Cognitive Biases and Practical Barriers Among Chinese Clinicians Regarding the Guidelines for the Prevention and Treatment of Chronic Hepatitis B(version 2022): Results of a Multicenter Survey

Cognitive Biases and Practical Barriers Among Chinese Clinicians Regarding the Guidelines for the Prevention and Treatment of Chronic Hepatitis B(version 2022): Results of a Multicenter Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Cognitive Biases and Practical Barriers Among Chinese Clinicians Regarding the Guidelines for the Prevention and Treatment of Chronic Hepatitis B(version 2022): Results of a Multicenter Survey Guangyuan Huo, Yujie Guo, Junnan Li, Xiaoli Liu, Fengna Yan, Huiwen Yan, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9541175/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background:Chronic hepatitis B virus (HBV) infection is a major global public health issue, and insufficient adherence to clinical guidelines has led to persistent preventable complications. By investigating clinicians’ cognitive characteristics regarding the Guidelines for the Prevention and Treatment of Chronic Hepatitis B (version 2022) and their impact on patient follow-up management, this study aims to address key barriers to translating evidence into clinical practice. Methods: This study conducted a large-scale, multicenter cross-sectional survey among 1,586 physicians from 50 hospitals across 14 cities to assess clinicians’ overall guideline awareness and patient follow-up practices. We collected data on guideline cognition, clinical management behaviors, and barriers to follow-up. Both traditional statistical methods and a machinelearning random forest model were applied to quantify feature significance. Results: Educational background, professional title, hospital tier, and departmental specialization have highly significant effects on physicians’ guideline cognition (P < 0.01). Additionally, the top 3 features in the random forest model by significance were geographical region, educational background, and professional title. Patient follow-up rates declined stepwise at 1, 3, and 5 years, and this decline was closely associated with physician-related factors (insufficient time for follow-up communication, lack of efficient follow-up tools) and patient-related factors (poor disease awareness, tendency toward self-discontinuation of medication). Meanwhile, hospital tier, department type, and general hospital geographical region were identified as critical factors of follow-up management ratio. Conclusions: Cognitive biases and practical barriers hinder the clinical translation of guidelines. Accordingly, we suggest that targeted interventions should be adopted, including geographically tailored training modules, AI-driven follow-up platforms, and policy-guided resource reallocation, thereby collectively promoting guideline implementation. Guidelines for the Prevention and Treatment of Chronic Hepatitis B Clinicians Questionnaire Survey Awareness Follow-up Full Text Additional Declarations No competing interests reported. Supplementary Files SupplementalInformation.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9541175","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":630905119,"identity":"3f92c818-f59a-42d3-a161-8515ab316b02","order_by":0,"name":"Guangyuan Huo","email":"","orcid":"","institution":"Beijing Ditan Hospital, Capital Medical University","correspondingAuthor":false,"prefix":"","firstName":"Guangyuan","middleName":"","lastName":"Huo","suffix":""},{"id":630905120,"identity":"33ace491-3d17-45e0-a936-3168610ed949","order_by":1,"name":"Yujie Guo","email":"","orcid":"","institution":"Beijing Ditan Hospital, Capital Medical 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Awareness, Follow-up","lastPublishedDoi":"10.21203/rs.3.rs-9541175/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9541175/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground:Chronic hepatitis B virus (HBV) infection is a major global public health issue, and insufficient adherence to clinical guidelines has led to persistent preventable complications. By investigating clinicians’ cognitive characteristics regarding the Guidelines for the Prevention and Treatment of Chronic Hepatitis B (version 2022) and their impact on patient follow-up management, this study aims to address key barriers to translating evidence into clinical practice.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: This study conducted a large-scale, multicenter cross-sectional survey among 1,586 physicians from 50 hospitals across 14 cities to assess clinicians’ overall guideline awareness and patient follow-up practices. We collected data on guideline cognition, clinical management behaviors, and barriers to follow-up. Both traditional statistical methods and a machinelearning random forest model were applied to quantify feature significance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: Educational background, professional title, hospital tier, and departmental specialization have highly significant effects on physicians’ guideline cognition (P \u0026lt; 0.01). Additionally, the top 3 features in the random forest model by significance were geographical region, educational background, and professional title. Patient follow-up rates declined stepwise at 1, 3, and 5 years, and this decline was closely associated with physician-related factors (insufficient time for follow-up communication, lack of efficient follow-up tools) and patient-related factors (poor disease awareness, tendency toward self-discontinuation of medication). Meanwhile, hospital tier, department type, and general hospital geographical region were identified as critical factors of follow-up management ratio.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions: Cognitive biases and practical barriers hinder the clinical translation of guidelines. Accordingly, we suggest that targeted interventions should be adopted, including geographically tailored training modules, AI-driven follow-up platforms, and policy-guided resource reallocation, thereby collectively promoting guideline implementation.\u003c/p\u003e","manuscriptTitle":"Cognitive Biases and Practical Barriers Among Chinese Clinicians Regarding the Guidelines for the Prevention and Treatment of Chronic Hepatitis B(version 2022): Results of a Multicenter Survey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-05 08:01:13","doi":"10.21203/rs.3.rs-9541175/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e4f17ef5-2358-488f-a0eb-9ef6602a7ea4","owner":[],"postedDate":"May 5th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-05T08:01:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-05 08:01:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9541175","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9541175","identity":"rs-9541175","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}