827 resultados para judgment and decision making


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We study the induced aggregation operators. The analysis begins with a revision of some basic concepts such as the induced ordered weighted averaging (IOWA) operator and the induced ordered weighted geometric (IOWG) operator. We then analyze the problem of decision making with Dempster-Shafer theory of evidence. We suggest the use of induced aggregation operators in decision making with Dempster-Shafer theory. We focus on the aggregation step and examine some of its main properties, including the distinction between descending and ascending orders and different families of induced operators. Finally, we present an illustrative example in which the results obtained using different types of aggregation operators can be seen.

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We study the induced aggregation operators. The analysis begins with a revision of some basic concepts such as the induced ordered weighted averaging (IOWA) operator and the induced ordered weighted geometric (IOWG) operator. We then analyze the problem of decision making with Dempster-Shafer theory of evidence. We suggest the use of induced aggregation operators in decision making with Dempster-Shafer theory. We focus on the aggregation step and examine some of its main properties, including the distinction between descending and ascending orders and different families of induced operators. Finally, we present an illustrative example in which the results obtained using different types of aggregation operators can be seen.

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Shared decision-making approach to uncertain clinical situations such as cancer screening seems more appropriate than ever. Shared decision making can be defined as an interactive process where physician and patient share all the stages of the decision making process. For patients who wish to be implicated in the management of their health conditions, physicians might express difficulty to do so. Use of patient decision aids appears to improve such process of shared decision making. L'incertitude quant à l'efficacité de certains dépistages de cancers et du traitement en cas de test positif rend l'application du partage de la décision particulièrement appropriée. Le concept du partage de la décision peut être défini comme un processus interactif où le médecin et le patient partagent les étapes du processus de décision. Face aux patients qui désirent être impliqués dans les décisions concernant leur santé, les médecins peinent parfois à le faire. Or, l'utilisation d'outils d'aide à la décision est un moyen efficace de favoriser ce partage de l'information et, si souhaité par le patient, de la décision.

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Discriminating complex sounds relies on multiple stages of differential brain activity. The specific roles of these stages and their links to perception were the focus of the present study. We presented 250ms duration sounds of living and man-made objects while recording 160-channel electroencephalography (EEG). Subjects categorized each sound as that of a living, man-made or unknown item. We tested whether/when the brain discriminates between sound categories even when not transpiring behaviorally. We applied a single-trial classifier that identified voltage topographies and latencies at which brain responses are most discriminative. For sounds that the subjects could not categorize, we could successfully decode the semantic category based on differences in voltage topographies during the 116-174ms post-stimulus period. Sounds that were correctly categorized as that of a living or man-made item by the same subjects exhibited two periods of differences in voltage topographies at the single-trial level. Subjects exhibited differential activity before the sound ended (starting at 112ms) and on a separate period at ~270ms post-stimulus onset. Because each of these periods could be used to reliably decode semantic categories, we interpreted the first as being related to an implicit tuning for sound representations and the second as being linked to perceptual decision-making processes. Collectively, our results show that the brain discriminates environmental sounds during early stages and independently of behavioral proficiency and that explicit sound categorization requires a subsequent processing stage.

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This paper applies probability and decision theory in the graphical interface of an influence diagram to study the formal requirements of rationality which justify the individualization of a person found through a database search. The decision-theoretic part of the analysis studies the parameters that a rational decision maker would use to individualize the selected person. The modeling part (in the form of an influence diagram) clarifies the relationships between this decision and the ingredients that make up the database search problem, i.e., the results of the database search and the different pairs of propositions describing whether an individual is at the source of the crime stain. These analyses evaluate the desirability associated with the decision of 'individualizing' (and 'not individualizing'). They point out that this decision is a function of (i) the probability that the individual in question is, in fact, at the source of the crime stain (i.e., the state of nature), and (ii) the decision maker's preferences among the possible consequences of the decision (i.e., the decision maker's loss function). We discuss the relevance and argumentative implications of these insights with respect to recent comments in specialized literature, which suggest points of view that are opposed to the results of our study.

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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.

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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.

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We assessed decision-making capacity and emotional reactivity in 20 patients with multiple sclerosis (MS) and in 16 healthy subjects using the Gambling Task (GT), a model of real-life decision making, and the skin conductance response (SCR). Demographic, neurological, affective, and cognitive parameters were analyzed in MS patients for their effect on decision-making performance. MS patients persisted longer (slope, -3.6%) than the comparison group (slope, -6.4%) in making disadvantageous choices as the GT progressed (p < 0.001), suggesting significant slower learning in MS. Patients with higher Expanded Disability Status Scale scores (EDSS >2.0) showed a different pattern of impairment in the learning process compared with patients with lower functional impairment (EDSS </=2.0). This slower learning was associated with impaired emotional reactivity (anticipatory SCR 3.9 vs 6.1 microSiemens [microS] for patients vs the comparison group, p < 0.0001; post-choice SCR 3.9 vs 6.2 microS, p < 0.0001), but not with executive dysfunction. Impaired emotional dimensions of behavior (assessed using the Dysexecutive Questionnaire, p < 0.002) also correlated with slower learning. Given the considerable consequences that impaired decision making can have on daily life, we suggest that this factor may contribute to handicap and altered quality of life secondary to MS and is dependent on emotional experience. Ann Neurol 2004.

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OBJECTIVE: The overall aim of this study was to discover how chaplains assess their role within ethically complex end-of-life decisions. METHODS: A questionnaire was sent to 256 chaplains working for German health care institutions. Questions about their role and satisfaction as well as demographic data were collected, which included information about the chaplains' integration within multi-professional teams. RESULTS: The response rate was 59%, 141 questionnaires were analyzed. Respondents reported being confronted with decisions concerning the limitation of life-sustaining treatment on average two to three times per month. Nearly 74% were satisfied with the decisions made within these situations. However, only 48% were satisfied with the communication process. Whenever chaplains were integrated within a multi-professional team there was a significantly higher satisfaction with both: the decisions made (p = 0.000) and the communication process (p = 0.000). Significance of the results: Although the results of this study show a relatively high satisfaction among surveyed chaplains with regard to the outcome of decisions, one of the major problems seems to reside in the communication process. A clear integration of chaplains within multi-professional teams (such as palliative care teams) appears to increase the satisfaction with the communication in ethically critical situations.

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ABSTRACT: BACKGROUND: Decision curve analysis has been introduced as a method to evaluate prediction models in terms of their clinical consequences if used for a binary classification of subjects into a group who should and into a group who should not be treated. The key concept for this type of evaluation is the "net benefit", a concept borrowed from utility theory. METHODS: We recall the foundations of decision curve analysis and discuss some new aspects. First, we stress the formal distinction between the net benefit for the treated and for the untreated and define the concept of the "overall net benefit". Next, we revisit the important distinction between the concept of accuracy, as typically assessed using the Youden index and a receiver operating characteristic (ROC) analysis, and the concept of utility of a prediction model, as assessed using decision curve analysis. Finally, we provide an explicit implementation of decision curve analysis to be applied in the context of case-control studies. RESULTS: We show that the overall net benefit, which combines the net benefit for the treated and the untreated, is a natural alternative to the benefit achieved by a model, being invariant with respect to the coding of the outcome, and conveying a more comprehensive picture of the situation. Further, within the framework of decision curve analysis, we illustrate the important difference between the accuracy and the utility of a model, demonstrating how poor an accurate model may be in terms of its net benefit. Eventually, we expose that the application of decision curve analysis to case-control studies, where an accurate estimate of the true prevalence of a disease cannot be obtained from the data, is achieved with a few modifications to the original calculation procedure. CONCLUSIONS: We present several interrelated extensions to decision curve analysis that will both facilitate its interpretation and broaden its potential area of application.

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ABSTRACT: BACKGROUND: Shared decision-making is not widely implemented in healthcare. We aimed to set a research agenda about promoting shared decision-making through continuing professional development. METHODS: Thirty-six participants met for two days. RESULTS: Participants suggested ways to improve an environmental scan that had inventoried 53 shared decision-making training programs from 14 countries. Their proposed research agenda included reaching an international consensus on shared decision-making competencies and creating a framework for accrediting continuing professional development initiatives in shared decision-making. CONCLUSIONS: Variability in shared decision-making training programs showcases the need for quality assurance frameworks.

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A new method for decision making that uses the ordered weighted averaging (OWA) operator in the aggregation of the information is presented. It is used a concept that it is known in the literature as the index of maximum and minimum level (IMAM). This index is based on distance measures and other techniques that are useful for decision making. By using the OWA operator in the IMAM, we form a new aggregation operator that we call the ordered weighted averaging index of maximum and minimum level (OWAIMAM) operator. The main advantage is that it provides a parameterized family of aggregation operators between the minimum and the maximum and a wide range of special cases. Then, the decision maker may take decisions according to his degree of optimism and considering ideals in the decision process. A further extension of this approach is presented by using hybrid averages and Choquet integrals. We also develop an application of the new approach in a multi-person decision-making problem regarding the selection of strategies.

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Most local agencies in Iowa currently make their pavement treatment decisions based on their limited experience due primarily to lack of a systematic decision-making framework and a decision-aid tool. The lack of objective condition assessment data of agency pavements also contributes to this problem. This study developed a systematic pavement treatment selection framework for local agencies to assist them in selecting the most appropriate treatment and to help justify their maintenance and rehabilitation decisions. The framework is based on an extensive literature review of the various pavement treatment techniques in terms of their technical applicability and limitations, meaningful practices of neighboring states, and the results of a survey of local agencies. The treatment selection framework involves three different steps: pavement condition assessment, selection of technically feasible treatments using decision trees, and selection of the most appropriate treatment considering the return-on-investment (ROI) and other non-economic factors. An Excel-based spreadsheet tool that automates the treatment selection framework was also developed, along with a standalone user guide for the tool. The Pavement Treatment Selection Tool (PTST) for Local Agencies allows users to enter the severity and extent levels of existing distresses and then, recommends a set of technically feasible treatments. The tool also evaluates the ROI of each feasible treatment and, if necessary, it can also evaluate the non-economic value of each treatment option to help determine the most appropriate treatment for the pavement. It is expected that the framework and tool will help local agencies improve their pavement asset management practices significantly and make better economic and defensible decisions on pavement treatment selection.