Effect of Harm Anchors in Visual Displays of Test Results on Patient Perceptions of Urgency About Near-Normal Values: Experimental Study.
Effect of Harm Anchors in Visual Displays of Test Results on Patient Perceptions of Urgency About Near-Normal Values: Experimental Study.
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DOI：
10.2196/jmir.8889
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发表时间：
2018-03-26
影响因子：
7.4
通讯作者：
Fagerlin A
中科院分区：
文献类型：
--
作者：
Zikmund-Fisher BJ;Scherer AM;Witteman HO;Solomon JB;Exe NL;Fagerlin A
面向患者的实验室测试结果显示通常为患者提供一个参考点（“标准范围”）。旨在测试在实验室测试结果的视觉显示中包含额外伤害锚参考点的影响，该参考点指示需要超出标准范围值多远才能表明存在重大患者风险。使用一个人口统计学上多样化的在线样本，我们比较了1618名美国成年人的反应，这些成年人观看了包括标准范围和伤害锚参考点的视线显示（“许多医生在此之前并不关心”）显示，包括（1）仅标准范围，（2）标准范围加评价类别（例如，“边界高”），或（3）显示偏离标准范围的程度的颜色梯度。提供伤害锚参考点显著降低了接近正常丙氨酸氨基转移酶和肌酐结果的紧迫感（P值<0.001），但血小板计数结果通常不会。值得注意的是，显示类型并没有显着改变的看法，更极端的结果在潜在的有害范围。伤害锚也大大减少了想要紧急联系医生或去医院了解这些测试结果的参与者数量。向患者提供关于何时检测结果变得临床相关的评估提示，可以减少不需要立即采取临床行动的超出范围结果的感知紧迫性。
Patient-facing displays of laboratory test results typically provide patients with one reference point (the “standard range”). To test the effect of including an additional harm anchor reference point in visual displays of laboratory test results, which indicates how far outside of the standard range values would need to be in order to suggest substantial patient risk. Using a demographically diverse, online sample, we compared the reactions of 1618 adults in the United States who viewed visual line displays that included both standard range and harm anchor reference points (“Many doctors are not concerned until here”) to displays that included either (1) only a standard range, (2) standard range plus evaluative categories (eg, “borderline high”), or (3) a color gradient showing degree of deviation from the standard range. Providing the harm anchor reference point significantly reduced perceived urgency of close-to-normal alanine aminotransferase and creatinine results (P values <.001) but not generally for platelet count results. Notably, display type did not significantly alter perceptions of more extreme results in potentially harmful ranges. Harm anchors also substantially reduced the number of participants who wanted to contact their doctor urgently or go to the hospital about these test results. Presenting patients with evaluative cues regarding when test results become clinically concerning can reduce the perceived urgency of out-of-range results that do not require immediate clinical action.
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DOI：
10.1016/s1386-5056(02)00070-9
发表时间：
2002-12-18
影响因子：
4.9
作者：
Cimino, JJ;Patel, VL;Kushniruk, AW
通讯作者：
Kushniruk, AW
影响因子：
2.2
作者：
Kelman A;Robinson CO;Cochin E;Ahluwalia NJ;Braverman J;Chiauzzi E;Simacek K
通讯作者：
Simacek K
DOI：
10.1093/jamia/ocx140
发表时间：
2018-04-01
影响因子：
6.4
作者：
Giardina, Traber D.;Baldwin, Jessica;Singh, Hardeep
通讯作者：
Singh, Hardeep
影响因子：
22.4
作者：
Hsee, CK;Loewenstein, GF;Bazerman, MH
通讯作者：
Bazerman, MH
图形有助于患者区分实验室测试结果中的紧急和非紧急偏差。
DOI：
10.1093/jamia/ocw169
发表时间：
2017-05-01
期刊：
Journal of the American Medical Informatics Association : JAMIA
影响因子：
--
作者：
Zikmund-Fisher BJ;Scherer AM;Witteman HO;Solomon JB;Exe NL;Tarini BA;Fagerlin A
通讯作者：
Fagerlin A