Vignette methodologies for studying clinicians' decision-making: Validity, utility, and application in ICD-11 field studies
Vignette methodologies for studying clinicians' decision-making: Validity, utility, and application in ICD-11 field studies
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DOI：
10.1016/j.ijchp.2014.12.001
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发表时间：
2015-05-01
影响因子：
8.8
通讯作者：
Reed, Geoffrey M.
中科院分区：
文献类型：
--
作者：
Evans, Spencer C.;Roberts, Michael C.;Reed, Geoffrey M.
基于晕轮的方法经常用于检查判断和决策过程，包括卫生专业人员做出的临床判断。人们有时会担心，小插曲不能准确地反映“真实的世界”的现象，这会影响这些研究结果和结论的有效性。本文概述了小插曲研究的定义特征、设计变化、优点和缺点，作为检查卫生专业人员如何形成临床判断的一种方式（例如，分配诊断、选择治疗）。作为传统调查和实验方法的“混合体”，小插曲研究可以提供实验的高内部效度和调查研究的高外部效度，以解开临床医生行为的多个预测因素。当小插曲研究设计得很好，以测试有关判断和决策的具体问题时，它们可以高度概括为“真实的生活”行为，同时克服与替代方法相关的伦理，实践和科学限制（例如，观察、自我报告、标准化患者、档案分析）。最后，我们总结了方法学建议，并描述了如何使用小插曲方法来调查临床医生在ICD-11精神和行为障碍分类的病例对照现场研究中的诊断决策，以及这些研究如何说明前面的概念和建议（C）2014 Asociacion Espanola de Psicologia Conductual。出版社：Elsevier Espana，S.L.U.
Vignette-based methodologies are frequently used to examine judgments and decision-making processes, including clinical judgments made by health professionals. Concerns are sometimes raised that vignettes do not accurately reflect "real world" phenomena, and that this affects the validity of results and conclusions of these studies. This article provides an overview of the defining features, design variations, strengths, and weaknesses of vignette studies as a way of examining how health professionals form clinical judgments (e.g., assigning diagnoses, selecting treatments). As a "hybrid" of traditional survey and experimental methods, vignette studies can offer aspects of both the high internal validity of experiments and the high external validity of survey research in order to disentangle multiple predictors of clinician behavior. When vignette studies are well designed to test specific questions about judgments and decision-making, they can be highly generalizable to "real life" behavior, while overcoming the ethical, practical, and scientific limitations associated with alternative methods (e.g., observation, self-report, standardized patients, archival analysis). We conclude with methodological recommendations and a description of how vignette methodologies are being used to investigate clinicians' diagnostic decisions in case-controlled field studies for the ICD-11 classification of mental and behavioural disorders, and how these studies illustrate the preceding concepts and recommendations (C) 2014 Asociacion Espanola de Psicologia Conductual. Published by Elsevier Espana, S.L.U.