会诊医生的诊治结论共识机制研究

Research on Consensus Mechanism of Diagnosis and Treatment Conclusion of Consultants

本文旨在探讨在疑难病症的会诊过程中,会诊医生形成一致诊治结论的共识机制的合理性。通过对会诊专家诊治结论的偏好度、会诊专家的可信度、会诊专家诊治结论的可信偏好度分别赋值,利用贝叶斯定理推断和验证疑难病症的会诊诊治结论共识的主观可能性概率。目前主要存在的三种达成会诊诊治结论共识的典型机制中,第一种机制显而易见是合理的;基于少数服从多数原则的第二种机制在持不同意见人数为绝对少数时也是合理的,但相对少数时则不能确保其合理性;在难以达成共识时由权威会诊专家做出诊断结论的第三种机制存在独断的风险。总之,会诊医生的诊治结论偏好和权威性禀赋在达成诊治结论共识中发挥着关键性作用。

This paper aims to explore the rationality of the consensus mechanism for the consultation doctors to form a consistent diagnosis and treatment conclusion during the consultation process of difficult and complicated diseases.By assigning values to the preference of the consultation expert's diagnosis and treatment conclusion,the credibility of the consultation expert,and the credibility preference of the consultation expert's diagnosis and treatment conclusion,the Bayes'theorem is used to infer and verify the subjective probability of the consensus of the consultation diagnosis and treatment conclusions of difficult and complicated diseases.At present,there are mainly three kinds of typical mechanisms for reaching consensus on diagnosis and treatment conclusions.When the consultation experts and the clinical physicians have the same consultation conclusions,the rationality of the consensus mechanism for diagnosis and treatment conclusions is obvious;the consensus on the diagnosis and treatment conclusions based on the principle of majority rule mechanism is reasonable when the number of dissenting opinions is an absolute minority,but when it is relatively small,its rationality cannot be ensured;when it is difficult to reach a consensus,to rely on the authoritative consultation experts to make a diagnosis is risky.The diagnosis and treatment conclusion preference and authoritative endowment of the consulting physicians play a key role in reaching a consensus on diagnosis and treatment conclusions.