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Primary Dental Journal Dec 2020Engaging patients in shared decision making (SDM) is a professional requirement since the Montgomery ruling in 2015. Endodontic treatments present a specific challenge...
Engaging patients in shared decision making (SDM) is a professional requirement since the Montgomery ruling in 2015. Endodontic treatments present a specific challenge to achieving SDM, both for the clinician and the patient. The treatments are often perceived as more challenging to complete by the clinician, and the assessment of risk and likely outcome requires a deep understanding of the (limited) evidence base. For the patient, decisions can be required at a time of acute symptoms and prolonged treatments. There are health literacy demands in comparison to some less complex dental treatments. Treatment decisions may be based more on inherent biases and prior experiences than objective probabilities. This article discusses options and supports effective shared decision making in endodontic treatment.
Topics: Decision Making; Decision Making, Shared; Dental Care; Endodontics; Humans; Patient Participation
PubMed: 33225852
DOI: 10.1177/2050168420963303 -
The Patient Dec 2020
Topics: Decision Making; Decision Making, Shared; Health Personnel; Humans; Patient-Centered Care; Self Care
PubMed: 33051858
DOI: 10.1007/s40271-020-00471-2 -
Journal of Personality and Social... Nov 2023Scarcity often encourages decisions that favor the present over the future. While prevailing theories largely attribute these decisions to myopic, impulsive decision...
Scarcity often encourages decisions that favor the present over the future. While prevailing theories largely attribute these decisions to myopic, impulsive decision making, five studies find support for an alternative, less prevalent perspective. We introduce the time horizon of threatened needs as an important determinant of scarcity's effect on intertemporal choice, demonstrating that people's decisions under scarcity reflect attempts to address threatened needs. Data from the Federal Reserve Bank of Philadelphia (Study 1) and preregistered studies ( = 10,297) show that time horizon moderates intertemporal decisions under scarcity. Study 2 manipulates scarcity perceptions among people engaged to be married, leading to increased preferences for sooner outcomes when wedding dates have shorter time horizons and a significant reversal when wedding dates have longer time horizons. Study 3 demonstrates that time horizon predicts intertemporal choice only when the intertemporal choice can help address threatened needs. Study 4 holds expense salience constant and replicates the moderation by time horizon using a paradigm that manipulates both scarcity and time horizon. Study 5 introduces multiple needs that vary in time horizon and importance, finding that decisions under scarcity reflect consideration of both the importance and temporal proximity of needs. These findings align with the perspective that people facing scarcity attempt to make decisions that are contextually appropriate. This work underscores the importance of understanding contextual variation in experiences of scarcity, suggests that decision making under scarcity is less thoughtless than presumed by the impulsive, myopic account, and offers recommendations for interventions for changing behavior under scarcity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Time Factors; Impulsive Behavior; Choice Behavior; Delay Discounting; Reward; Decision Making
PubMed: 37707481
DOI: 10.1037/pspa0000353 -
European Journal of Nuclear Medicine... Jan 2024
Topics: Humans; Uncertainty; Decision Making
PubMed: 37603085
DOI: 10.1007/s00259-023-06401-2 -
Proceedings of the National Academy of... Nov 2020Adversarial examples are carefully crafted input patterns that are surprisingly poorly classified by artificial and/or natural neural networks. Here we examine...
Adversarial examples are carefully crafted input patterns that are surprisingly poorly classified by artificial and/or natural neural networks. Here we examine adversarial vulnerabilities in the processes responsible for learning and choice in humans. Building upon recent recurrent neural network models of choice processes, we propose a general framework for generating adversarial opponents that can shape the choices of individuals in particular decision-making tasks toward the behavioral patterns desired by the adversary. We show the efficacy of the framework through three experiments involving action selection, response inhibition, and social decision-making. We further investigate the strategy used by the adversary in order to gain insights into the vulnerabilities of human choice. The framework may find applications across behavioral sciences in helping detect and avoid flawed choice.
Topics: Choice Behavior; Computer Simulation; Decision Making; Humans; Learning; Neural Networks, Computer; Reinforcement, Psychology; Reward
PubMed: 33148802
DOI: 10.1073/pnas.2016921117 -
Psychological Bulletin Jun 2021Visual attention is a fundamental aspect of most everyday decisions, and governments and companies spend vast resources competing for the attention of decision makers.... (Meta-Analysis)
Meta-Analysis
Visual attention is a fundamental aspect of most everyday decisions, and governments and companies spend vast resources competing for the attention of decision makers. In natural environments, choice options differ on a variety of visual factors, such as salience, position, or surface size. However, most decision theories ignore such visual factors, focusing on cognitive factors such as preferences as determinants of attention. To provide a systematic review of how the visual environment guides attention we meta-analyze 122 effect sizes on eye movements in decision making. A psychometric meta-analysis and Top10 sensitivity analysis show that visual factors play a similar or larger role than cognitive factors in determining attention. The visual factors that most influence attention are positioning information centrally, ρ = .43 (Top10 = .67), increasing the surface size, ρ = .35 (Top10 = .43), reducing the set size of competing information elements, ρ = .24 (Top10 = .24), and increasing visual salience, ρ = .13 (Top10 = .24). Cognitive factors include attending more to preferred choice options and attributes, ρ = .36 (Top10 = .31), effects of task instructions on attention, ρ = .35 (Top10 = .21), and attending more to the ultimately chosen option, ρ = .59 (Top10 = .26). Understanding real-world decision making will require the integration of both visual and cognitive factors in future theories of attention and decision making. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Choice Behavior; Decision Making; Eye Movements; Humans
PubMed: 34843300
DOI: 10.1037/bul0000328 -
PLoS Computational Biology Apr 2020
Topics: Decision Making; Goals; Humans; Thinking
PubMed: 32240159
DOI: 10.1371/journal.pcbi.1007706 -
Otolaryngology--head and Neck Surgery :... Mar 2016Shared decision making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve... (Review)
Review
OBJECTIVE
Shared decision making (SDM), an integrative patient-provider communication process emphasizing discussion of scientific evidence and patient/family values, may improve quality care delivery, promote evidence-based practice, and reduce overuse of surgical care. Little is known, however, regarding SDM in elective surgical practice. The purpose of this systematic review is to synthesize findings of studies evaluating use and outcomes of SDM in elective surgery.
DATA SOURCES
PubMed, Cochrane CENTRAL, EMBASE, CINAHL, and SCOPUS electronic databases.
REVIEW METHODS
We searched for English-language studies (January 1, 1990, to August 9, 2015) evaluating use of SDM in elective surgical care where choice for surgery could be ascertained. Identified studies were independently screened by 2 reviewers in stages of title/abstract and full-text review. We abstracted data related to population, study design, clinical dilemma, use of SDM, outcomes, treatment choice, and bias.
RESULTS
Of 10,929 identified articles, 24 met inclusion criteria. The most common area studied was spine (7 of 24), followed by joint (5 of 24) and gynecologic surgery (4 of 24). Twenty studies used decision aids or support tools, including modalities that were multimedia/video (13 of 20), written (3 of 20), or personal coaching (4 of 20). Effect of SDM on preference for surgery was mixed across studies, showing a decrease in surgery (9 of 24), no difference (8 of 24), or an increase (1 of 24). SDM tended to improve decision quality (3 of 3) as well as knowledge or preparation (4 of 6) while decreasing decision conflict (4 of 6).
CONCLUSION
SDM reduces decision conflict and improves decision quality for patients making choices about elective surgery. While net findings show that SDM may influence patients to choose surgery less often, the impact of SDM on surgical utilization cannot be clearly ascertained.
Topics: Choice Behavior; Decision Making; Decision Support Techniques; Elective Surgical Procedures; Humans
PubMed: 26645531
DOI: 10.1177/0194599815620558 -
Continuum (Minneapolis, Minn.) Oct 2021This article reviews the evidence on integrating palliative care into the care of patients with various types of serious neurologic illness, emphasizes the importance of... (Review)
Review
PURPOSE OF REVIEW
This article reviews the evidence on integrating palliative care into the care of patients with various types of serious neurologic illness, emphasizes the importance of palliative care in the neurocritical care unit, and suggests tools for clinicians to improve their communication skills and decision making.
RECENT FINDINGS
Palliative care is a holistic approach to medical care that aims to relieve physical, psychological, social, and spiritual suffering. It is both a medical specialty as young as neurocritical care itself and an approach to patient care by all clinicians who manage patients with serious illness. Patients presenting to the neurocritical care unit and their families have unique palliative care needs that challenge communication and shared decision making.
SUMMARY
Palliative care, effective communication, and shared decision making require a set of core skills that all neurology clinicians should master.
Topics: Communication; Decision Making; Decision Making, Shared; Humans; Neurology; Palliative Care
PubMed: 34618767
DOI: 10.1212/CON.0000000000001003 -
Nature Reviews. Neuroscience Oct 2019The outcome of a decision is often uncertain, and outcomes can vary over repeated decisions. Whether decision outcomes should substantially affect behaviour and learning... (Review)
Review
The outcome of a decision is often uncertain, and outcomes can vary over repeated decisions. Whether decision outcomes should substantially affect behaviour and learning depends on whether they are representative of a typically experienced range of outcomes or signal a change in the reward environment. Successful learning and decision-making therefore require the ability to estimate expected uncertainty (related to the variability of outcomes) and unexpected uncertainty (related to the variability of the environment). Understanding the bases and effects of these two types of uncertainty and the interactions between them - at the computational and the neural level - is crucial for understanding adaptive learning. Here, we examine computational models and experimental findings to distil computational principles and neural mechanisms for adaptive learning under uncertainty.
Topics: Adaptation, Biological; Animals; Brain; Choice Behavior; Decision Making; Humans; Learning; Nerve Net; Uncertainty
PubMed: 31147631
DOI: 10.1038/s41583-019-0180-y