Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 598 - файл

Under the increased pressure of time constraints and uncertainty, decision­making may be affected by heuristics or cognitive shortcuts. Heuristics may lead to bias or predictable and systematic cognitive lapses, as described in Table1.

There is a wealth of clinical-decision support tools, risk calculators, clinical guidelines, and evidence-based scientic publications to aid surgeons with clinical decision-making. The challenge of seeking answers in available resources, however, is identifying what is true and what is not. In recent years, our traditional trusted source of “truth” (published peer-reviewed literature) has come under increased scrutiny. Although we hope that scientic misconduct is uncommon, its actual inci­dence is unknown. “Mistakes,” ranging from benign errors to outright fraud, are detected with alarming frequency. Methodological aws and interpretive shortcom­ings compromise much of the biomedical literature. False-positive research ndings are ubiquitous, reecting awed treatment effect size, underpowered studies, improper statistical analysis, agrant data-mining, overtting, and a lack of conr­matory studies. These issues are exacerbated by publication bias and an archaic system of editorial peer review process. Even when based on thoroughly vetted evidence, a typical textbook merely lists the outcomes of surgical trials that focus on conventional variables, such as perioperative mortality or disease-free survival, but these may not directly inform clinical decisions [2].