Forrest, Jane L.; Miller, Syrene A.
Evidence-based decision making (EBDM) was incorporated into an institute for 42 dental hygiene, occupational therapy, and physical therapy faculty. The 4-day sessions addressed active teaching techniques, formulation of good questions, critical appraisal of evidence, and application, feedback, and evaluation. Most participants felt prepared to…
Narra, Lekha; Sahama, Tony; Stapleton, Peta
Large volumes of heterogeneous health data silos pose a big challenge when exploring for information to allow for evidence based decision making and ensuring quality outcomes. In this paper, we present a proof of concept for adopting data warehousing technology to aggregate and analyse disparate health data in order to understand the impact various lifestyle factors on obesity. We present a practical model for data warehousing with detailed explanation which can be adopted similarly for studying various other health issues.
Nüssler, Emil Karl; Eskildsen, Jacob Kjær; Håkonsson, Dorthe Døjbak
Surgeons who perform prolapse surgeries face the dilemma of choosing to use mesh, with its assumed benefits, and the risks associated with mesh. In this paper, we examine whether decisions to use mesh is evidence based. Based on data of 30,398 patients from the Swedish National Quality Register...... of Gynecological Surgery we examine factors related to decisions to use mesh. Our results indicate that decisions to use mesh are not evidence based, and cannot be explained neither by FDA safety communications, nor by medical conditions usually assumed to predict its usage. Instead, decisions to use mesh...... are highly influenced by the geographical placement of surgeons. Therfore, decisions to use mesh are boundedly rationality, rather than rational....
hen evaluating patients and making treatment decisions, physicians do not always have all the information necessary and may have to make judgments using limited information. This judgment is often intuitive in nature. The processes by which these judgments are made is of great theoretical and practical interest. In the 1960s, Amos Tversky and Daniel Kahnemann revolutionized the concept of human judgment. They introduced the notion that when individuals make judgments under uncertainty they use a limited number of cognitive processes. These processes are efficient and generally accurate, but can sometimes lead to errors or biases. In this review we discuss the nature of these processes and their potential effects on decision making.
Full Text Available Every day health professionals have to make dozens of decisions regarding patient care and management. It is not easy to integrate scientific evidence in this process. The primary ability we need in order to achieve successful results is learning how to recognize the circumstances in which evidence arising from results of scientific trials may help.
Spencer, Trina D.; Detrich, Ronnie; Slocum, Timothy A.
The research to practice gap in education has been a long-standing concern. The enactment of No Child Left Behind brought increased emphasis on the value of using scientifically based instructional practices to improve educational outcomes. It also brought education into the broader evidence-based practice movement that started in medicine and has…
Background Current healthcare systems have extended the evidence-based medicine (EBM) approach to health policy and delivery decisions, such as access-to-care, healthcare funding and health program continuance, through attempts to integrate valid and reliable evidence into the decision making process. These policy decisions have major impacts on society and have high personal and financial costs associated with those decisions. Decision models such as these function under a shared assumption of rational choice and utility maximization in the decision-making process. Discussion We contend that health policy decision makers are generally unable to attain the basic goals of evidence-based decision making (EBDM) and evidence-based policy making (EBPM) because humans make decisions with their naturally limited, faulty, and biased decision-making processes. A cognitive information processing framework is presented to support this argument, and subtle cognitive processing mechanisms are introduced to support the focal thesis: health policy makers' decisions are influenced by the subjective manner in which they individually process decision-relevant information rather than on the objective merits of the evidence alone. As such, subsequent health policy decisions do not necessarily achieve the goals of evidence-based policy making, such as maximizing health outcomes for society based on valid and reliable research evidence. Summary In this era of increasing adoption of evidence-based healthcare models, the rational choice, utility maximizing assumptions in EBDM and EBPM, must be critically evaluated to ensure effective and high-quality health policy decisions. The cognitive information processing framework presented here will aid health policy decision makers by identifying how their decisions might be subtly influenced by non-rational factors. In this paper, we identify some of the biases and potential intervention points and provide some initial suggestions about how the
Friesen-Storms, J.H.; Bours, G.J.; Weijden, T.T. van der; Beurskens, A.J.
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
GJ Bours; T van der Weijden; JH Friesen-Storms; AJ Beurskens
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
Wentworth, Laura; Mazzeo, Christopher; Connolly, Faith
Background: In the United States, an emphasis on evidence-based decision-making in education has received renewed interest with the recent passage of the Every Student Succeeds Act. However, how best, in practice, to support the use of evidence in educational decision-making remains unclear. Research Practice Partnerships (RPPs) are a popular…
Friesen-Storms, Jolanda H H M; Bours, Gerrie J J W; van der Weijden, Trudy; Beurskens, Anna J H M
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
Dupont, E. Muhlrad, N. Buttler, I. Gitelman, V. Giustiniani, G. Jähi, H. Machata, K. Martensen, H. Papadimitriou, E. Persia, L. Talbot, R. Vallet, G. Wijnen, W. & Yannis, G.
The objective of this research is the assessment of current needs for evidence-based road safety decision making in Europe, through the consultation of a panel of road safety experts. The members of this Experts Panel have extensive knowledge of road safety management processes and needs in their
Ann S. O’Malley MD, MPH
Full Text Available Introduction: Physicians vary widely in how they treat some health conditions, despite strong evidence favoring certain treatments over others. We examined physicians’ perspectives on factors that support or hinder evidence-based decisions and the implications for delivery systems, payers, and policymakers. Methods: We used Choosing Wisely ® recommendations to create four clinical vignettes for common types of decisions. We conducted semi-structured interviews with 36 specialists to identify factors that support or hinder evidence-based decisions. We examined these factors using a conceptual framework that includes six levels: patients, physicians, practice sites, organizations, networks and hospital affiliations, and the local market. In this model, population characteristics and payer and regulatory factors interact to influence decisions. Results: Patient openness to behavior modification and expectations, facilitated and hindered physicians in making evidence-based recommendations. Physicians’ communication skills were the most commonly mentioned facilitator. Practice site, organization, and hospital system barriers included measures of emergency department throughput, the order in which test options are listed in electronic health records (EHR, lack of relevant decision support in EHRs, and payment incentives that maximize billing and encourage procedures rather than medical management or counseling patients on behavior change. Factors from different levels interacted to undermine evidence-based care. Most physicians received billing feedback, but quality metrics on evidence-based service use were nonexistent for the four decisions in this study. Conclusions and Implications: Additional research and quality improvement may help to modify delivery systems to overcome barriers at multiple levels. Enhancing provider communication skills, improving decision support in EHRs, modifying workflows, and refining the design and interpretation of
Chowdhury, Tanvir Turin; Hemmelgarn, Brenda
Health-care systems require reliable information on which to base health-care planning and make decisions, as well as to evaluate their policy impact. Administrative data provide important information about health services use, expenditures, clinical outcomes, and may be used to assess quality of care. With increased digitalization and accessibility of administrative databases, these data are more readily available for health service research purposes, aiding evidence-based decision-making. This chapter discusses the utility of administrative data for population-based studies of health and health care.
Boisvert, Isabelle; Clemesha, Jennifer; Lundmark, Erik; Crome, Erica; Barr, Caitlin; McMahon, Catherine M
Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of information audiologists use when discussing rehabilitation choices with clients, and discuss the findings within the context of evidence-based practice and patient-centered care. To assess the changes that may have occurred over time, this study uses a questionnaire based on one of the few studies of decision-making behavior in audiologists, published in 1989. The present questionnaire was completed by 96 audiologists who attended the World Congress of Audiology in 2014. The responses were analyzed using qualitative and quantitative approaches. Results suggest that audiologists rank clinical test results and client preferences as the most important factors for decision-making. Discussion with colleagues or experts was also frequently reported as an important source influencing decision-making. Approximately 20% of audiologists mentioned utilizing research evidence to inform decision-making when no clear solution was available. Information shared at conferences was ranked low in terms of importance and reliability. This study highlights an increase in awareness of concepts associated with evidence-based practice and patient-centered care within audiology settings, consistent with current research-to-practice dissemination pathways. It also highlights that these pathways may not be sufficient for an effective clinical implementation of these practices.
Guo, Ruiling; Berkshire, Steven D; Fulton, Lawrence V; Hermanson, Patrick M
Purpose The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics. Design/methodology/approach A cross-sectional study was conducted among US healthcare leaders. Spearman's correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0. Findings One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders' values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous "use of EBMgt" response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman's correlation indicated statistically significant relationships between healthcare leaders' use of EBMgt and healthcare organization bed size ( rs = 0.217, n = 152, p making.
Nevin-Woods, Christine; Proud, Sylvia; Brownson, Ross C.
Background Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Community Context Administrative leaders at the Pueblo City–County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. Methods A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Outcome Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Interpretation Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments. PMID:26111156
Hardy, Anna K; Nevin-Woods, Christine; Proud, Sylvia; Brownson, Ross C
Evidence-based decision making (EBDM) is an effective strategy for addressing population health needs. Assessing and reducing barriers to using EBDM in local health departments may improve practice and provide insight into disseminating EBDM principles among public health practitioners. Administrative leaders at the Pueblo City-County Health Department, Pueblo, Colorado, used a systematic approach for implementing EBDM. Research partners engaged staff to understand factors that increase or deter its use. A survey was distributed to staff members at baseline to identify gaps in administrative and individual practice of EBDM. In-depth interviews were also conducted with 11 randomly selected staff members. Results were shared with staff and administration, after which activities were implemented to improve application of EBDM. A follow up survey was administered 1 year after the initial assessment. Survey data showed evidence of progress in engaging and educating staff members, and data showed improved attitudes toward EBDM (ie, several items showed significant improvement from baseline to follow-up). For example, staff members reported having the necessary skills to develop evidence-based interventions (73.9%), the ability to effectively communicate information on evidence-based strategies to policy makers (63.0%), access to current information on improving EBDM processes (65.2%), and a belief that evidence-based interventions are designed to be self-sustaining (43.5%). Within a local health department in which leaders have made EBDM a priority, addressing the culture and climate of the department may build EBDM. Future research may provide insight into tailoring EBDM within and across local health departments.
Jacobs Julie A
Full Text Available Abstract Background While increasing attention is placed on using evidence-based decision making (EBDM to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. Methods Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. Results In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. Conclusions The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence-based
Jacobs, Julie A; Clayton, Paula F; Dove, Cassandra; Funchess, Tanya; Jones, Ellen; Perveen, Ghazala; Skidmore, Brandon; Sutton, Victor; Worthington, Sarah; Baker, Elizabeth A; Deshpande, Anjali D; Brownson, Ross C
While increasing attention is placed on using evidence-based decision making (EBDM) to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA) to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability) in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence-based. The survey can serve as a valuable tool for other health
Field, Robert I; Caplan, Arthur L
Evidence-based decision making (EBDM) is a tool to assess the value of medical interventions by weighing costs and health outcomes that has increasingly been applied to vaccines. However, many of the ethical considerations that support EBDM when used to evaluate therapeutic care do not readily translate to prevention. This mismatch can result in policy decisions that produce unanticipated negative consequences, including public resistance. In its emphasis on quantifiable outcomes, EBDM invokes the ethical principle of rule-utilitarianism, which values the optimal long-run balance of benefit over harm. Vaccines raise a number of competing ethical concerns in ways that individual medical treatments do not. They rely on widespread compliance for effectiveness, which can limit individual autonomy, emphasize population over individual effects, which can obscure the imperative of beneficence to help the vulnerable, require a just allocation process within populations, and sometimes challenge strong social norms. For EBDM to effectively guide vaccine policy makers, such as the Advisory Committee on Immunization Practices (ACIP) in the United States, an ethical foundation is needed that systematically considers all relevant values and transparently places vaccination recommendations in the context of social norms and individual concerns. Copyright © 2011 Elsevier Ltd. All rights reserved.
Afzal, Muhammad; Hussain, Maqbool; Haynes, Robert Brian; Lee, Sungyoung
Processing huge repository of medical literature for extracting relevant and high-quality evidences demands efficient evidence support methods. We aim at developing methods to automate the process of finding quality evidences from a plethora of literature documents and grade them according to the context (local condition). We propose a two-level methodology for quality recognition and grading of evidences. First, quality is recognized using quality recognition model; second, context-aware grading of evidences is accomplished. Using 10-fold cross-validation, the proposed quality recognition model achieved an accuracy of 92.14 percent and improved the baseline system accuracy by about 24 percent. The proposed context-aware grading method graded 808 out of 1354 test evidences as highly beneficial for treatment purpose. This infers that around 60 percent evidences shall be given more importance as compared to the other 40 percent evidences. The inclusion of context in recommendation of evidence makes the process of evidence-based decision-making "situation-aware."
process were added with the intent of clarifying the tool’s purpose. Information about the risks and benefits according to risk levels was added to the Decision Boxes, to try to ease the adaptation of the information to individual patients. Conclusion Results will guide the development of the eight remaining Decision Boxes. A future study will evaluate the effect of Decision Boxes on the integration of evidence-based and shared decision making principles in clinical practice.
This article adds to the growing body of literature on the use of evidence-based practice (EBP) in social work. Specifically, it examines a 9-hour EBP educational model designed to prepare MSW students for appropriate decision-making strategies in working with multicultural client populations. The model places emphasis on identification and…
Boisvert, Isabelle; Clemesha, Jennifer; Lundmark, Erik; Crome, Erica; Barr, Caitlin; McMahon, Catherine M.
Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of ...
Dolan, James G
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).
Huff, Brian Lee
Foster youth in the K-12 setting consistently perform below most student subgroups due to high rates of school transfer and psychological problems from abuse or neglect. They were largely invisible to K–12 practitioners until 2013, when California became the first state to legislate the tracking of foster student performance. Although educators are accustomed to evidence-based decision-making practices as required under federal law, foster youth present a unique set of challenges - high mobi...
Behrouz soltany; Abol Hassan afkar; Seyedeh Hoda Mousavi; Tahereh Khazaei; Somaieh Roohani_Majd; Mohsen Nouri; Mohsen Mohammadi; Nasim Hatefi Moadab
Introduction:Now a day, Increasing growth of information and increase in complexity of jobs has lead to an increasing importance of educating employees. Toffler believes that education is the most important action and way to face great changes in future life and accepting changes.present study aims to study the effect of evidence based decision making workshop on healthcare managers by means of Krick-Patrick model. Methods and Material:present study was executed among 60 of health...
Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.
Lovelace, Kay A; Aronson, Robert E; Rulison, Kelly L; Labban, Jeffrey D; Shah, Gulzar H; Smith, Mark
We examined variation in the use of evidence-based decision-making (EBDM) practices across local health departments (LHDs) in the United States and the extent to which this variation was predicted by resources, personnel, and governance. We analyzed data from the National Association of County and City Health Officials Profile of Local Health Departments, the Association of State and Territorial Health Officials State Health Departments Profile, and the US Census using 2-level multilevel regression models. We found more workforce predictors than resource predictors. Thus, although resources are related to LHDs' use of EBDM practices, the way resources are used (e.g., the types and qualifications of personnel hired) may be more important.
Cvitanovic, C; McDonald, J; Hobday, A J
Effective conservation requires knowledge exchange among scientists and decision-makers to enable learning and support evidence-based decision-making. Efforts to improve knowledge exchange have been hindered by a paucity of empirically-grounded guidance to help scientists and practitioners design and implement research programs that actively facilitate knowledge exchange. To address this, we evaluated the Ningaloo Research Program (NRP), which was designed to generate new scientific knowledge to support evidence-based decisions about the management of the Ningaloo Marine Park in north-western Australia. Specifically, we evaluated (1) outcomes of the NRP, including the extent to which new knowledge informed management decisions; (2) the barriers that prevented knowledge exchange among scientists and managers; (3) the key requirements for improving knowledge exchange processes in the future; and (4) the core capacities that are required to support knowledge exchange processes. While the NRP generated expansive and multidisciplinary science outputs directly relevant to the management of the Ningaloo Marine Park, decision-makers are largely unaware of this knowledge and little has been integrated into decision-making processes. A range of barriers prevented efficient and effective knowledge exchange among scientists and decision-makers including cultural differences among the groups, institutional barriers within decision-making agencies, scientific outputs that were not translated for decision-makers and poor alignment between research design and actual knowledge needs. We identify a set of principles to be implemented routinely as part of any applied research program, including; (i) stakeholder mapping prior to the commencement of research programs to identify all stakeholders, (ii) research questions to be co-developed with stakeholders, (iii) implementation of participatory research approaches, (iv) use of a knowledge broker, and (v) tailored knowledge management
Full Text Available In the nursing profession, EBP makes a positive contribution to healthcare outcomes, care delivery, clinical teaching and research. The research objective was to determine the nurses' knowledge, attitude, practice towards EBP and barriers to use EBP in four (4 Government Hospitals in Malaysia, Hospital Universiti Sains Malaysia (HUSM, Hospital Pulau Pinang (HPP, Hospital Sultan Abdul Halim (HSAH and Hospital Seberang Jaya (HSJ. A cross-sectional study was conducted from January until December 2012 among (n=600 nurses working in all disciplines, on shift or day time duties in four selected hospitals. The questionnaire was adapted from a Singapore study (Majid, 2011. Results showed that among the nurses working in 4 different Malaysian hospitals, close to fifty percent (53 % knew what the evidence based practice meant. The items assessing the attitude showed a large number nurses responding that they did neither agree nor disagree with statements provided. The majority of the remaining nurses tended to show a rather positive attitude except when asked about how the workload interfered with their EBP practice. The practice level of EBP scored a mean of more than 3 out of maximal five for most items. Most nurses recognized there were many barriers to EBP in their working place. In conclusion, this study may have helped to increase our understanding of knowledge, attitudes, practice and barriers towards to use of EBP to the utilization of research by nurses through an exploration of perceived barriers and facilitators on the part of nurses.
Mohsen, Mona O.; Malki, Ahmed M.; Abdel-Aziz, Hassan
Evidence-Based Medicine is a relatively new term used in medical sittings and Health Information Technology (HIT). It is a form of medicine that integrates practitioners’ expertise with the best available practical evidences to improve better patient care. Evidence-Based Medicine has increasingly been used and incorporated into daily medical practices to overcome the shortcomings in the conventional standard care. The purpose of this literature review is to highlight the importance of Evidenc...
Full Text Available Patricia J Manns, Johanna DarrahDepartment of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, CanadaBackground and purpose: Scenarios are used as the basis from which to evaluate the use of the components of evidence-based practice in decision making, yet there are few examples of a standardized process of scenario writing. The aim of this paper is to describe a step-by-step scenario writing method used in the context of the authors’ curriculum research study.Methods: Scenario writing teams included one physical therapy clinician and one academic staff member. There were four steps in the scenario development process: (1 identify prevalent condition and brainstorm interventions; (2 literature search; (3 develop scenario framework; and (4 write scenario.Results: Scenarios focused only on interventions, not diagnostic or prognostic problems. The process led to two types of scenarios – ones that provided an intervention with strong research evidence and others where the intervention had weak evidence to support its use. The end product of the process was a scenario that incorporates aspects of evidence-based decision making and can be used as the basis for evaluation.Conclusion: The use of scenarios has been very helpful to capture therapists’ reasoning processes. The scenario development process was applied in an education context as part of a final evaluation of graduating clinical physical therapy students.Keywords: physical therapists, clinical decision making, evaluation, curriculum
Kimman, Tjeerd G; Boot, Hein J; Berbers, Guy A M; Vermeer-de Bondt, Patricia E; Ardine de Wit, G; de Melker, Hester E
Among all public health provisions national immunization programs (NIPs) are beyond doubt one of the most effective in reducing mortality, morbidity, and costs associated with major infectious diseases. To maintain their success, NIPs have to modernize in response to many new and old demands regarding efficacy, safety, availability of new vaccines, emerging and evolving pathogens, waning immunity, altered epidemiological situations, and the public's trust in the program. In this paper we present an evaluation model in the form of a checklist that may help in collecting relevant scientific information that is necessary for evaluation and decision making when considering changes in a NIP. Such a checklist points to relevant information on the vaccine-preventable disease, the pathogen causing it, the vaccine, and the cost-effectiveness ratio of the vaccine. However, the final judgment on a potential change in the NIP cannot be based on a simple algorithm, as the relevant information reflects factors of a very different kind and magnitude, to which different value judgements may be added, and which may have certain degrees of uncertainty. Because any change in the NIP may be accompanied by more or less unforeseen changes in the vaccine's efficacy, evolutionary consequences, including the antigenic composition of the pathogen, and the vaccine's safety profile, an intensive surveillance program should accompany any NIP. Elements thereof include clinical-epidemiological surveillance, surveillance of vaccination coverage, immune surveillance, surveillance of microbial population dynamics, and surveillance of adverse events and safety issues. We emphasize that the decision to introduce a vaccine in the NIP should be taken as seriously, both scientifically and ethically, as the decision to withhold a vaccine from the NIP. In the latter case one might be responsible for vaccine-preventable disease and mortality.
Wilczynski, Susan M.
Evidence-based practice (EBP) represents an important approach to educating and treating individuals diagnosed with disabilities or disorders. Understanding research findings is the cornerstone of EBP. The methodology of systematic reviews, which involves carefully analyzing research findings, can result a practice guideline that recommends…
Cooke, Steven J; Birnie-Gauvin, Kim; Lennox, Robert J; Taylor, Jessica J; Rytwinski, Trina; Rummer, Jodie L; Franklin, Craig E; Bennett, Joseph R; Haddaway, Neal R
Policy development and management decisions should be based upon the best available evidence. In recent years, approaches to evidence synthesis, originating in the medical realm (such as systematic reviews), have been applied to conservation to promote evidence-based conservation and environmental management. Systematic reviews involve a critical appraisal of evidence, but studies that lack the necessary rigour (e.g. experimental, technical and analytical aspects) to justify their conclusions are typically excluded from systematic reviews or down-weighted in terms of their influence. One of the strengths of conservation physiology is the reliance on experimental approaches that help to more clearly establish cause-and-effect relationships. Indeed, experimental biology and ecology have much to offer in terms of building the evidence base that is needed to inform policy and management options related to pressing issues such as enacting endangered species recovery plans or evaluating the effectiveness of conservation interventions. Here, we identify a number of pitfalls that can prevent experimental findings from being relevant to conservation or would lead to their exclusion or down-weighting during critical appraisal in a systematic review. We conclude that conservation physiology is well positioned to support evidence-based conservation, provided that experimental designs are robust and that conservation physiologists understand the nuances associated with informing decision-making processes so that they can be more relevant.
Birnie-Gauvin, Kim; Lennox, Robert J.; Taylor, Jessica J.; Rytwinski, Trina; Rummer, Jodie L.; Franklin, Craig E.; Bennett, Joseph R.; Haddaway, Neal R.
Abstract Policy development and management decisions should be based upon the best available evidence. In recent years, approaches to evidence synthesis, originating in the medical realm (such as systematic reviews), have been applied to conservation to promote evidence-based conservation and environmental management. Systematic reviews involve a critical appraisal of evidence, but studies that lack the necessary rigour (e.g. experimental, technical and analytical aspects) to justify their conclusions are typically excluded from systematic reviews or down-weighted in terms of their influence. One of the strengths of conservation physiology is the reliance on experimental approaches that help to more clearly establish cause-and-effect relationships. Indeed, experimental biology and ecology have much to offer in terms of building the evidence base that is needed to inform policy and management options related to pressing issues such as enacting endangered species recovery plans or evaluating the effectiveness of conservation interventions. Here, we identify a number of pitfalls that can prevent experimental findings from being relevant to conservation or would lead to their exclusion or down-weighting during critical appraisal in a systematic review. We conclude that conservation physiology is well positioned to support evidence-based conservation, provided that experimental designs are robust and that conservation physiologists understand the nuances associated with informing decision-making processes so that they can be more relevant. PMID:28835842
Lee, Anna; Joynt, Gavin M; Ho, Anthony M H; Keitz, Sheri; McGinn, Thomas; Wyer, Peter C
Decision analysis is a tool that clinicians can use to choose an option that maximizes the overall net benefit to a patient. It is an explicit, quantitative, and systematic approach to decision making under conditions of uncertainty. In this article, we present two teaching tips aimed at helping clinical learners understand the use and relevance of decision analysis. The first tip demonstrates the structure of a decision tree. With this tree, a clinician may identify the optimal choice among complicated options by calculating probabilities of events and incorporating patient valuations of possible outcomes. The second tip demonstrates how to address uncertainty regarding the estimates used in a decision tree. We field tested the tips twice with interns and senior residents. Teacher preparatory time was approximately 90 minutes. The field test utilized a board and a calculator. Two handouts were prepared. Learners identified the importance of incorporating values into the decision-making process as well as the role of uncertainty. The educational objectives appeared to be reached. These teaching tips introduce clinical learners to decision analysis in a fashion aimed to illustrate principles of clinical reasoning and how patient values can be actively incorporated into complex decision making.
Full Text Available At hazardous waste sites, volatile chemicals can migrate through groundwater and soil into buildings, a process known as vapor intrusion. Due to increasing recognition of vapor intrusion as a potential indoor air pollution source, in 2015 the U.S. Environmental Protection Agency (EPA released a new vapor intrusion guidance document. The guidance specifies two conditions for demonstrating that remediation is needed: (1 proof of a vapor intrusion pathway; and (2 evidence that human health risks exceed established thresholds (for example, one excess cancer among 10,000 exposed people. However, the guidance lacks details on methods for demonstrating these conditions. We review current evidence suggesting that monitoring and modeling approaches commonly employed at vapor intrusion sites do not adequately characterize long-term exposure and in many cases may underestimate risks. On the basis of this evidence, we recommend specific approaches to monitoring and modeling to account for these uncertainties. We propose a value of information approach to integrate the lines of evidence at a site and determine if more information is needed before deciding whether the two conditions specified in the vapor intrusion guidance are satisfied. To facilitate data collection and decision-making, we recommend a multi-directional community engagement strategy and consideration of environment justice concerns.
Full Text Available EQUIPT brings together expertise from multiple disciplines and aims to provide policy makers and wider stakeholders with bespoke information about the economic and wider returns that investing in evidence-based tobacco control including smoking cessation agendas can generate. Led by Health Economics Research Group (HERG at Brunel University, London, EQUIPT is a partnership of 11 consortium members from 7 member states – Belgium, Croatia, Germany, Hungary, the Netherlands, Spain and the UK.
Manns, Patricia J; Darrah, Johanna
Scenarios are used as the basis from which to evaluate the use of the components of evidence-based practice in decision making, yet there are few examples of a standardized process of scenario writing. The aim of this paper is to describe a step-by-step scenario writing method used in the context of the authors' curriculum research study. Scenario writing teams included one physical therapy clinician and one academic staff member. There were four steps in the scenario development process: (1) identify prevalent condition and brainstorm interventions; (2) literature search; (3) develop scenario framework; and (4) write scenario. Scenarios focused only on interventions, not diagnostic or prognostic problems. The process led to two types of scenarios - ones that provided an intervention with strong research evidence and others where the intervention had weak evidence to support its use. The end product of the process was a scenario that incorporates aspects of evidence-based decision making and can be used as the basis for evaluation. The use of scenarios has been very helpful to capture therapists' reasoning processes. The scenario development process was applied in an education context as part of a final evaluation of graduating clinical physical therapy students.
Bayer, Ronald; Johns, David Merritt; Galea, Sandro
For more than four decades, starting in the late 1960s, a sometimes furious battle has raged among scientists over the extent to which elevated salt consumption has adverse implications for population health and contributes to deaths from stroke and cardiovascular disease. Various studies and trials have produced conflicting results. Despite this scientific controversy over the quality of the evidence implicating dietary salt in disease, public health leaders at local, national, and international levels have pressed the case for salt reduction at the population level. This article explores the development of this controversy. It concludes that the concealment of scientific uncertainty in this case has been a mistake that has served neither the ends of science nor good policy. The article poses questions that arise from this debate and frames the challenges of formulating evidence-based public health practice and policy, particularly when the evidence is contested.
Yarber, Laura; Brownson, Carol A; Jacob, Rebekah R; Baker, Elizabeth A; Jones, Ellen; Baumann, Carsten; Deshpande, Anjali D; Gillespie, Kathleen N; Scharff, Darcell P; Brownson, Ross C
Evidence-based public health gives public health practitioners the tools they need to make choices based on the best and most current evidence. An evidence-based public health training course developed in 1997 by the Prevention Research Center in St. Louis has been taught by a transdisciplinary team multiple times with positive results. In order to scale up evidence-based practices, a train-the-trainer initiative was launched in 2010. This study examines the outcomes achieved among participants of courses led by trained state-level faculty. Participants from trainee-led courses in four states (Indiana, Colorado, Nebraska, and Kansas) over three years were asked to complete an online survey. Attempts were made to contact 317 past participants. One-hundred forty-four (50.9 %) reachable participants were included in analysis. Outcomes measured include frequency of use of materials, resources, and other skills or tools from the course; reasons for not using the materials and resources; and benefits from attending the course. Survey responses were tabulated and compared using Chi-square tests. Among the most commonly reported benefits, 88 % of respondents agreed that they acquired knowledge about a new subject, 85 % saw applications for the knowledge to their work, and 78 % agreed the course also improved abilities to make scientifically informed decisions at work. The most commonly reported reasons for not using course content as much as intended included not having enough time to implement evidence-based approaches (42 %); other staff/peers lack training (34 %); and not enough funding for continued training (34 %). The study findings suggest that utilization of course materials and teachings remains relatively high across practitioner groups, whether they were taught by the original trainers or by state-based trainers. The findings of this study suggest that train-the-trainer is an effective method for broadly disseminating evidence-based public health
Hayfaa A. Wahabi
Full Text Available Translation of research evidence into public health programs is lagging in Eastern Mediterranean Region. Graduate level public health curriculum at King Saud University (KSU, College of Medicine, Riyadh, is designed to equip students to integrate best available evidence in public health decision making. The objectives of study were to explore students’ opinion about the evidence based public health (EBPH courses and to survey the knowledge, opinion, and attitude of the students towards EBPH and perceived barriers for implementation of EBPH in decision making in public health. EBPH courses are designed based on a sequential framework. A survey was conducted at the completion of EBPH courses. Forty-five graduate students were invited to complete a validated self-administered questionnaire. It included questions about demography, opinion, and attitude towards EBPH and perceived barriers towards implementation of EBPH in the work environment. The response rate was 73%. Mean age of students was 30.1 (SD 2.3 years, and 51% were males. More than 80% had sound knowledge and could appreciate the importance of EBPH. The main perceived barriers to incorporate EBPH in decision making were lack of system of communication between researchers and policy makers and scarcity of research publications related to the public health problems.
Wahabi, Hayfaa A; Siddiqui, Amna Rehana; Mohamed, Ashry G; Al-Hazmi, Ali M; Zakaria, Nasriah; Al-Ansary, Lubna A
Translation of research evidence into public health programs is lagging in Eastern Mediterranean Region. Graduate level public health curriculum at King Saud University (KSU), College of Medicine, Riyadh, is designed to equip students to integrate best available evidence in public health decision making. The objectives of study were to explore students' opinion about the evidence based public health (EBPH) courses and to survey the knowledge, opinion, and attitude of the students towards EBPH and perceived barriers for implementation of EBPH in decision making in public health. EBPH courses are designed based on a sequential framework. A survey was conducted at the completion of EBPH courses. Forty-five graduate students were invited to complete a validated self-administered questionnaire. It included questions about demography, opinion, and attitude towards EBPH and perceived barriers towards implementation of EBPH in the work environment. The response rate was 73%. Mean age of students was 30.1 (SD 2.3) years, and 51% were males. More than 80% had sound knowledge and could appreciate the importance of EBPH. The main perceived barriers to incorporate EBPH in decision making were lack of system of communication between researchers and policy makers and scarcity of research publications related to the public health problems.
Tervonen, Tommi; van Valkenhoef, Gert; Buskens, Erik; Hillege, Hans L; Postmus, Douwe
Drug benefit-risk (BR) analysis is based on firm clinical evidence regarding various safety and efficacy outcomes. In this paper, we propose a new and more formal approach for constructing a supporting multi-criteria model that fully takes into account the evidence on efficacy and adverse drug reactions. Our approach is based on the stochastic multi-criteria acceptability analysis methodology, which allows us to compute the typical value judgments that support a decision, to quantify decision uncertainty, and to compute a comprehensive BR profile. We construct a multi-criteria model for the therapeutic group of second-generation antidepressants. We assess fluoxetine and venlafaxine together with placebo according to incidence of treatment response and three common adverse drug reactions by using data from a published study. Our model shows that there are clear trade-offs among the treatment alternatives. Copyright © 2011 John Wiley & Sons, Ltd.
Majid, Shaheen; Foo, Schubert; Luyt, Brendan; Zhang, Xue; Theng, Yin-Leng; Chang, Yun-Ke; Mokhtar, Intan A
Objective: Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population. The objective of this study was to explore nurses' awareness of, knowledge of, and attitude toward EBP and factors likely to encourage or create barriers to adoption. In addition, information sources used by nurses and their literature searching skills were also investigated. Method: A total of 2,100 copies of the questionnaire were distributed to registered nurses in 2 public hospitals in Singapore, and 1,486 completed forms were returned, resulting in a response rate of 70.8%. Results: More than 64% of the nurses expressed a positive attitude toward EBP. However, they pointed out that due to heavy workload, they cannot keep up to date with new evidence. Regarding self-efficacy of EBP-related abilities, the nurses perceived themselves to possess moderate levels of skills. The nurses also felt that EBP training, time availability, and mentoring by nurses with EBP experience would encourage them to implement EBP. The top three barriers to adopting EBP were lack of time, inability to understand statistical terms, and inadequate understanding of the jargon used in research articles. For literature searching, nurses were using basic search features and less than one-quarter of them were familiar with Boolean and proximity operators. Conclusion: Although nurses showed a positive attitude toward EBP, certain barriers were hindering their smooth adoption. It is, therefore, desirable that hospital management in Southeast Asia, particularly in Singapore, develop a comprehensive strategy for building EBP competencies through proper training. Moreover, hospital libraries should also play an active role in developing adequate information literacy skills among the nurses. PMID:21753915
Elbogen, Eric B.; Fuller, Sara; Johnson, Sally C.; Brooks, Stephanie; Kinneer, Patricia; Calhoun, Patrick; Beckham, Jean C.
Despite increased media attention on violent acts against others committed by military Veterans, few models have been developed to systematically guide violence risk assessment among Veterans. Ideally, a model would identify which Veterans are most at risk for violence and increased attention could then be turned to determining what could be done to prevent violent behavior. This article suggests how empirical approaches to risk assessment used successfully in civilian populations can be applied to Veterans. A review was conducted of the scientific literature on Veteran populations regarding factors related to interpersonal violence generally and to domestic violence specifically. A list was then generated of empirically-supported risk factors for clinicians to consider in practice. To conceptualize how these known risk factors relate to a Veteran’s violence potential, risk assessment scholarship was utilized to develop an evidence-based method to guide mental health professionals. The goals of this approach are to integrate science into practice, overcome logistical barriers, and permit more effective assessment, monitoring, and management of violence risk for clinicians working with Veterans, both in Veteran Administration settings and in the broader community. It is likely that the use of a systematic, empirical framework could lead to improved clinical decision-making in the area of risk assessment, and help reduce violence among Veterans. PMID:20627387
Crites, Gerald E; Markert, Ronald J; Goggans, D Stephen; Richardson, W Scott
Guidelines for the design of multiple-choice item (MCQ) tests of evidence-based medicine (EBM) and clinical decision making (CDM) have not been published. We describe a strategy to develop an EBM/CDM MCQ test database guided by educational theory and used psychometric analyses, including reliability, validity, and item analyses, to judge the strategy's success. The internal consistency reliability of tests derived from the database was in the good-to-excellent range (0.74-0.95) and test-retest reliability was fair (0.51). One test discriminated across three levels of EBM/CDM learners (discriminant validity). Tests also predictively correlated with other medical school assessments according to theory (convergent and discriminant validity). The items were infrequently misclassified, had statistics close to historical standards, and were acceptable after no more than one round of revisions. Our strategy for developing an EBM/CDM MCQ database was successful and tests derived from it can be flexibly sampled to assess different EBM/CDM knowledge domains and three levels of EBM/CDM learners. Assuming the availability of similar resources to support its application, this strategy should be replicable at other settings.
Hanna, Lezley-Anne; Hughes, Carmel
To explore the role of evidence of effectiveness when making decisions about over-the-counter (OTC) medication and to ascertain whether evidence-based medicine training raised awareness in decision-making. Additionally, this work aimed to complement the findings of a previous study because all participants in this current study had received training in evidence-based medicine (unlike the previous participants). Following ethical approval and an e-mailed invitation, face-to-face, semi-structured interviews were conducted with newly registered pharmacists (who had received training in evidence-based medicine as part of their MPharm degree) to discuss the role of evidence of effectiveness with OTC medicines. Interviews were recorded and transcribed verbatim. Following transcription, all data were entered into the NVivo software package (version 8). Data were coded and analysed using a constant comparison approach. Twenty-five pharmacists (7 males and 18 females; registered for less than 4 months) were recruited and all participated in the study. Their primary focus with OTC medicines was safety; sales of products (including those that lack evidence of effectiveness) were justified provided they did no harm. Meeting patient expectation was also an important consideration and often superseded evidence. Despite knowledge of the concept, and an awareness of ethical requirements, an evidence-based approach was not routinely implemented by these pharmacists. Pharmacists did not routinely utilize evidence-based resources when making decisions about OTC medicines and some felt uncomfortable discussing the evidence-base for OTC products with patients. The evidence-based medicine training that these pharmacists received appeared to have limited influence on OTC decision-making. More work could be conducted to ensure that an evidence-based approach is routinely implemented in practice. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.
Baker-Ericzén, Mary J.; Jenkins, Melissa M.; Park, Soojin; Garland, Ann F.
Background: Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective: The present study explored the role of prior training in evidence-based treatments (EBTs) on clinicians' assessment and treatment formulations using…
Saver, Barry G; Mazor, Kathleen M; Luckmann, Roger; Cutrona, Sarah L; Hayes, Marcela; Gorodetsky, Tatyana; Esparza, Nancy; Bacigalupe, Gonzalo
We wanted to evaluate novel decision aids designed to help patients trust and accept the controversial, evidence-based, US Preventive Services Task Force recommendations about prostate cancer screening (from 2012) and mammography screening for women aged 40 to 49 years (from 2009). We created recorded vignettes of physician-patient discussions about prostate cancer screening and mammography, accompanied by illustrative slides, based on principles derived from preceding qualitative work and behavioral science literature. We conducted a randomized crossover study with repeated measures with 27 men aged 50 to 74 years and 35 women aged 40 to 49 years. All participants saw a video intervention and a more traditional, paper-based decision aid intervention in random order. At entry and after seeing each intervention, they were surveyed about screening intentions, perceptions of benefits and harm, and decisional conflict. Changes in screening intentions were analyzed without regard to order of intervention after an initial analyses showed no evidence of an order effect. At baseline, 69% of men and 86% of women reported wanting screening, with 31% and 6%, respectively, unsure. Mean change on a 3-point, yes, unsure, no scale was -0.93 (P = persuasive video interventions significantly changed the screening intentions of substantial proportions of viewers. Our approach needs further testing but may provide a model for helping patients to consider and accept evidence-based, counterintuitive recommendations. © 2017 Annals of Family Medicine, Inc.
Murphy, Matthew; MacCarthy, M Jayne; McAllister, Lynda; Gilbert, Robert
Competency profiles for occupational clusters within Canada's substance abuse workforce (SAW) define the need for skill and knowledge in evidence-based practice (EBP) across all its members. Members of the Senior Management occupational cluster hold ultimate responsibility for decisions made within addiction services agencies and therefore must possess the highest level of proficiency in EBP. The objective of this study was to assess the knowledge of the principles of EBP, and use of the components of the evidence-based decision making (EBDM) process in members of this occupational cluster from selected addiction services agencies in Nova Scotia. A convenience sampling method was used to recruit participants from addiction services agencies. Semi-structured qualitative interviews were conducted with eighteen Senior Management. The interviews were audio-recorded, transcribed verbatim and checked by the participants. Interview transcripts were coded and analyzed for themes using content analysis and assisted by qualitative data analysis software (NVivo 9.0). Data analysis revealed four main themes: 1) Senior Management believe that addictions services agencies are evidence-based; 2) Consensus-based decision making is the norm; 3) Senior Management understand the principles of EBP and; 4) Senior Management do not themselves use all components of the EBDM process when making decisions, oftentimes delegating components of this process to decision support staff. Senior Management possess an understanding of the principles of EBP, however, when making decisions they often delegate components of the EBDM process to decision support staff. Decision support staff are not defined as an occupational cluster in Canada's SAW and have not been ascribed a competency profile. As such, there is no guarantee that this group possesses competency in EBDM. There is a need to advocate for the development of a defined occupational cluster and associated competency profile for this
Full Text Available Abstract Background There is a significant gap in the knowledge translation literature related to how research evidence actually contributes to health care decision-making. Decisions around what care to provide at the population (rather than individual level are particularly complex, involving considerations such as feasibility, cost, and population needs in addition to scientific evidence. One example of decision-making at this "population-policy" level involves what screening questions and intervention guides to include on standardized provincial prenatal records. As mandatory medical reporting forms, prenatal records are potentially powerful vehicles for promoting population-wide evidence-based care. However, the extent to which Canadian prenatal records reflect best-practice recommendations for the assessment of well-known risk factors such as maternal smoking and alcohol consumption varies markedly across Canadian provinces and territories. The goal of this study is to better understand the interaction of contextual factors and research evidence on decision-making at the population-policy level, by examining the processes by which provincial prenatal records are reviewed and revised. Methods Guided by Dobrow et al.'s (2004 conceptual model for context-based evidence-based decision-making, this study will use a multiple case study design with embedded units of analysis to examine contextual factors influencing the prenatal record revision process in different Canadian provinces and territories. Data will be collected using multiple methods to construct detailed case descriptions for each province/territory. Using qualitative data analysis techniques, decision-making processes involving prenatal record content specifically related to maternal smoking and alcohol use will be compared both within and across each case, to identify key contextual factors influencing the uptake and application of research evidence by prenatal record review
Harris, Claire; Allen, Kelly; Waller, Cara; Dyer, Tim; Brooke, Vanessa; Garrubba, Marie; Melder, Angela; Voutier, Catherine; Gust, Anthony; Farjou, Dina
This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects. From the literature and responses of local stakeholders it was clear that provision of expertise and education, training and support of health service staff would be required to achieve these aims. Four support services were proposed. This paper is a detailed case report of the development, implementation and evaluation of a Data Service, Capacity Building Service and Project Support Service. An Evidence Service is reported separately. Literature reviews, surveys, interviews, consultation and workshops were used to capture and process the relevant information. Existing theoretical frameworks were adapted for evaluation and explication of processes and outcomes. Surveys and interviews identified current practice in use of evidence in decision-making, implementation and evaluation; staff needs for evidence-based practice; nature, type and availability of local health service data; and preferred formats for education and training. The Capacity Building and Project Support Services were successful in achieving short term objectives; but long term outcomes were not evaluated due to reduced funding. The Data Service was not implemented at all. Factors influencing the processes and outcomes are discussed. Health service staff need access to education, training, expertise and support to enable evidence-based decision-making and to implement and evaluate the changes arising from those decisions. Three support services were proposed based on research
Shahmoradi, Leila; Safadari, Reza; Jimma, Worku
Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.
Zadeh, Rana; Sadatsafavi, Hessam; Xue, Ryan
This study describes a vision and framework that can facilitate the implementation of evidence-based design (EBD), scientific knowledge base into the process of the design, construction, and operation of healthcare facilities and clarify the related safety and quality outcomes for the stakeholders. The proposed framework pairs EBD with value-driven decision making and aims to improve communication among stakeholders by providing a common analytical language. Recent EBD research indicates that the design and operation of healthcare facilities contribute to an organization's operational success by improving safety, quality, and efficiency. However, because little information is available about the financial returns of evidence-based investments, such investments are readily eliminated during the capital-investment decision-making process. To model the proposed framework, we used engineering economy tools to evaluate the return on investments in six successful cases, identified by a literature review, in which facility design and operation interventions resulted in reductions in hospital-acquired infections, patient falls, staff injuries, and patient anxiety. In the evidence-based cases, calculated net present values, internal rates of return, and payback periods indicated that the long-term benefits of interventions substantially outweighed the intervention costs. This article explained a framework to develop a research-based and value-based communication language on specific interventions along the planning, design and construction, operation, and evaluation stages. Evidence-based and value-based design frameworks can be applied to communicate the life-cycle costs and savings of EBD interventions to stakeholders, thereby contributing to more informed decision makings and the optimization of healthcare infrastructures. © The Author(s) 2015.
Full Text Available Véronique LapaigeCanadian Health Services Research Foundation Fellow; PRO-ACTIVE Research Program (Participatory and Evaluative Research Program to Optimize Workplace Management: Application of Knowledge, Transfer of Expertise, Innovative Interventions, Training Transformational Leaders Pavillon Ferdinand-Vandry, CIFSS (Centre intégré de formation en sciences de la santé, Laval University, Quebec City, Quebec Canada Abstract: In the globalized knowledge economy, the challenge of translating knowledge into policy and practice is universal. At the dawn of the 21st century, the clinicians, leaders, and managers of health care organizations are increasingly required to bridge the research-practice gap. A shift from moving evidence to solving problems is due. However, despite a vast literature on the burgeoning field of knowledge translation research, the “evidence-based” issue remains for many health care professionals a day-to-day debate leading to unresolved questions. On one hand, many clinicians still resist to the implementation of evidence-based clinical practice, asking themselves why their current practice should be changed or expanded. On the other hand, many leaders and managers of health care organizations are searching how to keep pace with the demand of actionable knowledge. For example, they are wondering: (a if managerial and policy innovations are subjected to the same evidentiary standards as clinical innovations, and (b how they can adapt the scope of evidence-based medicine to the culture, context, and content of health policy and management. This paper focuses on evidence-based health care management within the context of contemporary globalization. In this paper, our heuristic hypothesis is that decision-making process related changes within clinical/managerial/policy environments must be given a socio-historical backdrop. We argue that the relationship between research on the transfer of knowledge and its uptake by
In the globalized knowledge economy, the challenge of translating knowledge into policy and practice is universal. At the dawn of the 21st century, the clinicians, leaders, and managers of health care organizations are increasingly required to bridge the research-practice gap. A shift from moving evidence to solving problems is due. However, despite a vast literature on the burgeoning field of knowledge translation research, the "evidence-based" issue remains for many health care professionals a day-to-day debate leading to unresolved questions. On one hand, many clinicians still resist to the implementation of evidence-based clinical practice, asking themselves why their current practice should be changed or expanded. On the other hand, many leaders and managers of health care organizations are searching how to keep pace with the demand of actionable knowledge. For example, they are wondering: (a) if managerial and policy innovations are subjected to the same evidentiary standards as clinical innovations, and (b) how they can adapt the scope of evidence-based medicine to the culture, context, and content of health policy and management. This paper focuses on evidence-based health care management within the context of contemporary globalization. In this paper, our heuristic hypothesis is that decision-making process related changes within clinical/managerial/policy environments must be given a socio-historical backdrop. We argue that the relationship between research on the transfer of knowledge and its uptake by clinical, managerial and policy target audiences has undergone a shift, resulting in increasing pressures in health care for intense researcher-practitioner collaboration and the development of "integrative KT platforms" at the crossroads of different fields (the field of knowledge management and the field of knowledge translation). The objectives of this paper are: (a) to provide an answer to the questions that health professionals ask most frequently
Morshed, A B; Ballew, P; Elliott, M B; Haire-Joshu, D; Kreuter, M W; Brownson, R C
The purpose of this evaluation was to assess the effect of the online evidence-based cancer control (EBCC) training on improving the self-reported evidence-based decision-making (EBDM) skills in cancer control among Nebraska public health professionals. Cross-sectional group comparison. Previously developed EBDM measures were administered via online surveys to 201 public health professionals at baseline (comparison group) and 123 professionals who took part in the training. Respondents rated the importance of and their skill level in 18 EBCC skills. Differences were examined using analysis of variance models adjusted for gender, age, years at agency, and years in position, and stratified by respondent educational attainment. Among professionals without an advanced degree, training participants reported higher overall skill scores (P = .016) than the baseline non-participant group, primarily driven by differences in the partnerships and collaboration and evaluation domains. No differences in importance ratings were observed. Among professionals with advanced degrees, there were no differences in skill scores and small differences in importance scores in the expected direction (P self-reported EBDM skills among public health professionals without an advanced degree, though a gap remained between the self-reported skills and the perceived importance of the skills. Further research on training content and modalities for professionals with higher educational attainment and baseline skill scores is needed. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
In the globalized knowledge economy, the challenge of translating knowledge into policy and practice is universal. At the dawn of the 21st century, the clinicians, leaders, and managers of health care organizations are increasingly required to bridge the research-practice gap. A shift from moving evidence to solving problems is due. However, despite a vast literature on the burgeoning field of knowledge translation research, the “evidence-based” issue remains for many health care professionals a day-to-day debate leading to unresolved questions. On one hand, many clinicians still resist to the implementation of evidence-based clinical practice, asking themselves why their current practice should be changed or expanded. On the other hand, many leaders and managers of health care organizations are searching how to keep pace with the demand of actionable knowledge. For example, they are wondering: (a) if managerial and policy innovations are subjected to the same evidentiary standards as clinical innovations, and (b) how they can adapt the scope of evidence-based medicine to the culture, context, and content of health policy and management. This paper focuses on evidence-based health care management within the context of contemporary globalization. In this paper, our heuristic hypothesis is that decision-making process related changes within clinical/managerial/policy environments must be given a socio-historical backdrop. We argue that the relationship between research on the transfer of knowledge and its uptake by clinical, managerial and policy target audiences has undergone a shift, resulting in increasing pressures in health care for intense researcher-practitioner collaboration and the development of “integrative KT platforms” at the crossroads of different fields (the field of knowledge management and the field of knowledge translation). The objectives of this paper are: (a) to provide an answer to the questions that health professionals ask most
Bates, Joanne; McClure, Janelle; Spinks, Andy
Evidence-based practice is the collection, interpretation, and use of data, such as collection statistics or assessment results, that measure the effectiveness of a library media program. In this article, the authors will present various forms of evidence and show that any library media specialist can use data to make informed decisions that…
Florkowski, Christopher; Don-Wauchope, Andrew; Gimenez, Nuria; Rodriguez-Capote, Karina; Wils, Julien; Zemlin, Annalise
Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870. The justification for POCT depends upon being able to demonstrate that a more timely result (shorter turnaround times (TATs)) is able to leverage a clinically important advantage in decision making compared with the central laboratory (CL). In the four decades since POCT was adapted for the self-monitoring of blood glucose levels by subjects with diabetes, numerous new POCT methodologies have become available, enabling the clinician to receive results and initiate treatment more rapidly. However, these instruments are often operated by staff not trained in laboratory medicine and hence are prone to errors in the analytical phase (as opposed to laboratory testing where the analytical phase has the least errors). In some environments, particularly remote rural settings, the CL may be at a considerable distance and timely availability of cardiac troponins and other analytes can triage referrals to the main centers, thus avoiding expensive unnecessary patient transportation costs. However, in the Emergency Department, availability of more rapid results with POCT does not always translate into shorter stays due to other barriers to implementation of care. In this review, we apply the principles of evidence-based
Mackenzie, Robin; Watts, John
Recent English cases have set a very low threshold for the capacity to consent to sexual activity, and the Court of Appeal in IM v LM (2014) has held that "the ability to use and weigh information is unlikely to loom large in the evaluation of consent to sexual relations." Such cases significantly affect the legal status of such activities involving persons diagnosed with a learning disability (LD), an autistic spectrum disorder (ASD) or other neurodiverse (ND) conditions. A principal focus on two cases in particular-IM v LM (2014) and A Local Authority v TZ (no 2) (2014)-supports the argument that the current test needs reframing from a relationship-centred perspective, in order to reflect an evidence-based model of sexual decision-making. Relevant training for persons diagnosed as LD, ASD, or ND is essential in order to promote socio-sexual competence. This is critical for resolving existing tensions between (1) sexual rights guaranteed in international agreements; (2) criminal law provisions and local authorities' obligations to protect the vulnerable; and (3) sexual health concerns. Copyright © 2015 Elsevier Ltd. All rights reserved.
religious acts of the prehistoric era to empirical-rational decisions of the Egyptian civilization, to modern day evidence-based medicine. Evidence-based medicine requires that clinical decisions and health policies on the prevention, diagnosis and ...
Harder, Thomas; Takla, Anja; Rehfuess, Eva; Sánchez-Vivar, Alex; Matysiak-Klose, Dorothea; Eckmanns, Tim; Krause, Gérard; de Carvalho Gomes, Helena; Jansen, Andreas; Ellis, Simon; Forland, Frode; James, Roberta; Meerpohl, Joerg J; Morgan, Antony; Schünemann, Holger; Zuiderent-Jerak, Teun; Wichmann, Ole
The Project on a Framework for Rating Evidence in Public Health (PRECEPT) was initiated and is being funded by the European Centre for Disease Prevention and Control (ECDC) to define a methodology for evaluating and grading evidence and strength of recommendations in the field of public health, with emphasis on infectious disease epidemiology, prevention and control. One of the first steps was to review existing quality appraisal tools (QATs) for individual research studies of various designs relevant to this area, using a question-based approach. Through team discussions and expert consultations, we identified 20 relevant types of public health questions, which were grouped into six domains, i.e. characteristics of the pathogen, burden of disease, diagnosis, risk factors, intervention, and implementation of intervention. Previously published systematic reviews were used and supplemented by expert consultation to identify suitable QATs. Finally, a matrix was constructed for matching questions to study designs suitable to address them and respective QATs. Key features of each of the included QATs were then analyzed, in particular in respect to its intended use, types of questions and answers, presence/absence of a quality score, and if a validation was performed. In total we identified 21 QATs and 26 study designs, and matched them. Four QATs were suitable for experimental quantitative study designs, eleven for observational quantitative studies, two for qualitative studies, three for economic studies, one for diagnostic test accuracy studies, and one for animal studies. Included QATs consisted of six to 28 items. Six of the QATs had a summary quality score. Fourteen QATs had undergone at least one validation procedure. The results of this methodological study can be used as an inventory of potentially relevant questions, appropriate study designs and QATs for researchers and authorities engaged with evidence-based decision-making in infectious disease epidemiology
Full Text Available the engagement between science and policymaking. It is concluded that the issue of evidence-based policymaking remains unresolved and questions for future research on the science–policy interface are raised....
Kaltoft, Mette Kjer; Dowie, Jack
’Evidence-based Health Care via Multi-Criteria Decision Analytic decision support: a Danish case study......’Evidence-based Health Care via Multi-Criteria Decision Analytic decision support: a Danish case study...
Buzhardt, Jay; Greenwood, Charles R.; Walker, Dale; Anderson, Rawni; Howard, Waylon; Carta, Judith J.
We investigated Early Head Start home visitors' use of evidence-based practices and the efficacy of a web-based system to support these practices. Home visitors learned to use 3 evidence-based practices: (a) frequent assessment of children's early communication for screening and progress monitoring, (b) 2 home-based language-promoting…
Davenport, Thomas H
Traditionally, decision making in organizations has rarely been the focus of systematic analysis. That may account for the astounding number of recent poor calls, such as decisions to invest in and securitize subprime mortgage loans or to hedge risk with credit default swaps. Business books are rich with insights about the decision process, but organizations have been slow to adopt their recommendations. It's time to focus on decision making, Davenport says, and he proposes four steps: (1) List and prioritize the decisions that must be made; (2) assess the factors that go into each, such as who plays what role, how often the decision must be made, and what information is available to support it; (3) design the roles, processes, systems, and behaviors your organization needs; and (4) institutionalize decision tools and assistance. The Educational Testing Service and The Stanley Works, among others, have succeeded in improving their decisions. ETS established a centralized deliberative body to make evidence-based decisions about new-product offerings, and Stanley has a Pricing Center of Excellence with internal consultants dedicated to its various business units. Leaders should bring multiple perspectives to their decision making, beware of analytical models that managers don't understand, be clear about their assumptions, practice "model management," and--because only people can revise decision criteria over time--cultivate human backups.
In the globalized knowledge economy, the challenge of translating knowledge into policy and practice is universal. At the dawn of the 21st century, the clinicians, leaders, and managers of health care organizations are increasingly required to bridge the research-practice gap. A shift from moving evidence to solving problems is due. However, despite a vast literature on the burgeoning field of knowledge translation research, the ?evidence-based? issue remains for many health care professional...
Al Hazzani, Saad A
This case report illustrates the use of evidence-based practice in formulating a comprehensive dental treatment plan for a patient who presented himself with signs of oral health debilitation accompanying methamphetamine (MA) abuse called "meth mouth" with the goal of providing dental care practitioners in Saudi Arabia with an insight into the global problem of MA abuse and its impact on oral health. This report documents the case of a 22-year-old male patient who reported to the clinic with rampant caries caused due to MA abuse exacerbated by poor oral hygiene and smoking habit. The treatment plan of this present case was formulated on the lines of the evidence-based dentistry approach. A clinical question was composed based on the Problem, Intervention, Comparison, and Outcome format to identify past studies and case reports on meth mouth. A standard search was conducted on PubMed Central. Standard guidelines on the treatment of meth mouth were extracted from the Web site of the American Dental Association. A total of 2 systematic reviews, 7 review articles, 4 epidemiologic studies, 5 case reports, and 1 American Dental Association guideline were found. Accelerated dental decay leading to rampant caries in young and middle-aged adults is a characteristic oral finding in MA abusers. The most important factor that affects the prognosis of dental care is complete cessation of MA use by the patient. Copyright © 2017 Elsevier Inc. All rights reserved.
Rwanda Journal Series F: Medicine and Health Sciences Vol. 2 No. 2, 2015. Making Evidence Based Changes on the Labor Ward of Muhima Hospital: Staff Teaching Staff. Jossette Umucyo1, Rondi Anderson1. 1Muhima Hospital, Kigali, Rwanda. Background. In January 2014 it was noted that Muhima hospital was lagging ...
Full Text Available Abstract Objective – The primary objective was to examine online journal database usage statistics for a provincial ministry of health in the context of evidence based decision-making. In addition, the study highlights implementation of the Journal Access Centre (JAC that is housed and powered by the Ontario Ministry of Health and Long-Term Care (MOHLTC to inform health systems policy-making. Methods – This was a prospective case study using descriptive analysis of the JAC usage statistics of journal articles from January 2009 to September 2013. Results – JAC enables ministry employees to access approximately 12,000 journals with full-text articles. JAC usage statistics for the 2011-2012 calendar years demonstrate a steady level of activity in terms of searches, with monthly averages of 5,129. In 2009-2013, a total of 4,759 journal titles were accessed including 1,675 journals with full-text. Usage statistics demonstrate that the actual consumption was over 12,790 full-text downloaded articles or approximately 2,700 articles annually. Conclusion – JAC’s steady level of activities, revealed by the study, reflects continuous demand for JAC services and products. It testifies that access to online journal databases has become part of routine government knowledge management processes. MOHLTC’s broad area of responsibilities with dynamically changing priorities translates into the diverse information needs of its employees and a large set of required journals. Usage statistics indicate that MOHLTC information needs cannot be mapped to a reasonably compact set of “core” journals with a subsequent subscription to those.
Ida Isnawati; Ali Saukah
This study investigated teachers' grading decision making, focusing on their beliefs underlying their grading decision making, their grading practices and assessment types, and factors they considered...
Full Text Available Cancer Research UK has developed PROforma, a formal language for modelling clinical processes, along with associated tools for creating decision support, care planning, clinical workflow management and other applications. The PROforma method has been evaluated in a variety of settings: in primary health care (prescribing, referral of suspected cancer patients, genetic risk assessment and in specialist care of patients with breast cancer, leukaemia, HIV infection and other conditions. About nine years of experience have been gained with PROforma technologies. Seven trials of decision support applications have been published or are in preparation. Each of these has shown significant positive effects on a variety of measures of quality and/or outcomes of care. This paper reviews the evidence base for the clinical effectiveness of these PROforma applications, and previews the CREDO project _a multi-centre trial of a complex PROforma application for supporting integrated breast cancer care across primary and secondary care settings.
Furberg Curt D
Full Text Available Abstract Contradictory statements about the non-steroidal anti-inflammatory drugs from the European Medicines Agency and the United States Food and Drug Administration have raised questions about whether regulatory decisions are evidence-based. For the selective COX-2 inhibitors, there are clear contraindications and warnings in Europe, but only a vaguely worded Black Box warning in the United States. All the non-selective agents are given an almost "clean bill of health" in Europe, while all of them are judged to have a similar risk-benefit ratio as celecoxib in the United States. The regulatory agencies have failed to recognize the clinical trial evidence that the risk of cardiovascular events varies substantially among the non-selective agents, with diclofenac carrying the highest risk of harm.
Seger, Carol A; Peterson, Erik J.
We rarely, if ever, repeatedly encounter exactly the same situation. This makes generalization crucial for real world decision making. We argue that categorization, the study of generalizable representations, is a type of decision making, and that categorization learning research would benefit from approaches developed to study the neuroscience of decision making. Similarly, methods developed to examine generalization and learning within the field of categorization may enhance decision making research. We first discuss perceptual information processing and integration, with an emphasis on accumulator models. We then examine learning the value of different decision making choices via experience, emphasizing reinforcement learning modeling approaches. Next we discuss how value is combined with other factors in decision making, emphasizing the effects of uncertainty. Finally, we describe how a final decision is selected via thresholding processes implemented by the basal ganglia and related regions. We also consider how memory related functions in the hippocampus may be integrated with decision making mechanisms and contribute to categorization. PMID:23548891
Isnawati, Ida; Saukah, Ali
This study investigated teachers' grading decision making, focusing on their beliefs underlying their grading decision making, their grading practices and assessment types, and factors they considered in grading decision making. Two teachers from two junior high schools applying different curriculum policies in grade reporting in Indonesian…
Leonardo Yuji Tamura
Full Text Available Quantum Electronics was a Brazilian startup in the 1990's that was acquired by an American equity fund in 2012. They are currently the largest manufacturer of vehicle tracking and infotainment systems. The company was founded by three college friends, who are currently executives at the company: Camilo Santos, Pedro Barbosa and Luana Correa. Edward Hutter was sent by the equity fund to take over the company’s finances, but is having trouble making organizational decisions with his colleagues. As a consultant, I was called to help them improve their decision making process and project prioritization. I adapted and deployed our firm's methodology, but, in the end, its adequacy is shown to be very much in question. The author of this case study intends to explore how actual organizational decisions rely on different decision models and their assumptions, .as well as demonstrate that a decision model is neither absolutely good nor bad as its quality is context dependent.
Enrique Benjamín Franklin Fincowsky
Full Text Available People and organizations make better or get wrong as consequence of making decisions. Sometimes making decisions is just a trial and error process. Some others, decisions are good and the results profitable with a few of mistakes, most of the time because it’s considered the experience and the control of a specific field or the good intention of who makes them. Actually, all kinds of decisions bring learning. What is important is the intention, the attitude and the values considered in this process. People from different scenes face many facts and circumstances—almost always out of control—that affect the making decisions process. There is not a unique way to make decisions for all companies in many settings. The person who makes a decision should identify the problem, to solve it later using alternatives and solutions. Even though, follow all the steps it’s not easy as it seems. Looking back the conditions related to the decisions, we can mention the followings: uncertainty, risk and certainty. When people identify circumstances and facts, as well as its effects in a possible situation, they will make decisions with certainty. As long as the information decreases and it becomes ambiguous the risk becomes an important factor in the making decisions process because they are connected to probable objectives (clear or subjective (opinion judgment or intuition. To finish, uncertainty, involves people that make a decision with no or little information about circumstances or criteria with basis
Dall, Sasha R. X.; Gosling, Samuel; Gordon D.A., Brown,; Dingemanse, Niels; Ido, Erev,; Martin, Kocher,; Laura, Schulz,; Todd, Peter M; Weissing, Franz; Wolf, Max; Hammerstein, Peter; Stevens, Jeffrey R.
Variation in how organisms allocate their behavior over their lifetimes is key to determining Darwinian fitness., and thus the evolution of human and nonhuman decision making. This chapter explores how decision making varies across biologically and societally significant scales and what role such
Linkov, Faina; Valappil, Benita; McAfee, Jacob; Goughnour, Sharon L; Hildrew, Douglas M; McCall, Andrew A; Linkov, Igor; Hirsch, Barry; Snyderman, Carl
To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS). This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator. Previously diagnosed VS patients were recruited by clinical investigators at the University of Pittsburgh Medical Center (UPMC). Classical content analysis was used for focus group data analysis. Providers were recruited from practices within the UPMC system and were surveyed using Delphi methods. This information can provide a basis for multi-criteria decision analysis (MCDA) framework to develop a treatment decision support system for patients with VS. Eight themes were derived from these data (focus group + surveys): doctor/health care system, side effects, effectiveness of treatment, anxiety, mortality, family/other people, quality of life, and post-operative symptoms. These data, as well as feedback from physicians were utilized in building a multi-criteria decision model. The study illustrated steps involved in the development of a decision support model that integrates evidence-based data and patient values to select treatment alternatives. Studies focusing on the actual development of the decision support technology for this group of patients are needed, as decisions are highly multifactorial. Such tools have the potential to improve decision making for complex medical problems with alternate treatment pathways. Copyright © 2016 Elsevier Inc. All rights reserved.
Orasanu, Judith; Statler, Irving C. (Technical Monitor)
The importance of decision-making to safety in complex, dynamic environments like mission control centers and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. A similar observation has been made in nuclear power plants. Yet laboratory research on decision making has not proven especially helpful in improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multidimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication
Jain, Lakhmi C
The present "Volume 1: Techniques and Applications" of the "Handbook on Decision Making" presents a useful collection of AI techniques, as well as other complementary methodologies, that are useful for the design and development of intelligent decision support systems. Application examples of how these intelligent decision support systems can be utilized to help tackle a variety of real-world problems in different domains, such as business, management, manufacturing, transportation and food industries, and biomedicine, are presented. The handbook includes twenty condensed c
Full Text Available Introduction: It has been found that the decision-making process in medicine is affected, to a large extent, by one’s experience, individual mentality, previous models, and common habitual approaches, in addition to scientific principles. Evidence-based medicine is an approach attempting to reinforce scientific, systematic and critical thinking in physicians and provide the ground for optimal decision making. In this connection, the purpose of the present study is to find out to what extent the education of evidence based medicine affects clinical decision making. Methods: The present quasi-experimental study was carried out on 110 clinical residents, who started their education in September, 2012 and finally 62 residents filled out the questionnaires. The instrument used was a researchermade questionnaire containing items on four decision-making approaches. The questionnaire was used both as a pre-test and a post-test to assess the residents’ viewpoints on decision making approaches. The validity of the questionnaire was determined using medical education and clinical professionals’ viewpoints, and the reliability was calculated through Chronbach alpha; it was found to be 0.93. The results were analyzed by paired t-test using SPSS, version 14. Results: The results demonstrated that evidence-based medicine workshop significantly affected the residents’ decision-making approaches (p<0.001. The pre-test showed that principles-based, reference-based and routine model-based approaches were more preferred before the program (p<0.001. However, after the implementation of the program, the dominant approaches used by the residents in their decision making were evidence-based ones. Conclusion: To develop the evidence-based approach, it is necessary for educational programs to continue steadily and goal-orientedly. In addition, the equipment infrastructure such as the Internet, access to data bases, scientific data, and clinical guides should
Stokman, Frans N.; Assen, Marcel A.L.M. van; Knoop, Jelle van der; Oosten, Reinier C.H. van
This paper introduces a methodology for strategic intervention in collective decision making.The methodology is based on (1) a decomposition of the problem into a few main controversial issues, (2) systematic interviews of subject area specialists to obtain a specification of the decision
Baldwin, Grover H.
The use of quantitative decision making tools provides the decision maker with a range of alternatives among which to decide, permits acceptance and use of the optimal solution, and decreases risk. Training line administrators in the use of these tools can help school business officials obtain reliable information upon which to base district…
Jonassen, David H.
Decision making is the most common kind of problem solving. It is also an important component skill in other more ill-structured and complex kinds of problem solving, including policy problems and design problems. There are different kinds of decisions, including choices, acceptances, evaluations, and constructions. After describing the centrality…
Meer, van Floor; Charbonnier, Lisette; Smeets, Paul A.M.
Food decisions determine energy intake. Since overconsumption is the main driver of obesity, the effects of weight status on food decision-making are of increasing interest. An additional factor of interest is age, given the rise in childhood obesity, weight gain with aging, and the increased
Lerner, Jennifer S; Li, Ye; Valdesolo, Piercarlo; Kassam, Karim S
A revolution in the science of emotion has emerged in recent decades, with the potential to create a paradigm shift in decision theories. The research reveals that emotions constitute potent, pervasive, predictable, sometimes harmful and sometimes beneficial drivers of decision making. Across different domains, important regularities appear in the mechanisms through which emotions influence judgments and choices. We organize and analyze what has been learned from the past 35 years of work on emotion and decision making. In so doing, we propose the emotion-imbued choice model, which accounts for inputs from traditional rational choice theory and from newer emotion research, synthesizing scientific models.
Full Text Available Abstract Background Decision aids (DA to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer. Methods Document development steps included preparing an evidence-based DA in standard medical parlance, iteratively translating it to emphasize shared decision making and plain language in three formats (booklet, Internet, and audio-tape. Scientific review of medical content was integrated with expert health literacy review of document structure and design. Formative evaluation methods included focus groups (n = 4 and survey of a new sample of men newly diagnosed with prostate cancer (n = 60, compared with historical controls (n = 184. Results A transparent description of the development process and design elements is reported. Formative evaluation among newly diagnosed prostate cancer patients found the DA to be clear and useful in reaching a decision. Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy. Conclusion The plain language DA presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men.
Stokman, Frans N.; van Assen, Marcel A L M; Knoop, Jelle van der; Oosten, Reinier C.H. van
This paper introduces a methodology for strategic intervention in collective decision making.The methodology is based on (1) a decomposition of the problem into a few main controversial issues, (2) systematic interviews of subject area specialists to obtain a specification of the decision setting,consisting of a list of stakeholders with their capabilities, positions, and salience on each of the issues; (3) computer simulation. The computer simulation models incorporate only the main processe...
In the times when the acquis of the European Union (EU) has developed so far as to reach a high level of technical complexity, in particular in certain policy fields such as environmental legislation, it is important to look at what kind of information and data policy decisions are based on. This position paper looks at the extent to which evidence-based decision-making process is being considered in the EU institutions when it comes to adopting legislation in the field of environment at the EU level. The paper calls for closer collaboration between scientists and decision-makers in view of ensuring that correct data is understood and taken into consideration when drafting, amending, negotiating and adopting new legal texts at all levels of the EU decision-making process. It concludes that better awareness of the need for such collaboration among the decision-makers as well as the scientific community would benefit the process and quality of the final outcomes (legislation).
Karny, Miroslav; Wolpert, David
Decision making (DM) is ubiquitous in both natural and artificial systems. The decisions made often differ from those recommended by the axiomatically well-grounded normative Bayesian decision theory, in a large part due to limited cognitive and computational resources of decision makers (either artificial units or humans). This state of a airs is often described by saying that decision makers are imperfect and exhibit bounded rationality. The neglected influence of emotional state and personality traits is an additional reason why normative theory fails to model human DM process. The book is a joint effort of the top researchers from different disciplines to identify sources of imperfection and ways how to decrease discrepancies between the prescriptive theory and real-life DM. The contributions consider: · how a crowd of imperfect decision makers outperforms experts' decisions; · how to decrease decision makers' imperfection by reducing knowledge available; ...
Higgins, Guy; Freedman, Jennifer
The most critical activity during emergencies or crises is making decisions about what to do next. This paper provides insights into the challenges that people face in making decisions at any time, but particularly during emergencies and crises. It also introduces the reader to the concept of different sense-making/decision-making domains, the human behaviours that can adversely affect decision making - decision derailers - and ways in which emergency responders can leverage this knowledge to make better decisions. While the literature on decision making is extensive, this paper is focused on those aspects that apply particularly to decision making in emergencies or times of crisis.
Pedersen, Carsten Lund; Andersen, Torben Juul
Strategic decision making remains a focal point in the strategy field, but despite decades of rich conceptual and empirical research we still seem distant from a level of understanding that can guide corporate practices effectively under turbulent and unpredictable environmental conditions. Hence...
Lauesen, Linne Marie
by the inclusion of multiple stakeholders. The conceptualization of the model enhances business ethics in decision making by managing and balancing stakeholder concerns with the same concerns as the traditional risk management models does – for the sake of the wider social responsibilities of the businesses...
HENDRIKS, M. M. W. B.; de Boer, J. H.; Smilde, A. K.; Doornbos, D. A.
Interest is growing in multicriteria decision making (MCDM) techniques and a large number of these techniques are now available. The purpose of this tutorial is to give a theoretical description of some of the MCDM techniques. Besides this we will give an overview of the differences and similarities
Aldashev, Gani; Kirchsteiger, Georg; Sebald, Alexander Christopher
It is a persistent finding in psychology and experimental economics that people's behavior is not only shaped by outcomes but also by decision-making procedures. In this paper we develop a general framework capable of modelling these procedural concerns. Within the context of psychological games we...
Karimian, Zahra; Kojuri, Javad; Sagheb, Mohammad Mahdi; Mahboudi, Ali; Saber, Mahboobeh; Amini, Mitra; Dehghani, Mohammad Reza
It has been found that the decision-making process in medicine is affected, to a large extent, by one's experience, individual mentality, previous models, and common habitual approaches, in addition to scientific principles. Evidence-based medicine is an approach attempting to reinforce scientific, systematic and critical thinking in physicians and provide the ground for optimal decision making. In this connection, the purpose of the present study is to find out to what extent the education of evidence based medicine affects clinical decision making. The present quasi-experimental study was carried out on 110 clinical residents, who started their education in September, 2012 and finally 62 residents filled out the questionnaires. The instrument used was a researcher-made questionnaire containing items on four decision-making approaches. The questionnaire was used both as a pre-test and a post-test to assess the residents' viewpoints on decision making approaches. The validity of the questionnaire was determined using medical education and clinical professionals' viewpoints, and the reliability was calculated through Chronbach alpha; it was found to be 0.93. The results were analyzed by paired t-test using SPSS, version 14. The results demonstrated that evidence-based medicine workshop significantly affected the residents' decision-making approaches (pbased, reference-based and routine model-based approaches were more preferred before the program (pevidence-based ones. To develop the evidence-based approach, it is necessary for educational programs to continue steadily and goal-orientedly. In addition, the equipment infrastructure such as the Internet, access to data bases, scientific data, and clinical guides should develop more in the medical departments.
A program was put in place that involved staff and midwifery students doing twice weekly presentations on the above topics at morning meetings, with support for their preparation that included learning how to access information from the internet and make a power point presentation. In addition global trainings on helping.
Brunner, E; Rayner, M; Thorogood, M.; Margetts, B.; Hooper, L; Summerbell, C; Dowler, E.; Hewitt, G; Robertson, A; Wiseman, M.
Public health nutrition enjoyed many breakthroughs in the\\ud 20th century – from the discovery of vitamins and the\\ud metabolic roles of some 60 macro- and micronutrients, to\\ud the effects of maternal and childhood diet on health over\\ud the life course. Moreover, the food shortages in the UK that\\ud were experienced during World War II gave the first\\ud opportunity to show that nutritional science could make a\\ud valuable contribution to public policy. However, public\\ud health nutrition is...
Full Text Available The aim of the present study was to determine the extent to which employees would like to participate in decision making concerning various organisational issues, especially those concerning: the work itself, working conditions, human resources issues, and corporate policy and planning. The sample consisted of 146 participants, including managers, middle managers, and junior officials from a South African development corporation. A questionnaire to measure employees' desire to participate in decision making was specially constructed for this investigation. It has found that employees with higher academic qualifications were more desirous to participate in decision-making at all levels than employees with lower academic qualifications. This was also true for employees in higher job grades than in lower job grades. Men were more desirous to participate in decision making than women. The implications of the findings are discussed. Opsomming Die doel van die huidige studie was om vas te stel in watter mate werknemers sal wil deelneem aan die besluit- nameproses van organisasies, veral rakende die volgende sake: die werk self, werksomstandighede, menslike hulpbronaangeleenthede en korporatiewe beleid en beplanning. Die steekproef het uit 146 deelnemers, insluitende bestuurders, middelvlakbestuurders en junior amptenare van'n Suid Afrikaanse ontwikkelingskorporasie, bestaan. nVraelys wat die begeerte van werknemers meet om aan die besluitnameproses deel te neem, is spesiaal vir die doel van hierdie ondersoek, ontwerp. Dit is bevind dat werknemers met hoer akademiese kwalifikasies meer begerig is om aan die besluitnameproses op alle vlakke deel te neem as werknemers met laer akademiese kwalifikasies. Dit was ook waar vir werknemers in hoervlakposte vergeleke met werknemers in laervlakposte. Mans was ook meer begerig om aan die besluitnameproses deel te neem as vroue. Die implikasies van die studie word bespreek.
B. Wierenga (Berend)
textabstractWhile a whole range of factors influences the outcomes of a marketing policy, it is managerial decision-making that can really make a difference. A clearer understanding of how marketers make decisions should therefore improve their quality.
Guy, Tatiana Valentine; Wolpert, David H
Prescriptive Bayesian decision making has reached a high level of maturity and is well-supported algorithmically. However, experimental data shows that real decision makers choose such Bayes-optimal decisions surprisingly infrequently, often making decisions that are badly sub-optimal. So prevalent is such imperfect decision-making that it should be accepted as an inherent feature of real decision makers living within interacting societies. To date such societies have been investigated from an economic and gametheoretic perspective, and even to a degree from a physics perspective. However, lit
The Analytic Hierarchy Process (AHP) is a procedure for establishing priorities in multi-criteria decision making problems. Here we discuss the Logarithmic Least Squares (LLS) method for the AHP and group-AHP, which provides an exact and unique solution for the priority vector. Also, we show that for the group-AHP, the LLS method is equivalent with the minimization of the weighted sum of generalized Kullback-Leibler divergences, between the group-priority vector and the priority vector of each expert.
Dias, Eduardo Rocha; da Silva, Geraldo Bezerra
ABSTRACT Objective To analyze, from the examination of decisions issued by Brazilian courts, how Evidence-Based Medicine was applied and if it led to well-founded decisions, searching the best scientific knowledge. Methods The decisions made by the Federal Courts were searched, with no time limits, at the website of the Federal Court Council, using the expression “Evidence-Based Medicine”. With regard to decisions issued by the court of the State of São Paulo, the search was done at the webpage and applying the same terms and criterion as to time. Next, a qualitative analysis of the decisions was conducted for each action, to verify if the patient/plaintiff’s situation, as well as the efficacy or inefficacy of treatments or drugs addressed in existing protocols were considered before the court granted the provision claimed by the plaintiff. Results In less than one-third of the decisions there was an appropriate discussion about efficacy of the procedure sought in court, in comparison to other procedures available in clinical guidelines adopted by the Brazilian Unified Health System (Sistema Único de Saúde) or by private health insurance plans, considering the individual situation. The majority of the decisions involved private health insurance plans (n=13, 68%). Conclusion The number of decisions that did consider scientific evidence and the peculiarities of each patient was a concern. Further discussion on Evidence-Based Medicine in judgments involving public healthcare are required. PMID:27074226
Harmon, Joel I.
The use of computerized decision support systems in higher education for making tactical institutional decisions is reviewed, with attention to the kind of administrative problems that lie somewhere between programmed to nonprogrammed decisions and require a combination of computer support and administrative judgment. (MSE)
Amorin-Woods, Lyndon G; Losco, Barrett E
Various models and decision-making aids exist for chiropractic clinical practice. "PICO-D Man" (Patient-Intervention-Comparator-Outcome-Duration Management) is a decision-aid developed in an educational setting which field practitioners may also find useful for applying defensible evidence-based practice. Clinical decision-making involves understanding and evaluating both the proposed clinicalintervention(s) and the relevant and available management options with respect to describing the patient and their problem, clinical and cost effectiveness, safety, feasibility and time-frame. For people consulting chiropractors this decision-aid usually requires the practitioner to consider a comparison of usual chiropractic care, (clinical management including a combination of active care and passive manual interventions), to usual medical care usually including medications, or other allied healthmanagement options while being mindful of the natural history of the persons' condition.
Hartley, Catherine A.; Phelps, Elizabeth A.
While the everyday decision-making of clinically anxious individuals is clearly influenced by their excessive fear and worry, the relationship between anxiety and decision-making remains relatively unexplored in neuroeconomic studies. In this review, we attempt to explore the role of anxiety in decision-making using a neuroeconomic approach. We first review the neural systems mediating fear and anxiety, which overlap with a network of brain regions implicated in studies of economic decision-m...
Bagheri, Pezhman; Mohammadi, Mohammad Reza; Shafiei, Nematollah
Several documents have investigated the area of Quran study and medicine from different points of view; the present study has been assessing all the documents about Quran study and medicine, published in Iranian scientific-research journals, to create an opportunity of revising the interventions executed in this areas and targeting the decisions in order to draw a clear and more realistic vision. In this simple review study, scientific-research and general informative websites in the period of 1992-2013 were explored by taking advantage of critical keywords such as Islamic medicine and Islamic lifestyle. After the initial retrieval, 348 articles were finally ready for the evaluation process. Chi-square test was used to assess the significance of patterns differences between years of study. Minimum and maximum numbers of articles were published in 1992 (0.28 %) and 2011 (12.35 %), respectively. The level of execution of studies by using different methods was as follows: about 3.44 % qualitative, 29.59 % cross-sectional descriptive-analytical, 30.45 % review, 1.14 % case-control, 17.52 % experimental, 3.73 % cohort methods and 12.93 % were performed by other methods. The most common subject study was "The effects of fasting and Ramadan on health" (21.83 %). The most important journals hosting this field articles were the journals of medicine and refinement (27.01 %), as well as the Quran and medicine (12.64 %), respectively. Chi-square test showed significant thematic differences during the 21 years of study. Based on the available evidences, the number of descriptive papers was yet more than the analytical, interventional and scientific-comparative articles. Also, the most studies had been reviewing the medical-Islamic documents. This reflects the need for revising the search strategies of Quran study and medicine.
Czaczkes, Tomer J; Czaczkes, Benjamin; Iglhaut, Carolin; Heinze, Jürgen
Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
David Molero López-Barajas
Full Text Available We show, in this work, a study based on the analysis of handball referees’ decisions making from the marks got in the spanish adaptation of Decision Making Questionnaire dealing with the following factors: stress in making decisions, quick decision with uncertainty and determination in the commitment of decisions making. We found significant differences in the three factors considered in function of the category of referees but not in terms of their age. With the data are collected and analyzed future lines of action considered in which the basis for this group tutoring
Feldman, M. S.; Sarbaugh-Thompson, M.
Electronic communication can either facilitate or sabotage decision-making contexts. This article formulates recommendations about when and how to use electronic communication to enhance decision making and describes various decision contexts. Solutions to communication problems such as groupthink, social deadlock, bureaucratic isolation from…
Hartley, Catherine A; Phelps, Elizabeth A
Although the everyday decision-making of clinically anxious individuals is clearly influenced by their excessive fear and worry, the relationship between anxiety and decision-making remains relatively unexplored in neuroeconomic studies. In this review, we attempt to explore the role of anxiety in decision-making with a neuroeconomic approach. We first review the neural systems mediating fear and anxiety, which overlap with a network of brain regions implicated in studies of economic decision-making. We then discuss the potential influence of cognitive biases associated with anxiety upon economic choice, focusing on a set of decision-making biases involving choice in the face of potential aversive outcomes. We propose that the neural circuitry supporting fear learning and regulation may mediate the influence of anxiety upon choice and suggest that techniques for altering fear and anxiety may also change decisions. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
In many application areas, it is necessary to make effective decisions under constraints. Several area-specific techniques are known for such decision problems; however, because these techniques are area-specific, it is not easy to apply each technique to other applications areas. Cross-fertilization between different application areas is one of the main objectives of the annual International Workshops on Constraint Programming and Decision Making. Those workshops, held in the US (El Paso, Texas), in Europe (Lyon, France), and in Asia (Novosibirsk, Russia), from 2008 to 2012, have attracted researchers and practitioners from all over the world. This volume presents extended versions of selected papers from those workshops. These papers deal with all stages of decision making under constraints: (1) formulating the problem of multi-criteria decision making in precise terms, (2) determining when the corresponding decision problem is algorithmically solvable; (3) finding the corresponding algorithms, and making...
decision theory to specific medical diagnostic or treatment problems. Giaugue and Peebles (1974) discuss analysis of the treatment of strep throat and...for Streptococcal Sore Throat and Rheumatic Fever", Technical Report, Naval Postgraduate School, Monterey, Calif., 93940 7- Giaugue, W.C: "A Utility...Sore Throat ang Rheumatic £ever - a Decision THeoLelic 22£roa>cH, Uoctoral THeslsJ Barvard~ Business 5cKool7 Boston, Bass., 1972. 3. Raiffa, H
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Weaver, Robert R
Evidence-based and patient-centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards 'cookbook' medicine undermine the view of patients as unique particulars, and diminish what might be considered patient-centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence-based and person-centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients' uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner-patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence-based and patient-centred approaches. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.
Christopher A. Dieckmann, PE, CSEP-Acq
The Idaho National Laboratory (INL) is funded through the Department of Energy (DOE) Office of Nuclear Energy and other customers who have direct contracts with the Laboratory. The people, equipment, facilities and other infrastructure at the laboratory require continual investment to maintain and improve the laboratory’s capabilities. With ever tightening federal and customer budgets, the ability to direct investments into the people, equipment, facilities and other infrastructure which are most closely aligned with the laboratory’s mission and customers’ goals grows increasingly more important. The ability to justify those investment decisions based on objective criteria that can withstand political, managerial and technical criticism also becomes increasingly more important. The Systems Engineering tools of decision analysis, risk management and roadmapping, when properly applied to such problems, can provide defensible decisions.
Arthur, Rudy; Sibani, Paolo
We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et. al. that we call...... the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures....
Arthur, R.; Sibani, P.
We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et al. that we call the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures.
Pearson, John M.; Watson, Karli K.; Platt, Michael L.
Neuroeconomics applies models from economics and psychology to inform neurobiological studies of choice. This approach has revealed neural signatures of concepts like value, risk, and ambiguity, which are known to influence decision-making. Such observations have led theorists to hypothesize a single, unified decision process that mediates choice behavior via a common neural currency for outcomes like food, money, or social praise. In parallel, recent neuroethological studies of decision-making have focused on natural behaviors like foraging, mate choice, and social interactions. These decisions strongly impact evolutionary fitness and thus are likely to have played a key role in shaping the neural circuits that mediate decision-making. This approach has revealed a suite of computational motifs that appear to be shared across a wide variety of organisms. We argue that the existence of deep homologies in the neural circuits mediating choice may have profound implications for understanding human decision-making in health and disease. PMID:24908481
A M Kustubayeva
Full Text Available The results of the experimental research of the connection between the efficiency of decision making and emotional intelligence are presented in the article. The empirical data indicate that the ability to regulate emotion is an important indicator of the efficiency of decision making in the conditions of psychological experiment.
Lobanova, E. N.; Zmitrovich, A. I.; Voshevoz, A. A.; Krivko-Krasko, A. V.
In this article we consider concepts and components of the Financial Decision Making System that is being developed in the Institute of Business and Management Technology, BSU. Such system can be successfully used either for training experts in financial analytics and financial management or for financial managers and financial directors in an enterprise for the effective financial decision making.
This thesis consists of three distinct papers related to the analysis of collective decision making. In the first paper I employ a mechanism-design approach to analyze a public procurement problem. In the second and third paper I analyze collective decision making in the form of voting.
Orasanu, Judith; Shafto, Michael G. (Technical Monitor)
The Importance of decision-making to safety in complex, dynamic environments like mission control centers, aviation, and offshore installations has been well established. NASA-ARC has a program of research dedicated to fostering safe and effective decision-making in the manned spaceflight environment. Because access to spaceflight is limited, environments with similar characteristics, including aviation and nuclear power plants, serve as analogs from which space-relevant data can be gathered and theories developed. Analyses of aviation accidents cite crew judgement and decision making as causes or contributing factors in over half of all accidents. Yet laboratory research on decision making has not proven especially helpful In improving the quality of decisions in these kinds of environments. One reason is that the traditional, analytic decision models are inappropriate to multi-dimensional, high-risk environments, and do not accurately describe what expert human decision makers do when they make decisions that have consequences. A new model of dynamic, naturalistic decision making is offered that may prove useful for improving decision making in complex, isolated, confined and high-risk environments. Based on analyses of crew performance in full-mission simulators and accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that
Full Text Available Decision-making is defined as a selection of a certain actionamong several alternatives. It is the essence of planning, asin the managerial sense there is no plan until a decision of engagementof resources, reputation and direction of activities ismade. Decision-making is, in fact, only a step in planning, evenwhen it is performed quickly and without special consideration.It is what we all experience every day. It is one of the most fascinatingbiological activities and the subject of frightening implicationsfor the whole human race. Since various techniques improvethe system and the quality of managerial decision-making,they are classified into three assumptions: risk analysis, decision-making trees, and the theory of revealed preference. Allof these are based on the interaction of a certain number of importantvariables out of which many contain the elements ofuncertainty, but maybe also high level of probability.
Schmidt, Nola A; Brown, Janet M
The purpose of this article is to describe the innovation-decision process teaching strategy (I-DPTS) based on the model of diffusion of innovations [Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York: Free Press]. A goal of baccalaureate nursing education is to develop competencies required for evidence-based practice. Such practice merges clinician expertise, patient preferences, and critical evaluation of the literature to improve patient outcomes and reduce health care costs [Melnyk, B. M. (2005). A primer on evidence-based practice. Paper presented at the Purdue School of Nursing Seventh Annual Helen R. Johnson Leadership Conference, West Lafayette, IN]. Several strategies to promote evidence-based practice have appeared in the literature. However, when they are examined in light of the innovation-decision process (Rogers, 2003), they do not address all the essential steps for adoption to occur. The I-DPTS allows students to achieve competencies necessary to overcome barriers associated with implementing best practices. This strategy was successfully implemented in a senior-level introductory nursing research class. Community representatives identified practice issues that could be addressed by student groups. After conducting a search of the literature, students analyzed the evidence, determined best practice based on the evidence, and developed a policy for implementation in clinical settings. At course end, representatives were invited to attend oral and poster presentations. Use of the I-DPTS better prepares students to implement best practice as they embark on their professional careers.
Aasekjaer, Katrine; Waehle, Hilde Valen; Ciliska, Donna; Nordtvedt, Monica Wammen; Hjälmhult, Esther
Even though health professionals have a positive attitude toward evidence-based practice (EBP), they have limited skills when it comes to implementation of EBP. A postprofessional program in EPB has been offered at Bergen University College since 2004. To date, there is limited knowledge of how the graduates of the program implement and make use of the EBP principles in their working environment in different healthcare settings. The aim of the study was to explore the facilitators and strategies to successful implementation of the steps of EBP as experienced by health professionals who had completed a postgraduate program in EBP. Grounded theory was used in gathering and analyzing data from single and focus group interviews of 20 health professionals who had attended a postprofessional program in EBP. Inclusion criteria also required current clinical practice. This study identified a specific set of activities used by health professionals when implementing EBP within their service organization. Creating an interest and understanding of EBP amongst their colleagues appeared to be a challenge, which they addressed by using the generated grounded theory of "tailoring principles." The dominant condition of this theory was management involvement. This study highlighted the importance of middle-range managers' coordinating and supporting role as a decisive component in the process of implementing EBP to clinical settings in Norway. Moreover, the dynamic complex process of "tailoring principles" also showed how the production of a clinical protocol became an outcome of implementation effectiveness as well as input for further intervention effectiveness. Tailoring the principle of EBP to the organizational and cultural context facilitated the implementation of EBP. © 2016 Sigma Theta Tau International.
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Perez Bernabeu Elena
Full Text Available Decision making is one of the important tasks of every manager. The process of taking decisions has to be based on knowledge. For optimizing this process some software solutions has been created. In this article we tried to summarize some of the features which exists in some software applications.
McDonald, Heather; Charles, Cathy; Gafni, Amiram
Abstract Context Promoting patient participation in treatment decision making is of increasing interest to researchers, clinicians and policy makers. Decision aids (DAs) are advocated as one way to help achieve this goal. Despite their proliferation, there has been little agreement on criteria or standards for evaluating these tools. To fill this gap, an international collaboration of researchers and others interested in the development, content and quality of DAs have worked over the past several years to develop a checklist and, based on this checklist, an instrument for determining whether any given DA meets a defined set of quality criteria. Objective/Methods In this paper, we offer a framework for assessing the conceptual clarity and evidence base used to support the development of quality criteria/standards for evaluating DAs. We then apply this framework to assess the conceptual clarity and evidence base underlying the International Patient Decision Aids Standards (IPDAS) checklist criteria for one of the checklist domains: how best to present in DAs probability information to patients on treatment benefits and risks. Conclusion We found that some of the central concepts underlying the presenting probabilities domain were not defined. We also found gaps in the empirical evidence and theoretical support for this domain and criteria within this domain. Finally, we offer suggestions for steps that should be undertaken for further development and refinement of quality standards for DAs in the future. PMID:22050440
Marewski, Julian N; Gigerenzer, Gerd
Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care.
Marewski, Julian N.; Gigerenzer, Gerd
Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care. PMID:22577307
Mark R Tonelli
Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.
Amorin-Woods, Lyndon G; Losco, Barrett E
.... Results "PICO-D Man" (Patient-Intervention-Comparator-Outcome-Duration Management) is a decision-aid developed in an educational setting which field practitioners may also find useful for applying defensible evidence-based practice...
Runge, Michael C.; Grand, James B.; Mitchell, Michael S.; Krausman, Paul R.; Cain, James W. III
Wildlife management is a decision-focused discipline. It needs to integrate traditional wildlife science and social science to identify actions that are most likely to achieve the array of desires society has surrounding wildlife populations. Decision science, a vast field with roots in economics, operations research, and psychology, offers a rich set of tools to help wildlife managers frame, decompose, analyze, and synthesize their decisions. The nature of wildlife management as a decision science has been recognized since the inception of the field, but formal methods of decision analysis have been underused. There is tremendous potential for wildlife management to grow further through the use of formal decision analysis. First, the wildlife science and human dimensions of wildlife disciplines can be readily integrated. Second, decisions can become more efficient. Third, decisions makers can communicate more clearly with stakeholders and the public. Fourth, good, intuitive wildlife managers, by explicitly examining how they make decisions, can translate their art into a science that is readily used by the next generation.
Full Text Available One of the leading descriptive theories of decision-making under risk, Tversky & Kahneman's Prospect theory, reveals that normative explanation of decisionmaking, based only on principle of maximizing outcomes expected utility, is unsustainable. It also underlines the effect of alternative factors on decision-making. Framing effect relates to an influence that verbal formulation of outcomes has on choosing between certain and risky outcomes; in negative frame people tend to be risk seeking, whereas in positive frame people express risk averse tendencies. Individual decisions are not based on objective probabilities of outcomes, but on subjective probabilities that depend on outcome desirability. Unrealistically pessimistic subjects assign lower probabilities (than the group average to the desired outcomes, while unrealistically optimistic subjects assign higher probabilities (than the group average to the desired outcomes. Experiment was conducted in order to test the presumption that there's a relation between unrealistic optimism and decision-making under risk. We expected optimists to be risk seeking, and pessimist to be risk averse. We also expected such cognitive tendencies, if they should become manifest, to be framing effect resistant. Unrealistic optimism scale was applied, followed by the questionnaire composed of tasks of decision-making under risk. Results within the whole sample, and results of afterwards extracted groups of pessimists and optimists both revealed dominant risk seeking tendency that is resistant to the influence of subjective probabilities as well as to the influence of frame in which the outcome is presented.
Stephanie Ying-Fen Chen
Full Text Available Two experiments investigated how category information is used in decision making under uncertainty and whether the framing of category information influences how it is used. Subjects were presented with vignettes in which the categorization of a critical item was ambiguous and were asked to choose among a set of actions with the goal of attaining the desired outcome for the main character in the story. The normative decision making strategy was to base the decision on all possible categories; however, research on a related topic, category-based induction, has found that people often only consider a single category when making predictions when categorization is uncertain. These experiments found that subjects tend to consider multiple categories when making decisions, but do so both when it is and is not appropriate, suggesting that use of multiple categories is not driven by an understanding of what categories are and are not relevant to the decision. Similarly, although a framing manipulation increased the rate of multiple-category use, it did so in situations in which multiple-category use was and was not appropriate.
The Iowa Gambling Task (IGT) measures affective decision making and has revealed decision making impairments across a wide range of eating disorders. This study aimed to investigate affective decision making in severely obese individuals.
Biedrzycki, Barbara A
To describe what is known about the factors that influence cancer clinical trial decision making. PubMed database and reference lists of identified articles. Variations in research design and methods, including sample characteristics, instrumentation, time between decision made and measurement of decision making, and response rates, have effects on what is known about decision making for cancer clinical trial participation. Communication, whether in the form of education about a cancer clinical trial or as a personal invitation to join, is an important factor influencing decision making. Personal and system factors influence the outcomes of decision making for cancer clinical trials. The process of decision making for cancer clinical trials is understudied. Nevertheless, the currently available cancer clinical trial decision-making literature suggests a multitude of factors that influence the outcomes of the decision to accept or decline clinical trial participation, as well as the psychosocial consequences of decisional regret, pressures, and satisfaction. The decision-making process of cancer clinical trials is a fertile area for research and, subsequently, evidence-based interventions. Oncology nurses are in a position to facilitate the process and to relieve the pressures patients perceive regarding decision making for cancer clinical trials that will benefit individuals and, ultimately, society.
Smith, Robert C; Fortin, Auguste H; Dwamena, Francesca; Frankel, Richard M
To review the scientific status of the biopsychosocial (BPS) model and to propose a way to improve it. Engel's BPS model added patients' psychological and social health concerns to the highly successful biomedical model. He proposed that the BPS model could make medicine more scientific, but its use in education, clinical care, and, especially, research remains minimal. Many aver correctly that the present model cannot be defined in a consistent way for the individual patient, making it untestable and non-scientific. This stems from not obtaining relevant BPS data systematically, where one interviewer obtains the same information another would. Recent research by two of the authors has produced similar patient-centered interviewing methods that are repeatable and elicit just the relevant patient information needed to define the model at each visit. We propose that the field adopt these evidence-based methods as the standard for identifying the BPS model. Identifying a scientific BPS model in each patient with an agreed-upon, evidence-based patient-centered interviewing method can produce a quantum leap ahead in both research and teaching. A scientific BPS model can give us more confidence in being humanistic. In research, we can conduct more rigorous studies to inform better practices. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Schraagen, J.M.; Militello, L.; Ormerod, T.; Lipshitz, R.
This book presents the latest work in the area of naturalistic decision making (NDM) and its extension into the area of macrocognition. It contains 18 chapters relating research centered on the study of expertise in naturalistic settings, written by international experts in NDM and cognitive systems
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Szu, Harold; Jung, TP; Makeig, Scott
We propose to enhance the decision making of pilot, co-pilot teams, over a range of vehicle platforms, with the aid of neuroscience. The goal is to optimize this collaborative decision making interplay in time-critical, stressful situations. We will research and measure human facial expressions, personality typing, and brainwave measurements to help answer questions related to optimum decision-making in group situations. Further, we propose to examine the nature of intuition in this decision making process. The brainwave measurements will be facilitated by a University of California, San Diego (UCSD) developed wireless Electroencephalography (EEG) sensing cap. We propose to measure brainwaves covering the whole head area with an electrode density of N=256, and yet keep within the limiting wireless bandwidth capability of m=32 readouts. This is possible because solving Independent Component Analysis (ICA) and finding the hidden brainwave sources allow us to concentrate selective measurements with an organized sparse source -->s sensing matrix [Φs], rather than the traditional purely random compressive sensing (CS) matrix[Φ].
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Decision making by various individuals can result in conflicts or cooperation between these individuals. Game theory deals with both the mathematical modeling of these situations of conflict and cooperation and with the analysis of these models using math atical techniques. This thesis focuses on
Full Text Available Each of us makes a number of decisions, from the less important to those with far-reaching consequences. As members of different groups, we are also actors of group decision making. In order to make a rational decision, a choice-making procedure must satisfy a number of assumptions (conditions of rationality. In addition, when it comes to group decisions, those procedures should also be “fair.” However, it is not possible to define a procedure of choice-making that would transform individual orders of alternatives based on preferences of perfectly rational individuals into a single social order and still meet conditions of rationality and ethics. The theory of deliberative democracy appeared in response to the impossibility of Social Choice theory. The basic assumption of deliberative democracy is that individuals adjust their preferences taking into account interests of the community. They are open for discussion with other group members and are willing to change their attitudes in order to achieve common interests. Ideally, group members come to an agreement during public discussion (deliberation. Still, this concept cannot completely overcome all the difficulties posed by the theory of social choice. Specifically, there is no solution for strategic and manipulative behavior of individuals. Also, the concept of deliberative democracy faces certain problems particular to this approach, such as, to name but a few, problems with the establishment of equality of participants in the debate and their motivation, as well as problems with the organization of public hearings. [Projekat Ministarstva nauke Republike Srbije, br. 47009: Evropske integracije i društveno-ekonomske promene privrede Srbije na putu ka EU i br. 179015: Izazovi i perspektive strukturnih promena u Srbiji: Strateški pravci ekonomskog razvoja i usklađivanje sa zahtevima EU
... the Doctors' clinical decision-making despite its huge limitations enumerated by the Doctors. Recommendations were made towards a balanced collection development of both print and non-print materials, aggressive re-sensitization and reorientation to the use of handheld digital devices for evidence-based medicine.
Evans, J S; Over, D E; Manktelow, K I
It is argued that reasoning in the real world supports decision making and is aimed at the achievement of goals. A distinction is developed between two notions of rationality: rationality which is reasoning in such a way as to achieve one's goals--within cognitive constraints--and rationality which is reasoning by a process of logic. This dichotomy is related to the philosophical distinction between practical and theoretical reasoning. It is argued that logicality (rationality) does not provide a good basis for rationality and some psychological research on deductive reasoning is re-examined in this light. First, we review belief bias effects in syllogistic reasoning, and argue that the phenomena do not support the interpretations of irrationality that are often placed upon them. Second, we review and discuss recent studies of deontic reasoning in the Wason selection task, which demonstrate the decision making, and rational nature of reasoning in realistic contexts. The final section of the paper examines contemporary decision theory and shows how it fails, in comparable manner to formal logic, to provide an adequate model for assessing the rationality of human reasoning and decision making.
Adepoju, Ibukun-Oluwa Omolade; Albersen, Bregje Joanna Antonia; De Brouwere, Vincent; van Roosmalen, Jos; Zweekhorst, M.B.M.
BACKGROUND: In a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for
Parsons, S; Jennings, NR
This paper summarises our on-going work on mixed- initiative decision making which extends both classical decision theory and a symbolic theory of decision making based on argumentation to a multi-agent domain.
Luiz Henrique Costa Garcia
Full Text Available The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education; British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters; Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations.
Garcia, Luiz Henrique Costa, E-mail: firstname.lastname@example.org [Associacao de Medicina Intensiva Brasileira (AMIB), Sao Paulo, SP (Brazil); Irmandade da Santa Casa de Misericordia de Sao Paulo, SP (Brazil); Ferreira, Bruna Cortez [Hospital de Base de Sao Jose do Rio Preto, SP (Brazil)
The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw-Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations. (author)
de la Rosa, Leonidas Enrique
If our decision-making processes are to some extent shaped by evolutionary pressures and our environment is different from that to which we adapted, some of our choices will not be in our best interest. But revealed preference is the only tool that we have so far to conduct a normative analysis. ....... Given advances in evolutionary psychology and neuroscience, I propose one way to model those evolutionary pressures that will hopefully prove useful in expanding normative economics.......If our decision-making processes are to some extent shaped by evolutionary pressures and our environment is different from that to which we adapted, some of our choices will not be in our best interest. But revealed preference is the only tool that we have so far to conduct a normative analysis...
Kerr, Norbert L; Tindale, R Scott
Theory and research on small group performance and decision making is reviewed. Recent trends in group performance research have found that process gains as well as losses are possible, and both are frequently explained by situational and procedural contexts that differentially affect motivation and resource coordination. Research has continued on classic topics (e.g., brainstorming, group goal setting, stress, and group performance) and relatively new areas (e.g., collective induction). Group decision making research has focused on preference combination for continuous response distributions and group information processing. New approaches (e.g., group-level signal detection) and traditional topics (e.g., groupthink) are discussed. New directions, such as nonlinear dynamic systems, evolutionary adaptation, and technological advances, should keep small group research vigorous well into the future.
Stephan, S. [Queensland Department of Mines and Energy, Qld. (Australia)
The decision making process during a mine emergency is explored. Using examples from other areas as well as mining industries, poor decision making processes are illustrated. Some decision traps discussed include group think, Abilene paradox, lack of frame control and confirmation bias. Practical techniques that a mine manager, as incident controller, can apply to improve the group decision making process are described. Techniques such as devils advocacy, dialectic decision making, scenario development and decision auditing are explained. 14 refs., 2 figs., 4 tabs.
Strathclyde, Scotland), Crest International Workshop: Advances in the Plankton Ecosystem Model and the Evaluation of Biodiversity , Tokyo University of...February) “Collective Motion, Collective Decision-Making, and Collective Action: From Microbes to Societies,” MASpread/Rapid Trade Meeting...and Collective Action: From Microbes to Societies.” Deutsche Physikalische Gesellschaft Spring Meeting. Physics of Socio-Economic Systems Division
Decisions relating to wildfire management are subject to multiple sources of uncertainty, and are made by a broad range of individuals, across a multitude of environmental and socioeconomic contexts. In this presentation I will review progress towards identification and characterization of uncertainties and how this information can support wildfire decision-making. First, I will review a typology of uncertainties common to wildfire management, highlighting some of the more salient sources of uncertainty and how they present challenges to assessing wildfire risk. This discussion will cover the expanding role of burn probability modeling, approaches for characterizing fire effects, and the role of multi-criteria decision analysis, and will provide illustrative examples of integrated wildfire risk assessment across a variety of planning scales. Second, I will describe a related uncertainty typology that focuses on the human dimensions of wildfire management, specifically addressing how social, psychological, and institutional factors may impair cost-effective risk mitigation. This discussion will encompass decision processes before, during, and after fire events, with a specific focus on active management of complex wildfire incidents. An improved ability to characterize uncertainties faced in wildfire management could lead to improved delivery of decision support, targeted communication strategies, and ultimately to improved wildfire management outcomes.
Marja-Leena Rönkkö; Jaana Lepistö
.... In this study, we examine school students’ decision making during a craft process. The study was conducted during the spring term of 2013 and examines how the students make various decisions during the craft making process...
Epstein, Ronald M; Alper, Brian S; Quill, Timothy E
Informed patients are more likely to actively participate in their care, make wiser decisions, come to a common understanding with their physicians, and adhere more fully to treatment; however, currently there are no evidence-based guidelines for discussing clinical evidence with patients in the process of making medical decisions. To identify ways to communicate evidence that improve patient understanding, involvement in decisions, and outcomes. Systematic review of MEDLINE for the period 1966-2003 and review of reference lists of retrieved articles to identify original research dealing with communication between clinicians and patients and directly addressing methods of presenting clinical evidence to patients. Two investigators and a research assistant screened 367 abstracts and 2 investigators reviewed 51 full-text articles, yielding 8 potentially relevant articles. Methods for communicating clinical evidence to patients include nonquantitative general terms, numerical translation of clinical evidence, graphical representations, and decision aids. Focus-group data suggest presenting options and/or equipoise before asking patients about preferred decision-making roles or formats for presenting details. Relative risk reductions may be misleading; absolute risk is preferred. Order of information presented and time-frame of outcomes can bias patient understanding. Limited evidence supports use of human stick figure graphics or faces for single probabilities and vertical bar graphs for comparative information. Less-educated and older patients preferred proportions to percentages and did not appreciate confidence intervals. Studies of decision aids rarely addressed patient-physician communication directly. No studies addressed clinical outcomes of discussions of clinical evidence. There is a paucity of evidence to guide how physicians can most effectively share clinical evidence with patients facing decisions; however, basing our recommendations largely on related
Hoag, Dana L.; Ascough, James C.; Keske-Handley, C.; Koontz, Lynne; Burk, A.R.
Since Ott's seminal book on environmental indices (1978), the use of indices has expanded into several natural resource disciplines, including ecological studies, environmental policymaking, and agricultural economics. However, despite their increasing use in natural resource disciplines, researchers and public decision makers continue to express concern about validity of these instruments to capture and communicate multidimensional, and sometimes disparate, characteristics of research data and stakeholder interests. Our purpose is to demonstrate how useful indices can be for communicating environmental information to decision makers. We discuss how environmental indices have evolved over four stages: 1) simple; 2) compound multicriteria; 3) the impact matrix and 4) disparate stakeholder management. We provide examples of simple and compound indices that were used by policy decision makers. We then build a framework, called an Impact Matrix (IM), that comprehensively accounts for multiple indices but lets the user decide how to integrate them. The IM was shaped from the concept of a financial risk payoff matrix and applied to ecosystem risk. While the IM offers flexibility, it does not address stakeholder preferences about which index to use. Therefore, the last phase in our evolutionary ladder includes stakeholder indices to specifically address disparate stakeholder preferences. Finally, we assert that an environmental index has the potential to increase resource efficiency, since the number of decision making resources may be reduced, and hence improve upon resource productivity
Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T
Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.
Montyla, Timo; Still, Johanna; Gullberg, Stina; Del Missier, Fabio
Objectives: This study examined decision-making competence in ADHD by using multiple decision tasks with varying demands on analytic versus affective processes. Methods: Adults with ADHD and healthy controls completed two tasks of analytic decision making, as measured by the Adult Decision-Making Competence (A-DMC) battery, and two affective…
Focuses on the use of graphic representations to enable students to improve their decision making skills in the social studies. Explores three visual aids used in assisting students with decision making: (1) the force field; (2) the decision tree; and (3) the decision making grid. (CMK)
Distributed Decision Making and Control is a mathematical treatment of relevant problems in distributed control, decision and multiagent systems, The research reported was prompted by the recent rapid development in large-scale networked and embedded systems and communications. One of the main reasons for the growing complexity in such systems is the dynamics introduced by computation and communication delays. Reliability, predictability, and efficient utilization of processing power and network resources are central issues and the new theory and design methods presented here are needed to analyze and optimize the complex interactions that arise between controllers, plants and networks. The text also helps to meet requirements arising from industrial practice for a more systematic approach to the design of distributed control structures and corresponding information interfaces Theory for coordination of many different control units is closely related to economics and game theory network uses being dictated by...
Gartlehner, Gerald; Matyas, Nina
Shared decision making in medicine has become a widely promoted approach. The goal is for patients and physicians to reach a mutual, informed decision by taking into consideration scientific evidence, clinical experience, and the patient's personal values or preferences. Shared decision making, however, is not a straightforward process. In practice, it might fall short of what it promises and might even be misused to whitewash monetary motives. In this article, which summarizes a presentation given at the 17(th) Annual Conference of the German Network Evidence-based Medicine on March 4(th), 2016 in Cologne, Germany, we discuss three contextual factors that in our opinion can have a tremendous impact on any informed decision making: 1) opinions and convictions of physicians or other clinicians; 2) uncertainty of the evidence regarding benefits and harms; 3) uncertainty of patients about their own values and preferences. But despite barriers and shortcomings, modern medicine currently does not have an alternative to shared decision making. Shared decision making has become a central theme in good quality health care because it has a strong ethical component. Advocates of shared decision making, however, must realize that not all patients prefer to participate in decision making. For those who do, however, we must ensure that shared decisions can be made in a neutral environment as free of biases and conflicts of interest as possible. Copyright © 2016. Published by Elsevier GmbH.
Forsythe, J Chris [Sandia Park, NM; Speed, Ann E [Albuquerque, NM; Jordan, Sabina E [Albuquerque, NM; Xavier, Patrick G [Albuquerque, NM
A method for computer emulation of human decision making defines a plurality of concepts related to a domain and a plurality of situations related to the domain, where each situation is a combination of at least two of the concepts. Each concept and situation is represented in the computer as an oscillator output, and each situation and concept oscillator output is distinguishable from all other oscillator outputs. Information is input to the computer representative of detected concepts, and the computer compares the detected concepts with the stored situations to determine if a situation has occurred.
McGrath, Michael Robert
Institutional strategic decisions require the participation of every individual with a significant stake in the solution, and group decision support systems are being developed to respond to the political and consensual problems of collective decision-making. (MSE)
van Kammen, Jessika; de Savigny, Don; Sewankambo, Nelson
Knowledge brokering is a promising strategy to close the "know-do gap" and foster greater use of research findings and evidence in policy-making. It focuses on organizing the interactive process between the producers and users of knowledge so that they can co-produce feasible and research-informed policy options. We describe a recent successful experience with this novel approach in the Netherlands and discuss the requirements for effective institutionalization of knowledge brokering. We also discuss the potential of this approach to assist health policy development in low-income countries based on the experience of developing the Regional East-African Health (REACH)-Policy Initiative. We believe that intermediary organizations, such as regional networks, dedicated institutional mechanisms and funding agencies, can play key roles in supporting knowledge brokering. We recommend the need to support and learn from the brokerage approach to strengthen the relationship between the research and policy communities and hence move towards a stronger culture of evidence-based policy and policy-relevant research.
Fischer, Alastair J.; Ghelardi, Gemma
The precautionary principle (PP) has been used in the evaluation of the effectiveness and/or cost-effectiveness of interventions designed to prevent future harms in a range of activities, particularly in the area of the environment. Here, we provide details of circumstances under which the PP can be applied to the topic of harm reduction in Public Health. The definition of PP that we use says that the PP reverses the onus of proof of effectiveness between an intervention and its comparator when the intervention has been designed to reduce harm. We first describe the two frameworks used for health-care evaluation: evidence-based medicine (EBM) and decision theory (DT). EBM is usually used in treatment effectiveness evaluation, while either EBM or DT may be used in evaluating the effectiveness of the prevention of illness. For cost-effectiveness, DT is always used. The expectation in Public Health is that interventions employed to reduce harm will not actually increase harm, where “harm” in this context does not include opportunity cost. That implies that an intervention’s effectiveness can often be assumed. Attention should therefore focus on its cost-effectiveness. This view is consistent with the conclusions of DT. It is also very close to the PP notion of reversing the onus of proof, but is not consistent with EBM as normally practiced, where the onus is on showing a new practice to be superior to usual practice with a sufficiently high degree of certainty. Under our definitions, we show that where DT and the PP differ in their evaluation is in cost-effectiveness, but only for decisions that involve potential catastrophic circumstances, where the nation-state will act as if it is risk-averse. In those cases, it is likely that the state will pay more, and possibly much more, than DT would allow, in an attempt to mitigate impending disaster. That is, the rules that until now have governed all cost-effectiveness analyses are shown not to apply to catastrophic
Wolgast, Kelly A
Decision-making is the mainstay of military leadership and command. Due to the changed nature of the current military environment, military commanders can no longer rely solely on the traditional Military Decision-making Process (MDMP...
Antonides, G.; Kroft, M.
The behavioral economic study of fairness was applied to household decision making. A sample of household partners judged the fairness of a number of hypothetical decisions of a household partner, varying in the context of the decision. Decisions made by the partner to make a large personal
Pieter Van Herck
Full Text Available CONTEXT: Health care technological evolution through new drugs, implants and other interventions is a key driver of healthcare spending. Policy makers are currently challenged to strengthen the evidence for and cost-effectiveness of reimbursement decisions, while not reducing the capacity for real innovations. This article examines six cases of reimbursement decision making at the national health insurance authority in Belgium, with outcomes that were contested from an evidence-based perspective in scientific or public media. METHODS: In depth interviews with key stakeholders based on the adapted framework of Davies allowed us to identify the relative impact of clinical and health economic evidence; experience, expertise & judgment; financial impact & resources; values, ideology & political beliefs; habit & tradition; lobbyists & pressure groups; pragmatics & contingencies; media attention; and adoption from other payers & countries. FINDINGS: Evidence was not the sole criterion on which reimbursement decisions were based. Across six equivocal cases numerous other criteria were perceived to influence reimbursement policy. These included other considerations that stakeholders deemed crucial in this area, such as taking into account the cost to the patient, and managing crisis scenarios. However, negative impacts were also reported, in the form of bypassing regular procedures unnecessarily, dominance of an opinion leader, using information selectively, and influential conflicts of interest. CONCLUSIONS: 'Evidence' and 'negotiation' are both essential inputs of reimbursement policy. Yet, purposely selected equivocal cases in Belgium provide a rich source to learn from and to improve the interaction between both. We formulated policy recommendations to reconcile the impact of all factors identified. A more systematic approach to reimburse new care may be one of many instruments to resolve the budgetary crisis in health care in other countries as
Van Herck, Pieter; Annemans, Lieven; Sermeus, Walter; Ramaekers, Dirk
Context Health care technological evolution through new drugs, implants and other interventions is a key driver of healthcare spending. Policy makers are currently challenged to strengthen the evidence for and cost-effectiveness of reimbursement decisions, while not reducing the capacity for real innovations. This article examines six cases of reimbursement decision making at the national health insurance authority in Belgium, with outcomes that were contested from an evidence-based perspective in scientific or public media. Methods In depth interviews with key stakeholders based on the adapted framework of Davies allowed us to identify the relative impact of clinical and health economic evidence; experience, expertise & judgment; financial impact & resources; values, ideology & political beliefs; habit & tradition; lobbyists & pressure groups; pragmatics & contingencies; media attention; and adoption from other payers & countries. Findings Evidence was not the sole criterion on which reimbursement decisions were based. Across six equivocal cases numerous other criteria were perceived to influence reimbursement policy. These included other considerations that stakeholders deemed crucial in this area, such as taking into account the cost to the patient, and managing crisis scenarios. However, negative impacts were also reported, in the form of bypassing regular procedures unnecessarily, dominance of an opinion leader, using information selectively, and influential conflicts of interest. Conclusions ‘Evidence’ and ‘negotiation’ are both essential inputs of reimbursement policy. Yet, purposely selected equivocal cases in Belgium provide a rich source to learn from and to improve the interaction between both. We formulated policy recommendations to reconcile the impact of all factors identified. A more systematic approach to reimburse new care may be one of many instruments to resolve the budgetary crisis in health care in other countries as well, by separating
Full Text Available The article shows the stages of development of the theory and practice of decision-making. Emphasis is placed on the contemporary culture of decision-making. At the base of the current trends is the transition from intuition and experience in decision-making to analytics. Modern business intelligence means the development of the culture of work with big data.
The article shows the stages of development of the theory and practice of decision-making. Emphasis is placed on the contemporary culture of decision-making. At the base of the current trends is the transition from intuition and experience in decision-making to analytics. Modern business intelligence means the development of the culture of work with big data.
Bridge, Jeffrey A.; McBee-Strayer, Sandra M.; Cannon, Elizabeth A.; Sheftall, Arielle H.; Reynolds, Brady; Campo, John V.; Pajer, Kathleen A.; Barbe, Remy P.; Brent, David A.
Objective: Decision-making deficits have been linked to suicidal behavior in adults. However, it remains unclear whether impaired decision making plays a role in the etiopathogenesis of youth suicidal behavior. The purpose of this study was to examine decision-making processes in adolescent suicide attempters and never-suicidal comparison…
There is an increasing global need for music therapy practice to be evidence-based with more experimental research findings. This is particularly the case as music therapy is introduced as a complementary therapy in many medical settings, with special reference to integrated care. Can music therapy be really evidence-based as is the case in medicine? How practical is it? Can the multidimensional role that a music therapist plays in a therapeutic setting, her skills, the time she spends with t...
Seidl, C.; Traub, S.
This paper investigates the existence of an editing phase and studies the com- pliance of subjects' behaviour with the most popular multiattribute decision rules. We observed that our data comply well with the existence of an editing phase, at least if we allow for a natural error rate of some 25%.
Hermans, Caroline M.; Erickson, Jon D.; Erickson, Jon D.; Messner, Frank; Ring, Irene
Environmental decision making involving multiple stakeholders can benefit from the use of a formal process to structure stakeholder interactions, leading to more successful outcomes than traditional discursive decision processes. There are many tools available to handle complex decision making. Here we illustrate the use of a multicriteria decision analysis (MCDA) outranking tool (PROMETHEE) to facilitate decision making at the watershed scale, involving multiple stakeholders, multiple criteria, and multiple objectives. We compare various MCDA methods and their theoretical underpinnings, examining methods that most realistically model complex decision problems in ways that are understandable and transparent to stakeholders.
Electroencephalogy ( EEG ) Feedback In Decision- Making The goal of this project is to investigate whether Electroencephalogy ( EEG ) can provide useful...feedback when training rapid decision-making. More specifically, EEG will allow us to provide online feedback about the neural decision processes...Electroencephalogy ( EEG ) Feedback In Decision-Making Report Title The goal of this project is to investigate whether Electroencephalogy ( EEG ) can provide useful
Full Text Available The main purpose of this study is to explore the relation between decision-making styles which are measured by the General decision-making style (GDMS test and information processing styles which are often termed cognitive styles and are, in this study, measured by Cognitive Style Inventory. The authors directed a survey research on 162 Iranian students. Structural equation modeling techniques were used to measure the impact of cognitive styles on decision-making styles. The authors found that cognitive styles have a positive impact on decision-making styles. In spite of the abundant research on factors that affect decision-making styles, few researches have tested the relationship between cognitive styles and decision-making styles. This study examines the impact of cognitive styles on decision-making styles in Iran. This study, like most research paper studies, cannot easily be generalized. Furthermore, the results of this study could be affected by economic conditions.
van der Linden, Willem J.
The use of Bayesian decision theory to solve problems in test-based decision making is discussed. Four basic decision problems are distinguished: (1) selection; (2) mastery; (3) placement; and (4) classification, the situation where each treatment has its own criterion. Each type of decision can be
Dobrajska, Magdalena; Billinger, Stephan; Becker, Markus
We report findings from an analysis of 234 firm boundary decisions that a manufacturing firm has made during a 10 year period. Extensive interviews with all major decision makers located both at the headquarters and subsidiaries allow us to examine (a) who was involved in each boundary decision...
Khan, Muhammad Waqas; Muehlschlegel, Susanne
Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit. Copyright © 2017 Elsevier Inc. All rights reserved.
Decision-making has evolved recently thanks to the introduction of information and communication technologies in many organizations, which has led to new kinds of decision-making processes, called "collaborative decision-making", at the organizational and cognitive levels. This book looks at the development of the decision-making process in organizations. Decision-aiding and its paradigm of problem solving are defined, showing how decision-makers now need to work in a cooperative way. Definitions of cooperation and associated concepts such as collaboration and coordination are given and a framework of cooperative decision support systems is presented, including intelligent DSS, cooperative knowledge-based systems, workflow, group support systems, collaborative engineering, integrating with a collaborative decision-making model in part or being part of global projects. Several models and experimental studies are also included showing that these new processes have to be supported by new types of tools, several ...
Søndergaard, Erik Stefan; Ahmed-Kristensen, Saeema
Many engineering companies experience new challenges when globalising product development. Global product development (GPD) is a relatively nascent research area, and previous research reveals the need for decision support frameworks. This research investigates how decisions are made when companies...... outsource or offshore product development tasks, and how these decisions can be improved. A brief literature review on existing research on GPD and decision making is given, followed by two case studies, where implications of decisions are investigated. The findings point towards further studies required...... for creating a decision support framework for managers to make better decisions in the future....
Quimbo Stella A
collection effort to account for unanticipated findings; introducing sustainable policy interventions based on the reform agenda; and providing results in real-time to policy makers through a combination of venues. Conclusion QIDS demonstrates that a large, prospective, randomized controlled policy experiment can be successfully implemented at a national level as part of sectoral reform. While we believe policy experiments should be used to generate evidence-based health policy, to do this requires opportunity and trust, strong collaborative relationships, and timing. This study nurtures the growing attitude that translation of scientific findings from the bedside to the community can be done successfully and that we should raise the bar on project evaluation and the policy-making process.
Full Text Available (INTJ) on the Myers-Briggs personality type indicators, and who then proceeded to explain their decision-making behaviour in the light of this. The Recognition-Primed Decision Model was supported in the sense that decision-making was seen by DM2, DM3...
West, Dana R.
Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. Ethical decision making for this study was defined as the degree to which decisions pertaining to…
Delegating decision making to those closest to implementation can result in better decisions, more support for improvement initiatives, and increased student performance. Shared decision making depends on capable school leadership, a professional community, instructional guidance mechanisms, knowledge and skills, information sharing, power, and…
Hagmayer, Y.; Witteman, C.L.M.
Normative causal decision theories argue that people should use their causal knowledge in decision making. Based on these ideas, we argue that causal knowledge and reasoning may support and thereby potentially improve decision making based on expected outcomes, narratives, and even cues. We will
Buzhardt, Jay; Greenwood, Charles; Walker, Dale; Carta, Judith; Terry, Barbara; Garrett, Matthew
Progress monitoring and data-based intervention decision making have become key components of providing evidence-based early childhood special education services. Unfortunately, there is a lack of tools to support early childhood service providers' decision-making efforts. The authors describe a Web-based system that guides service providers…
Brickman, Peggy; Gormally, Cara; Martella, Amedee Marchand
Typically, faculty receive feedback about teaching via two mechanisms: end-of-semester student evaluations and peer observation. However, instructors require more sustained encouragement and constructive feedback when implementing evidence-based teaching practices. Our study goal was to characterize the landscape of current instructional-feedback…
Ko, C-H; Wang, P-W; Liu, T-L; Chen, C-S; Yen, C-F; Yen, J-Y
Persistent gaming, despite acknowledgment of its negative consequences, is a major criterion for individuals with Internet gaming disorder (IGD). This study evaluated the adaptive decision-making, risky decision, and decision-making style of individuals with IGD. We recruited 87 individuals with IGD and 87 without IGD (matched controls). All participants underwent an interview based on the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) diagnostic criteria for IGD and completed an adaptive decision-making task; the Preference for Intuition and Deliberation Scale, Chen Internet Addiction Scale, and Barratt Impulsivity Scale were also assessed on the basis of the information from the diagnostic interviews. The results demonstrated that the participants in both groups tend to make more risky choices in advantage trials where their expected value (EV) was more favorable than those of the riskless choice. The tendency to make a risky choice in advantage trials was stronger among IGD group than that among controls. Participants of both groups made more risky choices in the loss domain, a risky option to loss more versus sure loss option, than they did in the gain domain, a risky option to gain more versus sure gain. Furthermore, the participants with IGD made more risky choices in the gain domain than did the controls. Participants with IGD showed higher and lower preferences for intuitive and deliberative decision-making styles, respectively, than controls and their preferences for intuition and deliberation were positively and negatively associated with IGD severity, respectively. These results suggested that individuals with IGD have elevated EV sensitivity for decision-making. However, they demonstrated risky preferences in the gain domain and preferred an intuitive rather than deliberative decision-making style. This might explain why they continue Internet gaming despite negative consequences. Thus, therapists should focus more on decision-making
Dohan, Daniel; Garrett, Sarah B; Rendle, Katharine A; Halley, Meghan; Abramson, Corey
When making health care decisions, patients and consumers use data but also gather stories from family and friends. When advising patients, clinicians consult the medical evidence but also use professional judgment. These stories and judgments, as well as other forms of narrative, shape decision making but remain poorly understood. Furthermore, qualitative research methods to examine narrative are rarely included in health science research. We illustrate how narratives shape decision making and explain why it is difficult but necessary to integrate qualitative research on narrative into the health sciences. We draw on social-scientific insights on rigorous qualitative research and our ongoing studies of decision making by patients with cancer, and we describe new tools and approaches that link qualitative research findings with the predominantly quantitative health science scholarship. Finally, we highlight the benefits of more fully integrating qualitative research and narrative analysis into the medical evidence base and into evidence-based medical practice. Project HOPE—The People-to-People Health Foundation, Inc.
Full Text Available environment made up of many domains, actors, resources, asset pools, factors and performance criteria. In his talk, Velthausz will discuss the ability to make and implement sound planning and operational decisions based on better informed decision...
Orasanu, Judith; Statler, Irving C. (Technical Monitor)
The importance of crew decision making to aviation safety has been well established through NTSB accident analyses: Crew judgment and decision making have been cited as causes or contributing factors in over half of all accidents in commercial air transport, general aviation, and military aviation. Yet the bulk of research on decision making has not proven helpful in improving the quality of decisions in the cockpit. One reason is that traditional analytic decision models are inappropriate to the dynamic complex nature of cockpit decision making and do not accurately describe what expert human decision makers do when they make decisions. A new model of dynamic naturalistic decision making is offered that may prove more useful for training or aiding cockpit decision making. Based on analyses of crew performance in full-mission simulation and National Transportation Safety Board accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation and reflect the crew's metacognitive skill. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relation between communication that serves to build performance. Implications of these findings for crew training will be discussed.
Smith, D L; Hamrick, M H; Anspaugh, D J
Teachers are usually very enthusiastic in their evaluations of decision stories. Decision Story Strategies offer a change of pace, promote student involvement and stimulate creative thinking, problem solving and everpresent creative teaching-learning opportunities. The real-life problems presented within the structure of a decision story provide meaningful learning opportunities for students. Students begin to think in a broader perspective when considering other points of view and information sources. The Decision Story Strategy used with the Decision-Making Model provides a powerful tool for health educators to develop skills for making and evaluating decisions in an interesting and meaningful context. It may not be a panacea for all health educators, but is an effective strategy for the teacher concerned with developing independent decision makers. Most importantly, students are provided opportunities to solve their present problems as well as develop decision-making skills for the future.
Abstract Decision making is one of the most important and frequent tasks among managers and employees in an organization. Knowledge about more stable cognitive characteristics underlying decision making styles has been requested. This study aimed to examine the relationship between rational decision making style, cognitive style, self efficacy and locus of control. Possible interaction effects in relation to gender were also analyzed. 186 employees at the Ministry of Defence were surveyed...
Weller, Joshua A.; Fisher, Philip A.
Although maltreated children involved with child welfare services are known to exhibit elevated levels of health-risking behaviors, little is known about their decision-making processes leading to these behaviors. Research findings suggest that maltreated children exhibit developmental delays in neurocognitive and emotional regulation systems that could adversely impact their abilities to make decisions under conditions of risk. Whereas prior researchers have examined risky decision making as...
Nesbitt, P.; Kennedy, Q.; Alt, JK; Fricker, RD; Whitaker, L.; Yang, J.; Appleget, JA; Huston, J.; Patton, S
Approved for public release; distribution is unlimited. This research aims to gain insight into optimal wargaming decision-making mechanisms using neurophysiological measures by investigating whether brain activation and visual scan patterns predict attention, perception, and/or decision-making errors through human-in-the-loop wargaming simulation experiments. We investigate whether brain activity and visual scan patterns can explain optimal wargaming decision making and its devel...
Schroeder, Julie; Guin, Cecile C.; Pogue, Rene; Bordelon, Danna
Providing an effective defense for individuals charged with capital crimes requires a diligent, thorough investigation by a mitigation specialist. However, research suggests that mitigation often plays a small role in the decision for life. Jurors often make sentencing decisions prematurely, basing those decisions on their personal reactions to…
..., this article offers material on some important issues - in the context of forensic psychology - such as ethical decision-making and principles, professional ethics, the regulation of psychology...
Qudrat-Ullah, Hassan; Spector, J Michael
The increasingly complex environment of today's world, characterized by technological innovation and global communication, generates myriads of possible and actual interactions while limited physical and intellectual resources severely impinge on decision makers, be it in the public or private domains. At the core of the decision-making process is the need for quality information that allows the decision maker to better assess the impact of decisions in terms of outcomes, nonlinear feedback processes and time delays on the performance of the complex system invoked. This volume is a timely review on the principles underlying complex decision making, the handling of uncertainties in dynamic envrionments and of the various modeling approaches used. The book consists of five parts, each composed of several chapters: I: Complex Decision Making: Concepts, Theories and Empirical Evidence II: Tools and Techniques for Decision Making in Complex Environments and Systems III: System Dynamics and Agent-Based Modeling IV:...
Kárný, Miroslav; Wolpert, David
This volume focuses on uncovering the fundamental forces underlying dynamic decision making among multiple interacting, imperfect and selﬁsh decision makers. The chapters are written by leading experts from different disciplines, all considering the many sources of imperfection in decision making, and always with an eye to decreasing the myriad discrepancies between theory and real world human decision making. Topics addressed include uncertainty, deliberation cost and the complexity arising from the inherent large computational scale of decision making in these systems. In particular, analyses and experiments are presented which concern: • task allocation to maximize “the wisdom of the crowd”; • design of a society of “edutainment” robots who account for one anothers’ emotional states; • recognizing and counteracting seemingly non-rational human decision making; • coping with extreme scale when learning causality in networks; • efﬁciently incorporating expert knowledge in personalized...
Harvey, Naomi D; Craigon, Peter J; Blythe, Simon A; England, Gary C W; Asher, Lucy
Working dog organisations, such as Guide Dogs, need to regularly assess the behaviour of the dogs they train. In this study we developed a questionnaire-style behaviour assessment completed by training supervisors of juvenile guide dogs aged 5, 8 and 12 months old (n = 1,401), and evaluated aspects of its reliability and validity. Specifically, internal reliability, temporal consistency, construct validity, predictive criterion validity (comparing against later training outcome) and concurrent criterion validity (comparing against a standardised behaviour test) were evaluated. Thirty-nine questions were sourced either from previously published literature or created to meet requirements identified via Guide Dogs staff surveys and staff feedback. Internal reliability analyses revealed seven reliable and interpretable trait scales named according to the questions within them as: Adaptability; Body Sensitivity; Distractibility; Excitability; General Anxiety; Trainability and Stair Anxiety. Intra-individual temporal consistency of the scale scores between 5-8, 8-12 and 5-12 months was high. All scales excepting Body Sensitivity showed some degree of concurrent criterion validity. Predictive criterion validity was supported for all seven scales, since associations were found with training outcome, at at-least one age. Thresholds of z-scores on the scales were identified that were able to distinguish later training outcome by identifying 8.4% of all dogs withdrawn for behaviour and 8.5% of all qualified dogs, with 84% and 85% specificity. The questionnaire assessment was reliable and could detect traits that are consistent within individuals over time, despite juvenile dogs undergoing development during the study period. By applying thresholds to scores produced from the questionnaire this assessment could prove to be a highly valuable decision-making tool for Guide Dogs. This is the first questionnaire-style assessment of juvenile dogs that has shown value in predicting
Kovner, Anthony R; Rundall, Thomas G
Reports of medical mistakes have splashed across newspapers and magazines in the United States. At the same time, instances of overuse, underuse, and misuse of management tactics and strategies receive far less attention. The sense of urgency associated with improving the quality of medical care does not exist with respect to improving the quality of management decision making. A more evidence-based approach would improve the competence of the decision-makers and their motivation to use more scientific methods when making a decision. The authors of this article consider a study of 68 U.S. health services managers that found a low level of evidence-based management behaviors. From the findings, four strategies are suggested to increase health systems managers' use of research evidence to improve decision making: focusing evidence-based decision making on strategically important issues, developing committees and other structures to diffuse management research throughout the organization, building a management culture that values research, and training managers in the competencies required to apply research evidence to health services management decisions. To aid the manager in understanding and applying an evidenced-based approach to decision making, the article provides practical tools, techniques, and resources for immediate use.
Reduction in prices now makes it possible for almost any institution to use computer graphics for administrative decision making and research. Current and potential uses of computer graphics in these two areas are discussed. (JN)
Lee, Matthew K; Most, Sam P
Evidence-based medicine has become increasingly prominent in the climate of modern day healthcare. The practice of evidence-based medicine involves the integration of the best available evidence with clinical experience and expertise to help guide clinical decision-making. The essential tenets of evidence-based medicine can be applied to both functional and aesthetic rhinoplasty. Current outcome measures in functional and aesthetic rhinoplasty, including objective, subjective, and clinician-reported measures, is summarized and the current data is reviewed. Copyright © 2015 Elsevier Inc. All rights reserved.
The evidential basis for disease management decision making is provided by data relating to risk factors. The decision process involves an assessment of the evidence leading to taking (or refraining from) action on the basis of a prediction. The primary objective of the decision process is to identify-at the time the decision is made-the control action that provides the best predicted end-of-season outcome, calculated in terms of revenue or another appropriate metric. Data relating to disease risk factors may take a variety of forms (e.g., continuous, discrete, categorical) on measurement scales in a variety of units. Log10-likelihood ratios provide a principled basis for the accumulation of evidence based on such data and allow predictions to be made via Bayesian updating of prior probabilities.
Daniel L. Schmoldt; David L. Peterson
Public land managers must treat multiple values coincidentally in time and space, which requires the participation of multiple resource specialists and consideration of diverse clientele interests in the decision process. This implies decision making that includes multiple participants, both internally and externally. Decades of social science research on decision...
Zavadskas, Edmundas Kazimieras; Govindan, K.; Antucheviciene, Jurgita
Formal decision-making methods can be used to help improve the overall sustainability of industries and organisations. Recently, there has been a great proliferation of works aggregating sustainability criteria by using diverse multiple criteria decision-making (MCDM) techniques. A number of review...... the advantages of hybrid approaches over individual methods, and we conclude that they can assist decision-makers in handling information such as stakeholders' preferences, interconnected or contradictory criteria, and uncertain environments. The main contribution of this work is identifying hybrid approaches...... as improvements for decision-making related to sustainability issues, while also promoting future application of the approaches....
Israelsen, Poul; Jørgensen, Brian
that aligns the descriptions of the economic consequences of modularization at the project and portfolio level which makes it possible to decentralize decision making while making sure that local goals are congruent with the global ones in order to avoid suboptimal behaviour. Keywords: Modularization...... which distorts the economic effects of modularization at the level of the individual product. This has the implication that decisions on modularization can only be made by top management if decision authority and relevant information are to be aligned. To overcome this problem, we suggest a solution......; Accounting; Cost allocation; Decision rule; Decentralization...
Thomson, Carrie Louise; Maskrey, Neal; Vlaev, Ivo
Despite the widespread inclusion of consultation skills in undergraduate healthcare curricula, patient-doctor interactions are often an imparting of evidence or information rather than an exchange. Evidence-based practice may be further enhanced by increasing explicit understanding of decision-making processes used by healthcare professionals and patients. This exploratory investigation evaluated the impact of an educational intervention on understanding of decision-making processes and practice. The effect of session schedule was assessed to inform the future delivery strategy of such approaches. Three groups of primary care health professionals (n = 85) completed questionnaires using Likert scales to assess strength of agreement with decision-making statements exploring four themes - Theory, Applied Theory, Practice and Joint Practice - pre-intervention and post-intervention. Responses were analysed, firstly to assess the impact of the intervention on understanding of decision-making processes and practice across all participants and then by group to determine the effect of session schedules on outcome measures. Overall agreement with the decision-making statements significantly increased after the learning set (Mean = -0.162, SD = 0.355); t(64) = -3.666, p processes and application to clinical practice. The extended learning sessions did not provide additional benefits over and above 2 half days or 1 whole day learning sessions. © 2016 John Wiley & Sons, Ltd.
Simon, Herbert A.
Describes the current state of knowledge about human decision-making and problem-solving processes, explaining recent developments and their implications for management and management training. Rational goal-setting is the key to effective decision making and accomplishment. Bounded rationality is a realistic orientation, because the world is too…
Brazer, S. David; Rich, William; Ross, Susan A.
Purpose: The dual purpose of this paper is to determine how superintendents in US school districts work with stakeholders in the decision-making process and to learn how different choices superintendents make affect decision outcomes. Design/methodology/approach: This multiple case study of three school districts employs qualitative methodology to…
van Vliet, Hans; Tang, Anthony
Traditionally, software architecture is seen as the result of the software architecture design process, the solution, usually represented by a set of components and connectors. Recently, the why of the solution, the set of design decisions made by the software architect, is complementing or even
The thesis focuses on rationality in decisions by managers. The terms rationality, irrationality and bounded rationality are defined in the first part. The current state of knowledge on the concept of bounded rationality in decision making is then followed by a specific consideration of managerial decision making. The chosen bounded rationality effects, including heuristics, are also described. The purpose of the second part of this study is to examine experimentally the differential uses of ...
S. Dominguez Martinez (Silvia)
textabstractEvery day individuals make numerous choices. What is important for making the right choice is that individuals have good information about the consequences of the different alternatives. However, investigating the full consequences of the different alternatives is complicated and
Schöbel, Markus; Rieskamp, Jörg; Huber, Rafael
People often make decisions in a social environment. The present work examines social influence on people's decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others' authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions.
Full Text Available People often make decisions in a social environment. The present work examines social influence on people's decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others' authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions.
Chang, Luke J; Sanfey, Alan G
Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels to the automatic system. This chapter will discuss a theoretical framework for understanding the role of emotion in decision-making and evidence supporting the underlying neural substrates. This chapter applies a conceptual framework to understanding the role of emotion in decision-making, and emphasizes a distinction between expected and immediate emotions. Expected emotions refer to anticipated emotional states associated with a given decision that are never actually experienced. Immediate emotions, however, are experienced at the time of decision, and either can occur in response to a particular decision or merely as a result of a transitory fluctuation. This chapter will review research from the neuroeconomics literature that supports a neural dissociation between these two classes of emotion and also discuss a few interpretive caveats. Several lines of research including regret, uncertainty, social decision-making, and moral decision-making have yielded evidence consistent with our formulization--expected and immediate emotions may invoke dissociable neural systems. This chapter provides a more specific conceptualization of the mediating role of emotions in the decision-making process, which has important implications for understanding the interacting neural systems underlying the interface between emotion and cognition--a topic of immediate value to anyone investigating topics within the context of social-cognitive-affective-neuroscience.
Fortnum, Debbie; Smolonogov, Tatiana; Walker, Rachael; Kairaitis, Luke; Pugh, Debbie
For patients with chronic kidney disease (CKD) who are progressing to end-stage kidney disease (ESKD) a decision of whether to undertake dialysis or conservative care is a critical component of the patient journey. Shared decision making for complex decisions such as this could be enhanced by a decision aid, a practice which is well utilised in other disciplines but limited for nephrology. A multidisciplinary team in Australia and New Zealand (ANZ) utilised current decision-making theory and best practice to develop the 'My Kidneys, My Choice', a decision aid for the treatment of kidney disease. A patient-centred, five-sectioned tool is now complete and freely available to all ANZ units to support the ESKD education and shared decision-making process. Distribution and education have occurred across ANZ and evaluation of the decision aid in practice is in the first phase. Development of a new tool such as an ESKD decision aid requires vision, multidisciplinary input and ongoing implementation resources. This tool is being integrated into ANZ, ESKD education practice and is promoting the philosophy of shared decision making. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.
Cooper, R J; Bissell, P; Wingfield, J
Increasing interest in empirical ethics has enhanced understanding of healthcare professionals' ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making. To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an under-researched professional group. 23 purposively sampled UK community pharmacists were asked, in semi-structured interviews, to describe ethical problems in their work and how they were resolved. Framework analysis of transcribed interviews utilised the four decision-making stages, together with constant comparative methods and deviant-case analysis. Pharmacists were often inattentive and constructed problems in legal terms. Ethical reasoning was limited, but examples of appeals to consequences, the golden rule, religious faith and common-sense experience emerged. Ethical intention was compromised by frequent concern about legal prosecution. Ethical inaction was common, typified by pharmacists' failure to report healthcare professionals' bad practices, and ethical passivity emerged to describe these negative examples of the four decision-making stages. Pharmacists occasionally described more ethically active decision-making, but this often involved ethical uncertainty. The four decision-making stages are a useful tool in considering how healthcare professionals try to resolve ethical problems in practice. They reveal processes often ignored in normative theories, and their recognition and the emergence of ethical passivity indicates the complexity of decision-making in practice. Ethical passivity may be deleterious to patients' welfare, and concerns emerge about improving pharmacists' ethical training and promoting ethical awareness and responsibility.
Rauscher, C; Salzberger, B
The medical treatment of migrants and refugees has recently become an important topic in the German healthcare system due to the large numbers of migrants. Healthcare for migrants includes treatment of acute illnesses and trauma on arrival, screening for chronic communicable and non-communicable diseases and in the long term, the integration into the local healthcare system. As health problems of migrants are diverse and dependent on the region of origin, guidelines should be readily available for all healthcare professionals involved in migrant healthcare. A literature search for comprehensive guidelines for screening and treatment of migrant's health problems detected 47 different guidelines including 2 comprehensive ones from the US Centers of Disease Control and Prevention and the Canadian Collaboration for Immigrant and Refugee Health. Comparative analysis of these guidelines could be a starting point for evidence-based European guidelines on migrant health.
The decision of not organizing a Program Evaluation System at country level government has many negative implications as far as the decision-making process is concerned. The lack of political responsiveness, fiscal discipline and institutional effectiveness are part of the effects. The government does not require a coherent, solid evaluation system and, in exchange, it gets ‘Bleak House’- type reports. Program evaluation offers the adequate tools to do evidence-based decision-making on public...
Hirshleifer, David; Jian, Ming; Zhang, Huai
In Chinese culture, certain digits are lucky and others unlucky. We test how such numerological superstition affects financial decision in the China IPO market. We find that the frequency of lucky numerical stock listing codes exceeds what would be expected by chance. Also consistent with superstition effects, newly listed firms with lucky listing codes are initially traded at a premium after controlling for known determinants of valuation multiples, the lucky number premium dissipates within...
Cara Okleshen Peters, Ph.D.
Full Text Available This paper highlights the potential of customer decision support systems (CDSS to assist students in education-related decision making. Faculty can use these resources to more effectively advise students on various elements of college life, while students can employ them to more actively participate in their own learning and improve their academic experience. This conceptual paper summarizes consumer decision support systems (CDSS concepts and presents exemplar websites students could utilize to support their education-related decision making. Finally, the authors discuss the potential benefits and drawbacks such resources engender from a student perspective and conclude with directions for future research.
Bals, Lydia; Kneis, Kyra; Lemke, Christine
the decision making process on R&D outsourcing are lacking. To address this gap, we present a framework developed in the context of a multinational pharmaceutical company. The framework builds on general make-or-buy frameworks and incorporates specificities of the service and knowledge-driven areas...... contributes to the emerging area of research into decision making processes on outsourcing in knowledge-intensive industries....
Full Text Available Supported decision-making is at the forefront of modern disability research. This is due to Article 12 of the Convention on the Rights of Persons with Disabilities (CRPD, which creates a state obligation to provide support for the exercise of legal capacity. This turned the practice of supported decision-making into a human rights imperative. Government and funding agencies are increasingly focusing their attention on the area. Researchers are similarly increasing their interest in the field. The impending danger is that the rush of interest in the area will overshadow the original intention of supported decision-making: to ensure that people with cognitive disability are provided with the freedom and the tools to participate as equal citizens and for every individual to be free to direct their own life. This article explores the theoretical foundations of supported decision-making and the evolution of supported decision-making research. It explains the research that is emerging in leading jurisdictions, the United States and Australia, and its potential to transform disability services and laws related to decision-making. Finally, it identifies areas of concern in the direction of such research and provides recommendations for ensuring that supported decision-making remains protective of the rights, will and preferences of people with cognitive disability.
Full Text Available The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict -associated with indicators of the activation of negative feelings (negative affect state and heart rate- has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making.
Boland, Laura; Kryworuchko, Jennifer; Saarimaki, Anton; Lawson, Margaret L
Decisional conflict is a state of uncertainty about the best treatment option among competing alternatives and is common among adult patients who are inadequately involved in the health decision making process. In pediatrics, research shows that many parents are insufficiently involved in decisions about their child's health. However, little is known about parents' experience of decisional conflict. We explored parents' perceived decision making involvement and its association with parents' decisional conflict. We conducted a descriptive survey study in a pediatric tertiary care hospital. Our survey was guided by validated decisional conflict screening items (i.e., the SURE test). We administered the survey to eligible parents after an ambulatory care or emergency department consultation for their child. Four hundred twenty-nine respondents were included in the analysis. Forty-eight percent of parents reported not being offered treatment options and 23% screened positive for decisional conflict. Parents who reported being offered options experienced less decisional conflict than parents who reported not being offered options (5% vs. 42%, p parents with options were more likely to: feel sure about the decision (RR 1.08, 95% CI 1.02-1.15); understand the information (RR 1.92, 95% CI 1.63-2.28); be clear about the risks and benefits (RR 1.12, 95% CI 1.05-1.20); and, have sufficient support and advice to make a choice (RR 1.07, 95% CI 1.03-1.11). Many parents in our sample experienced decisional conflict after their clinical consultation. Involving parents in the decision making process might reduce their risk of decisional conflict. Evidence based interventions that support parent decision making involvement, such as shared decision making, should be evaluated and implemented in pediatrics as a strategy to reduce parents' decisional conflict.
Delmar, M. V.; Sørensen, John Dalsgaard
The target group in this paper is people concerned with mathematical economic decision theory. It is shown how the numerically effective First Order Reliability Methods (FORM) can be used in rational management decision making, where some parameters in the applied decision basis are uncertainty...... quantities. The uncertainties are taken into account consistently and the decision analysis is based on the general decision theory in combination with reliability and optimization theory. Examples are shown where the described technique is used and some general conclusion are stated....
Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael
Using controlled experiments, we examine how individuals make choices when faced with multiple options. Choice tasks are designed to mimic the selection of health insurance, prescription drug, or retirement savings plans. In our experiment, available options can be objectively ranked allowing us to examine optimal decision making. First, the probability of a person selecting the optimal option declines as the number of options increases, with the decline being more pronounced for older subjects. Second, heuristics differ by age with older subjects relying more on suboptimal decision rules. In a heuristics validation experiment, older subjects make worse decisions than younger subjects. PMID:22544977
Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael
Using controlled experiments, we examine how individuals make choices when faced with multiple options. Choice tasks are designed to mimic the selection of health insurance, prescription drug, or retirement savings plans. In our experiment, available options can be objectively ranked allowing us to examine optimal decision making. First, the probability of a person selecting the optimal option declines as the number of options increases, with the decline being more pronounced for older subjects. Second, heuristics differ by age with older subjects relying more on suboptimal decision rules. In a heuristics validation experiment, older subjects make worse decisions than younger subjects.
Lu, Jie; Zhang, Guangquan
This book presents innovative theories, methodologies, and techniques in the field of risk management and decision making. It introduces new research developments and provides a comprehensive image of their potential applications to readers interested in the area. The collection includes: computational intelligence applications in decision making, multi-criteria decision making under risk, risk modelling,forecasting and evaluation, public security and community safety, risk management in supply chain and other business decision making, political risk management and disaster response systems. The book is directed to academic and applied researchers working on risk management, decision making, and management information systems.
Woodhouse, C. A.; Crimmins, M.; Ferguson, D. B.; Garfin, G. M.; Scott, C. A.
As society is confronted with population growth, limited resources, and the impacts of climate variability and change, it is vital that institutions of higher education promote the development of professionals who can work with decision-makers to incorporate scientific information into environmental planning and management. Skills for the communication of science are essential, but equally important is the ability to understand decision-making contexts and engage with resource managers and policy makers. It is increasingly being recognized that people who understand the linkages between science and decision making are crucial if science is to better support planning and policy. A new graduate-level seminar, "Making the Connection between Environmental Science and Decision Making," is a core course for a new post-baccalaureate certificate program, Connecting Environmental Science and Decision Making at the University of Arizona. The goal of the course is to provide students with a basic understanding of the dynamics between scientists and decision makers that result in scientific information being incorporated into environmental planning, policy, and management decisions. Through readings from the environmental and social sciences, policy, and planning literature, the course explores concepts including scientific information supply and demand, boundary organizations, co-production of knowledge, platforms for engagement, and knowledge networks. Visiting speakers help students understand some of the challenges of incorporating scientific information into planning and decision making within institutional and political contexts. The course also includes practical aspects of two-way communication via written, oral, and graphical presentations as well as through the interview process to facilitate the transfer of scientific information to decision makers as well as to broader audiences. We aspire to help students develop techniques that improve communication and
Cara Okleshen Peters, Ph.D.; David A. Bradbard, Ph.D.; Mary C. Martin, Ph.D.
This paper highlights the potential of customer decision support systems (CDSS) to assist students in education-related decision making. Faculty can use these resources to more effectively advise students on various elements of college life, while students can employ them to more actively participate in their own learning and improve their academic experience. This conceptual paper summarizes consumer decision support systems (CDSS) concepts and presents exemplar websites students could utili...
Pauley, Keryn; Flin, Rhona; Yule, Steven; Youngson, George
Surgical research on decision making and risk management usually focuses on perioperative care, despite the magnitude and frequency of intraoperative risks. The aim of this study was to examine surgeons' intraoperative decisions and risk management strategies to explore differences in cognitive processes. Critical decision method interviews were conducted with 24 consultant surgeons who recalled cases and selected important decisions during the operations. These decision were then discussed in detail in relation to decision-making style and risk management. The key decision in each case was made using either a rapid, intuitive mode (46%) or a more deliberate comparison of alternative courses of action (50%). Decision strategy was not related to surgical approach (endoscopic vs open), context (elective vs emergency), perceived time pressure, or situational threats. Risk management involved perceiving threats and assessing impact but also indicated the role of personal risk tolerance. Surgeons described making key intraoperative decisions using either an intuitive or an analytic mode of thinking. Surgeons' risk assessment, risk tolerance, and decision strategies appear to be influenced by their personalities. Copyright © 2011 Elsevier Inc. All rights reserved.
Wye, Lesley; Shaw, Alison; Sharp, Debbie
Abstract Objective Current government policies simultaneously pursue the development of ‘patient‐led’ and ‘evidence‐based’ approaches to healthcare. The objective of this study was to explore how primary care clinicians and Primary Care Trust (PCT) managers balance these potentially competing tensions when considering popular, controversial treatments, like complementary therapies, in consultations (clinicians) or funding decisions (PCT managers). Setting and participants We selected two case sites where complementary therapies were offered on NHS premises in England. We interviewed 18 PCT managers and clinicians, conducted an observation of a PCT meeting on complementary therapies and collected documentary data from referral databases and service funding bids. All interviews were taped, transcribed and analysed thematically. Interview, observation and documentary data were used to compare reported beliefs and behaviour to observed and documented behaviour. Results The majority of clinicians and PCT managers claimed that research evidence guided their decisions; those who did not felt increasingly marginalized. However, discrepancies between reported and observed behaviour suggest that perceptions of research evidence, rather than fact based knowledge, predominated when considering complementary therapies. Conclusion In the case of NHS complementary therapy service provision, patient preference may be largely insignificant in clinician and PCT managerial decisions, with decisions based mainly on ‘evidence rhetoric’ devised from collectively agreed, unchallenged, tacit perceptions of research literature. If a patient‐led NHS is to become a reality, NHS professionals need to cede the power that they wield with evidence rhetoric and acknowledge the legitimacy of patient preferences, views and alternative sources of evidence. PMID:19656225
Few topics in pediatric bioethics are as vexing as decision-making. Decision-making in pediatrics presents challenges for children, parents, and physicians alike. The related, yet distinct, concepts of assent and consent are central to pediatric decision-making. Although informed consent is largely regarded as a worthwhile adult principle, assent has been, and continues to be, mired in debate. Controversial subjects include a meaningful definition of assent; how old children should be to assent; who should be included in the assent process; parental permission; how to resolve disputes between children and their parents; the relationship between assent and consent; the quantity and quality of information to disclose to children and their families; how much and what information children desire and need; the necessity and methods for assessing both children's understanding of disclosed information and of the assent process itself; reconciling ethical and legal attitudes toward assent; and finally, an effective, practical, and realistically applicable decision-making model.
Seyed Mohammad Seyedhosseini
Full Text Available Minimizing the total cost is absolutely the goal of each supply chain, which is most of the time pursued. In this regards, quality related costs that have significant roles are sometimes neglected. Selecting suppliers, which supply relatively high quality raw materials in a lower cost is considered as a strategic decision. Make or Buy decision can be also noticed in supplier selection process. In this paper, the supply strategy: Make or Buy decision (SS: MOB is studied in order to find which strategy (Make or Buy should be chosen to minimize the total costs of supply chain. Therefore, two separate models are generated for each strategy and several examples are solved for the respective models. Computational experiments show the efficiency of the proposed models for making decision about selecting the best strategy.
Yew Kong Lee
Full Text Available BACKGROUND: Patient decisions are influenced by their personal values. However, there is a lack of clarity and attention on the concept of patient values in the clinical context despite clear emphasis on patient values in evidence-based medicine and shared decision making. The aim of the study was to explore the concept of patient values in the context of making decisions about insulin initiation among people with type 2 diabetes. METHODS AND FINDINGS: We conducted individual in-depth interviews with people with type 2 diabetes who were making decisions about insulin treatment. Participants were selected purposively to achieve maximum variation. A semi-structured topic guide was used to guide the interviews which were audio-recorded and analysed using a thematic approach. We interviewed 21 participants between January 2011 and March 2012. The age range of participants was 28-67 years old. Our sample comprised 9 women and 12 men. Three main themes, 'treatment-specific values', 'life goals and philosophies', and 'personal and social background', emerged from the analysis. The patients reported a variety of insulin-specific values, which were negative and/or positive beliefs about insulin. They framed insulin according to their priorities and philosophies in life. Patients' decisions were influenced by sociocultural (e.g. religious background and personal backgrounds (e.g. family situations. CONCLUSIONS: This study highlighted the need for expanding the current concept of patient values in medical decision making. Clinicians should address more than just values related to treatment options. Patient values should include patients' priorities, life philosophy and their background. Current decision support tools, such as patient decision aids, should consider these new dimensions when clarifying patient values.
Piet, Steven James; Gibson, Patrick Lavern; Joe, Jeffrey Clark; Kerr, Thomas A; Nitschke, Robert Leon; Dakins, Maxine Ellen
Hundreds of contaminated facilities and sites must be cleaned up. “Cleanup” includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done - some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches, including: • New ways (mental model) to analyze and visualize the problem, • Awareness of the option to shift strategy or reframe from a single decision to an adaptable network of decisions, and • Improved tactical processes that account for several challenges. These include the following: • Stakeholder values are a more fundamental basis for decision making and keeping than “meeting regulations.” • Late-entry players and future generations will question decisions. • People may resist making “irreversible” decisions. • People need “compelling reasons” to take action in the face of uncertainties. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period—from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept “as is” or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: • Knowledge: what is known about the problem and possible solutions? • Values: what is important to those affected by the decision? • Resources: what is available to implement
Bullen, Guy; Ouafae, Bennis; Kratz, Frédéric
International audience; This article proposes a generative approach to decision making in a complex and uncertain environment, as n alternative to normative or descriptive approaches. A simple and intuitive graphical model provides management teams with a non-restrictive framework for thinking through their decisions. The second half of the article proposes a mathematical model to estimate the multiple influences between decisions in a complex project, whether they are direct or indirect. Thi...
Koffarnus, Mikhail N; Kaplan, Brent A
As research on decision making in addiction accumulates, it is increasingly clear that decision-making processes are dysfunctional in addiction and that this dysfunction may be fundamental to the initiation and maintenance of addictive behavior. How drug-dependent individuals value and choose among drug and nondrug rewards is consistently different from non-dependent individuals. The present review focuses on the assessment of decision-making in addiction. We cover the common behavioral tasks that have shown to be fruitful in decision-making research and highlight analytical and graphical considerations, when available, to facilitate comparisons within and among studies. Delay discounting tasks, drug demand tasks, drug choice tasks, the Iowa Gambling Task, and the Balloon Analogue Risk Task are included. Copyright © 2017 Elsevier Inc. All rights reserved.
Identification of multiple criteria decision making / Magdalena Mißler-Behr ; Otto Opitz. - In: Conceptual and numerical analysis of data / Otto Opitz (ed.). - Berlin u.a. : Springer, 1989. - S. 407-415
Argues against the current trends in giving importance to subjective values in educational administration, particularly the argument that attention to subjective values can overcome the perceived irrelevance of scientific administration and organization theory and help administrators make better decisions. (MD)
Kitchener, Karen S., Ed.
Elaborates issues surrounding ethical decision making in counseling and mental health professions. Articles covering implications for training, ethical counseling of adolescents and the elderly, and reviews of research on counselor ethics are included. (BH)
Aalbers, H.L.; Whelan, E.; Parise, S.; Vialle, C.
The article focuses on the organizational decision-making management. Topics mentioned include the development of enterprise social software (ESS), the online corporate communities management, and the project management. Also mentioned are the importance of customer services, the bankruptcy
Van Vo, Dut; Beugelsdijk, Sjoerd; de Jong, Gjalt
This paper investigates how decision-making autonomy affects the possibility and intensity of innovation in subsidiaries of multinational enterprises (MNEs). Subsidiaries are increasingly identified as sources of innovation and as vehicles for cross-border transfer of new competences. The question...... of how much decision-making autonomy subsidiaries should have is a core issue in the management of headquarters-subsidiary relationships. Using two complementary theoretical perspectives, we hypothesize a non-linear relationship between subsidiary’s decision-making autonomy and innovation. We test our...... hypothesis in a multi-country and multiindustry database based on survey evidence of 134 subsidiaries located in five Central and Eastern European countries from 23 home countries. The empirical results provide support for a non-linear U shaped relationship between subsidiary decision-making autonomy...
... to a palliative care specialist or social worker. Barrier: Disagreeing with the doctor Solution: In shared decision making, the patient and doctor are partners. And sometimes, partners disagree. Communication is critical if a disagreement occurs. If a ...
Based partly on his experience at Ravenscote County Middle School, the author illustrates the increasing inappropriateness and indefensibility of headteacher autocracy and the dividends to be reaped from full staff participation in decision making. (Editor)
To describe women's experiences during decision making about hormonal and nonhormonal therapies during the menopausal transition. Transcripts from 21 semi-structured audio taped interviews with seven peri- and postmenopausal women who had a recently visited a nurse practitioner (NP) and were making a decision about menopausal management. Decision making was a nonlinear process in which women considered available options, weighed benefits and risks and likely outcomes. Reevaluation of the decision was ongoing. Both internal and external conditions influenced their decisions. Media reports of findings from the Women's Health Initiative study may have influenced some women's perceptions of the risk of using hormones for symptom relief. Women described caring and empowering consultations with the NPs. They appreciated provision of information, adequate time spent at the visit, and decision support. NPs have a critical role to play in providing women with current research findings about hormone therapy and alternatives for symptom relief, and assisting women with understanding risks and benefits of each possible choice. Both individual and group approaches for decision support should be available to women. The approach of a collaborative partnership in decision making is a model that is congruent with nursing practice. ©2010 The Author Journal compilation ©2010 American Academy of Nurse Practitioners.
Prior, Daniel W.; And Others
This article reviews the basic tenets of the Situational Leadership model, examines the steps of the Conflict Model for decision making, and presents a conceptual model that integrates the two. The integrated model aims to provide a systematic means for allowing individuals to learn how to participate in organizational decisions. (JDD)
Hicks, George E.; DeWalt, Cassandra Sligh
According to Erlandson and Bifano (1987), teacher empowerment is a vital dimension of the school's organization. Lieberman (1989) defined teacher empowerment as "empowering teachers to participate in group decisions and to have real decision-making roles in the school community" (p. 24). Furthermore, Summers (2006) addressed the need for…
Rilling, J.K.; Sanfey, A.G.
Given that we live in highly complex social environments, many of our most important decisions are made in the context of social interactions. Simple but sophisticated tasks from a branch of experimental economics known as game theory have been used to study social decision-making in the laboratory
Bleiler-Baxter, Sarah K.; Stephens, D. Christopher; Baxter, Wesley A.; Barlow, Angela T.
The goal in this article is to support teachers in better understanding what it means to model with mathematics by focusing on three key decision-making processes: Simplification, Relationship Mapping, and Situation Analysis. The authors use the Theme Park task to help teachers develop a vision of how students engage in these three decision-making…
This paper suggests an innovative idea of using the "technology fair" as a means for promoting pre-service teachers (university students) decision-making skills. The purpose of the study was to investigate the influence of a procedure of working with primary school children to complete and present a technology fair project, on the decision-making…
Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.
Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…
Santos, Eugene; Nguyen, Hien; Russell, Jacob; Kim, Keumjoo; Veenhuis, Luke; Boparai, Ramnjit; Stautland, Thomas Kristoffer
A Commander's decision making style represents how he weighs his choices and evaluates possible solutions with regards to his goals. Specifically, in the naval warfare domain, it relates the way he processes a large amount of information in dynamic, uncertain environments, allocates resources, and chooses appropriate actions to pursue. In this paper, we describe an approach to capture a Commander's decision style by creating a cognitive model that captures his decisionmaking process and evaluate this model using a set of scenarios using an online naval warfare simulation game. In this model, we use the Commander's past behaviors and generalize Commander's actions across multiple problems and multiple decision making sequences in order to recommend actions to a Commander in a manner that he may have taken. Our approach builds upon the Double Transition Model to represent the Commander's focus and beliefs to estimate his cognitive state. Each cognitive state reflects a stage in a Commander's decision making process, each action reflects the tasks that he has taken to move himself closer to a final decision, and the reward reflects how close he is to achieving his goal. We then use inverse reinforcement learning to compute a reward for each of the Commander's actions. These rewards and cognitive states are used to compare between different styles of decision making. We construct a set of scenarios in the game where rational, intuitive and spontaneous decision making styles will be evaluated.
Full Text Available Scores on the three-item Cognitive Reflection Test (CRT have been linked with dual-system theory and normative decision making (Frederick, 2005. In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT’s ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes; Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1 or calculated using proportions (Studies 1 and 2. These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.
Davies, Claire; Howell, Dana
Classification systems are available to subgroup patients with acute/nonspecific low back pain (LBP) to determine interventions. The use of classification systems by physical therapists (PT) has little published evidence. The aims of this study were to understand the process PTs use when assessing and determining interventions for patients with acute/nonspecific LBP in outpatient settings and what classification systems, if any, are used in clinical practice. Qualitative methods were used to investigate the decision-making process PTs use when managing patients with LBP. Semi-structured interviews focused on the decision-making process of examination and intervention selection for patients with LBP. Findings were verified through member checking, triangulation, and audit trail. Thirteen PTs were included in the study. Four decision-making preferences emerged from the data: (1) identifying the root cause, (2) eclectic approach, (3) experience-based management, and (4) evidence-based management. Experience, education, and other aspects of the PTs' backgrounds influenced their preferred decision-making style, and use of resources, such as classification systems, varied broadly.
The presented paper is a presentation of final results of research led throughout past years on a group of Polish and international SME’s. The essential aim was the elaboration of a decision – making model including both qualitative and quantitative factors that influence decision – making processes. Most focus has been put on geopolitical determinants of international companies’ development. In order to narrow the research field, a further limitation has been made in the type of undertaken s...
Marcel Zeelenberg; Rob M. A. Nelissen; Seger M. Breugelmans; Rik Pieters
We present a motivational account of the impact of emotion on decision making, termed the feeling-is-for-doing approach. We first describe the psychology of emotion and argue for a need to be specific when studying emotion's impact on decision making. Next we describe what our approach entails and how it relates emotion, via motivation to behavior. Then we offer two illustrations of our own research that provide support for two important elements in our reasoning. We end with specifying four ...
Background: A descriptive neuroeconomic model is aimed for relativity of the concept of economic man to empirical science.Method: A 4-level client-server-integrator model integrating the brain models of McLean and Luria is the general framework for the model of empirical findings.Results: Decision making relies on integration across brain levels of emotional intelligence (LU) and logico-matematico intelligence (RIA), respectively. The integrated decision making formula approaching zero by bot...
Pristed Nielsen, Helene
Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand......Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand...
Madsen, Henrik; Albeanu, Grigore; Burtschy, Bernard
Decision making addresses the usage of various methods to select "the best", in some way, alternative strategy (from many available) when a problem is given for solving. The authors propose the usage of neutrosophic way of thinking, called also Smarandache's logic, to select a model by experts when...... degrees of trustability, ultrastability (falsehood), and indeterminacy are used to decide. The procedures deal with multi-attribute neutrosophic decision making and a case study on e-learning software objects is presented....
Manning, Timmy; Sleator, Roy D; Walsh, Paul
Artificial neural networks (ANNs) are a class of powerful machine learning models for classification and function approximation which have analogs in nature. An ANN learns to map stimuli to responses through repeated evaluation of exemplars of the mapping. This learning approach results in networks which are recognized for their noise tolerance and ability to generalize meaningful responses for novel stimuli. It is these properties of ANNs which make them appealing for applications to bioinformatics problems where interpretation of data may not always be obvious, and where the domain knowledge required for deductive techniques is incomplete or can cause a combinatorial explosion of rules. In this paper, we provide an introduction to artificial neural network theory and review some interesting recent applications to bioinformatics problems. PMID:24335433
Broche-Pérez, Y; Herrera Jiménez, L F; Omar-Martínez, E
Decision-making is the process of selecting a course of action from among 2 or more alternatives by considering the potential outcomes of selecting each option and estimating its consequences in the short, medium and long term. The prefrontal cortex (PFC) has traditionally been considered the key neural structure in decision-making process. However, new studies support the hypothesis that describes a complex neural network including both cortical and subcortical structures. The aim of this review is to summarise evidence on the anatomical structures underlying the decision-making process, considering new findings that support the existence of a complex neural network that gives rise to this complex neuropsychological process. Current evidence shows that the cortical structures involved in decision-making include the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and dorsolateral prefrontal cortex (DLPFC). This process is assisted by subcortical structures including the amygdala, thalamus, and cerebellum. Findings to date show that both cortical and subcortical brain regions contribute to the decision-making process. The neural basis of decision-making is a complex neural network of cortico-cortical and cortico-subcortical connections which includes subareas of the PFC, limbic structures, and the cerebellum. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.
Weller, Joshua A; Fisher, Philip A
Although maltreated children involved with child welfare services are known to exhibit elevated levels of health-risking behaviors, little is known about their decision-making processes leading to such tendencies. Research findings suggest that maltreated children exhibit developmental delays in neurocognitive and emotional regulation systems that could adversely impact their abilities to make decisions under conditions of risk. Whereas prior researchers have examined risky decision making as a global construct, maltreated children's decision making was examined in two contexts in the present study: potential gains and potential losses. Comparing maltreated children (n = 25) and a nonmaltreated community group (n = 112), it was found that the maltreated children showed decision-making impairments for both domains: This impairment was especially prominent in the loss domain. The maltreated children took excessive risks and were insensitive to changes in expected value. Follow-up analyses revealed that these differences were primarily associated with insensitivity to changes in outcome magnitude for the risky option. Finally, response latency analyses indicated that the maltreated children were slower to make choices, reinforcing underlying differences in decision processes between groups. These results have implications for basic and translational science.
Piet, S. J.; Gibson, P. L.; Joe, J. C.; Kerr, T. A.; Nitschke, R. L.; Dakins, M. E.
Hundreds of contaminated facilities and sites must be cleaned up. ''Cleanup'' includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done--some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period-from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept ''as is'' or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: (1) Knowledge: what is known about the problem and possible solutions? (2) Values: what is important to those affected by the decision? (3) Resources: what is available to implement possible solutions or improve knowledge? This mental model helps analyze and visualize what is happening as decisions are made and kept. Why is there disagreement? Is there movement toward konvergence? Is a past decision drifting out of konvergence? The framework includes strategic improvements, i.e., expand the spectrum of alternatives to include adaptable alternatives and decision networks. It includes tactical process improvements derived from experience, values, and relevant literature. This paper includes diagnosis and medication (suggested path forward) for intractable cases.
While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the
Antani, Sameer; Demner-Fushman, Dina; Li, Jiang; Srinivasan, Balaji V.; Thoma, George R.
Essential information is often conveyed pictorially (images, illustrations, graphs, charts, etc.) in biomedical publications. A clinician's decision to access the full text when searching for evidence in support of clinical decision is frequently based solely on a short bibliographic reference. We seek to automatically augment these references with images from the article that may assist in finding evidence. In a previous study, the feasibility of automatically classifying images by usefulness (utility) in finding evidence was explored using supervised machine learning and achieved 84.3% accuracy using image captions for modality and 76.6% accuracy combining captions and image data for utility on 743 images from articles over 2 years from a clinical journal. Our results indicated that automatic augmentation of bibliographic references with relevant images was feasible. Other research in this area has determined improved user experience by showing images in addition to the short bibliographic reference. Multi-panel images used in our study had to be manually pre-processed for image analysis, however. Additionally, all image-text on figures was ignored. In this article, we report on developed methods for automatic multi-panel image segmentation using not only image features, but also clues from text analysis applied to figure captions. In initial experiments on 516 figure images we obtained 95.54% accuracy in correctly identifying and segmenting the sub-images. The errors were flagged as disagreements with automatic parsing of figure caption text allowing for supervised segmentation. For localizing text and symbols, on a randomly selected test set of 100 single panel images our methods reported, on the average, precision and recall of 78.42% and 89.38%, respectively, with an accuracy of 72.02%.
Full Text Available The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants’ choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward, the reward value of the decision outcome, which guided the update of value for each choice, is unknown beforehand. To estimate the reward value of emotional pictures from participants’ choice data, we used reinforcement learning models that have success- fully been used in previous studies for modeling value-based decision making. Consequently, we found that the estimated reward value was asymmetric between positive and negative pictures. The negative reward value of negative pictures (relative to neutral pictures was larger in magnitude than the positive reward value of positive pictures. This asymmetry was not observed in valence for an individual picture, which was rated by the participants regarding the emotion experienced upon viewing it. These results suggest that there may be a difference between experienced emotion and the effect of the experienced emotion on subsequent behavior. Our experimental and computational paradigm provides a novel way for quantifying how and what aspects of emotional events affect human behavior. The present study is a first step toward relating a large amount of knowledge in emotion science and in taking computational approaches to value-based decision making.
Full Text Available Celia Deane-Drummond's case for wisdom as an approach to ethical decision making and her doubts about case-oriented methodology are critiqued with reference to the SRT Project's Engineering Genesis study. Its approach is explored in practical decisions on various real life examples of genetic modification in crops and animals. It involved both intrinsic and consequential approaches, and identified key value positions behind different policies and stakeholders. The paper also clarifies the relationship between reactive (cost-benefit and precautionary risk assessment, explaining their strengths and limitations, and the role of underlying values in both forms of risk decision making.
The nature of retailer buying is changing, but not so our conceptualisations. Existing literature on retailer buying is characterised by a rather narrow focus on what retail buyers decide and which decision criteria they use to make decisions, whereas comparatively little attention has been devoted...... to the processes of how and why certain decisions are made. This paper aims to move beyond a focus on single decisions as discrete events to viewing retailer buying as something that occurs in ongoing relationally-responsive interaction between retailers and suppliers....
Marble, Julie Lynne; Medema, Heather Dawne; Hill, Susan Gardiner
Eight participants were asked to view a computer-based multimedia presentation on an environmental phenomenon. Participants were asked to play a role as a senior aide to a national legislator. In this role, they were told that the legislator had asked them to review a multimedia presentation regarding the hypoxic zone phenomenon in the Gulf of Mexico. Their task in assuming the role of a senior aide was to decide how important a problem this issue was to the United States as a whole, and the proportion of the legislator’s research budget that should be devoted to study of the problem. The presentation was divided into 7 segments, each containing some new information not contained in the previous segments. After viewing each segment, participants were asked to indicate how close they were to making a decision and how certain they were that their current opinion would be their final decision. After indicating their current state of decision-making, participants were interviewed regarding the factors affecting their decision-making. Of interest was the process by which participants moved toward a decision. This experiment revealed a number of possible directions for future research. There appeared to be two approaches to decision-making: Some decision-makers moved steadily toward a decision, and occasionally reversed decisions after viewing information, while others abruptly reached a decision after a certain time period spent reviewing the information. Although the difference in estimates of distance to decisions did not differ statistically for these two groups, that difference was reflected in the participants’ estimates of confidence that their current opinion would be their final decision. The interviews revealed that the primary difference between these two groups was in their trade-offs between willingness to spend time in information search and the acquisition of new information. Participants who were less confident about their final decision, tended to be
Shay, L Aubree; Lafata, Jennifer Elston
This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared. Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis. Patients' conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision. There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of "agreement" may be more important than the actual decision-making process for patients to label a decision as shared. Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM. Published by Elsevier Ireland Ltd.
Full Text Available Daryl S Spinner,1 Julie Birt,2 Jeffrey W Walter,1 Lee Bowman,2 Josephine Mauskopf,1 Michael F Drummond,3 Catherine Copley-Merriman11RTI Health Solutions, Research Triangle Park, NC, USA; 2Eli Lilly and Company, Indianapolis, IN, United States; 3University of York, York, UKBackground: Health-technology assessment (HTA plays an important role in informing drug-reimbursement decision-making in many countries. HTA processes for the Pharmaceutical Benefits Advisory Committee (PBAC in Australia, the Common Drug Review (CDR in Canada, and the National Institute for Health and Clinical Excellence (NICE in England and Wales are among the most established in the world. In this study, we performed nine in-depth case studies to assess whether different clinical evidence bases may have influenced listing recommendations made by PBAC, CDR, and NICE.Methods: Nine drugs were selected for which the three agencies had provided listing recommendations for the same indication between 2007 and 2010. We reviewed the evidence considered for each listing recommendation, identified the similarities and differences among the clinical evidence bases considered, and evaluated the extent to which different clinical evidence bases could have contributed to different decisions based on HTA body comments and public assessment of the evidence.Results: HTA agencies reached the same recommendation for reimbursement (recommended for listing for four drugs and different recommendations for five drugs. In all cases, each agency used different evidence bases in their recommendations. The agencies considered overlapping sets of clinical comparators and trials when evaluating the same drug. While PBAC and NICE considered indirect and/or mixed-treatment comparisons, CDR did not. In some cases, CDR and/or NICE excluded trials from review if the drug and/or the comparator were not administered according to the relevant marketing authorization.Conclusions: In the listing recommendations
Raicu, A.; Oanta, E.; Sabau, A.
Decision making process has a great influence in the development of a given project, the goal being to select an optimal choice in a given context. Because of its great importance, the decision making was studied using various science methods, finally being conceived the game theory that is considered the background for the science of logical decision making in various fields. The paper presents some basic ideas regarding the game theory in order to offer the necessary information to understand the multiple-criteria decision making (MCDM) problems in engineering. The solution is to transform the multiple-criteria problem in a one-criterion decision problem, using the notion of utility, together with the weighting sum model or the weighting product model. The weighted importance of the criteria is computed using the so-called Step method applied to a relation of preferences between the criteria. Two relevant examples from engineering are also presented. The future directions of research consist of the use of other types of criteria, the development of computer based instruments for decision making general problems and to conceive a software module based on expert system principles to be included in the Wiki software applications for polymeric materials that are already operational.
Full Text Available Byzantine fault tolerance is of high importance in the distributed computing environment where malicious attacks and software errors are common. A Byzantine process sends arbitrary messages to every other process. An effective fuzzy decision making approach is proposed to eliminate the Byzantine behaviour of the services in the distributed environment. It is proposed to derive a fuzzy decision set in which the alternatives are ranked with grade of membership and based on that an appropriate decision can be arrived on the messages sent by the different services. A balanced decision is to be taken from the messages received across the services. To accomplish this, Hurwicz criterion is used to balance the optimistic and pessimistic views of the decision makers on different services. Grades of membership for the services are assessed using the non-functional Quality of Service parameters and have been estimated using fuzzy entropy measure which logically ranks the participant services. This approach for decision making is tested by varying the number of processes, varying the number of faulty services, varying the message values sent to different services and considering the variation in the views of the decision makers about the services. The experimental result shows that the decision reached is an enhanced one and in case of conflict, the proposed approach provides a concrete result, whereas decision taken using the Lamport’s algorithm is an arbitrary one.
In the aftermath of seismic debacles like those that toppled Enron and WorldCom, corporate boards have been shaken up and made over. More directors are independent these days, for instance, and corporations now disclose directors' salaries and committee members' names. Research shows that most of the changes are having a positive effect on companies' performance. They are primarily structural, though, and don't go to the heart of a board's work: making the choices that shape a firm's future. Which decisions boards own and how those calls are made are largely hidden from the public. As a result, boards are often unable to learn from the best governance practices of their counterparts at other companies. This article pulls back the curtain and provides an inside look. Drawing on interviews with board members and executives at 31 companies, along with a close examination of three boardroom decisions, the author identifies several formal processes that can help companies improve their decision making: creating calendars that specify when the board and the standing committees will consider key items; drafting charters that define the decisions committees are responsible for; and developing decision protocols that divvy up responsibilities between directors and executives. The author also identifies a number of informal decision-making principles: Items that are strategically significant and touch on the firm's core values should go to the board. Large decisions should be divided into small pieces, so the board can devote sufficient attention to each one. Directors must remain vigilant to ensure that their decisions are effectively implemented. The CEO and either the nonexecutive chair or the lead director should engage in ongoing dialogue regarding which decisions to take to the full board and when. And directors should challenge assumptions before making yes-or-no decisions on management proposals.
Reaby, L L
The purpose of this study was to explore the breast restoration decision-making patterns used by women who opted to have their breast cancer treated by mastectomy. Sixty-four women wearing external breast prostheses and 31 women with breast reconstructions were interviewed. Modified versions of Simon's notion of "bounded rationality" and Janis and Mann's conflict model provided the conceptual scaffolding for the study. Five breast restoration decision-making patterns emerged from the analysis of the interview data: (a) Enlightened (actively seeks information, considers positive and negative aspects, and demonstrates deliberation on the alternatives), (b) Contented (passively accepts minimum information on alternatives because of a preference toward a particular type), (c) Sideliner (uncritically adopts any alternative that is easy and simple to implement), (d) Shifter (gives over the decision to others), and (e) Panic-stricken (can make no rational decision on alternatives). In the prosthesis group, the major pattern used was the Sideliner, and in the reconstruction group it was the Contented. None of the participants used the Enlightened pattern. The data indicated that there was no evidence of active information-seeking behavior or deliberation on the alternatives as part of the women's decision-making process. The findings suggest a need for a registered nurse oncology specialist to be accessible to women during the period when decisions regarding breast restoration are made. This professional has the knowledge to interact effectively with these women and serve as their advocate during the decision-making process. Implications for professional practice and a model for competent breast restoration decision making are presented.
Rogerson, Mark D.; Gottlieb, Michael C.; Handelsman, Mitchell M.; Knapp, Samuel; Younggren, Jeffrey
Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasi-legal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior,…
Henshall, Chris; Schuller, Tara
Identifying treatments that offer value and value for money is becoming increasingly important, with interest in how health technology assessment (HTA) and decision makers can take appropriate account of what is of value to patients and to society, and in the relationship between innovation and assessments of value. This study summarizes points from an Health Technology Assessment International (HTAi) Policy Forum discussion, drawing on presentations, discussions among attendees, and background papers. Various perspectives on value were considered; most place patient health at the core of value. Wider elements of value comprise other benefits for: patients; caregivers; the health and social care systems; and society. Most decision-making systems seek to take account of similar elements of value, although they are assessed and combined in different ways. Judgment in decisions remains important and cannot be replaced by mathematical approaches. There was discussion of the value of innovation and of the effects of value assessments on innovation. Discussion also included moving toward "progressive health system decision making," an ongoing process whereby evidence-based decisions on use would be made at various stages in the technology lifecycle. Five actions are identified: (i) development of a general framework for the definition and assessment of value; development by HTA/coverage bodies and regulators of (ii) disease-specific guidance and (iii) further joint scientific advice for industry on demonstrating value; (iv) development of a framework for progressive licensing, usage, and reimbursement; and (v) promoting work to better adapt HTA, coverage, and procurement approaches to medical devices.
Nielsen, Thomas Dyhre; Jaffray, Jean-Yves
Non-expected utility theories, such as rank dependent utility (RDU) theory, have been proposed as alternative models to EU theory in decision making under risk. These models do not share the separability property of expected utility theory. This implies that, in a decision tree, if the reduction......, the sophisticated strategy, i.e., the strategy generated by a standard rolling back of the decision tree, is likely to be dominated w.r.t. stochastic dominance. Dynamic consistency of choices remains feasible, and the decision maker can avoid dominated choices, by adopting a non-consequentialist behavior, with his...... choices in a subtree possibly depending on what happens in the rest of the tree. We propose a procedure which: (i) although adopting a non-consequentialist behavior, involves a form of rolling back of the decision tree; (ii) selects a non-dominated strategy that realizes a compromise between the decision...
Vetter, Donald P.; And Others
This unit on decision-making and discussion skills is the second of five units in a ninth grade social studies course (course described in SO 010 891). There are two major objectives: (1) given a problem, the student will make value judgments using decision-making skills; and (2) using proper discussion techniques, the student will analyze a…
St John, C.
Scientific information about climate change and other human impacts on the environment are increasingly available and sought after (often in the form of probabilistic forecasts or technical information related to engineering solutions). However, it is increasingly apparent that there are barriers to the use of this information by decision makers - either from its lack of application altogether, its usability for people without scientific backgrounds, or its ability to inform sound decisions and widespread behavior change. While the argument has been made that an information deficit is to blame, we argue that there is also a motivation deficit contributing to a lack of understanding of information about climate change impacts and solutions. Utilizing insight from over thirty years of research in social and cognitive psychology, in addition to other social sciences, the Center for Research on Environmental Decisions (CRED) seeks to understand how people make environmental decisions under conditions of uncertainty, and how these decisions can be improved. This presentation will focus specifically on recent research that has come forth since the 2009 publication of CRED's popular guide 'The Psychology of Climate Change Communication: A Guide for Scientists, Journalists, Educators, Political Aides, and the Interested Public.' Utilizing case studies from real world examples, this talk will explore how decision making can be improved through a better understanding of how people perceive and process uncertainty and risk. It will explore techniques such as choice architecture and 'nudging' behavior change, how social goals and group participation affect decision making, and how framing of environmental information influences mitigative behavior.
Robinson, Kelly F.; Fuller, Angela K.
Structured decision making (SDM) provides a framework for making sound decisions even when faced with uncertainty, and is a transparent, defensible, and replicable method used to understand complex problems. A hallmark of SDM is the explicit incorporation of values and science, which often includes participation from multiple stakeholders, helping to garner trust and ultimately result in a decision that is more likely to be implemented. The core steps in the SDM process are used to structure thinking about natural resources management choices, and include: (1) properly defining the problem and the decision context, (2) determining the objectives that help describe the aspirations of the decision maker, (3) devising management actions or alternatives that can achieve those objectives, (4) evaluating the outcomes or consequences of each alternative on each of the objectives, (5) evaluating trade-offs, and (6) implementing the decision. Participatory modeling for SDM includes engaging stakeholders in some or all of the steps of the SDM process listed above. In addition, participatory modeling often is crucial for creating qualitative and quantitative models of how the system works, providing data for these models, and eliciting expert opinion when data are unavailable. In these ways, SDM provides a framework for decision making in natural resources management that includes participation from stakeholder groups throughout the process, including the modeling phase.
Venkatraman, Vinod; Huettel, Scott
Complex economic decisions – whether investing money for retirement or purchasing some new electronic gadget – often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, to evaluate outcomes against a variety of contexts, and to flexibly match behavior to changes in the environment. In recent years, substantial research implicates the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision making. This region contains a functional topography such that the posterior dmPFC supports response-related control while the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue both for generalized contributions of the dmPFC to cognitive control, and for specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are also likely to be critical for decision making in other domains, including interpersonal interactions in social settings. PMID:22487037
Full Text Available A new combining criterion, the Multiplicative Proportional Deviative Influence (MPDI is presented for combining or aggregating multi-expert numerical judgments in Yes-or-No type ill-structured group decision making situations. This newly proposed criterion performs well in comparison with the widely used aggregation means: the Arithmetic Mean (AM, and Geometric Mean (GM, especially in better reflecting the degree of agreement between criteria levels or numerical experts’ judgments. The MPDI can be considered as another class of combining criteria that make effect of the degree of agreement among multiple numerical judgments. The MPDI is applicable in integrating several collaborative or synergistic decision making systems through combining final numerical decision outputs. A discussion and generalization of the proposed MPDI is discussed withnumerical example.
Bartsch, Andreas Joachim; Homola, György; Biller, Armin; Solymosi, László; Bendszus, Martin
Functional magnetic resonance imaging (fMRI) has become a popular research tool, yet its use for diagnostic purposes and actual treatment planning has remained less widespread. The literature yields rather sparse evidence-based data on clinical fMRI applications and accordant decision-making. Notwithstanding, blood oxygenation level dependent (BOLD)- and arterial spin labeling (ASL)-fMRI can be judiciously combined with perfusion measurements, electroencephalographic (EEG) recordings, diffusion-weighted imaging (DWI), and fiber tractographies to assist clinical decisions. In this article we provide an overview of clinical fMRI applications based on illustrative examples. Assessment of cochlear implant candidates by fMRI is covered in some detail, and distinct reference is made to particular challenges imposed by brain tumors, other space-occupying lesions, cortical dysplasias, seizure disorders, and vascular malformations. Specific strategies, merits, and pitfalls of analyzing and interpreting diagnostic fMRI studies in individual patients are highlighted. Copyright 2006 Wiley-Liss, Inc.
Carr, Priyanka B; Steele, Claude M
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.
Medicine is incorporating genetic services into all avenues of health-care, ranging from the rarest to the most common diseases. Cognitive theories of decision-making still dominate professionals' understanding of patient decision-making about how to use genetic information and whether to have testing. I discovered a conceptual model of decision-making while carrying out a phenomenological-hermeneutic descriptive study of a convenience sample of 12 couples who were interviewed while deciding whether to undergo prenatal genetic testing. Thirty-two interviews were conducted with 12 men and 12 women separately. Interviews were transcribed verbatim and all data were analyzed using three levels of coding that were sorted into 30 categories and then abstracted into three emergent meta-themes that described men's and women's attempts to make sense and find meaning in how to best use prenatal genetic technology. Their descriptions of how they thought about, communicated, and coped with their decision were so detailed it was possible to discern nine different types of thinking they engaged in while deciding to accept or decline testing. They believed that decision-making is a process of working through your own personal style of thinking. This might include only one or any combination of the following types of thinking: analytical, ethical, moral, reflective, practical, hypothetical, judgmental, scary, and second sight, as described in detail by these 12 couples.
Knoll, Melissa A Z
.... Behavioral economists and decision-making researchers, however, are interested in how people make decisions in the face of incomplete information, limited cognitive resources, and decision biases...
introduces an innovative management theory , denominated Evidence Based Management, that overcomes the old theories by suggesting a new approach that...like to stress the importance of the newly introduced Evidence Based Management theory , which allows to achieve speed whilst keeping decision makers...making system • High speed of execution • Evidence Based Management theory in line with this approach • Operational and tactical measures: – Port
We examine the main theoretical models of decision making under stress and the effects of decision stress on decision making process to provide a deeper understanding of the decision making phenomenon. The literature review reveals that stress can have an impact on each stage of the decision-making process. The review also finds that decision makers could enhance their decision-making performance and prevent potential decision failures by means of adapting certain coping strategies.
Gronlund, Andreas; Minnhagen, Petter
We investigate a social system of agents faced with a binary choice. We assume there is a correct, or beneficial, outcome of this choice. Furthermore, we assume agents are influenced by others in making their decision, and that the agents can obtain information that may guide them towards making a correct decision. The dynamic model we propose is of nonequilibrium type, converging to a final decision. We run it on random graphs and scale-free networks. On random graphs, we find two distinct regions in terms of the "finalizing time" -- the time until all agents have finalized their decisions. On scale-free networks on the other hand, there does not seem to be any such distinct scaling regions.
to address this factor explicitly is the ’ garbage can’ model of decision making (Cohen, 4 March , & Olsen , 1972). At first, the model focused largely...Learning Research and Development Center. 35 Cohen, M. D., March , J. G., & Olsen , J. P. (1972). A garbage can model of organizational choice...8217.WD EXECUTIVE SUMMARY Requirement: The failure of formal models to describe decisions made in natural environments has necessitated direct field
Celia Deane-Drummond's case for wisdom as an approach to ethical decision making and her doubts about case-oriented methodology are critiqued with reference to the SRT Project's Engineering Genesis study. Its approach is explored in practical decisions on various real life examples of genetic modification in crops and animals. It involved both intrinsic and consequential approaches, and identified key value positions behind different policies and stakeholders. The paper also clarifies the rel...
Tiago Oliveira; Jose Carlos Montoya; Paulo Novais; Ken Satoh
If there is no knowledge about the state of the world, getting the appropriate response to an event becomes impossible. Situations of uncertainty are common in the most varied environments and have the potential to impair or even stop the decision-making process. Thus, reaching an outcome in such situations requires the development of decision frameworks that account for missing, contradictory or uncertain information.
Black, Betty S.; Wechsler, Malory; Fogarty, Linda
Objectives This study examined the decision-making process used by individuals asked to participate in dementia research and their opinions on how future proxy research decisions would or should be made, including participants’ preferred ethical standards for decision-making. Design Cross-sectional qualitative methods. Setting University research institutions. Participants Informants were 39 of 46 cognitively impaired individuals (i.e., subjects) who were asked to join one of six dementia studies and 46 study partners or surrogate decision-makers. Measurements Semi-structured individual interviews were audio recorded and transcribed for content analysis. Results Within dyads, subjects and surrogates often differed in their perspectives on how decisions were made regarding whether to join a study, and no single method was identified as a predominant approach. While there was only fair agreement within dyads on who ultimately made the decision, subjects and surrogates most often said it was the subject. For future proxy research decisions, subjects and surrogates most often preferred the ethical standard of best interests and least often favored substituted judgment. However, many participants preferred a combination of best interests and substituted judgment or a more complex approach that also considers the interests of others. Conclusions Individuals with mild to moderate cognitive impairment can and do engage to some extent in the decision-making process for dementia research and can discuss their opinions on how they would want such decisions made for them in the future. These findings support the recommended approach for obtaining proxy consent and subject assent if the individual lacks consent capacity. PMID:23498382
Nørgaard, Maria Kümpel
Decision-making during food buying is a joint family activity involving both parents and children. Children manage to achieve a high degree of influence on many decisions, among other things, because they participate actively and help out doing various tasks. These decisions may turn out...... to be a choice of unhealthy food. Many decisions are made at the supermarket or other food shops, and food packaging is often used in the comparison of food products. Only rarely do families use nutritional information on food labels due to several problems in the understanding of these labels; this may result...... in difficulties in distinguishing among healthy and unhealthy food. Both parents and children being active in the decision process may lead to conflicts due to gaps in preference such as between healthy and unhealthy food. Families solve these conflicts via open communication patterns and a use of various...
Postmes, T; Spears, R; Cihangir, S
Two studies investigated the impact of group norms for maintaining consensus versus norms for critical thought on group decisions in a modification of the biased sampling paradigm (G. Stasser & W. Titus, 1985). Both studies showed that critical norms improved the quality of decisions, whereas consensus norms did not. This effect appeared to be mediated by the perceived value of shared and unshared information: Consensus norm groups valued shared information more highly than critical groups did, and valence was a good predictor of decision outcome. In addition, the 2nd study showed that the group norm manipulation has no impact on individual decisions, consistent with the assumption that this is a group effect. Results suggest that the content of group norms is an important factor influencing the quality of group decision-making processes and that the content of group norms may be related to the group's proneness for groupthink.
Lee, Daeyeol; Seo, Hyojung
Human choice behaviors during social interactions often deviate from the predictions of game theory. This might arise partly from the limitations in the cognitive abilities necessary for recursive reasoning about the behaviors of others. In addition, during iterative social interactions, choices might change dynamically as knowledge about the intentions of others and estimates for choice outcomes are incrementally updated via reinforcement learning. Some of the brain circuits utilized during social decision making might be general-purpose and contribute to isomorphic individual and social decision making. By contrast, regions in the medial prefrontal cortex (mPFC) and temporal parietal junction (TPJ) might be recruited for cognitive processes unique to social decision making. Copyright © 2015 Elsevier Ltd. All rights reserved.
Barfod, Michael Bruhn
The subject of this Ph.D. thesis entitled “Optimising Transport Decision Making using Customised Decision Models and Decision Conferences” is multi-criteria decision analysis (MCDA) and decision support in the context of transport infrastructure assessments. Despite the fact that large amounts...... identification to the possible decision making. The process makes use of a preliminary problem structuring phase, and an intervention phase featuring the concept of a decision conference where decision-makers and multiple stakeholders have the possibility of interacting with the decision support model...... depends to a high degree on subjective preferences stated by the decision-makers as the methodology deals with impacts (or criteria) that are difficult to quantify or assign with a monetary value. As a result of this an examination process is proposed that can guide the decision-makers through...
Portera Sánchez, A
In the human brain, simple molecules and complex circuits are constantly making decisions which are indispensable for our survival and also to accomplish a variety of daily activities such as walking, memorizing, conversing, composing music, painting or poetry.... All are the result of the integration of many neural systems that perceive many and simultaneous visual, tactile, auditory and/or mental stimuli. Once synthetized, they are immediately transmitted to the corresponding executive systems, thus completing the fascinating functional loop of decision-making: a) perception of stimuli or information which originate in the environment, b) selection and elaboration of the decision which is considered more appropriate or attractive according to personal experience or intuition and c) execution. If these neural nets have been damaged or haven failed to develop the mechanisms of facilitation or inhibition that govern them become unbalanced. If inhibition is reduced, excessive and violent behaviour is expressed as in patients suffering from manic phases. Conversely, if inhibition is excessive, decision making mechanisms are not operative. In either case, behaviour is not "reasonable" and does not follow prototypical patterns. All these processes must be the consequence of a constant molecular activity full of micro-decisions whose effectiveness depends on the histological and biochemical integrity of the neurons. This microenvironment is responsible for all types of decisions of all forms of life and represents one of the fundamental successes of evolution.
Nielsen, Jan Alexis
This article takes issue with the widespread assumption that students’ socioscientific decisions ought to be evidence based. On the basis of a careful conceptual analysis, it is argued that it is misleading to think in terms of evidence in socioscientific decision making because such decision mak...
Verhoef, L W
This article discusses two possible solutions to decision making about controls by users of vending machines: the 'one button to press' system (requiring a compound decision - the pressing of one button only); the 'several buttons to press' system (requiring a compound decision - the pressing of several buttons). The basis for the discussion is a field evaluation of a train ticket vending machine (TVM) that can sell 800 different types of tickets and can accept all kinds of payment. For this evaluation several hundred TVM users and ticket window users were observed and interviewed. Special attention was paid to the errors which were made.
Full Text Available The important managerial decision-making and the development of policies, strategies, internal normative acts and procedures must be solid grounded for efficient achieving of their objectives. To this end, the evidence-based approach uses various types of evidence, a leading role having those scientific, and the critical thinking. The evidence from behavioral sciences is especially important when the decisions objectives involve behavioral elements. They also help to ensure the rationality of any decision-making process. The concern for the use of behavioral sciences research in the decision-making preceded the occurrence of evidence-based approach. The increased knowledge fund of organizations, the access to the best practices and to the relevant scientific research findings represent only the initial stages of the evidence-based approach implementation and functioning. The ensuring of their effective use calls for special skills training among staff, the creation of tools and organizational mechanisms and of a facilitating organizational culture. This paper argues the need to integrate two approaches that promote the decision-making based on scientific evidence, the evidence-based approach and the use of behavioral and social sciences in the decision-making, to potentiate the contribution of the behavioral sciences to the increasing of the decision-making efficiency. The efforts made in this paper had overall objective to prepare and facilitate the use of research evidence provided by behavioral sciences in the organizational decision-making process by presenting the main concepts and knowledge in the field and by proposing an outline procedure specifically developed.
Bayard, Sophie; Abril, Beatriz; Yu, Huan; Scholz, Sabine; Carlander, Bertrand; Dauvilliers, Yves
To investigate decision-making and addictive behaviors in narcolepsy-cataplexy (NC). NC is caused by the loss of hypothalamic neurons that produce hypocretins. The hypocretin system plays a crucial role in sleep, wakefulness, and energy homeostasis, and is also involved in emotion regulation, reward processing, and addiction. Academic sleep center. 23 subject with NC and 23 matched healthy controls. We used the Iowa Gambling Task (IGT) to assess decision making under ambiguity condition based on emotional feedback processing and the Game of Dice Task (GDT) to assess decision making under risk condition. All participants underwent a semi-structured psychiatric interview and completed the Beck Depression Inventory-II and the UPPS Impulsive Behavior Scale. Patients underwent one night of polysomnography followed by an MSLT, with neuropsychological evaluation performed between MSLT sessions. NC patients had higher depressive symptoms and showed a significant lack of perseverance. One NC patient had a past history of drug dependence. NC patients also exhibited selective reduced IGT performance and normal performance on the GDT. No clinical or polysomnographic characteristics were associated with increased sensitivity to reward and/or decreased sensitivity to punishment. However, lack of perseverance in NC patients was associated with disadvantageous decision making on the IGT. We demonstrated a lack of perseverance and a selective reduced performance on decision making under ambiguity in NC in contrast to normal decision making under explicit conditions. Patients with narcolepsy-cataplexy may opt for choices with higher immediate emotional valence, regardless of higher future punishment, to compensate for their reduced reactivity to emotional stimuli.
Weiss, Carol H.; Murphy-Graham, Erin; Petrosino, Anthony; Gandhi, Allison G.
Evaluators sometimes wish for a Fairy Godmother who would make decision makers pay attention to evaluation findings when choosing programs to implement. The U.S. Department of Education came close to creating such a Fairy Godmother when it required school districts to choose drug abuse prevention programs only if their effectiveness was supported…
Gevarter, William B.
Models of human decision making are reviewed. Models which treat just the cognitive aspects of human behavior are included as well as models which include motivation. Both models which have associated computer programs, and those that do not, are considered. Since flow diagrams, that assist in constructing computer simulation of such models, were not generally available, such diagrams were constructed and are presented. The result provides a rich source of information, which can aid in construction of more realistic future simulations of human decision making.
The author proposes a new model for the assessment of decision-making capacity based on the principles of narrative medicine. The narrative method proposed by the author addresses the hidden power realtionships implicit in the current model of capacity assessment. Sample cases are reviewed using the traditional model in comparison with the narrative model. Narrative medicine provides an effective model for the assessment of decision-making capacity. Deficiencies in the traditional model capacity assessment can be effectively addressed using narrative strategies. © 2015 John Wiley & Sons, Ltd.
Full Text Available We present a motivational account of the impact of emotion on decision making, termed the feeling-is-for-doing approach. We first describe the psychology of emotion and argue for a need to be specific when studying emotion's impact on decision making. Next we describe what our approach entails and how it relates emotion, via motivation to behavior. Then we offer two illustrations of our own research that provide support for two important elements in our reasoning. We end with specifying four criteria that we consider to be important when studying how feeling guides our everyday doing.
Sax, Joanna K
Society is facing major challenges in climate change, health care and overall quality of life. Scientific advances to address these areas continue to grow, with overwhelming evidence that the application of highly tested forms of biotechnology is safe and effective. Despite scientific consensus in these areas, consumers appear reluctant to support their use. Research that helps to understand consumer decision-making and the public’s resistance to biotechnologies such as vaccines, fluoridated water programs and genetically engineered food, will provide great social value. This article is forward-thinking in that it suggests that important research in behavioral decision-making, specifically affect and ambiguity, can be used to help consumers make informed choices about major applications of biotechnology. This article highlights some of the most controversial examples: vaccinations, genetically engineered food, rbST treated dairy cows, fluoridated water, and embryonic stem cell research. In many of these areas, consumers perceive the risks as high, but the experts calculate the risks as low. Four major thematic approaches are proposed to create a roadmap for policymakers to consider for policy design and implementation in controversial areas of biotechnology. This article articulates future directions for studies that implement decision-making research to allow consumers to appropriately assign risk to their options and make informed decisions.
Dshemuchadse, Maja; Scherbaum, Stefan; Goschke, Thomas
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.…
Background: Decision is defined as a choice that you make about something after thinking about several possibilities. Human decision making and judgment is readily observable in reality. The Personality trait that Influence Decision Making is usually missing from research of decision making. The current study is focused on the characteristics which stimulate the decision making behavior but is not concerned about what makes a decision good or bad.This study aimed to compare the differences in...
G.R. Teisman (Geert)
textabstractThis article elaborates on the question how complex decision-making can be analysed. Three conceptual models are compared: the phase model, the stream model and the rounds model. Each model is based on specific assumptions about what decision-making is and how it should be analysed. The
Zeiss, Ragna; van Egmond, S.
This article studies the roles three science-based models play in Dutch policy and decision making processes. Key is the interaction between model construction and environment. Their political and scientific environments form contexts that shape the roles of models in policy decision making.
To make fast and accurate behavioral choices, we need to integrate noisy sensory input, take prior knowledge into account, and adjust our decision criteria. It was shown previously that in two-alternative-forced-choice tasks, optimal decision making can be formalized in the framework of a sequential probability ratio test and is then equivalent to a diffusion model. However, this analogy hides a “chicken and egg” problem: to know how quickly we should integrate the sensory input and set the optimal decision threshold, the reliability of the sensory observations must be known in advance. Most of the time, we cannot know this reliability without first observing the decision outcome. We consider here a Bayesian decision model that simultaneously infers the probability of two different choices and at the same time estimates the reliability of the sensory information on which this choice is based. We show that this can be achieved within a single trial, based on the noisy responses of sensory spiking neurons. The resulting model is a non-linear diffusion to bound where the weight of the sensory inputs and the decision threshold are both dynamically changing over time. In difficult decision trials, early sensory inputs have a stronger impact on the decision, and the threshold collapses such that choices are made faster but with low accuracy. The reverse is true in easy trials: the sensory weight and the threshold increase over time, leading to slower decisions but at much higher accuracy. In contrast to standard diffusion models, adaptive sensory weights construct an accurate representation for the probability of each choice. This information can then be combined appropriately with other unreliable cues, such as priors. We show that this model can account for recent findings in a motion discrimination task, and can be implemented in a neural architecture using fast Hebbian learning. PMID:22679418
To make fast and accurate behavioral choices, we need to integrate noisy sensory input, take prior knowledge into account, and adjust our decision criteria. It was shown previously that in two-alternative-forced-choice tasks, optimal decision making can be formalized in the framework of a sequential probability ratio test and is then equivalent to a diffusion model. However, this analogy hides a "chicken and egg" problem: to know how quickly we should integrate the sensory input and set the optimal decision threshold, the reliability of the sensory observations must be known in advance. Most of the time, we cannot know this reliability without first observing the decision outcome. We consider here a Bayesian decision model that simultaneously infers the probability of two different choices and at the same time estimates the reliability of the sensory information on which this choice is based. We show that this can be achieved within a single trial, based on the noisy responses of sensory spiking neurons. The resulting model is a non-linear diffusion to bound where the weight of the sensory inputs and the decision threshold are both dynamically changing over time. In difficult decision trials, early sensory inputs have a stronger impact on the decision, and the threshold collapses such that choices are made faster but with low accuracy. The reverse is true in easy trials: the sensory weight and the threshold increase over time, leading to slower decisions but at much higher accuracy. In contrast to standard diffusion models, adaptive sensory weights construct an accurate representation for the probability of each choice. This information can then be combined appropriately with other unreliable cues, such as priors. We show that this model can account for recent findings in a motion discrimination task, and can be implemented in a neural architecture using fast Hebbian learning.
Bastons, Miquel; Armengou, Jaume
There is both individual and collective widespread concern in society about the impact of human activity and the effects of our decisions on the physical and social environment. This concern is included within the idea of sustainability. The meaning of the concept is still ambiguous and its practical effectiveness disputed. Like many other authors, this article uses as a starting point the definition proposed by the World Commission on Environment and Development (Our common future, Oxford University Press, Oxford, 1987), considering it to be a proposal for changing the assessment of the effects of decisions, from at least two perspectives: (1) what effects we should consider and (2) how we should assess them. Based on this double perspective, sustainability is explored as a method for decision-making which both expands the assessment of the consequences, and also provides an objective criterion for such assessment. It will be argued that the idea of sustainability, seen from this perspective, brings to decision-making two qualities which had been partially lost: realism and impartiality. In turn, the criteria for realism and impartiality in decision-making can be used to identify the limitations of some partial approaches to sustainability, which suffer from insufficient realism (emotional altruism), insufficient impartiality (tactical altruism) or both phenomena at once (egoism). The article concludes by demonstrating how realism and impartiality provide the basis for a new form of sustainable decision-making (ethical sustainability), which is dependent on the development of two moral virtues, prudence and benevolence, and which brings practical effectiveness and ethical sense to the concept of sustainability.
Full Text Available Background: There is no clear guideline on how to teach students evidence-based decision making (EBDM, so this study aimed to assess the impact of an educational intervention on students’ EBDM skills. Methods: This was an explorative mixed-method study of 12 undergraduate occupational therapy students and their teacher. The teaching was aimed at increasing self-efficacy and cognitive skills in EBDM. Semi-structured interviews were conducted to gather the students’ perceived learning benefits. Before and after the intervention, a self-efficacy questionnaire, a critical thinking test, and scored generic cognitive skills in an argument were used as measures of learning achievements. Content analysis was applied to analyze the interview data. To analyze the quantitative data, the Wilcoxon signed rank test was applied. Results: Following the five teaching sessions, the participants’ experienced (a an understanding of the value and challenges in individually tailored EBDM, (b the ability to sort and select information, (c being more cautious in reasoning and reaching conclusions, and (d better interaction with clients. These categories were supported by significant increases in measures of self-efficacy and cognitive skills used in EBDM. Active, guided education and working with real clients were reported as powerful stimuli for learning. Conclusion: Critical thinking exercises used in authentic health professional evidence-based decisions are promising methods for promoting EBDM.
Tibor Besedeš; Cary Deck; Sudipta Sarangi; Mikhael Shor
Using controlled experiments, we examine how individuals make choices when faced with multiple options. Choice tasks are designed to mimic the selection of health insurance, prescription drug, or retirement savings plans. In our experiment, available options can be objectively ranked, allowing us to examine optimal decision making. First, the probability of a person selecting the optimal option declines as the number of options increases, with the decline being more pronounced for older subje...
Besedes, Tibor; Deck, Carey; Sarangi, Sudipta; Shor, Mikhael
Using controlled experiments, we examine how individuals make choices when faced with multiple options. Choice tasks are designed to mimic the selection of health insurance, prescription drug, or retirement savings plans. In our experiment, available options can be objectively ranked allowing us to examine optimal decision making. First, the probability of a person selecting the optimal option declines as the number of options increases, with the decline being more pronounced for older subjec...
Human actions, emotions, and decision making are products of complex interactions between explicit and implicit processes at various levels of spatial and temporal scales. Although it may not be possible to obtain to experimental data for all the complexity of human behavioral and emotional processes in our everyday life, recent studies have investigated the effects of social contexts on actions, emotions, and decision making; these studies include those in the fields of experimental psychology, cognitive science, and neuroscience. In this paper, we review several empirical studies that exemplify how our actions, social emotions, and decision making are influenced by the presence of implicit external, rather than internal factors, particularly by presence of other individuals. The following are the main principles identified. (1) Unconscious behavioral contagion: Individuals tend to mimic others' actions. This tendency occurs unconsciously even when the observed and the to-be-executed movements are unrelated at various levels and aspects of behaviors (e. g., behavioral tempo and speed). (2) Neural substrates of social emotions: Various social emotions, including admiration, compassion, envy, and schadenfreude, are represented in neuronal networks that are similar to those of basic emotional processes. (3) Evasive nature of human decision making: Individuals tend to overrate their own subjective impression of and emotional reaction in forecasting affective reaction to events in the future, even though the predictive power of information from peer group is much larger in this regard. Individuals are seldom aware of the dissociation between their intended choice and excuted actions and are willing to give elaborate explanations for the choices they, in fact, did not make. Using these empirical examples, I will illustrate the considerable influences of implicit, unconscious processes on human actions, emotions, and decision making.
Full Text Available Two procedures were adopted to assess decision-making styles in the workplace: (a the administration of traditional standardized self-report questionnaires and (b open-ended questions about the way respondents would take decisions in a critical business case. Seventy-four adults were given two questionnaires: the Preference for Intuition and Deliberation, which assesses “deliberative” or “intuitive” decision style, and the Style of Learning and Thinking, which assesses thinking styles as “left” (namely, analytical-systematic or “right” (that is, global-intuitive. Participants were also presented with a business case that involved taking a decision. Responses to the business case were used to classify approaches to decision making as “analytical-systematic” or “global-intuitive.” Results showed that the questionnaires correlated consistently with scores from the business case, thus supporting the notion that the assessment of decision style through self-report questionnaires is reliable and valid.
Evidence-based practice (EBP) is an influential interdisciplinary movement that originated in medicine as evidence-based medicine (EBM) about 1992. EBP is of considerable interest to library and information science (LIS) because it focuses on a thorough documentation of the basis for the decision...
Full Text Available Almost by definition decision-making is typical human activity, and therefore important psychological subject. The starting point of its classical conception within psychology could be traced back to economy and mathematic, with ideas of human as rational economic being, and conceptualising decision making as choice between two or more alternatives, and as such being a separate event in space and time. Already in fifties Herbert Simon challenged such a view with his concept of bounded rationality, emerging from the joint effect of internal limitations of the human mind, and the structure of external environments in which the mind operates. During the last decades with the shift to the real word situations where decisions are embedded in larger tasks, becoming so part of the study of action, the lost rational human appeared again as efficient creature in the complex environment. Gigerenzer showed how heuristics help in this process.
This book presents different methods for analyzing the body language (movement, position, use of personal space, silences, pauses and tone, the eyes, pupil dilation or constriction, smiles, body temperature and the like) for better understanding people’s needs and actions, including biometric data gathering and reading. Different studies described in this book indicate that sufficiently much data, information and knowledge can be gained by utilizing biometric technologies. This is the first, wide-ranging book that is devoted completely to the area of intelligent decision support systems, biometrics technologies and their integrations. This book is designated for scholars, practitioners and doctoral and master’s degree students in various areas and those who are interested in the latest biometric and intelligent decision making support problems and means for their resolutions, biometric and intelligent decision making support systems and the theory and practice of their integration and the opportunities fo...
Weiss, Carol H.; Cambone, Joseph
The attitudes of six principals serving in shared decision-making (SDM) high schools toward SDM were studied. Although three supported SDM as a vehicle for improving education, the others supported it for its own sake, to democratize schools. Problems in instituting the reforms in these schools are discussed. (SLD)
Chang, L.J.; Sanfey, A.G.
PURPOSE: Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels
Kustusch, Mary Bridget; Ptak, Corey; Sayre, Eleanor C.; Franklin, Scott V.
It is increasingly common in physics classes for students to work together to solve problems and perform laboratory experiments. When students work together, they need to negotiate the roles and decision making within the group. We examine how a large group of students negotiates authority as part of their two week summer College Readiness Program at Rochester Institute of Technology. The program is designed to develop metacognitive skills in first generation and Deaf and hard-of-hearing (DHH) STEM undergraduates through cooperative group work, laboratory experimentation, and explicit reflection exercises. On the first full day of the program, the students collaboratively developed a sign for the word ``metacognition'' for which there is not a sign in American Sign Language. This presentation will focus on three aspects of the ensuing discussion: (1) how the instructor communicated expectations about decision making; (2) how the instructor promoted student-driven decision making rather than instructor-driven policy; and (3) one student's shifts in decision making behavior. We conclude by discussing implications of this research for activity-based physics instruction.
Lapenta, William; Irwin, Dan
SERVIR is a regional visualization and monitoring system for Mesoamerica that integrates satellite and other geospatial data for improved scientific knowledge and decision making by managers, researchers, students, and the general public. SERVIR addresses the nine societal benefit areas of the Global Earth Observation System of Systems (GEOSS). This talk will provide an overview of products and services available through SERVIR.
This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…
van Ravenzwaaij, Don; van der Maas, Han L. J.; Wagenmakers, Eric-Jan
In their influential "Psychological Review" article, Bogacz, Brown, Moehlis, Holmes, and Cohen (2006) discussed optimal decision making as accomplished by the drift diffusion model (DDM). The authors showed that neural inhibition models, such as the leaky competing accumulator model (LCA) and the feedforward inhibition model (FFI), can mimic the…
Dominika Crnjac Milić
Full Text Available This paper provides a production analysis which can help management in the decision making process. Given that certain assumptions are correct, the mathematical interpretation of the optimal resource allocation and the income maximisation of a certain economic entity can be solved.
Full Text Available An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the well-studied stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability.
Lusby, Linda A.
This document examines the underlying rationale for the development of a global approach in consumer studies. The concept of consumer ethics is discussed and the consumer decision-making process is placed within an ecosystem perspective of the marketplace. The model developed introduces educators, marketers, and consumers to a more global…
Johnson, Daniel C.; Matthews, Wendy K.
The purpose of this descriptive study was to explore experienced general music teachers' decision-making processes. Participants included seven experienced, American general music teachers who contributed their views during two phases of data collection: (1) responses to three classroom scenarios; and (2) in-depth, semi-structured, follow-up…
Being able to make decisions is important for all students. Students need to have opportunities to choose from among alternative situations. Reading, as one curriculum area, provides a plethora of opportunities to choose and to select. The philosopher John Locke believed the following facets of an individual's development were in the ensuing order…
Full Text Available Problems involving more than one criterion abound. To help in the solution of such problems, a field of management science and operations research known as multiple criteria decision making (MCDM has emerged to help solve such problems. In this paper we discuss some recent developments in this important field.
Tarter, C. John; Hoy, Wayne K.
There is no single best decision-making approach. This article reviews and compares six contemporary models (classical, administrative, incremental, mixed-scanning, garbage-can, and political) and develops a framework and 10 propositions to match strategies with circumstances. A contingency approach suggests that administrators use satisficing (a…
Risk is a central feature of political decision making. Prospect theory, an empirically correct theory of choice under risk that deals precisely with this condition, therefore seems to have much to offer political science. Prospect theory's central finding is that individuals' attitude toward risk
Thomsen, Jesper Skovhus; Mosekilde, Erik; Sterman, John David
of this article is to show how the decision making behavior of real people in simulated corporate environments can lead to chaotic, hyperchaotic and higher-order hyperchaotic phenomena. Characteristics features of these complicated forms of behavior are analyzed with particular emphasis on an interesting form...
M. van der Ven (Myrthe)
markdownabstractThe _first aim_ of this thesis was to evaluate the added value of ultrasound in clinical decision making in patients with arthralgia, patients with psoriasis and monitoring RA patients. Our _second aim_ was to increase sensitivity of power Doppler ultrasound for MCP joints.
Pier Luigi Baldi
Full Text Available This issue deals with the partial data of a research in progress on focalization, pseudodiagnosticity and framing- effect in decision making, followed by the most important results of some experiments about the emotional aspects of the choice, and ends by stressing the potential contribution of the artificial neural networks to the medical diagnosis.
An ultrasound demonstration was conducted for participants (~ 110 people) of the Arkansas Cattle Grower’s Conference, Hope, AR. Evaluation of live animals with ultrasound technology allows beef producers the ability to make selection and management decisions. Specifically, ultrasound at the conclu...
The study examined the effect of household decision making on the use of contraceptives and fertility behaviour of ever-married men in Nigeria. Men's Recode Dataset of 2013 Nigerian Demographic and Health Survey (NDHS) dataset was used. A sample size of 8,981 ever married men aged 15-49 were analyzed using ...
Nielen, MMA; Veltman, DJ; de Jong, R; Mulder, G; den Boer, JA
Background: Neuro-imaging studies in OCD report the orbitofrontal cortex to be functionally abnormal. As these areas are presumed to be involved in decision making, studying this behavior in OCD may provide further insight into the cognitive deficits accompanying the disorder. Methods: Performance
Dec 1, 2017 ... Deferential vulnerability arises when individuals subordinate themselves or submit to an authority figure when making decisions about their day-to-day lives and existence within their specific environment and relationships. This customary obedience occurs in cultures where certain hierarchical systems ...
Notes that teachers make intentional decisions during interaction with children and reflect on what occurs in the environment. Focuses on teacher behavior along several continua: soft-hard, simple-complex, open-closed, intrusion-seclusion, and high versus low mobility. Illustrates theory with a transcribed observation. Adapts Jones and Prescott's…
Yurtseven, M. Kudret; Buchanan, Walter W.
Decision making in most universities is taught within the conventional OR/MS (Operations Research/Management Science) paradigm. This paradigm is known to be "hard" since it is consisted of mathematical tools, and normally suitable for solving structured problems. In complex situations the conventional OR/MS paradigm proves to be…
The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were…
Leliveld, Marijke Christina
This dissertation sheds more light on ethics in economic decision-making. Over the course of nine experiments, I studied (a) when people adhere to ethical standards like the do-no-harm principle, and (b) how people respond to situations in which ethical standards are violated by studying not only
Individual consumers are subject to different influences on how they make decisions and what decision-making style they use. Consumer decision-making styles are a mental orientation that characterises a consumer's approach to making choices. The main purpose of the study is to explore the decision-making styles of ...
Engineering designers must make evidence-based decisions when applying the practical tools and techniques of their discipline to human problems. Information literacy provides a structure for determining information gaps, locating appropriate and relevant information, applying that information effectively, and documenting and managing the knowledge…
Orasanu, Judith; Martin, Lynne; Davison, Jeannie; Null, Cynthia H. (Technical Monitor)
Despite efforts to design systems and procedures to support 'correct' and safe operations in aviation, errors in human judgment still occur and contribute to accidents. In this paper we examine how an NDM (naturalistic decision making) approach might help us to understand the role of decision processes in negative outcomes. Our strategy was to examine a collection of identified decision errors through the lens of an aviation decision process model and to search for common patterns. The second, and more difficult, task was to determine what might account for those patterns. The corpus we analyzed consisted of tactical decision errors identified by the NTSB (National Transportation Safety Board) from a set of accidents in which crew behavior contributed to the accident. A common pattern emerged: about three quarters of the errors represented plan-continuation errors, that is, a decision to continue with the original plan despite cues that suggested changing the course of action. Features in the context that might contribute to these errors were identified: (a) ambiguous dynamic conditions and (b) organizational and socially-induced goal conflicts. We hypothesize that 'errors' are mediated by underestimation of risk and failure to analyze the potential consequences of continuing with the initial plan. Stressors may further contribute to these effects. Suggestions for improving performance in these error-inducing contexts are discussed.
Schwikert, Shane R; Curran, Tim
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.
Wemm, Stephanie E; Wulfert, Edelgard
The study examined the effects of a social stressor (Trier Social Stress Test) on 24 male and 32 female college students' affective and physiological reactivity and their subsequent performance on a decision-making task (Iowa Gambling Task). The 56 participants were randomly assigned to a social stressor or a control condition. Compared to controls, participants in the stress condition responded with higher heart rates and skin conductance responses, reported more negative affect, and on the decision-making task made less advantageous choices. An exploratory regression analysis revealed that among men higher levels of heart rate were positively correlated with riskier choices on the Iowa Gambling Task, whereas for women this relationship was curvilinear. Exploratory correlational analyses showed that lower levels of skin conductance within the stress condition were associated with greater levels of substance use and gambling. The results suggest that the presence of a stressor may generally result in failure to attend to the full range of possible consequences of a decision. The relationship pattern between the degree of stress responding and successful decision making may be different for men and women.
Cristina C B Cavalcante
Full Text Available 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.
Naudé, Jérémie; Dongelmans, Malou; Faure, Philippe
Addiction to nicotine is characterized by impulses, urges and lack of self-control towards cigarettes. A key element in the process of addiction is the development of habits oriented towards nicotine consumption that surpass flexible systems as a consequence of a gradual adaptation to chronic drug exposure. However, the long-term effects of nicotine on brain circuits also induce wide changes in decision-making processes, affecting behaviors unrelated to cigarettes. This review aims at providing an update on the implications of nicotine on general decision-making processes, with an emphasis on impulsivity and risk-taking. As impulsivity is a rather ambiguous behavioral trait, we build on economic and normative theories to better characterize these nicotine-induced alterations in decision-making. Nonetheless, experimental data are sparse and often contradictory. We will discuss how the latest findings on the neurobiological basis of choice behavior may help disentangling these issues. We focus on the role of nicotine acetylcholine receptors and their different subunits, and on the spatio-temporal dynamics (i.e. diversity of the neural circuits, short- and long-term effects) of both endogenous acetylcholine and nicotine action. Finally, we try to link these neurobiological results with neuro-computational models of attention, valuation and action, and of the role of acetylcholine in these decision processes. This article is part of the Special Issue entitled 'The Nicotinic Acetylcholine Receptor: From Molecular Biology to Cognition'. Copyright © 2014 Elsevier Ltd. All rights reserved.
Kahneman, Daniel; Lovallo, Dan; Sibony, Olivier
When an executive makes a big bet, he or she typically relies on the judgment of a team that has put together a proposal for a strategic course of action. After all, the team will have delved into the pros and cons much more deeply than the executive has time to do. The problem is, biases invariably creep into any team's reasoning-and often dangerously distort its thinking. A team that has fallen in love with its recommendation, for instance, may subconsciously dismiss evidence that contradicts its theories, give far too much weight to one piece of data, or make faulty comparisons to another business case. That's why, with important decisions, executives need to conduct a careful review not only of the content of recommendations but of the recommendation process. To that end, the authors-Kahneman, who won a Nobel Prize in economics for his work on cognitive biases; Lovallo of the University of Sydney; and Sibony of McKinsey-have put together a 12-question checklist intended to unearth and neutralize defects in teams' thinking. These questions help leaders examine whether a team has explored alternatives appropriately, gathered all the right information, and used well-grounded numbers to support its case. They also highlight considerations such as whether the team might be unduly influenced by self-interest, overconfidence, or attachment to past decisions. By using this practical tool, executives will build decision processes over time that reduce the effects of biases and upgrade the quality of decisions their organizations make. The payoffs can be significant: A recent McKinsey study of more than 1,000 business investments, for instance, showed that when companies worked to reduce the effects of bias, they raised their returns on investment by seven percentage points. Executives need to realize that the judgment of even highly experienced, superbly competent managers can be fallible. A disciplined decision-making process, not individual genius, is the key to good
Odame, Augustina Yaa Oye
This dissertation is made up of three separate studies under the unifying theme of “Water Decision-Making under Uncertainty.” The first study analyzed a farmer’s decision to invest in a more efficient irrigation system given uncertainty about future water supplies and his post-investment efficiency. It found the price at which farmers would no longer produce to be a bigger consideration in irrigation investment than previously thought. It also found support for a careful identification and co...
Mbah, PhD2*, Ambuj Kumar, MD, MPH3, Kim Sehwan, PhD4*, Ronald Schonwetter, MD5* and Benjamin Djulbegovic, MD, PhD6 1Center for Evidence - Based Medicine , University...of South Florida, Tampa, FL 2USF, Tampa, FL 3University of South Florida, College of Medicine, Center for Evidence Based Medicine , Tampa...4HPC healthcare, Tampa, FL 5HPC Healthcare, Tampa, FL 6Center for Evidence - Based Medicine & Health Outcomes Research, University of South
Lubell, M.; Niles, M.; Salerno, J.
This talk will provide an overview of several studies of how farmers make decisions about climate change adaptation and mitigation. A particular focus will be the "limiting factors hypothesis", which argues that farmers will respond to the climate variables that usually have the largest impact on their crop productivity. For example, the most limiting factor in California is usually water so how climate change affects water will be the largest drive of climate adaptation decisions. This basic idea is drawn from the broader theory of "psychological distance", which argue that human decisions are more attuned to ideas that are psychologically closer in space, time, or other factors. Empirical examples come from California, New Zealand, and Africa.
Bright, Leslie Shay
The purpose of this study was to describe and determine the prevalence of decision-making characteristics of recreational backcountry groups when making a decision of where to travel and ride in avalanche terrain from the perspective of individuals. Decision-making characteristics encompassed communication, decision-making processes, leadership,…
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the relevant...
Sisson, Gretchen; Ralph, Lauren; Gould, Heather; Foster, Diana Greene
Little is known about how adoption factors into pregnancy decision making, particularly when abortion is unavailable. We used data from the Turnaway Study, a longitudinal study of 956 women seeking abortion, including 231 women denied abortions owing to gestational limits. Through semiannual quantitative interviews, we assessed the frequency with which women denied abortion consider and choose adoption, and, among adoption participants, decision satisfaction. We compared differences in the demographic profiles of parenting and adoption participants using mixed effects regression models. We conducted in-depth interviews with 31 women who received or were denied wanted abortions, including 2 adoption participants, focused on understanding pregnancy decision making and feelings about their choice. Interviews were coded using inductive and deductive methods. Most women who received abortions were aware of but uninterested in adoption. A minority of women denied abortions (n = 231; 14%) were considering adoption at 1 week after denial. Of participants who gave birth (n = 161), most (91%) chose parenting. Parenting participants (n = 146) did not differ from adoption participants (n = 15) on measures of age, race, or poverty status, although adoption participants were somewhat less likely to be employed (20% vs. 43%; p = .1), and somewhat more likely to have completed high school (87% vs. 74%; p = .08). Although satisfaction with their decision was high among adoption participants, in-depth interviews revealed mixed emotions. Among women motivated to avoid parenthood, as evidenced by abortion seeking, adoption is considered or chosen infrequently. Political promotion of adoption as an alternative to abortion is likely not grounded in the reality of women's decision making. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Campbell, Andrew; Whitehead, Jo; Finkelstein, Sydney
Decision making lies at the heart of our personal and professional lives. Yet the daunting reality is that enormously important decisions made by intelligent, responsible people with the best information and intentions are nevertheless hopelessly flawed at times. In part, that's due to the way our brains work. Modern neuroscience teaches us that two hard-wired processes in the brain--pattern recognition and emotional tagging--are critical to decision making. Both are normally reliable; indeed, they provide us with an evolutionary advantage. But in certain circumstances, either one can trip us up and skew our judgment. In this article, Campbell and Whitehead, directors at the Ashridge Strategic Management Centre, together with Finkelstein, of Dartmouth's Tuck School, describe the conditions that promote errors of judgment and explore how organizations can build safeguards against them into the decision-making process. In their analysis, the authors delineate three "red-flag conditions" that are responsible either for distorting emotional tagging or for encouraging people to see false patterns: conflicts of interest; attachments to people, places, or things; and the presence of misleading memories, which seem, but really are not, relevant and comparable to the current situation. Using a global chemical company as an example, the authors describe the steps leaders can take to counteract those biases: inject fresh experience or analysis, introduce further debate and more challenges to their thinking, and impose stronger governance. Rather than rely on the wisdom of experienced chairmen, the humility of CEOs, or the standard organizational checks and balances, the authors urge, everyone involved in important decisions should explicitly consider whether red flags exist and, if they do, lobby for appropriate safeguards.
Full Text Available The purpose of this article is to develop a comprehensive process for identifying and addressing primarily ethical issues related to the psychology profession in South Africa. In fulfilling this purpose, research was conducted of relevant ethical and to a lesser extent, legal aspects pertaining to the psychology profession. In an attempt to prevent unprofessional conduct claims against psychologists from succeeding and to alert psychologists to the concurrent ethical problems that may lead to malpractice suits, this article offers material on some important issues – in the context of forensic psychology – such as ethical decision-making and principles, professional ethics, the regulation of psychology as a profession, the Ethical Code of Professional Conduct to which a psychologist should adhere, ethical aspects and issues pertaining to forensic psychology in general, some ethical issues pertaining to child forensic psychology, summary guidelines for ethical decision-making and some steps to follow to ensure sound ethical decisionmaking.
This book is about using business intelligence as a management information system for supporting managerial decision making. It concentrates primarily on practical business issues and demonstrates how to apply data warehousing and data analytics to support business decision making. This book progresses through a logical sequence, starting with data model infrastructure, then data preparation, followed by data analysis, integration, knowledge discovery, and finally the actual use of discovered knowledge. All examples are based on the most recent achievements in business intelligence. Finally this book outlines an overview of a methodology that takes into account the complexity of developing applications in an integrated business intelligence environment. This book is written for managers, business consultants, and undergraduate and postgraduates students in business administration.
a range of 4-7 Hz) [Sauseng et al, 2006]. See, elaborated description at L4. Thalamo-cortico integration The characteristic resting pattern of the brain is α-waves in the 8-12 Hz/s band which indicates an autogenic cortical reset originated in Thalamus (α%) [Hanslmayr et al, 2007]. The dynamics......Background: A descriptive neuroeconomic model is aimed for relativity of the concept of economic man to empirical science. Method: A 4-level client-server-integrator model integrating the brain models of McLean and Luria is the general framework for the model of empirical findings. Results......: Decision making relies on integration across brain levels of emotional intelligence (LU) and logico-matematico intelligence (RIA), respectively. The integrated decision making formula approaching zero by bottom-up emotional and frontoparietal-downward logico-matematico learning is: CONC := LU...
Trevena, Lyndal; Shepherd, Heather L; Bonner, Carissa; Jansen, Jesse; Cust, Anne E; Leask, Julie; Shadbolt, Narelle; Del Mar, Chris; McCaffery, Kirsten; Hoffmann, Tammy
Shared decision making (SDM) is now firmly established within national clinical standards for accrediting hospitals, day procedure services, public dental services and medical education in Australia, with plans to align general practice, aged care and disability service. Implementation of these standards and training of health professionals is a key challenge for the Australian health sector at this time. Consumer involvement in health research, policy and clinical service governance has also increased, with a major focus on encouraging patients to ask questions during their clinical care. Tools to support shared decision making are increasingly used but there is a need for more systemic approaches to their development, cultural adaptation and implementation. Sustainable solutions to ensure tools are kept up-to-date with the best available evidence will be important for the future. Copyright © 2017. Published by Elsevier GmbH.
García-Altés, Anna; Argimon, Josep M
Improving the quality and transparency of governmental healthcare decision-making has an impact on the health of the population through policies, organisational management and clinical practice. Moreover, the comparison between healthcare centres and the transparent feedback of results to professionals and to the wider public contribute directly to improved results. The "Results Centre" of the Catalan healthcare system measures and disseminates the results achieved by the different healthcare centres in order to facilitate a shared decision-making process, thereby enhancing the quality of healthcare provided to the population of Catalonia (Spain). This is a pioneering initiative in Spain and is aligned with the most advanced countries in terms of policies of transparency and accountability. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Farrell, Dene; Sayama, Hiroki; Dionne, Shelley D.; Yammarino, Francis J.; Wilson, David Sloan
Team decision making dynamics are investigated from a novel perspective by shifting agency from decision makers to representations of potential solutions. We provide a new way to navigate social dynamics of collective decision making by interpreting decision makers as constituents of an evolutionary environment of an ecology of evolving solutions. We demonstrate distinct patterns of evolution with respect to three forms of variation: (1) Results with random variations in utility functions of individuals indicate that groups demonstrating minimal internal variation produce higher true utility values of group solutions and display better convergence; (2) analysis of variations in behavioral patterns within a group shows that a proper balance between selective and creative evolutionary forces is crucial to producing adaptive solutions; and (3) biased variations of the utility functions diminish the range of variation for potential solution utility, leaving only the differential of convergence performance static. We generally find that group cohesion (low random variation within a group) and composition (appropriate variation of behavioral patterns within a group) are necessary for a successful navigation of the solution space, but performance in both cases is susceptible to group level biases.
Full Text Available Judgments and decisions under uncertainty are frequently linked to a prior sequential search for relevant information. In such cases, the subject has to decide when to stop the search for information. Evidence accumulation models from social and cognitive psychology assume an active and sequential information search until enough evidence has been accumulated to pass a decision threshold. In line with such theories, we conceptualize the evidence threshold as the ``desired level of confidence'' (DLC of a person. This model is tested against a fixed stopping rule (one-reason decision making and against the class of multi-attribute information integrating models. A series of experiments using an information board for horse race betting demonstrates an advantage of the proposed model by measuring the individual DLC of each subject and confirming its correctness in two separate stages. In addition to a better understanding of the stopping rule (within the narrow framework of simple heuristics, the results indicate that individual aspiration levels might be a relevant factor when modelling decision making by task analysis of statistical environments.
Rao, Ravipudi Venkata
Manufacturing is the backbone of any industrialized nation. Recent worldwide advances in manufacturing technologies have brought about a metamorphism in the industry. Fast-changing technologies on the product front have created a need for an equally fast response from manufacturing industries. To meet these challenges, manufacturing industries have to select appropriate manufacturing strategies, product designs, manufacturing processes, work piece and tool materials, and machinery and equipment. The selection decisions are complex as decision making is more challenging today. Decision makers i
Chaudhry, Muhammad Shirjeel Riaz; Sidek, Mohmad Safhree
Approved for public release; distribution is unlimited This thesis proposes a decision-making model based on PESTEL (Political, Economic, Social, Technological, Environmental, and Legal) analysis, AHP (Analytical Hierarchical Process), and game theory. The case study used to demonstrate the concept is a 2013 Malaysian crisis wherein foreign intruders occupied a village in Sabah state. The Malaysian government, ultimately, launched a military operation to clear the area. The focus of our st...
Michael Christensen; Thorbjørn Knudsen
Starting from the premise that individuals within an organization are fallible, this paper advances the study of relationships between the organization's decision-making structure and its performance. We offer a general treatment that allows one to analyze the full range of organizational architectures between extreme centralized and decentralized forms (often referred to as hierarchies and polyarchies). Our approach furthermore allows designers to examine the change in the overall reliabilit...
Eshel eBen Jacob; Eshel eBen Jacob; Mingyang eLu; Daniel eSchultz; José N. Onuchic
The choice that bacteria make between sporulation and competence when subjected to stress provides a prototypical example of collective cell fate determination that is stochastic on the individual cell level, yet predictable (deterministic) on the population level. This collective decision is performed by an elaborated gene network. Considerable effort has been devoted to simplify its complexity by taking physics approaches to untangle the basic functional modules that are integrated to form...
Ben-Jacob, Eshel; Lu, Mingyang; Schultz, Daniel; Onuchic, Jose' N.
The choice that bacteria make between sporulation and competence when subjected to stress provides a prototypical example of collective cell fate determination that is stochastic on the individual cell level, yet predictable (deterministic) on the population level. This collective decision is performed by an elaborated gene network. Considerable effort has been devoted to simplify its complexity by taking physics approaches to untangle the basic functional modules that are integrated to form ...
Abstract Utility systems provide heat and power to industrial sites. The importance of operating these systems in an optimal way has increased significantly due to the unstable and in the long term rising prices of fossil fuels as well as the need for reducing the greenhouse gas emissions. This paper presents an analysis of the problem for supporting operator decision-making under conditions of variable steam demands from the production processes on an industrial site. An optimisat...
Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."
Gillespie, Brigid M; Chaboyer, Wendy; St John, Winsome; Morley, Nicola; Nieuwenhoven, Paul
To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice. With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area. A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice. Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes. The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes. These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes. © 2014 John Wiley & Sons Ltd.
Flaming, Susan C.
The continuing saga of satellite technology development is as much a story of successful risk management as of innovative engineering. How do program leaders on complex, technology projects manage high stakes risks that threaten business success and satellite performance? This grounded theory study of risk decision making portrays decision leadership practices at one communication satellite company. Integrated product team (IPT) leaders of multi-million dollar programs were interviewed and observed to develop an extensive description of the leadership skills required to navigate organizational influences and drive challenging risk decisions to closure. Based on the study's findings the researcher proposes a new decision making model, Deliberative Decision Making, to describe the program leaders' cognitive and organizational leadership practices. This Deliberative Model extends the insights of prominent decision making models including the rational (or classical) and the naturalistic and qualifies claims made by bounded rationality theory. The Deliberative Model describes how leaders proactively engage resources to play a variety of decision leadership roles. The Model incorporates six distinct types of leadership decision activities, undertaken in varying sequence based on the challenges posed by specific risks. Novel features of the Deliberative Decision Model include: an inventory of leadership methods for managing task challenges, potential stakeholder bias and debates; four types of leadership meta-decisions that guide decision processes, and aligned organizational culture. Both supporting and constraining organizational influences were observed as leaders managed major risks, requiring active leadership on the most difficult decisions. Although the company's engineering culture emphasized the importance of data-based decisions, the uncertainties intrinsic to satellite risks required expert engineering judgment to be exercised throughout. An investigation into
Perez, Maya; Gati, Itamar
We tested the associations among the career decision-making difficulties, the career decision status, and either (a) the career decision-making profiles of 575 young adults, or (b) the coping strategies of 379 young adults. As hypothesized, a more advanced decision status was negatively associated with both career decision-making difficulties…
Walker, Paul; Lovat, Terry
This paper is predicated on the understanding that clinical encounters between clinicians and patients should be seen primarily as inter-relations among persons and, as such, are necessarily moral encounters. It aims to relocate the discussion to be had in challenging medical decision-making situations, including, for example, as the end of life comes into view, onto a more robust moral philosophical footing than is currently commonplace. In our contemporary era, those making moral decisions must be cognizant of the existence of perspectives other than their own, and be attuned to the demands of inter-subjectivity. Applicable to clinical practice, we propose and justify a Habermasian approach as one useful means of achieving what can be described as dialogic consensus. The Habermasian approach builds around, first, his discourse theory of morality as universalizable to all and, second, communicative action as a cooperative search for truth. It is a concrete way to ground the discourse which must be held in complex medical decision-making situations, in its actual reality. Considerations about the theoretical underpinnings of the application of dialogic consensus to clinical practice, and potential difficulties, are explored.
Kaczmarczyk, Joseph; Davidson, Richard; Bryden, Daniele; Haselden, Stephen; Vivekananda-Schmidt, Pirashanthie
In Serious Games (SGs), educational content is integrated into a game so that learning is intrinsic to play, thereby motivating players and improving engagement. SGs enable learning by developing situated understanding in users and by enabling players to practise safe clinical decision making; however, the use of SGs in medical education is not well established. We aimed to design a game-based resource to teach clinical decision making to medical students, and to assess user perceptions of educational value, usability and the role for SGs in undergraduate training. An SG focusing on the acute management of tachyarrhythmias was developed. Third- and fourth-year medical students at the medical school were invited to use and evaluate the game using questionnaires and focus groups. We invited 479 students, and 281 accessed the game. Only 47 students completed the questionnaire and 31 students participated in the focus groups. The data suggest that SGs: (1) can allow students to rehearse taking responsibility for decision making; (2) are fun and motivational; (3) have a role in revising and consolidating knowledge; and (4) could be formative assessment tools. Serious Games enable learning by developing situated understanding in users SGs could be employed as adjuvant learning resources to develop students' skills and knowledge. Further empirical research is required to assess the added value of games in medical education. © 2015 John Wiley & Sons Ltd.
Camchong, Jazmin; Endres, Michael; Fein, George
Alcoholism can be described as a disorder characterized by impulsive decision-making processes, wherein potential short-term appetitive outcomes of drinking (e.g., intoxication) are deemed more important than potential long-term aversive consequences of drinking (e.g., drunk-driving arrests). Separate but interrelated neurocognitive pathways to impulsive decision making exist - one reflected by weak "top-down" executive control over impulsive and compulsive urges to consume alcohol, the other reflected by a strong "bottom-up" appetitive drive in impulsive and compulsive urges to consume alcohol. We present behavioral evidence of poor executive control and strong appetitive drive and neural evidence describing differences in functional and organizational patterns in brain executive control and appetitive drive networks. We discuss how these behavioral and neural aspects of alcoholism are associated with impulsive decision making and risky behavior in alcoholics, and how these patterns differ at different stages of alcoholism dependence and recovery. © 2014 Elsevier B.V. All rights reserved.
Kim, Hyojin; Lee, Daeyeol; Shin, Young-Min; Chey, Jeanyung
Adaptive decision making in dynamic social settings requires frequent re-evaluation of choice outcomes and revision of strategies. This requires an array of multiple cognitive abilities, such as working memory and response inhibition. Thus, the disruption of such abilities in schizophrenia can have significant implications for social dysfunctions in affected patients. In the present study, 20 schizophrenia patients and 20 control subjects completed two computerized binary decision-making tasks. In the first task, the participants played a competitive zero-sum game against a computer in which the predictable choice behavior was penalized and the optimal strategy was to choose the two targets stochastically. In the second task, the expected payoffs of the two targets were fixed and unaffected by the subject's choices, so the optimal strategy was to choose the target with the higher expected payoff exclusively. The schizophrenia patients earned significantly less money during the first task, even though their overall choice probabilities were not significantly different from the control subjects. This was mostly because patients were impaired in integrating the outcomes of their previous choices appropriately in order to maintain the optimal strategy. During the second task, the choices of patients and control subjects displayed more similar patterns. This study elucidated the specific components in strategic decision making that are impaired in schizophrenia. The deficit, which can be characterized as strategic stiffness, may have implications for the poor social adjustment in schizophrenia patients.
Sutton, Alex J.; Welton, Nicky J.; Ades, A. E.
In meta-analysis, between-study heterogeneity indicates the presence of effect-modifiers and has implications for the interpretation of results in cost-effectiveness analysis and decision making. A distinction is usually made between true variability in treatment effects due to variation in patient populations or settings and biases related to the way in which trials were conducted. Variability in relative treatment effects threatens the external validity of trial evidence and limits the ability to generalize from the results; imperfections in trial conduct represent threats to internal validity. We provide guidance on methods for meta-regression and bias-adjustment, in pairwise and network meta-analysis (including indirect comparisons), using illustrative examples. We argue that the predictive distribution of a treatment effect in a “new” trial may, in many cases, be more relevant to decision making than the distribution of the mean effect. Investigators should consider the relative contribution of true variability and random variation due to biases when considering their response to heterogeneity. In network meta-analyses, various types of meta-regression models are possible when trial-level effect-modifying covariates are present or suspected. We argue that a model with a single interaction term is the one most likely to be useful in a decision-making context. Illustrative examples of Bayesian meta-regression against a continuous covariate and meta-regression against “baseline” risk are provided. Annotated WinBUGS code is set out in an appendix. PMID:23804507
Irma Triasih Kurniawan
Full Text Available Motivational theories of choice focus on the influence of goal values and strength of reinforcement to explain behavior. By contrast relatively little is known concerning how the cost of an action, such as effort expended, contributes to a decision to act. Effort-based decision making addresses how we make an action choice based on an integration of action and goal values. Here we review behavioral and neurobiological data regarding the representation of effort as action cost, and how this impacts on decision making. Although organisms expend effort to obtain a desired reward there is a striking sensitivity to the amount of effort required, such that the net preference for an action decreases as effort cost increases. We discuss the contribution of the neurotransmitter dopamine (DA towards overcoming response costs and in enhancing an animal’s motivation towards effortful actions. We also consider the contribution of brain structures, including the basal ganglia (BG and anterior cingulate cortex (ACC, in the internal generation of action involving a translation of reward expectation into effortful action.
Keefe, Carole W; Thompson, Margaret E; Noel, Mary Margaret
Improving access to preventive care requires addressing patient, provider, and systems barriers. Patients often lack knowledge or are skeptical about the importance of prevention. Physicians feel that they have too little time, are not trained to deliver preventive services, and are concerned about the effectiveness of prevention. We have implemented an educational module in the required family practice clerkship (1) to enhance medical student learning about common clinical preventive services and (2) to teach students how to inform and involve patients in shared decision making about those services. Students are asked to examine available evidence-based information for preventive screening services. They are encouraged to look at the recommendations of various organizations and use such resources as reports from the U.S. Preventive Services Task Force to determine recommendations they want to be knowledgeable about in talking with their patients. For learning shared decision making, students are trained to use a model adapted from Braddock and colleagues(1) to discuss specific screening services and to engage patients in the process of making informed decisions about what is best for their own health. The shared decision making is presented and modeled by faculty, discussed in small groups, and students practice using Web-based cases and simulations. The students are evaluated using formative and summative performance-based assessments as they interact with simulated patients about (1) screening for high blood cholesterol and other lipid abnormalities, (2) screening for colorectal cancer, (3) screening for prostate cancer, and (4) screening for breast cancer. The final student evaluation is a ten-minute, videotaped discussion with a simulated patient about screening for colorectal cancer that is graded against a checklist that focuses primarily on the elements of shared decision making. Our medical students appear quite willing to accept shared decision making as
Temel, Veysel; Birol, Sefa Sahan; Nas, Kazim; Akpinar, Selahattin; Tekin, Murat
The aim of the study was to examine the self-esteem in decision-making and decision-making styles of the teachers in various branches of Çat town of Erzurum Province, Turkey in terms of some variables in 2014-2015 year. A total of 153 teachers (84 females and 69 males) (age (? = 1.6536 ± 0.72837) from different departments participated in the…
Full Text Available Abstract Background This study explores the role of pleasure in decision making. Results In Experiment 1, 12 subjects were presented with a questionnaire containing 46 items taken from the literature. Twenty-three items described a situation where a decision should be made and ended with a suggested solution. The other items served as filler items. The subjects were requested not to make a decision but to rate the pleasure or displeasure they experienced when reading the situation described in the item. The subjects' ratings were then compared to the decisions on the same situations made by the other subjects of the studies published by other workers. The ratings of pleasure/displeasure given by our subjects correlated significantly with the choices published by other authors. This result satisfies a necessary condition for pleasure to be the key of the decision making process in theoretical situations. In Experiment 2, a new group of 12 subjects rated their experience of pleasure/displeasure when reading various versions of 50 situations taken from daily life where an ethical decision had to be made (Questionnaire I including 200 items. This was followed by a multiple-choice test with the 50 situations (Questionnaire II using the same 200 items and offering the various behaviors. Subjects tended to choose ethical and unethical responses corresponding to their highest pleasure rating within each problem. In all cases the subjects' behavior was higher than chance level, and thus, followed the trend to maximize pleasure. In Experiment 3, 12 subjects reading 50 mathematical short problems followed by correct and incorrect versions of the answer to the problem (Questionnaire III, including 200 items. This was followed by a multiple-choice mathematical test with the 50 problems (Questionnaire IV using the same 200 items and offering the correct and incorrect answers. In questionnaire IV, subjects tended to choose correct as well as incorrect
Cabanac, Michel; Guillaume, Jacqueline; Balasko, Marta; Fleury, Adriana
This study explores the role of pleasure in decision making. In Experiment 1, 12 subjects were presented with a questionnaire containing 46 items taken from the literature. Twenty-three items described a situation where a decision should be made and ended with a suggested solution. The other items served as filler items. The subjects were requested not to make a decision but to rate the pleasure or displeasure they experienced when reading the situation described in the item. The subjects' ratings were then compared to the decisions on the same situations made by the other subjects of the studies published by other workers. The ratings of pleasure/displeasure given by our subjects correlated significantly with the choices published by other authors. This result satisfies a necessary condition for pleasure to be the key of the decision making process in theoretical situations. In Experiment 2, a new group of 12 subjects rated their experience of pleasure/displeasure when reading various versions of 50 situations taken from daily life where an ethical decision had to be made (Questionnaire I) including 200 items. This was followed by a multiple-choice test with the 50 situations (Questionnaire II) using the same 200 items and offering the various behaviors. Subjects tended to choose ethical and unethical responses corresponding to their highest pleasure rating within each problem. In all cases the subjects' behavior was higher than chance level, and thus, followed the trend to maximize pleasure. In Experiment 3, 12 subjects reading 50 mathematical short problems followed by correct and incorrect versions of the answer to the problem (Questionnaire III), including 200 items. This was followed by a multiple-choice mathematical test with the 50 problems (Questionnaire IV) using the same 200 items and offering the correct and incorrect answers. In questionnaire IV, subjects tended to choose correct as well as incorrect responses corresponding to their highest hedonic
Clinical Informatics Consult Service Positively Affects Some Clinical Decisions in the ICU. A Review of: Mulvaney, Shelagh A., Leonard Bickman, Nunzia B. Giuse, Warren E. Lambert, Nila A. Sathe, and Rebecca N. Jerome." A Randomized Effectiveness Trial of a Clinical Informatics Consult Service: Impact on Evidence-based Decision-making and Knowledge Implementation." Journal of the American Medical Informatics Association 15.2 (2008: 203-11.
Full Text Available Objective – To determine whether the provision of synthesized research evidence provided by the Clinical Informatics Consult Service (CICS affects the clinical decision-making of clinicians working in intensive care units (ICUs.Design – Non-blinded randomized control effectiveness trial.Setting – ICUs in United States-based 658 bed university hospital providing tertiary care for adults and children.Subjects – Clinical staff working within one of four ICUs who submitted a request for clinical information during the study period.Methods – Valid requests submitted by clinical staff from the four clinical ICUs (medical, paediatric, trauma, or neonatal were randomly allocated to receive information from the CICS (CICS provided or no information (no CICS provided. Pre-consult forms, completed at the time of the request, examined reasons for the request and the clinical actions clinicians thought might be influenced by the search results. Requestors could opt out of the no CICS provided group either before or after the randomization of their request. Responses to requests, supplied within 0.5 to 7 days as agreed with the requestor, included a search strategy and bibliographic references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research. Clinicians within both groups were free to conduct their own searches and reviews. An online evaluation form, emailed to recipients, was used to assess the impact of the information supplied. The evaluation form asked clinicians to record the time spent on their own searches, sources of information consulted including colleagues, the immediate and future impact of the information provided (either from the CICS or their own searches, what influence the information had on their clinical actions, whether there were any barriers to using the information, and quality and overall satisfaction with the results provided by the CICS. Data was analyzed according to the
Higgins, Paul [American Meteorological Society, Washington, DC (United States)
Climate Information Needs for Financial Decision Making (Final Report) This Department of Energy workshop award (grant #DE-SC0008480) provided primary support for the American Meteorological Society’s study on climate information needs for financial decision making. The goal of this study was to help advance societal decision making by examining the implications of climate variability and change on near-term financial investments. We explored four key topics: 1) the conditions and criteria that influence returns on investment of major financial decisions, 2) the climate sensitivity of financial decisions, 3) climate information needs of financial decision makers, and 4) potential new mechanisms to promote collaboration between scientists and financial decision makers. Better understanding of these four topics will help scientists provide the most useful information and enable financial decision makers to use scientific information most effectively. As a result, this study will enable leaders in business and government to make well-informed choices that help maximize long-term economic success and social wellbeing in the United States The outcomes of the study include a workshop, which brought together leaders from the scientific and financial decision making communities, a publication of the study report, and a public briefing of the results to the policy community. In addition, we will present the results to the scientific community at the AMS Annual Meeting in February, 2014. The study results were covered well by the media including Bloomberg News and E&E News. Upon request, we also briefed the Office of Science Technology Policy (OSTP) and the Council on Environmental Quality (CEQ) on the outcomes. We presented the results to the policy community through a public briefing in December on Capitol Hill. The full report is publicly available at www.ametsoc.org/cin. Summary of Key Findings The United States invests roughly $1.5 trillion U.S. dollars (USD) in
Olson, P D
This article discusses three methods managers can use to make decisions: intuition, management analysis, and Type 1 and Type 2 error analysis. Olson identifies studies that have shown that top managers work at an unrelenting pace and jump from one activity to another. He claims that managers do not have time to plan in a reflective, systematic manner. In fact, in his view, decision makers usually react intuitively to situations that can no longer be ignored. The author presents evidence that top managers prefer verbal media such as telephone calls and meeting for decision making because of their timeliness. He points out that the strategic data bank of the organization is largely in the mind of the manager. As a consequence, he states, an effective analysis requires that the manager communicate to the analyst the relevant data stored in his head. This process often makes it easier for the manager to solve the problem himself rather than delegate it to others. Olson identifies five organizational conditions that enable a top manager to effectively delegate problem solving tasks to management analysts: (1) the analyst must have the confidence of the same people who influence the manager; (2) the analyst must be able to adapt the techniques to the specific needs of the manager; (3) there must be sufficient time for the analyst to structure the problem and evaluate the alternatives; (4) the analyst must share in information gathered by the manager from verbal contacts; and (5) the manager must be part of an organization large enough to make it profitable for him to seek assistance from an analyst. When the above organizational conditions are not met, the author suggests Type 1 and Type 2 error analysis. He promotes this form of analysis as a method for using logic and intuition to consider various forms of information. This management tool is named for Type 1 error (accepting a proposal that should have been rejected) and Type 2 error (rejecting a proposal that should
Søndergaard, Erik Stefan; Ahmed-Kristensen, Saeema
Global Product Development (GPD), outsourcing and offshoring of product development is a widespread phenomenon on today’s global economy, and consequently most engineering manufacturing companies will have to make decisions regarding how to organise their product development activities globally...... to investigate how decisions are made and which information decisions are based on. The study found that decision making is not always structured, and that prioritised decision making is more dominant than planned decision making. The findings set the stage for further analysis of decision making in GPD......, and for development of support tools decision support tools for manager, which are based on empirical evidence and experience....
Wolfe, A.K.; Vogt, D.P.; Hwang, Ho-Ling [Oak Ridge National Lab., TN (United States)] [and others
Executive Order 12898, signed on February 11, 1994, broadly states that federal activities, programs, and policies should not produce disproportionately high and adverse impacts on minority and low-income populations. Moreover, the Order indicates that these populations should not be denied the benefits of, or excluded from participation in, these activities, programs, and policies. Because a presidential memorandum accompanying the order said that National Environmental Policy Act (NEPA) documents should begin to address environmental justice immediately, much attention has been paid to assessment-related issues. Also important, a topic that appears to have received relatively little attention, is how decision makers should be expected to use information about environmental justice in their decision making. This paper discusses issues surrounding the use of environmental justice information in the decision-making process by focusing on the following five main topics: (1) the importance, or weight, attached to environmental justice within larger decision-making contexts; (2) the potential tension between localized environmental justice issues and regional or national issues and needs; (3) the use of environmental justice information to develop (perhaps in concert with affected minority and low-income communities) appropriate mitigation strategies, or to establish conditions under which activities, programs, and policies may be accepted locally; (4) the general implications of shifting the distribution of broadly defined risks, costs, and benefits among different population groups; and (5) the implications of implementing environmental justice on an individual, ad hoc basis rather than within a larger environmental justice framework. This paper raises the issues and discusses the implications of alternative approaches to them.
Youssef, Farid F; Dookeeram, Karine; Basdeo, Vasant; Francis, Emmanuel; Doman, Mekaeel; Mamed, Danielle; Maloo, Stefan; Degannes, Joel; Dobo, Linda; Ditshotlo, Phatsimo; Legall, George
While early studies of moral decision making highlighted the role of rational, conscious executive processes involving frontal lobe activation more recent work has suggested that emotions and gut reactions have a key part to play in moral reasoning. Given that stress can activate many of the same brain regions that are important for and connected to brain centres involved in emotional processing we sought to evaluate if stress could influence moral decision making. Sixty-five undergraduate volunteers were randomly assigned to control (n=33) and experimental groups (n=32). The latter underwent the Trier Social Stress Test (TSST) and induction of stress was assessed by measurement of salivary cortisol levels. Subjects were then required to provide a response to thirty moral dilemmas via a computer interface that recorded both their decision and reaction time. Three types of dilemmas were used: non-moral, impersonal moral and personal moral. Using a binary logistic model there were no significant predicators of utilitarian response in non-moral and impersonal moral dilemmas. However the stressed group and females were found to predict utilitarian responses to personal moral dilemmas. When comparing percentage utilitarian responses there were no significant differences noted for the non-moral and impersonal moral dilemmas but the stressed group showed significantly less utilitarian responses compared to control subjects. The stress response was significantly negatively correlated with utilitarian responses. Females also showed significantly less utilitarian responses than males. We conclude that activation of the stress response predisposed participants to less utilitarian responses when faced with high conflict personal moral dilemmas and suggest that this offers further support for dual process theory of moral judgment. We also conclude that females tend to make less utilitarian personal moral decisions compared to males, providing further evidence that there are
Christoph W Korn
Full Text Available Living organisms need to maintain energetic homeostasis. For many species, this implies taking actions with delayed consequences. For example, humans may have to decide between foraging for high-calorie but hard-to-get, and low-calorie but easy-to-get food, under threat of starvation. Homeostatic principles prescribe decisions that maximize the probability of sustaining appropriate energy levels across the entire foraging trajectory. Here, predictions from biological principles contrast with predictions from economic decision-making models based on maximizing the utility of the endpoint outcome of a choice. To empirically arbitrate between the predictions of biological and economic models for individual human decision-making, we devised a virtual foraging task in which players chose repeatedly between two foraging environments, lost energy by the passage of time, and gained energy probabilistically according to the statistics of the environment they chose. Reaching zero energy was framed as starvation. We used the mathematics of random walks to derive endpoint outcome distributions of the choices. This also furnished equivalent lotteries, presented in a purely economic, casino-like frame, in which starvation corresponded to winning nothing. Bayesian model comparison showed that--in both the foraging and the casino frames--participants' choices depended jointly on the probability of starvation and the expected endpoint value of the outcome, but could not be explained by economic models based on combinations of statistical moments or on rank-dependent utility. This implies that under precisely defined constraints biological principles are better suited to explain human decision-making than economic models based on endpoint utility maximization.
Barani, Mariela; Kopitowski, Karin; Carrara, Carolina; Yanzi, María Victoria Ruiz
Argentina is a high-middle income country located in Southern South America with an estimated population of 44 million inhabitants. The epidemiological profile of the population is characterised by an increase of non-communicable diseases. The health system is heterogeneous, fragmented and loosely integrated. There are no unified research agenda or government initiatives encouraging the implementation of and research on shared decision making (SDM). Progress has been made lately to respect patient autonomy through the enactment of the 'Patients' Rights Act', which expressly enshrines the right of patients to get information as a key element of decision-making. To our knowledge, the team at the Department of Family and Community Medicine of the Hospital Italiano de Buenos Aires is the only one working on shared decision making in Argentina. This department carries out research, medical undergraduate and graduate training, and clinical practice implementation activities through strategies aimed at professionals and patients alike. We face some challenges regarding SDM, such as: 1) the fragmentation and the heterogeneity of the local health system; 2) we are a small group of people working on this topic who, simultaneously, have care, management, teaching and research responsibilities; 3) we have no government support and project funding is scarce; 4) due to the geographic location of the country, we must make a great effort in order to attend events on the state of the art in SDM. Given the current state of our health system, we believe the government is not likely to encourage, implement or research on SDM in the short term. Our group will continue to work on the local initiative and also to instil it in other interested groups. Copyright © 2017. Published by Elsevier GmbH.
Lipstein, Ellen A; Brinkman, William B; Fiks, Alexander G; Hendrix, Kristin S; Kryworuchko, Jennifer; Miller, Victoria A; Prosser, Lisa A; Ungar, Wendy J; Fox, David
There is growing interest in pediatric decision science, spurred by policies advocating for children's involvement in medical decision making. Challenges specific to pediatric decision research include the dynamic nature of child participation in decisions due to the growth and development of children, the family context of all pediatric decisions, and the measurement of preferences and outcomes that may inform decision making in the pediatric setting. The objectives of this article are to describe each of these challenges, to provide decision researchers with insight into pediatric decision making, and to establish a blueprint for future research that will contribute to high-quality pediatric medical decision making. Much work has been done to address gaps in pediatric decision science, but substantial work remains. Understanding and addressing the challenges that exist in pediatric decision making may foster medical decision-making science across the age spectrum. © The Author(s) 2014.
Community involvement is a cornerstone of the Superfund Program. Forums supporting community based decision-making have been established across the country. The challenge facing the Superfund program is how to effectively support the decision-making processes necessary to accelerate site cleanup and reuse of Superfund sites. This paper examines models of large group decision making; self-organizing processes; principles from the latest management theories; and experiences in the international development community. The convergence of these experiences offer new paradigms to frame the community based decision-making process being implemented across the country. This paper illustrates the value of stakeholder participation in understanding and resolving issues within a whole system framework. Since the 1900s, management theory has moved from ``experts solving problems`` to ``everybody improving whole systems``. When everybody understands the whole, fragmentation is reduced, stakeholders share a common understanding, and decision are made within a common context. Two models of large group decision making will be detailed: ``The Future Search Model`` and the ``Appreciation, Influence and Control Model (AIC) Self Organizing Model``. This paper applies these techniques to existing community involvement activity.
Full Text Available The engineering of large-scale decentralised systems requires sound methodologies to guarantee the attainment of the desired macroscopic system-level behaviour given the microscopic individual-level implementation. While a general-purpose methodology is currently out of reach, specific solutions can be given to broad classes of problems by means of well-conceived design patterns. We propose a design pattern for collective decision making grounded on experimental/theoretical studies of the nest-site selection behaviour observed in honeybee swarms (Apis mellifera. The way in which honeybee swarms arrive at consensus is fairly well-understood at the macroscopic level. We provide formal guidelines for the microscopic implementation of collective decisions to quantitatively match the macroscopic predictions. We discuss implementation strategies based on both homogeneous and heterogeneous multiagent systems, and we provide means to deal with spatial and topological factors that have a bearing on the micro-macro link. Finally, we exploit the design pattern in two case studies that showcase the viability of the approach. Besides engineering, such a design pattern can prove useful for a deeper understanding of decision making in natural systems thanks to the inclusion of individual heterogeneities and spatial factors, which are often disregarded in theoretical modelling.
Jensen, Rodrigo; Guedes, Erika de Souza; Leite, Maria Madalena Januário
To identify informatics abilities essential to decision making in nursing management. Survey study with specialist nurses in health informatics and management. An electronic questionnaire was built based on the competencies Information Literacy (five categories; 40 abilities) and Information Management (nine categories; 69 abilities) of the TIGER - Technology Informatics Guiding Education Reform - initiative, with the guiding question: Which informatics abilities are essential to decision making in management? Answers were sorted in a Likert scale, ranging from 1 to 5. Rasch analysis was conducted with the software WINSTEPS(®). Results were presented in logits, with cutoff value zero. Thirty-two specialists participated, coming from all regions of Brazil. In the information literacy competency, 18 abilities were considered essential and in Information Management, 38; these were sorted according to their degree of essentiality. It is believed that the incorporation of these abilities in teaching can support the education of nurse managers and contribute to evidence-based practice, incorporation of information and communication technologies in health and information management.
The volume delivers a wealth of effective methods to deal with various types of uncertainty inherently existing in human-centric decision problems. It elaborates on comprehensive decision frameworks to handle different decision scenarios, which help use effectively the explicit and tacit knowledge and intuition, model perceptions and preferences in a more human-oriented style. The book presents original approaches and delivers new results on fundamentals and applications related to human-centered decision making approaches to business, economics and social systems. Individual chapters cover multi-criteria (multiattribute) decision making, decision making with prospect theory, decision making with incomplete probabilistic information, granular models of decision making and decision making realized with the use of non-additive measures. New emerging decision theories being presented as along with a wide spectrum of ongoing research make the book valuable to all interested in the field of advanced decision-mak...
Aicken Catherine R H
Full Text Available Abstract Background Decision Analytic Models (DAMs are established means of evidence-synthesis to differentiate between health interventions. They have mainly been used to inform clinical decisions and health technology assessment at the national level, yet could also inform local health service planning. For this, a DAM must take into account the needs of the local population, but also the needs of those planning its services. Drawing on our experiences from stakeholder consultations, where we presented the potential utility of a DAM for planning local health services for sexually transmitted infections (STIs in the UK, and the evidence it could use to inform decisions regarding different combinations of service provision, in terms of their costs, cost-effectiveness, and public health outcomes, we discuss the barriers perceived by stakeholders to the use of DAMs to inform service planning for local populations, including (1 a tension between individual and population perspectives; (2 reductionism; and (3 a lack of transparency regarding models, their assumptions, and the motivations of those generating models. Discussion Technological advances, including improvements in computing capability, are facilitating the development and use of models such as DAMs for health service planning. However, given the current scepticism among many stakeholders, encouraging informed critique and promoting trust in models to aid health service planning is vital, for example by making available and explicit the methods and assumptions underlying each model, associated limitations, and the process of validation. This can be achieved by consultation and training with the intended users, and by allowing access to the workings of the models, and their underlying assumptions (e.g. via the internet, to show how they actually work. Summary Constructive discussion and education will help build a consensus on the purposes of STI services, the need for service planning to
Brixner, Diana; Maniadakis, Nikos; Kaló, Zoltán; Hu, Shanlian; Shen, Jie; Wijaya, Kalman
Off-patent pharmaceuticals (OPPs) represent more than 60% of the pharmaceutical market in many emerging countries, where they are frequently evaluated primarily on cost rather than with health technology assessment. OPPs are assumed to be identical to the originators. Branded and unbranded generic versions can, however, vary from the originator in active pharmaceutical ingredients, dosage, consistency formulation, excipients, manufacturing processes, and distribution, for example. These variables can alter the efficacy and safety of the product, negatively impacting both the anticipated cost savings and the population's health. In addition, many health care systems lack the resources or expertise to evaluate such products, and current assessment methods can be complex and difficult to adapt to a health system's needs. Multicriteria decision analysis (MCDA) simple scoring is an evidence-based health technology assessment methodology for evaluating OPPs, especially in emerging countries in which resources are limited but decision makers still must balance affordability with factors such as drug safety, level interchangeability, manufacturing site and active pharmaceutical ingredient quality, supply track record, and real-life outcomes. MCDA simple scoring can be applied to pharmaceutical pricing, reimbursement, formulary listing, and drug procurement. In November 2015, a workshop was held at the International Society for Pharmacoeconomics and Outcomes Research Annual Meeting in Milan to refine and prioritize criteria that can be used in MCDA simple scoring for OPPs, resulting in an example MCDA process and 22 prioritized criteria that health care systems in emerging countries can easily adapt to their own decision-making processes. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Grffith, Richard; Tengnah, Cassam
Shared decision-making lies at the heart of the Government's reforms of the NHS in England. The slogan, 'No decision about me without me', underpins shared decision-making that sees patients as active participants in their treatment decisions. In this article, Richard Griffith and Cassam Tengnah argue that for 'no decision about me, without me' to be a reality, district nurses must guard against paternalistic decision-making that excludes the views and wishes of their patients.
Roger L Sur
Full Text Available This essay reviews the historical circumstances surrounding the introduction and evolution of evidence-based medicine. Criticisms of the approach are also considered. Weaknesses of existing standards of clinical practice and efforts to bring more certainty to clinical decision making were the foundation for evidence-based medicine, which integrates epidemiology and medical research. Because of its utility in designing randomized clinical trials, assessing the quality of the literature, and applying medical research at the bedside, evidence-based medicine will continue to have a strong influence on everyday clinical practice.
Liu, Gordon G; Fukuda, Takashi; Lee, Chien Earn; Chen, Vivian; Zheng, Qiang; Kamae, Isao
To review the use of evidence in the market approval process, reimbursement, and price control mechanisms for medicines and medical devices in China, Japan, and Singapore. Documentary reviews relevant to public health policy and management by government authorities. Drug regulatory authorities play a vital role in the market authorization process of medical technologies. The approval criteria in the three countries are similar to those of the US Food and Drug Administration and many other countries, whose core measures are efficacy, safety, and quality, along with risk-based analyses in China and Singapore. All established the national drug list (Japan) or lists (China and Singapore) for reimbursement. Although Japan reimburses any drugs listed, China and Singapore selectively reimburse regarding the types of the list. The cost-effectiveness is utilized for prioritization of new drugs listed in Singapore. Japan controls the price by government, whereas Singapore keeps market liberalism, and China maintains a mixture of both. All three countries have established their own mechanisms, but cost-effectiveness requirements have not been fully introduced yet, partially applied to the reimbursement processes in Singapore.
Ryder, Andrew J.; Kimball, Ezekiel W.
Assessment to improve student learning and program effectiveness is an essential skill for student affairs practitioners. Empirical findings from a content analysis of the Professional Competency Areas for Student Affairs Practitioners (ACPA & NASPA, 2010) shed important light on reflexivity as a foundational aspect of assessment. Based on…
Tervonen, Tommi; van Valkenhoef, Gert; Buskens, Erik; Hillege, Hans L.; Postmus, Douwe
Drug benefit-risk (BR) analysis is based on firm clinical evidence regarding various safety and efficacy outcomes. In this paper, we propose a new and more formal approach for constructing a supporting multicriteria model that fully takes into account the evidence on efficacy and adverse drug
Jørgensen, Marianne Winther
Nikolas Rose's work on contemporary biopower centres the "biocitizen" as a subject governed through freedom and made individually responsible in matters of health. This article argues that a focus on its conditions of possibility will enable a better contextualisation of the biocitizen as merely one subject position among others. Using a…
Kimman, Tjeerd G; Boot, Hein J; Berbers, Guy A M; Vermeer-de Bondt, Patricia E; Wit, G Ardine de; Melker, Hester E de
Among all public health provisions national immunization programs (NIPs) are beyond doubt one of the most effective in reducing mortality, morbidity, and costs associated with major infectious diseases. To maintain their success, NIPs have to modernize in response to many new and old demands
Decision-making refers to assessing costs and benefits of competing actions, with either a known outcome or an uncertain result. Decision-making depends on several abilities, such as behavioural flexibility and inhibiting risky responses. Several factors affect decision-making, causing differences in the outcome of decision-making processes. The overall aim was to improve our understanding of effects of stress and gender on decision-making, in rodents and in humans. First, impulsive decision-...
Outputs of management process related to decision making and the implementation of decisions of the business. Business decision-making, in the widest sense of the time aspect, it can be seen from the operational and strategic character. In this paper, the focus is on analyzing leverage and rate of return the operational decision-making in the hotel as a function of current financing activities. Operational decision-making, must be aligned with strategic, so that all segments of the operationa...
Cells can cope with unpredictable environmental conditions by differentiating into appropriate states. In this talk, I will present our recent attempts to understand the role of genetic circuits in regulating the underlying process of cellular decision-making. Specifically, we are interested in how interactions within and across genetic circuits enable cells to choose among alternative fates. To address this question my laboratory is employing systems and synthetic biology approaches. Our ultimate goal is to uncover possible evolutionary pressures that may have selected for specific gene circuit architectures, dynamics and noise properties.
Andersen, Torben Juul; Bresser, Rudi K. F.; Hallin, Carina Antonia
Effective strategy-making in turbulent industries needs current insights that can inform ongoing decisions around adaptive strategic moves. Frontline employees involved in the daily business transactions are the first to see the subtle changes not otherwise observed by top managers. Top management...... with dominant logics anchored in previous business contexts usually receive updated information from performance reports for prior periods. All the while, we discern a human inclination linked to the position of power where managers subconsciously discard updated information from frontline employees. We present...
Hess, Søren; Bjerring, Ole Steen; Pfeiffer, Per
and initial stages. This article outlines the potential use of fluorodeoxyglucose-PET/CT in clinical decision making with special regard to preoperative evaluation and response assessment in gastric cancer (including the gastroesophageal junction), pancreatic cancer (excluding neuroendocrine tumors......Gastrointestinal malignancies comprise a heterogeneous group of diseases that include both common and rare diseases with very different presentations and prognoses. The mainstay of treatment is surgery in combination with preoperative and adjuvant chemotherapy depending on clinical presentation......), colorectal cancer, and gastrointestinal stromal tumors....
The computer revolution has had an enormous effect on all aspects of the practice of medicine, yet little thought has been given to the role of social media in identifying treatment choices for incompetent patients. We are currently living in the "Internet age" and many people have integrated social media into all aspects of their lives. As use becomes more prevalent, and as users age, social media are more likely to be viewed as a source of information regarding medical care preferences. This article explores the ethical and legal issues raised by the use of social media in surrogate decision making.
Full Text Available Belinda George, Vageesh Ayyar Department of Endocrinology, St. John’s Medical College Hospital, Bangalore, Karnataka, India Abstract: Growth hormone has now been available in medical practice for close to 50 years. Its use has provided dramatic results in patients with growth hormone deficiency and it is associated with an overall favorable safety profile. Over the years, the utility of growth hormone has expanded to include treatment for short stature associated with conditions other than growth hormone deficiency, and this situation warrants greater involvement of the child and parents in the shared decision-making process. Shared decision making is in good conformance to the principle of informed consent, and it also improves the compliance and adherence to therapy as the patient fully understands the benefit and safety of the treatment. In the pediatric-care setting, the decision-making interactions usually occur between the health care provider, patient, and parents. The process may range from an autonomous decision-making pattern, where the patient or parents are fully responsible for the decision taken, to the paternalistic decision-making pattern, where the health care provider assumes full responsibility for the decision taken. However, the ideal situation is one where a truly shared decision-making process happens, in which the doctor and patient/parents work together to choose an evidence-based option, in line with the patient’s preferences and wishes. The limited data available on shared decision making with regard to growth hormone replacement, however, is not very encouraging and suggests that the actual involvement of the parents as perceived by them is less than optimal. Introduction of a simple structured model for a shared decision-making process that can be easily incorporated into clinical practice and familiarization of health care providers with the same is essential to improve our shared decision-making practices
Moberg, Paul J; Rick, Jacqueline H
With our ageing population, the number of older adults with cognitive impairment has also increased. There is both an acute and growing need for evidence-based assessments to identify their decision making capacity and competence. In the present article we (1) present definitions of decision-making capacity and competence, (2) review cognitive functions that are central to decision-making capacity as well as the methods and procedures commonly used to assess these domains, and (3) address the communication of assessment findings to patients and their loved ones. The importance of assessing decision-making capacity in the context of specific functions and of respecting the values and interests of older adults are emphasized.
Full Text Available Abstract Background Applying evidence is one of the most challenging steps of evidence-based clinical practice. Healthcare professionals have difficulty interpreting evidence and translating it to patients. Decision boxes are summaries of the most important benefits and harms of diagnostic, therapeutic, and preventive health interventions provided to healthcare professionals before they meet the patient. Our hypothesis is that Decision boxes will prepare clinicians to help patients make informed value-based decisions. By acting as primers, the boxes will enhance the application of evidence-based practices and increase shared decision making during the clinical encounter. The objectives of this study are to provide a framework for developing Decision boxes and testing their value to users. Methods/Design We will begin by developing Decision box prototypes for 10 clinical conditions or topics based on a review of the research on risk communication. We will present two prototypes to purposeful samples of 16 family physicians distributed in two focus groups, and 32 patients distributed in four focus groups. We will use the User Experience Model framework to explore users' perceptions of the content and format of each prototype. All discussions will be transcribed, and two researchers will independently perform a hybrid deductive/inductive thematic qualitative analysis of the data. The coding scheme will be developed a priori from the User Experience Model's seven themes (valuable, usable, credible, useful, desirable, accessible and findable, and will include new themes suggested by the data (inductive analysis. Key findings will be triangulated using additional publications on the design of tools to improve risk communication. All 10 Decision boxes will be modified in light of our findings. Discussion This study will produce a robust framework for developing and testing Decision boxes that will serve healthcare professionals and patients alike. It
Lee, Bruce Y; Mueller, Leslie E; Tilchin, Carla G
Vaccines reside in a complex multiscale system that includes biological, clinical, behavioral, social, operational, environmental, and economical relationships. Not accounting for these systems when making decisions about vaccines can result in changes that have little effect rather than solutions, lead to unsustainable solutions, miss indirect (e.g., secondary, tertiary, and beyond) effects, cause unintended consequences, and lead to wasted time, effort, and resources. Mathematical and computational modeling can help better understand and address complex systems by representing all or most of the components, relationships, and processes. Such models can serve as "virtual laboratories" to examine how a system operates and test the effects of different changes within the system. Here are ten lessons learned from using computational models to bring more of a systems approach to vaccine decision making: (i) traditional single measure approaches may overlook opportunities; (ii) there is complex interplay among many vaccine, population, and disease characteristics; (iii) accounting for perspective can identify synergies; (iv) the distribution system should not be overlooked; (v) target population choice can have secondary and tertiary effects; (vi) potentially overlooked characteristics can be important; (vii) characteristics of one vaccine can affect other vaccines; (viii) the broader impact of vaccines is complex; (ix) vaccine administration extends beyond the provider level; and (x) the value of vaccines is dynamic. Copyright © 2016 Elsevier Ltd. All rights reserved.
Bestaoui Sebbane, Yasmina
This book provides an introduction to the emerging field of planning and decision making for aerial robots. An aerial robot is the ultimate form of Unmanned Aerial Vehicle, an aircraft endowed with built-in intelligence, requiring no direct human control and able to perform a specific task. It must be able to fly within a partially structured environment, to react and adapt to changing environmental conditions and to accommodate for the uncertainty that exists in the physical world. An aerial robot can be termed as a physical agent that exists and flies in the real 3D world, can sense its environment and act on it to achieve specific goals. So throughout this book, an aerial robot will also be termed as an agent. Fundamental problems in aerial robotics include the tasks of spatial motion, spatial sensing and spatial reasoning. Reasoning in complex environments represents a difficult problem. The issues specific to spatial reasoning are planning and decision making. Planning deals with the trajectory algori...
Cassey, Peter; Heathcote, Andrew; Brown, Scott D
Speed-accuracy tradeoff (SAT) is an adaptive process balancing urgency and caution when making decisions. Computational cognitive theories, known as "evidence accumulation models", have explained SATs via a manipulation of the amount of evidence necessary to trigger response selection. New light has been shed on these processes by single-cell recordings from monkeys who were adjusting their SAT settings. Those data have been interpreted as inconsistent with existing evidence accumulation theories, prompting the addition of new mechanisms to the models. We show that this interpretation was wrong, by demonstrating that the neural spiking data, and the behavioural data are consistent with existing evidence accumulation theories, without positing additional mechanisms. Our approach succeeds by using the neural data to provide constraints on the cognitive model. Open questions remain about the locus of the link between certain elements of the cognitive models and the neurophysiology, and about the relationship between activity in cortical neurons identified with decision-making vs. activity in downstream areas more closely linked with motor effectors.
Full Text Available Speed-accuracy tradeoff (SAT is an adaptive process balancing urgency and caution when making decisions. Computational cognitive theories, known as "evidence accumulation models", have explained SATs via a manipulation of the amount of evidence necessary to trigger response selection. New light has been shed on these processes by single-cell recordings from monkeys who were adjusting their SAT settings. Those data have been interpreted as inconsistent with existing evidence accumulation theories, prompting the addition of new mechanisms to the models. We show that this interpretation was wrong, by demonstrating that the neural spiking data, and the behavioural data are consistent with existing evidence accumulation theories, without positing additional mechanisms. Our approach succeeds by using the neural data to provide constraints on the cognitive model. Open questions remain about the locus of the link between certain elements of the cognitive models and the neurophysiology, and about the relationship between activity in cortical neurons identified with decision-making vs. activity in downstream areas more closely linked with motor effectors.
For many years, economic development has mean industrial recruitment where business-at-any-cost was preached by a small elite, where civic discord replaced civic discussion, where families made more money but had less to spend, where residents learned to lock their doors, where communities changed from the unique to commonplace and a thousand towns looked alike. But now, scores of communities are saying no to old, worn-out approaches to development and embracing a new kind of development that respects the community and the environment. Created collaboratively by people from all walks of community life, this new approach is called sustainable community economic development. Though new, sustainable development is based on traditional values of stewardship and working together. Its principles are powerful in their simplicity. Its lessons enrich community decision making. This paper describes these principles and lessons. It introduces a community decision-making process that applies them and suggests the kinds of results you can expect from such a process in your town.
Liebherz, Sarah; Härter, Martin; Dirmaier, Jörg; Tlach, Lisa
People with anxiety disorders are faced with treatment decisions considerably affecting their life. Patient decision aids are aimed at enabling patients to deliberate treatment options based on individual values and to participate in medical decisions. This is the first study to determine patients' information and decision-making needs as a pre-requisite for the development of patient decision aids for anxiety disorders. An online cross-sectional survey was conducted between January and April 2013 on the e-health portal http://www.psychenet.de by using a self-administered questionnaire with items on internet use, online health information needs, role in decision making and important treatment decisions. Descriptive and inferential statistical as well as qualitative data analyses were performed. A total of 60 people with anxiety disorders with a mean age of 33.3 years (SD 10.5) participated in the survey. The most prevalent reasons for online health information search were the need for general information on anxiety disorders, the search for a physician or psychiatrist and the insufficiency of information given by the healthcare provider. Respondents experienced less shared and more autonomous decisions than they preferred. They assessed decisions on psychotherapy, medication, and treatment setting (inpatient or outpatient) as the most difficult decisions. Our results confirm the importance of offering patient decision aids for people with anxiety disorders that encourage patients to participate in decision making by providing information about the pros and cons of evidence-based treatment options.
Reasons, methods used and decision-making for pregnancy termination among ... was influenced by socio-economic, educational and personal considerations. ... Conclusion: Relationship issues influence the decision-making process for ...
Evers, Colin W.
Explores implications for understanding educational decision making from a cognitive science perspective. Examines three models of mind providing the methodological framework for decision-making studies. The "absent mind" embodies the behaviorist research tradition. The "functionalist mind" underwrites traditional cognitivism…
There is a tendency for physicians to approach ethical problems in a manner similar to that in which they approach medical problems. Instead of disease categories (such as congestive heart failure or diarrhea), the physician substitutes moral quandaries (such as euthanasia or abortion). The goal is to learn what the "right" rules are for this particular problem at this particular moment. Although this method has important practical and instructive value, it can produce an empirical attitude toward ethics akin to that found in students who strive to learn medicine solely by algorithms. Using theoretical models as a center for discussion, this article has attempted to approach medical ethics as a decision-making process derived from the physician-patient relationship model in use. What is the type of physician-patient relationship that forms the soundest base for making ethical decisions? It must be realized that the contractual relationship cannot be ignored, for in our consumer-oriented society it will surely remain as a protection for the patient against the incompetent or immoral physician. It should not become the sole guide of physician behavior, however, lest we be satisfied with mediocre behavior as the maximal standard. Likewise, although technical competence is required for one to make the right and good decision, it is insufficient alone as a guide for moral behavior. Given the medically correct facts, a multitude of responses are available which necessitate a moral choice. Physicians need a guiding principle that goes beyond any aesthetic code of behavior, or protection of self-interest, and which enables them to deal with all the unexpected ethical questions faced in providing care to patients. Moral principles such as truth-telling, promise-keeping, and protecting the patient when he is vulnerable, help the physician to act in a moral manner, but lack the encompassing nature of the covenantal promise. The covenantal model includes a donative element
Vedsegaard, Helle; Schrader, Anne-Marie; Rom, Gitte
The current study responds to implementation challenges with translating evidence-based knowledge into practice. We explore how appreciative inquiry can be used in in-house learning sessions for nurses to enhance their knowledge in using a guideline on delirium as part of clinical decision making...... and axial coding drawing on the principles of grounded theory. The study shows that appreciative inquiry was meaningful to cardiology nurses in providing them with knowledge of using a guideline on delirium in clinical decision making, the main reasons being a) data on a current patient were included, b...
Van Santen, W.; Jonker, C.M.; Wijngaards, N.
Decision making during crises takes place in (multi-agency) teams, in a bureaucratic political context. As a result, the common notion that during crises decision making should be done in line with a Command & Control structure is invalid. This paper shows that the best way for crisis decision making teams in a bureaucratic political context is to follow an integrative negotiation approach as the shared mental model of decision making. This conclusion is based on an analysis of crisis decisio...
Nibbelink, Christine W; Brewer, Barbara B
Identify and summarize factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in Naturalistic Decision Making. Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue leading to poor patient outcomes. Naturalistic Decision Making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. Pubmed and CINAHL databases were searched and research meeting criteria was included. Data were identified from all included articles and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organization and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes. informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that Naturalistic Decision Making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using NDM as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. This article is protected by
Victoria eLee; Lasana eHarris
Social decision-making is often complex, requiring the decision-maker to make inferences of others' mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision-making involving social and non-social stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may inf...
The integration of research and practice is of concern in all helping professions. Has social work become an evidence-based profession as some claim? Characteristics of current-day social work are presented that dispute this view, related continuing concerns are suggested, and promising developments (mostly outside social work) are described that…
Daemers, Darie O A; van Limbeek, Evelien B M; Wijnen, Hennie A A; Nieuwenhuijze, Marianne J; de Vries, Raymond G
Although midwives make clinical decisions that have an impact on the health and well-being of mothers and babies, little is known about how they make those decisions. Wide variation in intrapartum decisions to refer women to obstetrician-led care suggests that midwives' decisions are based on more than the evidence based medicine (EBM) model - i.e. clinical evidence, midwife's expertise, and woman's values - alone. With this study we aimed to explore the factors that influence clinical decision-making of midwives who work independently. We used a qualitative approach, conducting in-depth interviews with a purposive sample of 11 Dutch primary care midwives. Data collection took place between May and September 2015. The interviews were semi-structured, using written vignettes to solicit midwives' clinical decision-making processes (Think Aloud method). We performed thematic analysis on the transcripts. We identified five themes that influenced clinical decision-making: the pregnant woman as a whole person, sources of knowledge, the midwife as a whole person, the collaboration between maternity care professionals, and the organisation of care. Regarding the midwife, her decisions were shaped not only by her experience, intuition, and personal circumstances, but also by her attitudes about physiology, woman-centredness, shared decision-making, and collaboration with other professionals. The nature of the local collaboration between maternity care professionals and locally-developed protocols dominated midwives' clinical decision-making. When midwives and obstetricians had different philosophies of care and different practice styles, their collaborative efforts were challenged. Midwives' clinical decision-making is a more varied and complex process than the EBM framework suggests. If midwives are to succeed in their role as promoters and protectors of physiological pregnancy and birth, they need to understand how clinical decisions in a multidisciplinary context are
Eshel eBen Jacob
Full Text Available The choice that bacteria make between sporulation and competence when subjected to stress provides a prototypical example of collective cell fate determination that is stochastic on the individual cell level, yet predictable (deterministic on the population level. This collective decision is performed by an elaborated gene network. Considerable effort has been devoted to simplify its complexity by taking physics approaches to untangle the basic functional modules that are integrated to form the complete network: 1. A stochastic switch whose transition probability is controlled by two order parameters – population density and internal/external stress. 2. An adaptable timer whose clock rate is normalized by the same two previous order parameters. 3. Sensing units which measure population density and external stress. 4. A communication module that exchanges information about the cells’ internal stress levels. 5. An oscillating gate of the stochastic switch which is regulated by the timer. The unique circuit architecture of the gate allows special dynamics and noise management features. The gate opens a window of opportunity in time for competence transitions, during which the circuit generates oscillations that are translated into a chain of short intervals with high transition probability. In addition, the unique architecture of the gate allows filtering of external noise and robustness against variations in circuit parameters and internal noise. We illustrate that a physics approach can be very valuable in investigating the decision process and in identifying its general principles. We also show that both cell-cell variability and noise have important functional roles in the collectively controlled individual decisions.
Ben-Jacob, Eshel; Lu, Mingyang; Schultz, Daniel; Onuchic, Jose' N
The choice that bacteria make between sporulation and competence when subjected to stress provides a prototypical example of collective cell fate determination that is stochastic on the individual cell level, yet predictable (deterministic) on the population level. This collective decision is performed by an elaborated gene network. Considerable effort has been devoted to simplify its complexity by taking physics approaches to untangle the basic functional modules that are integrated to form the complete network: (1) A stochastic switch whose transition probability is controlled by two order parameters-population density and internal/external stress. (2) An adaptable timer whose clock rate is normalized by the same two previous order parameters. (3) Sensing units which measure population density and external stress. (4) A communication module that exchanges information about the cells' internal stress levels. (5) An oscillating gate of the stochastic switch which is regulated by the timer. The unique circuit architecture of the gate allows special dynamics and noise management features. The gate opens a window of opportunity in time for competence transitions, during which the circuit generates oscillations that are translated into a chain of short intervals with high transition probability. In addition, the unique architecture of the gate allows filtering of external noise and robustness against variations in circuit parameters and internal noise. We illustrate that a physics approach can be very valuable in investigating the decision process and in identifying its general principles. We also show that both cell-cell variability and noise have important functional roles in the collectively controlled individual decisions.
behavior, such as the SRK concept, naturalistic decision making, and dynamic decision making.In this evolution, concepts such as decision making, management, and behavioral control merge and a concurrent change in concepts underlying design of systems aiming at control of behavior is visible, from...
Kampmann, Jennifer A.
Within the scope of leadership and management, decision making greatly defines the role of university administrator, in particular, the university department head and his/her ability to be a reflective practitioner in the realm of decision making. Decision making is one characteristic of university department head work which warrants close…
Crum, Karen S.
The goal of this study was to analyze the characteristics in the school board decision-making process and to discover whether school board members are aware of the characteristics surrounding the school board's decision-making process. Specifically, this study examines the decision-making process of a school board in Virginia, and it provides…
Kaplan, Raphael; Schuck, Nicolas W; Doeller, Christian F
A growing body of work is investigating the use of mental maps during decision-making. Here we discuss how decision-making organizes experiences according to an internal model of the current task, thereby structuring memory. Likewise, we consider how the structure of mental maps contributes to decision-making. Copyright © 2017 Elsevier Ltd. All rights reserved.
This paper is a brief description of a conference presentation consisting of a 2.5-hour clinic session on decision-making. A motion picture, "The Making of a Decision," followed by a lively discussion, was used to illustrate the strenghts and weaknesses of administrators in their decision-making process. Presented in the film are three…
James, Constance R.; Smith, J. Goosby
This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…
Smith, Mitchell R.; Zeuwts, Linus; Lenoir, Matthieu; Hens, Nathalie; De Jong, Laura M. S.; Coutts, Aaron J.
This study aimed to investigate the impact of mental fatigue on soccer-specific decision-making. Twelve well-trained male soccer players performed a soccer-specific decision-making task on two occasions, separated by at least 72 h. The decision-making task was preceded in a randomised order by 30
Suchman, J. Richard; DiSario, Martha R.
An instructional system is presented for building the competencies of adult basic education students in making consumer decisions, and offers a guide to teachers who wish to design their own decision-making problems for students. The first four chapters provide a brief introduction, discuss the rational consumer decision-making process and the…
E. Swanepoel; J. Surujlal
Implementing participative decision making practices has become increasingly popular amongst organisations. Numerous benefits, including increased morale and job satisfaction, have been associated with the effective implementation of participative decision making. This qualitative study was designed to investigate sport coaches’ views on participative decision making at their respective organisations. Scheduled interviews of between 30 – 40 minutes were conducted and recorded with a sample of...
King, Rhonda; King, John
Reports on a study that focused on Australian students' cognitive and social skills in group decision-making activities conducted in the classroom. Finds that students were motivated to participate in group decision-making and that students' decision-making strategies are destructive when students assert their own ideas at the expense of others.…
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making process. 9.6... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process... protection decision-making process to be followed by the Agency in applying the Orders to its actions. While...
O'Connor, Donna; Larkin, Paul; Williams, A. Mark
Background: Decision-making is a key component of performance in sport. However, there has been minimal investigation of how coaches may adapt practice sessions to specifically develop decision-making. Purpose: The aim in this exploratory study was to investigate the pedagogical approaches coaches use to develop decision-making in soccer. Method:…
Pier Luigi Baldi
Full Text Available A brief survey of key literature on emotions and decision-making introduces an empirical study of a group of university students exploring the effects of decision-making complexity on error risk. The results clearly show that decision-making under stress in the experimental group produces significantly more errors than in the stress-free control group.
Decker, Emilia; Linke, Simon; Hermoso, Virgilio; Geist, Juergen
Systematic conservation planning has become a standard approach globally, but prioritization of conservation efforts hardly considers species traits in decision making. This can be important for species persistence and thus adequacy of the conservation plan. Here, we developed and validated a novel approach of incorporating trophic information into a systematic conservation planning framework. We demonstrate the benefits of this approach using fish data from Europe's second largest river, the Danube. Our results show that adding trophic information leads to a different spatial configuration of priority areas at no additional cost. This can enhance identification of priority refugia for species in the lower position of the trophic web while simultaneously identifying areas that represent a more diverse species pool. Our methodological approach to incorporating species traits into systematic conservation planning is generally applicable, irrespective of realm, geographical area, and species composition and can potentially lead to more adequate conservation plans.
Simmonds, Anne H
Nurses are confronted daily with making ethical decisions in practice, in which the "right" or best course of action must be determined. However, for intrapartum nurses, the seemingly ordinary nature of ethical issues means that these concerns may be viewed merely as clinical or logistical problems to be solved, leaving the ethical dimensions obscured. This has consequences not only for women and the provision of safe, family-centered maternity care but also for the quality of nurses' work environments and degree of moral distress experienced. This article explores ethical aspects of intrapartum nursing by applying ethical principles and moral reasoning to an "everyday" situation encountered by intrapartum nurses in practice. Implications for practice and the development of healthy moral communities are considered.
Warren, Jamie B; Wiggins, Nikki
Since the Institute of Medicine published Crossing the Quality Chasm in 2001, healthcare systems have become more focused on improving the quality of healthcare delivery. At Oregon Health & Science University and Doernbecher Children's Hospital, we recognize the need to take an interprofessional, team-based approach to improving the care we provide to our current and future patients. We describe here an ongoing quality improvement project in the Doernbecher Neonatal Intensive Care Unit (NICU), with specific attention to the factors we believe have contributed to the implementation and early success of the project. These factors include the history of quality improvement work in our NICU and in the field of neonatology, the "dyad leadership" structure under which we operate in our NICU, and our developing understanding of the concept of "team intelligence." These elements have led to the formation of a team that can practice shared decision making and work as one to realize a shared goal.
Zafeiris, Anna; Koman, Zsombor; Mones, Enys; Vicsek, Tamás
An essential task of groups is to provide efficient solutions for the complex problems they face. Indeed, considerable efforts have been devoted to the question of collective decision-making related to problems involving a single dominant feature. Here we introduce a quantitative formalism for finding the optimal distribution of the group members' competences in the more typical case when the underlying problem is complex, i.e., multidimensional. Thus, we consider teams that are aiming at obtaining the best possible answer to a problem having a number of independent sub-problems. Our approach is based on a generic scheme for the process of evaluating the proposed solutions (i.e., negotiation). We demonstrate that the best performing groups have at least one specialist for each sub-problem - but a far less intuitive result is that finding the optimal solution by the interacting group members requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present empirical results obtained by using a large-scale database of citations being in good agreement with the above theory. The framework we have developed can easily be adapted to a variety of realistic situations since taking into account the weights of the sub-problems, the opinions or the relations of the group is straightforward. Consequently, our method can be used in several contexts, especially when the optimal composition of a group of decision-makers is designed.
Kelly, Rosemary R.; Hatcher, Tim
This study explored differences between career decision-making self-efficacy (CDMSE) and career barriers of students enrolled in applied technology programs compared to those enrolled in college transfer. Participants in the ex post facto cross-sectional survey included 787 students at a community college. The following research questions were…
Vijayalakshmi, R.; Anitha, V.; Ramakrishnan, T.; Sudhakar, Uma
Dentists need to make clinical decisions based on limited scientific evidence. In clinical practice, a clinician must weigh a myriad of evidences every day. The goal of evidence-based dentistry is to help practitioners provide their patients with optimal care. This is achieved by integrating sound research evidence with personal clinical expertise and patient values to determine the best course of treatment. Periodontology has a rich background of research and scholarship. Therefore, efficient use of this wealth of research data needs to be a part of periodontal practice. Evidence-based periodontology aims to facilitate such an approach and it offers a bridge from science to clinical practice. The clinician must integrate the evidence with patient preference, scientific knowledge, and personal experience. Most important, it allows us to care for our patients. Therefore, evidence-based periodontology is a tool to support decision-making and integrating the best evidence available with clinical practice. PMID:20142947
Adibi, Shawn; Abidi, Shawn; Bebermeyer, Richard D
Lack of transparency in funded research can compromise clinical decision-making in an evidence-based practice. Transparency can be defined as full disclosure of all financial assistance and support to authors and investigators. There is a perception that ethical principles are eroding and that research data can be biased due to conflicts of interest. These research outcomes biased or not, are used for clinical decision-making in the evidence-based practice. One suggested solution to this common ethical dilemma is to continue the dialogue on transparency in research and to create oversight bodies which include representatives from business and industry, private practice, academia, and research. There is increasing evidence of the need for more ethics education at all levels.
Hansen, Claus Thorp; Andreasen, Mogens Myrup
. The model is based on four observations: the engineering designers do not see a neat string of distinct and explicitly made decisions, there are several decision-makers during design, a design decision is not made at a distinct moment in time, and the decision object is evolving in time and changing...
This paper is an extension of the author's earlier work on developing management information services and creating a culture of assessment in libraries. The author will focus observations on the use of data in decision-making in libraries, specifically on the role of leadership in making evidence-based decision a reality, and will review new…
Colakkadioglu, Oguzhan; Celik, D. Billur
Problem Statement: Decision making is a critical cognitive process in every area of human life. In this process, the individuals play an active role and obtain outputs with their functional use of decision-making skills. Therefore, the decision-making process can affect the course of life, life satisfaction, and the social relations of an…
Dobrajska, Magdalena; Billinger, Stephan; Becker, Markus C.
takes place in response to changes in decision characteristics, including decision complexity, decision importance, CEO proximity, and the degree to which a decision is routine. We show various manifestations of the substitution mechanism and discuss implications for strategic decision-making.......Strategic decisions are often made by multiple organizational members who form decision-making structures specialized for a given strategic decision. We study a series of strategic decisions in a business unit of a global Fortune 500 firm, identifying for each decision the hierarchical...... and departmental positions of all participating organizational members. We find that firms substitute between different structural components in decision-making structures to combine hierarchical authority with cross-departmental coordination and redundant knowledge. This substitution between structural components...
Fischer, T; Brothers, K B; Erdmann, P; Langanke, M
Systems medicine is the name for an assemblage of scientific strategies and practices that include bioinformatics approaches to human biology (especially systems biology); "big data" statistical analysis; and medical informatics tools. Whereas personalized and precision medicine involve similar analytical methods applied to genomic and medical record data, systems medicine draws on these as well as other sources of data. Given this distinction, the clinical translation of systems medicine poses a number of important ethical and epistemological challenges for researchers working to generate systems medicine knowledge and clinicians working to apply it. This article focuses on three key challenges: First, we will discuss the conflicts in decision-making that can arise when healthcare providers committed to principles of experimental medicine or evidence-based medicine encounter individualized recommendations derived from computer algorithms. We will explore in particular whether controlled experiments, such as comparative effectiveness trials, should mediate the translation of systems medicine, or if instead individualized findings generated through "big data" approaches can be applied directly in clinical decision-making. Second, we will examine the case of the Riyadh Intensive Care Program Mortality Prediction Algorithm, pejoratively referred to as the "death computer," to demonstrate the ethical challenges that can arise when big-data-driven scoring systems are applied in clinical contexts. We argue that the uncritical use of predictive clinical algorithms, including those envisioned for systems medicine, challenge basic understandings of the doctor-patient relationship. Third, we will build on the recent discourse on secondary findings in genomics and imaging to draw attention to the important implications of secondary findings derived from the joint analysis of data from diverse sources, including data recorded by patients in an attempt to realize their
Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael
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...
Williams, Byron K.; Johnson, Fred A.
Adaptive management involves learning-oriented decision making in the presence of uncertainty about the responses of a resource system to management. It is implemented through an iterative sequence of decision making, monitoring and assessment of system responses, and incorporating what is learned into future decision making. Decision making at each point is informed by a value or objective function, for example total harvest anticipated over some time frame. The value function expresses the value associated with decisions, and it is influenced by system status as updated through monitoring. Often, decision making follows shortly after a monitoring event. However, it is certainly possible for the cadence of decision making to differ from that of monitoring. In this paper we consider different combinations of annual and biennial decision making, along with annual and biennial monitoring. With biennial decision making decisions are changed only every other year; with biennial monitoring field data are collected only every other year. Different cadences of decision making combine with annual and biennial monitoring to define 4 scenarios. Under each scenario we describe optimal valuations for active and passive adaptive decision making. We highlight patterns in valuation among scenarios, depending on the occurrence of monitoring and decision making events. Differences between years are tied to the fact that every other year a new decision can be made no matter what the scenario, and state information is available to inform that decision. In the subsequent year, however, in 3 of the 4 scenarios either a decision is repeated or monitoring does not occur (or both). There are substantive differences in optimal values among the scenarios, as well as the optimal policies producing those values. Especially noteworthy is the influence of monitoring cadence on valuation in some years. We highlight patterns in policy and valuation among the scenarios, and discuss management
The sheer volume and dynamics among system agents in healthcare makes decision-making a daunting task at all levels. Being clear about what leaders mean by "healthcare system" is critical in aligning system strategy and leadership decision-making. This article presents an emerging set of lenses (ideology and beliefs, rational and irrational information processing, interpersonal social dynamics, process and value creation, and context) to help frame leadership decision-making in healthcare systems. © 2015 The Canadian College of Health Leaders.
Kang, Sunghyun; Seo, Jiwan; Choi, Seungjin; Kim, Junho; Han, Sangyong
As the Internet technology and social media advance, various information and opinions are shared and distributed through the online communities. However, the existence of implicit and explicit bias of opinions may have a potential influence on the outcomes. Compared to the importance of mitigating biased information, the study in this field is relatively young and does not address many important issues. In this paper we propose the noble approach to mitigate the biased opinions using conventional machine learning methods. The proposed method extracts the useful features such as inclination and sentiment of the community members. They are classified based on their previous behavior, and the propensity of the members is understood. This information on each community and its members is very useful and improve the ability to make an unbiased decision. The proposed method presented in this paper is shown to have the ability to assist optimal, fair and good decision making while also reducing the influence of implicit bias.
This paper is a reflection on the representation of nurses and their practice at a global level. In considering the International Council of Nurses (ICN) conference in Malta (2011), it is clear that certain assumptions have been made about nurses and their practice which assume that globalization is under way for the whole of the profession and that the assumptions can be applied equally around the world. These assumptions appear in many ways to be implicit rather than explicit. The implicitness of the assumptions is examined against the particular decision-making processes adopted by the ICN. An attempt is then made to identify another base for the ongoing global work of the ICN. This involves the exploration of taboo (that which is forbidden because it is either holy or unclean) as a way of examining why nursing is not properly valued, despite years of international representation. The paper concludes with some thoughts on how such a new approach interfaces with the possibilities held out by new information technologies. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.
Shyung, Li-Rung; Lin, Shee-Chan; Shih, Shou-Chuan; Kao, Chin-Roa; Chou, Sun-Yen
AIM: To evaluate systematically our nine-year experience in treating right-sided diverticulitis of the colon, and to explore its clinical and radiological relationship. METHODS: The clinical and radiological data of 40 patients with colonic diverticulitis treated in Mackay Memorial Hospital, Taipei, from 1993 through 2002 were reviewed retrospectively. RESULTS: The average age of the patients with right-sided diverticulitis was 53.1 years, which was 11.6 years younger than that of the patients with left-sided diverticulitis. The preoperative diagnosis of appendicitis was made in 8 of 13 right-sided diverticulitis patients. Nine (69%) had right lower quadrant abdominal pain for more than 48 hours, and ten patients (77%) presented with fever. CT findings suggesting acute right-sided diverticulitis including thickening of the intestinal wall and pericolonic inflammation were present in five patients. CONCLUSION: Right-sided diverticulitis is easily confused with acute appendicitis because it occurs at a somewhat younger age than that in left-sided diverticulitis. Barium enema and CT are helpful for the early diagnosis of right-sided diverticulitis. While clearly not required in the majority of patients with right lower quadrant abdominal pain, barium enema and CT may be helpful in making the decision with a clinical history or physical examinations atypical of acute appendicitis. PMID:12632528
Mason, Keith J.
This research surveys twenty large companies and their travellers to identify and evaluate the effects of pressures on the business travel market in the future. The influence of the following areas on the decision making process are addressed: (1) Corporate travel policies and increasing professionalism in corporate purchasing; (2) The development of global strategic airline alliances; (3) The emergence of low cost airlines on short haul markets; and (4) The development of internet based booking tools and travel agency IT. The survey shows differences in views between travel managers, and travellers with regard to corporate travel policies. While travel managers see policy rules, travellers interpret these as guidelines, indicating travel managers will need to take further actions to exercise true control of travel budgets. The data shows that companies are more likely to prescribe a class of airline ticket, than the choice of airline itself. Corporate hierarchical bias in travel policies is still common both for short and particularly long haul flying. Other findings show that while travel managers believe that their companies are likely to sign global deals with strategic airline groups within a five year period in a bid to consolidating spending, they also believe that nearly a third of short haul flying will be taken with low cost carriers, indicating further penetration in this business travel market by these carriers. The paper also provides other predictions about the business travel market, based on the survey findings.
Zafeiris, Anna; Mones, Enys; Vicsek, Tamás
An essential task of groups is to provide efficient solutions for the complex problems they face. Indeed, considerable efforts have been devoted to the question of collective decision-making related to problems involving a single dominant feature. Here we introduce a quantitative formalism for finding the optimal distribution of the group members' competences in the more typical case when the underlying problem is complex, i.e., multidimensional. Thus, we consider teams that are aiming at obtaining the best possible answer to a problem having a number of independent sub-problems. Our approach is based on a generic scheme for the process of evaluating the proposed solutions (i.e., negotiation). We demonstrate that the best performing groups have at least one specialist for each sub-problem -- but a far less intuitive result is that finding the optimal solution by the interacting group members requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present emp...
Full Text Available In developed countries, nowadays we live in a networked society: a society of information, knowledge and services (Castells, 1996, with strong specificities in the Health field (Bourret, 2003, Silber, 2003. The World Health Organization (WHO has outlined the importance of information for improving health for all. However, financial resources remain limited. Health costs represent 11% of GNP in France, Germany, Switzerland and Canada, 14% in the USA, and 7.5% in Spain and the United Kingdom. Governments, local powers, health or insurance organizations therefore face difficult choices in terms of opportunities and priorities, and for that they need specific and valuable data. Firstly, this paper provide a comprehensive overview of our networked society and the appointment of ICT (Information and Communication Technologies and Health (in other words e-Health in a perspective of needs and uses at the micro, meso, and macro levels. We point out the main challenges of development of Nationwide Health Information Network both in the US, UK and France. Then we analyze the main issues about data for Decision Making in Networked Health: coordination and evaluation. In the last sections, we use an Information System perspective to investigate the three interoperability layers (micro, meso and macro. We analyze the requirements and challenges to design an interoperability global architecture which supports different kinds of interactions; then we focus on the harmonization efforts provided at several levels. Finally, we identify common methodological and engineering issues.
Full Text Available This study targets the decision-making process and the politico-administrative relations in the Public Procurement Review System in Albania (PPRS. The inner logic of this study is composed of interrelation between decision making and accountability of actions and inactions, which pose the risk for decision making to face corruption due to the lack of legal and/or social auditing mechanisms. The study targets decision making in Public Procurement Commission (PPC in Albania by reviewing decisions to identify stable patterns of fl awed, inconsistent interpretation which allow corruptive actions and inactions to take part.
Lettice, Fiona; Durowoju, Olatunde
Effective supply chain integration, and the tight co-ordination it creates, is an essential pre-requisite for successful supply chain management. Decision-Making for Supply Chain Integration is a practical reference on recent research in the area of supply chain integration focusing on distributed decision-making problems. Recent applications of various decision-making tools for integrating supply chains are covered including chapters focusing on: •Supplier selection, pricing strategy and inventory decisions in multi-level supply chains, •RFID-enabled distributed decision-making, •Operational risk issues and time-critical decision-making for sensitive logistics nodes, Modelling end to end processes to improve supply chain integration, and •Integrated systems to improve service delivery and optimize resource use. Decision-Making for Supply Chain Integration provides an insight into the tools and methodologies of this field with support from real-life case studies demonstrating successful application ...
Al-Hamdan, Zaid M; Bawadi, Hala A; Redman, Richard W; Al-Nawafleh, Ahmad H
Nurses in any organizational context are members of a team and cannot work independently. Teamwork requires making decisions frequently, and these decisions affect team performance on a regular basis. Ultimately, the team shapes the quality of patient care. This study examines nurse decision-making related to patient care, self-management and the work environment. Qualitative descriptive design was used to collect data. Eighteen staff nurses participated in semi-structured interviews to explore the perception of Jordanian staff nurses regarding their participation in decision-making. Variation in decision-making involvement was found to exist across unit types and from hospital to hospital. In general, the participants were not satisfied with their level of decision-making involvement and believed that they could participate more. The results have implications for nurse managers in facilitating the engagement of staff nurses in decision-making and creating an organizational culture to facilitate this engagement. Copyright © 2015 Elsevier Inc. All rights reserved.
Robson, Maggie; Cook, Peter; Hunt, Kathy; Alred, Geof; Robson, Dave
Explores the process of ethical decision-making in counseling research and examines to what extent decision-making is based on intuitive thinking. Reviews and considers several models of ethical problem solving. Argues that ethical decisions are reached through intuition, informed by ethical principles, codes of practice, and reference to the laws…
Conclusion: Caregivers' decisions to proceed with a percutaneous endoscopic gastrostomy procedure were mediated by desires to relieve patients' suffering. To empower caregivers to make enteral feeding decisions, nurses must provide sufficient information about percutaneous gastrostomy tubes and their care, support decision making and help to identify an opportunity for gastrostomy tube placement.
Van Santen, W.; Jonker, C.M.; Wijngaards, N.
Decision making during crises takes place in (multi-agency) teams, in a bureaucratic political context. As a result, the common notion that during crises decision making should be done in line with a Command & Control structure is invalid. This paper shows that the best way for crisis decision
Manikas, Konstantinos; Wnuk, Krzysztof; Shollo, Arisa
and review related literature consisted of software ecosystem governance, organizational decision making, and IT governance. Based on the identified studies, we propose a framework for defining the decision making strategies in the governance of software ecosystems. We identify five decision areas...
Alvino, Letizia; Franco, Massimo
The decision-making process has been analyzed in several disciplines (economics, social sciences, humanities, etc.) with the aim of creating models to help decision-makers in strategy formulation. The Organizational theory takes into account both the decision-making process of individuals and groups
... of decision making is vital to maximise consistency and the moral defensibility of these difficult decisions. This paper will describe possible approaches to making these decisions, discuss aspects of triage in patients with respiratory failure, and examine some of the consequences of ICU triage. SAJCC Vol. 21 (1) 2005: pp.
Significant variation was found in personal decision-making styles. However, some central themes emerged, such as the importance of sensitivity to the decision-making context, attention to the presentation of information, and the use of intuition. In terms of the use of decision support technology, the use of self-help tools, ...
Sissons, B; Gray, W A; Bater, A; Morrey, D
The vision of evidence-based medicine is that of experienced clinicians systematically using the best research evidence to meet the individual patient's needs. This vision remains distant from clinical reality, as no complete methodology exists to apply objective, population-based research evidence to the needs of an individual real-world patient. We describe an approach, based on techniques from machine learning, to bridge this gap between evidence and individual patients in oncology. We examine existing proposals for tackling this gap and the relative benefits and challenges of our proposed, k-nearest-neighbour-based, approach.
Mahmoodi, Neda; Sargeant, Sally
This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients' subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor-patient power dynamics within shared decision-making for breast cancer.