The InterActive Choice Aid: A new approach to supporting online consumer decision making

Interactive Choice Aid (ICA) is a decision aid, introduced in this paper, that systematically assists consumers with online purchase decisions. ICA integrates aspects from prescriptive decision theory, insights from descriptive decision research, and practical considerations; thereby combining pre-existing best practices with novel features. Instead of imposing an objectively ideal but unnatural decision procedure on the user, ICA assists the natural process of human decision-making by providing explicit support for the execution of the user's decision strategies. The application contains an innovative feature for in-depth comparisons of alternatives through which users' importance ratings are elicited interactively and in a playful way. The usability and general acceptance of the choice aid was studied; results show that ICA is a promising contribution and provides insights that may further improve its usability.

On Consumer Decision Strategies: New Approaches for Studying and Aiding Preferential Choices

This dissertation focuses on the strategies consumers use when making purchase decisions. It is organized in two main parts, one centering on descriptive and the other on applied decision making research. In the first part, a new process tracing tool called InterActive Process Tracing (IAPT) is pre- sented, which I developed to investigate the nature of consumers' decision strategies. This tool is a combination of several process tracing techniques, namely Active Information Search, Mouselab, and retrospective verbal protocol. To validate IAPT, two experiments on mobile phone purchase de- cisions were conducted where participants first repeatedly chose a mobile phone and then were asked to formalize their decision strategy so that it could be used to make choices for them. The choices made by the identified strategies correctly predicted the observed choices in 73% (Experiment 1) and 67% (Experiment 2) of the cases. Moreover, in Experiment 2, Mouselab and eye tracking were directly compared with respect to their impact on information search and strategy description. Only minor differences were found between these two methods. I conclude that IAPT is a useful research tool to identify choice strategies, and that using eye tracking technology did not increase its validity beyond that gained with Mouselab. In the second part, a prototype of a decision aid is introduced that was developed building in particular on the knowledge about consumers' decision strategies gained in Part I. This decision aid, which is called the InterActive Choice Aid (IACA), systematically assists consumers in their purchase decisions. To evaluate the prototype regarding its perceived utility, an experiment was conducted where IACA was compared to two other prototypes that were based on real-world consumer decision aids. All three prototypes differed in the number and type of tools they provided to facilitate the process of choosing, ranging from low (Amazon) to medium (Sunrise/dpreview) to high functionality (IACA). Overall, participants slightly preferred the prototype of medium functionality and this prototype was also rated best on the dimensions of understandability and ease of use. IACA was rated best regarding the two dimensions of ease of elimination and ease of comparison of alternatives. Moreover, participants choices were more in line with the normatively oriented weighted additive strategy when they used IACA than when they used the medium functionality prototype. The low functionality prototype was the least preferred overall. It is concluded that consumers can and will benefit from highly functional decision aids like IACA, but only when these systems are easy to understand and to use.

Shared decision making development in Switzerland: room for improvement!

In Switzerland there is a strong movement at a national policy level towards strengthening patient rights and patient involvement in health care decisions. Yet, there is no national programme promoting shared decision making. First decision support tools (prenatal diagnosis and screening) for the counselling process have been developed and implemented. Although Swiss doctors acknowledge that shared decision making is important, hierarchical structures and asymmetric physician-patient relationships are still prevailing. The last years have seen some promising activities regarding the training of medical students and the development of patient support programmes. Swiss direct democracy and the habit of consensual decision making and citizen involvement in general may provide a fertile ground for SDM development in the primary care setting.

Women's decision making and experience of subsequent pregnancy following stillbirth.

INTRODUCTION: This study sought to increase understanding of women's thoughts and feelings about decision making and the experience of subsequent pregnancy following stillbirth (intrauterine death after 24 weeks' gestation). METHODS: Eleven women were interviewed, 8 of whom were pregnant at the time of the interview. Modified grounded theory was used to guide the research methodology and to analyze the data. RESULTS: A model was developed to illustrate women's experiences of decision making in relation to subsequent pregnancy and of subsequent pregnancy itself. DISCUSSION: The results of the current study have significant implications for women who have experienced stillbirth and the health professionals who work with them. Based on the model, women may find it helpful to discuss their beliefs in relation to healing and health professionals to provide support with this in mind. Women and their partners may also benefit from explanations and support about the potentially conflicting emotions they may experience during this time.

How family caregivers' medical and moral assumptions influence decision making for patients in the vegetative state: a qualitative interview study.

Background Decisions on limiting life-sustaining treatment for patients in the vegetative state (VS) are emotionally and morally challenging. In Germany, doctors have to discuss, together with the legal surrogate (often a family member), whether the proposed treatment is in accordance with the patient's will. However, it is unknown whether family members of the patient in the VS actually base their decisions on the patient's wishes. Objective To examine the role of advance directives, orally expressed wishes, or the presumed will of patients in a VS for family caregivers' decisions on life-sustaining treatment. Methods and sample A qualitative interview study with 14 next of kin of patients in a VS in a long-term care setting was conducted; 13 participants were the patient's legal surrogates. Interviews were analysed according to qualitative content analysis. Results The majority of family caregivers said that they were aware of aforementioned wishes of the patient that could be applied to the VS condition, but did not base their decisions primarily on these wishes. They gave three reasons for this: (a) the expectation of clinical improvement, (b) the caregivers' definition of life-sustaining treatments and (c) the moral obligation not to harm the patient. If the patient's wishes were not known or not revealed, the caregivers interpreted a will to live into the patient's survival and non-verbal behaviour. Conclusions Whether or not prior treatment wishes of patients in a VS are respected depends on their applicability, and also on the medical assumptions and moral attitudes of the surrogates. We recommend repeated communication, support for the caregivers and advance care planning.

Effects of anxiety on visuospatial pattern discrimination and decision-making processes: what can we learn from brain dynamics ?

Detection and discrimination of visuospatial input involve at least extracting, selecting and encoding relevant information and decision-making processes allowing selecting a response. These two operations are altered, respectively, by attentional mechanisms that change discrimination capacities, and by beliefs concerning the likelihood of uncertain events. Information processing is tuned by the attentional level that acts like a filter on perception, while decision-making processes are weighed by subjective probability of risk. In addition, it has been shown that anxiety could affect the detection of unexpected events through the modification of the level of arousal. Consequently, purpose of this study concerns whether and how decision-making and brain dynamics are affected by anxiety. To investigate these questions, the performance of women with either a high (12) or a low (12) STAI-T (State-Trait Anxiety Inventory, Spielberger, 1983) was examined in a decision-making visuospatial task where subjects have to recognize a target visual pattern from non-target patterns. The target pattern was a schematic image of furniture arranged in such a way as to give the impression of a living room. Non-target patterns were created by either the compression or the dilatation of the distances between objects. Target and non-target patterns were always presented in the same configuration. Preliminary behavioral results show no group difference in reaction time. In addition, visuo-spatial abilities were analyzed trough the signal detection theory for quantifying perceptual decisions in the presence of uncertainty (Green and Swets, 1966). This theory treats detection of a stimulus as a decision-making process determined by the nature of the stimulus and cognitive factors. Astonishingly, no difference in d' (corresponding to the distance between means of the distributions) and c (corresponds to the likelihood ratio) indexes was observed. Comparison of Event-related potentials (ERP) reveals that brain dynamics differ according to anxiety. It shows differences in component latencies, particularly a delay in anxious subjects over posterior electrode sites. However, these differences are compensated during later components by shorter latencies in anxious subjects compared to non-anxious one. These inverted effects seem indicate that the absence of difference in reaction time rely on a compensation of attentional level that tunes cortical activation in anxious subjects, but they have to hammer away to maintain performance.

Impact of voting advice applications on voters's decision-making

So-called online Voting Advice Applications (VAAs) have become very popular all over Europe. Millions of voters are using them as an assistance to make up their minds for which party they should vote. Despite this popularity there are only very few studies about the impact of these tools on individual electoral choice. On the basis of the Swiss VAA smartvote we present some first findings about the question whether VAAs do have a direct impact on the actual vote of their users. In deed, we find strong evidence that Swiss voters were affected by smartvote. However, our findings are somewhat contrary to the results of previous studies from other countries. Furthermore, the quality of available data for such studies needs to be improved. Future studies should pay attention to both: the improvement of the available data, as well as the explanation of the large variance of findings between the specific European countries.

Decision making in a human population living sustainably

The Tiwi people of northern Australia have managed natural resources continuously for 6000-8000 years. Tiwi management objectives and outcomes may reflect how they gather information about the environment. We qualitatively analyzed Tiwi documents and management techniques to examine the relation between the social and physical environment of decision makers and their decision-making strategies. We hypothesized that principles of bounded rationality, namely, the use of efficient rules to navigate complex decision problems, explain how Tiwi managers use simple decision strategies (i.e., heuristics) to make robust decisions. Tiwi natural resource managers reduced complexity in decision making through a process that gathers incomplete and uncertain information to quickly guide decisions toward effective outcomes. They used management feedback to validate decisions through an information loop that resulted in long-term sustainability of environmental use. We examined the Tiwi decision-making processes relative to management of barramundi (Lates calcarifer) fisheries and contrasted their management with the state government's management of barramundi. Decisions that enhanced the status of individual people and their attainment of aspiration levels resulted in reliable resource availability for Tiwi consumers. Different decision processes adopted by the state for management of barramundi may not secure similarly sustainable outcomes.

Public particiation and the legitimacy of intergovernmental decision-making : a focus on the World Trade Organization

The legitimacy of the WTO's decision-making process has always been questioned, and many have advocated public participation mechanisms as a remedy. The present study considers the limits and potential of these mechanisms by advancing a conceptual framework, which distinguishes the four 'implementation parameters' of public participation: the goal, the object, the modalities, and the actors. It addresses the issue of legitimacy by considering to what extent, and by virtue of which legal developments, one can see implementing the democratic principle as a goal for public participation in the context of the WTO. By analyzing the institutional structure of the WTO and its different types of decisions, it then outlines how this goal should influence the object and modalities of public participation, which decision-making procedures should be opened to public participation, and how the mechanisms should be implemented in practice. Finally, it suggests speciflrc amendments to existing WTO affangements on public participation

Spatial predictions of phylogenetic diversity in conservation decision making.

Considering genetic relatedness among species has long been argued as an important step toward measuring biological diversity more accurately, rather than relying solely on species richness. Some researchers have correlated measures of phylogenetic diversity and species richness across a series of sites and suggest that values of phylogenetic diversity do not differ enough from those of species richness to justify their inclusion in conservation planning. We compared predictions of species richness and 10 measures of phylogenetic diversity by creating distribution models for 168 individual species of a species-rich plant family, the Cape Proteaceae. When we used average amounts of land set aside for conservation to compare areas selected on the basis of species richness with areas selected on the basis of phylogenetic diversity, correlations between species richness and different measures of phylogenetic diversity varied considerably. Correlations between species richness and measures that were based on the length of phylogenetic tree branches and tree shape were weaker than those that were based on tree shape alone. Elevation explained up to 31% of the segregation of species rich versus phylogenetically rich areas. Given these results, the increased availability of molecular data, and the known ecological effect of phylogenetically rich communities, consideration of phylogenetic diversity in conservation decision making may be feasible and informative.

Patients' preferences on information and involvement in decision-making for gastrointestinal surgery

Objective: The relationship between physicians and patients has undergone¦important changes, and the current emancipation of patients has led to¦a real partnership in medical decision-making. This study aimed to assess¦patients' preferences on different aspects of decision-making during treatment¦and potential complications, as well as the amount and type of preoperative¦information before visceral surgery.¦Methods: Prospective non-randomized study based on a questionnaire given¦to 253 consecutive patients scheduled for elective GI surgery.¦Results: Concerning surgical complications or treatment in the intensive care¦unit, 64% of patients wished to take actively part in any medical decisions.¦The respective figures for cardiac resuscitation and treatment limitations were¦89% and 60%. About information, 73%, 77% and 47% of patients wish¦detailed information, information on a potential ICUhospitalization and cardiac¦resuscitation, respectively. Elderly and low-educated patients were significantly¦less interested in shared medical decision-making (p = 0·003 and 0·015) and in¦information receiving (p = 0·03 and 0·05). Similarly, involvement of the family¦in decision-making was significantly less important in elderly and male patients¦(p = 0·05 and 0·03 respectively). Neither the type of operation (minor or major)¦nor the severity of disease (malignancies vs. non-malignancies) was a significant¦factor for shared decision-making, information or family involvement.¦Conclusion: The vast majority of surgical patients clearly want to get adequate¦preoperative information about their disease and the planned treatment. They¦also consider it as crucial to be involved in any kind of decision-making for¦treatment and complications. The family's role is limited to support the treating¦physicians if the patient is unable to participate in taking decisions.