Hesitant triangular fuzzy information aggregation operators based on Bonferroni means and their application to multiple attribute decision making.

PubMed

Wang, Chunyong; Li, Qingguo; Zhou, Xiaoqiang; Yang, Tian

2014-01-01

We investigate the multiple attribute decision-making (MADM) problems with hesitant triangular fuzzy information. Firstly, definition and some operational laws of hesitant triangular fuzzy elements are introduced. Then, we develop some hesitant triangular fuzzy aggregation operators based on Bonferroni means and discuss their basic properties. Some existing operators can be viewed as their special cases. Next, we apply the proposed operators to deal with multiple attribute decision-making problems under hesitant triangular fuzzy environment. Finally, an illustrative example is given to show the developed method and demonstrate its practicality and effectiveness.

Hesitant Triangular Fuzzy Information Aggregation Operators Based on Bonferroni Means and Their Application to Multiple Attribute Decision Making

PubMed Central

Zhou, Xiaoqiang; Yang, Tian

2014-01-01

We investigate the multiple attribute decision-making (MADM) problems with hesitant triangular fuzzy information. Firstly, definition and some operational laws of hesitant triangular fuzzy elements are introduced. Then, we develop some hesitant triangular fuzzy aggregation operators based on Bonferroni means and discuss their basic properties. Some existing operators can be viewed as their special cases. Next, we apply the proposed operators to deal with multiple attribute decision-making problems under hesitant triangular fuzzy environment. Finally, an illustrative example is given to show the developed method and demonstrate its practicality and effectiveness. PMID:25140338

The Voice of the Patient Methodology: A Novel Mixed-Methods Approach to Identifying Treatment Goals for Men with Prostate Cancer.

PubMed

Saigal, Christopher S; Lambrechts, Sylvia I; Seenu Srinivasan, V; Dahan, Ely

2017-06-01

Many guidelines advocate the use of shared decision making for men with newly diagnosed prostate cancer. Decision aids can facilitate the process of shared decision making. Implicit in this approach is the idea that physicians understand which elements of treatment matter to patients. Little formal work exists to guide physicians or developers of decision aids in identifying these attributes. We use a mixed-methods technique adapted from marketing science, the 'Voice of the Patient', to describe and identify treatment elements of value for men with localized prostate cancer. We conducted semi-structured interviews with 30 men treated for prostate cancer in the urology clinic of the West Los Angeles Veteran Affairs Medical Center. We used a qualitative analysis to generate themes in patient narratives, and a quantitative approach, agglomerative hierarchical clustering, to identify attributes of treatment that were most relevant to patients making decisions about prostate cancer. We identified five 'traditional' prostate cancer treatment attributes: sexual dysfunction, bowel problems, urinary problems, lifespan, and others' opinions. We further identified two novel treatment attributes: a treatment's ability to validate a sense of proactivity and the need for an incision (separate from risks of surgery). Application of a successful marketing technique, the 'Voice of the Customer', in a clinical setting elicits non-obvious attributes that highlight unique patient decision-making concerns. Use of this method in the development of decision aids may result in more effective decision support.

A Response-Time Approach to Comparing Generalized Rational and Take-the-Best Models of Decision Making

ERIC Educational Resources Information Center

Bergert, F. Bryan; Nosofsky, Robert M.

2007-01-01

The authors develop and test generalized versions of take-the-best (TTB) and rational (RAT) models of multiattribute paired-comparison inference. The generalized models make allowances for subjective attribute weighting, probabilistic orders of attribute inspection, and noisy decision making. A key new test involves a response-time (RT)…

A potential role of reward and punishment in the facilitation of the emotion-cognition dichotomy in the Iowa Gambling Task.

PubMed

Singh, Varsha

2013-01-01

The Iowa Gambling Task (IGT) is based on the assumption that a decision maker is equally motivated to seek reward and avoid punishment, and that decision making is governed solely by the intertemporal attribute (i.e., preference for an option that produces an immediate outcome instead of one that yields a delayed outcome is believed to reflect risky decision making and is considered a deficit). It was assumed in the present study that the emotion- and cognition-based processing dichotomy manifests in the IGT as reward and punishment frequency and the intertemporal attribute. It was further proposed that the delineation of emotion- and cognition-based processing is contingent upon reward and punishment as manifested in the frame of the task (variant type) and task motivation (instruction type). The effects of IGT variant type (reward vs. punishment) and instruction type (task motivation induced by instruction types: reward, punishment, reward and punishment, or no hint) on the intertemporal and frequency attributes of IGT decision-making were analyzed. Decision making in the reward variant was equally governed by both attributes, and significantly affected by instruction type, while decision making in the punishment variant was differentially affected by the two attributes and not significantly impacted by instruction type. These results suggest that reward and punishment manifested via task frame as well as the task motivation may facilitate the differentiation of emotion- and cognition-based processing in the IGT.

A potential role of reward and punishment in the facilitation of the emotion-cognition dichotomy in the Iowa Gambling Task

PubMed Central

Singh, Varsha

2013-01-01

The Iowa Gambling Task (IGT) is based on the assumption that a decision maker is equally motivated to seek reward and avoid punishment, and that decision making is governed solely by the intertemporal attribute (i.e., preference for an option that produces an immediate outcome instead of one that yields a delayed outcome is believed to reflect risky decision making and is considered a deficit). It was assumed in the present study that the emotion- and cognition-based processing dichotomy manifests in the IGT as reward and punishment frequency and the intertemporal attribute. It was further proposed that the delineation of emotion- and cognition-based processing is contingent upon reward and punishment as manifested in the frame of the task (variant type) and task motivation (instruction type). The effects of IGT variant type (reward vs. punishment) and instruction type (task motivation induced by instruction types: reward, punishment, reward and punishment, or no hint) on the intertemporal and frequency attributes of IGT decision-making were analyzed. Decision making in the reward variant was equally governed by both attributes, and significantly affected by instruction type, while decision making in the punishment variant was differentially affected by the two attributes and not significantly impacted by instruction type. These results suggest that reward and punishment manifested via task frame as well as the task motivation may facilitate the differentiation of emotion- and cognition-based processing in the IGT. PMID:24381567

Critical Thinking as a Leadership Attribute.

PubMed

Werner, Stacy H; Bleich, Michael R

2017-01-01

Leaders are tasked with making decisions that have substantial impact on an organization's well-being. Decision making requires critical thinking and requisite action taking. The nature of critical thinking and how professional development educators can strengthen this attribute are presented. J Contin Educ Nurs. 2017;48(1):9-11. Copyright 2017, SLACK Incorporated.

Multiple Attribute Group Decision-Making Methods Based on Trapezoidal Fuzzy Two-Dimensional Linguistic Partitioned Bonferroni Mean Aggregation Operators.

PubMed

Yin, Kedong; Yang, Benshuo; Li, Xuemei

2018-01-24

In this paper, we investigate multiple attribute group decision making (MAGDM) problems where decision makers represent their evaluation of alternatives by trapezoidal fuzzy two-dimensional uncertain linguistic variable. To begin with, we introduce the definition, properties, expectation, operational laws of trapezoidal fuzzy two-dimensional linguistic information. Then, to improve the accuracy of decision making in some case where there are a sort of interrelationship among the attributes, we analyze partition Bonferroni mean (PBM) operator in trapezoidal fuzzy two-dimensional variable environment and develop two operators: trapezoidal fuzzy two-dimensional linguistic partitioned Bonferroni mean (TF2DLPBM) aggregation operator and trapezoidal fuzzy two-dimensional linguistic weighted partitioned Bonferroni mean (TF2DLWPBM) aggregation operator. Furthermore, we develop a novel method to solve MAGDM problems based on TF2DLWPBM aggregation operator. Finally, a practical example is presented to illustrate the effectiveness of this method and analyses the impact of different parameters on the results of decision-making.

Multiple Attribute Group Decision-Making Methods Based on Trapezoidal Fuzzy Two-Dimensional Linguistic Partitioned Bonferroni Mean Aggregation Operators

PubMed Central

Yin, Kedong; Yang, Benshuo

2018-01-01

In this paper, we investigate multiple attribute group decision making (MAGDM) problems where decision makers represent their evaluation of alternatives by trapezoidal fuzzy two-dimensional uncertain linguistic variable. To begin with, we introduce the definition, properties, expectation, operational laws of trapezoidal fuzzy two-dimensional linguistic information. Then, to improve the accuracy of decision making in some case where there are a sort of interrelationship among the attributes, we analyze partition Bonferroni mean (PBM) operator in trapezoidal fuzzy two-dimensional variable environment and develop two operators: trapezoidal fuzzy two-dimensional linguistic partitioned Bonferroni mean (TF2DLPBM) aggregation operator and trapezoidal fuzzy two-dimensional linguistic weighted partitioned Bonferroni mean (TF2DLWPBM) aggregation operator. Furthermore, we develop a novel method to solve MAGDM problems based on TF2DLWPBM aggregation operator. Finally, a practical example is presented to illustrate the effectiveness of this method and analyses the impact of different parameters on the results of decision-making. PMID:29364849

Decision Making under Ambiguity and Objective Risk in Higher Age - A Review on Cognitive and Emotional Contributions.

PubMed

Liebherr, Magnus; Schiebener, Johannes; Averbeck, Heike; Brand, Matthias

2017-01-01

The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors - responsible for age-related differences in decision making - are additionally pointed out.

Decision Making under Ambiguity and Objective Risk in Higher Age – A Review on Cognitive and Emotional Contributions

PubMed Central

Liebherr, Magnus; Schiebener, Johannes; Averbeck, Heike; Brand, Matthias

2017-01-01

The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors – responsible for age-related differences in decision making – are additionally pointed out. PMID:29270145

Take-the-best and the influence of decision-inconsistent attributes on decision confidence and choices in memory-based decisions.

PubMed

Dummel, Sebastian; Rummel, Jan

2016-11-01

Take-the-best (TTB) is a decision strategy according to which attributes about choice options are sequentially processed in descending order of validity, and attribute processing is stopped once an attribute discriminates between options. Consequently, TTB-decisions rely on only one, the best discriminating, attribute, and lower-valid attributes need not be processed because they are TTB-irrelevant. Recent research suggests, however, that when attribute information is visually present during decision-making, TTB-irrelevant attributes are processed and integrated into decisions nonetheless. To examine whether TTB-irrelevant attributes are retrieved and integrated when decisions are made memory-based, we tested whether the consistency of a TTB-irrelevant attribute affects TTB-users' decision behaviour in a memory-based decision task. Participants first learned attribute configurations of several options. Afterwards, they made several decisions between two of the options, and we manipulated conflict between the second-best attribute and the TTB-decision. We assessed participants' decision confidence and the proportion of TTB-inconsistent choices. According to TTB, TTB-irrelevant attributes should not affect confidence and choices, because these attributes should not be retrieved. Results showed, however, that TTB-users were less confident and made more TTB-inconsistent choices when TTB-irrelevant information was in conflict with the TTB-decision than when it was not, suggesting that TTB-users retrieved and integrated TTB-irrelevant information.

Developing Decision-Making Skills for Socio-Scientific Issues

ERIC Educational Resources Information Center

Lee, Yeung Chung

2007-01-01

The ability to make informed decisions on science-related social issues is considered an important attribute of scientific literacy. Literature to inform science educators how to bridge the gap between rhetoric and practice--and to assist them in developing this attribute in their students--burgeons. In view of the great diversity of…

Survival or Mortality: Does Risk Attribute Framing Influence Decision-Making Behavior in a Discrete Choice Experiment?

PubMed

Veldwijk, Jorien; Essers, Brigitte A B; Lambooij, Mattijs S; Dirksen, Carmen D; Smit, Henriette A; de Wit, G Ardine

2016-01-01

To test how attribute framing in a discrete choice experiment (DCE) affects respondents' decision-making behavior and their preferences. Two versions of a DCE questionnaire containing nine choice tasks were distributed among a representative sample of the Dutch population aged 55 to 65 years. The DCE consisted of four attributes related to the decision regarding participation in genetic screening for colorectal cancer (CRC). The risk attribute included was framed positively as the probability of surviving CRC and negatively as the probability of dying from CRC. Panel mixed-logit models were used to estimate the relative importance of the attributes. The data of the positively and negatively framed DCE were compared on the basis of direct attribute ranking, dominant decision-making behavior, preferences, and importance scores. The majority (56%) of the respondents ranked survival as the most important attribute in the positively framed DCE, whereas only a minority (8%) of the respondents ranked mortality as the most important attribute in the negatively framed DCE. Respondents made dominant choices based on survival significantly more often than based on mortality. The framing of the risk attribute significantly influenced all attribute-level estimates and resulted in different preference structures among respondents in the positively and negatively framed data set. Risk framing affects how respondents value the presented risk. Positive risk framing led to increased dominant decision-making behavior, whereas negative risk framing led to risk-seeking behavior. Attribute framing should have a prominent part in the expert and focus group interviews, and different types of framing should be used in the pilot version of DCEs as well as in actual DCEs to estimate the magnitude of the effect of choosing different types of framing. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Deciding how to decide: ventromedial frontal lobe damage affects information acquisition in multi-attribute decision making.

PubMed

Fellows, Lesley K

2006-04-01

Ventromedial frontal lobe (VMF) damage is associated with impaired decision making. Recent efforts to understand the functions of this brain region have focused on its role in tracking reward, punishment and risk. However, decision making is complex, and frontal lobe damage might be expected to affect it at other levels. This study used process-tracing techniques to explore the effect of VMF damage on multi-attribute decision making under certainty. Thirteen subjects with focal VMF damage were compared with 11 subjects with frontal damage that spared the VMF and 21 demographically matched healthy control subjects. Participants chose rental apartments in a standard information board task drawn from the literature on normal decision making. VMF subjects performed the decision making task in a way that differed markedly from all other groups, favouring an 'alternative-based' information acquisition strategy (i.e. they organized their information search around individual apartments). In contrast, both healthy control subjects and subjects with damage predominantly involving dorsal and/or lateral prefrontal cortex pursued primarily 'attribute-based' search strategies (in which information was acquired about categories such as rent and noise level across several apartments). This difference in the pattern of information acquisition argues for systematic differences in the underlying decision heuristics and strategies employed by subjects with VMF damage, which in turn may affect the quality of their choices. These findings suggest that the processes supported by ventral and medial prefrontal cortex need to be conceptualized more broadly, to account for changes in decision making under conditions of certainty, as well as uncertainty, following damage to these areas.

Operation Exodus: The Massacre of 44 Philippine Police Commandos In Mamasapano Clash

DTIC Science & Technology

2016-09-01

strategic thinking, utilizing Game Theory and Multi-Attribute Decision Making; the combination of these two dynamic tools is used to evaluate their...thinking, utilizing Game Theory and Multi-Attribute Decision Making; the combination of these two dynamic tools is used to evaluate their potential...35 A. GAME THEORETIC APPROACH ......................................................36 B. APPLYING GAME THEORY TO OPLAN: EXODUS

Can promoting patient decision making be exclusionary? Moral expectations and cultural difference in the narratives of UK maternity clinicians.

PubMed

Davies, Myfanwy; Elwyn, Glyn; Papadopoulos, Irena; Fleming, Lon; Williams, Gareth

2009-01-01

Patient autonomy in health care decision making is increasingly advocated as a means of promoting patients' 'responsibilities' for treatments and costs. However, little is known with regard to clinicians' understanding of patients' potential responsibilities in decision making. We explore how clinicians may view decision making as a 'moral' obligation and examine how moral virtue is discursively constructed in this context and in the face of ethnic and social difference. Data reported are derived from an interview study that examined perceptions of maternity decision making among Arab Muslim women and clinicians. Results reported here are from the clinician sample which includes obstetricians, general practitioners (GPs) and midwives. Clinicians perceived that a key element of their role involved imparting relevant information to their clients and, increasingly, involving them in making autonomous decisions about their care. However, by analysing and assessing the attribution of specific cultural differences in clinicians' discussion of decision making processes with minority group women, we demonstrate how some clinicians justified their failure to promote autonomy through shared decision making with women from these groups. We will demonstrate these attributes to be those of passivity and non-rationality which entail some negative moral judgements and which have a complex relationship to gender and power

Prospect Theory and Interval-Valued Hesitant Set for Safety Evacuation Model

NASA Astrophysics Data System (ADS)

Kou, Meng; Lu, Na

2018-01-01

The study applies the research results of prospect theory and multi attribute decision making theory, combined with the complexity, uncertainty and multifactor influence of the underground mine fire system and takes the decision makers’ psychological behavior of emotion and intuition into full account to establish the intuitionistic fuzzy multiple attribute decision making method that is based on the prospect theory. The model established by this method can explain the decision maker’s safety evacuation decision behavior in the complex system of underground mine fire due to the uncertainty of the environment, imperfection of the information and human psychological behavior and other factors.

Counterfactual Thinking and Ethical Decision Making: A New Approach to an Old Problem for Marketing Education

ERIC Educational Resources Information Center

Celuch, Kevin; Saxby, Carl

2013-01-01

The present study extends understanding of the self-regulatory aspects of ethical decision making by integrating and exploring relationships among counterfactual thinking, attribution, anticipatory emotions, and ethical decision-making constructs and processes. Specifically, we examine the effects of a manipulation designed to stimulate a…

Development of Moral Emotions and Decision-Making from Childhood to Young Adulthood

ERIC Educational Resources Information Center

Hasegawa, Mari

2016-01-01

This study investigated the development of moral decision-making and moral emotion attributions in antisocial behavior and peer relationship dilemma scenarios. Participants were 540 school- and college-aged students, who were asked to explain their moral decision-making, subsequent emotions, and reasoning in regard to the scenarios. We combined…

Memory-Based Decision-Making with Heuristics: Evidence for a Controlled Activation of Memory Representations

ERIC Educational Resources Information Center

Khader, Patrick H.; Pachur, Thorsten; Meier, Stefanie; Bien, Siegfried; Jost, Kerstin; Rosler, Frank

2011-01-01

Many of our daily decisions are memory based, that is, the attribute information about the decision alternatives has to be recalled. Behavioral studies suggest that for such decisions we often use simple strategies (heuristics) that rely on controlled and limited information search. It is assumed that these heuristics simplify decision-making by…

Identification and Prioritization of Important Attributes of Disease-Modifying Drugs in Decision Making among Patients with Multiple Sclerosis: A Nominal Group Technique and Best-Worst Scaling.

PubMed

Kremer, Ingrid E H; Evers, Silvia M A A; Jongen, Peter J; van der Weijden, Trudy; van de Kolk, Ilona; Hiligsmann, Mickaël

2016-01-01

Understanding the preferences of patients with multiple sclerosis (MS) for disease-modifying drugs and involving these patients in clinical decision making can improve the concordance between medical decisions and patient values and may, subsequently, improve adherence to disease-modifying drugs. This study aims first to identify which characteristics-or attributes-of disease-modifying drugs influence patients´ decisions about these treatments and second to quantify the attributes' relative importance among patients. First, three focus groups of relapsing-remitting MS patients were formed to compile a preliminary list of attributes using a nominal group technique. Based on this qualitative research, a survey with several choice tasks (best-worst scaling) was developed to prioritize attributes, asking a larger patient group to choose the most and least important attributes. The attributes' mean relative importance scores (RIS) were calculated. Nineteen patients reported 34 attributes during the focus groups and 185 patients evaluated the importance of the attributes in the survey. The effect on disease progression received the highest RIS (RIS = 9.64, 95% confidence interval: [9.48-9.81]), followed by quality of life (RIS = 9.21 [9.00-9.42]), relapse rate (RIS = 7.76 [7.39-8.13]), severity of side effects (RIS = 7.63 [7.33-7.94]) and relapse severity (RIS = 7.39 [7.06-7.73]). Subgroup analyses showed heterogeneity in preference of patients. For example, side effect-related attributes were statistically more important for patients who had no experience in using disease-modifying drugs compared to experienced patients (p < .001). This study shows that, on average, patients valued effectiveness and unwanted effects as most important. Clinicians should be aware of the average preferences but also that attributes of disease-modifying drugs are valued differently by different patients. Person-centred clinical decision making would be needed and requires eliciting individual preferences.

Aggregation operators of neutrosophic linguistic numbers for multiple attribute group decision making.

PubMed

Ye, Jun

2016-01-01

Based on the concept of neutrosophic linguistic numbers (NLNs) in symbolic neutrosophic theory presented by Smarandache in 2015, the paper firstly proposes basic operational laws of NLNs and the expected value of a NLN to rank NLNs. Then, we propose the NLN weighted arithmetic average (NLNWAA) and NLN weighted geometric average (NLNWGA) operators and discuss their properties. Further, we establish a multiple attribute group decision-making (MAGDM) method by using the NLNWAA and NLNWGA operators under NLN environment. Finally, an illustrative example on a decision-making problem of manufacturing alternatives in the flexible manufacturing system is given to show the application of the proposed MAGDM method.

A response-time approach to comparing generalized rational and take-the-best models of decision making.

PubMed

Bergert, F Bryan; Nosofsky, Robert M

2007-01-01

The authors develop and test generalized versions of take-the-best (TTB) and rational (RAT) models of multiattribute paired-comparison inference. The generalized models make allowances for subjective attribute weighting, probabilistic orders of attribute inspection, and noisy decision making. A key new test involves a response-time (RT) approach. TTB predicts that RT is determined solely by the expected time required to locate the 1st discriminating attribute, whereas RAT predicts that RT is determined by the difference in summed evidence between the 2 alternatives. Critical test pairs are used that partially decouple these 2 factors. Under conditions in which ideal observer TTB and RAT strategies yield equivalent decisions, both the RT results and the estimated attribute weights suggest that the vast majority of subjects adopted the generalized TTB strategy. The RT approach is also validated in an experimental condition in which use of a RAT strategy is essentially forced upon subjects. (c) 2007 APA, all rights reserved.

Redefining roles of science in planning and management: ecology as a planning and management tool

Treesearch

Greg Mason; Stephen Murphy

2002-01-01

Science as a way of knowing has great value to decision-making but there is need to consider all its attributes and assess how science ought to be informing decision-making. Consideration of the critiques of science can make science stronger and more useful to decision-making in an environmental and ecological context. Scientists, planners, and managers need to...

Comparative analysis of decision maker preferences for equity/efficiency attributes in reimbursement decisions in three European countries.

PubMed

Baji, Petra; García-Goñi, Manuel; Gulácsi, László; Mentzakis, Emmanouil; Paolucci, Francesco

2016-09-01

In addition to cost-effectiveness, national guidelines often include other factors in reimbursement decisions. However, weights attached to these are rarely quantified, thus decisions can depend strongly on decision-maker preferences. To explore the preferences of policymakers and healthcare professionals involved in the decision-making process for different efficiency and equity attributes of interventions and to analyse cross-country differences. Discrete choice experiments (DCEs) were carried out in Austria, Hungary, and Norway with policymakers and other professionals working in the health industry (N = 153 respondents). Interventions were described in terms of different efficiency and equity attributes (severity of disease, target age of the population and willingness to subsidise others, potential number of beneficiaries, individual health benefit, and cost-effectiveness). Parameter estimates from the DCE were used to calculate the probability of choosing a healthcare intervention with different characteristics, and to rank different equity and efficiency attributes according to their importance. In all three countries, cost-effectiveness, individual health benefit and severity of the disease were significant and equally important determinants of decisions. All countries show preferences for interventions targeting young and middle aged populations compared to those targeting populations over 60. However, decision-makers in Austria and Hungary show preferences more oriented to efficiency than equity, while those in Norway show equal preferences for equity and efficiency attributes. We find that factors other than cost-effectiveness seem to play an equally important role in decision-making. We also find evidence of cross-country differences in the weight of efficiency and equity attributes.

Dissociation of emotional decision-making from cognitive decision-making in chronic schizophrenia.

PubMed

Lee, Yanghyun; Kim, Yang-Tae; Seo, Eugene; Park, Oaktae; Jeong, Sung-Hun; Kim, Sang Heon; Lee, Seung-Jae

2007-08-30

Recent studies have examined the decision-making ability of schizophrenic patients using the Iowa Gambling Task (IGT). These studies, however, were restricted to the assessment of emotional decision-making. Decision-making depends on cognitive functions as well as on emotion. The purpose of this study was to examine the performance of schizophrenic patients on the IGT and the Game of Dice Task (GDT), a decision-making task with explicit rules for gains and losses. In addition, it was intended to test whether poor performance on IGT is attributable to impairments in reversal learning within the schizophrenia group using the Simple Reversal Learning Task (SRLT), which is sensitive to measure the deficit of reversal learning following ventromedial prefrontal cortex damage. A group of 23 stable schizophrenic patients and 28 control subjects performed computerized versions of the IGT, GDT, SRLT and Wisconsin Card Sorting Test (WCST). While schizophrenic patients performed poorly on the IGT relative to normal controls, there was no significant difference between the two groups on GDT performance. The performance of the schizophrenia group on the SRLT was poorer than that of controls, but was not related to IGT performance. These data suggest that schizophrenic patients have impaired emotional decision-making but intact cognitive decision-making, suggesting that these two processes of decision-making are different. Furthermore, the impairments in reversal learning did not contribute to poor performance on the IGT in schizophrenia. Therefore, schizophrenic patients have difficulty in making decisions under ambiguous and uncertain situations whereas they make choices easily in clear and unequivocal ones. The emotional decision-making deficits in schizophrenia might be attributable more to another mechanism such as a somatic marker hypothesis than to an impairment in reversal learning.

Political ideology and labor arbitrators' decision making in work-family conflict cases.

PubMed

Biernat, Monica; Malin, Martin H

2008-07-01

Labor arbitrators were asked to render decisions about grievances brought by employees who had been fired because of problems created by work conflicts with family responsibilities. The study examined the effects of experimentally manipulated grievant attributes (gender, type of work-family conflict) as well as arbitrator attributes (gender, political ideology) on decision making. When employees were depicted as having had child care problems, liberal arbitrators tended to favor female over male grievants, and political conservatism predicted more favorable judgments rendered toward male grievants. Overall, the data suggest that child care responsibilities cue different patterns of gender bias among liberal and conservative decision makers.

Game Relativity: How Context Influences Strategic Decision Making

ERIC Educational Resources Information Center

Vlaev, Ivo; Chater, Nick

2006-01-01

Existing models of strategic decision making typically assume that only the attributes of the currently played game need be considered when reaching a decision. The results presented in this article demonstrate that the so-called "cooperativeness" of the previously played prisoner's dilemma games influence choices and predictions in the current…

How Decisions Emerge: Action Dynamics in Intertemporal Decision Making

ERIC Educational Resources Information Center

Dshemuchadse, Maja; Scherbaum, Stefan; Goschke, Thomas

2013-01-01

In intertemporal decision making, individuals prefer smaller rewards delivered sooner over larger rewards delivered later, often to an extent that seems irrational from an economical perspective. This behavior has been attributed to a lack of self-control and reflection, the nonlinearity of human time perception, and several other sources.…

Podium: Ranking Data Using Mixed-Initiative Visual Analytics.

PubMed

Wall, Emily; Das, Subhajit; Chawla, Ravish; Kalidindi, Bharath; Brown, Eli T; Endert, Alex

2018-01-01

People often rank and order data points as a vital part of making decisions. Multi-attribute ranking systems are a common tool used to make these data-driven decisions. Such systems often take the form of a table-based visualization in which users assign weights to the attributes representing the quantifiable importance of each attribute to a decision, which the system then uses to compute a ranking of the data. However, these systems assume that users are able to quantify their conceptual understanding of how important particular attributes are to a decision. This is not always easy or even possible for users to do. Rather, people often have a more holistic understanding of the data. They form opinions that data point A is better than data point B but do not necessarily know which attributes are important. To address these challenges, we present a visual analytic application to help people rank multi-variate data points. We developed a prototype system, Podium, that allows users to drag rows in the table to rank order data points based on their perception of the relative value of the data. Podium then infers a weighting model using Ranking SVM that satisfies the user's data preferences as closely as possible. Whereas past systems help users understand the relationships between data points based on changes to attribute weights, our approach helps users to understand the attributes that might inform their understanding of the data. We present two usage scenarios to describe some of the potential uses of our proposed technique: (1) understanding which attributes contribute to a user's subjective preferences for data, and (2) deconstructing attributes of importance for existing rankings. Our proposed approach makes powerful machine learning techniques more usable to those who may not have expertise in these areas.

Coding Theory Information Theory and Radar

DTIC Science & Technology

2005-01-01

the design and synthesis of artificial multiagent systems and for the understanding of human decision-making processes. This... altruism that may exist in a complex society. SGT derives its ability to account simultaneously for both group and individual interests from the structure of ...satisficing decision theory as a model of human decision mak- ing. 2 Multi-Attribute Decision Making Many decision problems involve the consideration of

Marketing the University to Student-Athletes: Understanding University Selection Criteria

ERIC Educational Resources Information Center

Judson, Kimberly M.; James, Jeffrey D.; Aurand, Timothy W.

2004-01-01

As competition for top athletes intensifies, and as challenges associated with recruitment increase, universities must develop and employ recruiting strategies based upon attributes that student-athletes identify as important to their decision-making process. The study investigates college choice decision attributes of student-athletes, identifies…

Some induced intuitionistic fuzzy aggregation operators applied to multi-attribute group decision making

NASA Astrophysics Data System (ADS)

Su, Zhi-xin; Xia, Guo-ping; Chen, Ming-yuan

2011-11-01

In this paper, we define various induced intuitionistic fuzzy aggregation operators, including induced intuitionistic fuzzy ordered weighted averaging (OWA) operator, induced intuitionistic fuzzy hybrid averaging (I-IFHA) operator, induced interval-valued intuitionistic fuzzy OWA operator, and induced interval-valued intuitionistic fuzzy hybrid averaging (I-IIFHA) operator. We also establish various properties of these operators. And then, an approach based on I-IFHA operator and intuitionistic fuzzy weighted averaging (WA) operator is developed to solve multi-attribute group decision-making (MAGDM) problems. In such problems, attribute weights and the decision makers' (DMs') weights are real numbers and attribute values provided by the DMs are intuitionistic fuzzy numbers (IFNs), and an approach based on I-IIFHA operator and interval-valued intuitionistic fuzzy WA operator is developed to solve MAGDM problems where the attribute values provided by the DMs are interval-valued IFNs. Furthermore, induced intuitionistic fuzzy hybrid geometric operator and induced interval-valued intuitionistic fuzzy hybrid geometric operator are proposed. Finally, a numerical example is presented to illustrate the developed approaches.

Decision aids for people facing health treatment or screening decisions.

PubMed

Stacey, Dawn; Légaré, France; Col, Nananda F; Bennett, Carol L; Barry, Michael J; Eden, Karen B; Holmes-Rovner, Margaret; Llewellyn-Thomas, Hilary; Lyddiatt, Anne; Thomson, Richard; Trevena, Lyndal; Wu, Julie H C

2014-01-28

Decision aids are intended to help people participate in decisions that involve weighing the benefits and harms of treatment options often with scientific uncertainty. To assess the effects of decision aids for people facing treatment or screening decisions. For this update, we searched from 2009 to June 2012 in MEDLINE; CENTRAL; EMBASE; PsycINFO; and grey literature. Cumulatively, we have searched each database since its start date including CINAHL (to September 2008). We included published randomized controlled trials of decision aids, which are interventions designed to support patients' decision making by making explicit the decision, providing information about treatment or screening options and their associated outcomes, compared to usual care and/or alternative interventions. We excluded studies of participants making hypothetical decisions. Two review authors independently screened citations for inclusion, extracted data, and assessed risk of bias. The primary outcomes, based on the International Patient Decision Aid Standards (IPDAS), were:A) 'choice made' attributes;B) 'decision-making process' attributes.Secondary outcomes were behavioral, health, and health-system effects. We pooled results using mean differences (MD) and relative risks (RR), applying a random-effects model. This update includes 33 new studies for a total of 115 studies involving 34,444 participants. For risk of bias, selective outcome reporting and blinding of participants and personnel were mostly rated as unclear due to inadequate reporting. Based on 7 items, 8 of 115 studies had high risk of bias for 1 or 2 items each.Of 115 included studies, 88 (76.5%) used at least one of the IPDAS effectiveness criteria: A) 'choice made' attributes criteria: knowledge scores (76 studies); accurate risk perceptions (25 studies); and informed value-based choice (20 studies); and B) 'decision-making process' attributes criteria: feeling informed (34 studies) and feeling clear about values (29 studies).A) Criteria involving 'choice made' attributes:Compared to usual care, decision aids increased knowledge (MD 13.34 out of 100; 95% confidence interval (CI) 11.17 to 15.51; n = 42). When more detailed decision aids were compared to simple decision aids, the relative improvement in knowledge was significant (MD 5.52 out of 100; 95% CI 3.90 to 7.15; n = 19). Exposure to a decision aid with expressed probabilities resulted in a higher proportion of people with accurate risk perceptions (RR 1.82; 95% CI 1.52 to 2.16; n = 19). Exposure to a decision aid with explicit values clarification resulted in a higher proportion of patients choosing an option congruent with their values (RR 1.51; 95% CI 1.17 to 1.96; n = 13).B) Criteria involving 'decision-making process' attributes:Decision aids compared to usual care interventions resulted in:a) lower decisional conflict related to feeling uninformed (MD -7.26 of 100; 95% CI -9.73 to -4.78; n = 22) and feeling unclear about personal values (MD -6.09; 95% CI -8.50 to -3.67; n = 18);b) reduced proportions of people who were passive in decision making (RR 0.66; 95% CI 0.53 to 0.81; n = 14); andc) reduced proportions of people who remained undecided post-intervention (RR 0.59; 95% CI 0.47 to 0.72; n = 18).Decision aids appeared to have a positive effect on patient-practitioner communication in all nine studies that measured this outcome. For satisfaction with the decision (n = 20), decision-making process (n = 17), and/or preparation for decision making (n = 3), those exposed to a decision aid were either more satisfied, or there was no difference between the decision aid versus comparison interventions. No studies evaluated decision-making process attributes for helping patients to recognize that a decision needs to be made, or understanding that values affect the choice.C) Secondary outcomes Exposure to decision aids compared to usual care reduced the number of people of choosing major elective invasive surgery in favour of more conservative options (RR 0.79; 95% CI 0.68 to 0.93; n = 15). Exposure to decision aids compared to usual care reduced the number of people choosing to have prostate-specific antigen screening (RR 0.87; 95% CI 0.77 to 0.98; n = 9). When detailed compared to simple decision aids were used, fewer people chose menopausal hormone therapy (RR 0.73; 95% CI 0.55 to 0.98; n = 3). For other decisions, the effect on choices was variable.The effect of decision aids on length of consultation varied from 8 minutes shorter to 23 minutes longer (median 2.55 minutes longer) with 2 studies indicating statistically-significantly longer, 1 study shorter, and 6 studies reporting no difference in consultation length. Groups of patients receiving decision aids do not appear to differ from comparison groups in terms of anxiety (n = 30), general health outcomes (n = 11), and condition-specific health outcomes (n = 11). The effects of decision aids on other outcomes (adherence to the decision, costs/resource use) were inconclusive. There is high-quality evidence that decision aids compared to usual care improve people's knowledge regarding options, and reduce their decisional conflict related to feeling uninformed and unclear about their personal values. There is moderate-quality evidence that decision aids compared to usual care stimulate people to take a more active role in decision making, and improve accurate risk perceptions when probabilities are included in decision aids, compared to not being included. There is low-quality evidence that decision aids improve congruence between the chosen option and the patient's values.New for this updated review is further evidence indicating more informed, values-based choices, and improved patient-practitioner communication. There is a variable effect of decision aids on length of consultation. Consistent with findings from the previous review, decision aids have a variable effect on choices. They reduce the number of people choosing discretionary surgery and have no apparent adverse effects on health outcomes or satisfaction. The effects on adherence with the chosen option, cost-effectiveness, use with lower literacy populations, and level of detail needed in decision aids need further evaluation. Little is known about the degree of detail that decision aids need in order to have a positive effect on attributes of the choice made, or the decision-making process.

Interval MULTIMOORA method with target values of attributes based on interval distance and preference degree: biomaterials selection

NASA Astrophysics Data System (ADS)

Hafezalkotob, Arian; Hafezalkotob, Ashkan

2017-06-01

A target-based MADM method covers beneficial and non-beneficial attributes besides target values for some attributes. Such techniques are considered as the comprehensive forms of MADM approaches. Target-based MADM methods can also be used in traditional decision-making problems in which beneficial and non-beneficial attributes only exist. In many practical selection problems, some attributes have given target values. The values of decision matrix and target-based attributes can be provided as intervals in some of such problems. Some target-based decision-making methods have recently been developed; however, a research gap exists in the area of MADM techniques with target-based attributes under uncertainty of information. We extend the MULTIMOORA method for solving practical material selection problems in which material properties and their target values are given as interval numbers. We employ various concepts of interval computations to reduce degeneration of uncertain data. In this regard, we use interval arithmetic and introduce innovative formula for interval distance of interval numbers to create interval target-based normalization technique. Furthermore, we use a pairwise preference matrix based on the concept of degree of preference of interval numbers to calculate the maximum, minimum, and ranking of these numbers. Two decision-making problems regarding biomaterials selection of hip and knee prostheses are discussed. Preference degree-based ranking lists for subordinate parts of the extended MULTIMOORA method are generated by calculating the relative degrees of preference for the arranged assessment values of the biomaterials. The resultant rankings for the problem are compared with the outcomes of other target-based models in the literature.

The Multi-Attribute Group Decision-Making Method Based on Interval Grey Trapezoid Fuzzy Linguistic Variables.

PubMed

Yin, Kedong; Wang, Pengyu; Li, Xuemei

2017-12-13

With respect to multi-attribute group decision-making (MAGDM) problems, where attribute values take the form of interval grey trapezoid fuzzy linguistic variables (IGTFLVs) and the weights (including expert and attribute weight) are unknown, improved grey relational MAGDM methods are proposed. First, the concept of IGTFLV, the operational rules, the distance between IGTFLVs, and the projection formula between the two IGTFLV vectors are defined. Second, the expert weights are determined by using the maximum proximity method based on the projection values between the IGTFLV vectors. The attribute weights are determined by the maximum deviation method and the priorities of alternatives are determined by improved grey relational analysis. Finally, an example is given to prove the effectiveness of the proposed method and the flexibility of IGTFLV.

Ants learn to rely on more informative attributes during decision-making.

PubMed

Sasaki, Takao; Pratt, Stephen C

2013-01-01

Evolutionary theory predicts that animals act to maximize their fitness when choosing among a set of options, such as what to eat or where to live. Making the best choice is challenging when options vary in multiple attributes, and animals have evolved a variety of heuristics to simplify the task. Many of these involve ranking or weighting attributes according to their importance. Because the importance of attributes can vary across time and place, animals might benefit by adjusting weights accordingly. Here, we show that colonies of the ant Temnothorax rugatulus use their experience during nest site selection to increase weights on more informative nest attributes. These ants choose their rock crevice nests on the basis of multiple features. After exposure to an environment where only one attribute differentiated options, colonies increased their reliance on this attribute relative to a second attribute. Although many species show experience-based changes in selectivity based on a single feature, this is the first evidence in animals for adaptive changes in the weighting of multiple attributes. These results show that animal collectives, like individuals, change decision-making strategies according to experience. We discuss how these colony-level changes might emerge from individual behaviour.

[A multi-measure analysis of the similarity, attraction, and compromise effects in multi-attribute decision making].

PubMed

Tsuzuki, Takashi; Matsui, Hiroshi; Kikuchi, Manabu

2012-12-01

In multi-attribute decision making, the similarity, attraction, and compromise effects warrant specific investigation as they cause violations of principles in rational choice. In order to investigate these three effects simultaneously, we assigned 145 undergraduates to three context effect conditions. We requested them to solve the same 20 hypothetical purchase problems, each of which had three alternatives described along two attributes. We measured their choices, confidence ratings, and response times. We found that manipulating the third alternative had significant context effects for choice proportions and confidence ratings in all three conditions. Furthermore, the attraction effect was the most prominent with regard to choice proportions. In the compromise effect condition, although the choice proportion of the third alternative was high, the confidence rating was low and the response time was long. These results indicate that the relationship between choice proportions and confidence ratings requires further theoretical investigation. They also suggest that a combination of experimental and modeling studies is imperative to reveal the mechanisms underlying the context effects in multi-attribute, multi-alternative decision making.

An attentional drift diffusion model over binary-attribute choice.

PubMed

Fisher, Geoffrey

2017-11-01

In order to make good decisions, individuals need to identify and properly integrate information about various attributes associated with a choice. Since choices are often complex and made rapidly, they are typically affected by contextual variables that are thought to influence how much attention is paid to different attributes. I propose a modification of the attentional drift-diffusion model, the binary-attribute attentional drift diffusion model (baDDM), which describes the choice process over simple binary-attribute choices and how it is affected by fluctuations in visual attention. Using an eye-tracking experiment, I find the baDDM makes accurate quantitative predictions about several key variables including choices, reaction times, and how these variables are correlated with attention to two attributes in an accept-reject decision. Furthermore, I estimate an attribute-based fixation bias that suggests attention to an attribute increases its subjective weight by 5%, while the unattended attribute's weight is decreased by 10%. Copyright © 2017 Elsevier B.V. All rights reserved.

[Medical decision making in symptoms of type 2 diabetes mellitus in general practice].

PubMed

de Cruppé, W; von dem Knesebeck, O; Gerstenberger, E; Link, C; Marceau, L; Siegrist, J; Geraedts, M; McKinlay, J

2011-02-01

Patient and physician attributes influence medical decisions as non-medical factors. The current study examines the influence of patient age and gender and physicians' gender and years of clinical experience on medical decision making in patients with undiagnosed diabetes type 2. A factorial experiment was conducted to estimate the influence of patient and physician attributes. An identical physician patient encounter with a patient presenting with diabetes symptoms was videotaped with varying patient attributes. Professional actors played the "patients". A sample of 64 randomly chosen and stratified (gender and years of experience) primary care physicians was interviewed about the presented videos. Results show few significant differences in diagnostic decisions: Younger patients were asked more frequently about psychosocial problems while with older patients a cancer diagnosis was more often taken into consideration. Female physicians made an earlier second appointment date compared to male physicians. Physicians with more years of professional experience considered more often diabetes as the diagnosis than physicians with less experience. Medical decision making in patients with diabetes type 2 is only marginally influenced by patients' and physicians' characteristics under study. © Georg Thieme Verlag KG Stuttgart · New York.

Identification and Prioritization of Important Attributes of Disease-Modifying Drugs in Decision Making among Patients with Multiple Sclerosis: A Nominal Group Technique and Best-Worst Scaling

PubMed Central

Kremer, Ingrid E. H.; van der Weijden, Trudy; van de Kolk, Ilona

2016-01-01

Objectives Understanding the preferences of patients with multiple sclerosis (MS) for disease-modifying drugs and involving these patients in clinical decision making can improve the concordance between medical decisions and patient values and may, subsequently, improve adherence to disease-modifying drugs. This study aims first to identify which characteristics–or attributes–of disease-modifying drugs influence patients´ decisions about these treatments and second to quantify the attributes’ relative importance among patients. Methods First, three focus groups of relapsing-remitting MS patients were formed to compile a preliminary list of attributes using a nominal group technique. Based on this qualitative research, a survey with several choice tasks (best-worst scaling) was developed to prioritize attributes, asking a larger patient group to choose the most and least important attributes. The attributes’ mean relative importance scores (RIS) were calculated. Results Nineteen patients reported 34 attributes during the focus groups and 185 patients evaluated the importance of the attributes in the survey. The effect on disease progression received the highest RIS (RIS = 9.64, 95% confidence interval: [9.48–9.81]), followed by quality of life (RIS = 9.21 [9.00–9.42]), relapse rate (RIS = 7.76 [7.39–8.13]), severity of side effects (RIS = 7.63 [7.33–7.94]) and relapse severity (RIS = 7.39 [7.06–7.73]). Subgroup analyses showed heterogeneity in preference of patients. For example, side effect-related attributes were statistically more important for patients who had no experience in using disease-modifying drugs compared to experienced patients (p < .001). Conclusions This study shows that, on average, patients valued effectiveness and unwanted effects as most important. Clinicians should be aware of the average preferences but also that attributes of disease-modifying drugs are valued differently by different patients. Person-centred clinical decision making would be needed and requires eliciting individual preferences. PMID:27812117

Research of Simple Multi-Attribute Rating Technique for Decision Support

NASA Astrophysics Data System (ADS)

Siregar, Dodi; Arisandi, Diki; Usman, Ari; Irwan, Dedy; Rahim, Robbi

2017-12-01

One of the roles of decision support system is that it can assist the decision maker in obtaining the appropriate alternative with the desired criteria, one of the methods that could apply for the decision maker is SMART method with multicriteria decision making. This multi-criteria decision-making theory has meaning where every alternative has criteria and has value and weight, and the author uses this approach to facilitate decision making with a compelling case. The problems discussed in this paper are classified into problems of a variety Multiobjective (multiple goals to be accomplished) and multicriteria (many of the decisive criteria in reaching such decisions).

Qualitatively Coherent Representation Makes Decision-Making Easier with Binary-Colored Multi-Attribute Tables: An Eye-Tracking Study

PubMed Central

Morii, Masahiro; Ideno, Takashi; Takemura, Kazuhisa; Okada, Mitsuhiro

2017-01-01

We aimed to identify the ways in which coloring cells affected decision-making in the context of binary-colored multi-attribute tables, using eye movement data. In our black-white attribute tables, the value of attributes was limited to two (with a certain threshold for each attribute) and each cell of the table was colored either black or white on the white background. We compared the two natural ways of systematic color assignment: “quantitatively coherent” ways and “qualitatively coherent” ways (namely, the ways in which the black-white distinction represented the quantitative amount distinction, and the ways in which the black-white distinction represented the quality distinction). The former consists of the following two types: (Type 1) “larger is black,” where the larger value-level was represented by black, and “smaller is white,” and (Type 2) “smaller is black.” The latter consisted of the following two types: (Type 3) “better is black,” and (Type 4) “worse is black.” We obtained the following two findings. [Result 1] The qualitatively coherent black-white tables (Types 3 and 4) made decision-making easier than the quantitatively coherent ones (Types 1 and 2). [Result 2] Among the two qualitatively coherent types, the “black is better” tables (Type 3) made decision making easier; in fact, the participants focused on the more important (black) cells in the case of “black is better” tables (Type 3) while they did not focus enough on the more important (white) ones in the case of the “white is better” tables (Type 4). We also examined some measures of eye movement patterns and showed that these measures supported our hypotheses. The data showed differences in the eye movement patterns between the first and second halves of each trial, which indicated the phased or combined decision strategies taken by the participants. PMID:28861020

Decision-making Strategies and Performance among Seniors1

PubMed Central

Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael

2011-01-01

Using paper and pencil experiments administered in senior centers, we examine decision-making performance in multi-attribute decision problems. We differentiate the effects of declining cognitive performance and changing cognitive process on decision-making performance of seniors as they age. We find a significant decline in performance with age due to reduced reliance on common heuristics and increased decision-making randomness among our oldest subjects. However, we find that increasing the number of options in a decision problem increases the number of heuristics brought to the task. This challenges the choice overload view that people give up when confronted with too much choice. PMID:22408282

A qualitative evaluation of the crucial attributes of contextual information necessary in EHR design to support patient-centered medical home care.

PubMed

Weir, Charlene R; Staggers, Nancy; Gibson, Bryan; Doing-Harris, Kristina; Barrus, Robyn; Dunlea, Robert

2015-04-16

Effective implementation of a Primary Care Medical Home model of care (PCMH) requires integration of patients' contextual information (physical, mental, social and financial status) into an easily retrievable information source for the healthcare team and clinical decision-making. This project explored clinicians' perceptions about important attributes of contextual information for clinical decision-making, how contextual information is expressed in CPRS clinical documentation as well as how clinicians in a highly computerized environment manage information flow related to these areas. A qualitative design using Cognitive Task Analyses and a modified Critical Incident Technique were used. The study was conducted in a large VA with a fully implemented EHR located in the western United States. Seventeen providers working in a PCMH model of care in Primary Care, Home Based Care and Geriatrics reported on a recent difficult transition requiring contextual information for decision-making. The transcribed interviews were qualitatively analyzed for thematic development related to contextual information using an iterative process and multiple reviewers with ATLAS@ti software. Six overarching themes emerged as attributes of contextual information: Informativeness, goal language, temporality, source attribution, retrieval effort, and information quality. These results indicate that specific attributes are needed to in order for contextual information to fully support clinical decision-making in a Medical Home care delivery environment. Improved EHR designs are needed for ease of contextual information access, displaying linkages across time and settings, and explicit linkages to both clinician and patient goals. Implications relevant to providers' information needs, team functioning and EHR design are discussed.

Cloud E-Learning Service Strategies for Improving E-Learning Innovation Performance in a Fuzzy Environment by Using a New Hybrid Fuzzy Multiple Attribute Decision-Making Model

ERIC Educational Resources Information Center

Su, Chiu Hung; Tzeng, Gwo-Hshiung; Hu, Shu-Kung

2016-01-01

The purpose of this study was to address this problem by applying a new hybrid fuzzy multiple criteria decision-making model including (a) using the fuzzy decision-making trial and evaluation laboratory (DEMATEL) technique to construct the fuzzy scope influential network relationship map (FSINRM) and determine the fuzzy influential weights of the…

Rejecting a bad option feels like choosing a good one.

PubMed

Perfecto, Hannah; Galak, Jeff; Simmons, Joseph P; Nelson, Leif D

2017-11-01

Across 4,151 participants, the authors demonstrate a novel framing effect, attribute matching, whereby matching a salient attribute of a decision frame with that of a decision's options facilitates decision-making. This attribute matching is shown to increase decision confidence and, ultimately, consensus estimates by increasing feelings of metacognitive ease. In Study 1, participants choosing the more attractive of two faces or rejecting the less attractive face reported greater confidence in and perceived consensus around their decision. Using positive and negative words, Study 2 showed that the attribute's extremity moderates the size of the effect. Study 3 found decision ease mediates these changes in confidence and consensus estimates. Consistent with a misattribution account, when participants were warned about this external source of ease in Study 4, the effect disappeared. Study 5 extended attribute matching beyond valence to objective judgments. The authors conclude by discussing related psychological constructs as well as downstream consequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Application of Grey Relational Analysis to Decision-Making during Product Development

ERIC Educational Resources Information Center

Hsiao, Shih-Wen; Lin, Hsin-Hung; Ko, Ya-Chuan

2017-01-01

A multi-attribute decision-making (MADM) approach was proposed in this study as a prediction method that differs from the conventional production and design methods for a product. When a client has different dimensional requirements, this approach can quickly provide a company with design decisions for each product. The production factors of a…

Women's and Men's Marriages: Marital Satisfaction, Perceived Control, and Attitudes toward Women.

ERIC Educational Resources Information Center

Madden, Margaret E.

Previous research on marriage indicates that perceptions of control are important to marital satisfaction. To investigate the relationship between attributions of personal control and other variables in marriage, e.g., measures of satisfaction, decision making, and task performance, and attributions of control over decisions and tasks, and to…

Evaluation of Communication about Groups: The Hydra Phenomenon.

ERIC Educational Resources Information Center

Desmond, Roger Jon; Bezzini, John

A study investigated how the attribution of a problem solution to an individual or group affects the consumer's perception of the solution's quality. Based on the tendency to support group decision-making (Hydra phenomenon) it was predicted that decisions attributed to groups would be perceived as higher in quality than those made by individuals,…

Performance Feedback Processing Is Positively Biased As Predicted by Attribution Theory.

PubMed

Korn, Christoph W; Rosenblau, Gabriela; Rodriguez Buritica, Julia M; Heekeren, Hauke R

2016-01-01

A considerable literature on attribution theory has shown that healthy individuals exhibit a positivity bias when inferring the causes of evaluative feedback on their performance. They tend to attribute positive feedback internally (e.g., to their own abilities) but negative feedback externally (e.g., to environmental factors). However, all empirical demonstrations of this bias suffer from at least one of the three following drawbacks: First, participants directly judge explicit causes for their performance. Second, participants have to imagine events instead of experiencing them. Third, participants assess their performance only after receiving feedback and thus differences in baseline assessments cannot be excluded. It is therefore unclear whether the classically reported positivity bias generalizes to setups without these drawbacks. Here, we aimed at establishing the relevance of attributions for decision-making by showing an attribution-related positivity bias in a decision-making task. We developed a novel task, which allowed us to test how participants changed their evaluations in response to positive and negative feedback about performance. Specifically, we used videos of actors expressing different facial emotional expressions. Participants were first asked to evaluate the actors' credibility in expressing a particular emotion. After this initial rating, participants performed an emotion recognition task and did--or did not--receive feedback on their veridical performance. Finally, participants re-rated the actors' credibility, which provided a measure of how they changed their evaluations after feedback. Attribution theory predicts that participants change their evaluations of the actors' credibility toward the positive after receiving positive performance feedback and toward the negative after negative performance feedback. Our results were in line with this prediction. A control condition without feedback showed that correct or incorrect performance alone could not explain the observed positivity bias. Furthermore, participants' behavior in our task was linked to the most widely used measure of attribution style. In sum, our findings suggest that positive and negative performance feedback influences the evaluation of task-related stimuli, as predicted by attribution theory. Therefore, our study points to the relevance of attribution theory for feedback processing in decision-making and provides a novel outlook for decision-making biases.

Performance Feedback Processing Is Positively Biased As Predicted by Attribution Theory

PubMed Central

Rodriguez Buritica, Julia M.; Heekeren, Hauke R.

2016-01-01

A considerable literature on attribution theory has shown that healthy individuals exhibit a positivity bias when inferring the causes of evaluative feedback on their performance. They tend to attribute positive feedback internally (e.g., to their own abilities) but negative feedback externally (e.g., to environmental factors). However, all empirical demonstrations of this bias suffer from at least one of the three following drawbacks: First, participants directly judge explicit causes for their performance. Second, participants have to imagine events instead of experiencing them. Third, participants assess their performance only after receiving feedback and thus differences in baseline assessments cannot be excluded. It is therefore unclear whether the classically reported positivity bias generalizes to setups without these drawbacks. Here, we aimed at establishing the relevance of attributions for decision-making by showing an attribution-related positivity bias in a decision-making task. We developed a novel task, which allowed us to test how participants changed their evaluations in response to positive and negative feedback about performance. Specifically, we used videos of actors expressing different facial emotional expressions. Participants were first asked to evaluate the actors’ credibility in expressing a particular emotion. After this initial rating, participants performed an emotion recognition task and did—or did not—receive feedback on their veridical performance. Finally, participants re-rated the actors’ credibility, which provided a measure of how they changed their evaluations after feedback. Attribution theory predicts that participants change their evaluations of the actors’ credibility toward the positive after receiving positive performance feedback and toward the negative after negative performance feedback. Our results were in line with this prediction. A control condition without feedback showed that correct or incorrect performance alone could not explain the observed positivity bias. Furthermore, participants’ behavior in our task was linked to the most widely used measure of attribution style. In sum, our findings suggest that positive and negative performance feedback influences the evaluation of task-related stimuli, as predicted by attribution theory. Therefore, our study points to the relevance of attribution theory for feedback processing in decision-making and provides a novel outlook for decision-making biases. PMID:26849646

Prescription medicines: decision-making preferences of patients who receive different levels of public subsidy.

PubMed

Robertson, Jane; Doran, Evan; Henry, David A; Salkeld, Glenn

2014-02-01

To compare the relative importance of medicine attributes and decision-making preferences of patients with higher or lower levels of insurance coverage in a publicly funded health care system. Cross-sectional telephone survey of randomly selected regular medicine users aged ≥18 years in the Hunter Valley, NSW, Australia. Questions about 27 medicine attributes and active involvement in decisions to start a new medicine. After adjustment, there were few differences between the 408 concession card holders (high insurance) and 410 general beneficiaries (low insurance) in their assessment of the importance of medicine attributes. For both groups, the explanation of treatment options, establishing the need for the medicine, and medicine efficacy and safety were the most important considerations. Medicine costs, the treatment burden and medicine familiarity were less important; the views of family and friends ranked lowest. There was a statistically significantly greater influence of the regular doctor for the concession card holders than general beneficiaries (93.6 vs. 84%, adjusted OR 2.80, 95% CI 1.31, 5.99). Concession card holders were more likely to favour doctors having more say in the decision-making process (crude OR 1.69, 95% CI 1.28, 2.24), and more likely to report the most recent treatment decision being made by the doctor alone, compared with general beneficiaries (61.2 vs. 40.3%). Medicine need, efficacy and safety are viewed as paramount for most patients, irrespective of insurance status. While patients report the importance of participation in treatment decisions, delegation of decision making to the doctor was common in practice. © 2011 John Wiley & Sons Ltd.

Fuzzy sets, rough sets, and modeling evidence: Theory and Application. A Dempster-Shafer based approach to compromise decision making with multiattributes applied to product selection

NASA Technical Reports Server (NTRS)

Dekorvin, Andre

1992-01-01

The Dempster-Shafer theory of evidence is applied to a multiattribute decision making problem whereby the decision maker (DM) must compromise with available alternatives, none of which exactly satisfies his ideal. The decision mechanism is constrained by the uncertainty inherent in the determination of the relative importance of each attribute element and the classification of existing alternatives. The classification of alternatives is addressed through expert evaluation of the degree to which each element is contained in each available alternative. The relative importance of each attribute element is determined through pairwise comparisons of the elements by the decision maker and implementation of a ratio scale quantification method. Then the 'belief' and 'plausibility' that an alternative will satisfy the decision maker's ideal are calculated and combined to rank order the available alternatives. Application to the problem of selecting computer software is given.

Research on Attribute Reduction in Hoisting Motor State Recognition of Quayside Container Crane

NASA Astrophysics Data System (ADS)

Li, F.; Tang, G.; Hu, X.

2017-07-01

In view of too many attributes in hoisting motor state recognition of quayside container crane. Attribute reduction method based on discernibility matrix is introduced to attribute reduction of lifting motor state information table. A method of attribute reduction based on the combination of rough set and genetic algorithm is proposed to deal with the hoisting motor state decision table. Under the condition that the information system's decision-making ability is unchanged, the redundant attribute is deleted. Which reduces the complexity and computation of the recognition process of the hoisting motor. It is possible to realize the fast state recognition.

Multiattribute evaluation in formulary decision making as applied to calcium-channel blockers.

PubMed

Schumacher, G E

1991-02-01

The use of multiattribute utility theory (MAUT) to make a formulary decision involving calcium-channel blockers (CCBs) is described. The MAUT method is a procedure for identifying, characterizing, and comparing the many variables that may affect a decision. Although applications in pharmacy have been infrequent, MAUT should be particularly appealing to formulary committees. The steps of the MAUT method are (1) determine the viewpoint of the decision makers, (2) identify the decision alternatives, (3) identify the attributes to be evaluated, (4) identify the factors to be used in evaluating the attributes, (5) establish a utility scale for scoring each factor, (6) transform the values for each factor to its utility scale, (7) determine weights for each attribute and factor, (8) calculate the total utility score for each decision alternative, (9) determine which decision alternative has the greatest total score, and (10) perform a sensitivity analysis. The viewpoint of a formulary committee in a health maintenance organization was simulated to develop a model for using the MAUT method to compare CCBs for single-agent therapy of chronic stable angina in ambulatory patients for one year. The attributes chosen were effectiveness, safety, patient acceptance, and cost and weighted 36%, 29%, 21%, and 14%, respectively, as contributions to the evaluation. The rank order of the decision alternatives was (1) generic verapamil, (2) brand-name verapamil, (3) diltiazem, (4) nicardipine, and (5) nifedipine. The MAUT method provides a standardized yet flexible format for comparing and selecting among formulary alternatives.

General Matthew B. Ridgway: Attributes of Battle Command and Decision-Making

DTIC Science & Technology

1998-02-13

information dominance require the attributes of future battle commanders be different than those of the past? This paper focuses on the intellectual and personality traits of General Matthew B. Ridgway as they apply to operational command and decision-making. These traits are considered essential for analysis and serve as a framework in which to examine their applicability to future command. The essential qualities of an operational commander are divided into two categories: intellect and personality. Each category is further divided into elemental traits. The application

Anthropology and decision making about chronic technological disasters: Mixed waste remediation on the Oak Ridge Reservation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolfe, A.K.; Schweitzer, M.

This paper discusses two related case studies of decision making about the remediation of mixed (hazardous and radioactive) wastes on the Oak Ridge Reservation in Tennessee. The three goals of the paper are to (1) place current decision-making efforts in the varied and evolving social, political, regulatory, economic, and technological contexts in which they occur; (2) present definitions and attributes of {open_quotes}successful{close_quotes} environmental decision making from the perspectives of key constituency groups that participate in decision making; and (3) discuss the role of anthropology in addressing environmental decision making. Environmental decision making about remediation is extraordinarily complex, involving human healthmore » and ecological risks; uncertainties about risks, technological ability to clean up, the financial costs of clean up; multiple and sometimes conflicting regulations; social equity and justice considerations; and decreasing budgets. Anthropological theories and methods can contribute to better understanding and, potentially, to better decision making.« less

Counseling Students' Decision Making Regarding Teaching Effectiveness: A Conjoint Analysis

ERIC Educational Resources Information Center

Pietrzak, Dale; Duncan, Kelly; Korcuska, James S.

2008-01-01

The authors examined the relative importance of 4 attributes of decision making for student evaluation of teaching effectiveness: perceived knowledge base of the professor, professor's delivery style, course organization, and course workload. Participants were 234 counseling graduate students from 6 midwestern universities in the United States.…

Lateral orbitofrontal cortex links social impressions to political choices.

PubMed

Xia, Chenjie; Stolle, Dietlind; Gidengil, Elisabeth; Fellows, Lesley K

2015-06-03

Recent studies of political behavior suggest that voting decisions can be influenced substantially by "first-impression" social attributions based on physical appearance. Separate lines of research have implicated the orbitofrontal cortex (OFC) in the judgment of social traits on the one hand and economic decision-making on the other, making this region a plausible candidate for linking social attributions to voting decisions. Here, we asked whether OFC lesions in humans disrupted the ability to judge traits of political candidates or affected how these judgments influenced voting decisions. Seven patients with lateral OFC damage, 18 patients with frontal damage sparing the lateral OFC, and 53 matched healthy participants took part in a simulated election paradigm, in which they voted for real-life (but unknown) candidates based only on photographs of their faces. Consistent with previous work, attributions of "competence" and "attractiveness" based on candidate appearance predicted voting behavior in the healthy control group. Frontal damage did not affect substantially the ability to make competence or attractiveness judgments, but patients with damage to the lateral OFC differed from other groups in how they applied this information when voting. Only attractiveness ratings had any predictive power for voting choices after lateral OFC damage, whereas other frontal patients and healthy controls relied on information about both competence and attractiveness in making their choice. An intact lateral OFC may not be necessary for judgment of social traits based on physical appearance, but it seems to be crucial in applying this information in political decision-making. Copyright © 2015 the authors 0270-6474/15/358507-08$15.00/0.

Value Focused Thinking in Developing Aerobatic Aircraft Selection Model for Turkish Air Force

DTIC Science & Technology

2012-03-22

many reasons . Most problems in decision- making involve multiple objectives and uncertainties. The number of alternatives can be significant and make ...and Republic of Turkey all around the world”. This is a clear and concise statement of the most basic reason for decision. After making interview...Hwang, C.-L. (1995). Multiple Attribute Decison Making : An Introduction. California: Sage Publications. 90 Vita First Lieutenant

Understanding Decision-Making in Specialized Domestic Violence Courts: Can Contemporary Theoretical Frameworks Help Guide These Decisions?

PubMed

Pinchevsky, Gillian M

2016-05-22

This study fills a gap in the literature by exploring the utility of contemporary courtroom theoretical frameworks-uncertainty avoidance, causal attribution, and focal concerns-for explaining decision-making in specialized domestic violence courts. Using data from two specialized domestic violence courts, this study explores the predictors of prosecutorial and judicial decision-making and the extent to which these factors are congruent with theoretical frameworks often used in studies of court processing. Findings suggest that these theoretical frameworks only partially help explain decision-making in the courts under study. A discussion of the findings and implications for future research is provided. © The Author(s) 2016.

The double-edged sword of genetic accounts of criminality: causal attributions from genetic ascriptions affect legal decision making.

PubMed

Cheung, Benjamin Y; Heine, Steven J

2015-12-01

Much debate exists surrounding the applicability of genetic information in the courtroom, making the psychological processes underlying how people consider this information important to explore. This article addresses how people think about different kinds of causal explanations in legal decision-making contexts. Three studies involving a total of 600 Mechanical Turk and university participants found that genetic, versus environmental, explanations of criminal behavior lead people to view the applicability of various defense claims differently, perceive the perpetrator's mental state differently, and draw different causal attributions. Moreover, mediation and path analyses highlight the double-edged nature of genetic attributions-they simultaneously reduce people's perception of the perpetrator's sense of control while increasing people's tendencies to attribute the cause to internal factors and to expect the perpetrator to reoffend. These countervailing relations, in turn, predict sentencing in opposite directions, although no overall differences in sentencing or ultimate verdicts were found. © 2015 by the Society for Personality and Social Psychology, Inc.

I know why you voted for Trump: (Over)inferring motives based on choice.

PubMed

Barasz, Kate; Kim, Tami; Evangelidis, Ioannis

2018-05-10

People often speculate about why others make the choices they do. This paper investigates how such inferences are formed as a function of what is chosen. Specifically, when observers encounter someone else's choice (e.g., of political candidate), they use the chosen option's attribute values (e.g., a candidate's specific stance on a policy issue) to infer the importance of that attribute (e.g., the policy issue) to the decision-maker. Consequently, when a chosen option has an attribute whose value is extreme (e.g., an extreme policy stance), observers infer-sometimes incorrectly-that this attribute disproportionately motivated the decision-maker's choice. Seven studies demonstrate how observers use an attribute's value to infer its weight-the value-weight heuristic-and identify the role of perceived diagnosticity: more extreme attribute values give observers the subjective sense that they know more about a decision-maker's preferences, and in turn, increase the attribute's perceived importance. The paper explores how this heuristic can produce erroneous inferences and influence broader beliefs about decision-makers. Copyright © 2018 Elsevier B.V. All rights reserved.

History matching through dynamic decision-making

PubMed Central

Maschio, Célio; Santos, Antonio Alberto; Schiozer, Denis; Rocha, Anderson

2017-01-01

History matching is the process of modifying the uncertain attributes of a reservoir model to reproduce the real reservoir performance. It is a classical reservoir engineering problem and plays an important role in reservoir management since the resulting models are used to support decisions in other tasks such as economic analysis and production strategy. This work introduces a dynamic decision-making optimization framework for history matching problems in which new models are generated based on, and guided by, the dynamic analysis of the data of available solutions. The optimization framework follows a ‘learning-from-data’ approach, and includes two optimizer components that use machine learning techniques, such as unsupervised learning and statistical analysis, to uncover patterns of input attributes that lead to good output responses. These patterns are used to support the decision-making process while generating new, and better, history matched solutions. The proposed framework is applied to a benchmark model (UNISIM-I-H) based on the Namorado field in Brazil. Results show the potential the dynamic decision-making optimization framework has for improving the quality of history matching solutions using a substantial smaller number of simulations when compared with a previous work on the same benchmark. PMID:28582413

Preference Reversals in Decision Making Under Risk are Accompanied by Changes in Attention to Different Attributes.

PubMed

Kim, Betty E; Seligman, Darryl; Kable, Joseph W

2012-01-01

Recent work has shown that visual fixations reflect and influence trial-to-trial variability in people's preferences between goods. Here we extend this principle to attribute weights during decision making under risk. We measured eye movements while people chose between two risky gambles or bid on a single gamble. Consistent with previous work, we found that people exhibited systematic preference reversals between choices and bids. For two gambles matched in expected value, people systematically chose the higher probability option but provided a higher bid for the option that offered the greater amount to win. This effect was accompanied by a shift in fixations of the two attributes, with people fixating on probabilities more during choices and on amounts more during bids. Our results suggest that the construction of value during decision making under risk depends on task context partly because the task differentially directs attention at probabilities vs. amounts. Since recent work demonstrates that neural correlates of value vary with visual fixations, our results also suggest testable hypotheses regarding how task context modulates the neural computation of value to generate preference reversals.

Decision Making for Pap Testing among Pacific Islander Women

ERIC Educational Resources Information Center

Weiss, Jie W.; Mouttapa, Michele; Sablan-Santos, Lola; DeGuzman Lacsamana, Jasmine; Quitugua, Lourdes; Park Tanjasiri, Sora

2016-01-01

This study employed a Multi-Attribute Utility (MAU) model to examine the Pap test decision-making process among Pacific Islanders (PI) residing in Southern California. A total of 585 PI women were recruited through social networks from Samoan and Tongan churches, and Chamorro family clans. A questionnaire assessed Pap test knowledge, beliefs and…

Maclaurin symmetric mean operators of linguistic intuitionistic fuzzy numbers and their application to multiple-attribute decision-making

NASA Astrophysics Data System (ADS)

Liu, Peide; Qin, Xiyou

2017-11-01

Linguistic intuitionistic fuzzy number (LIFN) is a special intuitionistic fuzzy number which can more easily describe the vagueness existing in the real decision-making. Maclaurin symmetric mean (MSM) operator has the characteristic of considering the interrelationships among any number of input parameters. In this paper, we extended the MSM operator to the LIFNs and some extended MSM operators for LIFNs were proposed, some new decision-making methods were developed. Firstly, we introduced the definition, score function, properties and operational rules of the LIFNs. Then, we proposed some linguistic intuitionistic fuzzy MSM operators, such as linguistic intuitionistic fuzzy Maclaurin symmetric mean operator, weighted linguistic intuitionistic fuzzy Maclaurin symmetric mean (WLIFMSM) operator, linguistic intuitionistic fuzzy dual Maclaurin symmetric mean operator, weighted linguistic intuitionistic fuzzy dual Maclaurin symmetric mean (WLIFDMSM) operator. In the meantime, we studied some important properties of these operators, and developed some methods based on WLIFMSM operator and WLIFDMSM operator for multi-attribute decision-making. Finally, we use an example to demonstrate the effectiveness of the proposed methods.

A dynamic, embodied paradigm to investigate the role of serotonin in decision-making

PubMed Central

Asher, Derrik E.; Craig, Alexis B.; Zaldivar, Andrew; Brewer, Alyssa A.; Krichmar, Jeffrey L.

2013-01-01

Serotonin (5-HT) is a neuromodulator that has been attributed to cost assessment and harm aversion. In this review, we look at the role 5-HT plays in making decisions when subjects are faced with potential harmful or costly outcomes. We review approaches for examining the serotonergic system in decision-making. We introduce our group’s paradigm used to investigate how 5-HT affects decision-making. In particular, our paradigm combines techniques from computational neuroscience, socioeconomic game theory, human–robot interaction, and Bayesian statistics. We will highlight key findings from our previous studies utilizing this paradigm, which helped expand our understanding of 5-HT’s effect on decision-making in relation to cost assessment. Lastly, we propose a cyclic multidisciplinary approach that may aid in addressing the complexity of exploring 5-HT and decision-making by iteratively updating our assumptions and models of the serotonergic system through exhaustive experimentation. PMID:24319413

Grey Language Hesitant Fuzzy Group Decision Making Method Based on Kernel and Grey Scale

PubMed Central

Diao, Yuzhu; Hu, Aqin

2018-01-01

Based on grey language multi-attribute group decision making, a kernel and grey scale scoring function is put forward according to the definition of grey language and the meaning of the kernel and grey scale. The function introduces grey scale into the decision-making method to avoid information distortion. This method is applied to the grey language hesitant fuzzy group decision making, and the grey correlation degree is used to sort the schemes. The effectiveness and practicability of the decision-making method are further verified by the industry chain sustainable development ability evaluation example of a circular economy. Moreover, its simplicity and feasibility are verified by comparing it with the traditional grey language decision-making method and the grey language hesitant fuzzy weighted arithmetic averaging (GLHWAA) operator integration method after determining the index weight based on the grey correlation. PMID:29498699

Grey Language Hesitant Fuzzy Group Decision Making Method Based on Kernel and Grey Scale.

PubMed

Li, Qingsheng; Diao, Yuzhu; Gong, Zaiwu; Hu, Aqin

2018-03-02

Based on grey language multi-attribute group decision making, a kernel and grey scale scoring function is put forward according to the definition of grey language and the meaning of the kernel and grey scale. The function introduces grey scale into the decision-making method to avoid information distortion. This method is applied to the grey language hesitant fuzzy group decision making, and the grey correlation degree is used to sort the schemes. The effectiveness and practicability of the decision-making method are further verified by the industry chain sustainable development ability evaluation example of a circular economy. Moreover, its simplicity and feasibility are verified by comparing it with the traditional grey language decision-making method and the grey language hesitant fuzzy weighted arithmetic averaging (GLHWAA) operator integration method after determining the index weight based on the grey correlation.

The Neurobiology of Decision-Making and Responsibility: Reconciling Mechanism and Mindedness

PubMed Central

Shadlen, Michael N.; Roskies, Adina L.

2012-01-01

This essay reviews recent developments in neurobiology which are beginning to expose the mechanisms that underlie some elements of decision-making that bear on attributions of responsibility. These “elements” have been mainly studied in simple perceptual decision tasks, which are performed similarly by humans and non-human primates. Here we consider the role of neural noise, and suggest that thinking about the role of noise can shift the focus of discussions of randomness in decision-making away from its role in enabling alternate possibilities and toward a potential grounding role for responsibility. PMID:22536171

The effect of subjective awareness measures on performance in artificial grammar learning task.

PubMed

Ivanchei, Ivan I; Moroshkina, Nadezhda V

2018-01-01

Systematic research into implicit learning requires well-developed awareness-measurement techniques. Recently, trial-by-trial measures have been widely used. However, they can increase complexity of a study because they are an additional experimental variable. We tested the effects of these measures on performance in artificial grammar learning study. Four groups of participants were assigned to different awareness measures conditions: confidence ratings, post-decision wagering, decision strategy attribution or none. Decision-strategy-attribution participants demonstrated better grammar learning and longer response times compared to controls. They also exhibited a conservative bias. Grammaticality by itself was a stronger predictor of strings endorsement in decision-strategy-attribution group compared to other groups. Confidence ratings and post-decision wagering only affected the response times. These results were supported by an additional experiment that used a balanced chunk strength design. We conclude that a decision-strategy-attribution procedure may force participants to adopt an analytical decision-making strategy and rely mostly on conscious knowledge of artificial grammar. Copyright © 2017 Elsevier Inc. All rights reserved.

Attitudes towards poverty, organizations, ethics and morals: Israeli social workers' shared decision making.

PubMed

Levin, Lia; Schwartz-Tayri, Talia

2017-06-01

Partnerships between service users and social workers are complex in nature and can be driven by both personal and contextual circumstances. This study sought to explore the relationship between social workers' involvement in shared decision making with service users, their attitudes towards service users in poverty, moral standards and health and social care organizations' policies towards shared decision making. Based on the responses of 225 licensed social workers from health and social care agencies in the public, private and third sectors in Israel, path analysis was used to test a hypothesized model. Structural attributions for poverty contributed to attitudes towards people who live in poverty, which led to shared decision making. Also, organizational support in shared decision making, and professional moral identity, contributed to ethical behaviour which led to shared decision making. The results of this analysis revealed that shared decision making may be a scion of branched roots planted in the relationship between ethics, organizations and Stigma. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

[Treatment Decision-Making Process of Cancer Patients].

PubMed

Lee, Shiu-Yu C Katie

2016-10-01

The decision-making process that is used by cancer patients to determine their treatment has become more multi-foci, difficult and complicated in recent years. This has in part been attributed to the increasing incidence rate of cancer in Taiwan and the rapid development of medical technologies and treatment modalities. Oncology nurses must assist patients and family to make informed and value-based treatment decisions. Decision-making is an information process that involves appraising one's own expectation and values based on his/her knowledge on cancer and treatment options. Because cancer treatment involves risks and uncertainties, and impacts quality of life, the treatment decision-making for cancer is often stressful, or even conflicting. This paper discusses the decision-making behaviors of cancer patients and the decisional conflict, participation, and informational needs that are involved in cancer treatment. The trend toward shared decision-making and decisional support will be also explored in order to facilitate the future development of appropriate clinical interventions and research.

Gist memory in the unconscious-thought effect.

PubMed

Abadie, Marlène; Waroquier, Laurent; Terrier, Patrice

2013-07-01

The unconscious-thought effect (UTE) occurs when people are better able to make complex decisions after a period of distraction rather than immediately or after a period of conscious deliberation. This finding has often been interpreted as evidence of unconscious thinking. In two experiments, we provided the first evidence that the UTE is accompanied by enhanced memory for the gist of decision-relevant attributes and demonstrated that the cognitive demands of a distraction task moderate its effect on decision making and gist memory. It was only following a low-demand distraction task that participants chose the best alternative more often and displayed enhanced gist memory for decision-relevant attributes. These findings suggest that the UTE occurs only if cognitive resources are available and that it is accompanied by enhanced organization of information in memory, as shown by the increase in gist memory.

Evaluation and selection of decision-making methods to assess landfill mining projects.

PubMed

Hermann, Robert; Baumgartner, Rupert J; Vorbach, Stefan; Ragossnig, Arne; Pomberger, Roland

2015-09-01

For the first time in Austria, fundamental technological and economic studies on recovering secondary raw materials from large landfills have been carried out, based on the 'LAMIS - Landfill Mining Austria' pilot project. A main focus of the research - and the subject of this article - was to develop an assessment or decision-making procedure that allows landfill owners to thoroughly examine the feasibility of a landfill mining project in advance. Currently there are no standard procedures that would sufficiently cover all the multiple-criteria requirements. The basic structure of the multiple attribute decision making process was used to narrow down on selection, conceptual design and assessment of suitable procedures. Along with a breakdown into preliminary and main assessment, the entire foundation required was created, such as definitions of requirements to an assessment method, selection and accurate description of the various assessment criteria and classification of the target system for the present 'landfill mining' vs. 'retaining the landfill in after-care' decision-making problem. Based on these studies, cost-utility analysis and the analytical-hierarchy process were selected from the range of multiple attribute decision-making procedures and examined in detail. Overall, both methods have their pros and cons with regard to their use for assessing landfill mining projects. Merging these methods or connecting them with single-criteria decision-making methods (like the net present value method) may turn out to be reasonable and constitute an appropriate assessment method. © The Author(s) 2015.

Suboptimal choice in rats: incentive salience attribution promotes maladaptive decision-making

PubMed Central

Chow, Jonathan J; Smith, Aaron P; Wilson, A George; Zentall, Thomas R; Beckmann, Joshua S

2016-01-01

Stimuli that are more predictive of subsequent reward also function as better conditioned reinforcers. Moreover, stimuli attributed with incentive salience function as more robust conditioned reinforcers. Some theories have suggested that conditioned reinforcement plays an important role in promoting suboptimal choice behavior, like gambling. The present experiments examined how different stimuli, those attributed with incentive salience versus those without, can function in tandem with stimulus-reward predictive utility to promote maladaptive decision-making in rats. One group of rats had lights associated with goal-tracking as the reward-predictive stimuli and another had levers associated with sign-tracking as the reward-predictive stimuli. All rats were first trained on a choice procedure in which the expected value across both alternatives was equivalent but differed in their stimulus-reward predictive utility. Next, the expected value across both alternatives was systematically changed so that the alternative with greater stimulus-reward predictive utility was suboptimal in regard to primary reinforcement. The results demonstrate that in order to obtain suboptimal choice behavior, incentive salience alongside strong stimulus-reward predictive utility may be necessary; thus, maladaptive decision-making can be driven more by the value attributed to stimuli imbued with incentive salience that reliably predict a reward rather than the reward itself. PMID:27993692

Suboptimal choice in rats: Incentive salience attribution promotes maladaptive decision-making.

PubMed

Chow, Jonathan J; Smith, Aaron P; Wilson, A George; Zentall, Thomas R; Beckmann, Joshua S

2017-03-01

Stimuli that are more predictive of subsequent reward also function as better conditioned reinforcers. Moreover, stimuli attributed with incentive salience function as more robust conditioned reinforcers. Some theories have suggested that conditioned reinforcement plays an important role in promoting suboptimal choice behavior, like gambling. The present experiments examined how different stimuli, those attributed with incentive salience versus those without, can function in tandem with stimulus-reward predictive utility to promote maladaptive decision-making in rats. One group of rats had lights associated with goal-tracking as the reward-predictive stimuli and another had levers associated with sign-tracking as the reward-predictive stimuli. All rats were first trained on a choice procedure in which the expected value across both alternatives was equivalent but differed in their stimulus-reward predictive utility. Next, the expected value across both alternatives was systematically changed so that the alternative with greater stimulus-reward predictive utility was suboptimal in regard to primary reinforcement. The results demonstrate that in order to obtain suboptimal choice behavior, incentive salience alongside strong stimulus-reward predictive utility may be necessary; thus, maladaptive decision-making can be driven more by the value attributed to stimuli imbued with incentive salience that reliably predict a reward rather than the reward itself. Copyright © 2016 Elsevier B.V. All rights reserved.

Global Educators' Personal Attribution of a Global Perspective

ERIC Educational Resources Information Center

Carano, Kenneth Thomas

2013-01-01

This case study of self-identifying global educators investigated factors that they attributed to the development of their global perspective and how it influenced curricular decision-making. Analysis resulted in seven themes identified by the participants as having attributed to the development of a global perspective: (a) family, (b) exposure to…

Decisions, Decisions, Decisions: Recreation Site Choice with Expected Congestion and Social Interaction

ERIC Educational Resources Information Center

Snipes, Katherine H.

2009-01-01

A set of computer-based recreation choice experiments were run to examine the effect of expected congestion and social interactions on the decision making process. MouseTrace is a process-tracing program that recorded individual subject's information acquisitions and provided the necessary information to determine if subjects used attribute-based…

An Integrated Approach of Fuzzy Linguistic Preference Based AHP and Fuzzy COPRAS for Machine Tool Evaluation.

PubMed

Nguyen, Huu-Tho; Md Dawal, Siti Zawiah; Nukman, Yusoff; Aoyama, Hideki; Case, Keith

2015-01-01

Globalization of business and competitiveness in manufacturing has forced companies to improve their manufacturing facilities to respond to market requirements. Machine tool evaluation involves an essential decision using imprecise and vague information, and plays a major role to improve the productivity and flexibility in manufacturing. The aim of this study is to present an integrated approach for decision-making in machine tool selection. This paper is focused on the integration of a consistent fuzzy AHP (Analytic Hierarchy Process) and a fuzzy COmplex PRoportional ASsessment (COPRAS) for multi-attribute decision-making in selecting the most suitable machine tool. In this method, the fuzzy linguistic reference relation is integrated into AHP to handle the imprecise and vague information, and to simplify the data collection for the pair-wise comparison matrix of the AHP which determines the weights of attributes. The output of the fuzzy AHP is imported into the fuzzy COPRAS method for ranking alternatives through the closeness coefficient. Presentation of the proposed model application is provided by a numerical example based on the collection of data by questionnaire and from the literature. The results highlight the integration of the improved fuzzy AHP and the fuzzy COPRAS as a precise tool and provide effective multi-attribute decision-making for evaluating the machine tool in the uncertain environment.

Use of structured decision making to identify monitoring variables and management priorities for salt marsh ecosystems

USGS Publications Warehouse

Neckles, Hilary A.; Lyons, James E.; Guntenspergen, Glenn R.; Shriver, W. Gregory; Adamowicz, Susan C.

2015-01-01

Most salt marshes in the USA have been degraded by human activities, and coastal managers are faced with complex choices among possible actions to restore or enhance ecosystem integrity. We applied structured decision making (SDM) to guide selection of monitoring variables and management priorities for salt marshes within the National Wildlife Refuge System in the northeastern USA. In general, SDM is a systematic process for decomposing a decision into its essential elements. We first engaged stakeholders in clarifying regional salt marsh decision problems, defining objectives and attributes to evaluate whether objectives are achieved, and developing a pool of alternative management actions for achieving objectives. Through this process, we identified salt marsh attributes that were applicable to monitoring National Wildlife Refuges on a regional scale and that targeted management needs. We then analyzed management decisions within three salt marsh units at Prime Hook National Wildlife Refuge, coastal Delaware, as a case example of prioritizing management alternatives. Values for salt marsh attributes were estimated from 2 years of baseline monitoring data and expert opinion. We used linear value modeling to aggregate multiple attributes into a single performance score for each alternative, constrained optimization to identify alternatives that maximized total management benefits subject to refuge-wide cost constraints, and used graphical analysis to identify the optimal set of alternatives for the refuge. SDM offers an efficient, transparent approach for integrating monitoring into management practice and improving the quality of management decisions.

Decision Making Methods in Space Economics and Systems Engineering

NASA Technical Reports Server (NTRS)

Shishko, Robert

2006-01-01

This viewgraph presentation reviews various methods of decision making and the impact that they have on space economics and systems engineering. Some of the methods discussed are: Present Value and Internal Rate of Return (IRR); Cost-Benefit Analysis; Real Options; Cost-Effectiveness Analysis; Cost-Utility Analysis; Multi-Attribute Utility Theory (MAUT); and Analytic Hierarchy Process (AHP).

An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

NASA Technical Reports Server (NTRS)

Elgin, Peter D.; Thomas, Rickey P.

2004-01-01

The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

Developing an Environmental Currency Relevant to People

EPA Science Inventory

EPA (and others worldwide) wanted to more fully include environmental attributes in decision making but there was no systematic approach that defined and organized the environment to identify and potentially quantify those environmental attributes that humans required, valued, or...

Framing effects in medical situations: distinctions of attribute, goal and risky choice frames.

PubMed

Peng, Jiaxi; Jiang, Yuan; Miao, Danmin; Li, Rui; Xiao, Wei

2013-06-01

To verify whether three different framing effects (risky choice, attribute and goal) exist in simulated medical situations and to analyse any differences. Medical decision-making problems were established, relating to medical skill evaluation, patient compliance and a selection of treatment options. All problems were described in positive and negative frame conditions. Significantly more positive evaluations were made if the doctor's medical records were described as 'of 100 patients, 70 patients became better' compared with those described as 'of 100 patients, 30 patients didn't become better'. Doctor's advice described in a negative frame resulted in significantly more decisions to comply, compared with advice described in a positive frame. Treatment options described in terms of survival rates resulted in significantly more adventurous choices compared with options described in terms of mortality rates. Decision-making reversal appeared in the risky choice and attribute frames, but not the goal frame. Framing effects were shown to exist in simulated medical situations, but there were significant differences among the three kinds of such effects.

The Elasticity of Preferences.

PubMed

Simon, Dan; Spiller, Stephen A

2016-12-01

We explore how preferences for attributes are constructed when people choose between multiattribute options. As found in prior research, we observed that while people make decisions, their preferences for the attributes in question shift to support the emerging choice, thus enabling confident decisions. The novelty of the studies reported here is that participants repeated the same task 6 to 8 weeks later. We found that between tasks, preferences returned to near their original levels, only to shift again to support the second choice, regardless of which choice participants made. Similar patterns were observed in a free-choice task (Study 1) and when the favorableness of options was manipulated (Study 2). It follows that preferences behave in an elastic manner: In the absence of situational pressures, they rest at baseline levels, but during the process of reaching a decision, they morph to support the chosen options. This elasticity appears to facilitate confident decision making in the face of decisional conflict.

Satisficing Decision-Making in Supervisory Control. Part 2.

DTIC Science & Technology

1986-07-31

purpose of the United States Government. C-P Department of Mechanical Engineering Massachusetts Institute of Technology Cambridge, Massachusetts 02139...of Mechanical Engineering Massachusetts Institute of Technology Cambridge MA 02139 Satisficing Decision-Making in Supervisory Control Leonid Charny...example, that there are two attributes, speed and accuracy, and one is selecting a robot manipulator based -4n these two parameters. A set of alternatives

Employee decision-making about disclosure of a mental disorder at work.

PubMed

Toth, Kate E; Dewa, Carolyn S

2014-12-01

Fear of stigma may lead employees to choose not to disclose a mental disorder in the workplace, thereby limiting help-seeking through workplace accommodation. Research suggests that various factors are considered in making decisions related to disclosure of concealable stigmatizing attributes, yet limited literature explores such decision-making in the context of mental disorder and work. The purpose of this grounded theory study was to develop a model of disclosure specific to mental health issues in a work context. In-depth interviews were conducted with 13 employees of a post-secondary educational institution in Canada. Data were analyzed according to grounded theory methods through processes of open, selective, and theoretical coding. Findings indicated that employees begin from a default position of nondisclosure that is attributable to fear of being stigmatized in the workplace as a result of the mental disorder. In order to move from the default position, employees need a reason to disclose. The decision-making process itself is a risk-benefit analysis, during which employees weigh risks and benefits within the existing context as they assess it. The model identifies that fear of stigmatization is one of the problems with disclosure at work and describes the disclosure decision-making process. Understanding of how employees make decisions about disclosure in the workplace may inform organizational policies, practices, and programs to improve the experiences of individuals diagnosed with a mental disorder at work. The findings suggest possible intervention strategies in education, policy, and culture for reducing stigma of mental disorders in the workplace.

Experimental analysis of multi-attribute decision-making based on Atanassov intuitionistic fuzzy sets: a discussion of anchor dependency and accuracy functions

NASA Astrophysics Data System (ADS)

Chen, Ting-Yu

2012-06-01

This article presents a useful method for relating anchor dependency and accuracy functions to multiple attribute decision-making (MADM) problems in the context of Atanassov intuitionistic fuzzy sets (A-IFSs). Considering anchored judgement with displaced ideals and solution precision with minimal hesitation, several auxiliary optimisation models have proposed to obtain the optimal weights of the attributes and to acquire the corresponding TOPSIS (the technique for order preference by similarity to the ideal solution) index for alternative rankings. Aside from the TOPSIS index, as a decision-maker's personal characteristics and own perception of self may also influence the direction in the axiom of choice, the evaluation of alternatives is conducted based on distances of each alternative from the positive and negative ideal alternatives, respectively. This article originates from Li's [Li, D.-F. (2005), 'Multiattribute Decision Making Models and Methods Using Intuitionistic Fuzzy Sets', Journal of Computer and System Sciences, 70, 73-85] work, which is a seminal study of intuitionistic fuzzy decision analysis using deduced auxiliary programming models, and deems it a benchmark method for comparative studies on anchor dependency and accuracy functions. The feasibility and effectiveness of the proposed methods are illustrated by a numerical example. Finally, a comparative analysis is illustrated with computational experiments on averaging accuracy functions, TOPSIS indices, separation measures from positive and negative ideal alternatives, consistency rates of ranking orders, contradiction rates of the top alternative and average Spearman correlation coefficients.

Decision Making in Nursing Practice: A Concept Analysis.

PubMed

Johansen, Mary L; O'Brien, Janice L

2016-01-01

The study aims to gain an understanding of the concept of decision making as it relates to the nurse practice environment. Rodgers' evolutionary method on concept analysis was used as a framework for the study of the concept. Articles from 1952 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, PubMed, and Science Direct. Findings suggest that decision making in the nurse practice environment is a complex process, integral to the nursing profession. The definition of decision making, and the attributes, antecedents, and consequences, are discussed. Contextual factors that influence the process are also discussed. An exemplar is presented to illustrate the concept. Decision making in the nurse practice environment is a dynamic conceptual process that may affect patient outcomes. Nurses need to call upon ways of knowing to make sound decisions and should be self-reflective in order to develop the process further in the professional arena. The need for further research is discussed. © 2015 Wiley Periodicals, Inc.

Decision Making Under Objective Risk Conditions-a Review of Cognitive and Emotional Correlates, Strategies, Feedback Processing, and External Influences.

PubMed

Schiebener, Johannes; Brand, Matthias

2015-06-01

While making decisions under objective risk conditions, the probabilities of the consequences of the available options are either provided or calculable. Brand et al. (Neural Networks 19:1266-1276, 2006) introduced a model describing the neuro-cognitive processes involved in such decisions. In this model, executive functions associated with activity in the fronto-striatal loop are important for developing and applying decision-making strategies, and for verifying, adapting, or revising strategies according to feedback. Emotional rewards and punishments learned from such feedback accompany these processes. In this literature review, we found support for the role of executive functions, but also found evidence for the importance of further cognitive abilities in decision making. Moreover, in addition to reflective processing (driven by cognition), decisions can be guided by impulsive processing (driven by anticipation of emotional reward and punishment). Reflective and impulsive processing may interact during decision making, affecting the evaluation of available options, as both processes are affected by feedback. Decision-making processes are furthermore modulated by individual attributes (e.g., age), and external influences (e.g., stressors). Accordingly, we suggest a revised model of decision making under objective risk conditions.

Ethnic differences in informed decision-making about prenatal screening for Down's syndrome.

PubMed

Fransen, Mirjam P; Essink-Bot, Marie-Louise; Vogel, Ineke; Mackenbach, Johan P; Steegers, Eric A P; Wildschut, Hajo I J

2010-03-01

The aim of this study was to assess ethnic variations in informed decision-making about prenatal screening for Down's syndrome and to examine the contribution of background and decision-making variables. Pregnant women of Dutch, Turkish and Surinamese origin were recruited between 2006 and 2008 from community midwifery or obstetrical practices in The Netherlands. Each woman was personally interviewed 3 weeks (mean) after booking for prenatal care. Knowledge, attitude and participation in prenatal screening were assessed following the 'Multidimensional Measure of Informed Choice' that has been developed and applied in the UK. In total, 71% of the Dutch women were classified as informed decision-makers, compared with 5% of the Turkish and 26% of the Surinamese women. Differences between Surinamese and Dutch women could largely be attributed to differences in educational level and age. Differences between Dutch and Turkish women could mainly be attributed to differences in language skills and gender emancipation. Women from ethnic minority groups less often made an informed decision whether or not to participate in prenatal screening. Interventions to decrease these ethnic differences should first of all be aimed at overcoming language barriers and increasing comprehension among women with a low education level. To further develop diversity-sensitive strategies for counselling, it should be investigated how women from different ethnic backgrounds value informed decision-making in prenatal screening, what decision-relevant knowledge they need and what they take into account when considering participation in prenatal screening.

Decision Making In Assignment Problem With Multiple Attributes Under Intuitionistic Fuzzy Environment

NASA Astrophysics Data System (ADS)

Mukherjee, Sathi; Basu, Kajla

2010-10-01

In this paper we develop a methodology to solve the multiple attribute assignment problems where the attributes are considered to be Intuitionistic Fuzzy Sets (IFS). We apply the concept of similarity measures of IFS to solve the Intuitionistic Fuzzy Multi-Attribute Assignment Problem (IFMAAP). The weights of the attributes are determined from expert opinion. An illustrative example is solved to verify the developed approach and to demonstrate its practicality.

Decision-making in irrigation networks: Selecting appropriate canal structures using multi-attribute decision analysis.

PubMed

Hosseinzade, Zeinab; Pagsuyoin, Sheree A; Ponnambalam, Kumaraswamy; Monem, Mohammad J

2017-12-01

The stiff competition for water between agriculture and non-agricultural production sectors makes it necessary to have effective management of irrigation networks in farms. However, the process of selecting flow control structures in irrigation networks is highly complex and involves different levels of decision makers. In this paper, we apply multi-attribute decision making (MADM) methodology to develop a decision analysis (DA) framework for evaluating, ranking and selecting check and intake structures for irrigation canals. The DA framework consists of identifying relevant attributes for canal structures, developing a robust scoring system for alternatives, identifying a procedure for data quality control, and identifying a MADM model for the decision analysis. An application is illustrated through an analysis for automation purposes of the Qazvin irrigation network, one of the oldest and most complex irrigation networks in Iran. A survey questionnaire designed based on the decision framework was distributed to experts, managers, and operators of the Qazvin network and to experts from the Ministry of Power in Iran. Five check structures and four intake structures were evaluated. A decision matrix was generated from the average scores collected from the survey, and was subsequently solved using TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) method. To identify the most critical structure attributes for the selection process, optimal attribute weights were calculated using Entropy method. For check structures, results show that the duckbill weir is the preferred structure while the pivot weir is the least preferred. Use of the duckbill weir can potentially address the problem with existing Amil gates where manual intervention is required to regulate water levels during periods of flow extremes. For intake structures, the Neyrpic® gate and constant head orifice are the most and least preferred alternatives, respectively. Some advantages of the Neyrpic® gate are ease of operation and capacity to measure discharge flows. Overall, the application to the Qazvin irrigation network demonstrates the utility of the proposed DA framework in selecting appropriate structures for regulating water flows in irrigation canals. This framework systematically aids the decision process by capturing decisions made at various levels (individual farmers to high-level management). It can be applied to other cases where a new irrigation network is being designed, or where changes in irrigation structures need to be identified to improve flow control in existing networks. Copyright © 2017 Elsevier B.V. All rights reserved.

An Integrated Approach of Fuzzy Linguistic Preference Based AHP and Fuzzy COPRAS for Machine Tool Evaluation

PubMed Central

Nguyen, Huu-Tho; Md Dawal, Siti Zawiah; Nukman, Yusoff; Aoyama, Hideki; Case, Keith

2015-01-01

Globalization of business and competitiveness in manufacturing has forced companies to improve their manufacturing facilities to respond to market requirements. Machine tool evaluation involves an essential decision using imprecise and vague information, and plays a major role to improve the productivity and flexibility in manufacturing. The aim of this study is to present an integrated approach for decision-making in machine tool selection. This paper is focused on the integration of a consistent fuzzy AHP (Analytic Hierarchy Process) and a fuzzy COmplex PRoportional ASsessment (COPRAS) for multi-attribute decision-making in selecting the most suitable machine tool. In this method, the fuzzy linguistic reference relation is integrated into AHP to handle the imprecise and vague information, and to simplify the data collection for the pair-wise comparison matrix of the AHP which determines the weights of attributes. The output of the fuzzy AHP is imported into the fuzzy COPRAS method for ranking alternatives through the closeness coefficient. Presentation of the proposed model application is provided by a numerical example based on the collection of data by questionnaire and from the literature. The results highlight the integration of the improved fuzzy AHP and the fuzzy COPRAS as a precise tool and provide effective multi-attribute decision-making for evaluating the machine tool in the uncertain environment. PMID:26368541

Choosing spouses and houses: Impaired congruence between preference and choice following damage to the ventromedial prefrontal cortex.

PubMed

Bowren, Mark D; Croft, Katie E; Reber, Justin; Tranel, Daniel

2018-03-01

A well-documented effect of focal ventromedial prefrontal cortex (vmPFC) damage is a deficit in real-world decision making. An important aspect of this deficit may be a deficiency in "internal consistency" during social decision making-that is, impaired congruence between expressed preferences versus actual behavioral choices. An example of low internal consistency would be if one expressed the desire to marry someone with impeccable moral character, yet proceeded to marry someone convicted of multiple felonies. Here, we used a neuropsychological approach to investigate neural correlates of internal consistency in complex decision making. Sixteen individuals with focal vmPFC lesions, 16 brain damage comparison individuals, and 16 normal comparison individuals completed a 3-option forced-choice preference task in which choices were made using attribute sets. Participants also completed visual-analogue preference ratings to indicate how much they liked each option, and rated the influence of each attribute on their decision making. Options were either social (potential spouses) or nonsocial (potential houses). Internal consistency for a trial was defined as agreement between the choice and the most positively rated option. A mixed design analysis of variance revealed that internal consistency between choices and preferences derived from summed attribute ratings was significantly lower for the vmPFC group relative to comparison participants, but only in the social condition (pη2 = .09), 95% CI [.002, .163]. Internal consistency during social decisions may be deficient in patients with vmPFC damage, leading to a discrepancy between preferences and choices. The vmPFC may provide an important neural mechanism for aligning behavioral choices with expressed preferences. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Incorporating patient-preference evidence into regulatory decision making.

PubMed

Ho, Martin P; Gonzalez, Juan Marcos; Lerner, Herbert P; Neuland, Carolyn Y; Whang, Joyce M; McMurry-Heath, Michelle; Hauber, A Brett; Irony, Telba

2015-10-01

Patients have a unique role in deciding what treatments should be available for them and regulatory agencies should take their preferences into account when making treatment approval decisions. This is the first study designed to obtain quantitative patient-preference evidence to inform regulatory approval decisions by the Food and Drug Administration Center for Devices and Radiological Health. Five-hundred and forty United States adults with body mass index (BMI) ≥ 30 kg/m(2) evaluated tradeoffs among effectiveness, safety, and other attributes of weight-loss devices in a scientific survey. Discrete-choice experiments were used to quantify the importance of safety, effectiveness, and other attributes of weight-loss devices to obese respondents. A tool based on these measures is being used to inform benefit-risk assessments for premarket approval of medical devices. Respondent choices yielded preference scores indicating their relative value for attributes of weight-loss devices in this study. We developed a tool to estimate the minimum weight loss acceptable by a patient to receive a device with a given risk profile and the maximum mortality risk tolerable in exchange for a given weight loss. For example, to accept a device with 0.01 % mortality risk, a risk tolerant patient will require about 10 % total body weight loss lasting 5 years. Patient preference evidence was used make regulatory decision making more patient-centered. In addition, we captured the heterogeneity of patient preferences allowing market approval of effective devices for risk tolerant patients. CDRH is using the study tool to define minimum clinical effectiveness to evaluate new weight-loss devices. The methods presented can be applied to a wide variety of medical products. This study supports the ongoing development of a guidance document on incorporating patient preferences into medical-device premarket approval decisions.

Choosing Spouses and Houses: Impaired Congruence Between Preference and Choice Following Damage to the Ventromedial Prefrontal Cortex

PubMed Central

Bowren, Mark D.; Croft, Katie E.; Reber, Justin; Tranel, Daniel

2017-01-01

Objective A well-documented effect of focal ventromedial prefrontal cortex (vmPFC) damage is a deficit in real-world decision-making. An important aspect of this deficit may be a deficiency in “internal consistency” during social decision-making – that is, impaired congruence between expressed preferences versus actual behavioral choices. An example of low internal consistency would be if one expressed the desire to marry someone with impeccable moral character,” yet proceeded to marry someone convicted of multiple felonies. Here, we used a neuropsychological approach to investigate neural correlates of internal consistency in complex decision-making. Method Sixteen individuals with focal vmPFC lesions, 16 brain-damage comparison individuals, and 16 normal comparison individuals completed a three-option forced-choice preference task in which choices were made using attribute sets. Participants also completed visual-analogue preference ratings to indicate how much they liked each option, and rated the influence of each attribute on their decision-making. Options were either social (potential spouses) or non-social (potential houses). Internal consistency for a trial was defined as agreement between the choice and the most positively rated option. Results A mixed design ANOVA revealed that internal consistency between choices and preferences derived from summed attribute ratings was significantly lower for the vmPFC group relative to comparison participants, but only in the social condition (pη2 = .09), 95% CI [.002, .163]. Conclusions Internal consistency during social decisions may be deficient in patients with vmPFC damage, leading to a discrepancy between preferences and choices. The vmPFC may provide an important neural mechanism for aligning behavioral choices with expressed preferences. PMID:29620403

The Protected Areas Visitor Impact Management (PAVIM) framework: A simplified process for making management decisions

USGS Publications Warehouse

Farrell, T.A.; Marion, J.L.

2002-01-01

Ecotourism and protected area visitation in Central and South America have resulted in ecological impacts, which some protected areas managers have addressed by employing visitor impact management frameworks. In this paper, we propose the Protected Area Visitor Impact Management (PAVIM) framework as an alternative to carrying capacity and other frameworks such as Limits of Acceptable Change. We use a set of evaluation criteria to compare the relative positive and negative attributes of carrying capacity, other decision-making frameworks and the new framework, within the context of their actual and potential use in Central and South America. Positive attributes of PAVIM include simplicity, flexibility, cost effectiveness, timeliness, and incorporating input from stakeholders and local residents. Negative attributes include diminished objectivity and cultural sensitivity issues. Further research and application of PAVIM are recommended.

Promoting Shared Decision Making in Disorders of Sex Development (DSD): Decision Aids and Support Tools.

PubMed

Siminoff, L A; Sandberg, D E

2015-05-01

Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach. © Georg Thieme Verlag KG Stuttgart · New York.

What counts as a decision? Predictors of perceived decision making.

PubMed

Chapman, G B; Niedermayer, L Y

2001-09-01

We examined lay perceptions of what counts as a decision. Eighty-six subjects read 10 scenarios that described clear decisions (e.g., choosing a graduate school), clear "nondecisions" (e.g., an accidental wrong turn), or ambiguous actions (e.g., eating a donut when on a diet or allowing someone else to make the decision). The subjects rated each scenario as to whether the actor had made a decision and also rated six other attributes. The scenarios were rated as clearly illustrating a decision if the actor engaged in a lot of thought and did not act reflexively. Consideration of consequences and having alternatives were moderately related to decision ratings, whereas having self-control problems and the influence of physiological drives showed little relationship with decision ratings. Thus, lay concepts of decision making differ from decision theory in that thoughtful, intentional behavior is more important in defining a decision than are decision theoretic components, such as alternatives and consequences.

Values in Health Policy – A Concept Analysis

PubMed Central

Shams, Lida; Akbari Sari, Ali; Yazdani, Shahram

2016-01-01

Background: Despite the significant role "values" play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of "values" and other concepts such as principles, criteria, attitudes, and beliefs. Methods: An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant’s method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of "value in health policy-making" were extracted. We also identified similarities and differences that exist between and within them. Results: We identified eight major attributes of "value in health policy-making": ideological origin, affect one’s choices, more resistant to change over time, source of motivation, ability to sacrifice one’s interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Conclusion: Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra theoretical support to decision-makers in their policy-making process, to help avoid poor policy formulation and wastage of limited resources. PMID:27801357

Diffusion theory of decision making in continuous report.

PubMed

Smith, Philip L

2016-07-01

I present a diffusion model for decision making in continuous report tasks, in which a continuous, circularly distributed, stimulus attribute in working memory is matched to a representation of the attribute in the stimulus display. Memory retrieval is modeled as a 2-dimensional diffusion process with vector-valued drift on a disk, whose bounding circle represents the decision criterion. The direction and magnitude of the drift vector describe the identity of the stimulus and the quality of its representation in memory, respectively. The point at which the diffusion exits the disk determines the reported value of the attribute and the time to exit the disk determines the decision time. Expressions for the joint distribution of decision times and report outcomes are obtained by means of the Girsanov change-of-measure theorem, which allows the properties of the nonzero-drift diffusion process to be characterized as a function of a Euclidian-distance Bessel process. Predicted report precision is equal to the product of the decision criterion and the drift magnitude and follows a von Mises distribution, in agreement with the treatment of precision in the working memory literature. Trial-to-trial variability in criterion and drift rate leads, respectively, to direct and inverse relationships between report accuracy and decision times, in agreement with, and generalizing, the standard diffusion model of 2-choice decisions. The 2-dimensional model provides a process account of working memory precision and its relationship with the diffusion model, and a new way to investigate the properties of working memory, via the distributions of decision times. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Cool Decision-Making in Adolescents with Behavior Disorder and/or Mild-to-Borderline Intellectual Disability.

PubMed

Bexkens, Anika; Jansen, Brenda R J; Van der Molen, Maurits W; Huizenga, Hilde M

2016-02-01

Adolescents with Behavior Disorders (BD), Mild-to-Borderline Intellectual Disability (MBID), and with both BD and MBID (BD + MBID) are known to take more risks than normal controls. To examine the processes underlying this increased risk-taking, the present study investigated cool decision-making strategies in 479 adolescents (12-18 years, 55.9 % male) from these four groups. Cool decision-making was assessed with the paper-and-pencil Gambling Machine Task. This task, in combination with advanced latent group analysis, allows for an assessment of decision strategies. Results indicated that adolescents with BD and controls were almost equivalent in their decision-making strategies, whereas adolescents with MBID and adolescents with BD + MBID were characterized by suboptimal decision-making strategies, with only minor differences between these two clinical groups. These findings may have important clinical implications, as they suggest that risk taking in adolescents with MBID and in adolescents with BD + MBID can be (partly) attributed to the strategies that these adolescents use to make their decisions. Interventions may therefore focus on an improvement of these strategies.

Three Human Attributes

ERIC Educational Resources Information Center

Eaves, Ronald C.; Williams, Thomas O., Jr.

2004-01-01

This study represents a beginning step in research that may ultimately show that the multitudes of human behavior that educators currently encounter may be reduced to three broad human attributes: arousal, affect, and cognition. The resulting simplicity should lead to improved understanding and better decision making by practitioners. Four…

Team Attributes, Processes, and Values: A Pedagogical Framework

ERIC Educational Resources Information Center

Keyton, Joann; Beck, Stephenson J.

2008-01-01

This article proposes a pedagogical framework to help students analyze their group and team interactions. Intersecting five fundamental group attributes (group size, group goal, group member interdependence, group structure, and group identity) with three overarching group processes (leadership, decision making, and conflict management) creates an…

A consensus reaching model for 2-tuple linguistic multiple attribute group decision making with incomplete weight information

NASA Astrophysics Data System (ADS)

Zhang, Wancheng; Xu, Yejun; Wang, Huimin

2016-01-01

The aim of this paper is to put forward a consensus reaching method for multi-attribute group decision-making (MAGDM) problems with linguistic information, in which the weight information of experts and attributes is unknown. First, some basic concepts and operational laws of 2-tuple linguistic label are introduced. Then, a grey relational analysis method and a maximising deviation method are proposed to calculate the incomplete weight information of experts and attributes respectively. To eliminate the conflict in the group, a weight-updating model is employed to derive the weights of experts based on their contribution to the consensus reaching process. After conflict elimination, the final group preference can be obtained which will give the ranking of the alternatives. The model can effectively avoid information distortion which is occurred regularly in the linguistic information processing. Finally, an illustrative example is given to illustrate the application of the proposed method and comparative analysis with the existing methods are offered to show the advantages of the proposed method.

Technology to control variation in meat quality

USDA-ARS?s Scientific Manuscript database

Consumers have certain expectations regarding the quality of the meat they purchase. Lean color is the primary quality attribute used by consumers to make purchase decisions. Similarly, repeat purchase decisions are generally a result of eating satisfaction, which is determined by the perceived va...

Patient‐focussed decision‐making in early‐stage prostate cancer: insights from a cognitively based decision aid

PubMed Central

Feldman‐Stewart, Deb; Brundage, Michael D; Manen, Lori Van; Svenson, Ola

2004-01-01

Abstract Purpose  To study the cognitive processes of early‐stage prostate cancer patients as they determined which treatment they preferred, using our cognitively based decision aid. Method  The aid was a one‐to‐one interview that included the structured presentation of information, listing exercises in which the patient identified attributes important to his decision, and trade‐off exercises to help him weigh and integrate those attributes together. At various points of the interview, patients identified the attributes they felt were important to their decision, rated their treatment options and completed standardized assessments relating to their decision. In addition, patients participated in a follow‐up interview at the time they made their actual treatment decision and again 3 months later. Results  Sixty of 70 (86%) of the invited patients participated in the study. Participating patients identified a median of four important attributes (range 1–10); 36 different attributes were identified at some point in the interview by the group. During the interview, 78% of patients changed which attributes they considered important, and 72% changed their treatment ratings. Stability of treatment choice after the interview and lack of regret after the decision were each positively associated with increasing differentiation between treatment options over time. Conclusions  The decision process appears to be dynamic for the patients with great variability across patients in what is important to the decision. Increasing stability of choice and lack of regret appear to be related positively to increasing difference over time in how attractive the preferred option is over its closest competitor, rather than to the size of the difference at any one point in time. PMID:15117387

Good-parent beliefs of parents of seriously ill children.

PubMed

Feudtner, Chris; Walter, Jennifer K; Faerber, Jennifer A; Hill, Douglas L; Carroll, Karen W; Mollen, Cynthia J; Miller, Victoria A; Morrison, Wynne E; Munson, David; Kang, Tammy I; Hinds, Pamela S

2015-01-01

Parents' beliefs about what they need to do to be a good parent when their children are seriously ill influence their medical decisions, and better understanding of these beliefs may improve decision support. To assess parents' perceptions regarding the relative importance of 12 good-parent attributes. A cross-sectional, discrete-choice experiment was conducted at a children's hospital. Participants included 200 parents of children with serious illness. Ratings of 12 good-parent attributes, with subsequent use of latent class analysis to identify groups of parents with similar ratings of attributes, and ascertainment of whether membership in a particular group was associated with demographic or clinical characteristics. The highest-ranked good-parent attribute was making sure that my child feels loved, followed by focusing on my child's health, making informed medical care decisions, and advocating for my child with medical staff. We identified 4 groups of parents with similar patterns of good-parent-attribute ratings, which we labeled as: child feels loved (n=68), child's health (n=56), advocacy and informed (n=55), and spiritual well-being (n=21). Compared with the other groups, the child's health group reported more financial difficulties, was less educated, and had a higher proportion of children with new complex, chronic conditions. Parents endorse a broad range of beliefs that represent what they perceive they should do to be a good parent for their seriously ill child. Common patterns of how parents prioritize these attributes exist, suggesting future research to better understand the origins and development of good-parent beliefs among these parents. More important, engaging parents individually regarding what they perceive to be the core duties they must fulfill to be a good parent may enable more customized and effective decision support.

Decision-making competence in younger and older adults: which cognitive abilities contribute to the application of decision rules?

PubMed

Rosi, Alessia; Bruine de Bruin, Wändi; Del Missier, Fabio; Cavallini, Elena; Russo, Riccardo

2017-12-28

Older adults perform worse than younger adults when applying decision rules to choose between options that vary along multiple attributes. Although previous studies have shown that general fluid cognitive abilities contribute to the accurate application of decision rules, relatively little is known about which specific cognitive abilities play the most important role. We examined the independent roles of working memory, verbal fluency, semantic knowledge, and components of executive functioning. We found that age-related decline in applying decision rules was statistically mediated by age-related decline in working memory and verbal fluency. Our results have implications for theories of aging and decision-making.

ANFIS multi criteria decision making for overseas construction projects: a methodology

NASA Astrophysics Data System (ADS)

Utama, W. P.; Chan, A. P. C.; Zulherman; Zahoor, H.; Gao, R.; Jumas, D. Y.

2018-02-01

A critical part when a company targeting a foreign market is how to make a better decision in connection with potential project selection. Since different attributes of information are often incomplete, imprecise and ill-defined in overseas projects selection, the process of decision making by relying on the experiences and intuition is a risky attitude. This paper aims to demonstrate a decision support method in deciding overseas construction projects (OCPs). An Adaptive Neuro-Fuzzy Inference System (ANFIS), the amalgamation of Neural Network and Fuzzy Theory, was used as decision support tool to decide to go or not go on OCPs. Root mean square error (RMSE) and coefficient of correlation (R) were employed to identify the ANFIS system indicating an optimum and efficient result. The optimum result was obtained from ANFIS network with two input membership functions, Gaussian membership function (gaussmf) and hybrid optimization method. The result shows that ANFIS may help the decision-making process for go/not go decision in OCPs.

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

PubMed

Carpenter, Stephanie M; Yates, J Frank; Preston, Stephanie D; Chen, Lydia

2016-01-01

Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional "coherence shifting," the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed.

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting

PubMed Central

Carpenter, Stephanie M.; Yates, J. Frank; Preston, Stephanie D.; Chen, Lydia

2016-01-01

Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional “coherence shifting,” the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed. PMID:26986752

Values in Health Policy - A Concept Analysis.

PubMed

Shams, Lida; Akbari Sari, Ali; Yazdani, Shahram

2016-08-17

Despite the significant role "values" play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of "values" and other concepts such as principles, criteria, attitudes, and beliefs. An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant's method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of "value in health policy-making" were extracted. We also identified similarities and differences that exist between and within them. We identified eight major attributes of "value in health policy-making": ideological origin, affect one's choices, more resistant to change over time, source of motivation, ability to sacrifice one's interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra theoretical support to decision-makers in their policy-making process, to help avoid poor policy formulation and wastage of limited resources. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Chronic work stress and decreased vagal tone impairs decision making and reaction time in jockeys.

PubMed

Landolt, Kathleen; Maruff, Paul; Horan, Ben; Kingsley, Michael; Kinsella, Glynda; O'Halloran, Paul D; Hale, Matthew W; Wright, Bradley J

2017-10-01

The inverse relationship between acute stress and decision-making is well documented, but few studies have investigated the impact of chronic stress. Jockeys work exhaustive schedules and have extremely dangerous occupations, with safe performance requiring quick reaction time and accurate decision-making. We used the effort reward imbalance (ERI) occupational stress model to assess the relationship of work stress with indices of stress physiology and decision-making and reaction time. Jockeys (N=32) completed computerised cognitive tasks (Cogstate) on two occasions; September and November (naturally occurring lower and higher stress periods), either side of an acute stress test. Higher ERI was correlated with the cortisol awakening responses (high stress r=-0.37; low stress r=0.36), and with decrements in decision-making comparable to having a blood alcohol concentration of 0.08 in the high stress period (p<0.001) The LF/HF ratio of heart rate variability impacted the association of ERI with decision-making. Potentially, this may be attributed to a 'tipping point' whereby the higher ERI reported by jockeys in the high stress period decreases vagal tone, which may contribute to reduced decision-making abilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

Identifying attributes of food literacy: a scoping review.

PubMed

Azevedo Perry, Elsie; Thomas, Heather; Samra, H Ruby; Edmonstone, Shannon; Davidson, Lyndsay; Faulkner, Amy; Petermann, Lisa; Manafò, Elizabeth; Kirkpatrick, Sharon I

2017-09-01

An absence of food literacy measurement tools makes it challenging for nutrition practitioners to assess the impact of food literacy on healthy diets and to evaluate the outcomes of food literacy interventions. The objective of the present scoping review was to identify the attributes of food literacy. A scoping review of peer-reviewed and grey literature was conducted and attributes of food literacy identified. Subjects included in the search were high-risk groups. Eligible articles were limited to research from Canada, USA, the UK, Australia and New Zealand. The search identified nineteen peer-reviewed and thirty grey literature sources. Fifteen identified food literacy attributes were organized into five categories. Food and Nutrition Knowledge informs decisions about intake and distinguishing between 'healthy' and 'unhealthy' foods. Food Skills focuses on techniques of food purchasing, preparation, handling and storage. Self-Efficacy and Confidence represent one's capacity to perform successfully in specific situations. Ecologic refers to beyond self and the interaction of macro- and microsystems with food decisions and behaviours. Food Decisions reflects the application of knowledge, information and skills to make food choices. These interdependent attributes are depicted in a proposed conceptual model. The lack of evaluated tools inhibits the ability to assess and monitor food literacy; tailor, target and evaluate programmes; identify gaps in programming; engage in advocacy; and allocate resources. The present scoping review provides the foundation for the development of a food literacy measurement tool to address these gaps.

Applicant Appearance and Selection Decision Making: Revitalizing Employment Interview Education.

ERIC Educational Resources Information Center

Ilkka, Richard J.

1995-01-01

Presents five instructional propositions based on employment interview research on the relationship between applicant appearance and interviewer selection decisions. Argues that educators should examine the process of appearance attribution, explore appearance and position expectations, invite dialog of alleged effects, and assess related…

Temporary site selection and decision-making methods: a case study of Tehran, Iran.

PubMed

Omidvar, Babak; Baradaran-Shoraka, Mohammad; Nojavan, Mehdi

2013-07-01

Decisions on selecting an appropriate site for temporary shelter used to be taken in a limited amount of time after a disaster. The need for a systematic method in this area inspired the MADM (multi-attribute decision making) for complex disaster management decisions. This research proposes a model for appropriate and systematic site selection for temporary shelters, before an earthquake, using a geographical information system and MADM based on an earthquake damage assessment. After the effective criteria for site selection of temporary shelters are determined, the geographical layers of these criteria are prepared for Municipal District No.1 of Greater Tehran, the capital of Iran. Given these attributes and the required shelter area (415-610 hectares), 14 zones are proposed initially. Various MADM methods are used for the final selection. The mean of the aggregated ranking results are determined, and 10 of the 14 initial zones are ranked. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

Mapping clinical outcomes expectations to treatment decisions: an application to vestibular schwannoma management.

PubMed

Cheung, Steven W; Aranda, Derick; Driscoll, Colin L W; Parsa, Andrew T

2010-02-01

Complex medical decision making obligates tradeoff assessments among treatment outcomes expectations, but an accessible tool to perform the necessary analysis is conspicuously absent. We aimed to demonstrate methodology and feasibility of adapting conjoint analysis for mapping clinical outcomes expectations to treatment decisions in vestibular schwannoma (VS) management. Prospective. Tertiary medical center and US-based otologists/neurotologists. Treatment preference profiles among VS stakeholders-61 younger and 74 older prospective patients, 61 observation patients, and 60 surgeons-were assessed for the synthetic VS case scenario of a 10-mm tumor in association with useful hearing and normal facial function. Treatment attribute utility. Conjoint analysis attribute levels were set in accordance to the results of a meta-analysis. Forty-five case series were disaggregated to formulate microsurgery facial nerve and hearing preservation outcomes expectations models. Attribute utilities were computed and mapped to the realistic treatment choices of translabyrinthine craniotomy, middle fossa craniotomy, and gamma knife radiosurgery. Among the treatment attributes of likelihoods of causing deafness, temporary facial weakness for 2 months, and incurable cancer within 20 years, and recovery time, permanent deafness was less important to tumor surgeons, and temporary facial weakness was more important to tumor surgeons and observation patients (Wilcoxon rank-sum, p < 0.001). Inverse mapping of preference profiles to realistic treatment choices showed all study cohorts were inclined to choose gamma knife radiosurgery. Mapping clinical outcomes expectations to treatment decisions for a synthetic clinical scenario revealed inhomogeneous drivers of choice selection among study cohorts. Medical decision engines that analyze personal preferences of outcomes expectations for VS and many other diseases may be developed to promote shared decision making among health care stakeholders and transparency in the informed consent process.

Stereotype threat affects financial decision making.

PubMed

Carr, Priyanka B; Steele, Claude M

2010-10-01

The research presented in this article provides the first evidence that one's decision making can be influenced by concerns about stereotypes and the devaluation of one's identity. Many studies document gender differences in decision making, and often attribute these differences to innate and stable factors, such as biological and hormonal differences. In three studies, we found that stereotype threat affected decision making and led to gender differences in loss-aversion and risk-aversion behaviors. In Study 1, women subjected to stereotype threat in academic and business settings were more loss averse than both men and women who were not facing the threat of being viewed in light of negative stereotypes. We found no gender differences in loss-aversion behavior in the absence of stereotype threat. In Studies 2a and 2b, we found the same pattern of effects for risk-aversion behavior that we had observed for loss-aversion behavior. In addition, in Study 2b, ego depletion mediated the effects of stereotype threat on women's decision making. These results suggest that individuals' decision making can be influenced by stereotype concerns.

An optimal brain can be composed of conflicting agents

PubMed Central

Livnat, Adi; Pippenger, Nicholas

2006-01-01

Many behaviors have been attributed to internal conflict within the animal and human mind. However, internal conflict has not been reconciled with evolutionary principles, in that it appears maladaptive relative to a seamless decision-making process. We study this problem through a mathematical analysis of decision-making structures. We find that, under natural physiological limitations, an optimal decision-making system can involve “selfish” agents that are in conflict with one another, even though the system is designed for a single purpose. It follows that conflict can emerge within a collective even when natural selection acts on the level of the collective only. PMID:16492775

Preferences for Training Options: A Conjoint Analysis

ERIC Educational Resources Information Center

Gan, Chui Goh; Lee, Julie Anne; Soutar, Geoffrey N.

2009-01-01

Singapore is a growing educational hub for the Asia Pacific region. However, no prior research has examined how Singaporean managers trade off attributes of training programs when making executive training decisions. The current study used conjoint analysis to identify the most important attributes of training programs as word of mouth, trainers'…

Misremembrance of options past: source monitoring and choice.

PubMed

Mather, M; Shafir, E; Johnson, M K

2000-03-01

This study reveals that when remembering past decisions, people engage in choice-supportive memory distortion. When asked to make memory attributions of options' features, participants made source-monitoring errors that supported their decisions. They tended to attribute, both correctly and incorrectly, more positive features to the option they had selected than to its competitor. In addition, they sometimes attributed, both correctly and incorrectly, more negative features to the nonselected option. This pattern of distortion may be beneficial to people's general well-being, reducing regret for options not taken. At the same time, it is problematic for memory accuracy, for accountability, and for learning from past experience.

Application of the fuzzy topsis multi-attribute decision making method to determine scholarship recipients

NASA Astrophysics Data System (ADS)

Irvanizam, I.

2018-03-01

Some scholarships have been routinely offered by Ministry of Research, Technology and Higher Education of the Republic of Indonesia for students at Syiah Kuala University. In reality, the scholarship selection process is becoming subjective and highly complex problem. Multi-Attribute Decision Making (MADM) techniques can be a solution in order to solve scholarship selection problem. In this study, we demonstrated the application of a fuzzy TOPSIS as an MADM technique by using a numerical example in order to calculate a triangular fuzzy number for the fuzzy data onto a normalized weight. We then use this normalized value to construct the normalized fuzzy decision matrix. We finally use the fuzzy TOPSIS to rank alternatives in descending order based on the relative closeness to the ideal solution. The result in terms of final ranking shows slightly different from the previous work.

What They Think: Attributions Made by Youth Workers about Youth Circumstances and the Implications for Service-Delivery in Out-of-School Time Programs

ERIC Educational Resources Information Center

Travis, Raphael

2010-01-01

The current study explored attributions made by youth work professionals ("workers") in out-of-school time (OST) programs about the social circumstances of and perceived need of program youth. It followed prior research examining impacts of worker-level attributions on decision-making in service delivery. Two types of OST programs were…

Impact of Decision Criteria on Federal Aviation Administration Certification of Military Commercial Derivative Aircraft

DTIC Science & Technology

2012-03-01

Capt Low was a member of the Sigma Iota Epsilon professional management fraternity. He has performed as an on-equipment and off-equipment...FAA Certification, Military Commercial Derivative Aircraft, Multi-Attribute Decision Making 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF

Agency Modulates the Lateral and Medial Prefrontal Cortex Responses in Belief-Based Decision Making

PubMed Central

Xue, Gui; He, Qinghua; Lu, Zhong-Lin; Levin, Irwin P.; Dong, Qi; Bechara, Antoine

2013-01-01

Many real-life decisions in complex and changing environments are guided by the decision maker’s beliefs, such as her perceived control over decision outcomes (i.e., agency), leading to phenomena like the “illusion of control”. However, the neural mechanisms underlying the “agency” effect on belief-based decisions are not well understood. Using functional imaging and a card guessing game, we revealed that the agency manipulation (i.e., either asking the subjects (SG) or the computer (CG) to guess the location of the winning card) not only affected the size of subjects’ bets, but also their “world model” regarding the outcome dependency. Functional imaging results revealed that the decision-related activation in the lateral and medial prefrontal cortex (PFC) was significantly modulated by agency and previous outcome. Specifically, these PFC regions showed stronger activation when subjects made decisions after losses than after wins under the CG condition, but the pattern was reversed under the SG condition. Furthermore, subjects with high external attribution of negative events were more affected by agency at the behavioral and neural levels. These results suggest that the prefrontal decision-making system can be modulated by abstract beliefs, and are thus vulnerable to factors such as false agency and attribution. PMID:23762332

Attribute Development Using Continuous Stakeholder Engagement to Prioritize Treatment Decisions: A Framework for Patient-Centered Research.

PubMed

dosReis, Susan; Castillo, Wendy Camelo; Ross, Melissa; Fitz-Randolph, Marcy; Vaughn-Lee, Angela; Butler, Beverly

To develop a methodological approach for selecting, validating, and prioritizing attributes for health care decision making. Participants (n = 48) were recruited from community support groups if they had a child aged 26 years or younger diagnosed with a coexisting mental health condition and cognitive impairment. Six in-depth interviews eliciting care management experiences were transcribed and coded into themes following the principles of grounded theory and the constant comparative method. Six focus groups involving 42 participants assessed the relevance, priority, and meaning and inter-relationship among the themes. The positive predictive value and sensitivity assessed agreement on thematic meaning. A final list was selected from the top priorities with good agreement as candidate attributes. Attribute levels reflecting the range of experiences in care management decisions emerged from the verbatim passages within each coded theme. Participants were the child's mother (73%), white (77%), married (69%), and on average 48 years old. The children were on average 14 years old; 44% had an intellectual disability, 25% had autism, and more than half had anxiety or attention-deficit/hyperactivity disorder. All 14 attributes identified from the in-depth interviews were deemed relevant. The positive predictive value exceeded 90%, and the sensitivity ranged from 64% to 89%. The final set of attributes formed the framework for care management decisions consisting of six attributes (medication, behavior, services, social, treatment effects, and school) each with three levels. A systematic approach grounded in qualitative methods produced a framework of relevant, important, and actionable attributes representing competing alternatives in clinical decisions. Copyright © 2016. Published by Elsevier Inc.

Knowledge Style Profiling: An Exploration of Cognitive, Temperament, Demographic and Organizational Characteristics among Decision Makers Using Advanced Analytical Technologies

ERIC Educational Resources Information Center

Polito, Vincent A., Jr.

2010-01-01

The objective of this research was to explore the possibilities of identifying knowledge style factors that could be used as central elements of a professional business analyst's (PBA) performance attributes at work for those decision makers that use advanced analytical technologies on decision making tasks. Indicators of knowledge style were…

Assessing the Effects of Financial Literacy on Patient Engagement.

PubMed

Meyer, Melanie A; Hudak, Ronald P

2016-07-01

We investigated the relationship between financial literacy and patient engagement while considering the possible interaction effects due to patient financial responsibility and patient-physician shared decision making, and the impact of personal attributes. Participants consisted of an Internet-based sample of American adults (N = 160). Hierarchical multiple linear regression analysis was conducted to examine the relationship of the study variables on patient engagement. We found that patient financial responsibility (β = -.19, p < .05) and patient-physician shared decision-making (β = .17, p < .05) predicted patient engagement. However, there was no statistically significant relationship between patient financial literacy and patient engagement; moreover, the moderation effects of patient financial responsibility and shared decision making with financial literacy also were not statistically significant. Increasing patient financial responsibility and patient-physician shared decision making can impact patient engagement. Understanding the predictors of patient engagement and the factors that influence financial behaviors may allow for the development of interventions to enable patients to make better healthcare decisions, and ultimately, improve health outcomes.

Policy impacts of ecosystem services knowledge

PubMed Central

Posner, Stephen M.; McKenzie, Emily; Ricketts, Taylor H.

2016-01-01

Research about ecosystem services (ES) often aims to generate knowledge that influences policies and institutions for conservation and human development. However, we have limited understanding of how decision-makers use ES knowledge or what factors facilitate use. Here we address this gap and report on, to our knowledge, the first quantitative analysis of the factors and conditions that explain the policy impact of ES knowledge. We analyze a global sample of cases where similar ES knowledge was generated and applied to decision-making. We first test whether attributes of ES knowledge themselves predict different measures of impact on decisions. We find that legitimacy of knowledge is more often associated with impact than either the credibility or salience of the knowledge. We also examine whether predictor variables related to the science-to-policy process and the contextual conditions of a case are significant in predicting impact. Our findings indicate that, although many factors are important, attributes of the knowledge and aspects of the science-to-policy process that enhance legitimacy best explain the impact of ES science on decision-making. Our results are consistent with both theory and previous qualitative assessments in suggesting that the attributes and perceptions of scientific knowledge and process within which knowledge is coproduced are important determinants of whether that knowledge leads to action. PMID:26831101

The antecedents and consequences of a beyond-choice view of decision situations: A construal level theory perspective.

PubMed

Halamish, Vered; Borovoi, Leah; Liberman, Nira

2017-02-01

Evaluating alternatives and comparing them to each other are integral to decision-making. In addition, however, decision makers may adopt a view that goes beyond choice and make inferences about the entire set of alternatives, about the dimensions that are relevant in similar decisions, and about the range of values on a specific dimension. We examined some antecedents and consequences of adopting a beyond-choice view of decision situations. Based on Construal Level Theory we suggest that a beyond-choice view entails high (vs. low) level of construal of the decision situation and hence is more likely to occur for decisions that are more psychologically distant. We further suggest that a consequence of a beyond-choice view might be a later difficulty to remember which attribute belongs to which alternative. To examine these predictions we conducted an experiment in which participants evaluated decision scenarios that were described as being relevant for the distant (vs. the near) future. One day later they answered a decision-related source recognition test in which they were asked to remember which attribute belongs to which alternative. As predicted, people had more source-memory errors in the distant than in the near future condition. These results suggest that a beyond-choice view of decision situations is an important consequence of psychological distance (vs. proximity). Copyright © 2016 Elsevier B.V. All rights reserved.

Potential mechanisms contributing to decision-making difficulties in late adulthood.

PubMed

McCarrey, Anna C; Henry, Julie D; Luszcz, Mary

2010-01-01

This paper critiques Brand and Markowitsch's viewpoint that the decision-making difficulties experienced by older adults during laboratory-based gambling tasks can be attributed to deficits in executive control and feedback operations. While Brand and Markowitsch provide an important platform with which to understand the role of these specific component processes, there are other additional mechanisms that also seem likely to be important when understanding gambling decisions in late adulthood. We focus on several of these mechanisms, and in particular, the manner in which decision-relevant information is received, the role of changes in emotion and motivation (with particular reference to Socioemotional Selectivity Theory), and changes in autobiographical memory that may affect understanding how decision-making during gambling occurs in late adulthood. By building on the cognitive-based and emotion-based processes that Brand and Markowitsch mention as important in decision-making by the aged, our critique highlights avenues for future research in this important area. Copyright 2010 S. Karger AG, Basel.

Shared decision making in chronic care in the context of evidence based practice in nursing.

PubMed

Friesen-Storms, Jolanda H H M; Bours, Gerrie J J W; van der Weijden, Trudy; Beurskens, Anna J H M

2015-01-01

In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient's values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient's values. The shared decision-making model seems to be helpful in the integration of the individual patient's values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient's willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making—integrated with evidence-based practice—can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence-based practice to deliver patient-centred care. Copyright © 2014 Elsevier Ltd. All rights reserved.

Informing vaccine decision-making: A strategic multi-attribute ranking tool for vaccines-SMART Vaccines 2.0.

PubMed

Knobler, Stacey; Bok, Karin; Gellin, Bruce

2017-01-20

SMART Vaccines 2.0 software is being developed to support decision-making among multiple stakeholders in the process of prioritizing investments to optimize the outcomes of vaccine development and deployment. Vaccines and associated vaccination programs are one of the most successful and effective public health interventions to prevent communicable diseases and vaccine researchers are continually working towards expanding targets for communicable and non-communicable diseases through preventive and therapeutic modes. A growing body of evidence on emerging vaccine technologies, trends in disease burden, costs associated with vaccine development and deployment, and benefits derived from disease prevention through vaccination and a range of other factors can inform decision-making and investment in new and improved vaccines and targeted utilization of already existing vaccines. Recognizing that an array of inputs influences these decisions, the strategic multi-attribute ranking method for vaccines (SMART Vaccines 2.0) is in development as a web-based tool-modified from a U.S. Institute of Medicine Committee effort (IOM, 2015)-to highlight data needs and create transparency to facilitate dialogue and information-sharing among decision-makers and to optimize the investment of resources leading to improved health outcomes. Current development efforts of the SMART Vaccines 2.0 framework seek to generate a weighted recommendation on vaccine development or vaccination priorities based on population, disease, economic, and vaccine-specific data in combination with individual preference and weights of user-selected attributes incorporating valuations of health, economics, demographics, public concern, scientific and business, programmatic, and political considerations. Further development of the design and utility of the tool is being carried out by the National Vaccine Program Office of the Department of Health and Human Services and the Fogarty International Center of the National Institutes of Health. We aim to demonstrate the utility of SMART Vaccines 2.0 through the engagement of a community of relevant stakeholders and to identify a limited number of pilot projects to determine explicitly defined attribute preferences and the related data and model requirements that are responsive to user needs and able to improve the use of evidence for vaccine-related decision-making and consequential priorities of vaccination options. Copyright © 2016 Elsevier Ltd. All rights reserved.

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

PubMed

Dolan, James G

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare

PubMed Central

Dolan, James G.

2010-01-01

Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers. Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine “hard data” with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings. The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP) PMID:21394218

The Role of Epistemic Motivation in Individuals' Response to Decision Complexity

ERIC Educational Resources Information Center

Amit, Adi; Sagiv, Lilach

2013-01-01

Integrating findings on the effects of more alternatives with findings on the effects of more attributes, we offer a motivational decision-making model, suggesting that epistemic motivation moderates individuals' responses to complex information. Study 1 empirically investigated the shared essence of four conceptualizations of epistemic…

Family involvement in medical decision-making: Perceptions of nursing and psychology students.

PubMed

Itzhaki, Michal; Hildesheimer, Galya; Barnoy, Sivia; Katz, Michael

2016-05-01

Family members often rely on health care professionals to guide and support them through the decision-making process. Although family involvement in medical decisions should be included in the preservice curriculum for the health care professions, perceptions of students in caring professions on family involvement in medical decision-making have not yet been examined. To examine the perceptions of nursing and psychology students on family involvement in medical decision-making for seriously ill patients. A descriptive cross-sectional design was used. First year undergraduate nursing and psychology students studying for their Bachelor of Arts degree were recruited. Perceptions were assessed with a questionnaire constructed based on the Multi-Attribute Utility Theory (MAUT), which examines decision-maker preferences. The questionnaire consisted of two parts referring to the respondent once as the patient and then as the family caregiver. Questionnaires were completed by 116 nursing students and 156 psychology students. Most were of the opinion that family involvement in decision-making is appropriate, especially when the patient is incapable of making decisions. Nursing students were more inclined than psychology students to think that financial, emotional, and value-based considerations should be part of the family's involvement in decision-making. Both groups of students perceived the emotional consideration as most acceptable, whereas the financial consideration was considered the least acceptable. Nursing and psychology students perceive family involvement in medical decision-making as appropriate. In order to train students to support families in the process of decision-making, further research should examine Shared Decision-Making (SDM) programs, which involve patient and clinician collaboration in health care decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Decision technology.

PubMed

Edwards, W; Fasolo, B

2001-01-01

This review is about decision technology-the rules and tools that help us make wiser decisions. First, we review the three rules that are at the heart of most traditional decision technology-multi-attribute utility, Bayes' theorem, and subjective expected utility maximization. Since the inception of decision research, these rules have prescribed how we should infer values and probabilities and how we should combine them to make better decisions. We suggest how to make best use of all three rules in a comprehensive 19-step model. The remainder of the review explores recently developed tools of decision technology. It examines the characteristics and problems of decision-facilitating sites on the World Wide Web. Such sites now provide anyone who can use a personal computer with access to very sophisticated decision-aiding tools structured mainly to facilitate consumer decision making. It seems likely that the Web will be the mode by means of which decision tools will be distributed to lay users. But methods for doing such apparently simple things as winnowing 3000 options down to a more reasonable number, like 10, contain traps for unwary decision technologists. The review briefly examines Bayes nets and influence diagrams-judgment and decision-making tools that are available as computer programs. It very briefly summarizes the state of the art of eliciting probabilities from experts. It concludes that decision tools will be as important in the 21st century as spreadsheets were in the 20th.

Shared decision-making in the paediatric field: a literature review and concept analysis.

PubMed

Park, Eun Sook; Cho, In Young

2017-09-13

The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field. © 2017 Nordic College of Caring Science.

Using multicriteria decision analysis during drug development to predict reimbursement decisions.

PubMed

Williams, Paul; Mauskopf, Josephine; Lebiecki, Jake; Kilburg, Anne

2014-01-01

Pharmaceutical companies design clinical development programs to generate the data that they believe will support reimbursement for the experimental compound. The objective of the study was to present a process for using multicriteria decision analysis (MCDA) by a pharmaceutical company to estimate the probability of a positive recommendation for reimbursement for a new drug given drug and environmental attributes. The MCDA process included 1) selection of decisions makers who were representative of those making reimbursement decisions in a specific country; 2) two pre-workshop questionnaires to identify the most important attributes and their relative importance for a positive recommendation for a new drug; 3) a 1-day workshop during which participants undertook three tasks: i) they agreed on a final list of decision attributes and their importance weights, ii) they developed level descriptions for these attributes and mapped each attribute level to a value function, and iii) they developed profiles for hypothetical products 'just likely to be reimbursed'; and 4) use of the data from the workshop to develop a prediction algorithm based on a logistic regression analysis. The MCDA process is illustrated using case studies for three countries, the United Kingdom, Germany, and Spain. The extent to which the prediction algorithms for each country captured the decision processes for the workshop participants in our case studies was tested using a post-meeting questionnaire that asked the participants to make recommendations for a set of hypothetical products. The data collected in the case study workshops resulted in a prediction algorithm: 1) for the United Kingdom, the probability of a positive recommendation for different ranges of cost-effectiveness ratios; 2) for Spain, the probability of a positive recommendation at the national and regional levels; and 3) for Germany, the probability of a determination of clinical benefit. The results from the post-meeting questionnaire revealed a high predictive value for the algorithm developed using MCDA. Prediction algorithms developed using MCDA could be used by pharmaceutical companies when designing their clinical development programs to estimate the likelihood of a favourable reimbursement recommendation for different product profiles and for different positions in the treatment pathway.

Using multicriteria decision analysis during drug development to predict reimbursement decisions

PubMed Central

Williams, Paul; Mauskopf, Josephine; Lebiecki, Jake; Kilburg, Anne

2014-01-01

Background Pharmaceutical companies design clinical development programs to generate the data that they believe will support reimbursement for the experimental compound. Objective The objective of the study was to present a process for using multicriteria decision analysis (MCDA) by a pharmaceutical company to estimate the probability of a positive recommendation for reimbursement for a new drug given drug and environmental attributes. Methods The MCDA process included 1) selection of decisions makers who were representative of those making reimbursement decisions in a specific country; 2) two pre-workshop questionnaires to identify the most important attributes and their relative importance for a positive recommendation for a new drug; 3) a 1-day workshop during which participants undertook three tasks: i) they agreed on a final list of decision attributes and their importance weights, ii) they developed level descriptions for these attributes and mapped each attribute level to a value function, and iii) they developed profiles for hypothetical products ‘just likely to be reimbursed’; and 4) use of the data from the workshop to develop a prediction algorithm based on a logistic regression analysis. The MCDA process is illustrated using case studies for three countries, the United Kingdom, Germany, and Spain. The extent to which the prediction algorithms for each country captured the decision processes for the workshop participants in our case studies was tested using a post-meeting questionnaire that asked the participants to make recommendations for a set of hypothetical products. Results The data collected in the case study workshops resulted in a prediction algorithm: 1) for the United Kingdom, the probability of a positive recommendation for different ranges of cost-effectiveness ratios; 2) for Spain, the probability of a positive recommendation at the national and regional levels; and 3) for Germany, the probability of a determination of clinical benefit. The results from the post-meeting questionnaire revealed a high predictive value for the algorithm developed using MCDA. Conclusions Prediction algorithms developed using MCDA could be used by pharmaceutical companies when designing their clinical development programs to estimate the likelihood of a favourable reimbursement recommendation for different product profiles and for different positions in the treatment pathway.

Effect of Women's Decision-Making Autonomy on Infant's Birth Weight in Rural Bangladesh

PubMed Central

Sharma, Arpana

2013-01-01

Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14–45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting. PMID:24575305

Neural reactivation links unconscious thought to decision-making performance.

PubMed

Creswell, John David; Bursley, James K; Satpute, Ajay B

2013-12-01

Brief periods of unconscious thought (UT) have been shown to improve decision making compared with making an immediate decision (ID). We reveal a neural mechanism for UT in decision making using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. Participants (N = 33) encoded information on a set of consumer products (e.g. 48 attributes describing four different cars), and we manipulated whether participants (i) consciously thought about this information (conscious thought), (ii) completed a difficult 2-back working memory task (UT) or (iii) made an immediate decision about the consumer products (ID) in a within-subjects blocked design. To differentiate UT neural activity from 2-back working memory neural activity, participants completed an independent 2-back task and this neural activity was subtracted from neural activity occurring during the UT 2-back task. Consistent with a neural reactivation account, we found that the same regions activated during the encoding of complex decision information (right dorsolateral prefrontal cortex and left intermediate visual cortex) continued to be activated during a subsequent 2-min UT period. Moreover, neural reactivation in these regions was predictive of subsequent behavioral decision-making performance after the UT period. These results provide initial evidence for post-encoding unconscious neural reactivation in facilitating decision making.

Neural reactivation links unconscious thought to decision-making performance

PubMed Central

Bursley, James K.; Satpute, Ajay B.

2013-01-01

Brief periods of unconscious thought (UT) have been shown to improve decision making compared with making an immediate decision (ID). We reveal a neural mechanism for UT in decision making using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. Participants (N = 33) encoded information on a set of consumer products (e.g. 48 attributes describing four different cars), and we manipulated whether participants (i) consciously thought about this information (conscious thought), (ii) completed a difficult 2-back working memory task (UT) or (iii) made an immediate decision about the consumer products (ID) in a within-subjects blocked design. To differentiate UT neural activity from 2-back working memory neural activity, participants completed an independent 2-back task and this neural activity was subtracted from neural activity occurring during the UT 2-back task. Consistent with a neural reactivation account, we found that the same regions activated during the encoding of complex decision information (right dorsolateral prefrontal cortex and left intermediate visual cortex) continued to be activated during a subsequent 2-min UT period. Moreover, neural reactivation in these regions was predictive of subsequent behavioral decision-making performance after the UT period. These results provide initial evidence for post-encoding unconscious neural reactivation in facilitating decision making. PMID:23314012

Consumer health plan choice: current knowledge and future directions.

PubMed

Scanlon, D P; Chernew, M; Lave, J R

1997-01-01

A keystone of the competitive strategy in health insurance markets is the assumption that "consumers" can make informed choices based on the costs and quality of competing health plans, and that selection effects are not large. However, little is known about how individuals use information other than price in the decision making process. This review summarizes the state of knowledge about how individuals make choices among health plans and outlines an agenda for future research. We find that the existing literature on health plan choice is no longer sufficient given the widespread growth and acceptance of managed care, and the increased proportion of consumers' income now going toward the purchase of health plans. Instead, today's environment of health plan choice requires better understanding of how plan attributes other than price influence plan choice, how other variables such as health status interact with plan attributes in the decision making process, and how specific populations differ from one another in terms of the sensitivity of their health plan choices to these different types of variables.

Will Anything Useful Come Out of Virtual Reality? Examination of a Naval Application

DTIC Science & Technology

1993-05-01

The term virtual reality can encompass varying meanings, but some generally accepted attributes of a virtual environment are that it is immersive...technology, but at present there are few practical applications which are utilizing the broad range of virtual reality technology. This paper will discuss an...Operability, operator functions, Virtual reality , Man-machine interface, Decision aids/decision making, Decision support. ASW.

A rough set approach for determining weights of decision makers in group decision making.

PubMed

Yang, Qiang; Du, Ping-An; Wang, Yong; Liang, Bin

2017-01-01

This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs' decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member' decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs' evaluations and selections.

Effects of Information Visualization on Older Adults' Decision-Making Performance in a Medicare Plan Selection Task: A Comparative Usability Study.

PubMed

Price, Margaux M; Crumley-Branyon, Jessica J; Leidheiser, William R; Pak, Richard

2016-06-01

Technology gains have improved tools for evaluating complex tasks by providing environmental supports (ES) that increase ease of use and improve performance outcomes through the use of information visualizations (info-vis). Complex info-vis emphasize the need to understand individual differences in abilities of target users, the key cognitive abilities needed to execute a decision task, and the graphical elements that can serve as the most effective ES. Older adults may be one such target user group that would benefit from increased ES to mitigate specific declines in cognitive abilities. For example, choosing a prescription drug plan is a necessary and complex task that can impact quality of life if the wrong choice is made. The decision to enroll in one plan over another can involve comparing over 15 plans across many categories. Within this context, the large amount of complex information and reduced working memory capacity puts older adults' decision making at a disadvantage. An intentionally designed ES, such as an info-vis that reduces working memory demand, may assist older adults in making the most effective decision among many options. The objective of this study is to examine whether the use of an info-vis can lower working memory demands and positively affect complex decision-making performance of older adults in the context of choosing a Medicare prescription drug plan. Participants performed a computerized decision-making task in the context of finding the best health care plan. Data included quantitative decision-making performance indicators and surveys examining previous history with purchasing insurance. Participants used a colored info-vis ES or a table (no ES) to perform the decision task. Task difficulty was manipulated by increasing the number of selection criteria used to make an accurate decision. A repeated measures analysis was performed to examine differences between the two table designs. Twenty-three older adults between the ages of 66 and 80 completed the study. There was a main effect for accuracy such that older adults made more accurate decisions in the color info-vis condition than the table condition. In the low difficulty condition, participants were more successful at choosing the correct answer when the question was about the gap coverage attribute in the info-vis condition. Participants also made significantly faster decisions in the info-vis condition than in the table condition. Reducing the working memory demand of the task through the use of an ES can improve decision accuracy, especially when selection criteria is only focused on a single attribute of the insurance plan.

A review of clinical decision making: models and current research.

PubMed

Banning, Maggi

2008-01-01

The aim of this paper was to review the current literature clinical decision-making models and the educational application of models to clinical practice. This was achieved by exploring the function and related research of the three available models of clinical decision making: information-processing model, the intuitive-humanist model and the clinical decision-making model. Clinical decision making is a unique process that involves the interplay between knowledge of pre-existing pathological conditions, explicit patient information, nursing care and experiential learning. Historically, two models of clinical decision making are recognized from the literature; the information-processing model and the intuitive-humanist model. The usefulness and application of both models has been examined in relation the provision of nursing care and care related outcomes. More recently a third model of clinical decision making has been proposed. This new multidimensional model contains elements of the information-processing model but also examines patient specific elements that are necessary for cue and pattern recognition. Literature review. Evaluation of the literature generated from MEDLINE, CINAHL, OVID, PUBMED and EBESCO systems and the Internet from 1980 to November 2005. The characteristics of the three models of decision making were identified and the related research discussed. Three approaches to clinical decision making were identified, each having its own attributes and uses. The most recent addition to the clinical decision making is a theoretical, multidimensional model which was developed through an evaluation of current literature and the assessment of a limited number of research studies that focused on the clinical decision-making skills of inexperienced nurses in pseudoclinical settings. The components of this model and the relative merits to clinical practice are discussed. It is proposed that clinical decision making improves as the nurse gains experience of nursing patients within a specific speciality and with experience, nurses gain a sense of saliency in relation to decision making. Experienced nurses may use all three forms of clinical decision making both independently and concurrently to solve nursing-related problems. It is suggested that O'Neill's clinical decision-making model could be tested by educators and experienced nurses to assess the efficacy of this hybrid approach to decision making.

Housing decision making methods for initiation development phase process

NASA Astrophysics Data System (ADS)

Zainal, Rozlin; Kasim, Narimah; Sarpin, Norliana; Wee, Seow Ta; Shamsudin, Zarina

2017-10-01

Late delivery and sick housing project problems were attributed to poor decision making. These problems are the string of housing developer that prefers to create their own approach based on their experiences and expertise with the simplest approach by just applying the obtainable standards and rules in decision making. This paper seeks to identify the decision making methods for housing development at the initiation phase in Malaysia. The research involved Delphi method by using questionnaire survey which involved 50 numbers of developers as samples for the primary stage of collect data. However, only 34 developers contributed to the second stage of the information gathering process. At the last stage, only 12 developers were left for the final data collection process. Finding affirms that Malaysian developers prefer to make their investment decisions based on simple interpolation of historical data and using simple statistical or mathematical techniques in producing the required reports. It was suggested that they seemed to skip several important decision-making functions at the primary development stage. These shortcomings were mainly due to time and financial constraints and the lack of statistical or mathematical expertise among the professional and management groups in the developer organisations.

Decision Making and Binge Drinking: A Longitudinal Study

PubMed Central

Goudriaan, Anna E.; Grekin, Emily R.; Sher, Kenneth J.

2009-01-01

Background: Behavioral decision making, as measured by the Iowa Gambling Task (IGT) is found to be diminished in individuals with substance dependence and other types of disinhibitory psychopathology. However, little is known regarding the relation between heavy alcohol use and decision-making skills in young adults. This study therefore investigated whether binge drinking is related to disadvantageous decision making, as measured by the IGT. We also examined the relation between decision making and impulsivity. Methods: Latent class growth analysis was used to classify college students into 4 groups (each group n = 50, 50% male), based on their binge drinking trajectories over a 2-year time period (precollege through second year of college). Participants were 200 college students, divided in 4 subgroups: (1) low binge drinkers, (2) stable moderate binge drinkers, (3) increasing binge drinkers, and (4) stable high binge drinkers. A measure of decision making, the IGT, impulsivity questionnaires, and multiple indicators of heavy alcohol use were included. Results: The stable high binge-drinking group made less advantageous choices on the IGT than the low binge-drinking group. Impulsivity was not related to decision-making performance. Decision-making performance did not differ by gender, but deck preferences and decision time patterns did differ; women preferred low frequency, high amount punishments to a greater extent than men. Conclusions: Although disadvantageous decision making is related to binge-drinking patterns in emerging adulthood, this relation is independent of impulsivity. Additionally, the association appears attributable to those who engage in heavy (binge) drinking at an early age, but not to age of onset of drinking in general. PMID:17403069

"I've never been a yes person": Decision-making participation and self-conceptualization after severe traumatic brain injury.

PubMed

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2017-11-01

Although adults who sustain a severe traumatic brain injury (TBI) require support to make decisions in their lives, little is known about their experience of this process. The aim of this study was to explore how participation in decision making contributes to self-conceptualization in adults with severe TBI. We used constructivist grounded theory methods. Data included 20 in-depth interviews with adults with severe TBI. Through a process of constant comparison, analysis involved open and focused coding until clear categories emerged and data saturation was achieved. Self-conceptualization emerged as a complex and multifaceted process, as individuals with TBI aimed to reestablish a sense of autonomy. We describe a recursive relationship in which decision-making participation assists the dynamic construction of self, and self-concept contributes to the experience of making decisions. The role of an individual's social support network in acting as a bridge between participation and self-conceptualization is presented. Findings emphasize that contributing to decisions about one's own goals across a range of life areas can reinforce a positive self-concept. It is vital that supporters understand that participation in decision making provides a pathway to conceptualizing self and aim to maximize the person's participation in the decision-making process. Implications for Rehabilitation Previous research has identified that the experience of sustaining TBI has a significant impact on a person's conceptualization of self. This study identified that decision-making experiences play an important role in the ongoing process of self-conceptualization after injury. Decision-making experiences can reinforce a person's self-concept or lead them to revise (positively or negatively) their sense of self. By maximizing the person's decision-making participation, those around them can support them to develop positive self-attributes and contribute to shaping their future goals.

The Role of Social Constructions and Biophysical Attributes of the Environment in Decision-Making in the Context of Biofuels and Rubber Production Partnership Regimes in Upland Philippines

NASA Astrophysics Data System (ADS)

Montefrio, M. F.

2012-12-01

Burgeoning attention in biofuels and natural rubber has spurred interest among governments and private companies in integrating marginalized communities into global commodity markets. Upland farmers from diverse cultural backgrounds and biophysical settings today are deciding whether to agree with partnership proposals from governments and private firms to grow biofuels and natural rubber. In this paper, I examine whether upland farmers' socio-environmental constructions (evaluative beliefs, place satisfaction, and ecological worldviews) and the actual biophysical attributes (land cover and soil types) of upland environments, respectively, function as significant predictors of the intent and decisions of indigenous and non-indigenous farmers to cooperate with government and private actors to establish certain biofuel crops and natural rubber production systems in Palawan, Philippines. Drawing from ethnography and statistical analysis of household surveys, I propose that social constructions and the biophysical attributes of the environment are closely related with each other and in turn both influence individual decision-making behavior in resource-based production partnership regimes. This has significant implications on the resilience of socio-ecological systems, particularly agro-ecosystems, as certain upland farmers prefer to engage in intensive, monocrop production of biofuels and natural rubber on relatively more biodiverse areas, such as secondary forests and traditional shifting cultivation lands. The study aims to advance new institutional theories of resource management, particularly Ostrom's Institutional Analysis and Development and Socio-Ecological Systems frameworks, and scholarship on environmental decision-making in the context of collective action.

A national study of breast and colorectal cancer patients' decision-making for novel personalized medicine genomic diagnostics.

PubMed

Issa, Amalia M; Tufail, Waqas; Atehortua, Nelson; McKeever, John

2013-05-01

Molecular diagnostics are increasingly being used to help guide decision-making for personalized medical treatment of breast and colorectal cancer patients. The main aim of this study was to better understand and determine breast and colorectal cancer patients' decision-making strategies and the trade-offs they make in deciding about characteristics of molecular genomic diagnostics for breast and colorectal cancer. We surveyed a nationally representative sample of 300 breast and colorectal cancer patients using a previously developed web-administered instrument. Eligibility criteria included patients aged 18 years and older with either breast or colorectal cancer. We explored several attributes and attribute levels of molecular genomic diagnostics in 20 scenarios. Our analysis revealed that both breast and colorectal cancer patients weighted the capability of molecular genomic diagnostics to determine the probability of treatment efficacy as being of greater importance than information provided to detect adverse events. The probability of either false-positive or -negative results was ranked highly as a potential barrier by both breast and colorectal patients. However, 78.6% of breast cancer patients ranked the possibility of a 'false-negative test result leading to undertreatment' higher than the 'chance of a false positive, which may lead to overtreatment' (68%). This finding contrasted with the views of colorectal cancer patients who ranked the chance of a false positive as being of greater concern than a false negative (72.8 vs 63%). Overall, cancer patients exhibited a high willingness to accept and pay for genomic diagnostic tests, especially among breast cancer patients. Cancer patients seek a test accuracy rate of 90% or higher. Breast and colorectal cancer patients' decisions about genomic diagnostics are influenced more by the probability of being cured than by avoiding potential severe adverse events. This study provides insights into the relative weight that breast and colorectal cancer patients place on various aspects of molecular genomic diagnostics, and the trade-offs they are willing to make among attributes of such tests.

Parental Influences, Career Decision-Making Attributions, and Self-Efficacy: Differences for Men and Women?

ERIC Educational Resources Information Center

Lease, Suzanne H.; Dahlbeck, David T.

2009-01-01

This study investigated the relations of maternal and paternal attachment, parenting styles, and career locus of control to college students' career decision self-efficacy and explored whether these relations differed by student gender. Data analysis using hierarchical multiple regression revealed that attachment was relevant for females' career…

The effect of parental intellectual disability status on child protection service worker decision making.

PubMed

Proctor, S N; Azar, S T

2013-12-01

There is evidence to suggest that parents with an intellectual disability (ID) constitute a higher proportion of child-protective services (CPS) cases than would be expected based on the prevalence of ID in the general population. Researchers have suggested that the stereotypic assumptions and expectations that CPS workers have about parents with an ID might influence decisions and responses made to such parents. This study examined whether parental ID (having an ID vs. not) had an effect on CPS workers' emotional reactions, attributions and decisions about risk to the child, whether to remove the child and workers' general willingness to help the parent. Two hundred and twelve CPS workers read vignettes describing parents who were labelled as either having or not having an ID. Workers responded to the vignettes by making ratings of their emotional reactions, attributions and decisions regarding risk, removal and helping. CPS workers made significantly higher ratings of pity, willingness to help and risk for parents with an ID than for parents without an ID. Lower ratings of anger and disgust were found for parents with an ID than for parents without an ID. Parents' intellectual status did not have a direct effect on workers' attributions or removal decisions. The results show evidence for the influence of stereotypes regarding parental ID due to its differential effect on CPS workers' emotional reactions and decisions about child risk and their willingness to help. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.

How the elderly and young adults differ in the decision making process of nonprescription medication purchases.

PubMed

Sansgiry, S S; Cady, P S

1996-01-01

The study compared elderly and young adults in their behavior and involvement in the decision making process of over-the-counter (OTC) medication purchases. Elderly subjects were more involved in the decision making process to purchase OTC medications compared to young adults. The elderly not only purchase and spend more money on medications but also read OTC labels completely. They requested help from the pharmacist more frequently than young adults. Needs of the elderly in making an OTC medication purchase were different compared to young adults. The two age groups differed on importance rating for several attributes regarding OTC medications, such as; ease of opening the package, child resistant package, side effects of medicine, manufacturer of medicine, print size on package labels, and greater choice of medicine.

Neural responses to feedback information produced by self-generated or other-generated decision-making and their impairment in schizophrenia.

PubMed

Toyomaki, Atsuhito; Hashimoto, Naoki; Kako, Yuki; Murohashi, Harumitsu; Kusumi, Ichiro

2017-01-01

Several studies of self-monitoring dysfunction in schizophrenia have focused on the sense of agency to motor action using behavioral and psychophysiological techniques. So far, no study has ever tried to investigate whether the sense of agency or causal attribution for external events produced by self-generated decision-making is abnormal in schizophrenia. The purpose of this study was to investigate neural responses to feedback information produced by self-generated or other-generated decision-making in a multiplayer gambling task using even-related potentials and electroencephalogram synchronization. We found that the late positive component and theta/alpha synchronization were increased in response to feedback information in the self-decision condition in normal controls, but that these responses were significantly decreased in patients with schizophrenia. These neural activities thus reflect the self-reference effect that affects the cognitive appraisal of external events following decision-making and their impairment in schizophrenia.

Emotion regulation and decision making under risk and uncertainty.

PubMed

Heilman, Renata M; Crişan, Liviu G; Houser, Daniel; Miclea, Mircea; Miu, Andrei C

2010-04-01

It is well established that emotion plays a key role in human social and economic decision making. The recent literature on emotion regulation (ER), however, highlights that humans typically make efforts to control emotion experiences. This leaves open the possibility that decision effects previously attributed to acute emotion may be a consequence of acute ER strategies such as cognitive reappraisal and expressive suppression. In Study 1, we manipulated ER of laboratory-induced fear and disgust, and found that the cognitive reappraisal of these negative emotions promotes risky decisions (reduces risk aversion) in the Balloon Analogue Risk Task and is associated with increased performance in the prehunch/hunch period of the Iowa Gambling Task. In Study 2, we found that naturally occurring negative emotions also increase risk aversion in Balloon Analogue Risk Task, but the incidental use of cognitive reappraisal of emotions impedes this effect. We offer evidence that the increased effectiveness of cognitive reappraisal in reducing the experience of emotions underlies its beneficial effects on decision making. Copyright 2010 APA, all rights reserved.

The inaction effect in the psychology of regret.

PubMed

Zeelenberg, Marcel; van de Bos, Kees; van Dijk, Eric; Pieters, Rik

2002-03-01

Previous research showed that decisions to act (i.e., actions) produce more regret than decisions not to act (i.e., inactions). This previous research focused on decisions made in isolation and ignored that decisions are often made in response to earlier outcomes. The authors show in 4 experiments that these prior outcomes may promote action and hence make inaction more abnormal. They manipulated information about a prior outcome. As hypothesized, when prior outcomes were positive or absent, people attributed more regret to action than to inaction. However, as predicted and counter to previous research, following negative prior outcomes, more regret was attributed to inaction, a finding that the authors label the inaction effect. Experiment 4, showing differential effects for regret and disappointment, demonstrates the need for emotion-specific predictions.

Ventromedial Frontal Lobe Damage Alters how Specific Attributes are Weighed in Subjective Valuation.

PubMed

Vaidya, Avinash R; Sefranek, Marcus; Fellows, Lesley K

2017-10-23

The concept of subjective value is central to current neurobiological views of economic decision-making. Much of this work has focused on signals in the ventromedial frontal lobe (VMF) that correlate with the subjective value of a variety of stimuli (e.g., food, monetary gambles), and are thought to support decision-making. However, the neural processes involved in assessing and integrating value information from the attributes of such complex options remain to be defined. Here, we tested the necessary role of VMF in weighting attributes of naturalistic stimuli during value judgments. We asked how distinct attributes of visual artworks influenced the subjective value ratings of subjects with VMF damage, compared to healthy participants and a frontal lobe damaged control group. Subjects with VMF damage were less influenced by the energy (emotion, complexity) and color radiance (warmth, saturation) of the artwork, while they were similar to control groups in considering saliency, balance and concreteness. These dissociations argue that VMF is critical for allowing certain affective content to influence subjective value, while sparing the influence of perceptual or representational information. These distinctions are important for better defining the often-underspecified concept of subjective value and developing more detailed models of the brain mechanisms underlying decision behavior. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Sleep-related car crashes: risk perception and decision-making processes in young drivers.

PubMed

Lucidi, Fabio; Russo, Paolo Maria; Mallia, Luca; Devoto, Alessandra; Lauriola, Marco; Violani, Cristiano

2006-03-01

The aim of the present study is to analyse factors affecting worries, coping strategies and decisions of young drivers regarding the risk of sleep-related car crashes. Furthermore, the study also analyses whether framing the same information about sleepiness in two different linguistic forms influences: (1) the evaluation of the level of risk associated to a specific level of drowsiness (Attribute Framing problem); (2) the willingness to enact strategies to "prevent" sleepiness before night-time driving (Goal Framing problem); (3) the choice between two different ways, both of equal expected efficacy, of lowering drowsiness (Risky decision-making Framing problem). Six hundred and ninety-five young drivers [(57.6% females, 42.4% males); mean age 20.85 years (S.D.=1.2)] answered questions on drive risk perception and sleepiness, on nocturnal driving experience and on the strategies to deal with driver sleepiness, responding to one of the two different versions of the framed problems. A sub-sample of 130 participants completed the framed problems in both versions. The results show that experiences of sleep attacks and nocturnal driving frequency in the past 6 months affect both risk perception and the preventive strategies adopted. Furthermore, the manipulation on two out of the three problems (attribute and risky decision-making frames) significantly affected the respondents' evaluation.

Service Oriented Architecture Security Risks and their Mitigation

DTIC Science & Technology

2012-10-01

this section can be mitigated by making use of suitable authentication , confidentiality, integrity, and authorisation standards such as Security...for authorisation . Machines/non-human users should be clearly identified and authenticated by the identity provision and authentication services... authentication , any security related attributes for the subject, and the authorisation decisions given based on the security and privilege attributes

Physicians' anxiety due to uncertainty and use of race in medical decision making.

PubMed

Cunningham, Brooke A; Bonham, Vence L; Sellers, Sherrill L; Yeh, Hsin-Chieh; Cooper, Lisa A

2014-08-01

The explicit use of race in medical decision making is contested. Researchers have hypothesized that physicians use race in care when they are uncertain. The aim of this study was to investigate whether physician anxiety due to uncertainty (ADU) is associated with a higher propensity to use race in medical decision making. This study included a national cross-sectional survey of general internists. A national sample of 1738 clinically active general internists drawn from the SK&A physician database were included in the study. ADU is a 5-item measure of emotional reactions to clinical uncertainty. Bonham and Sellers Racial Attributes in Clinical Evaluation (RACE) scale includes 7 items that measure self-reported use of race in medical decision making. We used bivariate regression to test for associations between physician characteristics, ADU, and RACE. Multivariate linear regression was performed to test for associations between ADU and RACE while adjusting for potential confounders. The mean score on ADU was 19.9 (SD=5.6). Mean score on RACE was 13.5 (SD=5.6). After adjusting for physician demographics, physicians with higher levels of ADU scored higher on RACE (+β=0.08 in RACE, P=0.04, for each 1-point increase in ADU), as did physicians who understood "race" to mean biological or genetic ancestral, rather than sociocultural, group. Physicians who graduated from a US medical school, completed fellowship, and had more white patients scored lower on RACE. This study demonstrates positive associations between physicians' ADU, meanings attributed to race, and self-reported use of race in medical decision making. Future research should examine the potential impact of these associations on patient outcomes and health care disparities.

Physicians’ Anxiety Due to Uncertainty and Use of Race in Medical Decision-Making

PubMed Central

Cunningham, Brooke A.; Bonham, Vence L.; Sellers, Sherrill L.; Yeh, Hsin-Chieh; Cooper, Lisa A.

2014-01-01

Background The explicit use of race in medical decision-making is contested. Researchers have hypothesized that physicians use race in care when they are uncertain. Objectives To investigate whether physician anxiety due to uncertainty is associated with a higher propensity to use race in medical decision-making. Research Design A national cross-sectional survey of general internists Subjects A national sample of 1738 clinically active general internists drawn from the SK&A physician database Measures Anxiety Due to Uncertainty (ADU) is a 5-item measure of emotional reactions to clinical uncertainty. Bonham and Sellers Racial Attributes in Clinical Evaluation (RACE) scale includes 7 items that measure self-reported use of race in medical decision-making. We used bivariate regression to test for associations between physician characteristics, ADU and RACE. Multivariate linear regression was performed to test for associations between ADU and RACE while adjusting for potential confounders. Results The mean score on ADU was 19.9 (SD=5.6). Mean score on RACE was 13.5 (SD=5.6). After adjusting for physician demographics, physicians with higher levels of ADU scored higher on RACE (+β=0.08 in RACE, p=0.04, for each 1-point increase in ADU), as did physicians who understand “race” to mean biological or genetic ancestral, rather than sociocultural, group. Physicians who graduated from a US medical school, completed fellowship, and had more white patients, scored lower on RACE. Conclusions This study demonstrates positive associations between physicians’ anxiety due to uncertainty, meanings attributed to race, and self-reported use of race in medical decision-making. Future research should examine the potential impact of these associations on patient outcomes and healthcare disparities. PMID:25025871

Clinical factors and the decision to transfuse chronic dialysis patients.

PubMed

Whitman, Cynthia B; Shreay, Sanatan; Gitlin, Matthew; van Oijen, Martijn G H; Spiegel, Brennan M R

2013-11-01

Red blood cell transfusion was previously the principle therapy for anemia in CKD but became less prevalent after the introduction of erythropoiesis-stimulating agents. This study used adaptive choice-based conjoint analysis to identify preferences and predictors of transfusion decision-making in CKD. A computerized adaptive choice-based conjoint survey was administered between June and August of 2012 to nephrologists, internists, and hospitalists listed in the American Medical Association Masterfile. The survey quantified the relative importance of 10 patient attributes, including hemoglobin levels, age, occult blood in stool, severity of illness, eligibility for transplant, iron indices, erythropoiesis-stimulating agents, cardiovascular disease, and functional status. Triggers of transfusions in common dialysis scenarios were studied, and based on adaptive choice-based conjoint-derived preferences, relative importance by performing multivariable regression to identify predictors of transfusion preferences was assessed. A total of 350 providers completed the survey (n=305 nephrologists; mean age=46 years; 21% women). Of 10 attributes assessed, absolute hemoglobin level was the most important driver of transfusions, accounting for 29% of decision-making, followed by functional status (16%) and cardiovascular comorbidities (12%); 92% of providers transfused when hemoglobin was 7.5 g/dl, independent of other factors. In multivariable regression, Veterans Administration providers were more likely to transfuse at 8.0 g/dl (odds ratio, 5.9; 95% confidence interval, 1.9 to 18.4). Although transplant eligibility explained only 5% of decision-making, nephrologists were five times more likely to value it as important compared with non-nephrologists (odds ratio, 5.2; 95% confidence interval, 2.4 to 11.1). Adaptive choice-based conjoint analysis was useful in predicting influences on transfusion decisions. Hemoglobin level, functional status, and cardiovascular comorbidities most strongly influenced transfusion decision-making, but preference variations were observed among subgroups.

Sex-Differences, Handedness, and Lateralization in the Iowa Gambling Task

PubMed Central

Singh, Varsha

2016-01-01

In a widely used decision-making task, the Iowa Gambling Task (IGT), male performance is observed to be superior to that of females, and is attributed to right lateralization (i.e., right hemispheric dominance). It is as yet unknown whether sex-differences in affect and motor lateralization have implications for sex-specific lateralization in the IGT, and specifically, whether sex-difference in performance in the IGT changes with right-handedness or with affect lateralization (decision valence, and valence-directed motivation). The present study (N = 320; 160 males) examined the effects of right-handedness (right-handedness vs. non-right-handedness) as a measure of motor lateralization, decision valence (reward vs. punishment IGT), and valence-directedness of task motivation (valence-directed vs. non-directed instructions), as measures of affective lateralization on IGT decision making. Analyses of variance revealed that both male and female participants showed valence-induced inconsistencies in advantageous decision-making; however, right-handed females made more disadvantageous decisions in a reward IGT. These results suggest that IGT decision-making may be largely right-lateralized in right-handed males, and show that sex and lateralized differences (motor and affect) have implications for sex-differences in IGT decision-making. Implications of the results are discussed with reference to lateralization and sex-differences in cognition. PMID:27303316

Determining rules for closing customer service centers: A public utility company's fuzzy decision

NASA Technical Reports Server (NTRS)

Dekorvin, Andre; Shipley, Margaret F.

1992-01-01

In the present work, we consider the general problem of knowledge acquisition under uncertainty. A commonly used method is to learn by examples. We observe how the expert solves specific cases and from this infer some rules by which the decision was made. Unique to this work is the fuzzy set representation of the conditions or attributes upon which the decision make may base his fuzzy set decision. From our examples, we infer certain and possible rules containing fuzzy terms. It should be stressed that the procedure determines how closely the expert follows the conditions under consideration in making his decision. We offer two examples pertaining to the possible decision to close a customer service center of a public utility company. In the first example, the decision maker does not follow too closely the conditions. In the second example, the conditions are much more relevant to the decision of the expert.

Do the right thing: the assumption of optimality in lay decision theory and causal judgment.

PubMed

Johnson, Samuel G B; Rips, Lance J

2015-03-01

Human decision-making is often characterized as irrational and suboptimal. Here we ask whether people nonetheless assume optimal choices from other decision-makers: Are people intuitive classical economists? In seven experiments, we show that an agent's perceived optimality in choice affects attributions of responsibility and causation for the outcomes of their actions. We use this paradigm to examine several issues in lay decision theory, including how responsibility judgments depend on the efficacy of the agent's actual and counterfactual choices (Experiments 1-3), individual differences in responsibility assignment strategies (Experiment 4), and how people conceptualize decisions involving trade-offs among multiple goals (Experiments 5-6). We also find similar results using everyday decision problems (Experiment 7). Taken together, these experiments show that attributions of responsibility depend not only on what decision-makers do, but also on the quality of the options they choose not to take. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of two multi-criteria decision techniques for eliciting treatment preferences in people with neurological disorders.

PubMed

Ijzerman, Maarten J; van Til, Janine A; Snoek, Govert J

2008-12-01

To present and compare two multi-criteria decision techniques (analytic hierarchy process [AHP] and conjoint analysis [CA]) for eliciting preferences in patients with cervical spinal cord injury (SCI) who are eligible for surgical augmentation of hand function, either with or without implantation of a neuroprosthesis. The methods were compared in respect to attribute weights, overall preference, and practical experiences. Two previously designed and administered multi-criteria decision surveys in patients with SCI were compared and further analysed. Attributes and their weights in the AHP experiment were determined by an expert panel, followed by determination of the weights in the patient group. Attributes for the CA were selected and validated using an expert panel, piloted in six patients with SCI and subsequently administered to the same group of patients as participated in the AHP experiment. Both experiments showed the importance of non-outcome-related factors such as inpatient stay and number of surgical procedures. In particular, patients were less concerned with clinical outcomes in actual decision making. Overall preference in both the AHP and CA was in favor of tendon reconstruction (0.6 vs 0.4 for neuroprosthetic implantation). Both methods were easy to apply, but AHP was less easily explained and understood. Both the AHP and CA methods produced similar outcomes, which may have been caused by the obvious preferences of patients. CA may be preferred because of the holistic approach of considering all treatment attributes simultaneously and, hence, its power in simulating real market decisions. On the other hand, the AHP method is preferred as a hands-on, easy-to-implement task with immediate feedback to the respondent. This flexibility allows AHP to be used in shared decision making. However, the way the technique is composed results in many inconsistencies. Patients preferred CA but complained about the number of choice tasks.

Factors that Influence Treatment and Non-treatment Decision Making Among Individuals with Inflammatory Bowel Disease: An Integrative Review.

PubMed

Kamp, Kendra J; Brittain, Kelly

2018-06-01

Inflammatory bowel disease (IBD) is a chronic illness with periods of varying disease activity called flares and remissions. Since IBD impacts quality of life, patients make IBD disease management decisions every day. Previous research indicates limited insight about factors that influence decisions regarding disease management and the types of decisions IBD patients make. The purpose of this integrative review is to identify types of treatment and non-treatment decisions and the factors that influence decision making regarding disease management among individuals with IBD. An integrative literature review was performed based on the Whittemore and Knafl framework. PubMed, Web of Science, and PsychINFO were searched for relevant articles, from 2010-2016, using the key terms: decision making, patient preferences, self-management, self-care, nutrition, diet, stress, symptom, Colitis, Crohns, and IBD. Twenty-eight articles met the inclusion criteria. From these, research showed two types of decisions: treatment decisions related to medication and surgery, and non-treatment decisions focused on diet modification. Five themes that influence decisions were identified: experiencing symptoms, provider recommendations, convenience attributes, psychosocial factors, and informational needs. Most of the studies found a positive relationship between an increased number of symptoms and a patient's willingness to engage in treatment decisions. Although support from providers is highly influential for treatment decisions, most studies reported that provider recommendations did not align with patient preferences. Future work is needed to understand factors that influence decisions among recently diagnosed patients, to focus on non-treatment-related decisions, and to clarify the role of psychosocial factors in promoting disease decision making among IBD patients. This integrative review identified that, for patients, experiencing symptoms is the most important factor that influences treatment and non-treatment decisions.

Toward an Ideal Senior High School Governance Structure.

ERIC Educational Resources Information Center

Treslan, D. L.

1979-01-01

This paper delineates six attributes of an ideal high school governance structure: respect, freedom, rationality, flexibility, equality, and involvement of staff and students in the decision-making process. (Author/SJL)

Pavlovian valuation systems in learning and decision making

PubMed Central

Clark, Jeremy J.; Hollon, Nick G.; Phillips, Paul E. M.

2012-01-01

Environmental stimuli guide value-based decision making, but can do so through cognitive representation of outcomes or through general-incentive properties attributed to the cues themselves. We assert that these differences are conferred through the use of alternative associative structures differing in computational intensity. Using this framework, we review scientific evidence to discern the neural substrates of these assumed separable processes. We suggest that the contribution of the mesolimbic dopamine system to Pavlovian valuation is restricted to an affective system that is only updated through experiential feedback of stimulus-outcome pairing, whereas the orbitofrontal cortex contributes to an alternative system capable of inferential reasoning. Finally we discuss the interactions and convergence of these systems and their implications for decision making and its pathology. PMID:22749132

A cloud model based multi-attribute decision making approach for selection and evaluation of groundwater management schemes

NASA Astrophysics Data System (ADS)

Lu, Hongwei; Ren, Lixia; Chen, Yizhong; Tian, Peipei; Liu, Jia

2017-12-01

Due to the uncertainty (i.e., fuzziness, stochasticity and imprecision) existed simultaneously during the process for groundwater remediation, the accuracy of ranking results obtained by the traditional methods has been limited. This paper proposes a cloud model based multi-attribute decision making framework (CM-MADM) with Monte Carlo for the contaminated-groundwater remediation strategies selection. The cloud model is used to handle imprecise numerical quantities, which can describe the fuzziness and stochasticity of the information fully and precisely. In the proposed approach, the contaminated concentrations are aggregated via the backward cloud generator and the weights of attributes are calculated by employing the weight cloud module. A case study on the remedial alternative selection for a contaminated site suffering from a 1,1,1-trichloroethylene leakage problem in Shanghai, China is conducted to illustrate the efficiency and applicability of the developed approach. Totally, an attribute system which consists of ten attributes were used for evaluating each alternative through the developed method under uncertainty, including daily total pumping rate, total cost and cloud model based health risk. Results indicated that A14 was evaluated to be the most preferred alternative for the 5-year, A5 for the 10-year, A4 for the 15-year and A6 for the 20-year remediation.

Intuitionistic uncertain linguistic partitioned Bonferroni means and their application to multiple attribute decision-making

NASA Astrophysics Data System (ADS)

Liu, Zhengmin; Liu, Peide

2017-04-01

The Bonferroni mean (BM) was originally introduced by Bonferroni and generalised by many other researchers due to its capacity to capture the interrelationship between input arguments. Nevertheless, in many situations, interrelationships do not always exist between all of the attributes. Attributes can be partitioned into several different categories and members of intra-partition are interrelated while no interrelationship exists between attributes of different partitions. In this paper, as complements to the existing generalisations of BM, we investigate the partitioned Bonferroni mean (PBM) under intuitionistic uncertain linguistic environments and develop two linguistic aggregation operators: intuitionistic uncertain linguistic partitioned Bonferroni mean (IULPBM) and its weighted form (WIULPBM). Then, motivated by the ideal of geometric mean and PBM, we further present the partitioned geometric Bonferroni mean (PGBM) and develop two linguistic geometric aggregation operators: intuitionistic uncertain linguistic partitioned geometric Bonferroni mean (IULPGBM) and its weighted form (WIULPGBM). Some properties and special cases of these proposed operators are also investigated and discussed in detail. Based on these operators, an approach for multiple attribute decision-making problems with intuitionistic uncertain linguistic information is developed. Finally, a practical example is presented to illustrate the developed approach and comparison analyses are conducted with other representative methods to verify the effectiveness and feasibility of the developed approach.

Focus Groups in Elderly Ophthalmologic Patients: Setting the Stage for Quantitative Preference Elicitation.

PubMed

Danner, Marion; Vennedey, Vera; Hiligsmann, Mickaël; Fauser, Sascha; Stock, Stephanie

2016-02-01

Patients suffering from age-related macular degeneration (AMD) are rarely actively involved in decision-making, despite facing preference-sensitive treatment decisions. This paper presents a qualitative study to prepare quantitative preference elicitation in AMD patients. The aims of this study were (1) to gain familiarity with and learn about the special requirements of the AMD patient population for quantitative data collection; and (2) to select/refine patient-relevant treatment attributes and levels, and gain insights into preference structures. Semi-structured focus group interviews were performed. An interview guide including preselected categories in the form of seven potentially patient-relevant treatment attributes was followed. To identify the most patient-relevant treatment attributes, a ranking exercise was performed. Deductive content analyses were done by two independent reviewers for each attribute to derive subcategories (potential levels of attributes) and depict preference trends. The focus group interviews included 21 patients. The interviews revealed that quantitative preference surveys in this population will have to be interviewer assisted to make the survey feasible for patients. The five most patient-relevant attributes were the effect on visual function [ranking score (RS): 139], injection frequency (RS: 101), approval status (RS: 83), side effects (RS: 79), and monitoring frequency (RS: 76). Attribute and level refinement was based on patients' statements. Preference trends and dependencies between attributes informed the quantitative instrument design. This study suggests that qualitative research is a very helpful step to prepare the design and administration of quantitative preference elicitation instruments. It especially facilitated familiarization with the target population and its preferences, and it supported attribute/level refinement.

Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

PubMed

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients' attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind.

Surrogate decision making: do we have to trade off accuracy and procedural satisfaction?

PubMed

Frey, Renato; Hertwig, Ralph; Herzog, Stefan M

2014-02-01

Making surrogate decisions on behalf of incapacitated patients can raise difficult questions for relatives, physicians, and society. Previous research has focused on the accuracy of surrogate decisions (i.e., the proportion of correctly inferred preferences). Less attention has been paid to the procedural satisfaction that patients' surrogates and patients attribute to specific approaches to making surrogate decisions. The objective was to investigate hypothetical patients' and surrogates' procedural satisfaction with specific approaches to making surrogate decisions and whether implementing these preferences would lead to tradeoffs between procedural satisfaction and accuracy. Study 1 investigated procedural satisfaction by assigning participants (618 in a mixed-age but relatively young online sample and 50 in an older offline sample) to the roles of hypothetical surrogates or patients. Study 2 (involving 64 real multigenerational families with a total of 253 participants) investigated accuracy using 24 medical scenarios. Hypothetical patients and surrogates had closely aligned preferences: Procedural satisfaction was highest with a patient-designated surrogate, followed by shared surrogate decision-making approaches and legally assigned surrogates. These approaches did not differ substantially in accuracy. Limitations are that participants' preferences regarding existing and novel approaches to making surrogate decisions can only be elicited under hypothetical conditions. Next to decision making by patient-designated surrogates, shared surrogate decision making is the preferred approach among patients and surrogates alike. This approach appears to impose no tradeoff between procedural satisfaction and accuracy. Therefore, shared decision making should be further studied in representative samples of the general population, and if people's preferences prove to be robust, they deserve to be weighted more strongly in legal frameworks in addition to patient-designated surrogates.

Unravelling the concept of consumer preference: implications for health policy and optimal planning in primary care.

PubMed

Foster, Michele M; Earl, Peter E; Haines, Terry P; Mitchell, Geoffrey K

2010-10-01

Accounting for consumer preference in health policy and delivery system design makes good economic sense since this is linked to outcomes, quality of care and cost control. Probability trade-off methods are commonly used in policy evaluation, marketing and economics. Increasingly applied to health matters, the trade-off preference model has indicated that consumers of health care discriminate between different attributes of care. However, the complexities of the health decision-making environment raise questions about the inherent assumptions concerning choice and decision-making behavior which frame this view of consumer preference. In this article, we use the example of primary care in Australia as a vehicle to examine the concept of 'consumer preference' from different perspectives within economics and discuss the significance of how we model preferences for health policy makers. In doing so, we question whether mainstream thinking, namely that consumers are capable of deliberating between rival strategies and are willing to make trade-offs, is a reliable way of thinking about preferences given the complexities of the health decision-making environment. Alternative perspectives on preference can assist health policy makers and health providers by generating more precise information about the important attributes of care that are likely to enhance consumer engagement and optimise acceptability of health care. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

[The framing effect: medical implications].

PubMed

Mazzocco, Ketti; Cherubini, Paolo; Rumiati, Rino

2005-01-01

Over the last 20 years, many studies explored how the way information is presented modifies choices. This sort of effect, referred to as "framing effects", typically consists of the inversion of choices when presenting structurally identical decision problems in different ways. It is a common assumption that physicians are unaffected (or less affected) by the surface description of a decision problem, because they are formally trained in medical decision making. However, several studies showed that framing effects occur even in the medical field. The complexity and variability of these effects are remarkable, making it necessary to distinguish among different framing effects, depending on whether the effect is obtained by modifying adjectives (attribute framing), goals of a behavior (goal framing), or the probability of an outcome (risky choice framing). A further reason for the high variability of the framing effects seems to be the domain of the decision problem, with different effects occurring in prevention decisions, disease-detection decisions, and treatment decisions. The present work reviews the studies on framing effects, in order to summarize them and clarify their possible role in medical decision making.

Applications of fuzzy ranking methods to risk-management decisions

NASA Astrophysics Data System (ADS)

Mitchell, Harold A.; Carter, James C., III

1993-12-01

The Department of Energy is making significant improvements to its nuclear facilities as a result of more stringent regulation, internal audits, and recommendations from external review groups. A large backlog of upgrades has resulted. Currently, a prioritization method is being utilized which relies on a matrix of potential consequence and probability of occurrence. The attributes of the potential consequences considered include likelihood, exposure, public health and safety, environmental impact, site personnel safety, public relations, legal liability, and business loss. This paper describes an improved method which utilizes fuzzy multiple attribute decision methods to rank proposed improvement projects.

Propulsion Airframe Aeroacoustics Technology Evaluation and Selection Using a Multi-Attribute Decision Making Process and Non-Deterministic Design

NASA Technical Reports Server (NTRS)

Burg, Cecile M.; Hill, Geoffrey A.; Brown, Sherilyn A.; Geiselhart, Karl A.

2004-01-01

The Systems Analysis Branch at NASA Langley Research Center has investigated revolutionary Propulsion Airframe Aeroacoustics (PAA) technologies and configurations for a Blended-Wing-Body (BWB) type aircraft as part of its research for NASA s Quiet Aircraft Technology (QAT) Project. Within the context of the long-term NASA goal of reducing the perceived aircraft noise level by a factor of 4 relative to 1997 state of the art, major configuration changes in the propulsion airframe integration system were explored with noise as a primary design consideration. An initial down-select and assessment of candidate PAA technologies for the BWB was performed using a Multi-Attribute Decision Making (MADM) process consisting of organized brainstorming and decision-making tools. The assessments focused on what effect the PAA technologies had on both the overall noise level of the BWB and what effect they had on other major design considerations such as weight, performance and cost. A probabilistic systems analysis of the PAA configurations that presented the best noise reductions with the least negative impact on the system was then performed. Detailed results from the MADM study and the probabilistic systems analysis will be published in the near future.

Cochlear Implant: the complexity involved in the decision making process by the family.

PubMed

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.

Patient centered decision making: use of conjoint analysis to determine risk-benefit trade-offs for preference sensitive treatment choices.

PubMed

Wilson, Leslie; Loucks, Aimee; Bui, Christine; Gipson, Greg; Zhong, Lixian; Schwartzburg, Amy; Crabtree, Elizabeth; Goodin, Douglas; Waubant, Emmanuelle; McCulloch, Charles

2014-09-15

Understanding patient preferences facilitates shared decision-making and focuses on patient-centered outcomes. Little is known about relapsing-remitting multiple sclerosis (RRMS) patient preferences for disease modifying therapies (DMTs). We use choice based conjoint (CBC) analysis to calculate patient preferences for risk/benefit trade-offs for hypothetical DMTs. Patients with RRMS were surveyed between 2012 and 2013. Our CBC survey mimicked the decision-making process and trade-offs of patients choosing DMTs, based on all possible DMT attributes. Mixed-effects logistic regression analyzed preferences. We estimated maximum acceptable risk trade-offs for various DMT benefits. Severe side-effect risks had the biggest impact on patient preference with a 1% risk, decreasing patient preference five-fold compared to no risk. (OR=0.22, p<0.001). Symptom improvement was the most preferred benefit (OR=3.68, p<0.001), followed by prevention of progression of 10 years (OR=2.4, p<0.001). Daily oral administration had the third highest DMT preference rating (OR=2.08, p<0.001). Patients were willing to accept 0.08% severe risk for a year delayed relapse, and 0.22% for 4 vs 2 year prevented progression. We provided patient preferences and risk-benefit trade-offs for attributes of all available DMTs. Evaluation of patient preferences is a key step in shared decision making and may significantly impact early drug initiation and compliance. Copyright © 2014 Elsevier B.V. All rights reserved.

MADM-based smart parking guidance algorithm

PubMed Central

Li, Bo; Pei, Yijian; Wu, Hao; Huang, Dijiang

2017-01-01

In smart parking environments, how to choose suitable parking facilities with various attributes to satisfy certain criteria is an important decision issue. Based on the multiple attributes decision making (MADM) theory, this study proposed a smart parking guidance algorithm by considering three representative decision factors (i.e., walk duration, parking fee, and the number of vacant parking spaces) and various preferences of drivers. In this paper, the expected number of vacant parking spaces is regarded as an important attribute to reflect the difficulty degree of finding available parking spaces, and a queueing theory-based theoretical method was proposed to estimate this expected number for candidate parking facilities with different capacities, arrival rates, and service rates. The effectiveness of the MADM-based parking guidance algorithm was investigated and compared with a blind search-based approach in comprehensive scenarios with various distributions of parking facilities, traffic intensities, and user preferences. Experimental results show that the proposed MADM-based algorithm is effective to choose suitable parking resources to satisfy users’ preferences. Furthermore, it has also been observed that this newly proposed Markov Chain-based availability attribute is more effective to represent the availability of parking spaces than the arrival rate-based availability attribute proposed in existing research. PMID:29236698

Use of multiattribute utility theory for formulary management in a health system.

PubMed

Chung, Seonyoung; Kim, Sooyon; Kim, Jeongmee; Sohn, Kieho

2010-01-15

The application, utility, and flexibility of the multiattribute utility theory (MAUT) when used as a formulary decision methodology in a Korean medical center were evaluated. A drug analysis model using MAUT consisting of 10 steps was designed for two drug classes of dihydropyridine calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs). These two drug classes contain the most diverse agents among cardiovascular drugs on Samsung Medical Center's drug formulary. The attributes identified for inclusion in the drug analysis model were effectiveness, safety, patient convenience, and cost, with relative weights of 50%, 30%, 10%, and 10%, respectively. The factors were incorporated into the model to quantify the contribution of each attribute. For each factor, a utility scale of 0-100 was established, and the total utility score for each alternative was calculated. An attempt was made to make the model adaptable to changing health care and regulatory circumstances. The analysis revealed amlodipine besylate to be an alternative agent, with the highest total utility score among the dihydropyridine CCBs, while barnidipine hydrochloride had the lowest score. For ARBs, losartan potassium had the greatest total utility score, while olmesartan medoxomil had the lowest. A drug analysis model based on the MAUT was successfully developed and used in making formulary decisions for dihydropyridine CCBs and ARBs for a Korean health system. The model incorporates sufficient utility and flexibility of a drug's attributes and can be used as an alternative decision-making tool for formulary management in health systems.

Maladaptive Decision Making in Adults with a History of Adolescent Alcohol use, in a Preclinical Model, Is Attributable to the Compromised Assignment of Incentive Value during Stimulus-Reward Learning.

PubMed

Kruse, Lauren C; Schindler, Abigail G; Williams, Rapheal G; Weber, Sophia J; Clark, Jeremy J

2017-01-01

According to recent WHO reports, alcohol remains the number one substance used and abused by adolescents, despite public health efforts to curb its use. Adolescence is a critical period of biological maturation where brain development, particularly the mesocorticolimbic dopamine system, undergoes substantial remodeling. These circuits are implicated in complex decision making, incentive learning and reinforcement during substance use and abuse. An appealing theoretical approach has been to suggest that alcohol alters the normal development of these processes to promote deficits in reinforcement learning and decision making, which together make individuals vulnerable to developing substance use disorders in adulthood. Previously we have used a preclinical model of voluntary alcohol intake in rats to show that use in adolescence promotes risky decision making in adulthood that is mirrored by selective perturbations in dopamine network dynamics. Further, we have demonstrated that incentive learning processes in adulthood are also altered by adolescent alcohol use, again mirrored by changes in cue-evoked dopamine signaling. Indeed, we have proposed that these two processes, risk-based decision making and incentive learning, are fundamentally linked through dysfunction of midbrain circuitry where inputs to the dopamine system are disrupted by adolescent alcohol use. Here, we test the behavioral predictions of this model in rats and present the findings in the context of the prevailing literature with reference to the long-term consequences of early-life substance use on the vulnerability to develop substance use disorders. We utilize an impulsive choice task to assess the selectivity of alcohol's effect on decision-making profiles and conditioned reinforcement to parse out the effect of incentive value attribution, one mechanism of incentive learning. Finally, we use the differential reinforcement of low rates of responding (DRL) task to examine the degree to which behavioral disinhibition may contribute to an overall decision-making profile. The findings presented here support the proposition that early life alcohol use selectively alters risk-based choice behavior through modulation of incentive learning processes, both of which may be inexorably linked through perturbations in mesolimbic circuitry and may serve as fundamental vulnerabilities to the development of substance use disorders.

Maladaptive Decision Making in Adults with a History of Adolescent Alcohol use, in a Preclinical Model, Is Attributable to the Compromised Assignment of Incentive Value during Stimulus-Reward Learning

PubMed Central

Kruse, Lauren C.; Schindler, Abigail G.; Williams, Rapheal G.; Weber, Sophia J.; Clark, Jeremy J.

2017-01-01

According to recent WHO reports, alcohol remains the number one substance used and abused by adolescents, despite public health efforts to curb its use. Adolescence is a critical period of biological maturation where brain development, particularly the mesocorticolimbic dopamine system, undergoes substantial remodeling. These circuits are implicated in complex decision making, incentive learning and reinforcement during substance use and abuse. An appealing theoretical approach has been to suggest that alcohol alters the normal development of these processes to promote deficits in reinforcement learning and decision making, which together make individuals vulnerable to developing substance use disorders in adulthood. Previously we have used a preclinical model of voluntary alcohol intake in rats to show that use in adolescence promotes risky decision making in adulthood that is mirrored by selective perturbations in dopamine network dynamics. Further, we have demonstrated that incentive learning processes in adulthood are also altered by adolescent alcohol use, again mirrored by changes in cue-evoked dopamine signaling. Indeed, we have proposed that these two processes, risk-based decision making and incentive learning, are fundamentally linked through dysfunction of midbrain circuitry where inputs to the dopamine system are disrupted by adolescent alcohol use. Here, we test the behavioral predictions of this model in rats and present the findings in the context of the prevailing literature with reference to the long-term consequences of early-life substance use on the vulnerability to develop substance use disorders. We utilize an impulsive choice task to assess the selectivity of alcohol’s effect on decision-making profiles and conditioned reinforcement to parse out the effect of incentive value attribution, one mechanism of incentive learning. Finally, we use the differential reinforcement of low rates of responding (DRL) task to examine the degree to which behavioral disinhibition may contribute to an overall decision-making profile. The findings presented here support the proposition that early life alcohol use selectively alters risk-based choice behavior through modulation of incentive learning processes, both of which may be inexorably linked through perturbations in mesolimbic circuitry and may serve as fundamental vulnerabilities to the development of substance use disorders. PMID:28790900

A Comparison of Juror Decision Making in Race-Based and Sexual Orientation-Based Hate Crime Cases.

PubMed

Gamblin, Bradlee W; Kehn, Andre; Vanderzanden, Karen; Ruthig, Joelle C; Jones, Kelly M; Long, Brittney L

2018-05-01

Several constructs have been identified as relevant to the juror decision-making process in hate crime cases. However, there is a lack of research on the relationships between these constructs and their variable influence across victim group. The purpose of the current study was to reexamine factors relevant to the juror decision-making process in hate crime cases within a structural model, and across victim group, to gauge the relative strength and explanatory power of various predictors. In the current study, 313 participants sentenced a perpetrator found guilty of a hate crime committed against either a Black man or a gay man; participants also responded to individual difference measures relevant to mock juror hate crime decision making, including prejudice toward the victim's social group. Using path analysis, we explored the role of juror prejudice on sentencing decisions in hate crime cases as well as similarities and differences based on the victimized group. Results indicated that, when the victim was a Black man, modern racism influenced sentencing both directly and indirectly through perpetrator blame attributions, explaining 18% of the variance in sentencing. In contrast, when the victim was a gay man, modern homophobia did not directly predict sentencing, and the overall model explained only 4% of the variance in sentencing, suggesting variables beyond juror prejudice may be better suited to explain juror decision making in sexual orientation-based hate crimes. The current study suggests that the role of juror prejudice in hate crime cases varies as a function of the victimized group and raises questions about the importance of juror prejudice in the sentencing of hate crime cases, particularly antigay prejudice. The importance of blame attributions, social dominance orientation, and juror beliefs regarding penalty enhancements for hate crime cases, as well as policy implications, are also addressed.

Effects of Information Visualization on Older Adults’ Decision-Making Performance in a Medicare Plan Selection Task: A Comparative Usability Study

PubMed Central

Price, Margaux M; Crumley-Branyon, Jessica J; Leidheiser, William R

2016-01-01

Background Technology gains have improved tools for evaluating complex tasks by providing environmental supports (ES) that increase ease of use and improve performance outcomes through the use of information visualizations (info-vis). Complex info-vis emphasize the need to understand individual differences in abilities of target users, the key cognitive abilities needed to execute a decision task, and the graphical elements that can serve as the most effective ES. Older adults may be one such target user group that would benefit from increased ES to mitigate specific declines in cognitive abilities. For example, choosing a prescription drug plan is a necessary and complex task that can impact quality of life if the wrong choice is made. The decision to enroll in one plan over another can involve comparing over 15 plans across many categories. Within this context, the large amount of complex information and reduced working memory capacity puts older adults’ decision making at a disadvantage. An intentionally designed ES, such as an info-vis that reduces working memory demand, may assist older adults in making the most effective decision among many options. Objective The objective of this study is to examine whether the use of an info-vis can lower working memory demands and positively affect complex decision-making performance of older adults in the context of choosing a Medicare prescription drug plan. Methods Participants performed a computerized decision-making task in the context of finding the best health care plan. Data included quantitative decision-making performance indicators and surveys examining previous history with purchasing insurance. Participants used a colored info-vis ES or a table (no ES) to perform the decision task. Task difficulty was manipulated by increasing the number of selection criteria used to make an accurate decision. A repeated measures analysis was performed to examine differences between the two table designs. Results Twenty-three older adults between the ages of 66 and 80 completed the study. There was a main effect for accuracy such that older adults made more accurate decisions in the color info-vis condition than the table condition. In the low difficulty condition, participants were more successful at choosing the correct answer when the question was about the gap coverage attribute in the info-vis condition. Participants also made significantly faster decisions in the info-vis condition than in the table condition. Conclusions Reducing the working memory demand of the task through the use of an ES can improve decision accuracy, especially when selection criteria is only focused on a single attribute of the insurance plan. PMID:27251110

A rough set approach for determining weights of decision makers in group decision making

PubMed Central

Yang, Qiang; Du, Ping-an; Wang, Yong; Liang, Bin

2017-01-01

This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs’ decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member’ decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs’ evaluations and selections. PMID:28234974

"Watching time tick by…": Decision making for Duchenne muscular dystrophy trials.

PubMed

Peay, Holly L; Scharff, Hadar; Tibben, Aad; Wilfond, Benjamin; Bowie, Janice; Johnson, Joanna; Nagaraju, Kanneboyina; Escolar, Diana; Piacentino, Jonathan; Biesecker, Barbara B

2016-01-01

This interview study explored clinicians' perspectives and parents' decision making about children's participation in Duchenne muscular dystrophy (DMD) clinical trials. Data from semi-structured interviews conducted with clinicians and parents in U.S. or Canada were assessed using thematic analysis. Eleven clinicians involved in ten trials and fifteen parents involved in six trials were interviewed. Parents described benefit-risk assessments using information from advocacy, peers, professionals, and sponsors. Strong influence was attributed to the progressive nature of DMD. Most expected direct benefit. Few considered the possibility of trial failure. Most made decisions to participate before the informed consent (IC) process, but none-the-less perceived informed choice with little to lose for potential gain. Clinicians described more influence on parental decisions than attributed by parents. Clinicians felt responsible to facilitate IC while maintaining hope. Both clinicians and parents reported criticisms about the IC process and regulatory barriers. The majority of parents described undertaking benefit-risk assessments that led to informed choices that offered psychological and potential disease benefits. Parents' high expectations influenced their decisions while also reflecting optimism. Clinicians felt challenged in balancing parents' expectations and likely outcomes. Prognosis-related pressures coupled with decision making prior to IC suggest an obligation to ensure educational materials are understandable and accurate, and to consider an expanded notion of IC timeframes. Anticipatory guidance about potential trial failure might facilitate parents' deliberations while aiding clinicians in moderating overly-optimistic motivations. Regulators and industry should appreciate special challenges in progressive disorders, where doing nothing was equated with doing harm. Copyright © 2015 Elsevier Inc. All rights reserved.

Value-Based Assessment of New Medical Technologies: Towards a Robust Methodological Framework for the Application of Multiple Criteria Decision Analysis in the Context of Health Technology Assessment.

PubMed

Angelis, Aris; Kanavos, Panos

2016-05-01

In recent years, multiple criteria decision analysis (MCDA) has emerged as a likely alternative to address shortcomings in health technology assessment (HTA) by offering a more holistic perspective to value assessment and acting as an alternative priority setting tool. In this paper, we argue that MCDA needs to subscribe to robust methodological processes related to the selection of objectives, criteria and attributes in order to be meaningful in the context of healthcare decision making and fulfil its role in value-based assessment (VBA). We propose a methodological process, based on multi-attribute value theory (MAVT) methods comprising five distinct phases, outline the stages involved in each phase and discuss their relevance in the HTA process. Importantly, criteria and attributes need to satisfy a set of desired properties, otherwise the outcome of the analysis can produce spurious results and misleading recommendations. Assuming the methodological process we propose is adhered to, the application of MCDA presents three very distinct advantages to decision makers in the context of HTA and VBA: first, it acts as an instrument for eliciting preferences on the performance of alternative options across a wider set of explicit criteria, leading to a more complete assessment of value; second, it allows the elicitation of preferences across the criteria themselves to reflect differences in their relative importance; and, third, the entire process of preference elicitation can be informed by direct stakeholder engagement, and can therefore reflect their own preferences. All features are fully transparent and facilitate decision making.

Decision precision or holistic heuristic?: Insights on on-site selection of student nurses and midwives.

PubMed

Macduff, Colin; Stephen, Audrey; Taylor, Ruth

2016-01-01

Concerns about quality of care delivery in the UK have led to more scrutiny of criteria and methods for the selection of student nurses. However few substantive research studies of on-site selection processes exist. This study elicited and interpreted perspectives on interviewing processes and related decision making involved in on-site selection of student nurses and midwives. Individual and focus group interviews were undertaken with 36 lecturers, 5 clinical staff and 72 students from seven Scottish universities. Enquiry focused primarily on interviewing of candidates on-site. Qualitative content analysis was used as a primary strategy, followed by in-depth thematic analysis. Students had very mixed experiences of interview processes. Staff typically took into account a range of candidate attributes that they valued in order to achieve holistic assessments. These included: interpersonal skills, team working, confidence, problem-solving, aptitude for caring, motivations, and commitment. Staff had mixed views of the validity and reliability of interview processes. A holistic heuristic for overall decision making predominated over belief in the precision of, and evidence base for, particular attribute measurement processes. While the development of measurement tools for particular attributes continues apace, tension between holism and precision is likely to persist within on-site selection procedures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Eliciting preferences for medical devices in South Korea: A discrete choice experiment.

PubMed

Lee, Hye-Jae; Bae, Eun-Young

2017-03-01

This study aims to identify the attributes that contribute to the value of medical devices and quantify the relative importance of them using a discrete choice experiment. Based on a literature review and expert consultation, seven attributes and their levels were identified-severity of disease (2), availability of substitutes (2), improvement in procedure (3), improvement in clinical outcomes (2), increase in survival (2), improvement in quality of life (3), and cost (4). Among 576 hypothetical profiles, optimal choice sets with 20 choices were developed and experts experienced in health technology assessment and reimbursement decision making in South Korea were surveyed. A total of 102 respondents participated in the survey. The results of the random-effect probit model showed that among the seven attributes, six, except for improvement in procedure, had a significant impact on respondents' choices on medical devices. Respondents were willing to pay the highest amount for devices that provided substantial improvements in quality of life, followed by increased survival, improved clinical outcome, treatment without substitutes, and technology for treating severe diseases. The findings of this experiment will inform decision-makers of the relative importance of the criteria and help them in reimbursement decision making of medical devices. Copyright © 2017 Elsevier B.V. All rights reserved.

Congruence between Preferred and Actual Participation Roles Increases Satisfaction with Treatment Decision Making among Japanese Women with Breast Cancer

PubMed

Yamauchi, Keiko; Nakao, Motoyuki; Nakashima, Mitsuyo; Ishihara, Yoko

2017-04-01

Objective: This study investigated the correlation between participation in the treatment decision-making process and satisfaction with the process among Japanese women with breast cancer. The influence of sociodemographic and clinical characteristics on satisfaction with the treatment decision-making process was also examined. Methods: We conducted a cross-sectional, self-administered internet survey of 650 Japanese women with breast cancer in March 2016. Decisional role (active, collaborative, passive) in the treatment decision-making was elicited using the Japanese version of the Control Preference Scale. Satisfaction with the decision-making process was assessed. Result: About half of the participants preferred to play a collaborative role, while half of the participants perceived that they played an active role. Satisfaction among the participants who made their treatment choice collaboratively with their physicians was significantly higher than that of participants who made the choice by themselves or entrusted their physicians to make the decision. However, two-way ANOVA demonstrated that satisfaction level was associated with the congruence between the participants’ preferred and actual decisional roles, but not with the actual decisional roles that they played. This association had no interaction with sociodemographic and clinical status, except for education level. A majority of the participants who participated in the roles they preferred in choosing their treatment option indicated that they would participate in the same role if they were to face a similar decision-making situation in the future. Conclusion: Regardless of their role played in the cancer treatment decision-making process, and irrespective of their sociodemographic and clinical status, Japanese women with breast cancer are more satisfied with the treatment decision-making process when their participation in the process matches their preferred role in the process. Creative Commons Attribution License

Stressing The Person: Legal and Everyday Person Attributions Under Stress

PubMed Central

Kubota, Jennifer T.; Mojdehbakhsh, Rachel; Raio, Candace; Brosch, Tobias; Uleman, Jim S.; Phelps, Elizabeth A.

2014-01-01

When determining the cause of a person’s behavior, perceivers often overweigh dispositional explanations and underweigh situational explanations, an error known as the Fundamental Attribution Error (FAE). The FAE occurs in part because dispositional explanations are relatively automatic, whereas considering the situation requires additional cognitive effort. Stress is known to impair the prefrontal cortex and executive functions important for the attribution process. We investigated if stress increases dispositional attributions in common place and legal situations. Experiencing a physiological stressor increased participants’ cortisol, dispositional attributions of common everyday behaviors, and negative evaluations. When determining whether a crime was due to the defendant’s disposition or the mitigating situation, self-reported stress correlated with increased dispositional judgments of defendant’s behavior. These findings indicate that stress may makes people more likely to commit the FAE and less favorable in their evaluations of others both in daily life and when making socially consequential judicial decisions. PMID:25175000

Intelligent data management for real-time spacecraft monitoring

NASA Technical Reports Server (NTRS)

Schwuttke, Ursula M.; Gasser, Les; Abramson, Bruce

1992-01-01

Real-time AI systems have begun to address the challenge of restructuring problem solving to meet real-time constraints by making key trade-offs that pursue less than optimal strategies with minimal impact on system goals. Several approaches for adapting to dynamic changes in system operating conditions are known. However, simultaneously adapting system decision criteria in a principled way has been difficult. Towards this end, a general technique for dynamically making such trade-offs using a combination of decision theory and domain knowledge has been developed. Multi-attribute utility theory (MAUT), a decision theoretic approach for making one-time decisions is discussed and dynamic trade-off evaluation is described as a knowledge-based extension of MAUT that is suitable for highly dynamic real-time environments, and provides an example of dynamic trade-off evaluation applied to a specific data management trade-off in a real-world spacecraft monitoring application.

Self-Stigma and Consumer Participation in Shared Decision Making in Mental Health Services.

PubMed

Hamann, Johannes; Bühner, Markus; Rüsch, Nicolas

2017-08-01

People with mental illness struggle with symptoms and with public stigma. Some accept common prejudices and lose self-esteem, resulting in shame and self-stigma, which may affect their interactions with mental health professionals. This study explored whether self-stigma and shame are associated with consumers' preferences for participation in medical decision making and their behavior in psychiatric consultations. In a cross-sectional study conducted in Germany, 329 individuals with a diagnosis of a schizophrenia spectrum disorder or an affective disorder and their psychiatrists provided sociodemographic and illness-related information. Self-stigma, shame, locus of control, and views about clinical decision making were assessed by self-report. Psychiatrists rated their impression of the decision-making behavior of consumers. Regression analyses and structural equation modeling were used to determine the association of self-stigma and shame with clinical decision making. Self-stigma was not related to consumers' participation preferences, but it was associated with some aspects of communicative behavior. Active and critical behavior (for example, expressing views, daring to challenge the doctor's opinion, and openly speaking out about disagreements with the doctor) was associated with less shame, less self-stigma, more self-responsibility, less attribution of external control to powerful others, and more years of education. Self-stigma and shame were associated with less participative and critical behavior, which probably leads to clinical encounters that involve less shared decision making and more paternalistic decision making. Paternalistic decision making may reinforce self-stigma and lead to poorer health outcomes. Therefore, interventions that reduce self-stigma and increase consumers' critical and participative communication may improve health outcomes.

Naturalistic Decision Making for Power System Operators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greitzer, Frank L.; Podmore, Robin; Robinson, Marck

2010-02-01

Motivation – Investigations of large-scale outages in the North American interconnected electric system often attribute the causes to three T’s: Trees, Training and Tools. To document and understand the mental processes used by expert operators when making critical decisions, a naturalistic decision making (NDM) model was developed. Transcripts of conversations were analyzed to reveal and assess NDM-based performance criteria. Findings/Design – An item analysis indicated that the operators’ Situation Awareness Levels, mental models, and mental simulations can be mapped at different points in the training scenario. This may identify improved training methods or analytical/ visualization tools. Originality/Value – This studymore » applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message – The NDM approach provides a viable framework for systematic training management to accelerate learning in simulator-based training scenarios for power system operators and teams.« less

Decision-making in female fertility preservation is balancing the expected burden of fertility preservation treatment and the wish to conceive.

PubMed

Baysal, Ö; Bastings, L; Beerendonk, C C M; Postma, S A E; IntHout, J; Verhaak, C M; Braat, D D M; Nelen, W L D M

2015-07-01

What are the decisive factors in fertility preservation (FP) decision-making in young women scheduled for gonadotoxic therapy? FP decision-making in young women scheduled for gonadotoxic therapy is mainly based on weighing two issues: the intensity of the wish to conceive a child in the future and the expected burden of undergoing FP treatment. Future fertility is of importance for young cancer patients whose reproductive function is being threatened by oncological therapy. To prevent or reduce severe psychological effects of infertility as well as feelings of regret about their FP decision after cancer treatment, the quality of fertility preservation counselling (FPC) should be improved. To improve care, those issues forming a decisive factor in FP decision-making for patients should be clarified, as these issues deserve extensive discussion during FPC. Until now, decisive factors have not been isolated from the complex interplay of all aspects of FP that women contemplate during FP decision-making. By using a mixed methods methodology, a questionnaire developed after qualitative research involving a selected group of five women who previously received FPC was retrospectively sent to eligible patients (n = 143) who had received FPC (1999 - July 2013) and to whom at least one FP option was offered. Patients had received FPC at a university hospital in the Netherlands, in a setting where financial factors do not play a role in FP. They were aged ≥16 years and were scheduled for gonadotoxic treatment. The relationship between patients' baseline characteristics, their attributed importance to 28 relevant importance items and their FP choices was investigated. After five interviews, 28 importance items for FP decision-making were identified and included in our questionnaire. Of these 28 importance items, 24 items could be clustered into seven importance themes. A total of 87 patients (61%) responded to our questionnaire. After performing a multivariable logistic regression analysis, proceeding with FP was related to higher attributed importance during FP decision-making to the theme 'Wish to conceive (in the future)' (odds ratio (OR) 10.8, 95% confidence interval (CI) 3.5-34.4) and the item 'Having a stable partner relationship' (OR 2.0, 95% CI 1.0-4.1), while higher attributed importance to the theme 'Expected burden of FP' during FP decision-making (OR 0.08, 95% CI 0.02-0.3) more often resulted in refraining from treatment. Besides possible recall and selection bias, the fact that this study was performed in Dutch patients aged ≥16 years counselled in a single centre, where finance was not an additional consideration, possibly limits the generalizability of our results to a broader European population of cancer patients. Furthermore, we are not able to draw conclusions about the causality of the associations observed in our study. The wish to conceive and the expected burden of FP treatment should be discussed carefully with patients during FP decision-making, either by the referring healthcare provider or by reproductive medicine specialist. Prospective research is needed to explore the causality of the associations found in this study. Furthermore, in order to deliver high quality patient-centred care, the development of tools to explore patients' wish to conceive (for example in different age categories) and tools to provide clear information about the burden of FP treatments (using the preferred information channels suggested by patients) is needed. This work was supported by the Radboud Institute for Health Sciences (research school affiliated to the Radboud university medical center). The authors have declared no conflicts of interest with respect to this work. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Influence of Lived Experience with Addiction and Recovery on Practice-Related Decisions among Professionals Working in Addiction Agencies Serving Women

ERIC Educational Resources Information Center

Novotna, Gabriela; Dobbins, Maureen; Jack, Susan M.; Sword, Wendy; Niccols, Alison; Brooks, Sandy; Henderson, Joanna

2013-01-01

Aims: The study objectives were to: (1) understand the value attributed to the lived experience of addiction and recovery among professionals working in addiction agencies serving women in Canada and (2) describe how lived experience influence practice-related decision-making. Methods: A descriptive qualitative study was conducted with a…

Bad Luck or Bad Decisions: College Students' Perceptions of the Reasons for and Consequences of Their Alcohol Overdose

ERIC Educational Resources Information Center

Reis, Janet

2007-01-01

Reasons for and immediate consequences of an alcohol overdose were explored for 217 undergraduate students requiring a medical emergency transport because of excessive alcohol consumption. The sample was categorized into 26 students attributing their overdose solely to bad luck and 191 students citing bad decision making as an explanation. A…

Eye Movements in Risky Choice

PubMed Central

Hermens, Frouke; Matthews, William J.

2015-01-01

Abstract We asked participants to make simple risky choices while we recorded their eye movements. We built a complete statistical model of the eye movements and found very little systematic variation in eye movements over the time course of a choice or across the different choices. The only exceptions were finding more (of the same) eye movements when choice options were similar, and an emerging gaze bias in which people looked more at the gamble they ultimately chose. These findings are inconsistent with prospect theory, the priority heuristic, or decision field theory. However, the eye movements made during a choice have a large relationship with the final choice, and this is mostly independent from the contribution of the actual attribute values in the choice options. That is, eye movements tell us not just about the processing of attribute values but also are independently associated with choice. The pattern is simple—people choose the gamble they look at more often, independently of the actual numbers they see—and this pattern is simpler than predicted by decision field theory, decision by sampling, and the parallel constraint satisfaction model. © 2015 The Authors. Journal of Behavioral Decision Making published by John Wiley & Sons Ltd. PMID:27522985

Adaptive management in the U.S. National Wildlife Refuge System: Science-management partnerships for conservation delivery

USGS Publications Warehouse

Moore, C.T.; Lonsdorf, E.V.; Knutson, M.G.; Laskowski, H.P.; Lor, S.K.

2011-01-01

Adaptive management is an approach to recurrent decision making in which uncertainty about the decision is reduced over time through comparison of outcomes predicted by competing models against observed values of those outcomes. The National Wildlife Refuge System (NWRS) of the U.S. Fish and Wildlife Service is a large land management program charged with making natural resource management decisions, which often are made under considerable uncertainty, severe operational constraints, and conditions that limit ability to precisely carry out actions as intended. The NWRS presents outstanding opportunities for the application of adaptive management, but also difficult challenges. We describe two cooperative programs between the Fish and Wildlife Service and the U.S. Geological Survey to implement adaptive management at scales ranging from small, single refuge applications to large, multi-refuge, multi-region projects. Our experience to date suggests three important attributes common to successful implementation: a vigorous multi-partner collaboration, practical and informative decision framework components, and a sustained commitment to the process. Administrators in both agencies should consider these attributes when developing programs to promote the use and acceptance of adaptive management in the NWRS. ?? 2010 .

Family physicians' beliefs about genetic contributions to racial/ethnic and gender differences in health and clinical decision-making.

PubMed

Warshauer-Baker, Esther; Bonham, Vence L; Jenkins, Jean; Stevens, Nancy; Page, Zintesia; Odunlami, Adebola; McBride, Colleen M

2008-01-01

Greater attention towards genetics as a contributor to group health differences may lead to inappropriate use of race/ethnicity and gender as genetic heuristics and exacerbate health disparities. As part of a web-based survey, 1,035 family physicians (FPs) rated the contribution of genetics and environment to racial/ethnic and gender differences in health outcomes, and the importance of race/ethnicity and gender in their clinical decision-making. FPs attributed racial/ethnic and gender differences in health outcomes equally to environment and genetics. These beliefs were not associated with rated importance of race/ethnicity or gender in clinical decision-making. FPs appreciate the complexity of genetic and environmental influences on health differences by race/ethnicity and gender. Copyright 2008 S. Karger AG, Basel.

Comparing Selections of Environmental Variables for Ecological Studies: A Focus on Terrain Attributes.

PubMed

Lecours, Vincent; Brown, Craig J; Devillers, Rodolphe; Lucieer, Vanessa L; Edinger, Evan N

2016-01-01

Selecting appropriate environmental variables is a key step in ecology. Terrain attributes (e.g. slope, rugosity) are routinely used as abiotic surrogates of species distribution and to produce habitat maps that can be used in decision-making for conservation or management. Selecting appropriate terrain attributes for ecological studies may be a challenging process that can lead users to select a subjective, potentially sub-optimal combination of attributes for their applications. The objective of this paper is to assess the impacts of subjectively selecting terrain attributes for ecological applications by comparing the performance of different combinations of terrain attributes in the production of habitat maps and species distribution models. Seven different selections of terrain attributes, alone or in combination with other environmental variables, were used to map benthic habitats of German Bank (off Nova Scotia, Canada). 29 maps of potential habitats based on unsupervised classifications of biophysical characteristics of German Bank were produced, and 29 species distribution models of sea scallops were generated using MaxEnt. The performances of the 58 maps were quantified and compared to evaluate the effectiveness of the various combinations of environmental variables. One of the combinations of terrain attributes-recommended in a related study and that includes a measure of relative position, slope, two measures of orientation, topographic mean and a measure of rugosity-yielded better results than the other selections for both methodologies, confirming that they together best describe terrain properties. Important differences in performance (up to 47% in accuracy measurement) and spatial outputs (up to 58% in spatial distribution of habitats) highlighted the importance of carefully selecting variables for ecological applications. This paper demonstrates that making a subjective choice of variables may reduce map accuracy and produce maps that do not adequately represent habitats and species distributions, thus having important implications when these maps are used for decision-making.

Medical decision-making and the patient: understanding preference patterns for growth hormone therapy using conjoint analysis.

PubMed

Singh, J; Cuttler, L; Shin, M; Silvers, J B; Neuhauser, D

1998-08-01

This study examines two questions that relate to patients' role in medical decision making: (1) Do patients utilize multiple attributes in evaluating different treatment options?, and (2) Do patient treatment preferences evidence heterogeneity and disparate patterns? Although research has examined these questions by using either individual- or aggregate-level approaches, the authors demonstrate an intermediate level approach (ie, relating to patient subgroups). The authors utilize growth augmentation therapy (GAT) as a context for analyzing these questions because GAT reflects a class of nonemergency treatments that (1) are based on genetic technology, (2) aim to improve the quality (rather than quantity) of life, and (3) offer useful insights for the patient's role in medical decision making. Using conjoint analysis, a methodology especially suited for the study of patient-consumer preferences but largely unexplored in the medical field, data were obtained from 154 parents for their decision to pursue GAT for their child. In all, six attributes were utilized to study GAT, including risk of long-term side effects (1:10,000 or 1:100,000), certainty of effect (50% or 100% of cases), amount of effect (1-2 inches or 4-5 inches in adult height), out-of-pocket cost ($100, $2,000, or $10,000/year) and child's attitude (likes or not likes therapy). An experimental design using conjoint analysis procedures revealed five preference patterns that reflect clear disparities in the importance that parents attach to the different attributes of growth therapy. These preference patterns are (1) child-focused (23%), (2) risk-conscious (36%), (3) balanced (23%), (4) cost-conscious (14%), and (5) ease-of-use (4%) oriented. Additional tests provided evidence for the validity of these preference patterns. Finally, this preference heterogeneity related systematically to parental characteristics (eg, demographic, psychologic). The study results offer additional insights into medical decision making with the consumer as the focal point and extend previous work that has tended to emphasize either an individual- or aggregate-based analysis. Implications for researchers and health care delivery in general and growth hormone management in particular are provided.

Empirical Evaluation of a Decision-Analytic Aid.

DTIC Science & Technology

1980-05-01

scenarios may be attributable to the use of the Baye- sian revision model by the latter group . In the A scenarios, as well as in the NA scenarios, aided...inten- tions and to make a decision by recommending one of four prespecified courses of action. The use of the aiding package significantly increased...courses of action. The use of the aiding package significantly in- I creased the number of correct decisions under the attack version of the scenarios

A Fuzzy Rule Based Decision Support System for Identifying Location of Water Harvesting Technologies in Rainfed Agricultural Regions

NASA Astrophysics Data System (ADS)

Chaubey, I.; Vema, V. K.; Sudheer, K.

2016-12-01

Site suitability evaluation of water conservation structures in water scarce rainfed agricultural areas consist of assessment of various landscape characteristics and various criterion. Many of these landscape characteristic attributes are conveyed through linguistic terms rather than precise numeric values. Fuzzy rule based system are capable of incorporating uncertainty and vagueness, when various decision making criteria expressed in linguistic terms are expressed as fuzzy rules. In this study a fuzzy rule based decision support system is developed, for optimal site selection of water harvesting technologies. Water conservation technologies like farm ponds, Check dams, Rock filled dams and percolation ponds aid in conserving water for irrigation and recharging aquifers and development of such a system will aid in improving the efficiency of the structures. Attributes and criteria involved in decision making are classified into different groups to estimate the suitability of the particular technology. The developed model is applied and tested on an Indian watershed. The input attributes are prepared in raster format in ArcGIS software and suitability of each raster cell is calculated and output is generated in the form of a thematic map showing the suitability of the cells pertaining to different technologies. The output of the developed model is compared against the already existing structures and results are satisfactory. This developed model will aid in improving the sustainability and efficiency of the watershed management programs aimed at enhancing in situ moisture content.

MAGDM linear-programming models with distinct uncertain preference structures.

PubMed

Xu, Zeshui S; Chen, Jian

2008-10-01

Group decision making with preference information on alternatives is an interesting and important research topic which has been receiving more and more attention in recent years. The purpose of this paper is to investigate multiple-attribute group decision-making (MAGDM) problems with distinct uncertain preference structures. We develop some linear-programming models for dealing with the MAGDM problems, where the information about attribute weights is incomplete, and the decision makers have their preferences on alternatives. The provided preference information can be represented in the following three distinct uncertain preference structures: 1) interval utility values; 2) interval fuzzy preference relations; and 3) interval multiplicative preference relations. We first establish some linear-programming models based on decision matrix and each of the distinct uncertain preference structures and, then, develop some linear-programming models to integrate all three structures of subjective uncertain preference information provided by the decision makers and the objective information depicted in the decision matrix. Furthermore, we propose a simple and straightforward approach in ranking and selecting the given alternatives. It is worth pointing out that the developed models can also be used to deal with the situations where the three distinct uncertain preference structures are reduced to the traditional ones, i.e., utility values, fuzzy preference relations, and multiplicative preference relations. Finally, we use a practical example to illustrate in detail the calculation process of the developed approach.

Evidence-based Sensor Tasking for Space Domain Awareness

NASA Astrophysics Data System (ADS)

Jaunzemis, A.; Holzinger, M.; Jah, M.

2016-09-01

Space Domain Awareness (SDA) is the actionable knowledge required to predict, avoid, deter, operate through, recover from, and/or attribute cause to the loss and/or degradation of space capabilities and services. A main purpose for SDA is to provide decision-making processes with a quantifiable and timely body of evidence of behavior(s) attributable to specific space threats and/or hazards. To fulfill the promise of SDA, it is necessary for decision makers and analysts to pose specific hypotheses that may be supported or refuted by evidence, some of which may only be collected using sensor networks. While Bayesian inference may support some of these decision making needs, it does not adequately capture ambiguity in supporting evidence; i.e., it struggles to rigorously quantify 'known unknowns' for decision makers. Over the past 40 years, evidential reasoning approaches such as Dempster Shafer theory have been developed to address problems with ambiguous bodies of evidence. This paper applies mathematical theories of evidence using Dempster Shafer expert systems to address the following critical issues: 1) How decision makers can pose critical decision criteria as rigorous, testable hypotheses, 2) How to interrogate these hypotheses to reduce ambiguity, and 3) How to task a network of sensors to gather evidence for multiple competing hypotheses. This theory is tested using a simulated sensor tasking scenario balancing search versus track responsibilities.

Cochlear Implant: the complexity involved in the decision making process by the family1

PubMed Central

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention. PMID:25029052

Using Case Studies in Business Education to Promote Networked Thinking: Findings of an Intervention Study

ERIC Educational Resources Information Center

Pilz, Matthias; Zenner, Lea

2018-01-01

Case studies are central to the way management is currently taught at universities. Among other benefits attributed to the case study method is that it promotes networked thinking by learners. Networked thinking takes account of interactions and repercussions, making it crucial to decision-making within the complex system of rules that shapes…

Helicopter simulation: Making it work

NASA Technical Reports Server (NTRS)

Payne, Barry

1992-01-01

The opportunities for improved training and checking by using helicopter simulators are greater than they are for airplane pilot training. Simulators permit the safe creation of training environments that are conducive to the development of pilot decision-making, situational awareness, and cockpit management. This paper defines specific attributes required in a simulator to meet a typical helicopter operator's training and checking objectives.

A novel design process for selection of attributes for inclusion in discrete choice experiments: case study exploring variation in clinical decision-making about thrombolysis in the treatment of acute ischaemic stroke.

PubMed

De Brún, Aoife; Flynn, Darren; Ternent, Laura; Price, Christopher I; Rodgers, Helen; Ford, Gary A; Rudd, Matthew; Lancsar, Emily; Simpson, Stephen; Teah, John; Thomson, Richard G

2018-06-22

A discrete choice experiment (DCE) is a method used to elicit participants' preferences and the relative importance of different attributes and levels within a decision-making process. DCEs have become popular in healthcare; however, approaches to identify the attributes/levels influencing a decision of interest and to selection methods for their inclusion in a DCE are under-reported. Our objectives were: to explore the development process used to select/present attributes/levels from the identified range that may be influential; to describe a systematic and rigorous development process for design of a DCE in the context of thrombolytic therapy for acute stroke; and, to discuss the advantages of our five-stage approach to enhance current guidance for developing DCEs. A five-stage DCE development process was undertaken. Methods employed included literature review, qualitative analysis of interview and ethnographic data, expert panel discussions, a quantitative structured prioritisation (ranking) exercise and pilot testing of the DCE using a 'think aloud' approach. The five-stage process reported helped to reduce the list of 22 initial patient-related factors to a final set of nine variable factors and six fixed factors for inclusion in a testable DCE using a vignette model of presentation. In order for the data and conclusions generated by DCEs to be deemed valid, it is crucial that the methods of design and development are documented and reported. This paper has detailed a rigorous and systematic approach to DCE development which may be useful to researchers seeking to establish methods for reducing and prioritising attributes for inclusion in future DCEs.

Improved hybridization of Fuzzy Analytic Hierarchy Process (FAHP) algorithm with Fuzzy Multiple Attribute Decision Making - Simple Additive Weighting (FMADM-SAW)

NASA Astrophysics Data System (ADS)

Zaiwani, B. E.; Zarlis, M.; Efendi, S.

2018-03-01

In this research, the improvement of hybridization algorithm of Fuzzy Analytic Hierarchy Process (FAHP) with Fuzzy Technique for Order Preference by Similarity to Ideal Solution (FTOPSIS) in selecting the best bank chief inspector based on several qualitative and quantitative criteria with various priorities. To improve the performance of the above research, FAHP algorithm hybridization with Fuzzy Multiple Attribute Decision Making - Simple Additive Weighting (FMADM-SAW) algorithm was adopted, which applied FAHP algorithm to the weighting process and SAW for the ranking process to determine the promotion of employee at a government institution. The result of improvement of the average value of Efficiency Rate (ER) is 85.24%, which means that this research has succeeded in improving the previous research that is equal to 77.82%. Keywords: Ranking and Selection, Fuzzy AHP, Fuzzy TOPSIS, FMADM-SAW.

A Temporal Mining Framework for Classifying Un-Evenly Spaced Clinical Data: An Approach for Building Effective Clinical Decision-Making System.

PubMed

Jane, Nancy Yesudhas; Nehemiah, Khanna Harichandran; Arputharaj, Kannan

2016-01-01

Clinical time-series data acquired from electronic health records (EHR) are liable to temporal complexities such as irregular observations, missing values and time constrained attributes that make the knowledge discovery process challenging. This paper presents a temporal rough set induced neuro-fuzzy (TRiNF) mining framework that handles these complexities and builds an effective clinical decision-making system. TRiNF provides two functionalities namely temporal data acquisition (TDA) and temporal classification. In TDA, a time-series forecasting model is constructed by adopting an improved double exponential smoothing method. The forecasting model is used in missing value imputation and temporal pattern extraction. The relevant attributes are selected using a temporal pattern based rough set approach. In temporal classification, a classification model is built with the selected attributes using a temporal pattern induced neuro-fuzzy classifier. For experimentation, this work uses two clinical time series dataset of hepatitis and thrombosis patients. The experimental result shows that with the proposed TRiNF framework, there is a significant reduction in the error rate, thereby obtaining the classification accuracy on an average of 92.59% for hepatitis and 91.69% for thrombosis dataset. The obtained classification results prove the efficiency of the proposed framework in terms of its improved classification accuracy.

A correlational study between signature, writing abilities and decision-making capacity among people with initial cognitive impairment.

PubMed

Renier, M; Gnoato, F; Tessari, A; Formilan, M; Busonera, F; Albanese, P; Sartori, G; Cester, A

2016-06-01

Some clinical conditions, including dementia, compromise cognitive functions involved in decision-making processes, with repercussions on the ability to subscribe a will. Because of the increasing number of aged people with cognitive impairment there is an acute and growing need for decision-making capacity evidence-based assessment. Our study investigates the relationship between writing abilities and cognitive integrity to see if it is possible to make inferences on decision-making capacity through handwriting analysis. We also investigated the relationship between signature ability and cognitive integrity. Thirty-six participants with diagnosis of MCI and 38 participants with diagnosis of initial dementia were recruited. For each subject we collected two samples of signature-an actual and a previous one-and an extract of spontaneous writing. Furthermore, we administered a neuropsychological battery to investigate cognitive functions involved in decision-making. We found significant correlations between spontaneous writing indexes and neuropsychological test results. Nonetheless, the index of signature deterioration does not correlate with the level of cognitive decline. Our results suggest that a careful analysis of spontaneous writing can be useful to make inferences on decision-making capacity, whereas great caution should be taken in attributing validity to handwritten signature of subjects with MCI or dementia. The analysis of spontaneous writing can be a reliable aid in cases of retrospective evaluation of cognitive integrity. On the other side, the ability to sign is not an index of cognitive integrity.

Productivity and turnover in PCPs: the role of staff participation in decision-making.

PubMed

Hung, Dorothy Y; Rundall, Thomas G; Cohen, Deborah J; Tallia, Alfred F; Crabtree, Benjamin F

2006-10-01

Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.

Information Search and Decision Making: The Effects of Age and Complexity on Strategy Use

PubMed Central

Queen, Tara L.; Hess, Thomas M.; Ennis, Gilda E.; Dowd, Keith; Grühn, Daniel

2012-01-01

The impact of task complexity on information search strategy and decision quality was examined in a sample of 135 young, middle-aged, and older adults. We were particularly interested in the competing roles of fluid cognitive ability and domain knowledge and experience, with the former being a negative influence and the latter being a positive influence on older adults’ performance. Participants utilized two decision matrices, which varied in complexity, regarding a consumer purchase. Using process tracing software and an algorithm developed to assess decision strategy, we recorded search behavior, strategy selection, and final decision. Contrary to expectations, older adults were not more likely than the younger age groups to engage in information-minimizing search behaviors in response to increases in task complexity. Similarly, adults of all ages used comparable decision strategies and adapted their strategies to the demands of the task. We also examined decision outcomes in relation to participants’ preferences. Overall, it seems that older adults utilize simpler sets of information primarily reflecting the most valued attributes in making their choice. The results of this study suggest that older adults are adaptive in their approach to decision making and this ability may benefit from accrued knowledge and experience. PMID:22663157

The best marketing strategy in aesthetic plastic surgery: evaluating patients' preferences by conjoint analysis.

PubMed

Marsidi, Nick; van den Bergh, Maurice W H M; Luijendijk, Roland W

2014-01-01

To provide the best marketing strategy for a private clinic, knowledge of patients' preferences is essential. In marketing, conjoint analysis has been frequently used to calculate which attributes of a product are most valuable to consumers. This study investigates the relative importance of attributes that influence the selection and decision-making process when choosing an aesthetic private clinic, using conjoint analysis. The following attributes were chosen by the senior author (R.W.L.) and a marketing and communications director after a preselection of 25 randomly selected people: relative cost of the procedure, travel time, experience of the plastic surgeon, size of the clinic, method of referral, and online presentation. The attributes were then divided into levels. Using a random factor conducted by SPSS, 18 different scenarios were created and rated online by 150 potential patients before their potential visit or consultation. The patients could rate these scenarios on a scale from 1 to 7 with respect to the likeliness of visiting the clinic. The most important attribute was experience of the surgeon (35.6 percent), followed by method of referral (21.5 percent), travel time (14.2 percent), cost of procedure (12.9 percent), online presentation (9.7 percent), and size of the clinic (6.1 percent). Six of 16 levels gave a negative influence on the decision making. The authors' study shows that the two most important attributes are the experience of the surgeon and the method of referral and that conjoint analysis is effective in determining patients' preferences. It also shows which levels positively or negatively contribute per attribute.

Clarifying values: an updated review

PubMed Central

2013-01-01

Background Consensus guidelines have recommended that decision aids include a process for helping patients clarify their values. We sought to examine the theoretical and empirical evidence related to the use of values clarification methods in patient decision aids. Methods Building on the International Patient Decision Aid Standards (IPDAS) Collaboration’s 2005 review of values clarification methods in decision aids, we convened a multi-disciplinary expert group to examine key definitions, decision-making process theories, and empirical evidence about the effects of values clarification methods in decision aids. To summarize the current state of theory and evidence about the role of values clarification methods in decision aids, we undertook a process of evidence review and summary. Results Values clarification methods (VCMs) are best defined as methods to help patients think about the desirability of options or attributes of options within a specific decision context, in order to identify which option he/she prefers. Several decision making process theories were identified that can inform the design of values clarification methods, but no single “best” practice for how such methods should be constructed was determined. Our evidence review found that existing VCMs were used for a variety of different decisions, rarely referenced underlying theory for their design, but generally were well described in regard to their development process. Listing the pros and cons of a decision was the most common method used. The 13 trials that compared decision support with or without VCMs reached mixed results: some found that VCMs improved some decision-making processes, while others found no effect. Conclusions Values clarification methods may improve decision-making processes and potentially more distal outcomes. However, the small number of evaluations of VCMs and, where evaluations exist, the heterogeneity in outcome measures makes it difficult to determine their overall effectiveness or the specific characteristics that increase effectiveness. PMID:24625261

A decision aid for men with early stage prostate cancer: theoretical basis and a test by surrogate patients

PubMed Central

Feldman‐Stewart, Deb; Brundage, Michael D.; Van Manen, Lori

2008-01-01

Background We developed a decision aid for patients with curable prostate cancer based on Svenson’s DiffCon Theory of Decision Making. This study was designed to determine if surrogate patients using the aid could understand the information presented, complete all tasks, show evidence of differentiation, and arrive at a preferred treatment choice. Methods Men, at least 50 years old and never diagnosed with prostate cancer, were recruited through local advertisements. Participants were asked to imagine that they were a case‐scenario patient. Then they completed the decision aid interview, which included three components: (i) information presentation, with comprehension questions, (ii) exercises to help identify attributes important to the decision, and (iii) value‐clarification exercises. Results Sixty‐nine men volunteered. They had a mean age of 61.2 (range 50–83) years, 37% had no formal education beyond high school, and 87% were living with a partner. All participants completed all aspects of the interview. They answered an average of 10 comprehension questions each, with a mean of 94.7% correct without a prompt. Each attribute in the information presented was identified by at least one participant as important to his decision. Participants identified a median of five attributes as important (ranges 1–14) at each of three points during the interview; 75% changed at least one important attribute during the interview. Forty‐nine per cent of participants also identified attributes as important that were not included in the presented information. Participants showed a wide range of values in each of seven trade‐off exercises. Eighty‐eight per cent of participants showed evidence of differentiation; 75% had a clear treatment preference by the end of the interview. Conclusions Our decision aid appears to meet its goals for surrogate patients and illustrates the strengths of the DiffCon theory. The ability of the aid to accommodate wide variability, both in information needs and in important attributes, is a particular strength of the decision aid. It now requires testing in patients with prostate cancer. PMID:11703496

Delay, doubt, and decision: how delaying a choice reduces the appeal of (descriptively) normative options.

PubMed

van de Ven, Niels; Gilovich, Thomas; Zeelenberg, Marcel

2010-04-01

To help explain a regularity in democratic elections, we examined whether choosing to delay making a choice between a focal option and an alternative tends to make people subsequently less likely to choose what they would otherwise have chosen. The results of two experiments demonstrated that participants who were induced to delay making a decision were indeed less likely to choose the descriptively normative option. An additional experiment that primed a sense of doubt in participants provided support for a self-perception account of this result. Electing to delay making a choice is interpreted as an indication of doubt--doubt that tends to be attributed to the most prominent option. Delay-induced doubt about the normative option makes it less likely to be selected.

The application of natural science data to land management decision-making

NASA Technical Reports Server (NTRS)

Williams, D. L.; Sharpe, C. P.; Rowe, P. G.

1974-01-01

A natural environmental analysis process which allows the decision maker to know the probable consequences of a decision prior to the act is developed. Emphasis is placed on the fit between the natural environment and the social, economic, and functional attributes of man's communities and the transition from nature in its present state to various forms and intensities of development. Applications of the analysis are examined. It is concluded that the analysis is a workable system for land use management.

The role of gist and verbatim memory in complex decision making: Explaining the unconscious-thought effect.

PubMed

Abadie, Marlène; Waroquier, Laurent; Terrier, Patrice

2017-05-01

Previous research showed that the unconscious-thought effect , which refers to an improvement in complex decision making following a distraction period, was moderated by the presentation format of pieces of information about different options. The aim of the current study was to replicate this finding and further examine the memory representations underlying decision making following a distraction or a deliberation period. Results showed that, when the information was presented blocked per option, participants were better able to differentiate the best option from the others after a distraction period than immediately after the information presentation or after a deliberation period. In addition, distracted participants retrieved more gist representations of the options when the information was presented per option. By contrast, participants were better able to differentiate the best option from the others after a deliberation period when the information was presented per attribute. Participants who deliberated also retrieved more verbatim representations when the information was presented per attribute. Finally, mediation analyses indicated that the accuracy of the evaluations of the options depends on gist memory when distracted but on verbatim memory when deliberating. These findings suggest that the effectiveness of distraction or deliberation depends on the memory representations of the different options. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Evolution of Patient Decision-Making Regarding Medical Treatment of Rheumatoid Arthritis.

PubMed

Mathews, Alexandra L; Coleska, Adriana; Burns, Patricia B; Chung, Kevin C

2016-03-01

The migration of health care toward a consumer-driven system favors increased patient participation during the treatment decision-making process. Patient involvement in treatment decision discussions has been linked to increased treatment adherence and patient satisfaction. Previous studies have quantified decision-making styles of patients with rheumatoid arthritis (RA); however, none of them have considered the evolution of patient involvement after living with RA for many years. We conducted a qualitative study to determine the decision-making model used by long-term RA patients, and to describe the changes in their involvement over time. Twenty participants were recruited from the ongoing Silicone Arthroplasty in Rheumatoid Arthritis study. Semistructured interviews were conducted and data were analyzed using grounded theory methodology. Nineteen out of 20 participants recalled using the paternalistic decision-making (PDM) model immediately following their diagnosis. Fourteen of the 19 participants who initially used PDM evolved to shared decision-making (SDM). Participants attributed the change in involvement to the development of a trusting relationship with their physician, as well as to becoming educated about the disease. When initially diagnosed with RA, patients may let their physician decide on the best treatment course. However, over time patients may evolve to exercise a more collaborative role. Physicians should understand that even within SDM, each patient can demonstrate a varied amount of autonomy. It is up to the physician to have a discussion with each patient to determine his or her desired level of involvement. © 2016, American College of Rheumatology.

Lay Consultations in Heart Failure Symptom Evaluation.

PubMed

Reeder, Katherine M; Sims, Jessica L; Ercole, Patrick M; Shetty, Shivan S; Wallendorf, Michael

2017-01-01

Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher's exact tests, along with logistic regression were used to characterize lay consultations in this sample. A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions.

Precipitation Variability and Projection Uncertainties in Climate Change Adaptation: Go Local!

EPA Science Inventory

Presentations agenda includes: Regional and local climate change effects: The relevance; Variability and uncertainty in decision- making and adaptation approaches; Adaptation attributes for the U.S. Southwest: Water availability, storage capacity, and related; EPA research...

Ethnicity and Acculturation: Influences on Asian American Consumers' Purchase Decision Making for Social Clothes.

ERIC Educational Resources Information Center

Kang, Jikyeong; Kim, Youn-Kyung

1998-01-01

Responses from 172 Chinese Americans, 185 Japanese Americans, and 144 Korean Americans revealed distinct reference group, media, and store attribute influences on clothing purchases. Patterns differed depending on degree of acculturation. (SK)

Relative importance of attributes of drug benefit plans: Thai civil servants' perspective.

PubMed

Ngorsuraches, Surachat; Wanishayakorn, Tanatape; Tanvejsilp, Pimwara; Udomaksorn, Siripa

2013-01-01

The drug benefit plan of Thailand's Civil Servant Medical Benefit Scheme (CSMBS) must be amended to control increasing costs; to that end, it is important to gather the views of beneficiaries before making changes to the benefit plan. To examine the relative importance of attributes of drug benefit plans from the perspective of CSMBS beneficiaries. Attributes and levels adopted from focus group discussions and a preliminary survey were used to develop a questionnaire concerning hypothetical drug benefit plans. A convenience sample of 650 CSMBS beneficiaries in Songkhla province was asked to rate the drug benefit plans. To determine the beneficiaries' decision models, judgment analysis was used. Policy-capturing analysis was used to examine the beneficiaries' preferences, and cluster analysis was conducted to explore the variability among judgment plans. Judgment policy insight was also examined. The results of the study showed that the beneficiaries weighed on cost-sharing as their most important attribute. The results remained unchanged, although only data from the beneficiaries who used the compensatory model were analyzed. The results of the cluster analysis showed that the largest cluster of beneficiaries weighed mostly on the cost-sharing attribute. The judgment policy insight results not only supported the finding that most beneficiaries focused on the cost-sharing attribute but also revealed that they might have the least understanding of how the formulary attribute affected beneficiaries' decision making. Cost-sharing was the most important attribute for the CSMBS beneficiaries. This study indicated that a possible preferred drug benefit plan should have no cost-sharing, permit access only to drugs listed in a closed formulary, allow beneficiaries to obtain 3 months of drugs, and allow them to obtain drugs from either a community pharmacy or a government hospital. Copyright © 2013 Elsevier Inc. All rights reserved.

Clinical Factors and the Decision to Transfuse Chronic Dialysis Patients

PubMed Central

Whitman, Cynthia B.; Shreay, Sanatan; Gitlin, Matthew; van Oijen, Martijn G. H.

2013-01-01

Summary Background and objectives Red blood cell transfusion was previously the principle therapy for anemia in CKD but became less prevalent after the introduction of erythropoiesis-stimulating agents. This study used adaptive choice-based conjoint analysis to identify preferences and predictors of transfusion decision-making in CKD. Design, setting, participants, & measurements A computerized adaptive choice-based conjoint survey was administered between June and August of 2012 to nephrologists, internists, and hospitalists listed in the American Medical Association Masterfile. The survey quantified the relative importance of 10 patient attributes, including hemoglobin levels, age, occult blood in stool, severity of illness, eligibility for transplant, iron indices, erythropoiesis-stimulating agents, cardiovascular disease, and functional status. Triggers of transfusions in common dialysis scenarios were studied, and based on adaptive choice-based conjoint-derived preferences, relative importance by performing multivariable regression to identify predictors of transfusion preferences was assessed. Results A total of 350 providers completed the survey (n=305 nephrologists; mean age=46 years; 21% women). Of 10 attributes assessed, absolute hemoglobin level was the most important driver of transfusions, accounting for 29% of decision-making, followed by functional status (16%) and cardiovascular comorbidities (12%); 92% of providers transfused when hemoglobin was 7.5 g/dl, independent of other factors. In multivariable regression, Veterans Administration providers were more likely to transfuse at 8.0 g/dl (odds ratio, 5.9; 95% confidence interval, 1.9 to 18.4). Although transplant eligibility explained only 5% of decision-making, nephrologists were five times more likely to value it as important compared with non-nephrologists (odds ratio, 5.2; 95% confidence interval, 2.4 to11.1). Conclusions Adaptive choice-based conjoint analysis was useful in predicting influences on transfusion decisions. Hemoglobin level, functional status, and cardiovascular comorbidities most strongly influenced transfusion decision-making, but preference variations were observed among subgroups. PMID:23929931

Patients’ Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings

PubMed Central

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

Background The contribution of patients’ non-medical characteristics to individual physicians’ decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients’ non-medical characteristics are presented at MDT meetings and how this information may affect the team’s final medical decisions. Design Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians’ verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. Results In the final sample of patients’ records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient’s age and his/her “likeability” were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients’ non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. Limitations The design of the study made it difficult to draw definite cause-and-effect conclusions. Conclusion The Social Representations approach suggests that patients’ non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians’ everyday professional practice. The links observed between patients’ attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind. PMID:27167521

A Moral (Normative) Framework for the Judgment of Actions and Decisions in the Construction Industry and Engineering: Part II.

PubMed

Alkhatib, Omar J

2017-12-01

The construction industry is typically characterized as a fragmented, multi-organizational setting in which members from different technical backgrounds and moral values join together to develop a particular business or project. The most challenging obstacle in the construction process is to achieve a successful practice and to identify and apply an ethical framework to manage the behavior of involved specialists and contractors and to ensure the quality of all completed construction activities. The framework should reflect a common moral ground for myriad people involved in this process to survive and compete ethically in today's turbulent construction market. This study establishes a framework for moral judgment of behavior and actions conducted in the construction process. The moral framework provides the basis of judging actions as "moral" or "immoral" based on three levels of moral accountability: personal, professional, and social. The social aspect of the proposed framework is developed primarily from the essential attributes of normative business decision-making models identified in the literature review and subsequently incorporates additional attributes related to professional and personal moral values. The normative decision-making models reviewed are based primarily on social attributes as related to moral theories (e.g., utilitarianism, duty, rights, virtue, etc.). The professional and moral attributes are established by identifying a set of common moral values recognized by professionals in the construction industry and required to prevent common construction breaches. The moral framework presented here is the complementary part of the ethical framework developed in Part I of this article and is based primarily on the personal behavior or the moral aspect of professional responsibility. The framework can be implemented as a form of preventive personal ethics, which would help avoid ethical dilemmas and moral implications in the first place. Furthermore, the moral framework can be considered as a decision-making model to guide actions and improve the moral reasoning process, which would help individuals think through possible implications and the consequences of ethical and moral issues in the construction industry.

Exploring regional stakeholder needs and requirements in terms of Extreme Weather Event Attribution

NASA Astrophysics Data System (ADS)

Schwab, M.; Meinke, I.; Vanderlinden, J. P.; Touili, N.; Von Storch, H.

2015-12-01

Extreme event attribution has increasingly received attention in the scientific community. It may also serve decision-making at the regional level where much of the climate change impact mitigation takes place. Nevertheless, there is, to date, little known about the requirements of regional actors in terms of extreme event attribution. We have therefore analysed these at the example of regional decision-makers for climate change-related activities and/or concerned with storm surge risks at the German Baltic Sea and heat wave risks in the Greater Paris area. In order to explore if stakeholders find scientific knowledge from extreme event attribution useful and how this information might be relevant to their decision-making, we consulted a diverse set of actors engaged in the assessment, mitigation and communication of storm surge, heat wave, and climate change-related risks. Extreme event attribution knowledge was perceived to be most useful to public and political awareness-raising, but was of little or no relevance for the consulted stakeholders themselves. It was not acknowledged that it would support adaptation planning as sometimes argued in the literature. The consulted coastal protection, health, and urban adaptation planners rather needed reliable statements about possible future changes in extreme events than causal statements about past events. To enhance salience, a suitable product of event attribution should be linked to regional problems, vulnerabilities, and impacts of climate change. Given that the tolerance of uncertainty is rather low, most of the stakeholders also claimed that a suitable product of event attribution is to be received from a trusted "honest broker" and published rather later, but with smaller uncertainties than vice versa. Institutional mechanisms, like regional climate services, which enable and foster communication, translation and mediation across the boundaries between knowledge and action can help fulfill such requirements. This is of particular importance for extreme event attribution which is often understood as science producing complex and abstract information attached to large uncertainties. They can serve as an interface for creating the necessary mutual understanding by being in a continuous dialogue with both science and stakeholders.

Think, blink or sleep on it? The impact of modes of thought on complex decision making.

PubMed

Newell, Ben R; Wong, Kwan Yao; Cheung, Jeremy C H; Rakow, Tim

2009-04-01

This paper examines controversial claims about the merit of "unconscious thought" for making complex decisions. In four experiments, participants were presented with complex decisions and were asked to choose the best option immediately, after a period of conscious deliberation, or after a period of distraction (said to encourage "unconscious thought processes"). In all experiments the majority of participants chose the option predicted by their own subjective attribute weighting scores, regardless of the mode of thought employed. There was little evidence for the superiority of choices made "unconsciously", but some evidence that conscious deliberation can lead to better choices. The final experiment suggested that the task is best conceptualized as one involving "online judgement" rather than one in which decisions are made after periods of deliberation or distraction. The results suggest that we should be cautious in accepting the advice to "stop thinking" about complex decisions.

Integrated Risk-Informed Decision-Making for an ALMR PRISM

DOE Office of Scientific and Technical Information (OSTI.GOV)

Muhlheim, Michael David; Belles, Randy; Denning, Richard S.

Decision-making is the process of identifying decision alternatives, assessing those alternatives based on predefined metrics, selecting an alternative (i.e., making a decision), and then implementing that alternative. The generation of decisions requires a structured, coherent process, or a decision-making process. The overall objective for this work is that the generalized framework is adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or no human intervention. The overriding goal of automation is to replace ormore » supplement human decision makers with reconfigurable decision-making modules that can perform a given set of tasks rationally, consistently, and reliably. Risk-informed decision-making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The probabilistic portion of the decision-making engine of the supervisory control system is based on the control actions associated with an ALMR PRISM. Newly incorporated into the probabilistic models are the prognostic/diagnostic models developed by Pacific Northwest National Laboratory. These allow decisions to incorporate the health of components into the decision–making process. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic portion of the decision-making engine uses thermal-hydraulic modeling and components for an advanced liquid-metal reactor Power Reactor Inherently Safe Module. The deterministic multi-attribute decision-making framework uses various sensor data (e.g., reactor outlet temperature, steam generator drum level) and calculates its position within the challenge state, its trajectory, and its margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. The metrics that are evaluated are based on reactor trip set points. The integration of the deterministic calculations using multi-physics analyses and probabilistic safety calculations allows for the examination and quantification of margin recovery strategies. This also provides validation of the control options identified from the probabilistic assessment. Thus, the thermalhydraulics analyses are used to validate the control options identified from the probabilistic assessment. Future work includes evaluating other possible metrics and computational efficiencies, and developing a user interface to mimic display panels at a modern nuclear power plant.« less

Teachers' Academic Appraisals and Referral Decisions: The Effect of Sharing Health Information when Diabetes Is Present

ERIC Educational Resources Information Center

Cunningham, Melissa M.; Wodrich, David L.

2012-01-01

Two prior studies showed that giving teachers more information about a student's illness led them to make better attributions about that student's classroom problems and better classroom accommodations. In this study, 235 teachers appraised academic competence and judged whether to seek help or make a referral for a hypothetical student with type…

Single-process versus multiple-strategy models of decision making: evidence from an information intrusion paradigm.

PubMed

Söllner, Anke; Bröder, Arndt; Glöckner, Andreas; Betsch, Tilmann

2014-02-01

When decision makers are confronted with different problems and situations, do they use a uniform mechanism as assumed by single-process models (SPMs) or do they choose adaptively from a set of available decision strategies as multiple-strategy models (MSMs) imply? Both frameworks of decision making have gathered a lot of support, but only rarely have they been contrasted with each other. Employing an information intrusion paradigm for multi-attribute decisions from givens, SPM and MSM predictions on information search, decision outcomes, attention, and confidence judgments were derived and tested against each other in two experiments. The results consistently support the SPM view: Participants seemingly using a "take-the-best" (TTB) strategy do not ignore TTB-irrelevant information as MSMs would predict, but adapt the amount of information searched, choose alternative choice options, and show varying confidence judgments contingent on the quality of the "irrelevant" information. The uniformity of these findings underlines the adequacy of the novel information intrusion paradigm and comprehensively promotes the notion of a uniform decision making mechanism as assumed by single-process models. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

Bad is freer than good: Positive-negative asymmetry in attributions of free will.

PubMed

Feldman, Gilad; Wong, Kin Fai Ellick; Baumeister, Roy F

2016-05-01

Recent findings support the idea that the belief in free will serves as the basis for moral responsibility, thus promoting the punishment of immoral agents. We theorized that free will extends beyond morality to serve as the basis for accountability and the capacity for change more broadly, not only for others but also for the self. Five experiments showed that people attributed higher freedom of will to negative than to positive valence, regardless of morality or intent, for both self and others. In recalling everyday life situations and in classical decision making paradigms, negative actions, negatives outcomes, and negative framing were attributed higher free will than positive ones. Free will attributions were mainly driven by action or outcome valence, but not intent. These findings show consistent support for the idea that free will underlies laypersons' sense-making for accountability and change under negative circumstances. Copyright © 2016 Elsevier Inc. All rights reserved.

Heuristic decision-making about research participation in children with cystic fibrosis.

PubMed

Christofides, Emily; Dobson, Jennifer A; Solomon, Melinda; Waters, Valerie; O'Doherty, Kieran C

2016-08-01

Traditional perspectives on informed consent assume that when faced with decisions about whether to participate in research, individuals behave according to principles of classical rationality, taking into account all available information to weigh risks and benefits to come to a decision that is optimal for them. However, theoretical and empirical research in psychology suggests that people may not make decisions in this way. Less is known about decision-making processes as they pertain to participating in biomedical research, particularly when the participants are children. We sought to better understand research decision processes especially in children who tend to participate extensively in research due to chronic illness. To learn more about children's decision-making in this context, we interviewed 19 young patients with cystic fibrosis (male n = 7; female n = 12) aged 8-18 years (M = 13 years) at a children's hospital in Canada between April and August 2013. We found that participants generally had a default approach to participation decisions, which they attributed to their parents' attitudes to research, experiences of having grown up participating in research, trusting the researchers, and wanting to help. Most of our participants made the decision to participate in research based on a heuristic with a baseline to say "yes", subject to change based on aspects of the research or particular preferences. In particular, concerns with the procedure, unwillingness to talk about cystic fibrosis, logistical challenges, and perceptions of risk all influenced the decision, as did the perceived importance or personal relevance of the research. Our study illustrates that rather than conducting risk/benefit analyses, participants tended to adopt a heuristic-like approach, consistent with decision theories that view heuristic decision-making as ecologically rational. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Influence of Genotype Information on Psychiatrists' Treatment Recommendations: More Experienced Clinicians Know Better What to Ignore.

PubMed

McMichael, Alan J; Boeri, Marco; Rolison, Jonathan J; Kane, Joe; O'Neill, Francis A; Scarpa, Ric; Kee, Frank

2017-01-01

This study applies attribute nonattendance to medical decision making. We aimed to demonstrate how this type of analysis can be used in medical decision making to assess whether psychiatrists were influenced in their treatment recommendations by information on the genotype of a patient, despite knowing the patient's response to treatment as measured by the Positive and Negative Syndrome Scale. A patient's genetic information may be used to predict their response to therapy; such information, however, becomes redundant, and should not influence decisions, once a clinician knows the patient's actual response to treatment. Sixty-seven psychiatrists were presented with patients' pre- or post-treatment scores on the Positive and Negative Syndrome Scale for two hypothetical treatments for schizophrenia. Psychiatrists were also informed whether the patient possessed a genotype linked to hyper-responsiveness to one of the treatments, and were asked to recommend one of these two treatments. Attribute nonattendance assessed whether the information on genotype influenced psychiatrists' treatment recommendations. Years of experience predicted whether psychiatrists were influenced by the genetic information. Psychiatrists with 1 year or less of experience had a 46% probability of considering genetic information, whereas psychiatrists with at least 15 years of experience had a lower probability (7%). Psychiatrists and other clinicians should be cautious about allowing a patient's genetic information to carry unnecessary weight in their clinical decision making. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The influence of a bystander agent's beliefs on children's and adults' decision-making process.

PubMed

Buttelmann, Frances; Buttelmann, David

2017-01-01

The ability to attribute and represent others' mental states (e.g., beliefs; so-called "theory of mind") is essential for participation in human social interaction. Despite a considerable body of research using tasks in which protagonists in the participants' attentional focus held false or true beliefs, the question of automatic belief attribution to bystander agents has received little attention. In the current study, we presented adults and 6-year-olds (N=92) with an implicit computer-based avoidance false-belief task in which participants were asked to place an object into one of three boxes. While doing so, we manipulated the beliefs of an irrelevant human-like or non-human-like bystander agent who was visible on the screen. Importantly, the bystander agent's beliefs were irrelevant for solving the task. Still, children's decision making was significantly influenced by the bystander agent's beliefs even if this was a non-human-like self-propelled object. Such an influence did not become obvious in adults' deliberate decisions but occurred only in their reaction times, which suggests that they also processed the bystander agent's beliefs but were able to suppress the influence of such beliefs on their behavior regulation. The results of a control study (N=53) ruled out low-level explanations and confirmed that self-propelledness of agents is a necessary factor for belief attribution to occur. Thus, not only do humans spontaneously ascribe beliefs to self-propelled bystander agents, but those beliefs even influence meaningful decisions in children. Copyright © 2016 Elsevier Inc. All rights reserved.

Long-term heavy marijuana users make costly decisions on a gambling task.

PubMed

Whitlow, Christopher T; Liguori, Anthony; Livengood, L Brooke; Hart, Stephanie L; Mussat-Whitlow, Becky J; Lamborn, Corey M; Laurienti, Paul J; Porrino, Linda J

2004-10-05

Chronic marijuana use has been associated with impairments of learning, memory, and executive functions. Little is known, however, about the effects of marijuana use on other cognitive domains, such as decision-making, which are thought to play an important role in addiction and drug abuse. The purpose of the present study was to determine if long-term heavy marijuana users employ different decision-making strategies than individuals with minimal marijuana exposure. Volunteers were assigned to a cannabis (n = 10) or control group (n = 10) based upon history of prior marijuana use. Demographic and neuropsychological variables were evaluated, and a decision-making task--the gambling task (GT) was administered. Although few demographic and neuropsychological differences were noted between groups, marijuana users made more decisions that led to larger immediate gains despite more costly losses than controls. These data suggest that long-term heavy marijuana users may have specific deficits in the ability to balance rewards and punishments that may contribute to continued drug-taking behavior. It is unknown, however, whether the basis for such deficits might be attributed directly to marijuana exposure or pre-existing genetic or behavioral differences.

The neural correlates of risky decision making across short and long runs

PubMed Central

Rao, Li-Lin; Dunn, John C.; Zhou, Yuan; Li, Shu

2015-01-01

People frequently change their preferences for options of gambles which they play once compared to those they play multiple times. In general, preferences for repeated play gambles are more consistent with the expected values of the options. According to the one-process view, the change in preference is due to a change in the structure of the gamble that is relevant to decision making. According to the two-process view, the change is attributable to a shift in the decision making strategy that is used. To adjudicate between these two theories, we asked participants to choose between gambles played once or 100 times, and to choose between them based on their expected value. Consistent with the two-process theory, we found a set of brain regions that were sensitive to the extent of behavioral change between single and aggregated play and also showed significant (de)activation in the expected value choice task. These results support the view that people change their decision making strategies for risky choice considered once or multiple times. PMID:26516095

A decision support system for delivering optimal quality peach and tomato

NASA Technical Reports Server (NTRS)

Thai, C. N.; Pease, J. N.; Shewfelt, R. L.

1990-01-01

Several studies have indicated that color and firmness are the two quality attributes most important to consumers in making purchasing decisions of fresh peaches and tomatoes. However, at present, retail produce managers do not have the proper information for handling fresh produce so it has the most appealing color and firmness when it reaches the consumer. This information should help them predict the consumer color and firmness perception and preference for produce from various storage conditions. Since 1987, for 'Redglobe' peach and 'Sunny' tomato, we have been generating information about their physical quality attributes (firmness and color) and their corresponding consumer sensory scores. This article reports on our current progress toward the goal of integrating such information into a model-based decision support system for retail level managers in handling fresh peaches and tomatoes.

Seeing the forest through the trees: improving decision making on the Iowa gambling task by shifting focus from short- to long-term outcomes

PubMed Central

Buelow, Melissa T.; Okdie, Bradley M.; Blaine, Amber L.

2013-01-01

Introduction: The present study sought to examine two methods by which to improve decision making on the Iowa Gambling Task (IGT): inducing a negative mood and providing additional learning trials. Method: In the first study, 194 undergraduate students [74 male; Mage = 19.44 (SD = 3.69)] were randomly assigned to view a series of pictures to induce a positive, negative, or neutral mood immediately prior to the IGT. In the second study, 276 undergraduate students [111 male; Mage = 19.18 (SD = 2.58)] completed a delay discounting task and back-to-back administrations of the IGT. Results: Participants in an induced negative mood selected more from Deck C during the final trials than those in an induced positive mood. Providing additional learning trials resulted in better decision making: participants shifted their focus from the frequency of immediate gains/losses (i.e., a preference for Decks B and D) to long-term outcomes (i.e., a preference for Deck D). In addition, disadvantageous decision making on the additional learning trials was associated with larger delay discounting (i.e., a preference for more immediate but smaller rewards). Conclusions: The present results indicate that decision making is affected by negative mood state, and that decision making can be improved by increasing the number of learning trials. In addition, the current results provide evidence of a relationship between performance on the IGT and on a separate measure of decision making, the delay discounting task. Moreover, the present results indicate that improved decision making on the IGT can be attributed to shifting focus toward long-term outcomes, as evidenced by increased selections from advantageous decks as well as correlations between the IGT and delay discounting task. Implications for the assessment of decision making using the IGT are discussed. PMID:24151485

The effect of introspection on judgment and decision making is dependent on the quality of conscious thinking.

PubMed

Leisti, Tuomas; Häkkinen, Jukka

2016-05-01

That introspection may impair certain judgments and result in fabrication has been attributed to a distracting shift from more adaptive intuitive processing to more analytic and conscious processing. This phenomenon was studied in an experiment where participants made multidimensional visual choices. It was found that the effect of this shift on decision-making performance was dependent on the quality of the explanations during introspection, while the performance in silent conditions was not. Therefore, it appears that the effect of introspection on judgments is not only influenced by the thinking mode per se, but also by the individual's ability to approach the decision problem analytically. Copyright © 2016 Elsevier Inc. All rights reserved.

Determining criminal responsibility: How relevant are insight and personal attitudes to mock jurors?

PubMed

Jung, Sandy

2015-01-01

High levels of insight are interpreted as indications of a treatment compliance and good outcome by clinical professionals. However, it is unclear whether a defendant's insight plays a role in the decision-making of jurors when determining criminal responsibility. It may be the case that personal biases and attitudes toward the mentally ill and the insanity defense are more relevant in such decisions. This study examines the influence of two core dimensions of insight and personal attitudes on juror decision-making. Participants read trial scenarios describing a defendant who is accused of a violent crime and is diagnosed with schizophrenia. Assigning a verdict of not criminally responsible to the defendant was not influenced by insight, but instead, by supportive attitudes of the insanity defense and higher attributions of blame to external factors and to psychological factors. These findings highlight the need for continued investigation in the area of extra-legal factors that guide legal decision-making when defendants have a mental disorder. Copyright © 2015 Elsevier Ltd. All rights reserved.

Visualization-based decision support for value-driven system design

NASA Astrophysics Data System (ADS)

Tibor, Elliott

In the past 50 years, the military, communication, and transportation systems that permeate our world, have grown exponentially in size and complexity. The development and production of these systems has seen ballooning costs and increased risk. This is particularly critical for the aerospace industry. The inability to deal with growing system complexity is a crippling force in the advancement of engineered systems. Value-Driven Design represents a paradigm shift in the field of design engineering that has potential to help counteract this trend. The philosophy of Value-Driven Design places the desires of the stakeholder at the forefront of the design process to capture true preferences and reveal system alternatives that were never previously thought possible. Modern aerospace engineering design problems are large, complex, and involve multiple levels of decision-making. To find the best design, the decision-maker is often required to analyze hundreds or thousands of combinations of design variables and attributes. Visualization can be used to support these decisions, by communicating large amounts of data in a meaningful way. Understanding the design space, the subsystem relationships, and the design uncertainties is vital to the advancement of Value-Driven Design as an accepted process for the development of more effective, efficient, robust, and elegant aerospace systems. This research investigates the use of multi-dimensional data visualization tools to support decision-making under uncertainty during the Value-Driven Design process. A satellite design system comprising a satellite, ground station, and launch vehicle is used to demonstrate effectiveness of new visualization methods to aid in decision support during complex aerospace system design. These methods are used to facilitate the exploration of the feasible design space by representing the value impact of system attribute changes and comparing the results of multi-objective optimization formulations with a Value-Driven Design formulation. The visualization methods are also used to assist in the decomposition of a value function, by representing attribute sensitivities to aid with trade-off studies. Lastly, visualization is used to enable greater understanding of the subsystem relationships, by displaying derivative-based couplings, and the design uncertainties, through implementation of utility theory. The use of these visualization methods is shown to enhance the decision-making capabilities of the designer by granting them a more holistic view of the complex design space.

The vexing problem of defining the meaning, role and measurement of values in treatment decision-making.

PubMed

Charles, Cathy; Gafni, Amiram

2014-03-01

Two international movements, evidence-based medicine (EBM) and shared decision-making (SDM) have grappled for some time with issues related to defining the meaning, role and measurement of values/preferences in their respective models of treatment decision-making. In this article, we identify and describe unresolved problems in the way that each movement addresses these issues. The starting point for this discussion is that at least two essential ingredients are needed for treatment decision-making: research information about treatment options and their potential benefits and risks; and the values/preferences of participants in the decision-making process. Both the EBM and SDM movements have encountered difficulties in defining the meaning, role and measurement of values/preferences in treatment decision-making. In the EBM model of practice, there is no clear and consistent definition of patient values/preferences and no guidance is provided on how to integrate these into an EBM model of practice. Methods advocated to measure patient values are also problematic. Within the SDM movement, patient values/preferences tend to be defined and measured in a restrictive and reductionist way as patient preferences for treatment options or attributes of options, while broader underlying value structures are ignored. In both models of practice, the meaning and expected role of physician values in decision-making are unclear. Values clarification exercises embedded in patient decision aids are suggested by SDM advocates to identify and communicate patient values/preferences for different treatment outcomes. Such exercises have the potential to impose a particular decision-making theory and/or process onto patients, which can change the way they think about and process information, potentially impeding them from making decisions that are consistent with their true values. The tasks of clarifying the meaning, role and measurement of values/preferences in treatment decision-making models such as EBM and SDM, and determining whose values ought to count are complex and difficult tasks that will not be resolved quickly. Additional conceptual thinking and research are needed to explore and clarify these issues. To date, the values component of these models remains elusive and underdeveloped.

Information-sharing to promote informed choice in prenatal screening in the spirit of the SOGC clinical practice guideline: a proposal for an alternative model.

PubMed

Vanstone, Meredith; Kinsella, Elizabeth Anne; Nisker, Jeff

2012-03-01

The 2011 SOGC clinical practice guideline "Prenatal Screening for Fetal Aneuploidy in Singleton Pregnancies" recommends that clinicians offer prenatal screening to all pregnant women and provide counselling in a non-directive manner. Non-directive counselling is intended to facilitate autonomous decision-making and remove the clinician's views regarding a particular course of action. However, recent research in genetic counselling raises concerns that non-directive counselling is neither possible nor desirable, and that it may not be the best way to facilitate informed choice. We propose an alternative model of information-sharing specific to prenatal screening that combines attributes of the models of informative decision-making and shared decision-making. Our proposed model is intended to provide clinicians with a strategy to communicate information about prenatal screening in a way that facilitates a shared deliberative process and autonomous decision-making. Our proposed model may better prepare a pregnant woman to make an informed choice about participating in prenatal screening on the basis of her consideration of the medical information provided by her clinician and her particular circumstances and values.

Comparison of preferences of healthcare professionals and MS patients for attributes of disease-modifying drugs: A best-worst scaling.

PubMed

Kremer, Ingrid E H; Evers, Silvia M A A; Jongen, Peter J; Hiligsmann, Mickaël

2018-02-01

The choice between disease-modifying drugs (DMDs) for the treatment of multiple sclerosis (MS) becomes more often a shared decision between the patient and the neurologist and MS nurse. This study aimed to assess which DMD attributes are most important for the healthcare professionals in selecting a DMD for a patient. Subsequently, within this perspective, the neurologists' and nurses' perspectives were compared. Lastly, the healthcare professionals' perspective was compared with the patients' perspective to detect any differences that may need attention in the communication about DMDs. A best-worst scaling (BWS) was conducted among 27 neurologists and 33 MS nurses treating patients with MS to determine the importance of 27 DMD attributes. These attributes were identified through three focus groups with MS patients in a previous study (N=19). Relative importance scores (RISs) were estimated for each attribute. Multivariable linear regression analyses were used to compare the different perspectives. According to the neurologists and nurses, safety of the DMD was the most important DMD attribute in the treatment decision, closely followed by effect on disability progression, quality of life and relapse rate. Patients with MS agreed with the importance of the last three attributes, but valued safety significantly lower (b=-2.59, P<.001). This study suggests that, overall, neurologists and nurses regard the same DMD attributes as important as MS patients with the notable exception of safety. This study provides valuable information for the development of interventions to support shared decision making and highlights which attributes of DMDs may need additional attention. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Theory of mind deficits partly mediate impaired social decision-making in schizophrenia.

PubMed

Yang, Liuqing; Li, Peifu; Mao, Haiying; Wang, Huiling; Shu, Chang; Bliksted, Vibeke; Zhou, Yuan

2017-05-05

Using paradigms from game theory, researchers have reported abnormal decision-making in social context in patients with schizophrenia. However, less is known about the underpinnings of the impairment. This study aimed to test whether theory of mind (ToM) deficits and/or neurocognitive dysfunctions mediate impaired social decision-making in patients with schizophrenia. We compared thirty-five patients with schizophrenia to thirty-eight matched healthy controls with regard to social decision-making using the mini Ultimatum Game (mini UG), a paradigm from game theory. Additionally, we assessed ToM using the Theory of Mind Picture Stories Task, a mental state attribution task, and assessed neurocognition using the Brief Assessment of Cognition in Schizophrenia. Mediation analyses were performed on the data. In contrast to the behavioral pattern of healthy controls in the mini UG, the patients with schizophrenia significantly accepted more disadvantageous offers and rejected more advantageous offers, and showed reduced sensitivity to the fairness-related context changes in the mini UG. Impaired ToM and neurocognition were also found in the patients. Mediation analyses indicated that ToM but not neurocognition partially mediated the group differences on the disadvantageous and advantageous offers in the mini UG. Patients with schizophrenia exhibited impaired social decision-making. This impairment can be partly explained by their ToM deficits rather than neurocognitive deficits. However, the exact nature of the ToM deficits that mediate impaired social decision-making needs to be identified in future.

Lay Consultations in Heart Failure Symptom Evaluation

PubMed Central

Reeder, Katherine M.; Sims, Jessica L.; Ercole, Patrick M.; Shetty, Shivan S.; Wallendorf, Michael

2017-01-01

Purpose Lay consultations can facilitate or impede healthcare. However, little is known about how lay consultations for symptom evaluation affect treatment decision-making. The purpose of this study was to explore the role of lay consultations in symptom evaluation prior to hospitalization among patients with heart failure. Methods Semi-structured interviews were conducted with 60 patients hospitalized for acute decompensated heart failure. Chi-square and Fisher’s exact tests, along with logistic regression were used to characterize lay consultations in this sample. Results A large proportion of patients engaged in lay consultations for symptom evaluation and decision-making before hospitalization. Lay consultants provided attributions and advice and helped make the decision to seek medical care. Men consulted more often with their spouse than women, while women more often consulted with adult children. Conclusions Findings have implications for optimizing heart failure self-management interventions, improving outcomes, and reducing hospital readmissions. PMID:29399657

Skill-related differences between athletes and nonathletes in speed discrimination.

PubMed

Thomson, Kaivo; Watt, Anthony; Liukkonen, Jarmo

2008-12-01

This study examined differences in decision-making time and accurscy as attributes of speed discrimination between participants skilled and less skilled in ball games. A total of 130 men, ages 18 to 28 years (M=21.2, SD=2.6), participated. The athlete sample (skilled group) comprised Estonian National League volleyball (n=26) and basketball players (n=27). The nonathlete sample (less skilled group) included 77 soldiers of the Estonian Defence Force with no reported top level experience in ball games. Speed-discrimination stimuli were images of red square shapes presented moving along the sagittal axis at four different virtual velocities on a computer (PC) screen which represented the frontal plane. Analysis indicated that only decision-making time was significantly different between the elite athlete and nonathlete groups. This finding suggests a possible effect of ball-game skills for decision-making time in speed discrimination.

Examining the value of travel time reliability for freight transportation to support freight planning and decision-making.

DOT National Transportation Integrated Search

2016-12-01

This report presents the findings of a valuation study recently conducted in Florida to quantify the : freight users willingness to pay (WTP) for the improvement of transportation-related attributes, : particularly reliability. A stated preference...

Information search and decision making: effects of age and complexity on strategy use.

PubMed

Queen, Tara L; Hess, Thomas M; Ennis, Gilda E; Dowd, Keith; Grühn, Daniel

2012-12-01

The impact of task complexity on information search strategy and decision quality was examined in a sample of 135 young, middle-aged, and older adults. We were particularly interested in the competing roles of fluid cognitive ability and domain knowledge and experience, with the former being a negative influence and the latter being a positive influence on older adults' performance. Participants utilized 2 decision matrices, which varied in complexity, regarding a consumer purchase. Using process tracing software and an algorithm developed to assess decision strategy, we recorded search behavior, strategy selection, and final decision. Contrary to expectations, older adults were not more likely than the younger age groups to engage in information-minimizing search behaviors in response to increases in task complexity. Similarly, adults of all ages used comparable decision strategies and adapted their strategies to the demands of the task. We also examined decision outcomes in relation to participants' preferences. Overall, it seems that older adults utilize simpler sets of information primarily reflecting the most valued attributes in making their choice. The results of this study suggest that older adults are adaptive in their approach to decision making and that this ability may benefit from accrued knowledge and experience. 2013 APA, all rights reserved

Exploratory Decision-Making as a Function of Lifelong Experience, Not Cognitive Decline

PubMed Central

2016-01-01

Older adults perform worse than younger adults in some complex decision-making scenarios, which is commonly attributed to age-related declines in striatal and frontostriatal processing. Recently, this popular account has been challenged by work that considered how older adults’ performance may differ as a function of greater knowledge and experience, and by work showing that, in some cases, older adults outperform younger adults in complex decision-making tasks. In light of this controversy, we examined the performance of older and younger adults in an exploratory choice task that is amenable to model-based analyses and ostensibly not reliant on prior knowledge. Exploration is a critical aspect of decision-making poorly understood across the life span. Across 2 experiments, we addressed (a) how older and younger adults differ in exploratory choice and (b) to what extent observed differences reflect processing capacity declines. Model-based analyses suggested that the strategies used by the 2 groups were qualitatively different, resulting in relatively worse performance for older adults in 1 decision-making environment but equal performance in another. Little evidence was found that differences in processing capacity drove performance differences. Rather the results suggested that older adults’ performance might result from applying a strategy that may have been shaped by their wealth of real-word decision-making experience. While this strategy is likely to be effective in the real world, it is ill suited to some decision environments. These results underscore the importance of taking into account effects of experience in aging studies, even for tasks that do not obviously tap past experiences. PMID:26726916

Elucidating the underlying components of food valuation in the human orbitofrontal cortex.

PubMed

Suzuki, Shinsuke; Cross, Logan; O'Doherty, John P

2017-12-01

The valuation of food is a fundamental component of our decision-making. Yet little is known about how value signals for food and other rewards are constructed by the brain. Using a food-based decision task in human participants, we found that subjective values can be predicted from beliefs about constituent nutritive attributes of food: protein, fat, carbohydrates and vitamin content. Multivariate analyses of functional MRI data demonstrated that, while food value is represented in patterns of neural activity in both medial and lateral parts of the orbitofrontal cortex (OFC), only the lateral OFC represents the elemental nutritive attributes. Effective connectivity analyses further indicate that information about the nutritive attributes represented in the lateral OFC is integrated within the medial OFC to compute an overall value. These findings provide a mechanistic account for the construction of food value from its constituent nutrients.

Familiarity and Recollection in Heuristic Decision Making

PubMed Central

Schwikert, Shane R.; Curran, Tim

2014-01-01

Heuristics involve the ability to utilize memory to make quick judgments by exploiting fundamental cognitive abilities. In the current study we investigated the memory processes that contribute to the recognition heuristic and the fluency heuristic, which are both presumed to capitalize on the by-products of memory to make quick decisions. In Experiment 1, we used a city-size comparison task while recording event-related potentials (ERPs) to investigate the potential contributions of familiarity and recollection to the two heuristics. ERPs were markedly different for recognition heuristic-based decisions and fluency heuristic-based decisions, suggesting a role for familiarity in the recognition heuristic and recollection in the fluency heuristic. In Experiment 2, we coupled the same city-size comparison task with measures of subjective pre-experimental memory for each stimulus in the task. Although previous literature suggests the fluency heuristic relies on recognition speed alone, our results suggest differential contributions of recognition speed and recollected knowledge to these decisions, whereas the recognition heuristic relies on familiarity. Based on these results, we created a new theoretical frame work that explains decisions attributed to both heuristics based on the underlying memory associated with the choice options. PMID:25347534

Familiarity and recollection in heuristic decision making.

PubMed

Schwikert, Shane R; Curran, Tim

2014-12-01

Heuristics involve the ability to utilize memory to make quick judgments by exploiting fundamental cognitive abilities. In the current study we investigated the memory processes that contribute to the recognition heuristic and the fluency heuristic, which are both presumed to capitalize on the byproducts of memory to make quick decisions. In Experiment 1, we used a city-size comparison task while recording event-related potentials (ERPs) to investigate the potential contributions of familiarity and recollection to the 2 heuristics. ERPs were markedly different for recognition heuristic-based decisions and fluency heuristic-based decisions, suggesting a role for familiarity in the recognition heuristic and recollection in the fluency heuristic. In Experiment 2, we coupled the same city-size comparison task with measures of subjective preexperimental memory for each stimulus in the task. Although previous literature suggests the fluency heuristic relies on recognition speed alone, our results suggest differential contributions of recognition speed and recollected knowledge to these decisions, whereas the recognition heuristic relies on familiarity. Based on these results, we created a new theoretical framework that explains decisions attributed to both heuristics based on the underlying memory associated with the choice options. PsycINFO Database Record (c) 2014 APA, all rights reserved.

The prefabricated building risk decision research of DM technology on the basis of Rough Set

NASA Astrophysics Data System (ADS)

Guo, Z. L.; Zhang, W. B.; Ma, L. H.

2017-08-01

With the resources crises and more serious pollution, the green building has been strongly advocated by most countries and become a new building style in the construction field. Compared with traditional building, the prefabricated building has its own irreplaceable advantages but is influenced by many uncertainties. So far, a majority of scholars have been studying based on qualitative researches from all of the word. This paper profoundly expounds its significance about the prefabricated building. On the premise of the existing research methods, combined with rough set theory, this paper redefines the factors which affect the prefabricated building risk. Moreover, it quantifies risk factors and establish an expert knowledge base through assessing. And then reduced risk factors about the redundant attributes and attribute values, finally form the simplest decision rule. This simplest decision rule, which is based on the DM technology of rough set theory, provides prefabricated building with a controllable new decision-making method.

Diagnostic decision-making and strategies to improve diagnosis.

PubMed

Thammasitboon, Satid; Cutrer, William B

2013-10-01

A significant portion of diagnostic errors arises through cognitive errors resulting from inadequate knowledge, faulty data gathering, and/or faulty verification. Experts estimate that 75% of diagnostic failures can be attributed to clinician diagnostic thinking failure. The cognitive processes that underlie diagnostic thinking of clinicians are complex and intriguing, and it is imperative that clinicians acquire explicit appreciation and application of different cognitive approaches to make decisions better. A dual-process model that unifies many theories of decision-making has emerged as a promising template for understanding how clinicians think and judge efficiently in a diagnostic reasoning process. The identification and implementation of strategies for decreasing or preventing such diagnostic errors has become a growing area of interest and research. Suggested strategies to decrease diagnostic error incidence include increasing clinician's clinical expertise and avoiding inherent cognitive errors to make decisions better. Implementing Interventions focused solely on avoiding errors may work effectively for patient safety issues such as medication errors. Addressing cognitive errors, however, requires equal effort on expanding the individual clinician's expertise. Providing cognitive support to clinicians for robust diagnostic decision-making serves as the final strategic target for decreasing diagnostic errors. Clinical guidelines and algorithms offer another method for streamlining decision-making and decreasing likelihood of cognitive diagnostic errors. Addressing cognitive processing errors is undeniably the most challenging task in reducing diagnostic errors. While many suggested approaches exist, they are mostly based on theories and sciences in cognitive psychology, decision-making, and education. The proposed interventions are primarily suggestions and very few of them have been tested in the actual practice settings. Collaborative research effort is required to effectively address cognitive processing errors. Researchers in various areas, including patient safety/quality improvement, decision-making, and problem solving, must work together to make medical diagnosis more reliable. © 2013 Mosby, Inc. All rights reserved.

Development of a First-of-a-Kind Deterministic Decision-Making Tool for Supervisory Control System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cetiner, Sacit M; Kisner, Roger A; Muhlheim, Michael David

2015-07-01

Decision-making is the process of identifying and choosing alternatives where each alternative offers a different approach or path to move from a given state or condition to a desired state or condition. The generation of consistent decisions requires that a structured, coherent process be defined, immediately leading to a decision-making framework. The overall objective of the generalized framework is for it to be adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or nomore » human intervention. The overriding goal of automation is to replace or supplement human decision makers with reconfigurable decision- making modules that can perform a given set of tasks reliably. Risk-informed decision making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The implementation of the probabilistic portion of the decision-making engine of the proposed supervisory control system was detailed in previous milestone reports. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic multi-attribute decision-making framework uses variable sensor data (e.g., outlet temperature) and calculates where it is within the challenge state, its trajectory, and margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. Metrics to be evaluated include stability, cost, time to complete (action), power level, etc. The integration of deterministic calculations using multi-physics analyses (i.e., neutronics, thermal, and thermal-hydraulics) and probabilistic safety calculations allows for the examination and quantification of margin recovery strategies. This also provides validation of the control options identified from the probabilistic assessment. Thus, the thermal-hydraulics analyses are used to validate the control options identified from the probabilistic assessment. Future work includes evaluating other possible metrics and computational efficiencies.« less

Patients' ratings of genetic conditions validate a taxonomy to simplify decisions about preconception carrier screening via genome sequencing.

PubMed

Leo, Michael C; McMullen, Carmit; Wilfond, Benjamin S; Lynch, Frances L; Reiss, Jacob A; Gilmore, Marian J; Himes, Patricia; Kauffman, Tia L; Davis, James V; Jarvik, Gail P; Berg, Jonathan S; Harding, Cary; Kennedy, Kathleen A; Simpson, Dana Kostiner; Quigley, Denise I; Richards, C Sue; Rope, Alan F; Goddard, Katrina A B

2016-03-01

Advances in genome sequencing and gene discovery have created opportunities to efficiently assess more genetic conditions than ever before. Given the large number of conditions that can be screened, the implementation of expanded carrier screening using genome sequencing will require practical methods of simplifying decisions about the conditions for which patients want to be screened. One method to simplify decision making is to generate a taxonomy based on expert judgment. However, expert perceptions of condition attributes used to classify these conditions may differ from those used by patients. To understand whether expert and patient perceptions differ, we asked women who had received preconception genetic carrier screening in the last 3 years to fill out a survey to rate the attributes (predictability, controllability, visibility, and severity) of several autosomal recessive or X-linked genetic conditions. These conditions were classified into one of five taxonomy categories developed by subject experts (significantly shortened lifespan, serious medical problems, mild medical problems, unpredictable medical outcomes, and adult-onset conditions). A total of 193 women provided 739 usable ratings across 20 conditions. The mean ratings and correlations demonstrated that participants made distinctions across both attributes and categories. Aggregated mean attribute ratings across categories demonstrated logical consistency between the key features of each attribute and category, although participants perceived little difference between the mild and serious categories. This study provides empirical evidence for the validity of our proposed taxonomy, which will simplify patient decisions for results they would like to receive from preconception carrier screening via genome sequencing. © 2016 Wiley Periodicals, Inc.

Emotion, decision making, and the amygdala.

PubMed

Seymour, Ben; Dolan, Ray

2008-06-12

Emotion plays a critical role in many contemporary accounts of decision making, but exactly what underlies its influence and how this is mediated in the brain remain far from clear. Here, we review behavioral studies that suggest that Pavlovian processes can exert an important influence over choice and may account for many effects that have traditionally been attributed to emotion. We illustrate how recent experiments cast light on the underlying structure of Pavlovian control and argue that generally this influence makes good computational sense. Corresponding neuroscientific data from both animals and humans implicate a central role for the amygdala through interactions with other brain areas. This yields a neurobiological account of emotion in which it may operate, often covertly, to optimize rather than corrupt economic choice.

"Paying the price to get there": Motherhood and the dynamics of pregnancy deliberations among women with disabilities.

PubMed

LaPierre, Tracey A; Zimmerman, Mary K; Hall, Jean P

2017-07-01

Women with disabilities report fewer pregnancies than those without disabilities. To explore the range of factors involved in pregnancy decision-making among women with disabilities, and give insight into the decision making process. Data were obtained from 4 focus groups conducted with 22 women of child-bearing age, who had a chronic physical or mental health condition or disability that influenced their pregnancy decisions. Group transcripts were analyzed using conventional content analysis to identify the types of factors that influence pregnancy decisions and themes related to pregnancy decision-making. Most had a strong desire for motherhood, although there were varied decisions and some ambivalence over whether or not to attempt pregnancy. Decisions were influenced by an interplay of biomedical, social and personal factors that shaped assessments of three key areas of consideration: importance, feasibility, and costs of pregnancy/motherhood. It is not just the 'biomedical facts' of health conditions that are relevant, but rather the meaning attributed to these facts and how they are weighed in relation to other significant non-medical factors. By moving beyond the medical model of disability to recognize the importance of social and personal factors, and engaging in patient-centered communication, healthcare providers can facilitate pregnancy decision-making that is consistent with the values and preferences of women with disabilities and improve quality of care and support. In order to make motherhood a more viable option for women with disabilities, societal attitudes and a lack of role models for these women also need to be addressed. Copyright © 2017 Elsevier Inc. All rights reserved.

An intelligent, knowledge-based multiple criteria decision making advisor for systems design

NASA Astrophysics Data System (ADS)

Li, Yongchang

In systems engineering, design and operation of systems are two main problems which always attract researcher's attentions. The accomplishment of activities in these problems often requires proper decisions to be made so that the desired goal can be achieved, thus, decision making needs to be carefully fulfilled in the design and operation of systems. Design is a decision making process which permeates through out the design process, and is at the core of all design activities. In modern aircraft design, more and more attention is paid to the conceptual and preliminary design phases so as to increase the odds of choosing a design that will ultimately be successful at the completion of the design process, therefore, decisions made during these early design stages play a critical role in determining the success of a design. Since aerospace systems are complex systems with interacting disciplines and technologies, the Decision Makers (DMs) dealing with such design problems are involved in balancing the multiple, potentially conflicting attributes/criteria, transforming a large amount of customer supplied guidelines into a solidly defined set of requirement definitions. Thus, one could state with confidence that modern aerospace system design is a Multiple Criteria Decision Making (MCDM) process. A variety of existing decision making methods are available to deal with this type of decision problems. The selection of the most appropriate decision making method is of particular importance since inappropriate decision methods are likely causes of misleading engineering design decisions. With no sufficient knowledge about each of the methods, it is usually difficult for the DMs to find an appropriate analytical model capable of solving their problems. In addition, with the complexity of the decision problem and the demand for more capable methods increasing, new decision making methods are emerging with time. These various methods exacerbate the difficulty of the selection of an appropriate decision making method. Furthermore, some DMs may be exclusively using one or two specific methods which they are familiar with or trust and not realizing that they may be inappropriate to handle certain classes of the problems, thus yielding erroneous results. These issues reveal that in order to ensure a good decision a suitable decision method should be chosen before the decision making process proceeds. The first part of this dissertation proposes an MCDM process supported by an intelligent, knowledge-based advisor system referred to as Multi-Criteria Interactive Decision-Making Advisor and Synthesis process (MIDAS), which is able to facilitate the selection of the most appropriate decision making method and which provides insight to the user for fulfilling different preferences. The second part of this dissertation presents an autonomous decision making advisor which is capable of dealing with ever-evolving real time information and making autonomous decisions under uncertain conditions. The advisor encompasses a Markov Decision Process (MDP) formulation which takes uncertainty into account when determines the best action for each system state. (Abstract shortened by UMI.)

Patient Preferences for Features of Health Care Delivery Systems: A Discrete Choice Experiment.

PubMed

Mühlbacher, Axel C; Bethge, Susanne; Reed, Shelby D; Schulman, Kevin A

2016-04-01

To estimate the relative importance of organizational-, procedural-, and interpersonal-level features of health care delivery systems from the patient perspective. We designed four discrete choice experiments (DCEs) to measure patient preferences for 21 health system attributes. Participants were recruited through the online patient portal of a large health system. We analyzed the DCE data using random effects logit models. DCEs were performed in which respondents were provided with descriptions of alternative scenarios and asked to indicate which scenario they prefer. Respondents were randomly assigned to one of the three possible health scenarios (current health, new lung cancer diagnosis, or diabetes) and asked to complete 15 choice tasks. Each choice task included an annual out-of-pocket cost attribute. A total of 3,900 respondents completed the survey. The out-of-pocket cost attribute was considered the most important across the four different DCEs. Following the cost attribute, trust and respect, multidisciplinary care, and shared decision making were judged as most important. The relative importance of out-of-pocket cost was consistently lower in the hypothetical context of a new lung cancer diagnosis compared with diabetes or the patient's current health. This study demonstrates the complexity of patient decision making processes regarding features of health care delivery systems. Our findings suggest the importance of these features may change as a function of an individual's medical conditions. © Health Research and Educational Trust.

The role of personal values in Chinese consumers' food consumption decisions. A case study of healthy drinks.

PubMed

Lee, Pui Yee; Lusk, Karen; Mirosa, Miranda; Oey, Indrawati

2014-02-01

Differences in culture, language, and behavior between Chinese and Western consumers make entering the Chinese market a challenge. Chinese consumers may desire similar product features (e.g. brand name, quality, and flavor) to Western consumers but the value that consumers attach to the same product may differ cross-nationally. Besides values, an understanding of desired product attributes and the consequences linking to these values is also important. To the authors' knowledge, there is no published scientific research that investigates how personal values influence Chinese consumers' food consumption decisions. The aim of this research was to identify the links among product attributes, consequences of these attributes, and personal values associated with healthy drink consumption decisions within the Chinese market. Specifically, this research employed means-end chain theory and used association pattern technique (APT) as the main data collection technique to identify these links. Focus groups (n=6) were held in Hangzhou, China to identify the important attributes and consequences involved in the consumption decisions of healthy drinks. These attributes and consequences along with Schwartz's 10 basic values were used to construct the matrices included in the APT survey. A total of 600 APT surveys were administered in six different companies in Hangzhou, with 570 returned. Construction of the hierarchical value map (HVM) identified four of Schwartz's personal values influencing Chinese consumers' healthy drink consumption decisions: security, hedonism, benevolence, and self-direction. Food safety was the foremost concern for Chinese consumers when choosing healthy drinks. Chinese consumers also sought a good tasting and nutritious drink that was good value for money. Results from this study provide food marketers with an in-depth understanding of Chinese consumers' healthy drink consumption decisions. Implications and recommendations are provided that will assist food marketers to effectively enact marketing strategies in China. Copyright © 2013 Elsevier Ltd. All rights reserved.

A decision aid for intensity-modulated radiation-therapy plan selection in prostate cancer based on a prognostic Bayesian network and a Markov model.

PubMed

Smith, Wade P; Doctor, Jason; Meyer, Jürgen; Kalet, Ira J; Phillips, Mark H

2009-06-01

The prognosis of cancer patients treated with intensity-modulated radiation-therapy (IMRT) is inherently uncertain, depends on many decision variables, and requires that a physician balance competing objectives: maximum tumor control with minimal treatment complications. In order to better deal with the complex and multiple objective nature of the problem we have combined a prognostic probabilistic model with multi-attribute decision theory which incorporates patient preferences for outcomes. The response to IMRT for prostate cancer was modeled. A Bayesian network was used for prognosis for each treatment plan. Prognoses included predicting local tumor control, regional spread, distant metastases, and normal tissue complications resulting from treatment. A Markov model was constructed and used to calculate a quality-adjusted life-expectancy which aids in the multi-attribute decision process. Our method makes explicit the tradeoffs patients face between quality and quantity of life. This approach has advantages over current approaches because with our approach risks of health outcomes and patient preferences determine treatment decisions.

Dietary self-control is related to the speed with which health and taste attributes are processed

PubMed Central

Sullivan, Nicolette; Hutcherson, Cendri; Harris, Alison; Rangel, Antonio

2015-01-01

We propose that self-control failures, and variation across individuals in self-control abilities, are partly due to differences in the speed with which the decision-making circuitry processes basic attributes like taste, versus more abstract attributes such as health. We test these hypotheses by combining a dietary choice task with a novel form of mouse tracking that allows us to pinpoint when different attributes are being integrated into the choice process with millisecond temporal resolution. We find that, on average, taste attributes are processed about 195 ms earlier than health attributes during the choice process. We also find that 13 - 39% of observed individual differences in self-control ability can be explained by differences in the relative speed with which taste and health attributes are processed. PMID:25515527

The effect of four user interface concepts on visual scan pattern similarity and information foraging in a complex decision making task.

PubMed

Starke, Sandra D; Baber, Chris

2018-07-01

User interface (UI) design can affect the quality of decision making, where decisions based on digitally presented content are commonly informed by visually sampling information through eye movements. Analysis of the resulting scan patterns - the order in which people visually attend to different regions of interest (ROIs) - gives an insight into information foraging strategies. In this study, we quantified scan pattern characteristics for participants engaging with conceptually different user interface designs. Four interfaces were modified along two dimensions relating to effort in accessing information: data presentation (either alpha-numerical data or colour blocks), and information access time (all information sources readily available or sequential revealing of information required). The aim of the study was to investigate whether a) people develop repeatable scan patterns and b) different UI concepts affect information foraging and task performance. Thirty-two participants (eight for each UI concept) were given the task to correctly classify 100 credit card transactions as normal or fraudulent based on nine transaction attributes. Attributes varied in their usefulness of predicting the correct outcome. Conventional and more recent (network analysis- and bioinformatics-based) eye tracking metrics were used to quantify visual search. Empirical findings were evaluated in context of random data and possible accuracy for theoretical decision making strategies. Results showed short repeating sequence fragments within longer scan patterns across participants and conditions, comprising a systematic and a random search component. The UI design concept showing alpha-numerical data in full view resulted in most complete data foraging, while the design concept showing colour blocks in full view resulted in the fastest task completion time. Decision accuracy was not significantly affected by UI design. Theoretical calculations showed that the difference in achievable accuracy between very complex and simple decision making strategies was small. We conclude that goal-directed search of familiar information results in repeatable scan pattern fragments (often corresponding to information sources considered particularly important), but no repeatable complete scan pattern. The underlying concept of the UI affects how visual search is performed, and a decision making strategy develops. This should be taken in consideration when designing for applied domains. Copyright © 2018 Elsevier Ltd. All rights reserved.

Prioritization of highway maintenance functions using multi-attribute decision making with fuzzy pairwise comparison.

DOT National Transportation Integrated Search

2011-09-01

"As is the case for most of the Departments of Transportation in the U.S., the Texas Department of : Transportation has been experiencing fluctuations of budget for maintaining and preserving its highway : infrastructure over the recent years. If the...

U.S. Decision Making and Post-Cold War NATO Enlargement

DTIC Science & Technology

2015-03-01

believed that President Yeltsin was truly committed to democratic reform in Russia and attributed Yeltsin’s public conflagrations to Russian...recommending any concrete steps toward enlargement.46 The position of America’s Allies began to change once the United States demonstrated its firm

Innovativeness and the Organizational Attributes of Schools.

ERIC Educational Resources Information Center

Eidell, Terry L.; And Others

Five papers focus on the interrelated themes of school organization and innovation. They report on some preliminary analyses of field studies conducted during 1968 on such structural, sociocultural, and sociopsychological variables as division of labor, performance of organizational functions, decision making studies and processes, hierarchies of…

What Do Patients Want from Otolaryngologists? A Discrete Choice Experiment.

PubMed

Naunheim, Matthew R; Rathi, Vinay K; Naunheim, Margaret L; Alkire, Blake C; Lam, Allen C; Song, Phillip C; Shrime, Mark G

2017-10-01

Objectives Patient preferences are crucial for the delivery of patient-centered care. Discrete choice experiments (DCEs) are an emerging quantitative methodology used for understanding these preferences. In this study, we employed DCE techniques to understand the preferences of patients presenting for an ear, nose, and throat clinic visit. Study Design DCE. Setting Decision science laboratory. Methods A DCE survey of 5 attributes-wait time, physician experience, physician personality, utilization of visit time, and cost/copayment-was constructed with structured qualitative interviews with patients. The DCE was administered to participants from the general population, who chose among hypothetical scenarios that varied across these attributes. A conditional logit model was used to determine relative attribute importance, with a separate logit model for determining subject effects. Results A total of 161 participants were included. Cost/copayment had the greatest impact on decision making (importance, 32.2%), followed by wait time and physician experience (26.5% and 24.7%, respectively). Physician personality mattered least (4.7%), although all attributes were significantly correlated to decision making. Participants preferred doctors who spent more time performing physical examination than listening or explaining. Participants were willing to pay $52 extra to avoid a 4-week delay in appointment time; $87 extra for a physician with 10 years of experience (vs 0 years); and $9 extra for a caring, friendly, and compassionate doctor (vs formal, efficient, and business-like). Conclusion DCEs allow for powerful economic analyses that may help physicians understand patient preferences. Our model showed that cost is an important factor to patients and that patients are willing to pay extra for timely appointments, experience, and thorough physical examination.

Evaluate the use of tanning agent in leather industry using material flow analysis, life cycle assessment and fuzzy multi-attribute decision making (FMADM)

NASA Astrophysics Data System (ADS)

Alfarisi, Salman; Sutono, Sugoro Bhakti; Sutopo, Wahyudi

2017-11-01

Tanning industry is one of the companies that produce many pollutants and cause the negative impact on the environment. In the production process of tanning leather, the use of input material need to be evaluated. The problem of waste, not only have a negative impact on the environment, but also human health. In this study, the impact of mimosa as vegetable tanning agent evaluated. This study will provide alternative solutions for improvements to the use of vegetable tanning agent. The alternative solution is change mimosa with indusol, gambier, and dulcotan. This study evaluate the vegetable tanning of some aspects using material flow analysis and life cycle assessment approach. Life cycle assessment (LCA) is used to evaluate the environmental impact of vegetable tanning agent. Alternative solution selection using fuzzy multi-attribute decision making (FMADM) approach. Results obtained by considering the environment, human toxicity, climate change, and marine aquatic ecotoxicity, is to use dulcotan.

Underground Mining Method Selection Using WPM and PROMETHEE

NASA Astrophysics Data System (ADS)

Balusa, Bhanu Chander; Singam, Jayanthu

2018-04-01

The aim of this paper is to represent the solution to the problem of selecting suitable underground mining method for the mining industry. It is achieved by using two multi-attribute decision making techniques. These two techniques are weighted product method (WPM) and preference ranking organization method for enrichment evaluation (PROMETHEE). In this paper, analytic hierarchy process is used for weight's calculation of the attributes (i.e. parameters which are used in this paper). Mining method selection depends on physical parameters, mechanical parameters, economical parameters and technical parameters. WPM and PROMETHEE techniques have the ability to consider the relationship between the parameters and mining methods. The proposed techniques give higher accuracy and faster computation capability when compared with other decision making techniques. The proposed techniques are presented to determine the effective mining method for bauxite mine. The results of these techniques are compared with methods used in the earlier research works. The results show, conventional cut and fill method is the most suitable mining method.

Bayesian Bigot? Statistical Discrimination, Stereotypes, and Employer Decision Making

PubMed Central

Pager, Devah; Karafin, Diana

2010-01-01

Much of the debate over the underlying causes of discrimination centers on the rationality of employer decision making. Economic models of statistical discrimination emphasize the cognitive utility of group estimates as a means of dealing with the problems of uncertainty. Sociological and social-psychological models, by contrast, question the accuracy of group-level attributions. Although mean differences may exist between groups on productivity-related characteristics, these differences are often inflated in their application, leading to much larger differences in individual evaluations than would be warranted by actual group-level trait distributions. In this study, the authors examine the nature of employer attitudes about black and white workers and the extent to which these views are calibrated against their direct experiences with workers from each group. They use data from fifty-five in-depth interviews with hiring managers to explore employers’ group-level attributions and their direct observations to develop a model of attitude formation and employer learning. PMID:20686633

Role of Travel Motivations, Perceived Risks and Travel Constraints on Destination Image and Visit Intention in Medical Tourism

PubMed Central

Khan, Mohammad J.; Chelliah, Shankar; Haron, Mahmod S.; Ahmed, Sahrish

2017-01-01

Travel motivations, perceived risks and travel constraints, along with the attributes and characteristics of medical tourism destinations, are important issues in medical tourism. Although the importance of these factors is already known, a comprehensive theoretical model of the decision-making process of medical tourists has yet to be established, analysing the intricate relationships between the different variables involved. This article examines a large body of literature on both medical and conventional tourism in order to propose a comprehensive theoretical framework of medical tourism decision-making. Many facets of this complex phenomenon require further empirical investigation. PMID:28417022

Role of Travel Motivations, Perceived Risks and Travel Constraints on Destination Image and Visit Intention in Medical Tourism: Theoretical model.

PubMed

Khan, Mohammad J; Chelliah, Shankar; Haron, Mahmod S; Ahmed, Sahrish

2017-02-01

Travel motivations, perceived risks and travel constraints, along with the attributes and characteristics of medical tourism destinations, are important issues in medical tourism. Although the importance of these factors is already known, a comprehensive theoretical model of the decision-making process of medical tourists has yet to be established, analysing the intricate relationships between the different variables involved. This article examines a large body of literature on both medical and conventional tourism in order to propose a comprehensive theoretical framework of medical tourism decision-making. Many facets of this complex phenomenon require further empirical investigation.

What is lacking in current decision aids on cancer screening?

PubMed Central

Jimbo, Masahito; Rana, Gurpreet K.; Hawley, Sarah; Holmes-Rovner, Margaret; Kelly-Blake, Karen; Nease, Donald E.; Ruffin, Mack T.

2013-01-01

Recent guidelines on cancer screening have given not only more screening options but also conflicting recommendations. Thus, patients, with their clinicians’ support, must decide whether to get screened or not, which modality to use, and how often to get screened. Decision aids could potentially lead to better shared decision making regarding screening between the patient and the clinician. We reviewed 73 decision aids on screening for breast, cervical, colorectal, and prostate cancers. The goal of this review was to assess the effectiveness of such decision aids, examine areas in need for more research, and determine how the decision aids can be currently applied in the real world setting. Most studies used sound study design. Significant variation existed in setting, theoretical framework, and measured outcomes. Just over a third of the decision aids included an explicit values clarification. Other than knowledge, little consistency was noted in which patient attributes were measured as outcomes. Few studies actually measured shared decision making. Little information was available on the feasibility and outcomes of integrating decision aids into practice. We discuss the implications for future research, as well as what the clinicians can do now to incorporate decision aids into their practice. PMID:23504675

Thinking Fast Increases Framing Effects in Risky Decision Making.

PubMed

Guo, Lisa; Trueblood, Jennifer S; Diederich, Adele

2017-04-01

Every day, people face snap decisions when time is a limiting factor. In addition, the way a problem is presented can influence people's choices, which creates what are known as framing effects. In this research, we explored how time pressure interacts with framing effects in risky decision making. Specifically, does time pressure strengthen or weaken framing effects? On one hand, research has suggested that framing effects evolve through the deliberation process, growing larger with time. On the other hand, dual-process theory attributes framing effects to an intuitive, emotional system that responds automatically to stimuli. In our experiments, participants made decisions about gambles framed in terms of either gains or losses, and time pressure was manipulated across blocks. Results showed increased framing effects under time pressure in both hypothetical and incentivized choices, which supports the dual-process hypothesis that these effects arise from a fast, intuitive system.

Game relativity: how context influences strategic decision making.

PubMed

Vlaev, Ivo; Chater, Nick

2006-01-01

Existing models of strategic decision making typically assume that only the attributes of the currently played game need be considered when reaching a decision. The results presented in this article demonstrate that the so-called "co-operativeness" of the previously played prisoner's dilemma games influence choices and predictions in the current prisoner's dilemma game, which suggests that games are not considered independently. These effects involved reinforcement-based assimilation to the previous choices and also a perceptual contrast of the present game with preceding games, depending on the range and the rank of their co-operativeness. A. Parducci's (1965) range frequency theory and H. Helson's (1964) adaptation level theory are plausible theories of relative judgment of magnitude information, which could provide an account of these context effects. ((c) 2006 APA, all rights reserved).

Parental Health Attributions of Childhood Health and Illness: Development of the Pediatric Cultural Health Attributions Questionnaire (Pedi-CHAQ).

PubMed

Vaughn, Lisa M; McLinden, Daniel J; Shellmer, Diana; Baker, Raymond C

2011-01-01

The causes attributed to childhood health and illness across cultures (cultural health attributions) are key factors that are now more frequently identified as affecting the health outcomes of children. Research suggests that the causes attributed to an event such as illness are thought to affect subsequent motivation, emotional response, decision making, and behavior. To date, there is no measure of health attributions appropriate for use with parents of pediatric patients. Using the Many-Facets approach to Rasch analysis, this study assesses the psychometrics of a newly developed instrument, the Pediatric Health Attributions Questionnaire (Pedi-CHAQ), a measure designed to assess the cultural health attributions of parents in diverse communities. Results suggest acceptable Rasch model statistics of fit and reliability for the Pedi-CHAQ. A shortened version of the questionnaire was developed as a result of this study and next steps are discussed.

Effects of emotion on prospection during decision-making.

PubMed

Worthy, Darrell A; Byrne, Kaileigh A; Fields, Sherecce

2014-01-01

In two experiments we examined the role of emotion, specifically worry, anxiety, and mood, on prospection during decision-making. Worry is a particularly relevant emotion to study in the context of prospection because high levels of worry may make individuals more aversive toward the uncertainty associated with the prospect of obtaining future improvements in rewards or states. Thus, high levels of worry might lead to reduced prospection during decision-making and enhance preference for immediate over delayed rewards. In Experiment 1 participants performed a two-choice dynamic decision-making task where they were required to choose between one option (the decreasing option) which provided larger immediate rewards but declines in future states, and another option (the increasing option) which provided smaller immediate rewards but improvements in future states, making it the optimal choice. High levels of worry were associated with poorer performance in the task. Additionally, fits of a sophisticated reinforcement-learning model that incorporated both reward-based and state-based information suggested that individuals reporting high levels of worry gave greater weight to the immediate rewards they would receive on each trial than to the degree to which each action would lead to improvements in their future state. In Experiment 2 we found that high levels of worry were associated with greater delay discounting using a standard delay discounting task. Combined, the results suggest that high levels of worry are associated with reduced prospection during decision-making. We attribute these results to high worriers' aversion toward the greater uncertainty associated with attempting to improve future rewards than to maximize immediate reward. These results have implications for researchers interested in the effects of emotion on cognition, and suggest that emotion strongly affects the focus on temporal outcomes during decision-making.

Patient autonomy in multiple sclerosis--possible goals and assessment strategies.

PubMed

Heesen, C; Köpke, S; Solari, A; Geiger, F; Kasper, J

2013-08-15

Patient autonomy has been increasingly acknowledged as prerequisite for successful medical decision making in Western countries. In medical decisions with a need to involve a health professional, patient autonomy becomes apparent in the extent of patients' participation in the communication as described in the concept of shared decision making. Patient autonomy can be derived from different perspectives or goals and the focus of evaluation approaches may vary accordingly. Multiple sclerosis (MS) is a paradigmatic disease to study patient autonomy mainly because MS patients are highly disease competent and due to ambiguous evidence on many aspects of disease-related medical decision making. This review gives an overview on measurement issues in studying decision making in MS, categorized according to prerequisites, process measures and outcomes of patient autonomy. As relevant prerequisites role preferences, risk attribution, risk tolerance, and risk knowledge are discussed. Regarding processes, we distinguish intra-psychic and interpersonal aspects. Intra-psychic processes are elucidated using the theory of planned behavior, which guided development of a 30-item scale to capture decisions about immunotherapy. Moreover, a theory of uncertainty management has been created resulting in the development of a corresponding measurement concept. Interpersonal processes evolving between physician and patient can be thoroughly analyzed from different perspectives by use of the newly developed comprehensive MAPPIN'SDM inventory. Concerning outcomes, besides health related outcomes, we discuss match of preferred roles during the decision encounters (preference match), decisional conflict as well as an application of the multidimensional measure of informed choice to decisions of MS patients. These approaches provide an overview on patient-inherent and interpersonal factors and processes modulating medical decision making and health behavior in MS and beyond. Copyright © 2013. Published by Elsevier B.V.

Carbon Cycle Science in Support of Decision-Making

NASA Astrophysics Data System (ADS)

Brown, M. E.; West, T. O.; McGlynn, E.; Gurwick, N. P.; Duren, R. M.; Ocko, I.; Paustian, K.

2016-12-01

There has been an extensive amount of basic and applied research conducted on biogeochemical cycles, land cover change, watershed to earth system modeling, climate change, and energy efficiency. Concurrently, there continues to be interest in how to best reduce net carbon emissions, including maintaining or augmenting global carbon stocks and decreasing fossil fuel emissions. Decisions surrounding reductions in net emissions should be grounded in, and informed by, existing scientific knowledge and analyses in order to be most effective. The translation of scientific research to decision-making is rarely direct, and often requires coordination of objectives or intermediate research steps. For example, complex model output may need to be simplified to provide mean estimates for given activities; biogeochemical models used for climate change prediction may need to be altered to estimate net carbon flux associated with particular activities; or scientific analyses may need to aggregate and analyze data in a different manner to address specific questions. In the aforementioned cases, expertise and capabilities of researchers and decision-makers are both needed, and early coordination and communication is most effective. Initial analysis of existing science and current decision-making needs indicate that (a) knowledge that is co-produced by scientists and decision-makers has a higher probability of being usable for decision making, (b) scientific work in the past decade to integrate activity data into models has resulted in more usable information for decision makers, (c) attribution and accounting of carbon cycle fluxes is key to using carbon cycle science for decision-making, and (d) stronger, long-term links among research on climate and management of carbon-related sectors (e.g., energy, land use, industry, and buildings) are needed to adequately address current issues.

Valuating Privacy with Option Pricing Theory

NASA Astrophysics Data System (ADS)

Berthold, Stefan; Böhme, Rainer

One of the key challenges in the information society is responsible handling of personal data. An often-cited reason why people fail to make rational decisions regarding their own informational privacy is the high uncertainty about future consequences of information disclosures today. This chapter builds an analogy to financial options and draws on principles of option pricing to account for this uncertainty in the valuation of privacy. For this purpose, the development of a data subject's personal attributes over time and the development of the attribute distribution in the population are modeled as two stochastic processes, which fit into the Binomial Option Pricing Model (BOPM). Possible applications of such valuation methods to guide decision support in future privacy-enhancing technologies (PETs) are sketched.

Patient and Oncology Nurse Preferences for the Treatment Options in Advanced Melanoma: A Discrete Choice Experiment.

PubMed

Liu, Frank Xiaoqing; Witt, Edward A; Ebbinghaus, Scot; DiBonaventura Beyer, Grace; Basurto, Enrique; Joseph, Richard W

2017-10-25

Understanding the perceptions of patients and oncology nurses about the relative importance of benefits and risks associated with newer treatments of advanced melanoma can help to inform clinical decision-making. The aims of this study were to quantify and compare the views of patients and oncology nurses regarding the importance of attributes of treatments of advanced melanoma. A discrete choice experiment (DCE) was conducted in US-based oncology nurses and patients diagnosed with advanced melanoma. Patients and nurses were enlisted through online panels. In a series of scenarios, respondents had to choose between 2 hypothetical treatments, each with 7 attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (DoT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3 or 4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to estimate preference weights. A total of 200 patients with advanced melanoma and 150 oncology nurses participated. The relative importance estimates of attributes by patients and nurses, respectively, were as follows: OS, 33% and 28%; AEs, 29% and 26%; ORR, 25% and 27%; PFS, 12% and 15%; DS, 2% and 3%; DoT, 0% and 0%; and MoA, 0% and 0%. Both patients and oncology nurses valued OS, ORR, and AEs as the most important treatment attributes for advanced melanoma, followed by PFS, whereas DS, DoT, and MoA were given less value in their treatment decisions. Oncology nurses and patients have similar views on important treatment considerations for advanced melanoma, which can help build trust in shared decision-making.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Women's role in sanitation decision making in rural coastal Odisha, India.

PubMed

Routray, Parimita; Torondel, Belen; Clasen, Thomas; Schmidt, Wolf-Peter

2017-01-01

While women and girls face special risks from lack of access to sanitation facilities, their ability to participate and influence household-level sanitation is not well understood. This paper examines the association between women's decision-making autonomy and latrine construction in rural areas of Odisha, India. We conducted a mixed-method study among rural households in Puri district. This included a cross sectional survey among 475 randomly selected households. These were classified as either having a functional latrine, a non-functional latrine or no latrine at all. We also conducted 17 in-depth interviews and 9 focus group discussions among household members of these three categories of households. Decisions on the construction of household level sanitation facilities were made exclusively by the male head in 80% of households; in 11% the decision was made by men who consulted or otherwise involved women. In only 9% of households the decision was made by women. Households where women were more involved in general decision making processes were no more likely to build a latrine, compared to households where they were excluded from decisions. Qualitative research revealed that women's non-involvement in sanitation decision making is attributed to their low socio-economic status and inability to influence the household's financial decisions. Female heads lacked confidence to take decisions independently, and were dependent on their spouse or other male family members for most decisions. The study revealed the existence of power hierarchies and dynamics within households, which constrained female's participation in decision-making processes regarding sanitation. Though governments and implementers emphasize women's involvement in sanitation programmes, socio-cultural factors and community and household level dynamics often prevent women from participating in sanitation-related decisions. Measures are needed for strengthening sanitation policies and effective implementation of programmes to address gender power relations and familial relationships that influence latrine adoption and use.

Women's role in sanitation decision making in rural coastal Odisha, India

PubMed Central

Torondel, Belen; Clasen, Thomas; Schmidt, Wolf-Peter

2017-01-01

Background While women and girls face special risks from lack of access to sanitation facilities, their ability to participate and influence household-level sanitation is not well understood. This paper examines the association between women's decision-making autonomy and latrine construction in rural areas of Odisha, India. Methods We conducted a mixed-method study among rural households in Puri district. This included a cross sectional survey among 475 randomly selected households. These were classified as either having a functional latrine, a non-functional latrine or no latrine at all. We also conducted 17 in-depth interviews and 9 focus group discussions among household members of these three categories of households. Results Decisions on the construction of household level sanitation facilities were made exclusively by the male head in 80% of households; in 11% the decision was made by men who consulted or otherwise involved women. In only 9% of households the decision was made by women. Households where women were more involved in general decision making processes were no more likely to build a latrine, compared to households where they were excluded from decisions. Qualitative research revealed that women’s non-involvement in sanitation decision making is attributed to their low socio-economic status and inability to influence the household’s financial decisions. Female heads lacked confidence to take decisions independently, and were dependent on their spouse or other male family members for most decisions. The study revealed the existence of power hierarchies and dynamics within households, which constrained female’s participation in decision-making processes regarding sanitation. Conclusions Though governments and implementers emphasize women’s involvement in sanitation programmes, socio-cultural factors and community and household level dynamics often prevent women from participating in sanitation-related decisions. Measures are needed for strengthening sanitation policies and effective implementation of programmes to address gender power relations and familial relationships that influence latrine adoption and use. PMID:28542525

Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection.

PubMed

Dobler, Claudia C; Bosnic-Anticevich, Sinthia; Armour, Carol L

2018-01-01

The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds) and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk-benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters.

Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection

PubMed Central

Bosnic-Anticevich, Sinthia; Armour, Carol L.

2018-01-01

The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds) and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk–benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters. PMID:29577042

Boundary Spanning in Offshored Information Systems Development Projects

ERIC Educational Resources Information Center

Krishnan, Poornima

2010-01-01

Recent growth in offshore outsourcing of information systems (IS) services is accompanied by managing the offshore projects successfully. Much of the project failures can be attributed to geographic and organizational boundaries which create differences in culture, language, work patterns, and decision making processes among the offshore project…

Extracting multistage screening rules from online dating activity data.

PubMed

Bruch, Elizabeth; Feinberg, Fred; Lee, Kee Yeun

2016-09-20

This paper presents a statistical framework for harnessing online activity data to better understand how people make decisions. Building on insights from cognitive science and decision theory, we develop a discrete choice model that allows for exploratory behavior and multiple stages of decision making, with different rules enacted at each stage. Critically, the approach can identify if and when people invoke noncompensatory screeners that eliminate large swaths of alternatives from detailed consideration. The model is estimated using deidentified activity data on 1.1 million browsing and writing decisions observed on an online dating site. We find that mate seekers enact screeners ("deal breakers") that encode acceptability cutoffs. A nonparametric account of heterogeneity reveals that, even after controlling for a host of observable attributes, mate evaluation differs across decision stages as well as across identified groupings of men and women. Our statistical framework can be widely applied in analyzing large-scale data on multistage choices, which typify searches for "big ticket" items.

Extracting multistage screening rules from online dating activity data

PubMed Central

Bruch, Elizabeth; Feinberg, Fred; Lee, Kee Yeun

2016-01-01

This paper presents a statistical framework for harnessing online activity data to better understand how people make decisions. Building on insights from cognitive science and decision theory, we develop a discrete choice model that allows for exploratory behavior and multiple stages of decision making, with different rules enacted at each stage. Critically, the approach can identify if and when people invoke noncompensatory screeners that eliminate large swaths of alternatives from detailed consideration. The model is estimated using deidentified activity data on 1.1 million browsing and writing decisions observed on an online dating site. We find that mate seekers enact screeners (“deal breakers”) that encode acceptability cutoffs. A nonparametric account of heterogeneity reveals that, even after controlling for a host of observable attributes, mate evaluation differs across decision stages as well as across identified groupings of men and women. Our statistical framework can be widely applied in analyzing large-scale data on multistage choices, which typify searches for “big ticket” items. PMID:27578870

Following your heart or your head: focusing on emotions versus information differentially influences the decisions of younger and older adults.

PubMed

Mikels, Joseph A; Löckenhoff, Corinna E; Maglio, Sam J; Goldstein, Mary K; Garber, Alan; Carstensen, Laura L

2010-03-01

Research on aging has indicated that whereas deliberative cognitive processes decline with age, emotional processes are relatively spared. To examine the implications of these divergent trajectories in the context of health care choices, we investigated whether instructional manipulations emphasizing a focus on feelings or details would have differential effects on decision quality among younger and older adults. We presented 60 younger and 60 older adults with health care choices that required them to hold in mind and consider multiple pieces of information. Instructional manipulations in the emotion-focus condition asked participants to focus on their emotional reactions to the options, report their feelings about the options, and then make a choice. In the information-focus condition, participants were instructed to focus on the specific attributes, report the details about the options, and then make a choice. In a control condition, no directives were given. Manipulation checks indicated that the instructions were successful in eliciting different modes of processing. Decision quality data indicate that younger adults performed better in the information-focus than in the control condition whereas older adults performed better in the emotion-focus and control conditions than in the information-focus condition. Findings support and extend extant theorizing on aging and decision making as well as suggest that interventions to improve decision-making quality should take the age of the decision maker into account.

Determination of Network Attributes from a High Resolution Terrain Data Base

DTIC Science & Technology

1987-09-01

and existing models is in the method used to make decisions. All of ,he models- reviewed when developing the ALARM strategy depended either on threshold...problems with the methods currently accepted and used to *model the decision process. These methods are recognized because they have their uses...observation, detection, and lines of sight along a narrow strip of terrain relative to the overall size of the sectors of the two forces. Existing methods of

Patient versus neurologist preferences: A discrete choice experiment for antiepileptic drug therapies.

PubMed

Ettinger, Alan B; Carter, John A; Rajagopalan, Krithika

2018-03-01

This assessment was conducted to quantify and compare patient and neurologist preferences regarding antiepileptic drug (AED) attributes for treating epilepsy. Patients with epilepsy (≥18years, treated with AEDs) and neurologists were recruited from nationally representative US panels to complete an online survey that included a discrete choice experiment (DCE). Participants chose between two hypothetical AEDs, characterized by six attributes in the DCE, which included 1) level of seizure control/reduction; 2) dosing frequency, 3) diminished coordination and balance, 4) psychiatric issues, 5) diminished energy level, and 6) dietary restrictions. The Sawtooth Software Choice-Based Conjoint (CBC) System for CBC Analysis was used to estimate treatment attribute ranking and weighting. Of the 720 respondents (518 patients and 202 neurologists), both patients and neurologists ranked seizure control as the most important attribute (rank 1) and dietary restrictions as the least important attribute (rank 6). However, seizure control had a significantly greater weighting in neurologists' decision-making than among patients (45% vs 32%, p<0.005). On the other hand, patients considered the risks of psychiatric adverse effects (19% vs 15%), diminished coordination and balance (16% vs 10%), and fatigue or diminished energy (13% vs 11%) as significantly more important (p<0.05) than did neurologists. Patients and neurologists had similar preference ranking order, with seizure reduction being ranked the most important attribute. However, neurologist treatment preferences were significantly more influenced by seizure reduction while patient preferences were significantly more influenced by adverse effects that may impact their quality of life. Understanding how patient and neurologist perspectives differ should encourage dialog to communicate the potential risks and benefits of AED therapy and assist in the shared decision-making process. Copyright © 2018 Elsevier Inc. All rights reserved.

Graduate Attributes for Master's Programs in Health Services and Policy Research: Results of a National Consultation

PubMed Central

Morgan, Steve; Orr, Karen; Mah, Catherine

2010-01-01

Objective: Our objective was to identify desirable attributes to be developed through graduate training in health services and policy research (HSPR) by identifying the knowledge, skills and abilities thought to be keys to success in HSPR-related careers. We aimed for a framework clear enough to serve as a touchstone for HSPR training programs across Canada yet flexible enough to permit diversity of specialization across and within those programs. Methods: Our approach involved several stages of data collection and analysis: a review of literature; telephone interviews with opinion leaders; online surveys of HSPR students, recent graduates and employers; an invitational workshop; and an interactive panel at a national conference. Our final framework was arrived at through an iterative process of thematic analysis, reflection on invited feedback from consultation participants and triangulation with existing competency frameworks. Results: Our final result was a framework that identifies traits, knowledge and abilities of master's-level graduates who are capable of fostering health system improvement through planning, management, analysis or monitoring that is informed by credible evidence and relevant theory. These attributes are organized into three levels: generic graduate attributes, knowledge related to health and health systems and, finally, attributes related to the application of knowledge for health system improvement. The HSPR-specific attributes include not only an understanding of HSPR theories and methods but also the skills related to the practical application of knowledge in the complex environments of health system decision-making and healthcare policy. Conclusion: Master's-level HSPR training programs should prepare students to pose and seek answers to important questions and provide them with the skills necessary to apply their knowledge within complex decision-making environments. PMID:21804839

Abnormal causal attribution leads to advantageous economic decision-making: A neuropsychological approach

PubMed Central

Koscik, Timothy R.; Tranel, Daniel

2013-01-01

People tend to assume that outcomes are caused by dispositional factors, e.g., a person’s constitution or personality, even when the actual cause is due to situational factors, e.g., luck or coincidence. This is known as the ‘correspondence bias.’ This tendency can lead normal, intelligent persons to make suboptimal decisions. Here, we used a neuropsychological approach to investigate the neural basis of the correspondence bias, by studying economic decision-making in patients with damage to the ventromedial prefrontal cortex (vmPFC). Given the role of the vmPFC in social cognition, we predicted that vmPFC is necessary for the normal correspondence bias. In our experiment, consistent with expectations, healthy (N=46) and brain-damaged (N=30) comparison participants displayed the correspondence bias when investing and invested no differently when given dispositional or situational information. By contrast, vmPFC patients (N=17) displayed a lack of correspondence bias and invested more when given dispositional than situational information. The results support the conclusion that vmPFC is critical for normal social inference and the correspondence bias, and our findings help clarify the important (and potentially disadvantageous) role of social inference in economic decision-making. PMID:23574584

A plea for virtue in ethics.

PubMed

Sisti, Dominic A; Baum-Baicker, Cynthia

2012-01-01

Comments on the original article, "Nonrational processes in ethical decision making" by M. D. Rogerson et al (see record 2011-19198-001). The current authors suggest that Rogerson, Gottlieb, Handelsman, Knapp, and Younggren (October 2011) presumed that the only ethical theories available for grounding decision-making models are of the rational, neoliberal variety. Rogerson et al stated, "Contextual, interpersonal, and intuitive factors are inextricably linked and inexorably influential in the process of ethical decision making. Ethical theory would benefit from encompassing these subtle yet powerful forces" (Rogerson et al., 2011, p. 616). They sought to augment these models with a cluster of contextual considerations, appending to them accounts of emotion, context, and intuition. First, notwithstanding the theories attributed to (the caricature of) Kant and his ilk, there are several ethical theories that include an account of what Rogerson et al. (2011) consider to be "nonrational" processes. From feminist theories to narrative ethics, sophisticated contextual theories have been developed and are readily available. Second, we question whether thick contextual considerations can simply be tacked on to extant models of decision making originally built upon a philosophical foundation that assumes a rational, autonomous agent who deliberates independently and logically.

Impaired flexibility in decision making in rats after administration of the pharmacological stressor yohimbine.

PubMed

Schwager, Andrea L; Haack, Andrew K; Taha, Sharif A

2014-10-01

Stress-induced disruption of decision making has been hypothesized to contribute to drug-seeking behaviors and addiction. Noradrenergic signaling plays a central role in mediating stress responses. However, the effects of acute stress on decision making, and the role of noradrenergic signaling in regulating these effects, have not been well characterized. To characterize changes in decision making caused by acute pharmacological stress, the effects of yohimbine (an α2-adrenergic antagonist) were examined in a delay discounting task. Noradrenergic contributions to decision making were further characterized by examining the effects of propranolol (a β antagonist), prazosin (an α1 antagonist), and guanfacine (an α2 agonist). Sprague-Dawley rats were administered drugs prior to performance on a delay discounting task, in which the delay preceding the large reward increased within each session (ascending delays). To dissociate drug-induced changes in delay sensitivity from behavioral inflexibility, drug effects were subsequently tested in a modified version of the discounting task, in which the delay preceding the large reward decreased within each session (descending delays). Yohimbine increased choice of the large reward when tested with ascending delays but decreased choice of the same large reward when tested with descending delays, suggesting that drug effects could be attributed to perseverative choice of the lever preferred at the beginning of the session. Propranolol increased choice of the large reward when tested with ascending delays. Prazosin and guanfacine had no effect on reward choice. The stress-like effects of yohimbine administration may impair decision making by causing inflexible, perseverative behavior.

Canceled connections: Lesion-derived network mapping helps explain differences in performance on a complex decision-making task

PubMed Central

Sutterer, Matthew J.; Bruss, Joel; Boes, Aaron D.; Voss, Michelle W.; Bechara, Antoine; Tranel, Daniel

2016-01-01

Studies of patients with brain damage have highlighted a broad neural network of limbic and prefrontal areas as important for adaptive decision-making. However, some patients with damage outside these regions have impaired decision-making behavior, and the behavioral impairments observed in these cases are often attributed to the general variability in behavior following brain damage, rather than a deficit in a specific brain-behavior relationship. A novel approach, lesion-derived network mapping, uses healthy subject resting-state functional connectivity (RSFC) data to infer the areas that would be connected with each patient’s lesion area in healthy adults. Here, we used this approach to investigate whether there was a systematic pattern of connectivity associated with decision-making performance in patients with focal damage in areas not classically associated with decision-making. These patients were categorized a priori into “impaired” or “unimpaired” groups based on their performance on the Iowa Gambling Task (IGT). Lesion-derived network maps based on the impaired patients showed overlap in somatosensory, motor and insula cortices, to a greater extent than patients who showed unimpaired IGT performance. Akin to the classic concept of “diaschisis” (von Monakow, 1914), this focus on the remote effects that focal damage can have on large-scale distributed brain networks has the potential to inform not only differences in decision-making behavior, but also other cognitive functions or neurological syndromes where a distinct phenotype has eluded neuroanatomical classification and brain-behavior relationships appear highly heterogeneous. PMID:26994344

Higher Trait Psychopathy Is Associated with Increased Risky Decision-Making and Less Coincident Insula and Striatal Activity

PubMed Central

Sutherland, Matthew T.; Fishbein, Diana H.

2017-01-01

Higher trait levels of psychopathy have been associated with both a tendency to maintain disadvantageous decision-making strategies and aberrant cortico-limbic neural activity. To explore the neural mechanisms associated with the psychopathy-related propensity to continue selecting risky choices, a non-forensic sample of participants completed a self-report psychopathy questionnaire and two runs of a risky decision-making task during H215O positron emission tomography (PET) scanning. In this secondary data analysis study, we leveraged data previously collected to examine the impact of previous drug use on risky decision-making to explore the relations between self-reported psychopathy and behavioral and brain metrics during performance of the Cambridge Decision-Making Task (CDMT), in which volunteers chose between small/likely or large/unlikely potential reward outcomes. Behaviorally, we observed that psychopathy scores were differentially correlated with the percent of risky decisions made in run 1 vs. run 2 of the task. Specifically, higher levels of psychopathy, above and beyond that attributable to drug use or sex, were associated with greater tendencies to make risky selections only in the second half (run 2) of the task. In parallel, psychopathy scores negatively correlated with regional cerebral blood flow (rCBF) in the right insula and right ventral striatum during run 2 of the CDMT. These exploratory outcomes suggest that greater levels of psychopathy may be associated with an inability to translate experience with negative outcomes into behavioral adaptations possibly due to decreased neural efficiency in regions related to somatic and/or reward feedback processes. PMID:29311863

Consumer preferences for general practitioner services.

PubMed

Morrison, Mark; Murphy, Tom; Nalder, Craig

2003-01-01

This study focuses on segmenting the market for General Practitioner services in a regional setting. Using factor analysis, five main service attributes are identified. These are clear communication, ongoing doctor-patient relationship, same gender as the patient, provides advice to the patient, and empowers the patient to make his/her own decisions. These service attributes are used as a basis for market segmentation, using both socio-demographic variables and cluster analysis. Four distinct market segments are identified, with varying degrees of viability in terms of target marketing.

The influence of expert opinions on the selection of wastewater treatment alternatives: a group decision-making approach.

PubMed

Kalbar, Pradip P; Karmakar, Subhankar; Asolekar, Shyam R

2013-10-15

The application of multiple-attribute decision-making (MADM) to real life decision problems suggests that avoiding the loss of information through scenario-based approaches and including expert opinions in the decision-making process are two major challenges that require more research efforts. Recently, a wastewater treatment technology selection effort has been made with a 'scenario-based' method of MADM. This paper focuses on a novel approach to incorporate expert opinions into the scenario-based decision-making process, as expert opinions play a major role in the selection of treatment technologies. The sets of criteria and the indicators that are used consist of both qualitative and quantitative criteria. The group decision-making (GDM) approach that is implemented for aggregating expert opinions is based on an analytical hierarchy process (AHP), which is the most widely used MADM method. The pairwise comparison matrices (PCMs) for qualitative criteria are formed based on expert opinions, whereas, a novel approach is proposed for generating PCMs for quantitative criteria. It has been determined that the experts largely prefer natural treatment systems because they are more sustainable in any scenario. However, PCMs based on expert opinions suggest that advanced technologies such as the sequencing batch reactor (SBR) can also be appropriate for a given decision scenario. The proposed GDM approach is a rationalized process that will be more appropriate in realistic scenarios where multiple stakeholders with local and regional societal priorities are involved in the selection of treatment technology. Copyright © 2013 Elsevier Ltd. All rights reserved.

Chronic alcohol intake during adolescence, but not adulthood, promotes persistent deficits in risk-based decision making

PubMed Central

Schindler, Abigail G; Tsutsui, Kimberly T; Clark, Jeremy J

2014-01-01

Background Adolescent alcohol use is a major public health concern and is strongly correlated with the development of alcohol abuse problems in adulthood. Adolescence is characterized by maturation and remodeling of brain regions implicated in decision making and therefore may be uniquely vulnerable to environmental insults such as alcohol exposure. We have previously demonstrated that voluntary alcohol consumption in adolescence results in maladaptive risk-based decision making in adulthood. However, it is unclear whether this effect on risk-based decision making can be attributed to chronic alcohol use in general or to a selective effect of alcohol use during the adolescent period. Methods Ethanol was presented to adolescent (PND 30–49) and adult rats (PND 80–99) for 20 days, either 24h or 1h/day, in a gel matrix consisting of distilled water, gelatin, Polycose (10%), and ethanol (10%). The 24h time course of ethanol intake was measured and compared between adolescent and adult animals. Following 20 days of withdrawal from ethanol, we assessed risk-based decision making with a concurrent instrumental probability-discounting task. Blood ethanol concentrations (BECs) were taken from trunk blood and assessed using the Analox micro-stat GM7 in separate groups of animals at different time points. Results Unlike animals exposed to ethanol during adolescence, animals exposed to alcohol during adulthood did not display differences in risk preference compared to controls. Adolescent and adult rats displayed similar ethanol intake levels and patterns when given either 24h or 1h access/day. In addition, while both groups reached significant BEC levels we failed to find a difference between adult and adolescent animals. Conclusions Here we show that adolescent, but not adult, ethanol intake leads to a persistent increase in risk preference which cannot be attributed to differences in intake levels or BECs attained. Our findings support previous work implicating adolescence as a time period of heightened susceptibility to the long-term negative effects of alcohol exposure. PMID:24689661

Chronic alcohol intake during adolescence, but not adulthood, promotes persistent deficits in risk-based decision making.

PubMed

Schindler, Abigail G; Tsutsui, Kimberly T; Clark, Jeremy J

2014-06-01

Adolescent alcohol use is a major public health concern and is strongly correlated with the development of alcohol abuse problems in adulthood. Adolescence is characterized by maturation and remodeling of brain regions implicated in decision making and therefore may be uniquely vulnerable to environmental insults such as alcohol exposure. We have previously demonstrated that voluntary alcohol consumption in adolescence results in maladaptive risk-based decision making in adulthood. However, it is unclear whether this effect on risk-based decision making can be attributed to chronic alcohol use in general or to a selective effect of alcohol use during the adolescent period. Ethanol (EtOH) was presented to adolescent (postnatal day [PND] 30 to 49) and adult rats (PND 80 to 99) for 20 days, either 24 hours or 1 h/d, in a gel matrix consisting of distilled water, gelatin, polycose (10%), and EtOH (10%). The 24-hour time course of EtOH intake was measured and compared between adolescent and adult animals. Following 20 days of withdrawal from EtOH, we assessed risk-based decision making with a concurrent instrumental probability-discounting task. Blood EtOH concentrations (BECs) were taken from trunk blood and assessed using the Analox micro-stat GM7 in separate groups of animals at different time points. Unlike animals exposed to EtOH during adolescence, animals exposed to alcohol during adulthood did not display differences in risk preference compared to controls. Adolescent and adult rats displayed similar EtOH intake levels and patterns when given either 24- or 1-hour access per day. In addition, while both groups reached significant BEC levels, we failed to find a difference between adult and adolescent animals. Here, we show that adolescent, but not adult, EtOH intake leads to a persistent increase in risk preference which cannot be attributed to differences in intake levels or BECs attained. Our findings support previous work implicating adolescence as a time period of heightened susceptibility to the long-term negative effects of alcohol exposure. Copyright © 2014 by the Research Society on Alcoholism.

Theory-informed design of values clarification methods: a cognitive psychological perspective on patient health-related decision making.

PubMed

Pieterse, Arwen H; de Vries, Marieke; Kunneman, Marleen; Stiggelbout, Anne M; Feldman-Stewart, Deb

2013-01-01

Healthcare decisions, particularly those involving weighing benefits and harms that may significantly affect quality and/or length of life, should reflect patients' preferences. To support patients in making choices, patient decision aids and values clarification methods (VCM) in particular have been developed. VCM intend to help patients to determine the aspects of the choices that are important to their selection of a preferred option. Several types of VCM exist. However, they are often designed without clear reference to theory, which makes it difficult for their development to be systematic and internally coherent. Our goal was to provide theory-informed recommendations for the design of VCM. Process theories of decision making specify components of decision processes, thus, identify particular processes that VCM could aim to facilitate. We conducted a review of the MEDLINE and PsycINFO databases and of references to theories included in retrieved papers, to identify process theories of decision making. We selected a theory if (a) it fulfilled criteria for a process theory; (b) provided a coherent description of the whole process of decision making; and (c) empirical evidence supports at least some of its postulates. Four theories met our criteria: Image Theory, Differentiation and Consolidation theory, Parallel Constraint Satisfaction theory, and Fuzzy-trace Theory. Based on these, we propose that VCM should: help optimize mental representations; encourage considering all potentially appropriate options; delay selection of an initially favoured option; facilitate the retrieval of relevant values from memory; facilitate the comparison of options and their attributes; and offer time to decide. In conclusion, our theory-based design recommendations are explicit and transparent, providing an opportunity to test each in a systematic manner. Copyright © 2012 Elsevier Ltd. All rights reserved.

Attribute Framing and Goal Framing Effects in Health Decisions.

PubMed

Krishnamurthy, Parthasarathy; Carter, Patrick; Blair, Edward

2001-07-01

Levin, Schneider, and Gaeth (LSG, 1998) have distinguished among three types of framing-risky choice, attribute, and goal framing-to reconcile conflicting findings in the literature. In the research reported here, we focus on attribute and goal framing. LSG propose that positive frames should be more effective than negative frames in the context of attribute framing, and negative frames should be more effective than positive frames in the context of goal framing. We test this framework by manipulating frame valence (positive vs negative) and frame type (attribute vs goal) in a unified context with common procedures. We also argue that the nature of effects in a goal-framing context may depend on the extent to which the research topic has "intrinsic self-relevance" to the population. In the context of medical decision making, we operationalize low intrinsic self-relevance by using student subjects and high intrinsic self-relevance by using patients. As expected, we find complete support for the LSG framework under low intrinsic self-relevance and modified support for the LSG framework under high intrinsic self-relevance. Overall, our research appears to confirm and extend the LSG framework. Copyright 2001 Academic Press.

Evidence-based safety (EBS) management: A new approach to teaching the practice of safety management (SM).

PubMed

Wang, Bing; Wu, Chao; Shi, Bo; Huang, Lang

2017-12-01

In safety management (SM), it is important to make an effective safety decision based on the reliable and sufficient safety-related information. However, many SM failures in organizations occur for a lack of the necessary safety-related information for safety decision-making. Since facts are the important basis and foundation for decision-making, more efforts to seek the best evidence relevant to a particular SM problem would lead to a more effective SM solution. Therefore, the new paradigm for decision-making named "evidence-based practice (EBP)" can hold important implications for SM, because it uses the current best evidence for effective decision-making. Based on a systematic review of existing SM approaches and an analysis of reasons why we need new SM approaches, we created a new SM approach called evidence-based safety (EBS) management by introducing evidence-based practice into SM. It was necessary to create new SM approaches. A new SM approach called EBS was put forward, and the basic questions of EBS such as its definition and core were analyzed in detail. Moreover, the determinants of EBS included manager's attitudes towards EBS; evidence-based consciousness in SM; evidence sources; technical support; EBS human resources; organizational culture; and individual attributes. EBS is a new and effective approach to teaching the practice of SM. Of course, further research on EBS should be carried out to make EBS a reality. Practical applications: Our work can provide a new and effective idea and method to teach the practice of SM. Specifically, EBS proposed in our study can help safety professionals make an effective safety decision based on a firm foundation of high-grade evidence. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Planning for Success: Integrating Analysis with Decision Making.

ERIC Educational Resources Information Center

Goho, James; Webb, Ken

2003-01-01

Describes a successful strategic planning process at a large community college, which linked the analytic inputs of research with the authority and intuition of leaders. Reports key factors attributed to the process' success, including a collegial and organized structure, detailed project management plans, and confidence in the environmental scan.…

Pre-Licensed Nursing Students Rate Professional Values

ERIC Educational Resources Information Center

Garee, Denise L.

2016-01-01

Ethical decision making of new nurses relies on professional values and moral development obtained during training. This descriptive, comparative study demonstrated the importance values attributed to the items of the Nurses' Professional Values Scale-Revised (Weis & Schank, 2009), by a sample of senior ADN and BSN students from across the…

Retirement Wealth, Income, and Decision Making in Higher Education.

ERIC Educational Resources Information Center

Lewis, W. Cris

1996-01-01

Retirement programs for college faculty are evaluated in terms of both their wealth-creation attributes and the incentives they provide for retirement. Wealth accumulation and relative cash flow from working compared to retirement are evaluated at various ages under alternative assumptions about rates of return and contribution rates. The nature…

Using Visual Information to Determine the Subjective Valuation of Public Space for Transportation : Application to Subway Crowding Costs in NYC

DOT National Transportation Integrated Search

2017-11-30

The objective of this project is to explore the role of visual information in determining the users subjective valuation of multidimensional trip attributes that are relevant in decision-making, but are neglected in standard travel demand models. ...

The Influence of Distributed Leadership on Teachers' Organizational Commitment: A Multilevel Approach

ERIC Educational Resources Information Center

Hulpia, Hester; Devos, Geert; Van Keer, Hilde

2009-01-01

In the present study the effects of a cooperative leadership team, distributed leadership, participative decision-making, and context variables on teachers' organizational commitment are investigated. Multilevel analyses on data from 1522 teachers indicated that 9% of the variance in teachers' organizational commitment is attributable to…

Comprehensible knowledge model creation for cancer treatment decision making.

PubMed

Afzal, Muhammad; Hussain, Maqbool; Ali Khan, Wajahat; Ali, Taqdir; Lee, Sungyoung; Huh, Eui-Nam; Farooq Ahmad, Hafiz; Jamshed, Arif; Iqbal, Hassan; Irfan, Muhammad; Abbas Hydari, Manzar

2017-03-01

A wealth of clinical data exists in clinical documents in the form of electronic health records (EHRs). This data can be used for developing knowledge-based recommendation systems that can assist clinicians in clinical decision making and education. One of the big hurdles in developing such systems is the lack of automated mechanisms for knowledge acquisition to enable and educate clinicians in informed decision making. An automated knowledge acquisition methodology with a comprehensible knowledge model for cancer treatment (CKM-CT) is proposed. With the CKM-CT, clinical data are acquired automatically from documents. Quality of data is ensured by correcting errors and transforming various formats into a standard data format. Data preprocessing involves dimensionality reduction and missing value imputation. Predictive algorithm selection is performed on the basis of the ranking score of the weighted sum model. The knowledge builder prepares knowledge for knowledge-based services: clinical decisions and education support. Data is acquired from 13,788 head and neck cancer (HNC) documents for 3447 patients, including 1526 patients of the oral cavity site. In the data quality task, 160 staging values are corrected. In the preprocessing task, 20 attributes and 106 records are eliminated from the dataset. The Classification and Regression Trees (CRT) algorithm is selected and provides 69.0% classification accuracy in predicting HNC treatment plans, consisting of 11 decision paths that yield 11 decision rules. Our proposed methodology, CKM-CT, is helpful to find hidden knowledge in clinical documents. In CKM-CT, the prediction models are developed to assist and educate clinicians for informed decision making. The proposed methodology is generalizable to apply to data of other domains such as breast cancer with a similar objective to assist clinicians in decision making and education. Copyright © 2017 Elsevier Ltd. All rights reserved.

Post-Marketing Regulation of Medicines Withdrawn from the Market Because of Drug-Attributed Deaths: An Analysis of Justification.

PubMed

Onakpoya, Igho J; Heneghan, Carl J; Aronson, Jeffrey K

2017-05-01

Several medicinal products have been withdrawn from the market because of drug-attributed deaths. However, there has been no investigation of whether such withdrawals were justified, and the extent to which confirmatory studies are used to investigate drug-adverse event relationships when deaths are reported is uncertain. We documented medicinal products withdrawn from the market because of drug-attributed deaths, identified confirmatory studies investigating the drug-adverse event relationships, examined whether withdrawals of medicinal products because of drug-attributed deaths after marketing were justified based on a mechanistic analysis, and examined the trends over time. We searched electronic and non-electronic sources to identify medicinal products that were withdrawn because of drug-attributed deaths. We used a previously published algorithm to examine whether the withdrawals of products were justified. We then searched PubMed and Google Scholar to identify studies investigating the drug-adverse event relationships, used the Oxford Centre for Evidence-Based Medicine criteria to document the levels of evidence, and assessed whether the evidence of an association was confirmed. We included 83 medicinal products. The reasons for withdrawal appeared to have been justified in 80 cases (96%). The median interval between the first reported adverse reaction that was related to the cause of death and the first reported death was 1 year (interquartile range = 1-3); products were withdrawn sooner when the interval between the first reported relevant adverse reaction and the first death was shorter. Confirmatory studies were conducted in 57 instances (69%), and there was evidence of an association in 52 cases (63%). Four products (5%) were re-introduced after initial withdrawal. Regulatory authorities have been justified in making withdrawal decisions when deaths have been attributed to medicinal products, using the precautionary principle when alternative decisions could have been made. Medicinal products are likely to be quickly withdrawn from the market when there is a short interval to the first reported deaths. The use of an algorithm such as we have used in this study could help to expedite the process of decision making.

Autogenerator-based modelling framework for development of strategic games simulations: rational pigs game extended.

PubMed

Fabac, Robert; Radošević, Danijel; Magdalenić, Ivan

2014-01-01

When considering strategic games from the conceptual perspective that focuses on the questions of participants' decision-making rationality, the very issues of modelling and simulation are rarely discussed. The well-known Rational Pigs matrix game has been relatively intensively analyzed in terms of reassessment of the logic of two players involved in asymmetric situations as gluttons that differ significantly by their attributes. This paper presents a successful attempt of using autogenerator for creating the framework of the game, including the predefined scenarios and corresponding payoffs. Autogenerator offers flexibility concerning the specification of game parameters, which consist of variations in the number of simultaneous players and their features and game objects and their attributes as well as some general game characteristics. In the proposed approach the model of autogenerator was upgraded so as to enable program specification updates. For the purpose of treatment of more complex strategic scenarios, we created the Rational Pigs Game Extended (RPGE), in which the introduction of a third glutton entails significant structural changes. In addition, due to the existence of particular attributes of the new player, "the tramp," one equilibrium point from the original game is destabilized which has an influence on the decision-making of rational players.

Autogenerator-Based Modelling Framework for Development of Strategic Games Simulations: Rational Pigs Game Extended

PubMed Central

Magdalenić, Ivan

2014-01-01

When considering strategic games from the conceptual perspective that focuses on the questions of participants' decision-making rationality, the very issues of modelling and simulation are rarely discussed. The well-known Rational Pigs matrix game has been relatively intensively analyzed in terms of reassessment of the logic of two players involved in asymmetric situations as gluttons that differ significantly by their attributes. This paper presents a successful attempt of using autogenerator for creating the framework of the game, including the predefined scenarios and corresponding payoffs. Autogenerator offers flexibility concerning the specification of game parameters, which consist of variations in the number of simultaneous players and their features and game objects and their attributes as well as some general game characteristics. In the proposed approach the model of autogenerator was upgraded so as to enable program specification updates. For the purpose of treatment of more complex strategic scenarios, we created the Rational Pigs Game Extended (RPGE), in which the introduction of a third glutton entails significant structural changes. In addition, due to the existence of particular attributes of the new player, “the tramp,” one equilibrium point from the original game is destabilized which has an influence on the decision-making of rational players. PMID:25254228

Self-determination and older people--a concept analysis.

PubMed

Ekelund, Christina; Dahlin-Ivanoff, Synneve; Eklund, Kajsa

2014-03-01

Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural. To define and clarify the concept of self-determination in relation to community-dwelling frail older people. Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes. Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice. This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

A conversation-based process tracing method for use with naturalistic decisions: an evaluation study.

PubMed

Williamson, J; Ranyard, R; Cuthbert, L

2000-05-01

This study is an evaluation of a process tracing method developed for naturalistic decisions, in this case a consumer choice task. The method is based on Huber et al.'s (1997) Active Information Search (AIS) technique, but develops it by providing spoken rather than written answers to respondents' questions, and by including think aloud instructions. The technique is used within a conversation-based situation, rather than the respondent thinking aloud 'into an empty space', as is conventionally the case in think aloud techniques. The method results in a concurrent verbal protocol as respondents make their decisions, and a retrospective report in the form of a post-decision summary. The method was found to be virtually non-reactive in relation to think aloud, although the variable of Preliminary Attribute Elicitation showed some evidence of reactivity. This was a methodological evaluation, and as such the data reported are essentially descriptive. Nevertheless, the data obtained indicate that the method is capable of producing information about decision processes which could have theoretical importance in terms of evaluating models of decision-making.

Usability and utility evaluation of the web-based "Should I Start Insulin?" patient decision aid for patients with type 2 diabetes among older people.

PubMed

Lee, Yew Kong; Lee, Ping Yein; Ng, Chirk Jenn; Teo, Chin Hai; Abu Bakar, Ahmad Ihsan; Abdullah, Khatijah Lim; Khoo, Ee Ming; Hanafi, Nik Sherina; Low, Wah Yun; Chiew, Thiam Kian

2018-01-01

This study aimed to evaluate the usability (ease of use) and utility (impact on user's decision-making process) of a web-based patient decision aid (PDA) among older-age users. A pragmatic, qualitative research design was used. We recruited patients with type 2 diabetes who were at the point of making a decision about starting insulin from a tertiary teaching hospital in Malaysia in 2014. Computer screen recording software was used to record the website browsing session and in-depth interviews were conducted while playing back the website recording. The interviews were analyzed using the framework approach to identify usability and utility issues. Three cycles of iteration were conducted until no more major issues emerged. Thirteen patients participated: median age 65 years old, 10 men, and nine had secondary education/diploma, four were graduates/had postgraduate degree. Four usability issues were identified (navigation between pages and sections, a layout with open display, simple language, and equipment preferences). For utility, participants commented that the website influenced their decision about insulin in three ways: it had provided information about insulin, it helped them deliberate choices using the option-attribute matrix, and it allowed them to involve others in their decision making by sharing the PDA summary printout.

The coherence effect: Blending cold and hot cognitions.

PubMed

Simon, Dan; Stenstrom, Douglas M; Read, Stephen J

2015-09-01

Previous research has shown that making complex judgments and decisions entails a mental reconstruction of the task in a way that increases the state of coherence between the emerging conclusion and its underlying attributes: The attributes that support the conclusion grow stronger, whereas the attributes that support the losing option weaken. This coherence effect is understood to occur bidirectionally, in that conclusions follow from the decision-maker's evaluation of the attributes, while the evaluations of the attributes shift to cohere with the emerging conclusion. The current studies were designed to extend the coherence effect to encompass cognitions that could be considered "hot," such as valence evaluations, motivation toward outcomes of events, liking and disliking of actors, and emotions toward actors. Study 1 found that evaluations of a complex social relationship were accompanied not only by supportive interpretations of the ambiguous facts, but also by concordant hot cognitions. Studies 2 through 4 included manipulations to demonstrate the spreading of coherence from cold to hot cognitions and in the opposite direction. We observed these effects following a manipulation of the facts (Study 2), a manipulation of participants' emotions toward the actor (Study 3), and a manipulation of participants' motivation toward the outcome of the case (Study 4). These results support the proposition that complex judgments and decisions are performed by coherence-based reasoning: a holistic, connectionist process that maximizes coherence among and between the myriad of factors involved in the tasks and the hot cognitive reactions to them. (c) 2015 APA, all rights reserved).

Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial.

PubMed

Churilov, Leonid; Liu, Daniel; Ma, Henry; Christensen, Soren; Nagakane, Yoshinari; Campbell, Bruce; Parsons, Mark W; Levi, Christopher R; Davis, Stephen M; Donnan, Geoffrey A

2013-04-01

The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes. The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial. A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution. Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented. The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Differences in Risk Aversion between Young and Older Adults.

PubMed

Albert, Steven M; Duffy, John

2012-01-15

Research on decision-making strategies among younger and older adults suggests that older adults may be more risk averse than younger people in the case of potential losses. These results mostly come from experimental studies involving gambling paradigms. Since these paradigms involve substantial demands on memory and learning, differences in risk aversion or other features of decision-making attributed to age may in fact reflect age-related declines in cognitive abilities. In the current study, older and younger adults completed a simpler, paired lottery choice task used in the experimental economics literature to elicit risk aversion. A similar approach was used to elicit participants' discount rates. The older adult group was more risk averse than younger adults (p < .05) and also had a higher discount rate (15.6-21.0% vs. 10.3-15.5%, p < .01), indicating lower expected utility from future income. Risk aversion and implied discount rates were weakly correlated. It may be valuable to investigate developmental changes in neural correlates of decision-making across the lifespan.

Differences in Risk Aversion between Young and Older Adults

PubMed Central

Albert, Steven M.; Duffy, John

2013-01-01

Research on decision-making strategies among younger and older adults suggests that older adults may be more risk averse than younger people in the case of potential losses. These results mostly come from experimental studies involving gambling paradigms. Since these paradigms involve substantial demands on memory and learning, differences in risk aversion or other features of decision-making attributed to age may in fact reflect age-related declines in cognitive abilities. In the current study, older and younger adults completed a simpler, paired lottery choice task used in the experimental economics literature to elicit risk aversion. A similar approach was used to elicit participants' discount rates. The older adult group was more risk averse than younger adults (p < .05) and also had a higher discount rate (15.6-21.0% vs. 10.3-15.5%, p < .01), indicating lower expected utility from future income. Risk aversion and implied discount rates were weakly correlated. It may be valuable to investigate developmental changes in neural correlates of decision-making across the lifespan. PMID:24319671

Perspectives on benefit-risk decision-making in vaccinology: Conference report.

PubMed

Greenberg, M; Simondon, F; Saadatian-Elahi, M

2016-01-01

Benefit/risk (B/R) assessment methods are increasingly being used by regulators and companies as an important decision-making tool and their outputs as the basis of communication. B/R appraisal of vaccines, as compared with drugs, is different due to their attributes and their use. For example, vaccines are typically given to healthy people, and, for some vaccines, benefits exist both at the population and individual level. For vaccines in particular, factors such as the benefit afforded through herd effects as a function of vaccine coverage and consequently impact the B/R ratio, should also be taken into consideration and parameterized in B/R assessment models. Currently, there is no single agreed methodology for vaccine B/R assessment that can fully capture all these aspects. The conference "Perspectives on Benefit-Risk Decision-making in Vaccinology," held in Annecy (France), addressed these issues and provided recommendations on how to advance the science and practice of B/R assessment of vaccines and vaccination programs.

Evaluating the Role of Attention in the Context of Unconscious Thought Theory: Differential Impact of Attentional Scope and Load on Preference and Memory

PubMed Central

Srinivasan, Narayanan; Mukherjee, Sumitava; Mishra, Maruti V.; Kesarwani, Smriti

2013-01-01

Attention is a key process used to conceptualize and define modes of thought, but we lack information about the role of specific attentional processes on preferential choice and memory in multi-attribute decision making. In this study, we examine the role of attention based on two dimensions, attentional scope and load on choice preference strength and memory using a paradigm that arguably elicits unconscious thought. Scope of attention was manipulated by using global or local processing during distraction (Experiment 1) and before the information-encoding stage (Experiment 2). Load was manipulated by using the n-back task in Experiment 1. Results from Experiment 1 show that global processing or distributed attention during distraction results in stronger preference irrespective of load but better memory only at low cognitive load. Task difficulty or load did not have any effect on preference or memory. In Experiment 2, distributed attention before attribute encoding facilitated only memory but did not influence preference. Results show that attentional processes at different stages of processing like distraction and information-encoding influence decision making processes. Scope of attention not only influences preference and memory but the manner in which attentional scope influences them depends on both load and stage of information processing. The results indicate the important role of attention in processes critical for decision making and calls for a re-evaluation of the unconscious thought theory (UTT) and the need for reconceptualizing the role of attention. PMID:23382726

Evaluating the role of attention in the context of unconscious thought theory: differential impact of attentional scope and load on preference and memory.

PubMed

Srinivasan, Narayanan; Mukherjee, Sumitava; Mishra, Maruti V; Kesarwani, Smriti

2013-01-01

Attention is a key process used to conceptualize and define modes of thought, but we lack information about the role of specific attentional processes on preferential choice and memory in multi-attribute decision making. In this study, we examine the role of attention based on two dimensions, attentional scope and load on choice preference strength and memory using a paradigm that arguably elicits unconscious thought. Scope of attention was manipulated by using global or local processing during distraction (Experiment 1) and before the information-encoding stage (Experiment 2). Load was manipulated by using the n-back task in Experiment 1. Results from Experiment 1 show that global processing or distributed attention during distraction results in stronger preference irrespective of load but better memory only at low cognitive load. Task difficulty or load did not have any effect on preference or memory. In Experiment 2, distributed attention before attribute encoding facilitated only memory but did not influence preference. Results show that attentional processes at different stages of processing like distraction and information-encoding influence decision making processes. Scope of attention not only influences preference and memory but the manner in which attentional scope influences them depends on both load and stage of information processing. The results indicate the important role of attention in processes critical for decision making and calls for a re-evaluation of the unconscious thought theory (UTT) and the need for reconceptualizing the role of attention.

Uncertainty and the difficulty of thinking through disjunctions.

PubMed

Shafir, E

1994-01-01

This paper considers the relationship between decision under uncertainty and thinking through disjunctions. Decision situations that lead to violations of Savage's sure-thing principle are examined, and a variety of simple reasoning problems that often generate confusion and error are reviewed. The common difficulty is attributed to people's reluctance to think through disjunctions. Instead of hypothetically traveling through the branches of a decision tree, it is suggested, people suspend judgement and remain at the node. This interpretation is applied to instances of decision making, information search, deductive and inductive reasoning, probabilistic judgement, games, puzzles and paradoxes. Some implications of the reluctance to think through disjunctions, as well as potential corrective procedures, are discussed.

Who Dares, Who Errs? Disentangling Cognitive and Motivational Roots of Age Differences in Decisions Under Risk.

PubMed

Pachur, Thorsten; Mata, Rui; Hertwig, Ralph

2017-04-01

We separate for the first time the roles of cognitive and motivational factors in shaping age differences in decision making under risk. Younger and older adults completed gain, loss, and mixed-domain choice problems as well as measures of cognitive functioning and affect. The older adults' decision quality was lower than the younger adults' in the loss domain, and this age difference was attributable to the older adults' lower cognitive abilities. In addition, the older adults chose the more risky option more often than the younger adults in the gain and mixed domains; this difference in risk aversion was attributable to less pronounced negative affect among the older adults. Computational modeling with a hierarchical Bayesian implementation of cumulative prospect theory revealed that the older adults had higher response noise and more optimistic decision weights for gains than did the younger adults. Moreover, the older adults showed no loss aversion, a finding that supports a positivity-focus (rather than a loss-prevention) view of motivational reorientation in older age.

Development of a decision aid for energy resource management for the Navajo Nation incorporating environmental cultural values

NASA Astrophysics Data System (ADS)

Necefer, Len Edward

Decision-making surrounding pathways of future energy resource management are complexity and requires balancing tradeoffs of multiple environmental, social, economic, and technical outcomes. Technical decision aid can provide a framework for informed decision making, allowing individuals to better understand the tradeoff between resources, technology, energy services, and prices. While technical decision aid have made significant advances in evaluating these quantitative aspects of energy planning and performance, they have not been designed to incorporate human factors, such as preferences and behavior that are informed by cultural values. Incorporating cultural values into decision tools can provide not only an improved decision framework for the Navajo Nation, but also generate new insights on how these perspective can improve decision making on energy resources. Ensuring these aids are a cultural fit for each context has the potential to increase trust and promote understanding of the tradeoffs involved in energy resource management. In this dissertation I present the development of a technical tool that explicitly addresses cultural and spiritual values and experimentally assesses their influence on the preferences and decision making of Navajo citizens. Chapter 2 describes the results of a public elicitation effort to gather information about stakeholder views and concerns related to energy development in the Navajo Nation in order to develop a larger sample survey and a decision-support tool that links techno-economic energy models with sociocultural attributes. Chapter 3 details the methods of developing the energy decision aid and its underlying assumptions for alternative energy projects and their impacts. This tool also provides an alternative to economic valuation of cultural impacts based upon an ordinal index tied to environmental impacts. Chapter 4 details the the influence of various cultural, environmental, and economic outcome information provided through the developed decision aid on beliefs and preferences related to the type and scale of energy development, trust of decision makers, and larger concern for environmental protection. Finally, chapter 5 presents concluding thoughts future research and on how technical-social decision tools can provide a means ensuring effective decision making on the Navajo Nation and other American Indian communities.

Identifying the mechanisms through which behavioral weight-loss treatment improves food decision-making in obesity.

PubMed

Demos, Kathryn E; McCaffery, Jeanne M; Thomas, J Graham; Mailloux, Kimberly A; Hare, Todd A; Wing, Rena R

2017-07-01

Behavioral weight loss (BWL) programs are the recommended treatment for obesity, yet it is unknown whether these programs change one's ability to use self-control in food choices and what specific mechanisms support such change. Using experimental economics methods, we investigated whether changes in dietary behavior in individuals with obesity following BWL are driven by one or more of the following potential mechanisms: changes in the perception of the 1) health or 2) taste of food items, and/or 3) shifting decision weights for health versus taste attributes. Therefore, we compared these mechanisms between obese participants and lifetime normal weight controls (NW) both before and after BWL. Females with obesity (N = 37, mean BMI = 33.2) completed a food choice task involving health ratings, taste ratings, and decision-making pre- and post-standard BWL intervention. NW controls (N = 30, BMI = 22.4) completed the same task. Individuals with obesity exhibited increased self-control (selecting healthier, less tasty food choices) post-treatment. However, their rates of self-control remained significantly lower than NW. We found no differences in initial health perceptions across groups, and no changes with treatment. In contrast, taste ratings and the relative value of taste versus health decreased following treatment. Although, post-treatment participants continued to perceive unhealthy foods as tastier and used less self-control than NW controls, they showed significant improvements in these domains following a BWL intervention. To help individuals improve dietary decisions, additional research is needed to determine how to make greater changes in taste preferences and/or the assignment of value to taste versus health attributes in food choices. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceptual grouping does not affect multi-attribute decision making if no processing costs are involved.

PubMed

Ettlin, Florence; Bröder, Arndt

2015-05-01

Adaptive strategy selection implies that a decision strategy is chosen based on its fit to the task and situation. However, other aspects, such as the way information is presented, can determine information search behavior; especially when the application of certain strategies over others is facilitated. But are such display effects on multi-attribute decisions also at work when the manipulation does not entail differential costs for different decision strategies? Three Mouselab experiments with hidden information and one eye tracking experiment with an open information board revealed that decision behavior is unaffected by purely perceptual manipulations of the display based on Gestalt principles; that is, based on manipulations that induce no noteworthy processing costs for different information search patterns. We discuss our results in the context of previous findings on display effects; specifically, how the combination of these findings and our results reveal the crucial role of differential processing costs for different strategies for the emergence of display effects. This finding describes a boundary condition of the commonly acknowledged influence of information displays and is in line with the ideas of adaptive strategy selection and cost-benefit tradeoffs. Copyright © 2015. Published by Elsevier B.V.

Response time modeling reveals multiple contextual cuing mechanisms.

PubMed

Sewell, David K; Colagiuri, Ben; Livesey, Evan J

2017-08-24

Contextual cuing refers to a response time (RT) benefit that occurs when observers search through displays that have been repeated over the course of an experiment. Although it is generally agreed that contextual cuing arises via an associative learning mechanism, there is uncertainty about the type(s) of process(es) that allow learning to influence RT. We contrast two leading accounts of the contextual cuing effect that differ in terms of the general process that is credited with producing the effect. The first, the expedited search account, attributes the cuing effect to an increase in the speed with which the target is acquired. The second, the decision threshold account, attributes the cuing effect to a reduction in the response threshold used by observers when making a subsequent decision about the target (e.g., judging its orientation). We use the diffusion model to contrast the quantitative predictions of these two accounts at the level of individual observers. Our use of the diffusion model allows us to also explore a novel decision-level locus of the cuing effect based on perceptual learning. This novel account attributes the RT benefit to a perceptual learning process that increases the quality of information used to drive the decision process. Our results reveal both individual differences in the process(es) involved in contextual cuing but also identify several striking regularities across observers. We find strong support for both the decision threshold account as well as the novel perceptual learning account. We find relatively weak support for the expedited search account.

Undetected cognitive impairment and decision-making capacity in patients receiving hospice care.

PubMed

Burton, Cynthia Z; Twamley, Elizabeth W; Lee, Lana C; Palmer, Barton W; Jeste, Dilip V; Dunn, Laura B; Irwin, Scott A

2012-04-01

: Cognitive dysfunction is common in patients with advanced, life-threatening illness and can be attributed to a variety of factors (e.g., advanced age, opiate medication). Such dysfunction likely affects decisional capacity, which is a crucial consideration as the end-of-life approaches and patients face multiple choices regarding treatment, family, and estate planning. This study examined the prevalence of cognitive impairment and its impact on decision-making abilities among hospice patients with neither a chart diagnosis of a cognitive disorder nor clinically apparent cognitive impairment (e.g., delirium, unresponsiveness). : A total of 110 participants receiving hospice services completed a 1-hour neuropsychological battery, a measure of decisional capacity, and accompanying interviews. : In general, participants were mildly impaired on measures of verbal learning, verbal memory, and verbal fluency; 54% of the sample was classified as having significant, previously undetected cognitive impairment. These individuals performed significantly worse than the other participants on all neuropsychological and decisional capacity measures, with effect sizes ranging from medium to very large (0.43-2.70). A number of verbal abilities as well as global cognitive functioning significantly predicted decision-making capacity. : Despite an absence of documented or clinically obvious impairment, more than half of the sample had significant cognitive impairments. Assessment of cognition in hospice patients is warranted, including assessment of verbal abilities that may interfere with understanding or reasoning related to treatment decisions. Identification of patients at risk for impaired cognition and decision making may lead to effective interventions to improve decision making and honor the wishes of patients and families.

The anterior insula bidirectionally modulates cost-benefit decision-making on a rodent gambling task.

PubMed

Daniel, M L; Cocker, P J; Lacoste, J; Mar, A C; Houeto, J L; Belin-Rauscent, A; Belin, D

2017-11-01

Deficits in cost-benefit decision-making, as assessed in the Iowa Gambling Task (IGT), are commonly observed in neuropsychiatric disorders such as addiction. There is considerable variation in the maximization of rewards on such tasks, both in the general population and in rodent models, suggesting individual differences in decision-making may represent a key endophenotype for vulnerability to neuropsychiatric disorders. Increasing evidence suggests that the insular cortex, which is involved in interoception and emotional processes in humans, may be a key neural locus in the control of decision-making processes. However, the extent to which the insula contributes to individual differences in cost-benefit decision-making remains unknown. Using male Sprague Dawley rats, we first assessed individual differences in the performance over the course of a single session on a rodent analogue of the IGT (rGT). Rats were matched for their ability to maximize reward and received bilateral excitotoxic or sham lesions of the anterior insula cortex (AIC). Animals were subsequently challenged on a second rGT session with altered contingencies. Finally, animals were also assessed for instrumental conditioning and reversal learning. AIC lesions produced bidirectional alterations on rGT performance; rats that had performed optimally prior to surgery subsequently showed impairments, and animals that had performed poorly showed improvements in comparison with sham-operated controls. These bidirectional effects were not attributable to alterations in behavioural flexibility or in motivation. These data suggest that the recruitment of the AIC during decision-making may be state-dependent and help guide response selection towards subjectively favourable options. © 2017 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Stockperson attitudes toward pig euthanasia.

PubMed

Rault, J-L; Holyoake, T; Coleman, G

2017-02-01

Euthanasia is a necessary act for any facility keeping live animals. Nevertheless, the crucial role and responsibility of the stockperson in deciding and conducting on-farm euthanasia has been overlooked. Stockperson characteristics and knowledge that lead to appropriate decision-making and the skills to competently perform the procedure remain to be identified. An important component of the stockperson's characteristics that predict behavior is the stockperson's attitudes. This preliminary study investigated the factors that influence stockperson attitudes toward the practice of on-farm euthanasia in the pork industry. A total of 120 stockpeople from 10 Australian pig farms (ranging in size from 50 to 4,754 sows and from 2 to 32 employees) completed a questionnaire based on focus group input to assess their attitudes toward euthanasia and decision processes. Factors identified included stockperson attitudes and attributes (empathy affect, empathy attribution, feeling bad about euthanizing, and negative attitudes to pigs), beliefs about the working environment (perceived time constraints and relying on others), and factors related to decision-making (comfortable with euthanasia, trouble deciding and avoid if possible, confidence, insufficient knowledge, seeking knowledge, and using sources to get advice). Numerous significant correlations were found between these variables. Furthermore, regression analyses showed confidence as the only significant predictor of being comfortable with euthanasia (12.5% of the variance; < 0.001); insufficient knowledge and empathy attribution both as predictors of trouble deciding and avoid if possible (15.1% of the variance; = 0.001 and = 0.032, respectively); and empathy affect, insufficient knowledge, and perceived time constraints as predictors of feeling bad about euthanizing (23.2% of the variance; < 0.001, = 0.006, and = 0.022, respectively). Stockpeople reported seeking more knowledge if they had not euthanized an animal before working with pigs ( = 0.05), and women reported greater difficulty than men in conducting euthanasia ( < 0.01). The findings indicate that euthanasia, which comprises both a decision-making process and the act itself, can adversely affect stockpeople. This preliminary study offers insights for implementation of successful practical and humane pig euthanasia protocols on farm. This will benefit stockperson well-being and animal well-being alike.

Decision aids for people facing health treatment or screening decisions.

PubMed

Stacey, Dawn; Légaré, France; Lewis, Krystina; Barry, Michael J; Bennett, Carol L; Eden, Karen B; Holmes-Rovner, Margaret; Llewellyn-Thomas, Hilary; Lyddiatt, Anne; Thomson, Richard; Trevena, Lyndal

2017-04-12

Decision aids are interventions that support patients by making their decisions explicit, providing information about options and associated benefits/harms, and helping clarify congruence between decisions and personal values. To assess the effects of decision aids in people facing treatment or screening decisions. Updated search (2012 to April 2015) in CENTRAL; MEDLINE; Embase; PsycINFO; and grey literature; includes CINAHL to September 2008. We included published randomized controlled trials comparing decision aids to usual care and/or alternative interventions. For this update, we excluded studies comparing detailed versus simple decision aids. Two reviewers independently screened citations for inclusion, extracted data, and assessed risk of bias. Primary outcomes, based on the International Patient Decision Aid Standards (IPDAS), were attributes related to the choice made and the decision-making process.Secondary outcomes were behavioural, health, and health system effects.We pooled results using mean differences (MDs) and risk ratios (RRs), applying a random-effects model. We conducted a subgroup analysis of studies that used the patient decision aid to prepare for the consultation and of those that used it in the consultation. We used GRADE to assess the strength of the evidence. We included 105 studies involving 31,043 participants. This update added 18 studies and removed 28 previously included studies comparing detailed versus simple decision aids. During the 'Risk of bias' assessment, we rated two items (selective reporting and blinding of participants/personnel) as mostly unclear due to inadequate reporting. Twelve of 105 studies were at high risk of bias.With regard to the attributes of the choice made, decision aids increased participants' knowledge (MD 13.27/100; 95% confidence interval (CI) 11.32 to 15.23; 52 studies; N = 13,316; high-quality evidence), accuracy of risk perceptions (RR 2.10; 95% CI 1.66 to 2.66; 17 studies; N = 5096; moderate-quality evidence), and congruency between informed values and care choices (RR 2.06; 95% CI 1.46 to 2.91; 10 studies; N = 4626; low-quality evidence) compared to usual care.Regarding attributes related to the decision-making process and compared to usual care, decision aids decreased decisional conflict related to feeling uninformed (MD -9.28/100; 95% CI -12.20 to -6.36; 27 studies; N = 5707; high-quality evidence), indecision about personal values (MD -8.81/100; 95% CI -11.99 to -5.63; 23 studies; N = 5068; high-quality evidence), and the proportion of people who were passive in decision making (RR 0.68; 95% CI 0.55 to 0.83; 16 studies; N = 3180; moderate-quality evidence).Decision aids reduced the proportion of undecided participants and appeared to have a positive effect on patient-clinician communication. Moreover, those exposed to a decision aid were either equally or more satisfied with their decision, the decision-making process, and/or the preparation for decision making compared to usual care.Decision aids also reduced the number of people choosing major elective invasive surgery in favour of more conservative options (RR 0.86; 95% CI 0.75 to 1.00; 18 studies; N = 3844), but this reduction reached statistical significance only after removing the study on prophylactic mastectomy for breast cancer gene carriers (RR 0.84; 95% CI 0.73 to 0.97; 17 studies; N = 3108). Compared to usual care, decision aids reduced the number of people choosing prostate-specific antigen screening (RR 0.88; 95% CI 0.80 to 0.98; 10 studies; N = 3996) and increased those choosing to start new medications for diabetes (RR 1.65; 95% CI 1.06 to 2.56; 4 studies; N = 447). For other testing and screening choices, mostly there were no differences between decision aids and usual care.The median effect of decision aids on length of consultation was 2.6 minutes longer (24 versus 21; 7.5% increase). The costs of the decision aid group were lower in two studies and similar to usual care in four studies. People receiving decision aids do not appear to differ from those receiving usual care in terms of anxiety, general health outcomes, and condition-specific health outcomes. Studies did not report adverse events associated with the use of decision aids.In subgroup analysis, we compared results for decision aids used in preparation for the consultation versus during the consultation, finding similar improvements in pooled analysis for knowledge and accurate risk perception. For other outcomes, we could not conduct formal subgroup analyses because there were too few studies in each subgroup. Compared to usual care across a wide variety of decision contexts, people exposed to decision aids feel more knowledgeable, better informed, and clearer about their values, and they probably have a more active role in decision making and more accurate risk perceptions. There is growing evidence that decision aids may improve values-congruent choices. There are no adverse effects on health outcomes or satisfaction. New for this updated is evidence indicating improved knowledge and accurate risk perceptions when decision aids are used either within or in preparation for the consultation. Further research is needed on the effects on adherence with the chosen option, cost-effectiveness, and use with lower literacy populations.

Attitudes toward Infection Prophylaxis in Pediatric Oncology: A Qualitative Approach

PubMed Central

Diorio, Caroline; Tomlinson, Deborah; Boydell, Katherine M.; Regier, Dean A.; Ethier, Marie-Chantal; Alli, Amanda; Alexander, Sarah; Gassas, Adam; Taylor, Jonathan; Kellow, Charis; Mills, Denise; Sung, Lillian

2012-01-01

Background The risks and benefits of infection prophylaxis are uncertain in children with cancer and thus, preferences should be considered in decision making. The purpose of this report was to describe the attitudes of parents, children and healthcare professionals to infection prophylaxis in pediatric oncology. Methods The study was completed in three phases: 1) An initial qualitative pilot to identify the main attributes influencing the decision to use infection prophylaxis, which were then incorporated into a discrete choice experiment; 2) A think aloud during the discrete choice experiment in which preferences for infection prophylaxis were elicited quantitatively; and 3) In-depth follow up interviews. Interviews were recorded verbatim and analyzed using an iterative, thematic analysis. Final themes were selected using a consensus approach. Results A total of 35 parents, 22 children and 28 healthcare professionals participated. All three groups suggested that the most important factor influencing their decision making was the effect of prophylaxis on reducing the chance of death. Themes of importance to the three groups included antimicrobial resistance, side effects of medications, the financial impact of outpatient prophylaxis and the route and schedule of administration. Conclusion Effect of prophylaxis on risk of death was a key factor in decision making. Other identified factors were antimicrobial resistance, side effects of medication, financial impact and administration details. Better understanding of factors driving decision making for infection prophylaxis will help facilitate future implementation of prophylactic regiments. PMID:23112849

Attitudes toward infection prophylaxis in pediatric oncology: a qualitative approach.

PubMed

Diorio, Caroline; Tomlinson, Deborah; Boydell, Katherine M; Regier, Dean A; Ethier, Marie-Chantal; Alli, Amanda; Alexander, Sarah; Gassas, Adam; Taylor, Jonathan; Kellow, Charis; Mills, Denise; Sung, Lillian

2012-01-01

The risks and benefits of infection prophylaxis are uncertain in children with cancer and thus, preferences should be considered in decision making. The purpose of this report was to describe the attitudes of parents, children and healthcare professionals to infection prophylaxis in pediatric oncology. THE STUDY WAS COMPLETED IN THREE PHASES: 1) An initial qualitative pilot to identify the main attributes influencing the decision to use infection prophylaxis, which were then incorporated into a discrete choice experiment; 2) A think aloud during the discrete choice experiment in which preferences for infection prophylaxis were elicited quantitatively; and 3) In-depth follow up interviews. Interviews were recorded verbatim and analyzed using an iterative, thematic analysis. Final themes were selected using a consensus approach. A total of 35 parents, 22 children and 28 healthcare professionals participated. All three groups suggested that the most important factor influencing their decision making was the effect of prophylaxis on reducing the chance of death. Themes of importance to the three groups included antimicrobial resistance, side effects of medications, the financial impact of outpatient prophylaxis and the route and schedule of administration. Effect of prophylaxis on risk of death was a key factor in decision making. Other identified factors were antimicrobial resistance, side effects of medication, financial impact and administration details. Better understanding of factors driving decision making for infection prophylaxis will help facilitate future implementation of prophylactic regiments.

Using multi-criteria decision making for selection of the optimal strategy for municipal solid waste management.

PubMed

Jovanovic, Sasa; Savic, Slobodan; Jovicic, Nebojsa; Boskovic, Goran; Djordjevic, Zorica

2016-09-01

Multi-criteria decision making (MCDM) is a relatively new tool for decision makers who deal with numerous and often contradictory factors during their decision making process. This paper presents a procedure to choose the optimal municipal solid waste (MSW) management system for the area of the city of Kragujevac (Republic of Serbia) based on the MCDM method. Two methods of multiple attribute decision making, i.e. SAW (simple additive weighting method) and TOPSIS (technique for order preference by similarity to ideal solution), respectively, were used to compare the proposed waste management strategies (WMS). Each of the created strategies was simulated using the software package IWM2. Total values for eight chosen parameters were calculated for all the strategies. Contribution of each of the six waste treatment options was valorized. The SAW analysis was used to obtain the sum characteristics for all the waste management treatment strategies and they were ranked accordingly. The TOPSIS method was used to calculate the relative closeness factors to the ideal solution for all the alternatives. Then, the proposed strategies were ranked in form of tables and diagrams obtained based on both MCDM methods. As shown in this paper, the results were in good agreement, which additionally confirmed and facilitated the choice of the optimal MSW management strategy. © The Author(s) 2016.

[Mechanisms for allocating financial resources after decentralization in the state of Jalisco].

PubMed

Pérez-Núñez, Ricardo; Arredondo-López, Armando; Pelcastre, Blanca

2006-01-01

To analyze, from the decision maker's perspective, the financial resource allocation process of the health services of the state of Jalisco (SSJ, per its abbreviation in spanish), within the context of decentralization. Through a qualitative approximation using semi-structured individual interviews of key personnel in managerial positions as the method for compiling information, the experience of the SSJ in financial resource allocation was documented. From September to November 2003, the perception of managers and administrators regarding their level of autonomy in decision-making was explored as well as the process they follow for the allocation of financial resources, in order to identify the criteria they use and their justifications. From the point of view of decision-makers, autonomy of the SSJ has increased considerably since decentralization was implemented, although the degree of decision-making freedom remains limited due mainly to high adminstrative costs associated with salaries. In this sense, the implications attributable to labor situations that are still centralized are evident. Some innovative systems for financial resource allocation have been established in the SSJ for the sanitary regions and hospitals based upon administrative-managerial and productivity incentives. Adjustments were also made for degree of marginalization and population lag, under the equity criterion. General work conditions and decision-making autonomy of the sanitary regions constitute outstanding aspects pending decentralization. Although decentralization has granted more autonomy to the SSJ, the level of decision-making freedom for allocating financial resources has been held within the highest hierarchical levels.

Evolution of a CDC Public Health Research Agenda for Low-Risk Prostate Cancer

PubMed Central

Hall, Ingrid J.; Smith, Judith Lee

2016-01-01

Men with prostate cancer face difficult choices when selecting a therapy for localized prostate cancer. Comparative data from controlled studies are lacking and clinical opinions diverge about the benefits and harms of treatment options. Consequently, there is limited guidance for patients regarding the impact of treatment decisions on quality of life. There are opportunities for public health to intervene at several decision-making points. Information on typical quality of life outcomes associated with specific prostate cancer treatments could help patients select treatment options. From 2003 to present, the Division of Cancer Prevention and Control at CDC has supported projects to explore patient information-seeking behavior post-diagnosis, caregiver and provider involvement in treatment decision making, and patient quality of life following prostate cancer treatment. CDC's work also includes research that explores barriers and facilitators to the presentation of active surveillance as a viable treatment option and promotes equal access to information for men and their caregivers. This article provides an overview of the literature and considerations that initiated establishing a prospective public health research agenda around treatment decision making. Insights gathered from CDC-supported studies are poised to enhance understanding of the process of shared decision making and the influence of patient, caregiver, and provider preferences on the selection of treatment choices. These findings provide guidance about attributes that maximize patient experiences in survivorship, including optimal quality of life and patient and caregiver satisfaction with information, treatment decisions, and subsequent care. PMID:26590643

Educating Our Communities and Ourselves about Conservation of Aquatic Resources through Environmental Outreach.

ERIC Educational Resources Information Center

Bjorkland, Ronald; Pringle, Catherine M.

2001-01-01

Highlights the inadequacy of environmental education in the United States based on the public's understanding of aquatic ecosystems. Points out the importance of scientific information in the decision making process and the importance of freshwater resources and ecosystems on the economy and cultural attributes. Discusses the workshop…

23 CFR 658.23 - LCV freeze; cargo-carrying unit freeze.

Code of Federal Regulations, 2010 CFR

2010-04-01

... safety purposes and road construction, a State may make minor adjustments of a temporary and emergency... decision is reached that minor adjustments made by a State are not legitimately attributable to road or bridge construction or safety, the FHWA will inform the State, and the original conditions of the freeze...

Group Decision Making Based on Heronian Aggregation Operators of Intuitionistic Fuzzy Numbers.

PubMed

Liu, Peide; Chen, Shyi-Ming

2017-09-01

Archimedean t -conorm and t -norm provide the general operational rules for intuitionistic fuzzy numbers (IFNs). The aggregation operators based on them can generalize most of the existing aggregation operators. At the same time, the Heronian mean (HM) has a significant advantage of considering interrelationships between the attributes. Therefore, it is very necessary to extend the HM based on IFNs and to construct intuitionistic fuzzy HM operators based on the Archimedean t -conorm and t -norm. In this paper, we first discuss intuitionistic fuzzy operational rules based on the Archimedean t -conorm and t -norm. Then, we propose the intuitionistic fuzzy Archimedean Heronian aggregation (IFAHA) operator and the intuitionistic fuzzy weight Archimedean Heronian aggregation (IFWAHA) operator. We also further discuss some properties and some special cases of these new operators. Moreover, we also propose a new multiple attribute group decision making (MAGDM) method based on the proposed IFAHA operator and the proposed IFWAHA operator. Finally, we use an illustrative example to show the MAGDM processes and to illustrate the effectiveness of the developed method.

Uncertainty in sample estimates and the implicit loss function for soil information.

NASA Astrophysics Data System (ADS)

Lark, Murray

2015-04-01

One significant challenge in the communication of uncertain information is how to enable the sponsors of sampling exercises to make a rational choice of sample size. One way to do this is to compute the value of additional information given the loss function for errors. The loss function expresses the costs that result from decisions made using erroneous information. In certain circumstances, such as remediation of contaminated land prior to development, loss functions can be computed and used to guide rational decision making on the amount of resource to spend on sampling to collect soil information. In many circumstances the loss function cannot be obtained prior to decision making. This may be the case when multiple decisions may be based on the soil information and the costs of errors are hard to predict. The implicit loss function is proposed as a tool to aid decision making in these circumstances. Conditional on a logistical model which expresses costs of soil sampling as a function of effort, and statistical information from which the error of estimates can be modelled as a function of effort, the implicit loss function is the loss function which makes a particular decision on effort rational. In this presentation the loss function is defined and computed for a number of arbitrary decisions on sampling effort for a hypothetical soil monitoring problem. This is based on a logistical model of sampling cost parameterized from a recent geochemical survey of soil in Donegal, Ireland and on statistical parameters estimated with the aid of a process model for change in soil organic carbon. It is shown how the implicit loss function might provide a basis for reflection on a particular choice of sample size by comparing it with the values attributed to soil properties and functions. Scope for further research to develop and apply the implicit loss function to help decision making by policy makers and regulators is then discussed.

Emergence of an abstract categorical code enabling the discrimination of temporally structured tactile stimuli

PubMed Central

Rossi-Pool, Román; Salinas, Emilio; Zainos, Antonio; Alvarez, Manuel; Vergara, José; Parga, Néstor; Romo, Ranulfo

2016-01-01

The problem of neural coding in perceptual decision making revolves around two fundamental questions: (i) How are the neural representations of sensory stimuli related to perception, and (ii) what attributes of these neural responses are relevant for downstream networks, and how do they influence decision making? We studied these two questions by recording neurons in primary somatosensory (S1) and dorsal premotor (DPC) cortex while trained monkeys reported whether the temporal pattern structure of two sequential vibrotactile stimuli (of equal mean frequency) was the same or different. We found that S1 neurons coded the temporal patterns in a literal way and only during the stimulation periods and did not reflect the monkeys’ decisions. In contrast, DPC neurons coded the stimulus patterns as broader categories and signaled them during the working memory, comparison, and decision periods. These results show that the initial sensory representation is transformed into an intermediate, more abstract categorical code that combines past and present information to ultimately generate a perceptually informed choice. PMID:27872293

Eliciting consumer preferences for health plans.

PubMed

Booske, B C; Sainfort, F; Hundt, A S

1999-10-01

To examine (1) what people say is important to them in choosing a health plan; (2) the effect, if any, that giving health plan information has on what people say is important to them; and (3) the effect of preference elicitation methods on what people say is important. A random sample of 201 Wisconsin state employees who participated in a health plan choice experiment during the 1995 open enrollment period. We designed a computer system to guide subjects through the review of information about health plan options. The system began by eliciting the stated preferences of the subjects before they viewed the information, at time 0. Subjects were given an opportunity to revise their preference structures first after viewing summary information about four health plans (time 1) and then after viewing more extensive, detailed information about the same options (time 2). At time 2, these individuals were also asked to rate the relative importance of a predefined list of health plan features presented to them. Data were collected on the number of attributes listed at each point in time and the importance weightings assigned to each attribute. In addition, each item on the attribute list was content analyzed. The provision of information changes the preference structures of individuals. Costs (price) and coverage dominated the attributes cited both before and after looking at health plan information. When presented with information on costs, quality, and how plans work, many of these relatively well educated consumers revised their preference structures; yet coverage and costs remained the primary cited attributes. Although efforts to provide health plan information should continue, decisions on the information to provide and on making it available are not enough. Individuals need help in understanding, processing, and using the information to construct their preferences and make better decisions.

Bayesian outcome-based strategy classification.

PubMed

Lee, Michael D

2016-03-01

Hilbig and Moshagen (Psychonomic Bulletin & Review, 21, 1431-1443, 2014) recently developed a method for making inferences about the decision processes people use in multi-attribute forced choice tasks. Their paper makes a number of worthwhile theoretical and methodological contributions. Theoretically, they provide an insightful psychological motivation for a probabilistic extension of the widely-used "weighted additive" (WADD) model, and show how this model, as well as other important models like "take-the-best" (TTB), can and should be expressed in terms of meaningful priors. Methodologically, they develop an inference approach based on the Minimum Description Length (MDL) principles that balances both the goodness-of-fit and complexity of the decision models they consider. This paper aims to preserve these useful contributions, but provide a complementary Bayesian approach with some theoretical and methodological advantages. We develop a simple graphical model, implemented in JAGS, that allows for fully Bayesian inferences about which models people use to make decisions. To demonstrate the Bayesian approach, we apply it to the models and data considered by Hilbig and Moshagen (Psychonomic Bulletin & Review, 21, 1431-1443, 2014), showing how a prior predictive analysis of the models, and posterior inferences about which models people use and the parameter settings at which they use them, can contribute to our understanding of human decision making.

Difficult Decisions: A Qualitative Exploration of the Statistical Decision Making Process from the Perspectives of Psychology Students and Academics

PubMed Central

Allen, Peter J.; Dorozenko, Kate P.; Roberts, Lynne D.

2016-01-01

Quantitative research methods are essential to the development of professional competence in psychology. They are also an area of weakness for many students. In particular, students are known to struggle with the skill of selecting quantitative analytical strategies appropriate for common research questions, hypotheses and data types. To begin understanding this apparent deficit, we presented nine psychology undergraduates (who had all completed at least one quantitative methods course) with brief research vignettes, and asked them to explicate the process they would follow to identify an appropriate statistical technique for each. Thematic analysis revealed that all participants found this task challenging, and even those who had completed several research methods courses struggled to articulate how they would approach the vignettes on more than a very superficial and intuitive level. While some students recognized that there is a systematic decision making process that can be followed, none could describe it clearly or completely. We then presented the same vignettes to 10 psychology academics with particular expertise in conducting research and/or research methods instruction. Predictably, these “experts” were able to describe a far more systematic, comprehensive, flexible, and nuanced approach to statistical decision making, which begins early in the research process, and pays consideration to multiple contextual factors. They were sensitive to the challenges that students experience when making statistical decisions, which they attributed partially to how research methods and statistics are commonly taught. This sensitivity was reflected in their pedagogic practices. When asked to consider the format and features of an aid that could facilitate the statistical decision making process, both groups expressed a preference for an accessible, comprehensive and reputable resource that follows a basic decision tree logic. For the academics in particular, this aid should function as a teaching tool, which engages the user with each choice-point in the decision making process, rather than simply providing an “answer.” Based on these findings, we offer suggestions for tools and strategies that could be deployed in the research methods classroom to facilitate and strengthen students' statistical decision making abilities. PMID:26909064

Difficult Decisions: A Qualitative Exploration of the Statistical Decision Making Process from the Perspectives of Psychology Students and Academics.

PubMed

Allen, Peter J; Dorozenko, Kate P; Roberts, Lynne D

2016-01-01

Quantitative research methods are essential to the development of professional competence in psychology. They are also an area of weakness for many students. In particular, students are known to struggle with the skill of selecting quantitative analytical strategies appropriate for common research questions, hypotheses and data types. To begin understanding this apparent deficit, we presented nine psychology undergraduates (who had all completed at least one quantitative methods course) with brief research vignettes, and asked them to explicate the process they would follow to identify an appropriate statistical technique for each. Thematic analysis revealed that all participants found this task challenging, and even those who had completed several research methods courses struggled to articulate how they would approach the vignettes on more than a very superficial and intuitive level. While some students recognized that there is a systematic decision making process that can be followed, none could describe it clearly or completely. We then presented the same vignettes to 10 psychology academics with particular expertise in conducting research and/or research methods instruction. Predictably, these "experts" were able to describe a far more systematic, comprehensive, flexible, and nuanced approach to statistical decision making, which begins early in the research process, and pays consideration to multiple contextual factors. They were sensitive to the challenges that students experience when making statistical decisions, which they attributed partially to how research methods and statistics are commonly taught. This sensitivity was reflected in their pedagogic practices. When asked to consider the format and features of an aid that could facilitate the statistical decision making process, both groups expressed a preference for an accessible, comprehensive and reputable resource that follows a basic decision tree logic. For the academics in particular, this aid should function as a teaching tool, which engages the user with each choice-point in the decision making process, rather than simply providing an "answer." Based on these findings, we offer suggestions for tools and strategies that could be deployed in the research methods classroom to facilitate and strengthen students' statistical decision making abilities.

Involving Patients in Weighting Benefits and Harms of Treatment in Parkinson's Disease

PubMed Central

Weernink, Marieke G. M.; van Til, Janine A.; van Vugt, Jeroen P. P.; Movig, Kris L. L.; Groothuis-Oudshoorn, Catharina G. M.; IJzerman, Maarten J.

2016-01-01

Introduction Little is known about how patients weigh benefits and harms of available treatments for Parkinson’s Disease (oral medication, deep brain stimulation, infusion therapy). In this study we have (1) elicited patient preferences for benefits, side effects and process characteristics of treatments and (2) measured patients’ preferred and perceived involvement in decision-making about treatment. Methods Preferences were elicited using a best-worst scaling case 2 experiment. Attributes were selected based on 18 patient-interviews: treatment modality, tremor, slowness of movement, posture and balance problems, drowsiness, dizziness, and dyskinesia. Subsequently, a questionnaire was distributed in which patients were asked to indicate the most and least desirable attribute in nine possible treatment scenarios. Conditional logistic analysis and latent class analysis were used to estimate preference weights and identify subgroups. Patients also indicated their preferred and perceived degree of involvement in treatment decision-making (ranging from active to collaborative to passive). Results Two preference patterns were found in the patient sample (N = 192). One class of patients focused largely on optimising the process of care, while the other class focused more on controlling motor-symptoms. Patients who had experienced advanced treatments, had a shorter disease duration, or were still employed were more likely to belong to the latter class. For both classes, the benefits of treatment were more influential than the described side effects. Furthermore, many patients (45%) preferred to take the lead in treatment decisions, however 10.8% perceived a more passive or collaborative role instead. Discussion Patients weighted the benefits and side effects of treatment differently, indicating there is no “one-size-fits-all” approach to choosing treatments. Moreover, many patients preferred an active role in decision-making about treatment. Both results stress the need for physicians to know what is important to patients and to share treatment decisions to ensure that patients receive the treatment that aligns with their preferences. PMID:27575744

Environmental impact assessment: Retrospect and prospect

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jay, Stephen; Jones, Carys; Slinn, Paul

2007-05-15

The widespread experience of environmental impact assessment (EIA) as an anticipatory environmental management tool has generated a considerable debate over the extent to which it is achieving its purposes. This has been measured in terms of EIA 'effectiveness', especially as discussion has moved away from issues of procedural implementation, to the more substantive goals of EIA and its place within broader decision-making contexts. Empirical studies have revealed the relatively weak degree of influence on planning decisions that is being exerted by EIA, which is increasingly being attributed to its rationalist beginnings. This article seeks to direct this debate towards themore » founding political purposes of EIA which, it is argued, provide a neglected, yet strong, basis for EIA reform. A number of illustrative suggestions are made as a result of this redirection, to enable EIA to adopt a more determinative role in decision making and to contribute to more sustainable patterns of development planning.« less

Judicial virtues and decision-making in the VCAT Guardianship List.

PubMed

Polkinghorn, Richard

2014-06-01

The contemporary legal theory of virtue jurisprudence provides great insight into the proper practice of Australian tribunal members and the desired operation of tribunals. Virtue jurisprudence identifies the attributes of "good" tribunal members and provides guidance on how legal disputes should be decided. This article focuses on the fundamental virtues relevant to tribunal practice in the Guardianship List of the Victorian Civil and Administrative Tribunal. The special features of this tribunal jurisdiction, particularly the disadvantaged nature of its primary client group, require tribunal members to undertake a fact-finding, inquisitorial role, as well as a support and advisory role. Decision-makers must also become conversant with expert evidence and the process of testing expert evidence; they cannot simply defer to the expert on issues of decision-making capacity. This analysis considers the fundamental breaches of human rights that occur when tribunal members fail to execute this multilevel task properly.

Integrated modelling of stormwater treatment systems uptake.

PubMed

Castonguay, A C; Iftekhar, M S; Urich, C; Bach, P M; Deletic, A

2018-05-24

Nature-based solutions provide a variety of benefits in growing cities, ranging from stormwater treatment to amenity provision such as aesthetics. However, the decision-making process involved in the installation of such green infrastructure is not straightforward, as much uncertainty around the location, size, costs and benefits impedes systematic decision-making. We developed a model to simulate decision rules used by local municipalities to install nature-based stormwater treatment systems, namely constructed wetlands, ponds/basins and raingardens. The model was used to test twenty-four scenarios of policy-making, by combining four asset selection, two location selection and three budget constraint decision rules. Based on the case study of a local municipality in Metropolitan Melbourne, Australia, the modelled uptake of stormwater treatment systems was compared with attributes of real-world systems for the simulation period. Results show that the actual budgeted funding is not reliable to predict systems' uptake and that policy-makers are more likely to plan expenditures based on installation costs. The model was able to replicate the cumulative treatment capacity and the location of systems. As such, it offers a novel approach to investigate the impact of using different decision rules to provide environmental services considering biophysical and economic factors. Copyright © 2018 Elsevier Ltd. All rights reserved.

Selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision-making?

PubMed

Hakkennes, Sharon; Hill, Keith D; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

2013-01-01

This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. Multi-site prospective observational cohort study. Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p < 0.05). This study highlights the importance of pre-morbid function and social factors in addition to post-stroke function in the decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.

Societal preferences in the treatment of pediatric medulloblastoma: Balancing risk of death and quality of life.

PubMed

Khakban, Amir; Mohammadi, Tima; Lynd, Larry D; Mabbott, Don; Bouffet, Eric; Gastonguay, Louise; Zafari, Zafar; Malkin, David; Taylor, Michael; Marra, Carlo A

2017-06-01

Medulloblastoma is the most prevalent childhood brain cancer. Children with medulloblastoma typically receive a combination of surgery, radiation, and chemotherapy. The survival rate is high but survivors often have sequelae from radiotherapy of the entire developing brain and spinal cord. Ongoing genetic studies have suggested that decreasing the dose of radiation might be possible among children with favorable molecular variants; however, this may result in an increased disease recurrence. As such, there is a need to investigate the nature of trade-offs that individuals are willing to make regarding the treatment of medulloblastoma. We used best-worst scaling to estimate the importance of attributes affecting the general public's decision making around the treatment of medulloblastoma. After conducting focus groups, we selected three relevant attributes: (1) the accuracy of the genetic test; (2) the probability of serious adverse effects of the treatment(s); and (3) the survival rate. Using the paired method, we applied a conditional logit model to estimate preferences. In total, 3,006 respondents (51.3% female) with an average age of 43 years answered the questionnaires. All coefficients were statistically significantly different from zero and the attribute levels of adverse effects and the survival rate had the most impact on individuals' stated decision making. Overall, respondents showed high sensitivity to children experiencing disability particularly in the setting of a good prognosis. However, among children with poor prognostic molecular variants, participants showed tolerance about having a child with mild and partial disability compared to a low rate of survival. © 2016 Wiley Periodicals, Inc.

Individual Differences in Subjective Utility and Risk Preferences: The Influence of Hedonic Capacity and Trait Anxiety

PubMed Central

Howlett, Jonathon R.; Paulus, Martin P.

2017-01-01

Individual differences in decision-making are important in both normal populations and psychiatric conditions. Variability in decision-making could be mediated by different subjective utilities or by other processes. For example, while traditional economic accounts attribute risk aversion to a concave subjective utility curve, in practice other factors could affect risk behavior. This distinction may have important implications for understanding the biological basis of variability in decision-making and for developing interventions to improve decision-making. Another aspect of decision-making that may vary between individuals is the sensitivity of subjective utility to counterfactual outcomes (outcomes that could have occurred, but did not). We investigated decision-making in relation to hedonic capacity and trait anxiety, two traits that relate to psychiatric conditions but also vary in the general population. Subjects performed a decision-making task, in which they chose between low- and high-risk gambles to win 0, 20, or 40 points on each trial. Subjects then rated satisfaction after each outcome on a visual analog scale, indicating subjective utility. Hedonic capacity was positively associated with the subjective utility of winning 20 points but was not associated with the concavity of the subjective utility curve (constructed using the mean subjective utility of winning 0, 20, or 40 points). Consistent with economic theory, concavity of the subjective utility curve was associated with risk aversion. Hedonic capacity was independently associated with risk seeking (i.e., not mediated by the shape of the subjective utility curve), while trait anxiety was unrelated to risk preferences. Contrary to our expectations, counterfactual sensitivity was unrelated to hedonic capacity and trait anxiety. Nevertheless, trait anxiety was associated with a self-report measure of regret-proneness, suggesting that counterfactual influences may occur via a pathway that is separate from immediate counterfactual processing biases. Taken together, our results show that hedonic capacity but not trait anxiety affects risk-taking through a mechanism that appears independent of the shape of the subjective utility curve, while hedonic capacity and trait anxiety do not affect the influence of counterfactual outcomes on subjective utility. The results have implications for understanding the underlying mechanisms of variable decision-making and for developing interventions to improve decision-making. PMID:28588508

Individual Differences in Subjective Utility and Risk Preferences: The Influence of Hedonic Capacity and Trait Anxiety.

PubMed

Howlett, Jonathon R; Paulus, Martin P

2017-01-01

Individual differences in decision-making are important in both normal populations and psychiatric conditions. Variability in decision-making could be mediated by different subjective utilities or by other processes. For example, while traditional economic accounts attribute risk aversion to a concave subjective utility curve, in practice other factors could affect risk behavior. This distinction may have important implications for understanding the biological basis of variability in decision-making and for developing interventions to improve decision-making. Another aspect of decision-making that may vary between individuals is the sensitivity of subjective utility to counterfactual outcomes (outcomes that could have occurred, but did not). We investigated decision-making in relation to hedonic capacity and trait anxiety, two traits that relate to psychiatric conditions but also vary in the general population. Subjects performed a decision-making task, in which they chose between low- and high-risk gambles to win 0, 20, or 40 points on each trial. Subjects then rated satisfaction after each outcome on a visual analog scale, indicating subjective utility. Hedonic capacity was positively associated with the subjective utility of winning 20 points but was not associated with the concavity of the subjective utility curve (constructed using the mean subjective utility of winning 0, 20, or 40 points). Consistent with economic theory, concavity of the subjective utility curve was associated with risk aversion. Hedonic capacity was independently associated with risk seeking (i.e., not mediated by the shape of the subjective utility curve), while trait anxiety was unrelated to risk preferences. Contrary to our expectations, counterfactual sensitivity was unrelated to hedonic capacity and trait anxiety. Nevertheless, trait anxiety was associated with a self-report measure of regret-proneness, suggesting that counterfactual influences may occur via a pathway that is separate from immediate counterfactual processing biases. Taken together, our results show that hedonic capacity but not trait anxiety affects risk-taking through a mechanism that appears independent of the shape of the subjective utility curve, while hedonic capacity and trait anxiety do not affect the influence of counterfactual outcomes on subjective utility. The results have implications for understanding the underlying mechanisms of variable decision-making and for developing interventions to improve decision-making.

Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

NASA Technical Reports Server (NTRS)

Patrick, Nicholas J. M.; Sheridan, Thomas B.

1996-01-01

Most decisions made in the cockpit are related to safety, and have therefore been proceduralized in order to reduce risk. There are very few which are made on the basis of a value metric such as economic cost. One which can be shown to be value based, however, is the selection of a flight profile. Fuel consumption and flight time both have a substantial effect on aircraft operating cost, but they cannot be minimized simultaneously. In addition, winds, turbulence, and performance vary widely with altitude and time. These factors make it important and difficult for pilots to (a) evaluate the outcomes associated with a particular trajectory before it is flown and (b) decide among possible trajectories. The two elements of this problem considered here are: (1) determining what constitutes optimality, and (2) finding optimal trajectories. Pilots and dispatchers from major u.s. airlines were surveyed to determine which attributes of the outcome of a flight they considered the most important. Avoiding turbulence-for passenger comfort-topped the list of items which were not safety related. Pilots' decision making about the selection of flight profile on the basis of flight time, fuel burn, and exposure to turbulence was then observed. Of the several behavioral and prescriptive decision models invoked to explain the pilots' choices, utility maximization is shown to best reproduce the pilots' decisions. After considering more traditional methods for optimizing trajectories, a novel method is developed using a genetic algorithm (GA) operating on a discrete representation of the trajectory search space. The representation is a sequence of command altitudes, and was chosen to be compatible with the constraints imposed by Air Traffic Control, and with the training given to pilots. Since trajectory evaluation for the GA is performed holistically, a wide class of objective functions can be optimized easily. Also, using the GA it is possible to compare the costs associated with different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimality with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider unmodelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

NASA Technical Reports Server (NTRS)

Patrick, Nicholas J. M.; Sheridan, Thomas B.

1996-01-01

Most decisions made in the cockpit are related to safety, and have therefore been proceduralized in order to reduce risk. There are very few which are made on the basis of a value metric such as economic cost. One which can be shown to be value based, however, is the selection of a flight profile. Fuel consumption and flight time both have a substantial effect on aircraft operating cost, but they cannot be minimized simultaneously. In addition, winds, turbulence, and performance x,ary widely with altitude and time. These factors make it important and difficult for pilots to (a) evaluate the outcomes associated with a particular trajectory before it is flown and (b) decide among possible trajectories. The two elements of this problem considered here are (1) determining, what constitutes optimality, and (2) finding optimal trajectories. Pilots and dispatchers from major U.S. airlines were surveyed to determine which attributes of the outcome of a flight they considered the most important. Avoiding turbulence-for passenger comfort topped the list of items which were not safety related. Pilots' decision making about the selection of flight profile on the basis of flight time, fuel burn, and exposure to turbulence was then observed. Of the several behavioral and prescriptive decision models invoked to explain the pilots' choices, utility maximization is shown to best reproduce the pilots' decisions. After considering more traditional methods for optimizing trajectories, a novel method is developed using a genetic algorithm (GA) operating on a discrete representation of the trajectory search space. The representation is a sequence of command altitudes, and was chosen to be compatible with the constraints imposed by Air Traffic Control, and with the training given to pilots. Since trajectory evaluation for the GA is performed holistically, a wide class of objective functions can be optimized easily. Also, using the GA it is possible to compare the costs associated with different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimility with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider un-modelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

Inflated Applicants: Attribution Errors in Performance Evaluation by Professionals

PubMed Central

Swift, Samuel A.; Moore, Don A.; Sharek, Zachariah S.; Gino, Francesca

2013-01-01

When explaining others' behaviors, achievements, and failures, it is common for people to attribute too much influence to disposition and too little influence to structural and situational factors. We examine whether this tendency leads even experienced professionals to make systematic mistakes in their selection decisions, favoring alumni from academic institutions with high grade distributions and employees from forgiving business environments. We find that candidates benefiting from favorable situations are more likely to be admitted and promoted than their equivalently skilled peers. The results suggest that decision-makers take high nominal performance as evidence of high ability and do not discount it by the ease with which it was achieved. These results clarify our understanding of the correspondence bias using evidence from both archival studies and experiments with experienced professionals. We discuss implications for both admissions and personnel selection practices. PMID:23894437

Using augmented reality to inform consumer choice and lower carbon footprints

NASA Astrophysics Data System (ADS)

Isley, Steven C.; Ketcham, Robert; Arent, Douglas J.

2017-05-01

Consumers who wish to consider product attributes like carbon footprints in their purchasing decisions are often blocked from meaningful action by a lack of information. We conducted a randomized controlled trial at a grocery store to evaluate the effects of providing such product attribute and carbon footprint information via augmented reality (AR) displays on bottled water and breakfast cereal, two frequently purchased goods. Using an AR smartphone app that combines comparative and detailed product information into personalized data and recommendations, a 23% reduction in carbon footprint was found for bottled water, and non-significant reductions for breakfast cereal. However, AR informed choice lead to healthier cereal purchases with an average of 32% less sugar, 15% less fat, and 9.8% less sodium. This research suggests that AR techniques can help facilitate complex decision-making and lead to better choices.

Knowledge based system and decision making methodologies in materials selection for aircraft cabin metallic structures

NASA Astrophysics Data System (ADS)

Adhikari, Pashupati Raj

Materials selection processes have been the most important aspects in product design and development. Knowledge-based system (KBS) and some of the methodologies used in the materials selection for the design of aircraft cabin metallic structures are discussed. Overall aircraft weight reduction means substantially less fuel consumption. Part of the solution to this problem is to find a way to reduce overall weight of metallic structures inside the cabin. Among various methodologies of materials selection using Multi Criterion Decision Making (MCDM) techniques, a few of them are demonstrated with examples and the results are compared with those obtained using Ashby's approach in materials selection. Pre-defined constraint values, mainly mechanical properties, are employed as relevant attributes in the process. Aluminum alloys with high strength-to-weight ratio have been second-to-none in most of the aircraft parts manufacturing. Magnesium alloys that are much lighter in weight as alternatives to the Al-alloys currently in use in the structures are tested using the methodologies and ranked results are compared. Each material attribute considered in the design are categorized as benefit and non-benefit attribute. Using Ashby's approach, material indices that are required to be maximized for an optimum performance are determined, and materials are ranked based on the average of consolidated indices ranking. Ranking results are compared for any disparity among the methodologies.

Adolescent and Adult Reasoning about Gender Roles and Fairness in Benin, West Africa

ERIC Educational Resources Information Center

Conry-Murray, Clare

2009-01-01

This study examined reasoning about gender roles in a traditional society in Benin, West Africa. Ninety-seven male and female adolescents and adults evaluated conflicts between a husband and a wife over gender norms to determine whether gender norms, are judged to be moral or conventional. Although most attributed decision-making power to the…

Language Switching--but Not Foreign Language Use Per Se--Reduces the Framing Effect

ERIC Educational Resources Information Center

Oganian, Y.; Korn, C. W.; Heekeren, H. R.

2016-01-01

Recent studies reported reductions of well-established biases in decision making under risk, such as the framing effect, during foreign language (FL) use. These modulations were attributed to the use of FL itself, which putatively entails an increase in emotional distance. A reduced framing effect in this setting, however, might also result from…

Cold or Calculating? Reduced Activity in the Subgenual Cingulate Cortex Reflects Decreased Emotional Aversion to Harming in Counterintuitive Utilitarian Judgment

ERIC Educational Resources Information Center

Wiech, Katja; Kahane, Guy; Shackel, Nicholas; Farias, Miguel; Savulescu, Julian; Tracey, Irene

2013-01-01

Recent research on moral decision-making has suggested that many common moral judgments are based on immediate intuitions. However, some individuals arrive at highly counterintuitive utilitarian conclusions about when it is permissible to harm other individuals. Such utilitarian judgments have been attributed to effortful reasoning that has…

Integrating resource, social and managerial indicators of quality into carrying capacity decision making

Treesearch

Peter Newman; Robert Manning; Bill Valliere

2002-01-01

As use in national parks and related areas continues to rise and visitors and types of activities continue to diversify, we are challenged to balance use and preservation in parks, wilderness and related areas. Faced with these challenges, integrative approaches to defining, monitoring and managing ecological, social and managerial setting attributes is crucial. This...

Zoning of an agricultural field using a fuzzy indicator model in combination with tool for multi-attributed decision-making

USDA-ARS?s Scientific Manuscript database

Zoning of agricultural fields is an important task for utilization of precision farming technology. This paper extends previously published work entitled “Zoning of an agricultural field using a fuzzy indicator model” to a general case where there is disagreement between groups of managers or expert...

Open Educational Resources: A Review of Attributes for Adoption in an Online Bachelor's Degree Program

ERIC Educational Resources Information Center

Neely, Patricia; Tucker, Jan P.; Au, Angela

2016-01-01

As concerns about the skyrocketing costs of a college degree have converged with the increasing availability of open educational resources (OER), higher education administrators are asking faculty and curriculum designers to use OERs to design courses and programs. This case study explores the decision making process and outcomes of an online,…

In Defense of an Instrument-Based Approach to Validity

ERIC Educational Resources Information Center

Hood, S. Brian

2012-01-01

Paul E. Newton argues in favor of a conception of validity, viz, "the consensus definition of validity," according to which the extension of the predicate "is valid" is a subset of "assessment-based decision-making procedure[s], which [are] underwritten by an argument that the assessment procedure can be used to measure the attribute entailed by…

"Your Credibility Could Be Shot": Preservice Teachers' Thinking about Nonfiction Graphic Novels, Curriculum Decision Making, and Professional Acceptance

ERIC Educational Resources Information Center

Clark, J. Spencer

2013-01-01

This article examined the value of using nonfiction graphic novels as historical narratives in the social studies curriculum. Preservice teachers evaluated several graphic novels and identified attributes of graphic novels that could contribute to students' development of historical thinking and understanding of multiple perspectives. Despite the…

Sowing seeds: transperineal implantation.

PubMed

Amerine, E; Nagle, G M; Bollinger, J R

2000-02-01

Prostate cancer, the second leading cause of male deaths in the United States, has increased by 126% since 1987 (Stephenson, 1998). Early diagnosis is attributed to public awareness and technologic advances. Multiple options for definitive treatment with equally positive outcomes dramatically influence the patient's decision-making process. One popular option for these patients is transperineal implantation of radioactive seeds into the prostate.

Anhedonia and anxiety underlying depressive symptomatology have distinct effects on reward-based decision-making.

PubMed

Harlé, Katia M; Guo, Dalin; Zhang, Shunan; Paulus, Martin P; Yu, Angela J

2017-01-01

Depressive pathology, which includes both heightened negative affect (e.g., anxiety) and reduced positive affect (e.g., anhedonia), is known to be associated with sub-optimal decision-making, particularly in uncertain environments. Here, we use a computational approach to quantify and disambiguate how individual differences in these affective measures specifically relate to different aspects of learning and decision-making in reward-based choice behavior. Fifty-three individuals with a range of depressed mood completed a two-armed bandit task, in which they choose between two arms with fixed but unknown reward rates. The decision-making component, which chooses among options based on current expectations about reward rates, is modeled by two different decision policies: a learning-independent Win-stay/Lose-shift (WSLS) policy that ignores all previous experiences except the last trial, and Softmax, which prefers the arm with the higher expected reward. To model the learning component for the Softmax choice policy, we use a Bayesian inference model, which updates estimated reward rates based on the observed history of trial outcomes. Softmax with Bayesian learning better fits the behavior of 55% of the participants, while the others are better fit by a learning-independent WSLS strategy. Among Softmax "users", those with higher anhedonia are less likely to choose the option estimated to be most rewarding. Moreover, the Softmax parameter mediates the inverse relationship between anhedonia and overall monetary gains. On the other hand, among WSLS "users", higher state anxiety correlates with increasingly better ability of WSLS, relative to Softmax, to explain subjects' trial-by-trial choices. In summary, there is significant variability among individuals in their reward-based, exploratory decision-making, and this variability is at least partly mediated in a very specific manner by affective attributes, such as hedonic tone and state anxiety.

Social network and decision-making in primates: a report on Franco-Japanese research collaborations.

PubMed

Sueur, Cédric; Pelé, Marie

2016-07-01

Sociality is suggested to evolve as a strategy for animals to cope with challenges in their environment. Within a population, each individual can be seen as part of a network of social interactions that vary in strength, type and dynamics (Sueur et al. 2011a). The structure of this social network can strongly impact upon not only on the fitness of individuals and their decision-making, but also on the ecology of populations and the evolution of a species. Our Franco-Japanese collaboration allowed us to study social networks in several species (Japanese macaques, chimpanzees, colobines, etc.) and on different topics (social epidemiology, social evolution, information transmission). Individual attributes such as stress, rank or age can affect how individuals take decisions and the structure of the social network. This heterogeneity is linked to the assortativity of individuals and to the efficiency of the flow within a network. It is important, therefore, that this heterogeneity is integrated in the process or pattern under study in order to provide a better resolution of investigation and, ultimately, a better understanding of behavioural strategies, social dynamics and social evolution. How social information affects decision-making could be important to understand how social groups make collective decisions and how information may spread throughout the social group. In human beings, road-crossing behaviours in the presence of other individuals is a good way to study the influence of social information on individual behaviour and decision-making, for instance. Culture directly affects which information - personal vs social - individuals prefer to follow. Our collaboration contributed to the understanding of the relative influence of different factors, cultural and ecological, on primate, including human, sociality.

Exploring complex dynamics in multi agent-based intelligent systems: Theoretical and experimental approaches using the Multi Agent-based Behavioral Economic Landscape (MABEL) model

NASA Astrophysics Data System (ADS)

Alexandridis, Konstantinos T.

This dissertation adopts a holistic and detailed approach to modeling spatially explicit agent-based artificial intelligent systems, using the Multi Agent-based Behavioral Economic Landscape (MABEL) model. The research questions that addresses stem from the need to understand and analyze the real-world patterns and dynamics of land use change from a coupled human-environmental systems perspective. Describes the systemic, mathematical, statistical, socio-economic and spatial dynamics of the MABEL modeling framework, and provides a wide array of cross-disciplinary modeling applications within the research, decision-making and policy domains. Establishes the symbolic properties of the MABEL model as a Markov decision process, analyzes the decision-theoretic utility and optimization attributes of agents towards comprising statistically and spatially optimal policies and actions, and explores the probabilogic character of the agents' decision-making and inference mechanisms via the use of Bayesian belief and decision networks. Develops and describes a Monte Carlo methodology for experimental replications of agent's decisions regarding complex spatial parcel acquisition and learning. Recognizes the gap on spatially-explicit accuracy assessment techniques for complex spatial models, and proposes an ensemble of statistical tools designed to address this problem. Advanced information assessment techniques such as the Receiver-Operator Characteristic curve, the impurity entropy and Gini functions, and the Bayesian classification functions are proposed. The theoretical foundation for modular Bayesian inference in spatially-explicit multi-agent artificial intelligent systems, and the ensembles of cognitive and scenario assessment modular tools build for the MABEL model are provided. Emphasizes the modularity and robustness as valuable qualitative modeling attributes, and examines the role of robust intelligent modeling as a tool for improving policy-decisions related to land use change. Finally, the major contributions to the science are presented along with valuable directions for future research.

“Kinect-ing” With Clinicians: A Knowledge Translation Resource to Support Decision Making About Video Game Use in Rehabilitation

PubMed Central

Levac, Danielle; Espy, Deborah; Fox, Emily; Pradhan, Sujata

2015-01-01

Microsoft's Kinect for Xbox 360 virtual reality (VR) video games are promising rehabilitation options because they involve motivating, full-body movement practice. However, these games were designed for recreational use, which creates challenges for clinical implementation. Busy clinicians require decision-making support to inform game selection and implementation that address individual therapeutic goals. This article describes the development and preliminary evaluation of a knowledge translation (KT) resource to support clinical decision making about selection and use of Kinect games in physical therapy. The knowledge-to-action framework guided the development of the Kinecting With Clinicians (KWiC) resource. Five physical therapists with VR and video game expertise analyzed the Kinect Adventure games. A consensus-building method was used to arrive at categories to organize clinically relevant attributes guiding game selection and game play. The process and results of an exploratory usability evaluation of the KWiC resource by clinicians through interviews and focus groups at 4 clinical sites is described. Subsequent steps in the evaluation and KT process are proposed, including making the KWiC resource Web-based and evaluating the utility of the online resource in clinical practice. PMID:25256741

"Kinect-ing" with clinicians: a knowledge translation resource to support decision making about video game use in rehabilitation.

PubMed

Levac, Danielle; Espy, Deborah; Fox, Emily; Pradhan, Sujata; Deutsch, Judith E

2015-03-01

Microsoft's Kinect for Xbox 360 virtual reality (VR) video games are promising rehabilitation options because they involve motivating, full-body movement practice. However, these games were designed for recreational use, which creates challenges for clinical implementation. Busy clinicians require decision-making support to inform game selection and implementation that address individual therapeutic goals. This article describes the development and preliminary evaluation of a knowledge translation (KT) resource to support clinical decision making about selection and use of Kinect games in physical therapy. The knowledge-to-action framework guided the development of the Kinecting With Clinicians (KWiC) resource. Five physical therapists with VR and video game expertise analyzed the Kinect Adventure games. A consensus-building method was used to arrive at categories to organize clinically relevant attributes guiding game selection and game play. The process and results of an exploratory usability evaluation of the KWiC resource by clinicians through interviews and focus groups at 4 clinical sites is described. Subsequent steps in the evaluation and KT process are proposed, including making the KWiC resource Web-based and evaluating the utility of the online resource in clinical practice. © 2015 American Physical Therapy Association.

Risk Taking and Decision Making in Kidney Paired Donation: A Qualitative Study by Semistructured Interviews.

PubMed

Baines, L S; Dulku, H; Jindal, R M; Papalois, V

2018-06-01

Despite excellent outcomes of kidney paired donation (KPD), little is known about how a patient's frame (apply cognitive bias) or weight (attribute value) and concerns relating to risk, justice, and equity affect his or her decision-making process. A pilot study consisting of 3 KPD transplant recipients and 3 KPD kidney donors in the last year was conducted to identify and explore themes in decision making and risk taking. The pilot study was followed by the main study comprised of 20 recipients who had already undergone KPD transplantation and 20 donors who had undergone donor nephrectomy. We conducted semistructured interviews in this cohort and analyzed the data thematically. Each donor-recipient pair was interviewed together to facilitate dyadic conversation and provide deeper insight into the decision-making process leading to transplant and donation. Common themes to both recipient and donor decision making included quality of life; characteristics of the unknown donor and post-transplant expectations. Recipient-specific themes included failure to reach life span milestones, experiences of fellow patients, and altruistic desire to expand the donor pool. Donor-specific themes included balancing existing life commitments with the recipient's need for a kidney, equity and mental accounting in kidney exchange (comparable quality of the kidney received versus the kidney donated), and logistical justice for the recipient. Donors and recipients frame and weight the concepts of risk, justice, and equity differently. This may have direct implications to facilitating patient-centered communication and engagement in KPD pairs. Copyright © 2018 Elsevier Inc. All rights reserved.

Reversal of Alcohol-Induced Dysregulation in Dopamine Network Dynamics May Rescue Maladaptive Decision-making

PubMed Central

Schindler, Abigail G.; Soden, Marta E.; Zweifel, Larry S.

2016-01-01

Alcohol is the most commonly abused substance among adolescents, promoting the development of substance use disorders and compromised decision-making in adulthood. We have previously demonstrated, with a preclinical model in rodents, that adolescent alcohol use results in adult risk-taking behavior that positively correlates with phasic dopamine transmission in response to risky options, but the underlying mechanisms remain unknown. Here, we show that adolescent alcohol use may produce maladaptive decision-making through a disruption in dopamine network dynamics via increased GABAergic transmission within the ventral tegmental area (VTA). Indeed, we find that increased phasic dopamine signaling after adolescent alcohol use is attributable to a midbrain circuit, including the input from the pedunculopontine tegmentum to the VTA. Moreover, we demonstrate that VTA dopamine neurons from adult rats exhibit enhanced IPSCs after adolescent alcohol exposure corresponding to decreased basal dopamine levels in adulthood that negatively correlate with risk-taking. Building on these findings, we develop a model where increased inhibitory tone on dopamine neurons leads to a persistent decrease in tonic dopamine levels and results in a potentiation of stimulus-evoked phasic dopamine release that may drive risky choice behavior. Based on this model, we take a pharmacological approach to the reversal of risk-taking behavior through normalization of this pattern in dopamine transmission. These results isolate the underlying circuitry involved in alcohol-induced maladaptive decision-making and identify a novel therapeutic target. SIGNIFICANCE STATEMENT One of the primary problems resulting from chronic alcohol use is persistent, maladaptive decision-making that is associated with ongoing addiction vulnerability and relapse. Indeed, studies with the Iowa Gambling Task, a standard measure of risk-based decision-making, have reliably shown that alcohol-dependent individuals make riskier, more maladaptive choices than nondependent individuals, even after periods of prolonged abstinence. Using a preclinical model, in the current work, we identify a selective disruption in dopamine network dynamics that may promote maladaptive decision-making after chronic adolescent alcohol use and demonstrate its pharmacological reversal in adulthood. Together, these results highlight a novel neural mechanism underlying heightened risk-taking behavior in alcohol-dependent individuals and provide a potential therapeutic target for further investigation. PMID:27030756

How consumers are affected by product descriptions in online shopping: Event-related potentials evidence of the attribute framing effect.

PubMed

Jin, Jia; Zhang, Wuke; Chen, Mingliang

2017-12-01

Due to the limitations of the human ability to process information, e-consumers' decisions are likely to be influenced by various cognitive biases, such as the attribute framing effect. This effect has been well studied by numerous scholars; however, the associated underlying neural mechanisms with a critical temporal resolution have not been revealed. Thus, this study applies the measurement of event-related potentials (ERPs) to directly examine the role of attribute framing in information processing and decision-making in online shopping. The behavioral results showed that participants demonstrated a higher purchase intention with a shorter reaction time under a positive framing condition compared to participants under a negative framing condition. Compared with positive framing messages, the results of ERPs indicated that negative framing messages attracted more attention resources at the early stage of rapid automatic processing (larger P2 amplitude) and resulted in greater cognitive conflict and decision difficulty (larger P2-N2 complex). Moreover, compared with negative messages, positive framing messages allowed consumers to perceive a better future performance of products and classify these products as a categorization of higher evaluation (larger LPP amplitude) at the late cognitive processing stage of evaluation. Based on these results, we provide evidence for a better understanding of how different attribute framing messages are processed and ultimately lead to the framing effect. Copyright © 2017 Elsevier Ireland Ltd and Japan Neuroscience Society. All rights reserved.

Junior doctors' extended work hours and the effects on their performance: the Irish case.

PubMed

Flinn, Fiona; Armstrong, Claire

2011-04-01

To explore the relationship between junior doctors' long working hours and their performance in a variety of cognitive and clinical decision-making tests. Also, to consider the implications of performance decrements in such tests for healthcare quality. A within-subject design was used to eliminate variation related to individual differences. Each participant was tested twice, once post call and once rested. At each session, participants were tested on cognitive functioning and clinical decision-making. The study was based on six acute Irish hospitals during 2008. Thirty junior hospital doctors, ages ranged from 23 to 30 years; of them, 17 of the participants were female and 13 were male. Measures Cognitive functioning was measured by the MindStreams Global Assessment Battery (NeuroTrax Corp., NY, USA). This is a set of computerized tests, designed for use in medical settings, that assesses performance in memory, executive function, visual spatial perception, verbal function, attention, information processing speed and motor skills. Clinical decision-making was tested using Key Features Problems. Each Key Features Problem consists of a case scenario and then three to four questions about this scenario. In an effort to make it more realistic, the speed with which participants completed the three problems was also recorded. Participants' global cognitive scores, attention, information processing speed and motor skills were significantly worse post call than when rested. They also took longer to complete clinical decision-making questions in the post-call condition and obtained lower scores than when rested. There are significant negative changes in doctors' cognitive functioning and clinical decision-making performance that appear to be attributable to long working hours. This therefore raises the important question of whether working long hours decreases healthcare quality and compromises patient safety.

Food Culture, Preferences and Ethics in Dysphagia Management.

PubMed

Kenny, Belinda

2015-11-01

Adults with dysphagia experience difficulties swallowing food and fluids with potentially harmful health and psychosocial consequences. Speech pathologists who manage patients with dysphagia are frequently required to address ethical issues when patients' food culture and/ or preferences are inconsistent with recommended diets. These issues incorporate complex links between food, identity and social participation. A composite case has been developed to reflect ethical issues identified by practising speech pathologists for the purposes of illustrating ethical concerns in dysphagia management. The case examines a speech pathologist's role in supporting patient autonomy when patients and carers express different goals and values. The case presents a 68-year-old man of Australian/Italian heritage with severe swallowing impairment and strong values attached to food preferences. The case is examined through application of the dysphagia algorithm, a tool for shared decision-making when patients refuse dietary modifications. Case analysis revealed the benefits and challenges of shared decision-making processes in dysphagia management. Four health professional skills and attributes were identified as synonymous with shared decision making: communication, imagination, courage and reflection. © 2015 John Wiley & Sons Ltd.

Application fuzzy multi-attribute decision analysis method to prioritize project success criteria

NASA Astrophysics Data System (ADS)

Phong, Nguyen Thanh; Quyen, Nguyen Le Hoang Thuy To

2017-11-01

Project success is a foundation for project owner to manage and control not only for the current project but also for future potential projects in construction companies. However, identifying the key success criteria for evaluating a particular project in real practice is a challenging task. Normally, it depends on a lot of factors, such as the expectation of the project owner and stakeholders, triple constraints of the project (cost, time, quality), and company's mission, vision, and objectives. Traditional decision-making methods for measuring the project success are usually based on subjective opinions of panel experts, resulting in irrational and inappropriate decisions. Therefore, this paper introduces a multi-attribute decision analysis method (MADAM) for weighting project success criteria by using fuzzy Analytical Hierarchy Process approach. It is found that this method is useful when dealing with imprecise and uncertain human judgments in evaluating project success criteria. Moreover, this research also suggests that although cost, time, and quality are three project success criteria projects, the satisfaction of project owner and acceptance of project stakeholders with the completed project criteria is the most important criteria for project success evaluation in Vietnam.

Framing Options as Choice or Opportunity: Does the Frame Influence Decisions?

PubMed

Abhyankar, Purva; Summers, Barbara A; Velikova, Galina; Bekker, Hilary L

2014-07-01

Health professionals must enable patients to make informed decisions about health care choices through unbiased presentation of all options. This study examined whether presenting the decision as "opportunity" rather than "choice" biased individuals' preferences in the context of trial participation for cancer treatment. Self-selecting healthy women (N = 124) were randomly assigned to the following decision frames: opportunity to take part in the trial (opt-in), opportunity to be removed from the trial (opt-out), and choice to have standard treatment or take part in the trial (choice). The computer-based task required women to make a hypothetical choice about a real-world cancer treatment trial. The software presented the framed scenario, recorded initial preference, presented comprehensive and balanced information, traced participants' use of information during decision making, and recorded final decision. A posttask paper questionnaire assessed perceived risk, attitudes, subjective norm, perceived behavioral control, and satisfaction with decision. Framing influenced women's immediate preferences. Opportunity frames, whether opt-in or opt-out, introduced a bias as they discouraged women from choosing standard treatment. Using the choice frame avoided this bias. The opt-out opportunity frame also affected women's perceived social norm; women felt that others endorsed the trial option. The framing bias was not present once participants had had the opportunity to view detailed information on the options within a patient decision aid format. There were no group differences in information acquisition and final decisions. Sixteen percent changed their initial preference after receiving full information. A "choice" frame, where all treatment options are explicit, is less likely to bias preferences. Presentation of full information in parallel, option-by-attribute format is likely to "de-bias" the decision frame. Tailoring of information to initial preferences would be ill-advised as preferences may change following detailed information. © The Author(s) 2014.

At Least I Tried: The Relationship between Regulatory Focus and Regret Following Action vs. Inaction

PubMed Central

Itzkin, Adi; Van Dijk, Dina; Azar, Ofer H.

2016-01-01

Regret is an unpleasant feeling that may arise following decisions that ended poorly, and may affect the decision-maker's well-being and future decision making. Some studies show that a decision to act leads to greater regret than a decision not to act when both resulted in failure, because the latter is usually the norm. In some cases, when the norm is to act, this pattern is reversed. We suggest that the decision maker's regulatory focus, affects regret after action or inaction. Specifically, promotion-focused individuals, who tend to be more proactive, view action as more normal than prevention-focused individuals, and therefore experience regulatory fit when an action decision is made. Hence, we hypothesized that promotion-focused individuals will feel less regret than prevention-focused individuals when a decision to act ended poorly. In addition, we hypothesized that a trigger for change implied in the situation, decreases the level of regret following action. We tested our hypotheses on a sample of 330 participants enrolled in an online survey. The participants received six decision scenarios, in which they were asked to evaluate the level of regret following action and inaction. Individual regulatory focus was measured by two different scales. Promotion-focused individuals attributed less regret than prevention-focused individuals to action decisions. Regret following inaction was not affected by regulatory focus. In addition, a trigger for change decreases regret following action. Orthodox people tend to attribute more regret than non-orthodox to a person who made an action decision. The results contribute to the literature by showing that not only the situation but also the decision maker's orientation affects the regret after action vs. inaction. PMID:27833581

What vaccine product attributes do immunization program stakeholders value? Results from interviews in six low- and middle-income countries.

PubMed

Kristensen, Debra D; Bartholomew, Kate; Villadiego, Shirley; Lorenson, Kristina

2016-12-07

This study attempts to capture the opinions of stakeholders working in immunization programs in low- and middle-income countries to understand how vaccine products could be improved to better meet their needs and to obtain feedback on specific vaccine product attributes including the number of doses per container and ease of preparing a dose for administration. We also reviewed how procurement decisions are made within immunization programs. Semi-structured interviews were undertaken with 158 immunization stakeholders in Brazil, China, India, Peru, the Philippines, and Tanzania. Interviewees included national decision-makers and advisors involved in vaccine-purchasing decisions (n=30), national Expanded Programme on Immunization managers (n=6), and health and logistics personnel at national, subnational, and health-facility levels (n=122). Immunization stakeholders at all levels of the supply chain valued vaccine product attributes that prevent heat damage, decrease vaccine wastage, and simplify delivery. Minimizing the time required to prepare a dose is especially valued by those closest to the work of actually administering vaccines. Respondents appreciated the benefits of lower-multidose presentations on reducing wastage but seemed to prefer single-dose vials even more. They also expressed concern about the need for training and the potential for confusion and vial contamination if opened vials of liquid preservative-free vaccines are not handled properly. Procurement decision-making processes varied widely between countries, though most relied heavily on international agencies and vaccine manufacturers for information. Copyright © 2016. Published by Elsevier Ltd.

A Probabilistic, Dynamic, and Attribute-wise Model of Intertemporal Choice

PubMed Central

Dai, Junyi; Busemeyer, Jerome R.

2014-01-01

Most theoretical and empirical research on intertemporal choice assumes a deterministic and static perspective, leading to the widely adopted delay discounting models. As a form of preferential choice, however, intertemporal choice may be generated by a stochastic process that requires some deliberation time to reach a decision. We conducted three experiments to investigate how choice and decision time varied as a function of manipulations designed to examine the delay duration effect, the common difference effect, and the magnitude effect in intertemporal choice. The results, especially those associated with the delay duration effect, challenged the traditional deterministic and static view and called for alternative approaches. Consequently, various static or dynamic stochastic choice models were explored and fit to the choice data, including alternative-wise models derived from the traditional exponential or hyperbolic discount function and attribute-wise models built upon comparisons of direct or relative differences in money and delay. Furthermore, for the first time, dynamic diffusion models, such as those based on decision field theory, were also fit to the choice and response time data simultaneously. The results revealed that the attribute-wise diffusion model with direct differences, power transformations of objective value and time, and varied diffusion parameter performed the best and could account for all three intertemporal effects. In addition, the empirical relationship between choice proportions and response times was consistent with the prediction of diffusion models and thus favored a stochastic choice process for intertemporal choice that requires some deliberation time to make a decision. PMID:24635188

Lost in the crowd? Using eye-tracking to investigate the effect of complexity on attribute non-attendance in discrete choice experiments.

PubMed

Spinks, Jean; Mortimer, Duncan

2016-02-03

The provision of additional information is often assumed to improve consumption decisions, allowing consumers to more accurately weigh the costs and benefits of alternatives. However, increasing the complexity of decision problems may prompt changes in information processing. This is particularly relevant for experimental methods such as discrete choice experiments (DCEs) where the researcher can manipulate the complexity of the decision problem. The primary aims of this study are (i) to test whether consumers actually process additional information in an already complex decision problem, and (ii) consider the implications of any such 'complexity-driven' changes in information processing for design and analysis of DCEs. A discrete choice experiment (DCE) is used to simulate a complex decision problem; here, the choice between complementary and conventional medicine for different health conditions. Eye-tracking technology is used to capture the number of times and the duration that a participant looks at any part of a computer screen during completion of DCE choice sets. From this we can analyse what has become known in the DCE literature as 'attribute non-attendance' (ANA). Using data from 32 participants, we model the likelihood of ANA as a function of choice set complexity and respondent characteristics using fixed and random effects models to account for repeated choice set completion. We also model whether participants are consistent with regard to which characteristics (attributes) they consider across choice sets. We find that complexity is the strongest predictor of ANA when other possible influences, such as time pressure, ordering effects, survey specific effects and socio-demographic variables (including proxies for prior experience with the decision problem) are considered. We also find that most participants do not apply a consistent information processing strategy across choice sets. Eye-tracking technology shows promise as a way of obtaining additional information from consumer research, improving DCE design, and informing the design of policy measures. With regards to DCE design, results from the present study suggest that eye-tracking data can identify the point at which adding complexity (and realism) to DCE choice scenarios becomes self-defeating due to unacceptable increases in ANA. Eye-tracking data therefore has clear application in the construction of guidelines for DCE design and during piloting of DCE choice scenarios. With regards to design of policy measures such as labelling requirements for CAM and conventional medicines, the provision of additional information has the potential to make difficult decisions even harder and may not have the desired effect on decision-making.

Dietary self-control is related to the speed with which attributes of healthfulness and tastiness are processed.

PubMed

Sullivan, Nicolette; Hutcherson, Cendri; Harris, Alison; Rangel, Antonio

2015-02-01

We propose that self-control failures, and variation across individuals in self-control abilities, are partly due to differences in the speed with which the decision-making circuitry processes basic attributes, such as tastiness, versus more abstract attributes, such as healthfulness. We tested these hypotheses by combining a dietary-choice task with a novel form of mouse tracking that allowed us to pinpoint when different attributes were being integrated into the choice process with temporal resolution at the millisecond level. We found that, on average, tastiness was processed about 195 ms earlier than healthfulness during the choice process. We also found that 13% to 39% of observed individual differences in self-control ability could be explained by differences in the relative speed with which tastiness and healthfulness were processed. © The Author(s) 2014.

The neural basis of responsibility attribution in decision-making.

PubMed

Li, Peng; Shen, Yue; Sui, Xue; Chen, Changming; Feng, Tingyong; Li, Hong; Holroyd, Clay

2013-01-01

Social responsibility links personal behavior with societal expectations and plays a key role in affecting an agent's emotional state following a decision. However, the neural basis of responsibility attribution remains unclear. In two previous event-related brain potential (ERP) studies we found that personal responsibility modulated outcome evaluation in gambling tasks. Here we conducted a functional magnetic resonance imaging (fMRI) study to identify particular brain regions that mediate responsibility attribution. In a context involving team cooperation, participants completed a task with their teammates and on each trial received feedback about team success and individual success sequentially. We found that brain activity differed between conditions involving team success vs. team failure. Further, different brain regions were associated with reinforcement of behavior by social praise vs. monetary reward. Specifically, right temporoparietal junction (RTPJ) was associated with social pride whereas dorsal striatum and dorsal anterior cingulate cortex (ACC) were related to reinforcement of behaviors leading to personal gain. The present study provides evidence that the RTPJ is an important region for determining whether self-generated behaviors are deserving of praise in a social context.

The Neural Basis of Responsibility Attribution in Decision-Making

PubMed Central

Li, Peng; Shen, Yue; Sui, Xue; Chen, Changming; Feng, Tingyong; Li, Hong; Holroyd, Clay

2013-01-01

Social responsibility links personal behavior with societal expectations and plays a key role in affecting an agent’s emotional state following a decision. However, the neural basis of responsibility attribution remains unclear. In two previous event-related brain potential (ERP) studies we found that personal responsibility modulated outcome evaluation in gambling tasks. Here we conducted a functional magnetic resonance imaging (fMRI) study to identify particular brain regions that mediate responsibility attribution. In a context involving team cooperation, participants completed a task with their teammates and on each trial received feedback about team success and individual success sequentially. We found that brain activity differed between conditions involving team success vs. team failure. Further, different brain regions were associated with reinforcement of behavior by social praise vs. monetary reward. Specifically, right temporoparietal junction (RTPJ) was associated with social pride whereas dorsal striatum and dorsal anterior cingulate cortex (ACC) were related to reinforcement of behaviors leading to personal gain. The present study provides evidence that the RTPJ is an important region for determining whether self-generated behaviors are deserving of praise in a social context. PMID:24224053

Evolution of Structural Empowerment: Moving From Shared to Professional Governance.

PubMed

Clavelle, Joanne T; Porter O'Grady, Tim; Weston, Marla J; Verran, Joyce A

2016-06-01

The aim of this study is to describe the maturation of the concept of shared governance to professional governance as a framework for structural empowerment. An analysis of the literature and concept clarification of structural empowerment and shared governance demonstrate that the concept and attributes of shared governance have evolved toward professional governance. A comprehensive, deductive literature review and concept clarification of structural empowerment, shared governance, and related constructs was completed. The concept and practice of shared governance has matured to a concept of professional governance with the attributes of accountability, professional obligation, collateral relationships, and effective decision-making.

Intuition: A Concept Analysis.

PubMed

Chilcote, Deborah R

2017-01-01

The purpose of this article is to conceptually examine intuition; identify the importance of intuition in nursing education, clinical practice, and patient care; encourage acceptance of the use of intuition; and add to the body of nursing knowledge. Nurses often report using intuition when making clinical decisions. Intuition is a rapid, unconscious process based in global knowledge that views the patient holistically while synthesizing information to improve patient outcomes. However, with the advent of evidence-based practice (EBP), the use of intuition has become undervalued in nursing. Walker and Avant's framework was used to analyze intuition. A literature search from 1987 to 2014 was conducted using the following keywords: intuition, intuition and nursing, clinical decision making, clinical decision making and intuition, patient outcomes, EBP, and analytical thinking. The use of intuition is reported by nurses, but is not legitimized within the nursing profession. Defining attributes of intuition are an unconscious, holistic knowledge gathered without using an analytical process and knowledge derived through synthesis, not analysis. Consequences include verification of intuition through an analytical process and translating that knowledge into a course of action. This article supports the use of intuition in nursing by offering clarity to the concept, adds to the nursing knowledge base, encourages a holistic view of the patient during clinical decision making, and encourages nurse educators to promote the use of intuition. © 2016 Wiley Periodicals, Inc.

Unconscious emotional reasoning and the therapeutic misconception.

PubMed

Charuvastra, A; Marder, S R

2008-03-01

The "therapeutic misconception" describes a process whereby research volunteers misinterpret the intentions of researchers and the nature of clinical research. This misinterpretation leads research volunteers to falsely attribute a therapeutic potential to clinical research, and compromises informed decision making, therefore compromising the ethical integrity of a clinical experiment. We review recent evidence from the neurobiology of social cognition to provide a novel framework for thinking about the therapeutic misconception. We argue that the neurobiology of social cognition should be considered in any ethical analysis of how people make decisions about participating in clinical trials. The neurobiology of social cognition also suggests how the complicated dynamics of the doctor-patient relationship may unavoidably interfere with the process of obtaining informed consent. Following this argument we suggest new ways to prevent or at least mitigate the therapeutic misconception.

Investigating industrial investigation: examining the impact of a priori knowledge and tunnel vision education.

PubMed

Maclean, Carla L; Brimacombe, C A Elizabeth; Lindsay, D Stephen

2013-12-01

The current study addressed tunnel vision in industrial incident investigation by experimentally testing how a priori information and a human bias (generated via the fundamental attribution error or correspondence bias) affected participants' investigative behavior as well as the effectiveness of a debiasing intervention. Undergraduates and professional investigators engaged in a simulated industrial investigation exercise. We found that participants' judgments were biased by knowledge about the safety history of either a worker or piece of equipment and that a human bias was evident in participants' decision making. However, bias was successfully reduced with "tunnel vision education." Professional investigators demonstrated a greater sophistication in their investigative decision making compared to undergraduates. The similarities and differences between these two populations are discussed. (c) 2013 APA, all rights reserved

Strategies to improve healthcare websites.

PubMed

Johnson, Constance; Peterson, Susan K; Turley, James P; Ensor, Joe; Amos, Christopher; Spitz, Margaret; Levin, Bernard; Berry, Donald

2006-01-01

Healthcare websites that are influential in healthcare decision-making must be evaluated for accuracy, readability and understandability by the average population. Most existing frameworks for designing and evaluating interactive websites focus on the utility and usability of the site. Although these are significant to the design of the basic site, they are not sufficient. We have developed an iterative framework that considers additional attributes.

Using multi-attribute decision-making approaches in the selection of a hospital management system.

PubMed

Arasteh, Mohammad Ali; Shamshirband, Shahaboddin; Yee, Por Lip

2018-01-01

The most appropriate organizational software is always a real challenge for managers, especially, the IT directors. The illustration of the term "enterprise software selection", is to purchase, create, or order a software that; first, is best adapted to require of the organization; and second, has suitable price and technical support. Specifying selection criteria and ranking them, is the primary prerequisite for this action. This article provides a method to evaluate, rank, and compare the available enterprise software for choosing the apt one. The prior mentioned method is constituted of three-stage processes. First, the method identifies the organizational requires and assesses them. Second, it selects the best method throughout three possibilities; indoor-production, buying software, and ordering special software for the native use. Third, the method evaluates, compares and ranks the alternative software. The third process uses different methods of multi attribute decision making (MADM), and compares the consequent results. Based on different characteristics of the problem; several methods had been tested, namely, Analytic Hierarchy Process (AHP), Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), Elimination and Choice Expressing Reality (ELECTURE), and easy weight method. After all, we propose the most practical method for same problems.

The socialization effect on decision making in the Prisoner's Dilemma game: An eye-tracking study

PubMed Central

Myagkov, Mikhail G.; Harriff, Kyle

2017-01-01

We used a mobile eye-tracking system (in the form of glasses) to study the characteristics of visual perception in decision making in the Prisoner's Dilemma game. In each experiment, one of the 12 participants was equipped with eye-tracking glasses. The experiment was conducted in three stages: an anonymous Individual Game stage against a randomly chosen partner (one of the 12 other participants of the experiment); a Socialization stage, in which the participants were divided into two groups; and a Group Game stage, in which the participants played with partners in the groups. After each round, the respondent received information about his or her personal score in the last round and the overall winner of the game at the moment. The study proves that eye-tracking systems can be used for studying the process of decision making and forecasting. The total viewing time and the time of fixation on areas corresponding to noncooperative decisions is related to the participants’ overall level of cooperation. The increase in the total viewing time and the time of fixation on the areas of noncooperative choice is due to a preference for noncooperative decisions and a decrease in the overall level of cooperation. The number of fixations on the group attributes is associated with group identity, but does not necessarily lead to cooperative behavior. PMID:28394939

Serotonin enhances the impact of health information on food choice.

PubMed

Vlaev, Ivo; Crockett, Molly J; Clark, Luke; Müller, Ulrich; Robbins, Trevor W

2017-06-01

Serotonin has been implicated in promoting self-control, regulation of hunger and physiological homeostasis, and regulation of caloric intake. However, it remains unclear whether the effects of serotonin on caloric intake reflect purely homeostatic mechanisms, or whether serotonin also modulates cognitive processes involved in dietary decision making. We investigated the effects of an acute dose of the serotonin reuptake inhibitor citalopram on choices between food items that differed along taste and health attributes, compared with placebo and the noradrenaline reuptake inhibitor atomoxetine. Twenty-seven participants attended three sessions and received single doses of atomoxetine, citalopram, and placebo in a double-blind randomised cross-over design. Relative to placebo, citalopram increased choices of more healthy foods over less healthy foods. Citalopram also increased the emphasis on health considerations in decisions. Atomoxetine did not affect decision making relative to placebo. The results support the hypothesis that serotonin may influence food choice by enhancing a focus on long-term goals. The findings are relevant for understanding decisions about food consumption and also for treating health conditions such as eating disorders and obesity.

Rigorously testing multialternative decision field theory against random utility models.

PubMed

Berkowitsch, Nicolas A J; Scheibehenne, Benjamin; Rieskamp, Jörg

2014-06-01

Cognitive models of decision making aim to explain the process underlying observed choices. Here, we test a sequential sampling model of decision making, multialternative decision field theory (MDFT; Roe, Busemeyer, & Townsend, 2001), on empirical grounds and compare it against 2 established random utility models of choice: the probit and the logit model. Using a within-subject experimental design, participants in 2 studies repeatedly choose among sets of options (consumer products) described on several attributes. The results of Study 1 showed that all models predicted participants' choices equally well. In Study 2, in which the choice sets were explicitly designed to distinguish the models, MDFT had an advantage in predicting the observed choices. Study 2 further revealed the occurrence of multiple context effects within single participants, indicating an interdependent evaluation of choice options and correlations between different context effects. In sum, the results indicate that sequential sampling models can provide relevant insights into the cognitive process underlying preferential choices and thus can lead to better choice predictions. PsycINFO Database Record (c) 2014 APA, all rights reserved.

A fuzzy set preference model for market share analysis

NASA Technical Reports Server (NTRS)

Turksen, I. B.; Willson, Ian A.

1992-01-01

Consumer preference models are widely used in new product design, marketing management, pricing, and market segmentation. The success of new products depends on accurate market share prediction and design decisions based on consumer preferences. The vague linguistic nature of consumer preferences and product attributes, combined with the substantial differences between individuals, creates a formidable challenge to marketing models. The most widely used methodology is conjoint analysis. Conjoint models, as currently implemented, represent linguistic preferences as ratio or interval-scaled numbers, use only numeric product attributes, and require aggregation of individuals for estimation purposes. It is not surprising that these models are costly to implement, are inflexible, and have a predictive validity that is not substantially better than chance. This affects the accuracy of market share estimates. A fuzzy set preference model can easily represent linguistic variables either in consumer preferences or product attributes with minimal measurement requirements (ordinal scales), while still estimating overall preferences suitable for market share prediction. This approach results in flexible individual-level conjoint models which can provide more accurate market share estimates from a smaller number of more meaningful consumer ratings. Fuzzy sets can be incorporated within existing preference model structures, such as a linear combination, using the techniques developed for conjoint analysis and market share estimation. The purpose of this article is to develop and fully test a fuzzy set preference model which can represent linguistic variables in individual-level models implemented in parallel with existing conjoint models. The potential improvements in market share prediction and predictive validity can substantially improve management decisions about what to make (product design), for whom to make it (market segmentation), and how much to make (market share prediction).

Qualitative Analysis of Surveyed Emergency Responders and the Identified Factors That Affect First Stage of Primary Triage Decision-Making of Mass Casualty Incidents

PubMed Central

Klein, Kelly R.; Burkle Jr., Frederick M.; Swienton, Raymond; King, Richard V.; Lehman, Thomas; North, Carol S.

2016-01-01

Introduction: After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions. Methods: A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage. Results: 403 unique completed surveys were analyzed. 92% practiced a structural triage approach with the rest reporting they used “gestalt”.(gut feeling) Twelve per cent were identified as having placed patients in an expectant category during triage. Respiratory status, ability to speak, perfusion/pulse were all ranked in the top three. Gut feeling regardless of statistical analysis was fourth. Supplies were ranked in the top four when analyzed for those who had placed patients in the expectant category. Conclusion: Primary triage decisions in a mass casualty scenario are multifactorial and encompass patient mobility, life saving interventions, situational instincts, and logistics. PMID:27651979

Risky Group Decision-Making Method for Distribution Grid Planning

NASA Astrophysics Data System (ADS)

Li, Cunbin; Yuan, Jiahang; Qi, Zhiqiang

2015-12-01

With rapid speed on electricity using and increasing in renewable energy, more and more research pay attention on distribution grid planning. For the drawbacks of existing research, this paper proposes a new risky group decision-making method for distribution grid planning. Firstly, a mixing index system with qualitative and quantitative indices is built. On the basis of considering the fuzziness of language evaluation, choose cloud model to realize "quantitative to qualitative" transformation and construct interval numbers decision matrices according to the "3En" principle. An m-dimensional interval numbers decision vector is regarded as super cuboids in m-dimensional attributes space, using two-level orthogonal experiment to arrange points uniformly and dispersedly. The numbers of points are assured by testing numbers of two-level orthogonal arrays and these points compose of distribution points set to stand for decision-making project. In order to eliminate the influence of correlation among indices, Mahalanobis distance is used to calculate the distance from each solutions to others which means that dynamic solutions are viewed as the reference. Secondly, due to the decision-maker's attitude can affect the results, this paper defines the prospect value function based on SNR which is from Mahalanobis-Taguchi system and attains the comprehensive prospect value of each program as well as the order. At last, the validity and reliability of this method is illustrated by examples which prove the method is more valuable and superiority than the other.

A Neural Signature Encoding Decisions under Perceptual Ambiguity

PubMed Central

Sun, Sai; Yu, Rongjun

2017-01-01

Abstract People often make perceptual decisions with ambiguous information, but it remains unclear whether the brain has a common neural substrate that encodes various forms of perceptual ambiguity. Here, we used three types of perceptually ambiguous stimuli as well as task instructions to examine the neural basis for both stimulus-driven and task-driven perceptual ambiguity. We identified a neural signature, the late positive potential (LPP), that encoded a general form of stimulus-driven perceptual ambiguity. In addition to stimulus-driven ambiguity, the LPP was also modulated by ambiguity in task instructions. To further specify the functional role of the LPP and elucidate the relationship between stimulus ambiguity, behavioral response, and the LPP, we employed regression models and found that the LPP was specifically associated with response latency and confidence rating, suggesting that the LPP encoded decisions under perceptual ambiguity. Finally, direct behavioral ratings of stimulus and task ambiguity confirmed our neurophysiological findings, which could not be attributed to differences in eye movements either. Together, our findings argue for a common neural signature that encodes decisions under perceptual ambiguity but is subject to the modulation of task ambiguity. Our results represent an essential first step toward a complete neural understanding of human perceptual decision making. PMID:29177189

A Neural Signature Encoding Decisions under Perceptual Ambiguity.

PubMed

Sun, Sai; Yu, Rongjun; Wang, Shuo

2017-01-01

People often make perceptual decisions with ambiguous information, but it remains unclear whether the brain has a common neural substrate that encodes various forms of perceptual ambiguity. Here, we used three types of perceptually ambiguous stimuli as well as task instructions to examine the neural basis for both stimulus-driven and task-driven perceptual ambiguity. We identified a neural signature, the late positive potential (LPP), that encoded a general form of stimulus-driven perceptual ambiguity. In addition to stimulus-driven ambiguity, the LPP was also modulated by ambiguity in task instructions. To further specify the functional role of the LPP and elucidate the relationship between stimulus ambiguity, behavioral response, and the LPP, we employed regression models and found that the LPP was specifically associated with response latency and confidence rating, suggesting that the LPP encoded decisions under perceptual ambiguity. Finally, direct behavioral ratings of stimulus and task ambiguity confirmed our neurophysiological findings, which could not be attributed to differences in eye movements either. Together, our findings argue for a common neural signature that encodes decisions under perceptual ambiguity but is subject to the modulation of task ambiguity. Our results represent an essential first step toward a complete neural understanding of human perceptual decision making.

Key attributes of expert NRL referees.

PubMed

Morris, Gavin; O'Connor, Donna

2017-05-01

Experiential knowledge of elite National Rugby League (NRL) referees was investigated to determine the key attributes contributing to expert officiating performance. Fourteen current first-grade NRL referees were asked to identify the key attributes they believed contributed to their expert refereeing performance. The modified Delphi method involved a 3-round process of an initial semi-structured interview followed by 2 questionnaires to reach consensus of opinion. The data revealed 25 attributes that were rated as most important that underpin expert NRL refereeing performance. Results illustrate the significance of the cognitive category, with the top 6 ranked attributes all cognitive skills. Of these, the referees ranked decision-making accuracy as the most important attribute, followed by reading the game, communication, game understanding, game management and knowledge of the rules. Player rapport, positioning and teamwork were the top ranked game skill attributes underpinning performance excellence. Expert referees also highlighted a number of psychological attributes (e.g., concentration, composure and mental toughness) that were significant to performance. There were only 2 physiological attributes (fitness, aerobic endurance) that were identified as significant to elite officiating performance. In summary, expert consensus was attained which successfully provided a hierarchy of the most significant attributes of expert NRL refereeing performance.

Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool.

PubMed

Streufert, Ben; Reed, Shelby D; Orlando, Lori A; Taylor, Dean C; Huber, Joel C; Mather, Richard C

2017-03-01

Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown. To test a novel shared decision-making tool after sustained FTASD. Specifically measured were the following: (1) importance of aspects of operative versus nonoperative treatment, (2) respondents' agreement with results generated by the tool, (3) willingness to share these results with physicians, and (4) association of results with choice of treatment after FTASD. Cross-sectional study; Level of evidence, 3. A tool was designed and tested using members of Amazon Mechanical Turk, an online panel. The tool included an adaptive conjoint analysis exercise, a method to understand individuals' perceived importance of the following attributes of treatment: (1) chance of recurrent dislocation, (2) cost, (3) short-term limits on shoulder motion, (4) limits on participation in high-risk activities, and (5) duration of physical therapy. Respondents then chose between operative and nonoperative treatment for hypothetical shoulder dislocation. Overall, 374 of 501 (75%) respondents met the inclusion criteria, of which most were young, active males; one-third reported prior dislocation. From the conjoint analysis, the importance of recurrent dislocation and cost of treatment were the most important attributes. A substantial majority agreed with the tool's ability to generate representative preferences and indicated that they would share these preferences with their physician. Importance of recurrence proved significantly predictive of respondents' treatment choices, independent of sex or age; however, activity level was important to previous dislocators. A total of 125 (55%) males and 33 (23%) females chose surgery after FTASD, as did 37% of previous dislocators compared with 45% of nondislocators. When given thorough information about the risks and benefits, respondents had strong preferences for operative treatment after an FTASD. Respondents agreed with the survey results and wanted to share the information with providers. Recurrence was the most important attribute and played a role in decisions about treatment.

Preferences of colorectal cancer patients for treatment and decision-making: a systematic literature review.

PubMed

Damm, K; Vogel, A; Prenzler, A

2014-11-01

Treatment decisions in life-threatening diseases, like colorectal cancer (CRC), are crucial, since they have a great impact on patient's survival and health-related quality of life. Thereby, the inclusion of patient's preferences becomes more and more important; however, these first need to be identified. Therefore, we conducted a systematic literature review in 12 electronic databases, published between 2000 and 2012, in order to identify patient's preferences concerning treatment preferences and involvement in the decision-making process. Nineteen studies were included and thoroughly analysed. This review shows that CRC patients do have preferences regarding different treatment options and outcomes; however, these preferences are not homogenous and seem to depend on personal factors like age and gender. Despite the existence of these preferences, the majority of patients prefer a passive role in the decision-making process, which in part may be explained by the severity of the disease. Again, subgroup analyses reveal the impact of personal factors like gender and education on the preference. Due to the importance of personal factors in the analysis of patient preferences, we identified an urgent need for larger studies that are suitable for subgroup analyses and incorporate multi-attributive measurement techniques, like discrete choice methods. © 2014 John Wiley & Sons Ltd.

The process of processing: exploring the validity of Neisser's perceptual cycle model with accounts from critical decision-making in the cockpit.

PubMed

Plant, Katherine L; Stanton, Neville A

2015-01-01

The perceptual cycle model (PCM) has been widely applied in ergonomics research in domains including road, rail and aviation. The PCM assumes that information processing occurs in a cyclical manner drawing on top-down and bottom-up influences to produce perceptual exploration and actions. However, the validity of the model has not been addressed. This paper explores the construct validity of the PCM in the context of aeronautical decision-making. The critical decision method was used to interview 20 helicopter pilots about critical decision-making. The data were qualitatively analysed using an established coding scheme, and composite PCMs for incident phases were constructed. It was found that the PCM provided a mutually exclusive and exhaustive classification of the information-processing cycles for dealing with critical incidents. However, a counter-cycle was also discovered which has been attributed to skill-based behaviour, characteristic of experts. The practical applications and future research questions are discussed. Practitioner Summary: This paper explores whether information processing, when dealing with critical incidents, occurs in the manner anticipated by the perceptual cycle model. In addition to the traditional processing cycle, a reciprocal counter-cycle was found. This research can be utilised by those who use the model as an accident analysis framework.

Variation Among Pediatric Orthopaedic Surgeons When Treating Medial Epicondyle Fractures.

PubMed

Hughes, Meghan; Dua, Karan; O'Hara, Nathan N; Brighton, Brian K; Ganley, Theodore J; Hennrikus, William L; Herman, Martin J; Hyman, Joshua E; Lawrence, J Todd; Mehlman, Charles T; Noonan, Kenneth J; Otsuka, Norman Y; Schwend, Richard M; Shrader, M Wade; Smith, Brian G; Sponseller, Paul D; Abzug, Joshua M

2017-10-18

Medial epicondyle fractures are a common pediatric and adolescent injury accounting for 11% to 20% of elbow fractures in this population. This purpose of this study was to determine the variability among pediatric orthopaedic surgeons when treating pediatric medial epicondyle fractures. A discrete choice experiment was conducted to determine which patient and injury attributes influence the management of medial epicondyle fractures by pediatric orthopaedic surgeons. A convenience sample of 13 pediatric orthopaedic surgeons reviewed 60 case vignettes of medial epicondyle fractures that included elbow radiographs and patient/injury characteristics. Displacement was incorporated into the study model as a fixed effect. Surgeons were queried if they would treat the injury with immobilization alone or open reduction and internal fixation (ORIF). Statistical analysis was performed using a mixed effect regression model. In addition, surgeons filled out a demographic questionnaire and a risk assessment to determine if these factors affected clinical decision-making. Elbow dislocation and fracture displacement were the only attributes that significantly influenced surgeons to perform surgery (P<0.05). The presence of an elbow dislocation had the largest impact on surgeons when choosing operative care (β=-0.14; P=0.02). In addition, for every 1 mm increase in displacement, surgeons tended to favor ORIF by a factor of 0.09 (P<0.01). Sex, mechanism of injury, and sport participation did not influence decision-making. In total, 54% of the surgeons demonstrated a preference for ORIF for the included scenarios. On the basis of the personality Likert scale, participants were neither high-risk takers nor extremely risk adverse with an average-risk score of 2.24. Participant demographics did not influence decision-making. There is substantial variation among pediatric orthopaedic surgeons when treating medial epicondyle fractures. The decision to operate is significantly based on the degree of fracture displacement and if there is a concomitant elbow dislocation. There is no standardization regarding how to treat medial epicondyle fractures and better treatment algorithms are needed to provide better patient outcomes. Level V.

Design of decision support interventions for medication prescribing.

PubMed

Horsky, Jan; Phansalkar, Shobha; Desai, Amrita; Bell, Douglas; Middleton, Blackford

2013-06-01

Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety. Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort. Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks. Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Limbic Justice—Amygdala Involvement in Immediate Rejection in the Ultimatum Game

PubMed Central

Fransson, Peter; Petrovic, Predrag; Johannesson, Magnus; Ingvar, Martin

2011-01-01

Imaging studies have revealed a putative neural account of emotional bias in decision making. However, it has been difficult in previous studies to identify the causal role of the different sub-regions involved in decision making. The Ultimatum Game (UG) is a game to study the punishment of norm-violating behavior. In a previous influential paper on UG it was suggested that frontal insular cortex has a pivotal role in the rejection response. This view has not been reconciled with a vast literature that attributes a crucial role in emotional decision making to a subcortical structure (i.e., amygdala). In this study we propose an anatomy-informed model that may join these views. We also present a design that detects the functional anatomical response to unfair proposals in a subcortical network that mediates rapid reactive responses. We used a functional MRI paradigm to study the early components of decision making and challenged our paradigm with the introduction of a pharmacological intervention to perturb the elicited behavioral and neural response. Benzodiazepine treatment decreased the rejection rate (from 37.6% to 19.0%) concomitantly with a diminished amygdala response to unfair proposals, and this in spite of an unchanged feeling of unfairness and unchanged insular response. In the control group, rejection was directly linked to an increase in amygdala activity. These results allow a functional anatomical detection of the early neural components of rejection associated with the initial reactive emotional response. Thus, the act of immediate rejection seems to be mediated by the limbic system and is not solely driven by cortical processes, as previously suggested. Our results also prompt an ethical discussion as we demonstrated that a commonly used drug influences core functions in the human brain that underlie individual autonomy and economic decision making. PMID:21559322

Discrepancies between adolescents' attributed relevance and experiences regarding communication are associated with poorer client participation and learning processes in psychosocial care.

PubMed

Jager, Margot; Reijneveld, Sijmen A; Metselaar, Janneke; Knorth, Erik J; De Winter, Andrea F

2014-12-01

To examine adolescents' attributed relevance and experiences regarding communication, and whether discrepancies in these are associated with clients' participation and learning processes in psychosocial care. Adolescents receiving psychosocial care (n=211) completed measures of communication in three domains: affective communication, information provision, and shared decision-making. Participation involved clients' attendance and adherence (professional-reported). Learning processes involved clients' improved understanding and improved confidence (client and professional-reported). Important but less often experienced affective communication was associated with low adherence (odds ratio, 95% confidence interval: 2.8, 1.1-6.8), less improvement in understanding (3.7, 1.5-9.0), and less improvement in confidence (4.5, 1.8-11.6). If information provision or shared decision-making was important but less often experienced, adolescents were more likely to demonstrate less improvement in understanding (3.1, 1.1-8.5; 4.2, 1.7-10.8). The combination "less important but experienced" only had an effect regarding affective communication; these adolescents were more likely to demonstrate less improvement in confidence (6.0, 2.3-15.4). Discrepancies between attributed relevance and experiences frequently occur. These discrepancies negatively affect adolescents' participation and their learning processes, although the pattern differs across communication domains. Care professionals should pay considerable attention to their clients' communication preferences and adapt their communication style when necessary. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Enablement in health care context: a concept analysis.

PubMed

Hudon, Catherine; St-Cyr Tribble, Denise; Bravo, Gina; Poitras, Marie-Eve

2011-02-01

The enablement process is defined as a professional intervention aiming to recognize, support and emphasize the patient's capacity to have control over her or his health and life. The purpose of this article was to study the enablement concept through a concept analysis in the health care context to identify: (1) its attributes and (2) its antecedents and consequents. A concept analysis was performed according to the method of Rodgers. The literature was reviewed from 1980 to June 2008, using search strategies adapted to the databases Cinahl, Medline, Embase, PsycInfo and Social Works Abstract, and hand searching. All articles contributing to a deeper understanding of the concept were included. The analysis was carried out according to a thematic analysis procedure, as described by Miles & Huberman. The search identified 1305 citations. After in-depth assessment of 148 potentially eligible citations, 61 articles were included in the review. Five articles were added with hand searching. Sixty-seven per cent of these articles were related to nursing. The attributes of the enablement concept included: contribution to the therapeutic relationship; consideration of the person as a whole; facilitation of learning; valorization of the person's strengths; implication and support to decision making; and broadening of the possibilities. These attributes could be used as a basis for other studies on enablement. Conceptual and empirical work is still needed to better position this concept among others such as patient-centred care, shared decision making and patient's participation. © 2010 Blackwell Publishing Ltd.

Thermal power systems small power systems applications project. Decision analysis for evaluating and ranking small solar thermal power system technologies. Volume 1: A brief introduction to multiattribute decision analysis. [explanation of multiattribute decision analysis methods used in evaluating alternatives for small powered systems

NASA Technical Reports Server (NTRS)

Feinberg, A.; Miles, R. F., Jr.

1978-01-01

The principal concepts of the Keeney and Raiffa approach to multiattribute decision analysis are described. Topics discussed include the concepts of decision alternatives, outcomes, objectives, attributes and their states, attribute utility functions, and the necessary independence properties for the attribute states to be aggregated into a numerical representation of the preferences of the decision maker for the outcomes and decision alternatives.

Multi-criteria decision analysis in environmental sciences: ten years of applications and trends.

PubMed

Huang, Ivy B; Keisler, Jeffrey; Linkov, Igor

2011-09-01

Decision-making in environmental projects requires consideration of trade-offs between socio-political, environmental, and economic impacts and is often complicated by various stakeholder views. Multi-criteria decision analysis (MCDA) emerged as a formal methodology to face available technical information and stakeholder values to support decisions in many fields and can be especially valuable in environmental decision making. This study reviews environmental applications of MCDA. Over 300 papers published between 2000 and 2009 reporting MCDA applications in the environmental field were identified through a series of queries in the Web of Science database. The papers were classified by their environmental application area, decision or intervention type. In addition, the papers were also classified by the MCDA methods used in the analysis (analytic hierarchy process, multi-attribute utility theory, and outranking). The results suggest that there is a significant growth in environmental applications of MCDA over the last decade across all environmental application areas. Multiple MCDA tools have been successfully used for environmental applications. Even though the use of the specific methods and tools varies in different application areas and geographic regions, our review of a few papers where several methods were used in parallel with the same problem indicates that recommended course of action does not vary significantly with the method applied. Published by Elsevier B.V.

Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage.

PubMed

Paolucci, Francesco; Redekop, Ken; Fouda, Ayman; Fiorentini, Gianluca

2017-12-01

Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors/attributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.

Negative and positive pretrial publicity affect juror memory and decision making.

PubMed

Ruva, Christine L; McEvoy, Cathy

2008-09-01

The experiment examined the effects of exposure to pretrial publicity (PTP) and delay on juror memory and decision-making. Mock jurors read news articles containing negative PTP, positive PTP, or unrelated articles. Five days later, they viewed a videotaped murder trial, after which they made decisions about guilt. Finally, all participants independently attributed specific information as having been presented during the trial or in the news articles. Half of the jurors rendered their verdicts and completed the source-memory test immediately after the trial, while the other half did so after a 2-day delay. Exposure to PTP significantly affected guilty verdicts, perceptions of defendant credibility, juror ratings of the prosecuting and defense attorneys, and misattributions of PTP as having been presented as trial evidence. Similar effects were obtained for negative and positive PTP. Delay significantly increased source-memory errors but did not influence guilt ratings. Defendant's credibility and juror ratings of prosecuting and defense attorneys significantly mediated the effect of PTP on guilt ratings. (c) 2008 APA, all rights reserved.

Rough Evaluation Structure: Application of Rough Set Theory to Generate Simple Rules for Inconsistent Preference Relation

NASA Astrophysics Data System (ADS)

Gehrmann, Andreas; Nagai, Yoshimitsu; Yoshida, Osamu; Ishizu, Syohei

Since management decision-making becomes complex and preferences of the decision-maker frequently becomes inconsistent, multi-attribute decision-making problems were studied. To represent inconsistent preference relation, the concept of evaluation structure was introduced. We can generate simple rules to represent inconsistent preference relation by the evaluation structures. Further rough set theory for the preference relation was studied and the concept of approximation was introduced. One of our main aims of this paper is to introduce a concept of rough evaluation structure for representing inconsistent preference relation. We apply rough set theory to the evaluation structure, and develop a method for generating simple rules for inconsistent preference relations. In this paper, we introduce concepts of totally ordered information system, similarity class of preference relation, upper and lower approximation of preference relations. We also show the properties of rough evaluation structure and provide a simple example. As an application of rough evaluation structure, we analyze questionnaire survey of customer preferences about audio players.

Toward an operational model of decision making, emotional regulation, and mental health impact.

PubMed

Collura, Thomas Francis; Zalaquett, Ronald P; Bonnstetter, Carlos Joyce; Chatters, Seria J

2014-01-01

Current brain research increasingly reveals the underlying mechanisms and processes of human behavior, cognition, and emotion. In addition to being of interest to a wide range of scientists, educators, and professionals, as well as laypeople, brain-based models are of particular value in a clinical setting. Psychiatrists, psychologists, counselors, and other mental health professionals are in need of operational models that integrate recent findings in the physical, cognitive, and emotional domains, and offer a common language for interdisciplinary understanding and communication. Based on individual traits, predispositions, and responses to stimuli, we can begin to identify emotional and behavioral pathways and mental processing patterns. The purpose of this article is to present a brain-path activation model to understand individual differences in decision making and psychopathology. The first section discusses the role of frontal lobe electroencephalography (EEG) asymmetry, summarizes state- and trait-based models of decision making, and provides a more complex analysis that supplements the traditional simple left-right brain model. Key components of the new model are the introduction of right hemisphere parallel and left hemisphere serial scanning in rendering decisions, and the proposition of pathways that incorporate both past experiences as well as future implications into the decision process. Main attributes of each decision-making mechanism are provided. The second section applies the model within the realm of clinical mental health as a tool to understand specific human behavior and pathology. Applications include general and chronic anxiety, depression, paranoia, risk taking, and the pathways employed when well-functioning operational integration is observed. Finally, specific applications such as meditation and mindfulness are offered to facilitate positive functioning.

Attributions of responsibility and affective reactions to decision outcomes.

PubMed

Zeelenberg, M; van der Pligt, J; de Vries, N K

2000-06-01

Immediate affective reactions to outcomes are more intense following decisions to act than following decisions not to act. This finding holds for both positive and negative outcomes. We relate this "actor-effect" to attribution theory and argue that decision makers are seen as more responsible for outcomes when these are the result of a decision to act as compared to a decision not to act. Experiment 1 (N = 80) tests the main assumption underlying our reasoning and shows that affective reactions to decision outcomes are indeed more intense when the decision maker is seen as more responsible. Experiment 2 (N = 40) tests whether the actor effect can be predicted on the basis of differential attributions following action and inaction. Participants read vignettes in which active and passive actors obtained a positive or negative outcome. Action resulted in more intense affect than inaction, and positive outcomes resulted in more intense affect than negative outcomes. Experiment 2 further shows that responsibility attributions and affective reactions to outcomes are highly correlated; that is, more extreme affective reactions are associated with more internal attributions. We discuss the implications for research on post-decisional reactions.

Auditory attention and multiattribute decision-making during a 33 h sleep-deprivation period: mean performance and between-subject dispersions.

PubMed

Linde, L; Edland, A; Bergström, M

1999-05-01

One purpose of this study was to compare attention in the evening (22:00 h), in the late night (04:00 h), in the morning (10:00 h) and in the afternoon (16:00 h) during a period of complete wakefulness beginning at 08:00 h with a mean daytime performance without sleep deprivation. Another purpose was to investigate sleep deprivation effects on a multi-attribute decision-making task with and without time pressure. Twelve sleep-deprived male students were compared with 12 male non-sleep-deprived students. Both groups were tested five times with an auditory attention and a symbol coding task. Significant declines (p < 0.05) in mean level of performance on the auditory attention task were found at 04:00, 10:00 and 16:00 h for subjects forced to the vigil. However, the effect of the sleep deprivation manifested itself even more in increased between-subject dispersions. There were no differences between time pressure and no time pressure on the decision-making task and no significant differences between sleep-deprived and non-sleep-deprived subjects in decision strategies. In fact, the pattern of decision strategies among the sleep-deprived subject was more similar to a pattern of decision strategies typical for non-stressful conditions than the pattern of decision strategies among the non-sleep-deprived subjects. This result may have been due to the fact that the sleep loss acted as a dearouser. Here too, however, the variances differed significantly among sleep-deprived and non-sleep-deprived subjects, indicating that the sleep-deprived subjects were more variable in their decision strategy pattern than the control group.

A framework to investigate drivers of adaptation decisions in marine fishing: Evidence from urban, semi-urban and rural communities.

PubMed

Malakar, Krishna; Mishra, Trupti; Patwardhan, Anand

2018-05-11

Traditional fishing livelihoods need to adapt to changing fish catch/populations, led by numerous anthropogenic, environmental and climatic stressors. The decision to adapt can be influenced by a variety of socio-economic and perceptual factors. However, adaptation decision-making in fishing communities has rarely been studied. Based on previous literature and focus group discussions with community, this study identifies few prominent adaptation responses in marine fishing and proposes credible factors driving decisions to adopt them. Further, a household survey is conducted, and the association of these drivers with various adaptation strategies is examined among fisherfolk of Maharashtra (India). This statistical analysis is based on 601 responses collected across three regional fishing groups: urban, semi-urban and rural. Regional segregation is done to understand variability in decision-making among groups which might be having different socio-economic and perceptual attributes. The survey reveals that only few urban fishing households have been able to diversify into other livelihoods. While having economic capital increases the likelihood of adaptation among urban and semi-urban communities, rural fishermen are significantly driven by social capital. Perception of climate change affecting fish catch drives adoption of mechanized boats solely in urban region. But increasing number of extreme events affects decisions of semi-urban and rural fishermen. Further, rising pollution and trade competition is associated with adaptation responses in the urban and semi-urban community. Higher education might help fishermen choose convenient forms of adaptation. Also, cooperative membership and subsidies are critical in adaptation decisions. The framework and insights of the study suggest the importance of acknowledging differential decision-making of individuals and communities, for designing effective adaptation and capacity-building policies. Copyright © 2018 Elsevier B.V. All rights reserved.

Which Psychological Resilience Attributes Are Associated with Lower Aspects of Anxiety in Boys with an Autism Spectrum Disorder? Implications for Guidance and Counselling Interventions

ERIC Educational Resources Information Center

Bitsika, Vicki; Sharpley, Christopher F.

2014-01-01

The effect of psychological resilience as a buffer against anxiety was investigated in a sample of 39 boys with high-functioning autism spectrum disorder (ASD) via individual online questionnaire responses to standardised inventories for assessing anxiety and psychological resilience. Ability to handle problems, make good decisions, think before…

The Use of Individual Growth and Developmental Indicators for Progress Monitoring and Intervention Decision Making in Early Education

ERIC Educational Resources Information Center

Walker, Dale; Carta, Judith J.; Greenwood, Charles R.; Buzhardt, Joseph F.

2008-01-01

Progress monitoring tools have been shown to be essential elements in current approaches to intervention problem-solving models. Such tools have been valuable not only in marking individual children's level of performance relative to peers but also in measuring change in skill level in a way that can be attributed to intervention and development.…

Rational Snacking: Young Children's Decision-Making on the Marshmallow Task is Moderated by Beliefs about Environmental Reliability

ERIC Educational Resources Information Center

Kidd, Celeste; Palmeri, Holly; Aslin, Richard N.

2013-01-01

Children are notoriously bad at delaying gratification to achieve later, greater rewards (e.g., Piaget, 1970)--and some are worse at waiting than others. Individual differences in the ability-to-wait have been attributed to self-control, in part because of evidence that long-delayers are more successful in later life (e.g., Shoda, Mischel, &…

"Only you can play with me!" Children's inclusive decision making, reasoning, and emotions based on peers' gender and behavior problems.

PubMed

Peplak, Joanna; Song, Ju-Hyun; Colasante, Tyler; Malti, Tina

2017-10-01

This study examined the development of children's decisions, reasoning, and emotions in contexts of peer inclusion/exclusion. We asked an ethnically diverse sample of 117 children aged 4years (n=59; 60% girls) and 8years (n=58; 49% girls) to choose between including hypothetical peers of the same or opposite gender and with or without attention deficit/hyperactivity problems and aggressive behavior. Children also provided justifications for, and emotions associated with, their inclusion decisions. Both 4- and 8-year-olds predominantly chose to include the in-group peer (i.e., the same-gender peer and peers without behavior problems), thereby demonstrating a normative in-group inclusive bias. Nevertheless, children included the out-group peer more in the gender context than in the behavior problem contexts. The majority of children reported group functioning-related, group identity-related, and stereotype-related reasoning after their in-group inclusion decisions, and they associated happy feelings with such decisions. Although most children attributed sadness to the excluded out-group peer, they attributed more anger to the excluded out-group peer in the aggression context compared with other contexts. We discuss the implications of our findings for current theorizing about children's social-cognitive and emotional development in contexts of peer inclusion and exclusion. Copyright © 2017 Elsevier Inc. All rights reserved.

Examining extrinsic factors that influence product acceptance: a review.

PubMed

Li, X E; Jervis, S M; Drake, M A

2015-05-01

Drivers of liking (DOL) studies are useful for product development to formulate acceptable products; however, DOL alone are insufficient for understanding why a product is purchased and repurchased, which is ultimately the indication of a successful product. Ultimately sensory attributes drive product success (that is, repeat and continued purchase). However, ignoring the importance of extrinsic factors may neglect the vital product attributes responsible for the initial purchase, which may in turn, affect repeat purchase. The perception of sensory attributes assessed by DOL is mitigated by external perceptions of quality. If the sensory attributes do not deliver based upon the quality cues, the product will not be acceptable. Four key extrinsic factors that affect DOL are the perceived satiety, brand and labeling, price, and the emotional impact to decision making. In order to more thoroughly understand what the DOL for a product is, these 4 product cues should be considered in conjunction with sensory attribute perception to gain a holistic understanding of product acceptance. © 2015 Institute of Food Technologists®

Evolutionary and Neural Computing Based Decision Support System for Disease Diagnosis from Clinical Data Sets in Medical Practice.

PubMed

Sudha, M

2017-09-27

As a recent trend, various computational intelligence and machine learning approaches have been used for mining inferences hidden in the large clinical databases to assist the clinician in strategic decision making. In any target data the irrelevant information may be detrimental, causing confusion for the mining algorithm and degrades the prediction outcome. To address this issue, this study attempts to identify an intelligent approach to assist disease diagnostic procedure using an optimal set of attributes instead of all attributes present in the clinical data set. In this proposed Application Specific Intelligent Computing (ASIC) decision support system, a rough set based genetic algorithm is employed in pre-processing phase and a back propagation neural network is applied in training and testing phase. ASIC has two phases, the first phase handles outliers, noisy data, and missing values to obtain a qualitative target data to generate appropriate attribute reduct sets from the input data using rough computing based genetic algorithm centred on a relative fitness function measure. The succeeding phase of this system involves both training and testing of back propagation neural network classifier on the selected reducts. The model performance is evaluated with widely adopted existing classifiers. The proposed ASIC system for clinical decision support has been tested with breast cancer, fertility diagnosis and heart disease data set from the University of California at Irvine (UCI) machine learning repository. The proposed system outperformed the existing approaches attaining the accuracy rate of 95.33%, 97.61%, and 93.04% for breast cancer, fertility issue and heart disease diagnosis.

Role of the medial prefrontal cortex in impaired decision making in juvenile attention-deficit/hyperactivity disorder.

PubMed

Hauser, Tobias U; Iannaccone, Reto; Ball, Juliane; Mathys, Christoph; Brandeis, Daniel; Walitza, Susanne; Brem, Silvia

2014-10-01

Attention-deficit/hyperactivity disorder (ADHD) has been associated with deficient decision making and learning. Models of ADHD have suggested that these deficits could be caused by impaired reward prediction errors (RPEs). Reward prediction errors are signals that indicate violations of expectations and are known to be encoded by the dopaminergic system. However, the precise learning and decision-making deficits and their neurobiological correlates in ADHD are not well known. To determine the impaired decision-making and learning mechanisms in juvenile ADHD using advanced computational models, as well as the related neural RPE processes using multimodal neuroimaging. Twenty adolescents with ADHD and 20 healthy adolescents serving as controls (aged 12-16 years) were examined using a probabilistic reversal learning task while simultaneous functional magnetic resonance imaging and electroencephalogram were recorded. Learning and decision making were investigated by contrasting a hierarchical Bayesian model with an advanced reinforcement learning model and by comparing the model parameters. The neural correlates of RPEs were studied in functional magnetic resonance imaging and electroencephalogram. Adolescents with ADHD showed more simplistic learning as reflected by the reinforcement learning model (exceedance probability, Px = .92) and had increased exploratory behavior compared with healthy controls (mean [SD] decision steepness parameter β: ADHD, 4.83 [2.97]; controls, 6.04 [2.53]; P = .02). The functional magnetic resonance imaging analysis revealed impaired RPE processing in the medial prefrontal cortex during cue as well as during outcome presentation (P < .05, family-wise error correction). The outcome-related impairment in the medial prefrontal cortex could be attributed to deficient processing at 200 to 400 milliseconds after feedback presentation as reflected by reduced feedback-related negativity (ADHD, 0.61 [3.90] μV; controls, -1.68 [2.52] μV; P = .04). The combination of computational modeling of behavior and multimodal neuroimaging revealed that impaired decision making and learning mechanisms in adolescents with ADHD are driven by impaired RPE processing in the medial prefrontal cortex. This novel, combined approach furthers the understanding of the pathomechanisms in ADHD and may advance treatment strategies.

Cost effectiveness of pediatric pneumococcal conjugate vaccines: a comparative assessment of decision-making tools.

PubMed

Chaiyakunapruk, Nathorn; Somkrua, Ratchadaporn; Hutubessy, Raymond; Henao, Ana Maria; Hombach, Joachim; Melegaro, Alessia; Edmunds, John W; Beutels, Philippe

2011-05-12

Several decision support tools have been developed to aid policymaking regarding the adoption of pneumococcal conjugate vaccine (PCV) into national pediatric immunization programs. The lack of critical appraisal of these tools makes it difficult for decision makers to understand and choose between them. With the aim to guide policymakers on their optimal use, we compared publicly available decision-making tools in relation to their methods, influential parameters and results. The World Health Organization (WHO) requested access to several publicly available cost-effectiveness (CE) tools for PCV from both public and private provenance. All tools were critically assessed according to the WHO's guide for economic evaluations of immunization programs. Key attributes and characteristics were compared and a series of sensitivity analyses was performed to determine the main drivers of the results. The results were compared based on a standardized set of input parameters and assumptions. Three cost-effectiveness modeling tools were provided, including two cohort-based (Pan-American Health Organization (PAHO) ProVac Initiative TriVac, and PneumoADIP) and one population-based model (GlaxoSmithKline's SUPREMES). They all compared the introduction of PCV into national pediatric immunization program with no PCV use. The models were different in terms of model attributes, structure, and data requirement, but captured a similar range of diseases. Herd effects were estimated using different approaches in each model. The main driving parameters were vaccine efficacy against pneumococcal pneumonia, vaccine price, vaccine coverage, serotype coverage and disease burden. With a standardized set of input parameters developed for cohort modeling, TriVac and PneumoADIP produced similar incremental costs and health outcomes, and incremental cost-effectiveness ratios. Vaccine cost (dose price and number of doses), vaccine efficacy and epidemiology of critical endpoint (for example, incidence of pneumonia, distribution of serotypes causing pneumonia) were influential parameters in the models we compared. Understanding the differences and similarities of such CE tools through regular comparisons could render decision-making processes in different countries more efficient, as well as providing guiding information for further clinical and epidemiological research. A tool comparison exercise using standardized data sets can help model developers to be more transparent about their model structure and assumptions and provide analysts and decision makers with a more in-depth view behind the disease dynamics. Adherence to the WHO guide of economic evaluations of immunization programs may also facilitate this process. Please see related article: http://www.biomedcentral.com/1741-7007/9/55.

Selecting essential information for biosurveillance--a multi-criteria decision analysis.

PubMed

Generous, Nicholas; Margevicius, Kristen J; Taylor-McCabe, Kirsten J; Brown, Mac; Daniel, W Brent; Castro, Lauren; Hengartner, Andrea; Deshpande, Alina

2014-01-01

The National Strategy for Biosurveillance defines biosurveillance as "the process of gathering, integrating, interpreting, and communicating essential information related to all-hazards threats or disease activity affecting human, animal, or plant health to achieve early detection and warning, contribute to overall situational awareness of the health aspects of an incident, and to enable better decision-making at all levels." However, the strategy does not specify how "essential information" is to be identified and integrated into the current biosurveillance enterprise, or what the metrics qualify information as being "essential". The question of data stream identification and selection requires a structured methodology that can systematically evaluate the tradeoffs between the many criteria that need to be taken in account. Multi-Attribute Utility Theory, a type of multi-criteria decision analysis, can provide a well-defined, structured approach that can offer solutions to this problem. While the use of Multi-Attribute Utility Theoryas a practical method to apply formal scientific decision theoretical approaches to complex, multi-criteria problems has been demonstrated in a variety of fields, this method has never been applied to decision support in biosurveillance.We have developed a formalized decision support analytic framework that can facilitate identification of "essential information" for use in biosurveillance systems or processes and we offer this framework to the global BSV community as a tool for optimizing the BSV enterprise. To demonstrate utility, we applied the framework to the problem of evaluating data streams for use in an integrated global infectious disease surveillance system.

Comparative SWOT analysis of strategic environmental assessment systems in the Middle East and North Africa region.

PubMed

Rachid, G; El Fadel, M

2013-08-15

This paper presents a SWOT analysis of SEA systems in the Middle East North Africa region through a comparative examination of the status, application and structure of existing systems based on country-specific legal, institutional and procedural frameworks. The analysis is coupled with the multi-attribute decision making method (MADM) within an analytical framework that involves both performance analysis based on predefined evaluation criteria and countries' self-assessment of their SEA system through open-ended surveys. The results show heterogenous status with a general delayed progress characterized by varied levels of weaknesses embedded in the legal and administrative frameworks and poor integration with the decision making process. Capitalizing on available opportunities, the paper highlights measures to enhance the development and enactment of SEA in the region. Copyright © 2013 Elsevier Ltd. All rights reserved.

Decision making on organ donation: the dilemmas of relatives of potential brain dead donors.

PubMed

de Groot, Jack; van Hoek, Maria; Hoedemaekers, Cornelia; Hoitsma, Andries; Smeets, Wim; Vernooij-Dassen, Myrra; van Leeuwen, Evert

2015-09-17

This article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and decision-making process when post-mortal donation is at stake. This article describes the perspectives of the relatives. A content-analysis of 22 semi-structured in-depth interviews with relatives involved in an organ donation decision. Three themes were identified: 'conditions', 'ethical considerations' and 'look back'. Conditions were: 'sense of urgency', 'incompetence to decide' and 'agreement between relatives'. Ethical considerations result in a dilemma for non-donor families: aiding people or protecting the deceased's body, especially when they do not know his/her preference. Donor families respect the deceased's last will, generally confirmed in the National Donor Register. Looking back, the majority of non-donor families resolved their dilemma by justifying their decision with external arguments (lack of time, information etc.). Some non-donor families would like to be supported during decision-making. The discrepancy between general willingness to donate and the actual refusal of a donation request can be explained by multiple factors, with a cumulative effect. Firstly, half of the participants (most non-donor families) stated that they felt that they were not competent to decide in such a crisis and they seem to struggle with utilitarian considerations against their wish to protect the body. Secondly, non-donor families refused telling that they did not know the deceased's wishes or contesting posthumous autonomy of the eligible. Thirdly, the findings emphasise the importance of Donor Registration, because it seems to prevent dilemmas in decision-making, at least for donor families. Discrepancies between willingness to consent to donate and refusal at the bedside can be attributed to an unresolved dilemma: aiding people or protect the body of the deceased. Non-donor families felt incompetent to decide. They refused consent for donation, since their deceased had not given any directive. When ethical considerations do not lead to an unambiguous answer, situational factors were pivotal. Relatives of unregistered eligible donors are more prone to unstable decisions. To overcome ambivalence, coaching during decision-making is worth investigation.

Improving the food waste composting facilities site selection for sustainable development using a hybrid modified MADM model.

PubMed

Liu, Kung-Ming; Lin, Sheng-Hau; Hsieh, Jing-Chzi; Tzeng, Gwo-Hshiung

2018-05-01

With the growth of population and the development of urbanization, waste management has always been a critical global issue. Recently, more and more countries have found that food waste constitutes the majority of municipal waste, if they are disposed of properly, will bring more benefits in sustainable development. Regarding the issue of selecting and improving the location to make the disposal facility towards achieving the aspiration level for sustainable development, since it involves multiple and complicated interaction factors about environment, society, and economy which have to be considered properly in the decision-making process of mutual influence relationship. It is basically a multiple attribute decision making (MADM) issue, a difficult problem which has been obsessing the governments of many countries is widely studied and discussed. This study uses the new hybrid modified MADM model, as follows, first to build an influential network relation map (INRM) via DEMATEL technique, next to confirm the influential weightings via DANP (DEMATEL-based ANP), and then to construct a decision-making model via a hybrid modified VIKOR method to improve and select the location for remaining the best disposal facilities. Finally, an empirical case study is illustrated to demonstrate that the proposed model can be effective and useful. In finding the process of decision making, environmental pollution is the main concern of many people in the area, but actually it is the resistance by the general public that has to be considered with first priority. Copyright © 2018. Published by Elsevier Ltd.

Personal and family attributes of pregnant teenagers: findings from a community-based study in Sri Lanka.

PubMed

Fernando, Dulitha N; Gunawardena, Nalika S; Weerasinghe, Manuj Chrishantha

2014-01-01

Teenage pregnancies are associated with negative outcomes. Prevention requires understanding them and their families. This study aimed to describe personal and family attributes of pregnant teenagers in Sri Lanka. This was a community-based study in Sri Lanka among 510 pregnant teenagers. Half (50%) of the subjects were 19 years of age at the time of pregnancy. A majority (79.8%) had studied up to grades 6-11. Confidence in decision-making (80.7%) and in refusing unnecessary requests (88.3%) was "excellent" in a majority. Mean age of marriage/co-habiting was 17.6 years. For 31%, marriage/cohabiting was a sudden decision taken jointly with their partner (81.6%) and 83% reported being "legally" married. Substantial proportions of mothers (17.6%) and fathers (13.9%) had not attended school, and 33.1% mothers had worked abroad. Teenagers reported the death of a parent (14.1%), parental separation (10.9%) and being brought up by relatives (20%). Only a few rated strictness of rules/regulations (32.4%), freedom to discuss problems regarding puberty (25.5%), love affairs (12.7%) and sexuality (26.7%) as excellent/good. Of the spouses, 12.9% were <20 years, 71.9% had low education and 98.8% were employed. A majority had "planned" the pregnancy, and for 79.8%, the reason was "husband's wish to have a baby". Pregnant teenagers were mostly in their late teens, from poor families and with low formal education. Though teenagers showed confidence in decision-making, the decision to have a pregnancy had mostly been their spouses. Parents and spouses of the teenagers were also young, less educated and poor. There was evidence of poor parenting practices.

Individual differences and reasoning: a study on personality traits.

PubMed

Bensi, Luca; Giusberti, Fiorella; Nori, Raffaella; Gambetti, Elisa

2010-08-01

Personality can play a crucial role in how people reason and decide. Identifying individual differences related to how we actively gather information and use evidence could lead to a better comprehension and predictability of human reasoning. Recent findings have shown that some personality traits are related to similar decision-making patterns showed by people with mental disorders. We performed research with the aim to investigate delusion-proneness, obsessive-like personality, anxiety (trait and state), and reasoning styles in individuals from the general population. We introduced personality trait and state anxiety scores in a regression model to explore specific associations with: (1) amount of data-gathered prior to making a decision; and (2) the use of confirmatory and disconfirmatory evidence. Results showed that all our independent variables were positively or negatively associated with the amount of data collected in order to make simple probabilistic decisions. Anxiety and obsessiveness were the only predictors of the weight attributed to evidence in favour or against a hypothesis. Findings were discussed in relation to theoretical assumptions, predictions, and clinical implications. Personality traits can predict peculiar ways to reason and decide that, in turn, could be involved to some extent in the formation and/or maintenance of psychological disorders.

Agent-based modeling of deforestation in southern Yucatán, Mexico, and reforestation in the Midwest United States

PubMed Central

Manson, Steven M.; Evans, Tom

2007-01-01

We combine mixed-methods research with integrated agent-based modeling to understand land change and economic decision making in the United States and Mexico. This work demonstrates how sustainability science benefits from combining integrated agent-based modeling (which blends methods from the social, ecological, and information sciences) and mixed-methods research (which interleaves multiple approaches ranging from qualitative field research to quantitative laboratory experiments and interpretation of remotely sensed imagery). We test assumptions of utility-maximizing behavior in household-level landscape management in south-central Indiana, linking parcel data, land cover derived from aerial photography, and findings from laboratory experiments. We examine the role of uncertainty and limited information, preferences, differential demographic attributes, and past experience and future time horizons. We also use evolutionary programming to represent bounded rationality in agriculturalist households in the southern Yucatán of Mexico. This approach captures realistic rule of thumb strategies while identifying social and environmental factors in a manner similar to econometric models. These case studies highlight the role of computational models of decision making in land-change contexts and advance our understanding of decision making in general. PMID:18093928

Naturalistic Decision Making For Power System Operators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greitzer, Frank L.; Podmore, Robin; Robinson, Marck

2009-06-23

Abstract: Motivation -- As indicated by the Blackout of 2003, the North American interconnected electric system is vulnerable to cascading outages and widespread blackouts. Investigations of large scale outages often attribute the causes to the three T’s: Trees, Training and Tools. A systematic approach has been developed to document and understand the mental processes that an expert power system operator uses when making critical decisions. The approach has been developed and refined as part of a capability demonstration of a high-fidelity real-time power system simulator under normal and emergency conditions. To examine naturalistic decision making (NDM) processes, transcripts of operator-to-operatormore » conversations are analyzed to reveal and assess NDM-based performance criteria. Findings/Design -- The results of the study indicate that we can map the Situation Awareness Level of the operators at each point in the scenario. We can also identify clearly what mental models and mental simulations are being performed at different points in the scenario. As a result of this research we expect that we can identify improved training methods and improved analytical and visualization tools for power system operators. Originality/Value -- The research applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message -- The NDM approach provides an ideal framework for systematic training management and mitigation to accelerate learning in team-based training scenarios with high-fidelity power grid simulators.« less

Psychiatric patients' preferences and experiences in clinical decision-making: examining concordance and correlates of patients' preferences.

PubMed

De las Cuevas, Carlos; Peñate, Wenceslao; de Rivera, Luis

2014-08-01

To assess the concordance between patients' preferred role in clinical decision-making and the role they usually experience in their psychiatric consultations and to analyze the influence of socio-demographic, clinical and personality characteristics on patients' preferences. 677 consecutive psychiatric outpatients were invited to participate in a cross-sectional survey and 507 accepted. Patients completed Control Preference Scale twice consecutively before consultation, one for their preferences of participation and another for the style they usually experienced until then, and locus of control and self-efficacy scales. Sixty-three percent of psychiatric outpatients preferred a collaborative role in decision-making, 35% preferred a passive role and only a 2% an active one. A low concordance for preferred and experienced participation in medical decision-making was registered, with more than a half of patients wanting a more active role than they actually had. Age and doctors' health locus of control orientation were found to be the best correlates for participation preferences, while age and gender were for experienced. Psychiatric diagnoses registered significant differences in patients' preferences of participation but no concerning experiences. The limited concordance between preferred and experienced roles in psychiatric patients is indicative that clinicians need to raise their sensitivity regarding patient's participation. The assessment of patient's attribution style should be useful for psychiatrist to set objectives and priority in the communication with their patients. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Shared decision making in the safety net: where do we go from here?

PubMed

Bouma, Angelique B; Tiedje, Kristina; Poplau, Sara; Boehm, Deborah H; Shah, Nilay D; Commers, Matthew J; Linzer, Mark; Montori, Victor M

2014-01-01

Shared decision making (SDM) is an interactive process between clinicians and patients in which both share information, deliberate together, and make clinical decisions. Clinics serving safety net patients face special challenges, including fewer resources and more challenging work environments. The use of SDM within safety net institutions has not been well studied. We recruited a convenience sample of 15 safety net primary care clinicians (13 physicians, 2 nurse practitioners). Each answered a 9-item SDM questionnaire and participated in a semistructured interview. From the transcribed interviews and questionnaire data, we identified themes and suggestions for introducing SDM into a safety net environment. Clinicians reported only partially fulfilling the central components of SDM (sharing information, deliberating, and decision making). Most clinicians expressed interest in SDM by stating that they "selected a treatment option together" with patients (8 of 15 in strong or complete agreement), but only a minority (3 of 15) "thoroughly weighed the different treatment options" together with patients. Clinicians attributed this gap to many barriers, including time pressure, overwhelming visit content, patient preferences, and lack of available resources. All clinicians believed that lack of time made it difficult to practice SDM. To increase use of SDM in the safety net, efficient SDM interventions designed for this environment, team care, and patient engagement in SDM will need further development. Future studies should focus on adapting SDM to safety net settings and determine whether SDM can reduce health care disparities.

Optimization of the decision-making process for the selection of therapeutics to undergo clinical testing for spinal cord injury in the North American Clinical Trials Network.

PubMed

Guest, James; Harrop, James S; Aarabi, Bizhan; Grossman, Robert G; Fawcett, James W; Fehlings, Michael G; Tator, Charles H

2012-09-01

The North American Clinical Trials Network (NACTN) includes 9 clinical centers funded by the US Department of Defense and the Christopher Reeve Paralysis Foundation. Its purpose is to accelerate clinical testing of promising therapeutics in spinal cord injury (SCI) through the development of a robust interactive infrastructure. This structure includes key committees that serve to provide longitudinal guidance to the Network. These committees include the Executive, Data Management, and Neurological Outcome Assessments Committees, and the Therapeutic Selection Committee (TSC), which is the subject of this manuscript. The NACTN brings unique elements to the SCI field. The Network's stability is not restricted to a single clinical trial. Network members have diverse expertise and include experts in clinical care, clinical trial design and methodology, pharmacology, preclinical and clinical research, and advanced rehabilitation techniques. Frequent systematic communication is assigned a high value, as is democratic process, fairness and efficiency of decision making, and resource allocation. This article focuses on how decision making occurs within the TSC to rank alternative therapeutics according to 2 main variables: quality of the preclinical data set, and fit with the Network's aims and capabilities. This selection process is important because if the Network's resources are committed to a therapeutic, alternatives cannot be pursued. A proposed methodology includes a multicriteria decision analysis that uses a Multi-Attribute Global Inference of Quality matrix to quantify the process. To rank therapeutics, the TSC uses a series of consensus steps designed to reduce individual and group bias and limit subjectivity. Given the difficulties encountered by industry in completing clinical trials in SCI, stable collaborative not-for-profit consortia, such as the NACTN, may be essential to clinical progress in SCI. The evolution of the NACTN also offers substantial opportunity to refine decision making and group dynamics. Making the best possible decisions concerning therapeutics selection for trial testing is a cornerstone of the Network's function.

Stimulus Value Signals in Ventromedial PFC Reflect the Integration of Attribute Value Signals Computed in Fusiform Gyrus and Posterior Superior Temporal Gyrus

PubMed Central

Lim, Seung-Lark; O'Doherty, John P.

2013-01-01

We often have to make choices among multiattribute stimuli (e.g., a food that differs on its taste and health). Behavioral data suggest that choices are made by computing the value of the different attributes and then integrating them into an overall stimulus value signal. However, it is not known whether this theory describes the way the brain computes the stimulus value signals, or how the underlying computations might be implemented. We investigated these questions using a human fMRI task in which individuals had to evaluate T-shirts that varied in their visual esthetic (e.g., color) and semantic (e.g., meaning of logo printed in T-shirt) components. We found that activity in the fusiform gyrus, an area associated with the processing of visual features, correlated with the value of the visual esthetic attributes, but not with the value of the semantic attributes. In contrast, activity in posterior superior temporal gyrus, an area associated with the processing of semantic meaning, exhibited the opposite pattern. Furthermore, both areas exhibited functional connectivity with an area of ventromedial prefrontal cortex that reflects the computation of overall stimulus values at the time of decision. The results provide supporting evidence for the hypothesis that some attribute values are computed in cortical areas specialized in the processing of such features, and that those attribute-specific values are then passed to the vmPFC to be integrated into an overall stimulus value signal to guide the decision. PMID:23678116

Stimulus value signals in ventromedial PFC reflect the integration of attribute value signals computed in fusiform gyrus and posterior superior temporal gyrus.

PubMed

Lim, Seung-Lark; O'Doherty, John P; Rangel, Antonio

2013-05-15

We often have to make choices among multiattribute stimuli (e.g., a food that differs on its taste and health). Behavioral data suggest that choices are made by computing the value of the different attributes and then integrating them into an overall stimulus value signal. However, it is not known whether this theory describes the way the brain computes the stimulus value signals, or how the underlying computations might be implemented. We investigated these questions using a human fMRI task in which individuals had to evaluate T-shirts that varied in their visual esthetic (e.g., color) and semantic (e.g., meaning of logo printed in T-shirt) components. We found that activity in the fusiform gyrus, an area associated with the processing of visual features, correlated with the value of the visual esthetic attributes, but not with the value of the semantic attributes. In contrast, activity in posterior superior temporal gyrus, an area associated with the processing of semantic meaning, exhibited the opposite pattern. Furthermore, both areas exhibited functional connectivity with an area of ventromedial prefrontal cortex that reflects the computation of overall stimulus values at the time of decision. The results provide supporting evidence for the hypothesis that some attribute values are computed in cortical areas specialized in the processing of such features, and that those attribute-specific values are then passed to the vmPFC to be integrated into an overall stimulus value signal to guide the decision.

Dynamic modulation of decision biases by brainstem arousal systems.

PubMed

de Gee, Jan Willem; Colizoli, Olympia; Kloosterman, Niels A; Knapen, Tomas; Nieuwenhuis, Sander; Donner, Tobias H

2017-04-11

Decision-makers often arrive at different choices when faced with repeated presentations of the same evidence. Variability of behavior is commonly attributed to noise in the brain's decision-making machinery. We hypothesized that phasic responses of brainstem arousal systems are a significant source of this variability. We tracked pupil responses (a proxy of phasic arousal) during sensory-motor decisions in humans, across different sensory modalities and task protocols. Large pupil responses generally predicted a reduction in decision bias. Using fMRI, we showed that the pupil-linked bias reduction was (i) accompanied by a modulation of choice-encoding pattern signals in parietal and prefrontal cortex and (ii) predicted by phasic, pupil-linked responses of a number of neuromodulatory brainstem centers involved in the control of cortical arousal state, including the noradrenergic locus coeruleus. We conclude that phasic arousal suppresses decision bias on a trial-by-trial basis, thus accounting for a significant component of the variability of choice behavior.

Dynamic modulation of decision biases by brainstem arousal systems

PubMed Central

de Gee, Jan Willem; Colizoli, Olympia; Kloosterman, Niels A; Knapen, Tomas; Nieuwenhuis, Sander; Donner, Tobias H

2017-01-01

Decision-makers often arrive at different choices when faced with repeated presentations of the same evidence. Variability of behavior is commonly attributed to noise in the brain’s decision-making machinery. We hypothesized that phasic responses of brainstem arousal systems are a significant source of this variability. We tracked pupil responses (a proxy of phasic arousal) during sensory-motor decisions in humans, across different sensory modalities and task protocols. Large pupil responses generally predicted a reduction in decision bias. Using fMRI, we showed that the pupil-linked bias reduction was (i) accompanied by a modulation of choice-encoding pattern signals in parietal and prefrontal cortex and (ii) predicted by phasic, pupil-linked responses of a number of neuromodulatory brainstem centers involved in the control of cortical arousal state, including the noradrenergic locus coeruleus. We conclude that phasic arousal suppresses decision bias on a trial-by-trial basis, thus accounting for a significant component of the variability of choice behavior. DOI: http://dx.doi.org/10.7554/eLife.23232.001 PMID:28383284

Selecting a provider: what factors influence patients' decision making?

PubMed

Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda

2011-01-01

Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation.

Model For Marketing Strategy Decision Based On Multicriteria Decicion Making: A Case Study In Batik Madura Industry

NASA Astrophysics Data System (ADS)

Anna, I. D.; Cahyadi, I.; Yakin, A.

2018-01-01

Selection of marketing strategy is a prominent competitive advantage for small and medium enterprises business development. The selection process is is a multiple criteria decision-making problem, which includes evaluation of various attributes or criteria in a process of strategy formulation. The objective of this paper is to develop a model for the selection of a marketing strategy in Batik Madura industry. The current study proposes an integrated approach based on analytic network process (ANP) and technique for order preference by similarity to ideal solution (TOPSIS) to determine the best strategy for Batik Madura marketing problems. Based on the results of group decision-making technique, this study selected fourteen criteria, including consistency, cost, trend following, customer loyalty, business volume, uniqueness manpower, customer numbers, promotion, branding, bussiness network, outlet location, credibility and the inovation as Batik Madura marketing strategy evaluation criteria. A survey questionnaire developed from literature review was distributed to a sample frame of Batik Madura SMEs in Pamekasan. In the decision procedure step, expert evaluators were asked to establish the decision matrix by comparing the marketing strategy alternatives under each of the individual criteria. Then, considerations obtained from ANP and TOPSIS methods were applied to build the specific criteria constraints and range of the launch strategy in the model. The model in this study demonstrates that, under current business situation, Straight-focus marketing strategy is the best marketing strategy for Batik Madura SMEs in Pamekasan.

A case-based reasoning system based on weighted heterogeneous value distance metric for breast cancer diagnosis.

PubMed

Gu, Dongxiao; Liang, Changyong; Zhao, Huimin

2017-03-01

We present the implementation and application of a case-based reasoning (CBR) system for breast cancer related diagnoses. By retrieving similar cases in a breast cancer decision support system, oncologists can obtain powerful information or knowledge, complementing their own experiential knowledge, in their medical decision making. We observed two problems in applying standard CBR to this context: the abundance of different types of attributes and the difficulty in eliciting appropriate attribute weights from human experts. We therefore used a distance measure named weighted heterogeneous value distance metric, which can better deal with both continuous and discrete attributes simultaneously than the standard Euclidean distance, and a genetic algorithm for learning the attribute weights involved in this distance measure automatically. We evaluated our CBR system in two case studies, related to benign/malignant tumor prediction and secondary cancer prediction, respectively. Weighted heterogeneous value distance metric with genetic algorithm for weight learning outperformed several alternative attribute matching methods and several classification methods by at least 3.4%, reaching 0.938, 0.883, 0.933, and 0.984 in the first case study, and 0.927, 0.842, 0.939, and 0.989 in the second case study, in terms of accuracy, sensitivity×specificity, F measure, and area under the receiver operating characteristic curve, respectively. The evaluation result indicates the potential of CBR in the breast cancer diagnosis domain. Copyright © 2017 Elsevier B.V. All rights reserved.

Patients' Preferences for the Treatment of Metastatic Castrate-resistant Prostate Cancer: A Discrete Choice Experiment.

PubMed

Eliasson, Lina; de Freitas, Hayley M; Dearden, Lindsay; Calimlim, Brian; Lloyd, Andrew J

2017-04-01

Patient treatment preferences are increasingly being used to inform health care decision making. This discrete choice experiment assessed how men perceive the risks and benefits of hypothetical treatment options for metastatic castrate-resistant prostate cancer (mCRPC). Treatment attributes for inclusion were identified through a review of the literature and product labels. Expert interviews confirmed clinical appropriateness and patient relevance of the attributes, which included effectiveness (delay in months before chemotherapy), steroid use, possible drug interactions (additional hospital visits for monitoring), fogginess (effects on cognition and memory), fatigue (extreme tiredness), food restrictions, and bone pain. Following a pilot, the final discrete choice experiment included 18 choice sets presenting treatments for mCRPC and was completed by men with mCRPC in France, Germany, and the United Kingdom. Data were analyzed using a conditional logit model, with odds ratios (ORs) used to indicate preference for attributes, and tradeoff measures (TOM) were estimated using the ratio of coefficients. Within each attribute category and with all other factors being equal, participants (N = 285) indicated a strong preference for treatments that fully control bone pain (OR = 12.069 [95% CI, 10.555-13.800]) and for treatments that delay chemotherapy (OR, 1.727 [95% CI, 1.548-1.927]). They also preferred treatments that were associated with the lowest risk of fogginess (OR, 2.115 [95% CI, 1.849-2.420]), a lower risk of fatigue (OR, 1.365 [95% CI 1.219-1.528]), and fewer additional hospital visits (OR, 1.245 [95% CI 1.111-1.397]) than the respective reference categories. Participants preferred to use steroids under advice from a physician (OR, 1.275 [95% CI 1.132-1.437]). Food restrictions related to taking medication were not a significant concern for participants. TOM results indicated that large tradeoffs in effectiveness, fogginess, and fatigue are required for patients to prefer a treatment with uncontrolled bone pain that is very difficult to live with. Men with mCRPC consider a wide range of factors when making decisions regarding their treatment. They showed a strong preference for treatment associated with better control of bone pain. They also placed value on treatments that could delay the need for chemotherapy, and they preferred to avoid side effects such as cognition and memory loss, and extreme tiredness. TOMs highlighted the importance of symptom control, even compared with potential side effects. An understanding of the degree to which patients value the attributes associated with various treatment options will assist clinicians and health care professionals when making decisions regarding the management of men with mCRPC. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Decision analysis in formulary decision making.

PubMed

Schechter, C B

1993-06-01

Although decision making about what drugs to include in an institutional formulary appears to lend itself readily to quantitative techniques such as decision analysis and cost-benefit analysis, a review of the literature reveals that very little has been published in this area. Several of the published decision analyses use non-standard techniques that are, at best, of unproved validity, and may seriously distort the underlying issues through covert under-counting or double-counting of various drug attributes. Well executed decision analyses have contributed to establishing that drug acquisition costs are not an adequate measure of the total economic impact of formulary decisions and that costs of labour and materials associated with drug administration must be calculated on an institution-specific basis to reflect unique staffing patterns, bulk purchasing practices, and the availability of surplus capacity within the institution which might be mobilised at little marginal cost. Clinical studies of newly introduced drugs frequently fail to answer the questions that weigh most heavily on the structuring of a formal assessment of a proposed formulary acquisition. Studies comparing a full spectrum of therapeutically equivalent drugs are rarely done, and individual studies of particular pairs of drugs can rarely be used together because of differences in methodology or patient populations studied. Gathering of institution-specific economic and clinical data is a daunting, labour-intensive task. In many institutions, incentive and reward structures discourage behaviour that takes the broad institutional perspective that is intrinsic to a good decision analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature.

PubMed

Roman, Tamlyn Eslie; Cleary, Susan; McIntyre, Diane

2017-02-27

The concept of decision space holds appeal as an approach to disaggregating the elements that may influence decision-making in decentralized systems. This narrative review aims to explore the functioning of decision space and the factors that influence decision space. A narrative review of the literature was conducted with searches of online databases and academic journals including PubMed Central, Emerald, Wiley, Science Direct, JSTOR, and Sage. The articles were included in the review based on the criteria that they provided insight into the functioning of decision space either through the explicit application of or reference to decision space, or implicitly through discussion of decision-making related to organizational capacity or accountability mechanisms. The articles included in the review encompass literature related to decentralisation, management and decision space. The majority of the studies utilise qualitative methodologies to assess accountability mechanisms, organisational capacities such as finance, human resources and management, and the extent of decision space. Of the 138 articles retrieved, 76 articles were included in the final review. The literature supports Bossert's conceptualization of decision space as being related to organizational capacities and accountability mechanisms. These functions influence the decision space available within decentralized systems. The exact relationship between decision space and financial and human resource capacities needs to be explored in greater detail to determine the potential influence on system functioning. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Attention and attribute overlap in preferential choice.

PubMed

Bhatia, Sudeep

2017-07-01

Attributes that are common, or overlapping, across alternatives in two-alternative forced preferential choice tasks are often non-diagnostic. In many settings, attending to and evaluating these attributes does not help the decision maker determine which of the available alternatives is the most desirable. For this reason, many existing behavioural theories propose that decision makers ignore common attributes while deliberating. Across six experiments, we find that decision makers do direct their attention selectively and ignore attributes that are not present in or associated with either of the available alternatives. However, they are as likely to attend to common attributes as they are to attend to attributes that are unique to a single alternative. These results suggest the need for novel theories of attention in preferential choice.

Brain activation for lexical decision and reading aloud: two sides of the same coin?

PubMed

Carreiras, Manuel; Mechelli, Andrea; Estévez, Adelina; Price, Cathy J

2007-03-01

This functional magnetic resonance imaging study compared the neuronal implementation of word and pseudoword processing during two commonly used word recognition tasks: lexical decision and reading aloud. In the lexical decision task, participants made a finger-press response to indicate whether a visually presented letter string is a word or a pseudoword (e.g., "paple"). In the reading-aloud task, participants read aloud visually presented words and pseudowords. The same sets of words and pseudowords were used for both tasks. This enabled us to look for the effects of task (lexical decision vs. reading aloud), lexicality (words vs. nonwords), and the interaction of lexicality with task. We found very similar patterns of activation for lexical decision and reading aloud in areas associated with word recognition and lexical retrieval (e.g., left fusiform gyrus, posterior temporal cortex, pars opercularis, and bilateral insulae), but task differences were observed bilaterally in sensorimotor areas. Lexical decision increased activation in areas associated with decision making and finger tapping (bilateral postcentral gyri, supplementary motor area, and right cerebellum), whereas reading aloud increased activation in areas associated with articulation and hearing the sound of the spoken response (bilateral precentral gyri, superior temporal gyri, and posterior cerebellum). The effect of lexicality (pseudoword vs. words) was also remarkably consistent across tasks. Nevertheless, increased activation for pseudowords relative to words was greater in the left precentral cortex for reading than lexical decision, and greater in the right inferior frontal cortex for lexical decision than reading. We attribute these effects to differences in the demands on speech production and decision-making processes, respectively.

Strategic Mobility 21: ICODES Extension Technical Plan

DTIC Science & Technology

2006-09-30

re-planning tasks in a dynamically changing decision- making environment (Figure 2). The internal ontology is divided into logical domains that can...another web browser window opens. This window is divided into two sections. One section displays a graphical representation of the conveyance and its...referenced objects with attributes that can be reasoned about by the TRANSWAY agents. Context is provided by an internal ontology that is divided into

Geographic Profiling: Knowledge Through Prediction

DTIC Science & Technology

2014-06-01

FTO Foreign Terrorist Organization GIS geographic information systems LE lawless elements MADM multi-attribute decision making MILF Moro Islamic...or her life. Anchor points can include the offender’s home , his or her workplace, a home of a friend of the offender, or even a bar or restaurant...more generally for the improvement of police patrols. In Memphis, TN, city officials have seen a decrease in crime with the help of operation Blue

Using ecological production functions to link ecological ...

EPA Pesticide Factsheets

Ecological production functions (EPFs) link ecosystems, stressors, and management actions to ecosystem services (ES) production. Although EPFs are acknowledged as being essential to improve environmental management, their use in ecological risk assessment has received relatively little attention. Ecological production functions may be defined as usable expressions (i.e., models) of the processes by which ecosystems produce ES, often including external influences on those processes. We identify key attributes of EPFs and discuss both actual and idealized examples of their use to inform decision making. Whenever possible, EPFs should estimate final, rather than intermediate, ES. Although various types of EPFs have been developed, we suggest that EPFs are more useful for decision making if they quantify ES outcomes, respond to ecosystem condition, respond to stressor levels or management scenarios, reflect ecological complexity, rely on data with broad coverage, have performed well previously, are practical to use, and are open and transparent. In an example using pesticides, we illustrate how EPFs with these attributes could enable the inclusion of ES in ecological risk assessment. The biggest challenges to ES inclusion are limited data sets that are easily adapted for use in modeling EPFs and generally poor understanding of linkages among ecological components and the processes that ultimately deliver the ES. We conclude by advocating for the incorporation into E

Understanding clinicians’ decisions to offer intravenous thrombolytic treatment to patients with acute ischaemic stroke: a protocol for a discrete choice experiment

PubMed Central

De Brún,, Aoife; Flynn, Darren; Joyce, Kerry; Ternent, Laura; Price, Christopher; Rodgers, Helen; Ford, Gary A; Lancsar, Emily; Rudd, Matthew; Thomson, Richard G

2014-01-01

Background Intravenous thrombolysis is an effective emergency treatment for acute ischaemic stroke for patients meeting specific criteria. Approximately 12% of eligible patients in England, Wales and Northern Ireland received thrombolysis in the first quarter of 2013, yet as many as 15% are eligible to receive treatment. Suboptimal use of thrombolysis may have been largely attributable to structural factors; however, with the widespread implementation of 24/7 hyper acute stroke services, continuing variation is likely to reflect differences in clinical decision-making, in particular the influence of ambiguous areas within the guidelines, licensing criteria and research evidence. Clinicians’ perceptions about thrombolysis may now exert a greater influence on treatment rates than structural/service factors. This research seeks to elucidate factors influencing thrombolysis decision-making by using patient vignettes to identify (1) patient-related and clinician-related factors that may help to explain variation in treatment and (2) associated trade-offs in decision-making based on the interplay of critical factors. Methods/analysis A discrete choice experiment (DCE) will be conducted to better understand how clinicians make decisions about whether or not to offer thrombolysis to patients with acute ischaemic stroke. To inform the design, exploratory work will be undertaken to ensure that (1) all potentially influential factors are considered for inclusion; and (2) to gain insights into the ‘grey areas’ of patient factors. A fractional factorial design will be used to combine levels of patient factors in vignettes, which will be presented to clinicians to allow estimation of the variable effects on decisions to offer thrombolysis. Ethics and dissemination Ethical approval for this study was obtained from the Newcastle University Research Ethics Committee. The results will be disseminated in peer review publications and at national conferences. Findings will be translated into continuing professional development activities and will support implementation of a computerised decision aid for thrombolysis (COMPASS) in acute stroke care. PMID:25009137

Identification of Patient Characteristics Influencing Setting of Care Decisions for Patients With Acute Bacterial Skin and Skin Structure Infections: Results of a Discrete Choice Experiment.

PubMed

Lane, Suzanne; Johnston, Karissa; Sulham, Katherine A; Syed, Iqra; Pollack, Charles V; Holland, Thomas; Nathwani, Dilip

2016-03-01

Rates of acute bacterial skin and skin structure infections (ABSSSI) have sharply increased since 2000. Treatment may be administered in the inpatient or outpatient setting; clinical decision-making regarding hospitalization is inconsistent, often leading to hospitalization of some patients with ABSSSI who qualify for outpatient parenteral antimicrobial therapy, which leads to increased overall care costs. New antibiotics such as oritavancin are hypothesized to be a cost-effective option improving accessibility to ambulatory treatment of ABSSSI. The goal of this study was to understand the patient attributes that affect clinical decision-making regarding the setting of care for ABSSSI treatment. An observational, cross-sectional study was conducted that surveyed clinicians of various specialties from the United States and the United Kingdom. The survey collected quantitative responses and used a series of choice-based experimental designs to evaluate patient attributes influencing clinical treatment decisions. Infection severity, severe comorbidities, and age ≥ 75 years were observed to have the greatest impact on treatment location decisions (odds ratio [OR], 0.000-0.004 [95% CI, 0.000-0.011], vs mild ABSSSI; OR, 0.246-0.484 [95% CI, 0.154-0.788], vs no active comorbidities; OR, 0.136-0.523 [95% CI, 0.070-0.888], vs ≤ 18 years, respectively). The majority of respondents indicated they would consider oritavancin to avoid postdischarge outpatient parenteral antimicrobial therapy or oral therapy, regardless of the pathogen (63.5%-83.5%). Key factors influencing ABSSSI treatment setting were severity of infection, severity of comorbidities, and age. Clinicians surveyed identified patient profiles in which single-dose oritavancin might enable wholly outpatient or shortened inpatient management. Additional studies to elucidate the ABSSSI care pathways that include oritavancin and other novel antibiotics are needed. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

Broader perspective on ecosystem sustainability: consequences for decision making.

PubMed

Sidle, Roy C; Benson, William H; Carriger, John F; Kamai, Toshitaka

2013-06-04

Although the concept of ecosystem sustainability has a long-term focus, it is often viewed from a static system perspective. Because most ecosystems are dynamic, we explore sustainability assessments from three additional perspectives: resilient systems; systems where tipping points occur; and systems subject to episodic resetting. Whereas foundations of ecosystem resilience originated in ecology, recent discussions have focused on geophysical attributes, and it is recognized that dynamic system components may not return to their former state following perturbations. Tipping points emerge when chronic changes (typically anthropogenic, but sometimes natural) push ecosystems to thresholds that cause collapse of process and function and may become permanent. Ecosystem resetting occurs when episodic natural disasters breach thresholds with little or no warning, resulting in long-term changes to environmental attributes or ecosystem function. An example of sustainability assessment of ecosystem goods and services along the Gulf Coast (USA) demonstrates the need to include both the resilient and dynamic nature of biogeomorphic components. Mountain road development in northwest Yunnan, China, makes rivers and related habitat vulnerable to tipping points. Ecosystems reset by natural disasters are also presented, emphasizing the need to understand the magnitude frequency and interrelationships among major disturbances, as shown by (i) the 2011 Great East Japan Earthquake and resulting tsunami, including how unsustainable urban development exacerbates geodisaster propagation, and (ii) repeated major earthquakes and associated geomorphic and vegetation disturbances in Papua New Guinea. Although all of these ecosystem perturbations and shifts are individually recognized, they are not embraced in contemporary sustainable decision making.

Broader perspective on ecosystem sustainability: Consequences for decision making

PubMed Central

Sidle, Roy C.; Benson, William H.; Carriger, John F.; Kamai, Toshitaka

2013-01-01

Although the concept of ecosystem sustainability has a long-term focus, it is often viewed from a static system perspective. Because most ecosystems are dynamic, we explore sustainability assessments from three additional perspectives: resilient systems; systems where tipping points occur; and systems subject to episodic resetting. Whereas foundations of ecosystem resilience originated in ecology, recent discussions have focused on geophysical attributes, and it is recognized that dynamic system components may not return to their former state following perturbations. Tipping points emerge when chronic changes (typically anthropogenic, but sometimes natural) push ecosystems to thresholds that cause collapse of process and function and may become permanent. Ecosystem resetting occurs when episodic natural disasters breach thresholds with little or no warning, resulting in long-term changes to environmental attributes or ecosystem function. An example of sustainability assessment of ecosystem goods and services along the Gulf Coast (USA) demonstrates the need to include both the resilient and dynamic nature of biogeomorphic components. Mountain road development in northwest Yunnan, China, makes rivers and related habitat vulnerable to tipping points. Ecosystems reset by natural disasters are also presented, emphasizing the need to understand the magnitude frequency and interrelationships among major disturbances, as shown by (i) the 2011 Great East Japan Earthquake and resulting tsunami, including how unsustainable urban development exacerbates geodisaster propagation, and (ii) repeated major earthquakes and associated geomorphic and vegetation disturbances in Papua New Guinea. Although all of these ecosystem perturbations and shifts are individually recognized, they are not embraced in contemporary sustainable decision making. PMID:23686583

Positives and pathologies of natural resource management on private land-conservation areas.

PubMed

Clements, Hayley S; Cumming, Graeme S

2017-06-01

In managed natural resource systems, such as fisheries and rangelands, there is a recognized trade-off between managing for short-term benefits and managing for longer term resilience. Management actions that stabilize ecological attributes or processes can improve productivity in the supply of ecosystem goods and services in the short term but erode system resilience at longer time scales. For example, fire suppression in rangelands can increase grass biomass initially but ultimately result in an undesirable, shrub-dominated system. Analyses of this phenomenon have focused largely on how management actions influence slow-changing biophysical system attributes (such as vegetation composition). Data on the frequency of management actions that reduce natural ecological variation on 66 private land-conservation areas (PLCAs) in South Africa were used to investigate how management actions are influenced by manager decision-making approaches, a largely ignored part of the problem. The pathology of natural resource management was evident on some PLCAs: increased focus on revenue-generation in decision making resulted in an increased frequency of actions to stabilize short-term variation in large mammal populations, which led to increased revenues from ecotourism or hunting. On many PLCAs, these management actions corresponded with a reduced focus on ecological monitoring and an increase in overstocking of game (i.e., ungulate species) and stocking of extralimitals (i.e., game species outside their historical range). Positives in natural resource management also existed. Some managers monitored slower changing ecological attributes, which resulted in less-intensive management, fewer extralimital species, and lower stocking rates. Our unique, empirical investigation of monitoring-management relationships illustrates that management decisions informed by revenue monitoring versus ecological monitoring can have opposing consequences for natural resource productivity and sustainability. Promoting management actions that maintain resilience in natural resource systems therefore requires cognizance of why managers act the way they do and how these actions can gradually shift managers toward unsustainable strategies. © 2016 Society for Conservation Biology.

Integrated Decision-Making Tool to Develop Spent Fuel Strategies for Research Reactors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beatty, Randy L; Harrison, Thomas J

IAEA Member States operating or having previously operated a Research Reactor are responsible for the safe and sustainable management and disposal of associated radioactive waste, including research reactor spent nuclear fuel (RRSNF). This includes the safe disposal of RRSNF or the corresponding equivalent waste returned after spent fuel reprocessing. One key challenge to developing general recommendations lies in the diversity of spent fuel types, locations and national/regional circumstances rather than mass or volume alone. This is especially true given that RRSNF inventories are relatively small, and research reactors are rarely operated at a high power level or duration typical ofmore » commercial power plants. Presently, many countries lack an effective long-term policy for managing RRSNF. This paper presents results of the International Atomic Energy Agency (IAEA) Coordinated Research Project (CRP) #T33001 on Options and Technologies for Managing the Back End of the Research Reactor Nuclear Fuel Cycle which includes an Integrated Decision Making Tool called BRIDE (Back-end Research reactor Integrated Decision Evaluation). This is a multi-attribute decision-making tool that combines the Total Estimated Cost of each life-cycle scenario with Non-economic factors such as public acceptance, technical maturity etc and ranks optional back-end scenarios specific to member states situations in order to develop a specific member state strategic plan with a preferred or recommended option for managing spent fuel from Research Reactors.« less

What we talk about when we talk about depression: doctor-patient conversations and treatment decision outcomes

PubMed Central

Karasz, Alison; Dowrick, Christopher; Byng, Richard; Buszewicz, Marta; Ferri, Lucia; Hartman, Tim C Olde; van Dulmen, Sandra; van Weel-Baumgarten, Evelyn; Reeve, Joanne

2011-01-01

Background Efforts to address depression in primary care settings have focused on the introduction of care guidelines emphasising pharmacological treatment. To date, physician adherence remains low. Little is known of the types of information exchange or other negotiations in doctor-patient consultations about depression that influence physician decision making about treatment. Aim The study sought to understand conversational influences on physician decision making about treatment for depression. Design A secondary analysis of consultation data collected in other studies. Using a maximum variation sampling strategy, 30 transcripts of primary care consultations about distress or depression were selected from datasets collected in three countries. Transcripts were analysed to discover factors associated with prescription of medication. Method The study employed two qualitative analysis strategies: a micro-analysis approach, which examines how conversation partners shape the dialogue towards pragmatic goals; and a narrative analysis approach of the problem presentation. Results Patients communicated their conceptual representations of distress at the outset of each consultation. Concepts of depression were communicated through the narrative form of the problem presentation. Three types of narratives were identified: those emphasising symptoms, those emphasising life situations, and mixed narratives. Physician decision making regarding medication treatment was strongly associated with the form of the patient’s narrative. Physicians made few efforts to persuade patients to accept biomedical attributions or treatments. Conclusion Results of the study provide insight into why adherence to depression guidelines remains low. Data indicate that patient agendas drive the ‘action’ in consultations about depression. Physicians appear to be guided by common-sense decision-making algorithms emphasising patients’ views and preferences. PMID:22520683

How decisions emerge: action dynamics in intertemporal decision making.

PubMed

Dshemuchadse, Maja; Scherbaum, Stefan; Goschke, Thomas

2013-02-01

In intertemporal decision making, individuals prefer smaller rewards delivered sooner over larger rewards delivered later, often to an extent that seems irrational from an economical perspective. This behavior has been attributed to a lack of self-control and reflection, the nonlinearity of human time perception, and several other sources. Although an increasing number of models propose different mathematical descriptions of temporal discounting, the dynamics of the decision process behind temporal discounting are much less clear. In this study, we obtained further insights into the mechanisms of intertemporal decisions by observing choice action dynamics via a novel combination of continuously recorded mouse movements and a multiple regression approach. Participants had to choose between two hypothetical options (sooner/smaller vs. later/larger) by moving the mouse cursor from the bottom of the screen either to the top left or to the top right. We observed less direct mouse movements when participants chose later/larger rewards, indicating that participants had to overcome the attraction of the sooner/smaller reward first. Additionally, our results suggest that framing time information differently changes the weighting of value. We conclude that using a continuous process-oriented approach could further advance the understanding of intertemporal choice beyond the identification of the best fitted mathematical description of the discounting function by uncovering the way intertemporal decisions are performed. 2013 APA, all rights reserved