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Neuron May 2022Logistic regressions were developed in economics to model individual choice behavior. In recent years, they have become an important tool in decision neuroscience. Here,... (Review)
Review
Logistic regressions were developed in economics to model individual choice behavior. In recent years, they have become an important tool in decision neuroscience. Here, I describe and discuss different logistic models, emphasizing the underlying assumptions and possible interpretations. Logistic models may be used to quantify a variety of behavioral traits, including the relative subjective value of different goods, the choice accuracy, risk attitudes, and choice biases. More complex logistic models can be used for choices between good bundles, in cases of nonlinear value functions, and for choices between multiple options. Finally, logistic models can quantify the explanatory power of neuronal activity on choices, thus providing a valid alternative to receiver operating characteristic (ROC) analyses.
Topics: Choice Behavior; Decision Making; Neurons; Neurosciences
PubMed: 35334232
DOI: 10.1016/j.neuron.2022.03.002 -
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 -
European Journal of Nuclear Medicine... Jan 2024
Topics: Humans; Uncertainty; Decision Making
PubMed: 37603085
DOI: 10.1007/s00259-023-06401-2 -
The American Journal of Emergency... Jul 2024Emergency physicians (EPs) navigate high-pressure environments, making rapid decisions amidst ambiguity. Their choices are informed by a complex interplay of experience,... (Review)
Review
Emergency physicians (EPs) navigate high-pressure environments, making rapid decisions amidst ambiguity. Their choices are informed by a complex interplay of experience, information, and external forces. While cognitive shortcuts (heuristics) expedite assessments, there are multiple ways they can be subtly manipulated, potentially leading to reflexive control: external actors steering EPs' decisions for their own benefit. Pharmaceutical companies, device manufacturers, and media narratives are among the numerous factors that influence the EPs' information landscape. Using tactics such as selective data dissemination, framing, and financial incentives, these actors can exploit pre-existing cognitive biases like anchoring, confirmation, and availability. This creates fertile ground for reflexive control, where EPs may believe they are acting independently while unknowingly serving the goals of external influencers. The consequences of manipulated decision making can be severe: misdiagnoses, inappropriate treatments, and increased healthcare costs. Ethical dilemmas arise when external pressures conflict with patient well-being. Recognizing these dangers empowers EPs to resist reflexive control through (1) critical thinking: examining information for potential biases and prioritizing evidence-based practices, (2) continuous education: learning about cognitive biases and mitigation strategies, and (3) institutional policies: implementing regulations to reduce external influence and to promote transparency. This vulnerability of emergency medicine decision making highlights the need for awareness, education, and robust ethical frameworks. Understanding reflexive control techniques is crucial for safeguarding patient care and promoting independent, ethical decision making in emergency medicine.
Topics: Humans; Emergency Medicine; Clinical Decision-Making; Decision Making
PubMed: 38677197
DOI: 10.1016/j.ajem.2024.04.037 -
Biological Psychology Jan 2023This study investigates whether decision-making under uncertainty is influenced by the cardiac cycle. To test this hypothesis, we examined the influence of the cardiac...
This study investigates whether decision-making under uncertainty is influenced by the cardiac cycle. To test this hypothesis, we examined the influence of the cardiac cycle on an individual's decision-making process in a gambling experiment. Participants were asked to choose one option with a sure payout or uncertain option with varying degrees of winning probability, ambiguity, and monetary amounts. The onset of presentation of the options is timed to coincide with either cardiac ventricular systole or diastole. The results show that, for most participants, the risk aversion score was lower in the systole trial than in the diastole trial. Model-based exploratory analysis revealed that the higher propensity to take risks in the systole trial compared with that in the diastole trial could be captured better by the change in the gambling bias against the utility of the risky options, rather than by a change in risk attitude. The results provide evidence that the natural fluctuation of cardiac afferent signals can affect risky decision-making.
Topics: Humans; Decision Making; Gambling; Risk-Taking; Uncertainty; Systole; Diastole
PubMed: 36464201
DOI: 10.1016/j.biopsycho.2022.108471 -
Therapeutische Umschau. Revue... 2022Shared Decision-Making in Preventive Activities Shared Decision-Making (SDM) is particularly useful in conditions where decisions are preference-sensitive, i.e., where... (Review)
Review
Shared Decision-Making in Preventive Activities Shared Decision-Making (SDM) is particularly useful in conditions where decisions are preference-sensitive, i.e., where preferences and values of patients are crucial for the further proceeding. This typically applies to conditions where the potential benefit and the potential harm are similar. Preventive activities are characterized by the fact that there is no current burden of disease and the benefit to expect is far in the future. Therefore, it is preference-sensitive if the current effort really pays off. The procedure of SDM in (preventive) counselling can be classified into three steps: , and . For every step, we present examples of how to talk. After an overview of the current evidence, we present four examples of how to apply SDM in preventive conditions: quit-smoking counselling, lifestyle coaching, vaccination counselling and screening for cancer. Finally, we focus on the role of activated patients and point out the opportunity for SDM during . For all these implementation issues useful tools and links are presented. In summary, important elements of SDM, such as patient centeredness, clarifying needs/goals and shared responsibility, are crucial for the entire spectre of caring for patients, not only for prevention.
Topics: Decision Making; Decision Making, Shared; Humans; Patient Participation
PubMed: 36164734
DOI: 10.1024/0040-5930/a001378 -
Anxiety, Stress, and Coping Nov 2022Previous research has shown that immediate emotions and cognitive processing of the stakes of outcomes influence decision-making under uncertainty. The effect of...
BACKGROUND
Previous research has shown that immediate emotions and cognitive processing of the stakes of outcomes influence decision-making under uncertainty. The effect of perceived beneficial stakes and different types of immediate emotions on decision-making is an important topic that has received little attention in the literature. This study investigated the effects of trait anxiety and anticipatory emotions (fear, sadness, excitement and comfortability) on the perception of thee stakes of outcomes and behavioral intentions.
METHOD
Participants from the community completed a task measuring anticipatory emotions and their perceived stakes of risky and beneficial outcomes in a range of uncertain situations. Trait anxiety was also measured.
RESULTS
Results revealed that anticipatory emotions (except for sadness), trait anxiety and subjective stakes all demonstrated significant associations with risky behavioral intention in uncertain situations. Anticipatory emotions, but not trait anxiety, had stable effects on stake perceptions. However, trait anxiety moderated the effect of excitement on risky behavioral intention. In addition, positive emotions (comfortability and excitement) and beneficial stakes demonstrated consistent effects in the decision-making process.
CONCLUSIONS
The current study sheds light on future immediate-emotion-based interventions for deficits in uncertain decision-making.
Topics: Anxiety; Decision Making; Emotions; Fear; Humans; Uncertainty
PubMed: 34747282
DOI: 10.1080/10615806.2021.1994143 -
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 -
Seminars in Nephrology Nov 2022Advance care planning, shared decision making, and serious illness conversations are communication processes designed to promote patient-centered care. In... (Review)
Review
Advance care planning, shared decision making, and serious illness conversations are communication processes designed to promote patient-centered care. In onconephrology, patients face a series of complex medical decisions regarding their care at the intersection of oncology and nephrology. Clinicians who aim to ensure that patient preferences and values are integrated into treatment planning must work within a similarly complex care team comprising multiple disciplines. In this review, we describe key decision points in a patient's care trajectory, as well as guidance on how and when to engage in advance care planning, shared decision making, and serious illness discussions. Further research on these processes in the complex context of onconephrology is needed.
Topics: Humans; Decision Making, Shared; Advance Care Planning; Patient Care Planning; Patient-Centered Care; Communication; Decision Making
PubMed: 37121171
DOI: 10.1016/j.semnephrol.2023.151349 -
Zeitschrift Fur Evidenz, Fortbildung... Jun 2022Argentina is an upper-middle income country located in South America with an estimated population of 46.2 million inhabitants. There is no unified research agenda or...
Argentina is an upper-middle income country located in South America with an estimated population of 46.2 million inhabitants. There is no unified research agenda or government initiatives encouraging the implementation and research of Shared Decision-Making (SDM). Our working group at the Family and Community Medicine Division of the Hospital Italiano de Buenos Aires is the leading centre for research and implementation of SDM in the country. The implementation strategy is articulated in undergraduate, postgraduate and continuous medical education. However, it is challenged by the professionals' perception that they are already doing it or lack time during consultations. We have advanced research to understand how to adapt tools to measure and implement SDM in our settings. Still, we face additional challenges related to funding, accessing diverse populations beyond the reach of our institution and incorporating patients in the co-production of research. While most of our efforts arise from the voluntary work of our healthcare professionals, we believe this is a strength since SDM research and implementation are then directly linked to patient care.
Topics: Argentina; Decision Making; Decision Making, Shared; Germany; Humans; Patient Participation
PubMed: 35610137
DOI: 10.1016/j.zefq.2022.04.008