急诊医学医患共同决策中的博弈分析

通过急诊医学的实践，借助博弈论方法分析了急诊医学中实施医患共同决策（shared decision making，SDM）的现状，为急诊医学中实施SDM提供参考意见。分析发现，在急诊医疗决策中存在“公地悲剧”“蜈蚣博弈”“博傻理论”等博弈现象。急诊医学中的信息技术滞后、医患对SDM的认知不足、医患信任等因素是影响SDM在急诊医学中实施的重要博弈因素。通过推动急诊医学的信息化建设、SDM理念的普及和技能培训，借助博弈论的方法和相关法律制度的完善，提升互联网作为健康宣传和健康教育的工具作用，有利于SDM在急诊医学的应用推广，从而促进急诊医学和谐医患关系的构建。

Game Analysis of Shared Decision-making in the Doctor-patient Relationship of Emergency Medicine

In order to provide a reference for the implementation of shared decision making (SDM) in emergency medicine, current situation of SDM in emergency medicine was analyzed with game theory in emergency practice. It is found that there are some kinds of game phenomenon such as "tragedy of the commons" "centipede game" "greater food theory" in emergency medical decision-making. The lag of information technology in emergency medicine, the lack of awareness of SDM among physicians and patients, and the trust between physicians and patients are important factors affecting the implementation of SDM in emergency medicine. SDM application in emergency medicine will be promoted through the informatization construction, the popularization of SDM concepts, skills training, with the approach of game theory and the improvement of relevant legal systems, which will eventually promote emergency medicine and a harmonious doctor-patient relationship.