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Heuristics in the delivery room
Science ( IF 44.7 ) Pub Date : 2021-10-15 , DOI: 10.1126/science.abc9818
Manasvini Singh 1
Affiliation  

Clinical decisions made in the delivery setting are often made under high pressure and great uncertainty, and have serious consequences for mother and baby. Theories of decision-making suggest that individuals in such settings may resort to using heuristics, or simplified decision rules, to aid complex decision-making. This study investigates whether physicians’ delivery mode decisions (i.e., when to perform a vaginal versus a cesarean delivery) are influenced by such a heuristic. Electronic health records spanning 86,000 deliveries suggest that if the prior patient had complications in one delivery mode, the physician will be more likely to switch to the other—and likely inappropriate—delivery mode for the subsequent patient, regardless of patient indications. There is evidence that this heuristic has small, suboptimal effects on patient health.

中文翻译:

产房的启发式

在分娩环境中做出的临床决定通常是在高压和极大的不确定性下做出的,并且会对母亲和婴儿造成严重后果。决策理论表明,在这种情况下,个人可能会求助于使用启发式或简化的决策规则来帮助做出复杂的决策。本研究调查医生的分娩方式决定(即何时进行阴道分娩与剖宫产)是否受到这种启发式的影响。跨越 86,000 次分娩的电子健康记录表明,如果先前的患者在一种分娩模式下出现并发症,那么无论患者适应症如何,医生更有可能为随后的患者切换到另一种可能不合适的分娩模式。有证据表明,这种启发式方法对患者健康的影响很小,次优。
更新日期:2021-10-14
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