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Intuitive decision making

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https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#1
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28727259/developing-an-aftercare-decision-aid-assessing-health-professionals-and-patients-preferences
#2
Linda Klaassen, Carmen Dirksen, Liesbeth Boersma, Ciska Hoving
Personalising aftercare for curatively treated breast cancer patients is expected to improve patient satisfaction with care. A patient decision aid can support women in making decisions about their aftercare trajectory, but is currently not available. The aim of this study was to assess the needs of patients and health professionals with regard to an aftercare decision aid to systematically develop such a decision aid. Focus groups with patients and individual interviews with health professionals were digitally recorded and coded using the Framework analysis...
July 20, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28716132/a-patient-safety-and-professional-perspective-on-non-conveyance-in-ambulance-care-a-systematic-review
#3
REVIEW
Remco H A Ebben, Lilian C M Vloet, Renate F Speijers, Nico W Tönjes, Jorik Loef, Thomas Pelgrim, Margreet Hoogeveen, Sivera A A Berben
BACKGROUND: This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. METHODS: We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28696337/memristive-device-based-learning-for-navigation-in-robots
#4
Mohammad Sarim, Manish Kumar, Rashmi Jha, Ali A Minai
Biomimetic robots have gained attention recently for various applications ranging from resource hunting to search and rescue operations during disasters. Biological species are known to intuitively learn from the environment, gather and process data, and make appropriate decisions. Such sophisticated computing capabilities in robots are difficult to achieve, especially if done in real-time with ultra- low energy consumption. Here, we present a novel memristive device based learning architecture for robots. Two terminal memristive devices with resistive switching of oxide layer are modeled in a crossbar array to develop a neuromorphic platform that can impart active real-time learning capabilities in a robot...
July 11, 2017: Bioinspiration & Biomimetics
https://www.readbyqxmd.com/read/28685273/bayesian-techniques-for-analyzing-group-differences-in-the-iowa-gambling-task-a-case-study-of-intuitive-and-deliberate-decision-makers
#5
REVIEW
Helen Steingroever, Thorsten Pachur, Martin Šmíra, Michael D Lee
The Iowa Gambling Task (IGT) is one of the most popular experimental paradigms for comparing complex decision-making across groups. Most commonly, IGT behavior is analyzed using frequentist tests to compare performance across groups, and to compare inferred parameters of cognitive models developed for the IGT. Here, we present a Bayesian alternative based on Bayesian repeated-measures ANOVA for comparing performance, and a suite of three complementary model-based methods for assessing the cognitive processes underlying IGT performance...
July 6, 2017: Psychonomic Bulletin & Review
https://www.readbyqxmd.com/read/28671478/a-qualitative-study-exploring-factors-influencing-clinical-decision-making-for-influenza-like-illness-in-solapur-city-maharashtra-india
#6
A S Ahankari, P R Myles, S Tsang, F Khan, S Atre, T Langley, A Kudale, M Bains
The co-existence of different types of medical systems (medical pluralism) is a typical feature of India's healthcare system. For conditions such as influenza-like illness (ILI), where non-specific disease signs/symptoms exist, clinical reasoning in the context of medical pluralism becomes crucial. Recognising this need, we undertook a qualitative study, which explored factors underpinning clinical decisions on diagnosis and management of ILI. The study involved semi-structured interviews including clinical vignettes with 20 healthcare practitioners (working within allopathy, homeopathy and Ayurveda) working in the private healthcare sector in Solapur city, India...
July 3, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28667086/suitable-support-for-anxious-hospice-patients-what-do-nurses-know-do-and-need-an-explanatory-mixed-method-study
#7
Danielle Zweers, Everlien de Graaf, Saskia Teunissen
OBJECTIVE: To provide insight into what nurses know, do and need to provide support to anxious patients in hospice care (HC). METHODS: A mixed method study consisted of an online survey and focus groups (FGs) about what nurses know, do, and need was conducted. 336 HC nurses were invited to participate. Descriptive statistics were computed using SPSS. The χ(2) and t-tests were conducted to compare. The FGs were transcribed verbatim and thematically analysed. RESULTS: The survey was completed by 265 nurses (79%), and five FGs (n=25) were conducted...
June 30, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28651546/allocating-health-care-resources-a-questionnaire-experiment-on-the-predictive-success-of-rules
#8
Marlies Ahlert, Lars Schwettmann
BACKGROUND: The topic of this paper is related to equity in health within a country. In public health care sectors of many countries decisions on priority setting with respect to treatment of different types of diseases or patient groups are implicitly or explicitly made. Priorities are realized by allocation decisions for medical resources where moral judgments play an important role with respect to goals and measures that should be applied. The aim of this study is to explore the moral intuitions held in the German society related to priorities in medical treatment...
June 26, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28646731/the-adaptive-decision-making-risky-decision-and-decision-making-style-of-internet-gaming-disorder
#9
C-H Ko, P-W Wang, T-L Liu, C-S Chen, C-F Yen, J-Y Yen
BACKGROUND: 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. METHODS: 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...
May 25, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
https://www.readbyqxmd.com/read/28627841/clinical-decision-making-from-theory-to-practice%C3%A2-and-backward
#10
Lionel De Alencastro, Carole Clair, Isabella Locatelli, Mark H Ebell, Nicolas Senn
Being able to analyze all the successive steps of decision making from the first contact with the patient to the final diagnosis is complex because it refers sometimes to intuitive elements proper to each clinician. However, understanding how they integrate probabilities of diseases into their clinical practice and manage diagnostic uncertainties is crucial. This allows a more rational practice of medicine and identifying factors related to the patient, physician or context that may modify the clinical decision making...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28559334/response-time-in-economic-games-reflects-different-types-of-decision-conflict-for-prosocial-and-proself-individuals
#11
Toshio Yamagishi, Yoshie Matsumoto, Toko Kiyonari, Haruto Takagishi, Yang Li, Ryota Kanai, Masamichi Sakagami
Behavioral and neuroscientific studies explore two pathways through which internalized social norms promote prosocial behavior. One pathway involves internal control of impulsive selfishness, and the other involves emotion-based prosocial preferences that are translated into behavior when they evade cognitive control for pursuing self-interest. We measured 443 participants' overall prosocial behavior in four economic games. Participants' predispositions [social value orientation (SVO)] were more strongly reflected in their overall game behavior when they made decisions quickly than when they spent a longer time...
June 13, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28557945/how-entrustment-is-informed-by-holistic-judgments-across-time-in-a-family-medicine-residency-program-an-ethnographic-nonparticipant-observational-study
#12
Margaretha H Sagasser, Cornelia R M G Fluit, Chris van Weel, Cees P M van der Vleuten, Anneke W M Kramer
PURPOSE: Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. METHOD: A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands...
June 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28544082/a-resource-of-potential-drug-targets-and-strategic-decision-making-for-obstructive-sleep-apnoea-pharmacotherapy
#13
REVIEW
Richard L Horner, Kevin P Grace, Andrew Wellman
There is currently no pharmacotherapy for obstructive sleep apnoea (OSA) but there is no principled a priori reason why there should not be one. This review identifies a rational decision-making strategy with the necessary logical underpinnings that any reasonable approach would be expected to navigate to develop a viable pharmacotherapy for OSA. The process first involves phenotyping an individual to quantify and characterize the critical predisposing factor(s) to their OSA pathogenesis and identify, a priori, if the patient is likely to benefit from a pharmacotherapy that targets those factors...
July 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28536918/-cognitive-errors-in-diagnostic-decision-making
#14
REVIEW
Martin Gäbler
Approximately 10-15% of our diagnostic decisions are faulty and may lead to unfavorable and dangerous outcomes, which could be avoided. These diagnostic errors are mainly caused by cognitive biases in the diagnostic reasoning process.Our medical diagnostic decision-making is based on intuitive "System 1" and analytical "System 2" diagnostic decision-making and can be deviated by unconscious cognitive biases.These deviations can be positively influenced on a systemic and an individual level. For the individual, metacognition (internal withdrawal from the decision-making process) and debiasing strategies, such as verification, falsification and rule out worst-case scenarios, can lead to improved diagnostic decisions making...
May 23, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28516209/foreign-language-effect-and-psychological-distance
#15
Hong Im Shin, Juyoung Kim
Does using a foreign language result in forming different moral decisions than using our mother tongue? Two studies were conducted to investigate whether there is a relationship between foreign language effects (differences between native vs. foreign language conditions) and psychological distance. Study 1 tested four moral dilemmas adapted from Greene et al. (Cognition 107: 1144-1155, 2008). Non-fluent Korean-English bilingual participants (N = 161) indicated decisions regarding four moral dilemmas in either Korean or English languages...
May 17, 2017: Journal of Psycholinguistic Research
https://www.readbyqxmd.com/read/28514250/accept-or-decline-an-analytics-based-decision-tool-for-kidney-offer-evaluation
#16
Dimitris Bertsimas, Jerry Kung, Nikolaos Trichakis, David Wojciechowski, Parsia A Vagefi
BACKGROUND: When a deceased-donor kidney is offered to a waitlisted candidate, the decision to accept or decline the organ relies primarily upon a practitioner's experience and intuition. Such decisions must achieve a delicate balance between estimating the immediate benefit of transplantation and the potential for future higher-quality offers. However, the current experience-based paradigm lacks scientific rigor and is subject to the inaccuracies that plague anecdotal decision-making...
May 17, 2017: Transplantation
https://www.readbyqxmd.com/read/28507361/self-related-factors-and-decision-making-styles-among-early-adults
#17
Naila Batool, Muhammad Naveed Riaz, Muhammad Akram Riaz, Masud Akhtar
OBJECTIVE: To examine the effect of self-related factors, including self-regulation, self-esteem and self-efficacy, on decision-making styles of early adults. METHODS: The cross-sectional study was conducted from February to August, 2014 at four universities of Islamabad, Pakistan, and comprised adult students of both Social and Natural sciences. Data was collected through Self-Regulation Questionnaire, Self-Esteem Scale, Self-Efficacy Scale and the General Decision Making Styles Questionnaire...
May 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28490292/countering-cognitive-biases-in-minimising-low-value-care
#18
REVIEW
Ian A Scott, Jason Soon, Adam G Elshaug, Robyn Lindner
Cognitive biases in decision making may make it difficult for clinicians to reconcile evidence of overuse with highly ingrained prior beliefs and intuition. Such biases can predispose clinicians towards low value care and may limit the impact of recently launched campaigns aimed at reducing such care. Commonly encountered biases comprise commission bias, illusion of control, impact bias, availability bias, ambiguity bias, extrapolation bias, endowment effects, sunken cost bias and groupthink. Various strategies may be used to counter such biases, including cognitive huddles, narratives of patient harm, value considerations in clinical assessments, defining acceptable levels of risk of adverse outcomes, substitution, reflective practice and role modelling, normalisation of deviance, nudge techniques and shared decision making...
May 15, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28471111/intelligent-diagnosis-of-jaundice-with-dynamic-uncertain-causality-graph-model
#19
Shao-Rui Hao, Shi-Chao Geng, Lin-Xiao Fan, Jia-Jia Chen, Qin Zhang, Lan-Juan Li
Jaundice is a common and complex clinical symptom potentially occurring in hepatology, general surgery, pediatrics, infectious diseases, gynecology, and obstetrics, and it is fairly difficult to distinguish the cause of jaundice in clinical practice, especially for general practitioners in less developed regions. With collaboration between physicians and artificial intelligence engineers, a comprehensive knowledge base relevant to jaundice was created based on demographic information, symptoms, physical signs, laboratory tests, imaging diagnosis, medical histories, and risk factors...
May 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28470830/a-critique-of-the-principle-of-respect-for-autonomy-grounded-in-african-thought
#20
Kevin G Behrens
I give an account how the principle of 'respect for autonomy' dominates the field of bioethics, and how it came to triumph over its competitors, 'respect for persons' and 'respect for free power of choice'. I argue that 'respect for autonomy' is unsatisfactory as a basic principle of bioethics because it is grounded in too individualistic a worldview, citing concerns of African theorists and other communitarians who claim that the principle fails to acknowledge the fundamental importance of understanding persons within the nexus of their communal relationships...
May 3, 2017: Developing World Bioethics
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