The Perceived Ability of Gastroenterologists, Hepatologists and Surgeons Can Bias Medical Decision Making

被引:9
作者
Cucchetti, Alessandro [1 ,2 ]
Evans, Dylan [3 ]
Casadei-Gardini, Andrea [4 ]
Piscaglia, Fabio [1 ]
Maroni, Lorenzo [1 ]
Odaldi, Federica [1 ]
Ercolani, Giorgio [1 ,2 ]
机构
[1] Alma Mater Studiorum Univ Bologna, S Orsola Malpighi Hosp, Dept Med & Surg Sci DIMEC, I-40138 Bologna, Italy
[2] Morgagni Pierantoni Hosp, I-47121 Forli, Italy
[3] Project Point, Cork T23, Ireland
[4] Univ Hosp Modena, Div Med Oncol, Dept Med & Surg Sci Children & Adults, Via Pozzo 71, I-41122 Modena, Italy
关键词
Dunning-Kruger; medical decision making; medical error; survey; hepatology; surgery; KNOWLEDGE; SELF; CONFIDENCE; REGRET; CHOICE;
D O I
10.3390/ijerph17031058
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Medical errors are a troubling issue and physicians should be careful to scrutinize their own decisions, remaining open to the possibility that they may be wrong. Even so, doctors may still be overconfident. A survey was here conducted to test how medical experience and self-confidence can affect physicians working in the specific clinical area. Potential participants were contacted through personalized emails and invited to contribute to the survey. The "risk-intelligence" test consists of 50 statements about general knowledge in which participants were asked to indicate how likely they thought that each statement was true or false. The risk-intelligence quotient (RQ), a measure of self-confidence, varies between 0 and 100. The higher the RQ score, the better the confidence in personal knowledge. To allow for a representation of 1000 physicians, the sample size was calculated as 278 respondents. A total of 1334 individual emails were sent to reach 278 respondents. A control group of 198 medical students were also invited, of them, 54 responded to the survey. The mean RQ (SD)of physicians was 61.1 (11.4) and that of students was 52.6 (9.9). Assuming age as indicator of knowledge, it was observed that physicians <= 34 years had a mean RQ of 59.1 (10.1); those of 35-42 years had 61.0 (11.0); in those of 43-51 years increased to 62.9 (12.2); reached a plateau of 63.0 (11.5) between 52-59 years and decreased to 59.6 (12.1) in respondents >= 60 years (r(2):0.992). Doctors overestimate smaller probabilities and under-estimate higher probabilities. Specialists in gastroenterology and hepato-biliary diseases suffer from some degree of self-confidence bias, potentially leading to medical errors. Approaches aimed at ameliorating the self-judgment should be promoted more widely in medical education.
引用
收藏
页数:11
相关论文
共 25 条
[1]   PHYSICIANS USE OF PROBABILISTIC INFORMATION IN A REAL CLINICAL SETTING [J].
CHRISTENSENSZALANSKI, JJJ ;
BUSHYHEAD, JB .
JOURNAL OF EXPERIMENTAL PSYCHOLOGY-HUMAN PERCEPTION AND PERFORMANCE, 1981, 7 (04) :928-935
[2]  
Cohen J., 1988, Statistical Power Analysis for the Behavioral Sciences., V2nd, DOI [DOI 10.1007/978-1-4684-5439-0_2, DOI 10.4324/9780203771587, 10.4324/9780203771587]
[3]   Perceived versus actual knowledge about correct condom use among US adolescents: Results from a national study [J].
Crosby, RA ;
Yarber, WL .
JOURNAL OF ADOLESCENT HEALTH, 2001, 28 (05) :415-420
[4]   When to Perform Hepatic Resection for Intermediate-Stage Hepatocellular Carcinoma [J].
Cucchetti, Alessandro ;
Djulbegovic, Benjamin ;
Tsalatsanis, Athanasios ;
Vitale, Alessandro ;
Hozo, Iztok ;
Piscaglia, Fabio ;
Cescon, Matteo ;
Ercolani, Giorgio ;
Tuci, Francesco ;
Cillo, Umberto ;
Pinna, Antonio Daniele .
HEPATOLOGY, 2015, 61 (03) :905-914
[5]   Does student confidence on multiple-choice question assessments provide useful information? [J].
Curtis, Donald A. ;
Lind, Samuel L. ;
Boscardin, Christy K. ;
Dellinges, Mark .
MEDICAL EDUCATION, 2013, 47 (06) :578-584
[6]  
Darwin C., 1871, P423
[7]   Acceptable regret in medical decision making [J].
Djulbegovic, B ;
Hozo, I ;
Schwartz, A ;
McMasters, KM .
MEDICAL HYPOTHESES, 1999, 53 (03) :253-259
[8]  
Dunning David, 2004, Psychol Sci Public Interest, V5, P69, DOI 10.1111/j.1529-1006.2004.00018.x
[9]   Diagnostic error in medical education: where wrongs can make rights [J].
Eva, Kevin W. .
ADVANCES IN HEALTH SCIENCES EDUCATION, 2009, 14 :71-81
[10]  
Evans Dylan., 2012, Risk Intelligence: How to Live with Uncertainty