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Annals of Palliative Medicine Feb 2020Patients, and their families, with Parkinson's disease (PD) and related disorders face many issues, including physical, psychological, social and spiritual. Palliative... (Review)
Review
Patients, and their families, with Parkinson's disease (PD) and related disorders face many issues, including physical, psychological, social and spiritual. Palliative care is an essential part of care from the time of diagnosis, and should be provided by all services involved with the patient and family. Specialist palliative care is able to support the overall care particularly for complex issues-whether symptoms or psychosocial and spiritual problems, ethical and decisions making issues, and at the end of life. This should be in collaboration with other teams, working together to improve the quality of life (QOL) of patients and families, supporting the professional teams and enabling patients to be as fully involved in the decisions about their care and at the end of life.
Topics: Decision Making; Humans; Palliative Care; Parkinson Disease
PubMed: 32008340
DOI: 10.21037/apm.2019.12.01 -
Behavioral Neuroscience Apr 2021One of the most important factors in decision-making is estimating the value of available options. Subregions of the prefrontal cortex, including the orbitofrontal... (Review)
Review
One of the most important factors in decision-making is estimating the value of available options. Subregions of the prefrontal cortex, including the orbitofrontal cortex (OFC), have been deemed essential for this process. Value computations require a complex integration across numerous dimensions, including, reward magnitude, effort, internal state, and time. The importance of the temporal dimension is well illustrated by temporal discounting tasks, in which subjects select between smaller-sooner versus larger-later rewards. The specific role of OFC in telling time and integrating temporal information into decision-making remains unclear. Based on the current literature, in this review we reevaluate current theories of OFC function, accounting for the influence of time. Incorporating temporal information into value estimation and decision-making requires distinct, yet interrelated, forms of temporal information including the ability to tell time, represent time, create temporal expectations, and the ability to use this information for optimal decision-making in a wide range of tasks, including temporal discounting and wagering. We use the term "temporal cognition" to refer to the integrated use of these different aspects of temporal information. We suggest that the OFC may be a critical site for the integration of reward magnitude and delay, and thus important for temporal cognition. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Cognition; Decision Making; Delay Discounting; Humans; Prefrontal Cortex; Reward
PubMed: 34060872
DOI: 10.1037/bne0000430 -
Philosophical Transactions of the Royal... Mar 2021Do we have any valid reasons to affirm that non-human primates display economic behaviour in a sufficiently rich and precise sense of the phrase? To address this...
Do we have any valid reasons to affirm that non-human primates display economic behaviour in a sufficiently rich and precise sense of the phrase? To address this question, we have to develop a set of criteria to assess the vast array of experimental studies and field observations on individual cognitive and behavioural competences as well as the collective organization of non-human primates. We review a sample of these studies and assess how they answer to the following four main challenges. (i) Do we see any economic organization or institutions emerge among groups of non-human primates? (ii) Are the cognitive abilities, and often biases, that have been evidenced as underlying typical economic decision-making among humans, also present among non-human primates? (iii) Can we draw positive lessons from performance comparisons among primate species, humans and non-humans but also across non-human primate species, as elicited by canonical game-theoretical experimental paradigms, especially as far as economic cooperation and coordination are concerned? And (iv) in which way should we improve models and paradigms to obtain more ecological data and conclusions? Articles discussed in this paper most often bring about positive answers and promising perspectives to support the existence and prevalence of economic behaviours among non-human primates. This article is part of the theme issue 'Existence and prevalence of economic behaviours among non-human primates'.
Topics: Animals; Choice Behavior; Decision Making; Economics, Behavioral; Primates
PubMed: 33423625
DOI: 10.1098/rstb.2019.0676 -
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 -
Acta Neurochirurgica Sep 2021In modern neurosurgery, there are often several treatment alternatives, with different risks and benefits. Shared decision-making (SDM) has gained interest during the... (Review)
Review
BACKGROUND
In modern neurosurgery, there are often several treatment alternatives, with different risks and benefits. Shared decision-making (SDM) has gained interest during the last decade, although SDM in the neurosurgical field is not widely studied. Therefore, the aim of this scoping review was to present the current landscape of SDM in neurosurgery.
METHODS
A literature review was carried out in PubMed and Scopus. We used a search strategy based on keywords used in existing literature on SDM in neurosurgery. Full-text, peer-reviewed articles published from 2000 up to the search date February 16, 2021, with patients 18 years and older were included if articles evaluated SDM in neurosurgery from the patient's perspective.
RESULTS
We identified 22 articles whereof 7 covered vestibular schwannomas, 7 covered spinal surgery, and 4 covered gliomas. The other topics were brain metastases, benign brain lesions, Parkinson's disease and evaluation of neurosurgical care. Different methods were used, with majority using forms, questionnaires, or interviews. Effects of SDM interventions were studied in 6 articles; the remaining articles explored factors influencing patients' decisions or discussed SDM aids.
CONCLUSION
SDM is a tool to involve patients in the decision-making process and considers patients' preferences and what the patients find important. This scoping review illustrates the relative lack of SDM in the neurosurgical literature. Even though results indicate potential benefit of SDM, the extent of influence on treatment, outcome, and patient's satisfaction is still unknown. Finally, the use of decision aids may be a meaningful contribution to the SDM process.
Topics: Decision Making; Decision Making, Shared; Humans; Neurosurgery; Patient Participation; Surveys and Questionnaires
PubMed: 33942189
DOI: 10.1007/s00701-021-04867-3 -
Medicine, Health Care, and Philosophy Mar 2024During the last decades, shared decision making (SDM) has become a very popular model for the physician-patient relationship. SDM can refer to a process (making a...
During the last decades, shared decision making (SDM) has become a very popular model for the physician-patient relationship. SDM can refer to a process (making a decision in a shared way) and a product (making a shared decision). In the literature, by far most attention is devoted to the process. In this paper, I investigate the product, wondering what is involved by a medical decision being shared. I argue that the degree to which a decision to implement a medical alternative is shared should be determined by taking into account six considerations: (i) how the physician and the patient rank that alternative, (ii) the individual preference scores the physician and the patient (would) assign to that alternative, (iii) the similarity of the preference scores, (iv) the similarity of the rankings, (v) the total concession size, and (vi) the similarity of the concession sizes. I explain why shared medical decisions are valuable, and sketch implications of the analysis for the physician-patient relationship.
Topics: Humans; Patient Participation; Decision Making, Shared; Physician-Patient Relations; Physicians; Decision Making
PubMed: 38010578
DOI: 10.1007/s11019-023-10179-3 -
Journal of Behavioral Addictions Oct 2023People with Gambling Disorder (GD) often make risky decisions and experience cognitive distortions about gambling. Moreover, people with GD have been shown to be overly...
BACKGROUND AND AIMS
People with Gambling Disorder (GD) often make risky decisions and experience cognitive distortions about gambling. Moreover, people with GD have been shown to be overly confident in their decisions, especially when money can be won. Here we investigated if and how the act of making a risky choice with varying monetary stakes impacts confidence differently in patients with GD (n = 27) relative to healthy controls (HCs) (n = 30).
METHODS
We used data from our previous mixed-gamble study, in which participants were given the choice of a certain option or a 50/50 gamble with potential gains or losses, after which they rated their confidence.
RESULTS
While HCs were more confident when making certain than risky choices, GD patients were specifically more confident when making risky choices than certain choices. Notably, relative to HCs, confidence of patients with GD decreased more strongly with higher gain values when making a certain choice, suggesting a stronger fear of missing out or "anticipated regret" of missing out on potential gains when rejecting the risky choice.
DISCUSSION
The current findings highlight the potential relevance of confidence and "regret" as cognitive mechanisms feeding into excessive risk-taking as seen in GD. Moreover, this study adds to the limited previous work investigating how confidence is affected in value-based risky contexts.
Topics: Humans; Gambling; Risk-Taking; Decision Making; Choice Behavior; Emotions
PubMed: 37603457
DOI: 10.1556/2006.2023.00041 -
PLoS Computational Biology May 2022A large literature has accumulated suggesting that human and animal decision making is driven by at least two systems, and that important functions of these systems can...
A large literature has accumulated suggesting that human and animal decision making is driven by at least two systems, and that important functions of these systems can be captured by reinforcement learning algorithms. The "model-free" system caches and uses stimulus-value or stimulus-response associations, and the "model-based" system implements more flexible planning using a model of the world. However, it is not clear how the two systems interact during deliberation and how a single decision emerges from this process, especially when they disagree. Most previous work has assumed that while the systems operate in parallel, they do so independently, and they combine linearly to influence decisions. Using an integrated reinforcement learning/drift-diffusion model, we tested the hypothesis that the two systems interact in a non-linear fashion similar to other situations with cognitive conflict. We differentiated two forms of conflict: action conflict, a binary state representing whether the systems disagreed on the best action, and value conflict, a continuous measure of the extent to which the two systems disagreed on the difference in value between the available options. We found that decisions with greater value conflict were characterized by reduced model-based control and increased caution both with and without action conflict. Action conflict itself (the binary state) acted in the opposite direction, although its effects were less prominent. We also found that between-system conflict was highly correlated with within-system conflict, and although it is less clear a priori why the latter might influence the strength of each system above its standard linear contribution, we could not rule it out. Our work highlights the importance of non-linear conflict effects, and provides new constraints for more detailed process models of decision making. It also presents new avenues to explore with relation to disorders of compulsivity, where an imbalance between systems has been implicated.
Topics: Algorithms; Animals; Decision Making; Reinforcement, Psychology
PubMed: 35511764
DOI: 10.1371/journal.pcbi.1010047 -
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 -
Topics in Cognitive Science Jul 2022Scientists studying decision-making often provide a set of choices, each specified with values or distributions of values, and probabilities or distributions of...
Scientists studying decision-making often provide a set of choices, each specified with values or distributions of values, and probabilities or distributions of probabilities. For example, "Would you prefer $100 with probability 1.0 or $1 with probability .9 and $1,000 with probability 0.1?" Other decision research examines choices made in the absence of most quantitative information; for example, "Would you prefer a Ford now or a Porsche a year from now?," "Which food would you prefer," but models the findings with precise quantitative assumptions. Yet other research does neither; for example, modeling verbally stated choices with verbally stated heuristics. This article asks about the relevance of the first two research approaches for much of the decision-making made in life. The use of quantitative research and modeling is unsurprising, given that this approach underlies most of science. In life, values and probabilities are almost always partly or wholly vague and qualitative rather than quantitative. For example, when deciding which house to buy, there are relevant features such as size, color, neighborhood schools, construction materials, attractiveness, and many more, but the decision-maker finds it difficult and of little use to assign these precise values or weights. Nonetheless, humans have evolved to make decisions in such vaguely specified settings. I provide an example showing how a very high degree of uncertainty can defeat the application of quantitative decision-making, but such a demonstration is not critical if quantitative research and modeling produce a good understanding of and a good approximation to decision-making in the natural environment. This perspective addresses these issues.
Topics: Decision Making; Heuristics; Humans; Probability; Uncertainty
PubMed: 34050714
DOI: 10.1111/tops.12541