Judgments Of Appropriateness Research Articles

Caregivers’ Social Conformity Predicts Their Judgments of Toddlers’ Moral Agency

ABSTRACT Research Findings: Social constructivist theories have proposed that caregivers’ perceptions of children as morally responsible agents are an important factor in children’s moral development. However, there is substantial variance in caregivers’ ascriptions of moral agency to young children. The present study examined caregiver social conformity and reflective functioning as factors potentially explaining these interindividual differences. We presented caregivers (N = 232) with videos of young children’s (age: 10 months, 30 months) moral transgressions (kicking, hitting, hair pulling) and subsequent reactions to these transgressions (moral reaction – holding child accountable; non-moral reaction – not holding child accountable). Caregivers rated the appropriateness of both types of reactions. Further, we assessed caregivers’ social conformist attitudes and their reflective functioning abilities. Results showed that caregivers judged moral reactions to be more appropriate and non-moral reactions to be less appropriate with 30 months as compared to 10 months. Increasing caregiver social conformity related to increasing appropriateness judgments of moral reactions. In addition, increasing caregiver reflective functioning abilities related to increasing appropriateness judgments of non-moral reactions. Practice or Policy: These findings point to reflective functioning as potential supporting factor and high social conformity as potential risk factor for caregivers’ and teachers’ flexible and sensitive responding in morally relevant interactions in early childhood.

Factors influencing clinician decision-making about POLST use with nursing facility residents: A qualitative study.

National POLST guidance indicates POLST is intended for individuals at risk of life-threatening clinical events due to serious illness. Even though this patient population includes many, but not all, nursing facility residents, there is evidence that POLST is used broadly in this setting. This study aimed to identify clinician perspectives regarding factors that influence their decision-making about whether to use POLST with nursing facility residents and to distinguish between inappropriate and appropriate use. We conducted a descriptive qualitative study to explore the experience of nursing facility clinicians using POLST with residents and deciding who is appropriate and inappropriate for POLST. Participants were purposively sampled from multiple states using POLST. Interviews were audio-recorded and professionally transcribed. We used rapid qualitative analysis to code data and identify themes. We interviewed 28 clinicians from 14 states about how they decided whether to use POLST with nursing facility residents and to distinguish between inappropriate and appropriate use. Four themes emerged as factors driving clinician-decision-making POLST use: (1) belief that "everyone is appropriate"; (2) resident and family preferences; (3) resident health status; and (4) policies requiring POLST [Correction added after first online publication on 07 Feb 2024. The word "For" has been changed to "Four" in the previous sentence.]. In most cases, participants cited resident and family preferences for treatment limitations as well as prognosis and clinical assessments in determining when POLST use was appropriate. Factors influencing potentially inappropriate POLST use included nursing facility policies requiring POLST completion that preempted clinical judgments of appropriateness. Findings highlight the disconnect between National POLST guidance and current use of POLST in nursing facilities. Policies requiring POLST use in nursing facilities and the belief that "everyone is appropriate" may impede clinician autonomy and lead to potentially inappropriate POLST use. Given varying approaches to POLST use in nursing facilities, there is a need to refocus attention on the intended population for POLST.

Concept-Based Language Instruction Effects for Second and Heritage Language Learners: The Case of Korean Speech Level

Abstract Concept-Based Language Instruction (C-BLI) has been shown to be an effective approach for teaching second language (L2) learners complex grammatical features. However, it is unclear whether C-BLI is equally effective for heritage language (HL) learners. 30 L2 and 27 HL learners of Korean completed a series of tasks designed in a pre-intervention-post-test model that focused on speech level through verbal morphology of honorific second-person address forms. The positive change seen in self-reported understanding of speech level from pre- to post-test in both groups was not significantly different, indicating equal self-reported gains in understanding, regardless of group. However, the qualitative analysis showed differences in the ways that L2 and HL learners verbalized their understanding and appropriateness judgments of speech level. The findings provide evidence that HL learners benefit equally in overall growth, although slightly differently in how they develop, from C-BLI.

Men’s Facial Hair Preferences Reflect Facial Hair Impression Management Functions Across Contexts and Men Know It

Men with distinct facial hair are perceived as more aggressive, dominant, older, and more formidable, mostly by other men. However, despite considerable interest in the social perception of beardedness, only a few studies have explored men’s preferences toward facial hair. We investigated men’s preferences toward facial hair and whether their judgments of facial hair appropriateness in social situations depended on their actual beardedness and the type of social interaction (N = 509; age: M = 29.35, SD = 7.24). Men preferred having more facial hair, particularly when they have a heavy stubble or a full beard. Men preferred more facial hair for themselves compared to other men, suggesting that men’s preferences for facial hair could be based on the frequency-dependent value of a display, namely more value assigned to rarer attributes. Men’s judgments of the appropriateness of facial hair were sensitive to social situations for displaying facial hair as well. More facial hair was considered more appropriate for informal situations, especially with another man. Social norms associated with formal interaction could, therefore, limit the impression management functions of beards in intrasexual competition.

Culturally constituted universals: Evidential basis of belief matters.

Differences in the sequence with which children pass the tasks in Wellman and Liu's (2004) theory of mind (ToM) battery is increasingly bringing into question the universal and cultural specifics of children's developing understanding of others' minds. Children from China, Iran, and Turkey pass the knowledge access (KA) task of the battery earlier than they pass the diverse beliefs (DB) task (e.g., Selcuk etal., 2018). This pattern is the reverse of what has been documented with children from Australia and the US (e.g., Peterson etal., 2005). This paper presents three studies with Turkish samples that explore the possible reasons for developmental sequence and performance differences in the ToM battery. Study 1 investigated Turkish-speaking adults' judgments of appropriateness for different epistemic verbs as used in the DB and false belief (FB) tasks. Study 2 investigated whether adults' performance (i.e., accuracy, reaction time) on FB tasks were affected by culturally preferred uses of these verbs. Collectively these studies showed that adults found different epistemic language ("guess," "think," and the Turkish-specific "falsely think") to be appropriate for different belief-based tasks. However, there was no difference in adults' performance based on epistemic language. In Study 3, Turkish-speaking preschoolers' performance in belief-related tasks based on variations in epistemic language and epistemic features (i.e., presence of evidence) was investigated. Among five modifications, Turkish children benefited only from a modification that involved the manipulation of the epistemological basis for ambiguous beliefs (i.e., visual evidence for belief). RESEARCH HIGHLIGHTS: Turkish adults find different epistemic language ("guess," "think," and the Turkish-specific "falsely-think") to be appropriate for different belief-based tasks (diverse and false belief tasks). Turkish adults' performance on false belief (FB) tasks is not affected by epistemic language. Turkish children perform better in diverse beliefs (DB) task if an epistemological basis for ambiguous beliefs (i.e., visual evidence for either belief) is provided.

Seen and not seen: How people judge ambiguous behavior during the COVID-19 pandemic.

The online version contains supplementary material available at 10.1007/s11166-022-09396-7.

ODP637 Clinical Appropriateness of Telehealth: A Qualitative Study of Endocrinologists’ Perspectives

Abstract Background The increase in outpatient endocrinology care delivered by synchronous video telehealth during the COVID-19 pandemic is likely to persist post-pandemic. There is little data to guide endocrinologists’ judgments of clinical appropriateness (safety and effectiveness) for telehealth. We sought to examine how endocrinologists determine clinical appropriateness for telehealth and identify strategies to navigate barriers to its safe and effective use. Methods We conducted qualitative, semi-structured interviews with 26 purposively selected US endocrinologists to explore how they determined which outpatient situations were safe and effective for synchronous video telehealth. We used a directed content analysis to identify perceptions of which patients and situations worked best with telehealth, and describe adaptations made to accommodate telehealth visits. Results Endocrinologists’ judgments about which patient visits were appropriate for telehealth were influenced by four factors: clinical considerations, non-clinical patient factors, purpose and timing of the visit, and clinician willingness to adapt to remote formats. These factors were weighed differently according to participants’ risk tolerances, values related to the physical exam and face-to-face interactions, and assumptions about patient capabilities and preferences. (1) Clinical considerations included medical complexity, availability of lab data, and perceived need for in-person physical exams. Participants agreed on appropriateness of uncomplicated thyroid disease for telehealth but disagreed about the need for in-person diabetic foot exams. (2) Non-clinical patient factors included patient age, tech literacy, and travel burden. Some participants believed older patients struggled with telehealth; others believed the opposite. (3) Purpose and timing of the visit included discussions of initial vs. follow-up visits, time since the last in-person visit, and the patient-clinician relationship. An established face-to-face patient-clinician relationship ameliorated participants’ concerns about telehealth related to communication, patient buy-in to care, and patient visit preparedness. (4) To increase telehealth safety and effectiveness, some participants adapted their practices to include teaching patients how to conduct physical exams independently or with coaching from the clinician, obtaining patient health data electronically, having patients complete required testing during visits to other clinicians, and planning for yearly face-to-face visits. Conclusions Judgments about appropriateness of telehealth for similar clinical situations were heavily subjective, and driven by individual values, perceptions of risk, and willingness to adapt established practice. This wide variation in judgments risks contributing to clinically inappropriate variation in the use of telehealth that, in turn, threatens equitable access to endocrinology care. Evidence-based guidelines on appropriate use of telehealth are needed and should be grounded in data on best practices and outcomes of telehealth vs. face-to-face care. In the absence of guidelines, consensus statements can provide interim guidance to endocrinologists on determining clinical appropriateness of telehealth so clinicians might feel comfortable honoring patient requests for telehealth. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 1:18 p.m. - 1:23 p.m.

YouTube Influencers: A New Defense against Childhood Obesity?

ABSTRACT Childhood obesity is a serious public health issue. While advertising on children’s television has been established as a contributing factor to poor dietary habits, less is known regarding the influence of food promotions in social media. Thus, this 2-part exploratory study examined the content and effects of food promotions in YouTube. Our data revealed that fruits and vegetables are more likely to be promoted on this newer platform than in television advertising. Study 2 then revealed that exposure to a promotion for healthy food was associated with more positive evaluations of the food. However, neither judgments of appropriateness nor persuasion knowledge activation were significantly associated with evaluations of the healthy food. Thus, our findings did not support the use of the persuasion knowledge model in examining covert advertising of healthy foods to children and instead provides support for the mere exposure effect.

Clinical Appropriateness of Telehealth: A Qualitative Study of Endocrinologists' Perspectives.

Outpatient endocrinology care delivered by telehealth is likely to remain common after the pandemic. There are few data to guide endocrinologists' judgments of clinical appropriateness (safety and effectiveness) for telehealth by synchronous video. We examined how, in the absence of guidelines, endocrinologists determine clinical appropriateness for telehealth, and we identified their strategies to navigate barriers to safe and effective use. We conducted qualitative, semi-structuredinterviews with 26 purposively selected US endocrinologists. We used a directed content analysis to characterize participant perceptions of which patients and situations were clinically appropriate for telehealth and to identify adaptations they made to accommodate telehealth visits. Endocrinologists' perspectives about appropriateness for telehealth were influenced by clinical considerations, nonclinical patient factors, and the type and timing of the visit. These factors were weighed differently across individual participants according to their risk tolerance, values related to the physical examination and patient relationships, and impressions of patient capabilities and preferences. Some participants made practice adaptations that increased their comfort offering telehealth to a wider swath of patients. Endocrinologists' judgments about clinical appropriateness of telehealth for different patient situations varied widely across participants. The risk of such divergent approaches to determining appropriateness is unintended and clinically unwarranted variation in use of telehealth, compromising quality of care. Expert consensus is needed to guide endocrinologists now, along with studies to anchor future evidence-based guidelines for determining clinical appropriateness of telehealth in endocrinology.

APPROPRIATENESS OF CARDIOVASCULAR PREVENTIVE MEDICATION IN OLDER PEOPLE: A QUALITATIVE RAM-STUDY

Objective: In clinical practice and science, there is debate for which older adults the benefits of cardiovascular preventive medications (CPM) still outweigh the risks in older age. Therefore, we aimed to assess how various clinical characteristics influence the judgement of appropriateness of CPM (i.a. antihypertensive treatment) in older adults. Design and method: With the RAND/ University of California at Los Angeles appropriateness Method (RAM) the appropriateness of CPM for adults = > 75 year was assessed with regard to clinical characteristics (cardiovascular history, complexity of health problems, age, side-effects and life expectancy). A multi-disciplinary panel (n = 14 panelists) received an up to date overview of the literature, and judged the appropriateness of starting and stopping cholesterol lowering medication, antihypertensives, and platelet aggregation inhibitors, on 1- to 9 point Likert scales (1 = extremely inappropriate; 9 = extremely appropriate), for various clinical scenarios. There were two rating rounds, with one face-to-face discussion in between. The appropriateness judgments were based on the median panel rating and level of disagreement Results: The panelists emphasized the importance of the individual context of the patient for appropriateness of CPM. They judged that in general, a history of atherosclerotic cardiovascular disease (ASCVD) strongly adds to the appropriateness of CPM, while increasing complexity of health problems, presence of hindering or severe side-effects, and life expectancy < 1 year all contribute to the inappropriateness of CPM. Age had only minor influence on the appropriateness judgments. The appropriateness judgments were different for the three types of CPM. The literature, time-to-benefit, remaining life-expectancy, number needed to treat, and quality of life, were major themes in the panel discussions. The considerations to stop CPM were different from the considerations not to start CPM. Conclusions: Next to the patients’ individual context, which was considered decisive in the final decision to start or stop CPM, there were general trends of how clinical characteristics influenced the appropriateness, according to the multi-disciplinary panel. The decision to stop, and not start CPM, appeared to be two distinct concepts. Results of this study may be used in efforts to support clinical decision making about CPM in older adults.

Assessment of the appropriateness of cardiovascular preventive medication in older people: using the RAND/UCLA Appropriateness Method.

BackgroundIn clinical practice and science, there is debate for which older adults the benefits of cardiovascular preventive medications (CPM) still outweigh the risks in older age. Therefore, we aimed to assess how various clinical characteristics influence the judgement of appropriateness of CPM in older adults.MethodWe assessed the appropriateness of CPM for adults ≥75 years with regard to clinical characteristics (cardiovascular variables, complexity of health problems, age, side effects and life expectancy) using the RAND/ University of California at Los Angeles Appropriateness Method. A multidisciplinary panel, including 11 medical professionals and 3 older representatives of the target population, received an up-to-date overview of the literature. Using 9-point Likert scales (1 = extremely inappropriate; 9 = extremely appropriate), they assessed the appropriateness of starting and stopping cholesterol lowering medication, antihypertensives and platelet aggregation inhibitors, for various theoretical clinical scenarios. There were two rating rounds, with one face-to-face discussion in between. The overall appropriateness judgments were based on the median panel ratings of the second round and level of disagreement.ResultsThe panelists emphasized the importance of the individual context of the patient for appropriateness of CPM. They judged that in general, a history of atherosclerotic cardiovascular disease strongly adds to the appropriateness of CPM, while increasing complexity of health problems, presence of hindering or severe side effects, and life expectancy < 1 year all contribute to the inappropriateness of CPM. Age had only minor influence on the appropriateness judgments. The appropriateness judgments were different for the three types of CPM. The literature, time-to-benefit, remaining life expectancy, number needed to treat, and quality of life, were major themes in the panel discussions. The considerations to stop CPM were different from the considerations not to start CPM.ConclusionNext to the patients’ individual context, which was considered decisive in the final decision to start or stop CPM, there were general trends of how clinical characteristics influenced the appropriateness, according to the multidisciplinary panel. The decision to stop, and not start CPM, appeared to be two distinct concepts. Results of this study may be used in efforts to support clinical decision making about CPM in older adults.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12877-022-03082-8.

Social appropriateness perception of dynamic interactions

The current study explored the judgement of communicative appropriateness while processing a dialogue between two individuals. All stimuli were presented as audio-visual as well as audio-only vignettes and 24 young adults reported their social impression (appropriateness) of literal, blunt, sarcastic, and teasing statements. On average, teasing statements were rated as more appropriate when processing audiovisual statements compared to the audio-only version of a stimuli, while sarcastic statements were judged as less appropriate with additional visual information. These results indicate a rejection of the Tinge Hypothesis for audio-visual vignettes while confirming it for the reduced, audio-only counterparts. We also analyzed time-frequency EEG data of four frequency bands that have been related to language processing: alpha, beta, theta and low gamma. We found desynchronization in the alpha band literal versus nonliteral items, confirming the assumption that the alpha band reflects stimulus complexity. The analysis also revealed a power increase in the theta, beta and low gamma band, especially when comparing blunt and nonliteral statements in the audio-only condition. The time-frequency results corroborate the prominent role of the alpha and theta bands in language processing and offer new insights into the neural correlates of communicative appropriateness and social aspects of speech perception.

There Is Crying in Football: Reactions to an Athlete’s Weeping

The current study hypothesized that the status of a professional American football player would influence how observers perceived his weeping after losing a game. It was also predicted that the importance of the game (the NFL Super Bowl vs. a regular season game) would influence perceptions of his tears. Two hundred twenty-two adults, recruited nationally, read 1 of 4 vignettes in a 2 (player status: high- or low-performing) x 2 (game status: Super Bowl or regular season game) between-subjects design. The vignette describes a close game that is ultimately lost by the target’s team, with the target weeping at its conclusion. Participants (N = 213) rated his postgame weeping as more appropriate and justifiable, using an allowance composite score, as it was found that there was a significant difference for both player, F(2, 196) = 10.13, p &lt; .001; Wilks’ Lambda= .91; η2 = .09, and game, F(2, 196) = 4.27, p = .02; Wilks’ Lambda = .96; η2 = .04, status. There were also significant differences found in analyses for player status on perceived emotional stability, F(1, 202) = 20.22, p &lt; .001, η2 = .09, and game status on perceived competency, F(1, 200) = 173.63, p &lt; .001, η2 = .47. The ramifications of these findings, that situational details and personal attributes of the target influence observers’ judgments of emotional appropriateness, are discussed.

EVALUATING FRAMEWORK OF A CALL MATERIAL TO IMPROVE COMMUNICATIVE COMPETENCE IN ENGLISH

The computer-assisted language learning (CALL) assessment needs to be evaluated as other technical materials in compliance with the same system norms. The scope and purpose of the research are to benefit the selection of different CALL materials. According to Levy and Stockwell, there are three types of CALL material evaluation: (1) Checklists (2) Methodological framework (3) SLA based language learning approaches. The present study process may refer to three phases such as examining, determining and analyzing. A framework is proposed which includes a common evaluation workflow model for designing and performing CALL evaluations carried out by evaluators in the formal evaluation area. A framework of assessments is proposed. The following framework is used for evaluating a CALL material: 1. Technical preview 2. Operational description 3. Teacher fit 4. Learner fit 5. Implementation schemes and 6. Appropriateness judgments

Pharmacist-Led Intervention on the Inappropriate Use of Stress Ulcer Prophylaxis Pharmacotherapy in Intensive Care Units: A Systematic review.

Background: Pharmacist’s direct intervention or participation in multidisciplinary management teams can improve the clinical outcome and quality of life of patients. We aimed to determine the effectiveness of pharmacist-led interventions on the inappropriate use of stress ulcer prophylaxis (SUP) pharmacotherapy in intensive care units (ICUs). Methods: A systematic review was performed for relevant studies using searched PubMed, EMBASE (Ovid), the Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), and four Chinese databases from the establishment of databases to 12 March 2020. We conducted a descriptive analysis of participants, the intervention content and delivery, and the effects on inappropriate medication rates. Results: From 529 records, 8 studies from 9 articles were included in the systematic review. The time of appropriateness judgment and the criteria of “appropriate” varied from included studies. Pharmacist interventions mainly included clarifying indications for SUP pharmacotherapy, education and awareness campaign, reviewed patients on SUP pharmacotherapy during rounds, and adjustments of drug use. Five (62.5%) studies found a significant intervention effect during hospitalization, while 2 (25%) studies at ICU transfer and 2 (25%) studies at hospital discharge. 4 (50%) studies identified the complications related to SUP pharmacotherapy and found no significant difference. 4 (50%) studies declared the pharmacist-led interventions were associated with cost savings. Conclusion: Pharmacist-led intervention is associated with a decrease in inappropriate use of SUP pharmacotherapy during hospitalization, at ICU transferred and hospital discharged, and a lot of medical cost savings. Further research is needed to determine whether pharmacist-led intervention is cost-effective.

Development and Underlying Structure of a Second-Generation Appropriateness Classification System for Total Knee Arthroplasty.

Evidence supports the validity of total knee arthroplasty (TKA) appropriateness classification based on the RAND Corporation and University of California Los Angeles system.The system, however, is ~2 decades old, and the science and clinical application of TKA has changed dramatically. We undertook this study to describe the methods used to develop a second-generation system and to examine the structure of the system to determine the extent to which each of the indication criteria informed appropriateness. Multivariable multinomial regression analyses determined the extent to which each of the 8 individually analyzed indication criteria informed appropriateness judgments. Classification tree analysis illustrates how the indication criteria, in combination, led to judgments of appropriate, inappropriate, or uncertain. An expert panel selected 8 indication criteria (i.e., age, knee pain, function, radiographic osteoarthritis severity, osteoarthritis location, psychological factors, pain catastrophizing, and comorbidities). A total of 1,008 clinical scenarios were written, based on the criteria. Regression analyses indicated that age, knee pain, function, and radiographic severity dominated prediction of appropriateness, while the other criteria played a smaller role. Classification tree analysis confirmed the regression findings. Our second-generation classification system, which incorporates contemporary indicators of TKA prognosis and risk, demonstrated preliminary evidence for utility in clinical practice.

Autonomous vehicles: How perspective-taking accessibility alters moral judgments and consumer purchasing behavior

In preparation for unavoidable collisions, autonomous vehicle (AV) manufacturers could program their cars with utilitarian ethical algorithms that maximize the number of lives saved during a crash. However, recent research employing hypothetical AV crash scenarios reveals that people are not willing to purchase a utilitarian AV despite judging them to be morally appropriate (Bonnefon, Shariff, & Rahwan, 2016). This important result, indicating evidence for a social dilemma, has not yet been psychologically explored by behavioral scientists. In order to address the psychological underpinnings of this phenomenon, we developed and tested a novel theoretical proposal – perspective-taking accessibility (PT accessibility). Accordingly, we established that providing participants with access to both situational perspectives (AV buyers can be passengers or pedestrians) in crash scenarios, eliminated the behavioral inconsistency between their utilitarian judgments of moral appropriateness and non-utilitarian purchasing behavior. Moreover, our full PT accessibility induced respondents' utilitarian prosocial judgments and purchasing behavior (Experiments 1a and 1b) and consistent utilitarian preferences across judgment tasks (Experiment 2). Crucially, with full PT accessibility, participants' utilitarian purchasing behavior as well as their willingness to buy and ride utilitarian AVs were informed by their utilitarian moral judgments. Full PT accessibility provides the participants with even odds of being a pedestrian or passenger in crash scenarios, and thus impartiality. It could be argued that full PT accessibility is a new type of ‘veil of ignorance’, which is not based on purposely induced self-interest and uneven risk options (as in Huang, Greene, & Bazerman, 2019), but rather is based on even odds of being a passenger or pedestrian, and therefore with even 50/50 chance to die/live as passenger or pedestrian. Under these circumstances one can measure utilitarian preferences.

Development of safety and usability guideline for clinical information system.

Clinical information systems (CISs) that do not consider usability and safety could lead to harmful events. Therefore, we aimed to develop a safety and usability guideline of CISs that is comprehensive for both users and developers. And the guideline was categorized to apply actual clinical workflow and work environment.The guideline components were extracted through a systematic review of the articles published between 2000 and 2015, and existing CIS safety and/or usability design guidelines. The guideline components were categorized according to clinical workflow and types of user interface (UI). The contents of the guideline were evaluated and validated by experts with 3 specialties: medical informatics, patient safety, and human engineering.Total 1276 guideline components were extracted through article and guideline review. Of these, 464 guideline components were categorized according to 5 divisions of the clinical workflow: “Data identification and selection,” “Document entry,” “Order entry,” “Clinical decision support and alert,” and “Management”. While 521 guideline components were categorized according to 4 divisions of UI: UIs related to information process steps, “Perception,” “Recognition,” “Control,” and “Feedback”. We developed a guideline draft with 219 detailed guidance for clinical task and 70 for UI. Overall appropriateness and comprehensiveness were proven to achieve more than 90% in experts’ survey. However, there were significant differences among the groups of specialties in the judgment of appropriateness (P < .001) and comprehensiveness (P = .038).We developed and verified a safety and usability guideline for CIS that qualifies the requirements of both clinical workflows and usability issues. The developed guideline can be a practical tool to enhance the usability and safety of CISs. Further validation is required by applying the guideline for designing the actual CIS.

재판상 공유물분할 - 전면적 가액보상방법에서 상당성 판단을 중심으로 -

공유물분할의 한 방법인 소위 전면적 가액보상에 의한 분할방법이 인정되게 된 경위를 일본과 우리의 판례와 학설의 동향을 통해 살펴보았다. 그리고 전면적 가액보상에 의한 분할의 인정을 위한 첫 번째 요건인 상당성 판단의 구조를 일본의 재판례 분석을 통해 다음과 같은 사항을 확인하였고, 이를 기초로 우리 판례에서의 상당성 판단에 적용해 보았다.<BR> 첫째, 상당성 판단을 할 때 가장 중요한 고려사정은 분할방법에 대한 각 공유자의 희망 및 그 합리성이라고 할 수 있다. 구체적으로는 공유물의 성질이나 형상과 공유물의 이용상황과 같은 객관적인 사정을 기초로 각 공유자의 희망(특히 현물의 취득)이 합리적인지를 판단하고, 각 공유자의 희망이 모두 합리적일 때는 각 공유자가 공유물을 취득할 필요성을 비교ㆍ검토해서 어느 공유자에게 현물의 취득을 인정하는 것이 상당한지를 판단하여야 한다.<BR> 둘째, 공유물의 성질이나 형상은 분할방법에 대한 공유자의 희망 및 그 합리성, 특정 공유자가 현물을 취득하는 것의 상당성 판단 뿐만 아니라 그 전제가 되는 현물분할의 불능 또는 가능성의 판단에도 고려되고 있다.<BR> 셋째, 공유관계의 발생원인은 일반론적인 관점에서 상당성의 판단에 고려하는데 그치고 있으나, 공유물의 분할을 희망하는 자의 지분취득 경위도 공유자의 희망 및 그 합리성을 판단하는 기초사정이 될 수 있다.<BR> 넷째, 공유자 수 및 지분의 비율은 다수의 지분을 가진 공유자가 공유물의 단독 취득을 희망할 때 그 취득의 필요성을 뒷받침하는 사정으로서 상당성 인정에서 긍정적으로 고려될 수 있다. 그러나 이는 보조적 의미를 가지는데 그치고 있다.

Systematic review and narrative review lead experts to different cancer trial predictions: a randomized trial

ObjectivesThe objective of the study was to assess the impact of narrative review (NR) vs. systematic review (SR) on expert assessments of a clinical trial. Study Design and SettingExperts in colon and rectal surgery were randomized to read an NR or SR for an ongoing clinical trial involving surgery for colorectal cancer. Experts from the United States and Canada completed online or paper surveys between December 2018 and June 2019. After reading the NR or SR, experts predicted the trial's outcome and evaluated the trial under a hypothetical ethical review. ResultsExperts who read the NR (n = 55) compared with those who read the SR (n = 56) were more likely to predict a higher absolute risk reduction, 58% vs. 33%, P = 0.018, mean predictions 10.6% vs. 6.6%, mean difference 4.0% [95% confidence interval: 0.3%, 7.8%]. Experts who read the NR were more likely to evaluate the trial more favorably under a hypothetical ethical review, 48% vs. 26%, P = 0.039, 20.0% vs. 8.9% “strongly in favor” of trial being pursued. Conclusion:An NR and an SR for the same trial led to different judgments of likely outcomes and ethical appropriateness. These differences point to a potential source of unaddressed bias in ethical review.