期刊文章%@ 2561-326X %I JMIR出版物% v6 %N 卡塔尔世界杯8强波胆分析10 %P e38977% T外行人的分诊能力:回顾性探索性分析A Kopka,Marvin %A Feufel,Markus A %A Balzer,Felix %A Schmieding,Malte L %+柏林慈善会- Universitätsmedizin医学信息学研究所，德国柏林慈善会1号，柏林，10117,49 30 450 581 052，德国柏林，Universität柏林和Humboldt-Universität zu柏林的法人成员，marvin.kopka@charite.de %K数字健康%K分诊%K自我分诊%K紧急评估%K以患者为中心的护理%K护理导航%K决策支持%K症状检查%K护理%K支持%K医疗%K健康专业人员%K患者%K自我评估%K决策%K准确性%K误差%K敏感性%K紧急%K女性%K男性%D 2022 %7 12.10.2022 %9论文来源%J JMIR表格Res %G英语%X虽然医疗决策可能被认为是一项涉及卫生专业人员的任务，但许多决定，包括关键的与健康有关的决定，都是由外行人单独做出的。具体来说，作为大多数护理事件的第一步，是患者决定是否以及在哪里寻求医疗保健(分诊)。过度谨慎的自我评估(即过度分类)可能导致医疗设施的过度利用和急诊科的过度拥挤，而不谨慎的决定(即分类不足)则对患者的健康构成风险。最近，面向患者的决策支持系统，通常被称为症状检查器，已经开发出来帮助外行人做出这些决定。目的:探讨外行人自我分诊能力的影响因素及其自我分诊决策的风险厌恶程度。方法:我们分析了91名外行人对45个虚构的简短病人描述(病例小特写;N = 4095评估)。 Using signal detection theory and descriptive and inferential statistics, we explored whether the type of medical decision laypersons face, their confidence in their decision, and sociodemographic factors influence their triage accuracy and the type of errors they make. We distinguished between 2 decisions: whether emergency care was required (decision 1) and whether self-care was sufficient (decision 2). Results: The accuracy of detecting emergencies (decision 1) was higher (mean 82.2%, SD 5.9%) than that of deciding whether any type of medical care is required (decision 2, mean 75.9%, SD 5.25%; t>90=8.4; P<.001; Cohen d=0.9). Sensitivity for decision 1 was lower (mean 67.5%, SD 16.4%) than its specificity (mean 89.6%, SD 8.6%) whereas sensitivity for decision 2 was higher (mean 90.5%, SD 8.3%) than its specificity (mean 46.7%, SD 15.95%). Female participants were more risk averse and overtriaged more often than male participants, but age and level of education showed no association with participants’ risk averseness. Participants’ triage accuracy was higher when they were certain about their appraisal (2114/3381, 62.5%) than when being uncertain (378/714, 52.9%). However, most errors occurred when participants were certain of their decision (1267/1603, 79%). Participants were more commonly certain of their overtriage errors (mean 80.9%, SD 23.8%) than their undertriage errors (mean 72.5%, SD 30.9%; t>89=3.7; P<.001; d=0.39). Conclusions: Our study suggests that laypersons are overcautious in deciding whether they require medical care at all, but they miss identifying a considerable portion of emergencies. Our results further indicate that women are more risk averse than men in both types of decisions. Layperson participants made most triage errors when they were certain of their own appraisal. Thus, they might not follow or even seek advice (eg, from symptom checkers) in most instances where advice would be useful. %M 36222793 %R 10.2196/38977 %U https://formative.www.mybigtv.com/2022/10/e38977 %U https://doi.org/10.2196/38977 %U http://www.ncbi.nlm.nih.gov/pubmed/36222793