Choosing Doctors Wisely: Can Assisted Choice Enhance Patients' Selection of Clinicians?
Choosing Doctors Wisely: Can Assisted Choice Enhance Patients' Selection of Clinicians?
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DOI：
10.1177/1077558717743822
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发表时间：
2019-10-01
影响因子：
2.5
通讯作者：
Schlesinger, Mark
中科院分区：
文献类型：
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作者：
Martino, Steven C.;Grob, Rachel;Schlesinger, Mark
我们进行了模拟临床医生选择实验，比较了随机分配到四个实验组的参与者（N = 688）的选择和决策过程：一个仅报告定量性能信息的传统网站，一个报告定性（患者评论）和定量信息的网站，第二个网站通过决策辅助（患者评论的标签）增强，决策辅助网站通过训练有素的导航员进一步增强。引入患者评论增强了对质量信息的参与，但导致决策质量下降，特别是选择与消费者陈述的偏好的一致性。标记评论有助于消除决策质量的下降，尽管导航器臂中偏好一致的选择比例最高。导航员对高质量信息的参与度和对可用选择的满意度同样最高。针对高技能和低技能决策者的调查结果。因此，导航辅助可能是一种有前途的策略，可以在信息丰富的环境中公平地促进更高质量的选择。
We conducted a simulated clinician-choice experiment, comparing choices and decision-making processes of participants (N = 688) randomized among four experimental arms: a conventional website reporting only quantitative performance information, a website reporting both qualitative (patient comments) and quantitative information, the second website augmented by a decision aid (labeling of patient comments), and the decision-aided website further augmented by the presence of a trained navigator. Introducing patient comments enhanced engagement with the quality information but led to a decline in decision quality, particularly the consistency of choices with consumers' stated preferences. Labeling comments helped erase the decline in decision quality, although the highest percentage of preference-congruent choices was seen in the navigator arm. Engagement with the quality information and satisfaction with choices available were likewise highest in the navigator arm. Findings held for high- and low-skilled decision makers. Thus, navigator assistance may be a promising strategy for equitably promoting higher quality choices in information-rich contexts.