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Proceedings of the National Academy of... Aug 2013All decisions, whether they are personal, public, or business-related, are based on the decision maker's beliefs and values. Science can and should help decision makers...
All decisions, whether they are personal, public, or business-related, are based on the decision maker's beliefs and values. Science can and should help decision makers by shaping their beliefs. Unfortunately, science is not easily accessible to decision makers, and scientists often do not understand decision makers' information needs. This article presents a framework for bridging the gap between science and decision making and illustrates it with two examples. The first example is a personal health decision. It shows how a formal representation of the beliefs and values can reflect scientific inputs by a physician to combine with the values held by the decision maker to inform a medical choice. The second example is a public policy decision about managing a potential environmental hazard. It illustrates how controversial beliefs can be reflected as uncertainties and informed by science to make better decisions. Both examples use decision analysis to bridge science and decisions. The conclusions suggest that this can be a helpful process that requires skills in both science and decision making.
Topics: Choice Behavior; Communication; Decision Making; Humans; Information Dissemination; Science
PubMed: 23940310
DOI: 10.1073/pnas.1213532110 -
Health Expectations : An International... Aug 2022Shared decision-making (SDM) is intended to increase patient-centredness of medical decision-making for patients with acute and chronic conditions. Concurrently, patient... (Review)
Review
INTRODUCTION
Shared decision-making (SDM) is intended to increase patient-centredness of medical decision-making for patients with acute and chronic conditions. Concurrently, patient decision aids (PtDAs) can supplement SDM by providing information to guide communication between patients and healthcare providers. Because of the prevalence of chronic conditions, where decisions may be extended or recurring, we sought to explore how effectively these tools have been leveraged in this context.
METHODS
We conducted a narrative review of the literature on both SDM and PtDAs, searching PubMed and Boston University's library database search tool for English-language articles published from January 2005 until March 2021. Additional search terms focused on temporality. Drawing from our findings, we developed a combined framework to highlight areas for future research using the discussion of end-of-life decisions as an exemplar to illustrate its relevance to chronic care contexts.
RESULTS
After screening 57 articles, we identified 25 articles that fulfilled the inclusion criteria on SDM, PtDA use and temporality for chronic care. The literature on SDM highlighted time outside of the medical visit and opportunity to include outside decision partners as important elements of the process. PtDAs were commonly evaluated for process-related and proximal outcomes, but less often for distal outcomes. Early evidence points to the value of comparative outcome evaluation based on the timing of PtDA distribution.
CONCLUSION
Our review of the literature on SDM and PtDAs reveals less attention to the timing of PtDAs relative to that of SDM. We highlight the need for further study of timing in PtDA use to improve longitudinal SDM for chronic care. The model that we propose in our discussion provides a starting point for future research on PtDA efficacy.
PATIENT OR PUBLIC CONTRIBUTION
Five patient consultants provided input and feedback on the development and utility of our model.
Topics: Clinical Decision-Making; Decision Making; Decision Making, Shared; Decision Support Techniques; Humans; Patient Participation
PubMed: 35652372
DOI: 10.1111/hex.13531 -
Journal of Neuroscience Research Jan 2017The ability to weigh the costs and benefits of various options to make an adaptive decision is critical to an organism's survival and wellbeing. Many psychiatric... (Review)
Review
The ability to weigh the costs and benefits of various options to make an adaptive decision is critical to an organism's survival and wellbeing. Many psychiatric diseases are characterized by maladaptive decision making, indicating a need for better understanding of the mechanisms underlying this process and the ways in which it is altered under pathological conditions. Great strides have been made in uncovering these mechanisms, but the majority of what is known comes from studies conducted solely in male subjects. In recent years, decision-making research has begun to include female subjects to determine whether sex differences exist and to identify the mechanisms that contribute to such differences. This Mini-Review begins by describing studies that have examined sex differences in animal (largely rodent) models of decision making. Possible explanations, both theoretical and biological, for such differences in decision making are then considered. The Mini-Review concludes with a discussion of the implications of sex differences in decision making for understanding psychiatric conditions. © 2016 Wiley Periodicals, Inc.
Topics: Animals; Behavior, Animal; Decision Making; Models, Animal; Sex Characteristics
PubMed: 27870448
DOI: 10.1002/jnr.23810 -
ELife Sep 2020Human decisions are based on finite information, which makes them inherently imprecise. But what determines the degree of such imprecision? Here, we develop an efficient...
Human decisions are based on finite information, which makes them inherently imprecise. But what determines the degree of such imprecision? Here, we develop an efficient coding framework for higher-level cognitive processes in which information is represented by a finite number of discrete samples. We characterize the sampling process that maximizes perceptual accuracy or fitness under the often-adopted assumption that full adaptation to an environmental distribution is possible, and show how the optimal process differs when detailed information about the current contextual distribution is costly. We tested this theory on a numerosity discrimination task, and found that humans efficiently adapt to contextual distributions, but in the way predicted by the model in which people must economize on environmental information. Thus, understanding decision behavior requires that we account for biological restrictions on information coding, challenging the often-adopted assumption of precise prior knowledge in higher-level decision systems.
Topics: Adult; Algorithms; Choice Behavior; Decision Making; Female; Humans; Male; Models, Psychological; Task Performance and Analysis; Young Adult
PubMed: 32930663
DOI: 10.7554/eLife.54962 -
ELife Nov 2021Sex-based modulation of cognitive processes could set the stage for individual differences in vulnerability to neuropsychiatric disorders. While value-based decision...
Sex-based modulation of cognitive processes could set the stage for individual differences in vulnerability to neuropsychiatric disorders. While value-based decision making processes in particular have been proposed to be influenced by sex differences, the overall correct performance in decision making tasks often show variable or minimal differences across sexes. Computational tools allow us to uncover latent variables that define different decision making approaches, even in animals with similar correct performance. Here, we quantify sex differences in mice in the latent variables underlying behavior in a classic value-based decision making task: a restless two-armed bandit. While male and female mice had similar accuracy, they achieved this performance via different patterns of exploration. Male mice tended to make more exploratory choices overall, largely because they appeared to get 'stuck' in exploration once they had started. Female mice tended to explore less but learned more quickly during exploration. Together, these results suggest that sex exerts stronger influences on decision making during periods of learning and exploration than during stable choices. Exploration during decision making is altered in people diagnosed with addictions, depression, and neurodevelopmental disabilities, pinpointing the neural mechanisms of exploration as a highly translational avenue for conferring sex-modulated vulnerability to neuropsychiatric diagnoses.
Topics: Animals; Anxiety; Choice Behavior; Decision Making; Exploratory Behavior; Female; Male; Mice; Reward; Sex Factors
PubMed: 34796870
DOI: 10.7554/eLife.69748 -
Topics in Cognitive Science Jul 2010
Topics: Decision Making; Humans; Models, Psychological; Morals
PubMed: 25163870
DOI: 10.1111/j.1756-8765.2010.01101.x -
Annual Review of Psychology Jan 2015Humans exhibit a suite of biases when making economic decisions. We review recent research on the origins of human decision making by examining whether similar choice... (Review)
Review
Humans exhibit a suite of biases when making economic decisions. We review recent research on the origins of human decision making by examining whether similar choice biases are seen in nonhuman primates, our closest phylogenetic relatives. We propose that comparative studies can provide insight into four major questions about the nature of human choice biases that cannot be addressed by studies of our species alone. First, research with other primates can address the evolution of human choice biases and identify shared versus human-unique tendencies in decision making. Second, primate studies can constrain hypotheses about the psychological mechanisms underlying such biases. Third, comparisons of closely related species can identify when distinct mechanisms underlie related biases by examining evolutionary dissociations in choice strategies. Finally, comparative work can provide insight into the biological rationality of economically irrational preferences.
Topics: Animals; Biological Evolution; Decision Making; Humans; Primates
PubMed: 25559115
DOI: 10.1146/annurev-psych-010814-015310 -
International Journal of Law and... 2019A person's capacity to process advice is an important aspect of decision making in the real world. For example, in decisions about treatment, the way patients respond to... (Review)
Review
A person's capacity to process advice is an important aspect of decision making in the real world. For example, in decisions about treatment, the way patients respond to the advice of family, friends and medical professionals may be used (intentionally or otherwise) as a marker of the "use or weigh" requirement of decision-making capacity. Here we explore neuroscientific research on decision-making to identify features of advice-taking that help conceptualize this requirement. We focus on studies of the neural and computational basis of decision-making in laboratory settings. These studies originally investigated simple perceptual decisions about ambiguous stimuli, but have more recently been extended to more complex "value-based" decisions involving the comparison of subjective preferences. Value-based decisions are a useful model system for capacity-related decision-making as they do not have an objectively 'correct' answer and are instead based on subjective preferences. In this context, advice-taking can be seen as a process in which new evidence for one or other option is integrated, leading to altered behaviour or choices. We use this framework to distinguish between different types of advice-taking: private compliance consists of updating one's privately held beliefs based on new evidence, whereas in the case of public compliance, people change their behaviour at a surface level without shifting their privately-held beliefs. Importantly, both types of advice-taking may lead to similar outcomes but rely on different decision processes. We suggest that understanding how multiple mechanisms drive advice-taking holds promise for targeting decision-making support and improving our understanding of the use and weigh requirement in cases of contested capacity.
Topics: Choice Behavior; Cognitive Neuroscience; Compliance; Decision Making; Humans; Judgment; Mental Competency; Metacognition
PubMed: 31785723
DOI: 10.1016/j.ijlp.2019.101504 -
Neuroscience and Biobehavioral Reviews Apr 2023Making effective decisions during approach-avoidance conflict is critical in daily life. Aberrant decision-making during approach-avoidance conflict is evident in a... (Review)
Review
Making effective decisions during approach-avoidance conflict is critical in daily life. Aberrant decision-making during approach-avoidance conflict is evident in a range of psychological disorders, including anxiety, depression, trauma-related disorders, substance use disorders, and alcohol use disorders. To help clarify etiological pathways and reveal novel intervention targets, clinical research into decision-making is increasingly adopting a computational psychopathology approach. This approach uses mathematical models that can identify specific decision-making related processes that are altered in mental health disorders. In our review, we highlight foundational approach-avoidance conflict research, followed by more in-depth discussion of computational approaches that have been used to model behavior in these tasks. Specifically, we describe the computational models that have been applied to approach-avoidance conflict (e.g., drift-diffusion, active inference, and reinforcement learning models), and provide resources to guide clinical researchers who may be interested in applying computational modeling. Finally, we identify notable gaps in the current literature and potential future directions for computational approaches aimed at identifying mechanisms of approach-avoidance conflict in psychopathology.
Topics: Humans; Decision Making; Alcoholism; Anxiety Disorders; Learning; Anxiety; Avoidance Learning
PubMed: 36804398
DOI: 10.1016/j.neubiorev.2023.105103 -
Anaesthesia Feb 2023
Topics: Humans; Uncertainty; Emotions; Decision Making; Communication
PubMed: 36196780
DOI: 10.1111/anae.15875