诊断的CG平均得分明显高于填充病例(0.80vs.0.59,p<0.01),但在这两种类型的病例中,EG的平均得分没有显着差异(0.66与0.64,p=0.756)。每个实验案例的EG和CG得分明显不同,而在填料情况下没有观察到差异。在EG中,错误诊断为DF的疾病比例在71%至100%之间。在任何情况下,通过非分析推理获得的平均诊断准确性得分与通过反射推理获得的平均诊断准确性得分之间都没有显着差异。结论可用性偏差导致诊断错误。误诊不能总是仅通过采用反思方法来修复。
Objective Empirical evidence on the availability bias associated with diagnostic errors is still insufficient. We investigated whether or not recent experience with clinical problems can lead physicians to make diagnostic errors due to availability bias and whether or not reflection counteracts this bias. Methods Forty-six internal medicine residents were randomly divided into a control group (CG) and experimental group (EG). Among the eight clinical cases used in this
study, three experimental cases were similar to the disease of dengue fever (DF) but exhibited different diagnoses, one was actually DF, and the other four filler cases were not associated with DF. First, only the EG received information on DF, while the CG knew nothing about this
study. Then, six hours later, all participants were asked to diagnose eight clinical cases via nonanalytic reasoning. Finally, four cases were diagnosed again via reflective reasoning. Results In stage 2, the average score of the CG in the diagnosis of experimental cases was significantly higher than that of the filler cases (0.80 vs. 0.59, p<0.01), but the EG\'s average score in the two types of cases was not significantly different (0.66 vs. 0.64, p=0.756). The EG and CG had significantly different scores for each experimental case, while no difference was observed in the filler cases. The proportion of diseases incorrectly diagnosed as DF among experimental cases ranged from 71% to 100% in the EG. There were no significant differences between the mean diagnostic accuracy scores obtained by nonanalytic reasoning and those obtained by the reflective reasoning in any cases. Conclusion Availability bias led to diagnostic errors. Misdiagnoses cannot always be repaired solely by adopting a reflective approach.