Decision Satisfaction Research Articles

Impact of personality on the decision process and on satisfaction rates in pseudophakic presbyopic correction.

To explore the impact of personality on the decision process and satisfaction rates in pseudophakic presbyopic correction. Department of Ophthalmology, University Hospital of Alexandroupolis, Greece. Prospective, comparative study. A consistent consultation was conducted in patients with cataract that explained the benefits and the drawbacks of bilateral trifocal correction, which was offered at no extra cost. In all participants, personality was evaluated by The Traits Personality Questionnaire 5. Data modeling with decision trees and multiple regression analysis identified the contributions of personality traits to the decision process and postoperative satisfaction. Of 120 participants (60 men and 60 women), 81 (67.5%, 24 men, 57 women) selected premium correction. In men, low neuroticism and high extraversion were the primary personality contributors for selecting premium surgery. In women, all personality traits contributed to the selection process. Women were more demanding in the expected postoperative distant acuity than men (0.1 vs 0.2 logMAR) to present high satisfaction. For both men and women, openness to experience, conscientiousness, and extraversion are primary contributors for optimal satisfaction rates. Men and women demonstrate differences in the selection process for premium pseudophakic surgery and differences in the expected postoperative visual acuity. It seems that the personality of the patient plays a significant role in the perceived outcome after premium surgery.

Women's Breast Cancer Screening Confidence by Screening Modality and Breast Density: A Breast Cancer Surveillance Consortium Survey Study.

Objective: Little is known about women's confidence in their breast cancer screening. We sought to characterize breast cancer screening confidence by imaging modality and clinically assessed breast density. Materials and Methods: We undertook a cross-sectional survey of women ages 40-74 years who received digital mammography (DM), digital breast tomosynthesis (DBT), and/or breast magnetic resonance imaging (MRI) with a normal screening exam in the prior year. The main outcome was women's confidence (Very, Somewhat, A little, Not at all) in their breast cancer screening detecting any cancer. Multivariable logistic regression identified correlates of being very confident in breast cancer screening by screening modality group: Group 1) DM vs. DBT and Group 2) DM or DBT alone vs. with supplemental MRI. Results: Overall, 2329 of 7439 (31.3%) invitees participated, with 30%-61% being very confident in their screening across modality and density subgroups. Having dense versus nondense breasts was associated with lower odds of being very confident (Group 1: odds ratio [OR]: 0.58; 95% confidence interval [CI]: 0.46-0.79; Group 2: OR: 0.56; 95% CI: 0.40-0.79). There were no differences by modality within Group 1, but for Group 2, women undergoing MRI had higher odds of being very confident (OR: 1.69; 95% CI: 1.21-2.37). Other correlates of greater screening confidence were as follows: Group 1-being offered a screening test choice and cost not influencing modality received, and Group 2-decision satisfaction and worry. Conclusions: Women with dense breasts had lower screening confidence regardless of screening modality and those undergoing MRI had higher confidence regardless of density. The importance of informing women about screening options is underscored by observed associations between screening choice, decision satisfaction, and screening confidence. ClinicalTrials.gov: NCT02980848.

Implementation of advance care planning decision aids for patients undergoing high-risk surgery: a field-testing study

BackgroundPatients undergoing high-risk surgery are at a risk of sudden deterioration of their health. This study aimed to examine the feasibility of the development of two patient decision aids (PtDAs) to assist patients undergoing high-risk surgeries in informed decision-making about their medical care in a crisis.MethodsThis field testing implemented two PtDAs that met the international criteria developed by the researchers for patients before surgery. Study participants were patients scheduled to be admitted to the intensive care unit after surgery at one acute care hospital in Japan and their families. The study used a mixed-methods approach. The primary outcome was patients’ decision satisfaction evaluated by the SURE test. Secondary outcomes were the perception of the need to discuss advance care planning (ACP) before surgery and mental health status. The families were also surveyed on their confidence in proxy decision-making (NRS: 0–10, quantitative data). In addition, interviews were conducted after discharge to assess the acceptability of PtDAs. Data were collected before (preoperative outpatients, baseline: T0) and after providing PtDAs (in the hospital: T1) and following discharge (T2, T3).ResultsNine patients were enrolled, of whom seven agreed to participate (including their families). The SURE test scores (mean ± SD) were 2.1 ± 1.2 (T0), 3.4 ± 0.8 (T2), and 3.9 ± 0.4 (T3). The need to discuss ACP before surgery was 8.7 ± 1.3 (T1) and 9.1 ± 0.9 (T2). The degree of confidence in family surrogate decision-making was 6.1 ± 2.5 (T0), 7.7 ± 1.4 (T1), and 8.1 ± 1.5 (T2). The patients reported that using PtDAs provided an opportunity to share their thoughts with their families and inspired them to start mapping their life plans. Additionally, patients wanted to share and discuss their decision-making process with medical professionals after the surgery.ConclusionsPtDAs supporting ACP in patients undergoing high-risk surgery were developed, evaluated, and accepted. However, they did not involve any discussion of patients’ ACP treatment wishes with their families. Medical providers should be coached to provide adequate support to patients. In the future, larger studies evaluating the effectiveness of PtDAs are necessary.

제품유형과 통제욕구가 소비자의 자율쇼핑 시스템 채택의향에 미치는 영향

Purpose: With the proliferation of artificial intelligence (AI) and autonomous technology, automation has changed many aspects of the retail industry. This research explored the nascent but essential topic of how consumers respond to autonomous shopping systems to which consumers delegate substantial parts of shopping decisions and tasks. Autonomous shopping systems have changed the shopping process tremendously by reducing or eliminating the need for human decision-making. Recommend systems offer personalized recommendations and take a supporting role, but autonomous shopping systems go beyond providing suggestions or recommendations by actively taking over shopping processe without consumers’ intervention. Removing the decision-making process offers advantages such as saving time and effort or alleviating cognitive tradeoffs. On the other hand, consumers may be reluctant to adopt autonomous shopping systems due to the lack of perceived control or higher uncertainty of decision satisfaction. In this study, two experiments were conducted to see when consumers’ adoption intention toward autonomous shopping systems increases by focusing on the moderating role of hedonic vs. utilitarian product type and consumers’ desire for control. Research design, data, and methodology: Study 1 was conducted to verify that the product type moderates the effect of the shopping system type on consumers’ attitudes toward the shopping system, including product evaluation and shopping system adoption intention. The experiment used a 2 × 2 between-subjects factorial design of the shopping system type (recommend system vs. autonomous shopping system) and product type (utilitarian product vs. hedonic product). One hundred and forty-one responses were used in the analysis. The purpose of Study 2 was to test the moderating role of consumers’ desire for control in the effect of shopping system type on attitudes toward the shopping system. For this experiment, a 2 × 2 between-subjects factorial design of shopping system type (recommendation system vs. autonomous shopping system) and desire for control (low vs. high) was used. One hundred and sixty-one responses were used in the analysis. Results: Study 1 found that consumers’ attitudes toward autonomous shopping systems differ by product type. For the hedonic product, product evaluation and shopping system adoption intention was higher in recommend system than autonomous shopping system. For the utilitarian product, however, there was no difference in product evaluation and adoption intention between recommend system and autonomous shopping system. Study 2 revealed that the desire for control could be a psychological barrier to autonomous shopping system acceptance. Specifically, for consumers with a low desire for control, there was no difference in product evaluation and adoption intention between recommend system and autonomous shopping system. On the contrary, for consumers with a high desire for control, product evaluation and adoption intention were lower in the autonomous shopping system than the recommend system. Conclusions: This research provides several theoretical and managerial contributions by adding new insights into the psychology of automation and human-technology interactions in the retail industry. First, this study extends the literature by addressing whether hedonic vs. utilitarian product type leads to the preference for or resistance to autonomous shopping systems. The results suggest that the autonomous shopping system would be more effective in cases of shopping utilitarian (vs. hedonic) products. Managers could apply an effective shopping system introduction in a way that is aligned with the target products. When hedonic attributes are relatively more important, promoting products with recommend system is desirable. On the other hand, when utilitarian attributes are relatively more important, selling products with the autonomous shopping system would be more effective. Second, when the desire for control is high (vs. low), consumers are less willing to adopt the autonomous shopping system. Consistent with this result, marketers should establish and apply an effective marketing strategy by adjusting the autonomy level of the shopping system according to the consumers’ desire for control.

Exploring the hedonic factors affecting customer experiences in phygital retailing

Phygital retailing connects physical and digital world to build unique customer experiences. Although the applications of phygital retailing are increasing, it is yet to understand what factors may influence customer experiences, especially among the hedonic factors. This study thus examines this gap by exploring the hedonic factors that affect customer experiences in phygital retailing. Moreover, the role of gender is also explored as a boundary condition. This study is conducted using as a sample of 237 customers who experienced phygital retailing in China. Data are analyzed using PLS and PROCESS macro, which indicate that hedonic factors (i.e., mental imagery, entertainment, and aesthetics) affect customer experiences, which eventually affect customers’ decision satisfaction. This study further finds that the impacts of mental imagery, entertainment and aesthetics on customer experiences are higher for female customers than for male customers.

An Evaluation of a Web-Based Decision Aid for Treatment Planning of Small Kidney Tumors: Pilot Randomized Controlled Trial.

BackgroundSurgery is the most common treatment for localized small kidney masses (SKMs) up to 4 cm, despite a lack of evidence for improved overall survival. Nonsurgical management options are gaining recognition, as evidence supports the indolence of most SKMs. Decision aids (DAs) have been shown to improve patient comprehension of the trade-offs of treatment options and overall decision quality, and may improve consideration of all major options according to individual health priorities and preferences.ObjectiveThis pilot randomized controlled trial (RCT) primarily aims to evaluate the impact of a new web-based DA on treatment decisions for patients with SKM; that is, selection of surgical versus nonsurgical treatment options. Secondary objectives include an assessment of decision-making outcomes: decisional conflict, decision satisfaction, and an understanding of individual preferences for treatment that incorporate the trade-offs associated with surgical versus nonsurgical interventions.MethodsThree phases comprise the construction and evaluation of a new web-based DA on SKM treatment. In phase 1, this DA was developed in print format through a multidisciplinary design committee incorporating patient focus groups. Phase 2 was an observational study on patient knowledge and decision-making measures after randomization to receive the printed DA or institutional educational materials, which identified further educational needs applied to a web-based DA. Phase 3 will preliminarily evaluate the web-based DA: in a pilot RCT, 50 adults diagnosed with SKMs will receive the web-based DA or an existing web-based institutional website at urology clinics at a large academic medical center. The web-based DA applies risk communication and information about diagnosis and treatment options, elicits preferences regarding treatment options, and provides a set of options to consider with their doctor based on a decision-analytic model of benefits/harm analysis that accounts for comorbidity, age group, and tumor features. Questionnaires and treatment decision data will be gathered before and after viewing the educational material.ResultsThis phase will consist of a pilot RCT from August 2022 to January 2023 to establish feasibility and preliminarily evaluate decision outcomes. Previous study phases from 2018 to 2020 supported the feasibility of providing the printed DA in urology clinics before clinical consultation and demonstrated increased patient knowledge about the diagnosis and treatment options and greater likelihood of favoring nonsurgical treatment just before consultation. This study was funded by the National Cancer Institute. Recruitment will begin in August 2022.ConclusionsA web-based DA has been designed to address educational needs for patients making treatment decisions for SKM, accounting for comorbidities and treatment-related benefits and risks. Outcomes from the pilot trial will evaluate the potential of a web-based DA in personalizing treatment decisions and in helping patients weigh attributes of surgical versus nonsurgical treatment options for their SKMs.Trial RegistrationClinicalTrials.gov NCT05387863; https://clinicaltrials.gov/ct2/show/NCT05387863International Registered Report Identifier (IRRID)PRR1-10.2196/41451

Patient experience and decisional satisfaction with the informed consent process for elective gynecologic surgeries: A cross-sectional study

BackgroundThe informed consent process is a vital component of daily medical practice. It involves providing patients with sufficient, accurate, and understandable information to decide on a contemplated therapy. The study aims to evaluate the patient experience and satisfaction with the preoperative informed consent process. MethodsA cross-sectional study was performed on adult women admitted for elective gynecologic surgery in a tertiary training hospital. Participants were recruited on their second postoperative day and were asked to answer a structured questionnaire assessing decisional satisfaction and experience with the informed consent process. Satisfaction was measured using a 6-item Satisfaction with Decision Scale. Knowledge of the surgery and experience with the informed consent were measured using an Informed Consent Questionnaire. Bivariate associations between highly satisfied and not highly satisfied groups were tested using Fisher exact test. ResultsA total of 150 patients were enrolled in the study with a mean age of 44.5 years. The resident-in-charge provided the information and assisted in the documentation of the informed consent in 86.7% and 67.3% of patients, respectively. There was an overall high decisional satisfaction with a mean score of 27.4 and 52.7% of patients strongly agreeing to all statements of the Satisfaction with Decision Scale. The majority of the respondents were informed and acknowledged comprehension of the surgery including its risks, benefits, and alternative treatment options. Knowing the success rate and benefits of the procedure as well as being informed of the need for postoperative catheterization were significantly associated with high satisfaction. ConclusionKnowledge and understanding of the key components of informed consent influence patient satisfaction. The current study highlights the high decisional satisfaction rates of patients who underwent elective gynecologic surgery. Strategies to further improve this patient-physician encounter include the establishment of standard policies on personnel involved, timing, and quality of information given to patients. Patient satisfaction should serve as an indicator of the quality of healthcare rendered and guide for continuous improvement of services.

Analyzing the Contribution of ERP Systems to Improving the Performance of Organizations

This study examines how Enterprise Resource Planning (ERP) systems affect the performance of organizations. First, by analyzing the impact of these systems on the five determining forces of the competitive structure and the entire value chain. Then, by an empirical study to identify their contributions within three large companies located in the northern region of Africa. A series of interviews and meetings with the managers that have a very remarkable and credible experience in the field (the directors of information systems, finance directors, sales directors, and human resources directors). The results of this research indicate that the implementation of ERP systems has positive effects on performance. In particular, cost reduction, task automation, customer satisfaction and improvement of decision making.

Factors influencing patients' decision-making about preimplantation genetic testing for monogenic disorders.

What are the roles of individual and interpersonal factors in couples' decision-making regarding preimplantation genetic testing for monogenic disorders (PGT-M)? Couples' decision-making regarding PGT-M was associated with individual and interpersonal factors, that is the perceived consistency of information received, satisfaction with information, self-efficacy (individuals' beliefs in their ability to make decisions), actual knowledge about PGT-M and social support from the partner. Various factors have been shown to be associated with decision-making regarding PGT-M. However, PGT-M is experienced at an individual level, and to date, no studies have investigated the roles of the above-mentioned individual and interpersonal factors. This is a cross-sectional study with 279 participants. Participants were recruited through IVFAustralia, Sydney Children's Hospital and support groups from May 2020 to November 2021. Participants were women who had undergone or were considering PGT-M and their partners. Participants were recruited through IVFAustralia, Sydney Children's Hospital and support groups to complete online questionnaires. Decisional regret, decisional satisfaction and decisional conflict were measured as outcome variables. Multiple linear regressions were performed to examine the association between factors and outcome variables. Mann-Whitney U tests were performed to test the differences between participants who had undergone PGT-M and those who were considering PGT-M. For couples who had undergone PGT-M, decisional regret was significantly negatively associated with perceived consistency of information received (β = -0.26, P < 0.01), self-efficacy (β = -0.25, P < 0.01) and actual knowledge about PGT-M (β = -0.30, P < 0.001), while decisional satisfaction had positive association with satisfaction with information received (β = 0.37, P < 0.001) and self-efficacy (β = 0.24, P < 0.05). For couples who were considering PGT-M, decisional conflict was negatively associated with satisfaction with information received (β = -0.56, P < 0.001). For females who had undergone PGT-M, decisional regret was negatively associated with social support from the partner (β = -0.35, P < 0.05) in addition to perceived consistency of information received (β = -0.24, P < 0.05). In this group, decisional satisfaction was positively associated with women's satisfaction with the information received (β = 0.34, P < 0.01), social support from the partner (β = 0.26, P < 0.05) and self-efficacy (β = 0.25, P < 0.05). For females who were considering PGT-M, decisional conflict was negatively associated with satisfaction with the information received (β = -0.43, P < 0.01) and social support from the partner (β = -0.30, P < 0.05). This study also identified those aspects of PGT-M that couples felt most concerned about in relation to their decision-making, in particular safety issues such as short- or long-term health problems for the baby and potential harms to the embryos and the mother's health. The likelihood of getting pregnant and having a baby with a genetic condition being tested for were also important in couples' decision-making. This study assessed the concerns of couples about having a baby with a variety of genetic conditions. However, condition-specific issues might not be covered. Furthermore, social support from the partner was assessed among females only. Male participants' perceived social support from their partner and the association between mutual support and decision-making were not assessed due to the absence of dyadic data. Results highlight the importance of effective patient education on PGT-M and the need to provide high-quality and consistent information in the context of patient-centred care. Patients are likely to benefit from information that addresses their specific concerns in relation to PGT-M. From females' perspective, support from partners is essential, and partners should, therefore, be encouraged to participate in all stages of the decision-making process. Suggestions for future studies were made. B.M. was funded through a Senior Research Fellowship Level B (ID 1078523) from the National Health and Medical Research Council of Australia. L.C. was supported by a University International Postgraduate Award under the Australian Government Research Training Program (RTP) scholarship. No other funding was received for this study. The authors report no competing interests. N/A.

Shared decision making in cardiology: a systematic review and meta-analysis

ObjectivesTo evaluate the effectiveness of interventions to improve shared decision making (SDM) in cardiology with particular focus on patient-centred outcomes such as decisional conflict.MethodsWe searched Embase (OVID), the Cochrane library,...

Decision Reversibility and Satisfaction: The Mediating Role of Counterfactual Thinking and Anticipated Regret.

PurposeExtensive research has shown that reversible decisions yield lower post-decision satisfaction than irreversible decisions. However, to date, little is known about how decision reversibility affects post-decision satisfaction. Based on regret theory, this study aimed to examine the mediating role of counterfactual thinking and anticipated regret in the association between decision reversibility and satisfaction.MethodsIn this study (130 participants), participants were randomly assigned to two personnel decision situations with reversible and irreversible decision outcomes, and all participants completed questionnaires during the process of completing the decision task. The questionnaires used included the Counterfactual Thinking for Negative Events Scale, Anticipated Regret Scale, and satisfaction questionnaire. Finally, the data were statistically analyzed using the base package in R and PROCESS 3.5.ResultsThe results show that (1) Compared to irreversible decisions, reversible decisions have a significant negative impact on satisfaction. (2) Counterfactual thinking plays a mediating role between decision reversibility and satisfaction. (3) Compared with irreversible decisions, reversible decisions further lowered the level of post-decision satisfaction through the chain mediating effects of counterfactual thinking and anticipated regret.ConclusionPeople’s lowered levels of post-decision satisfaction in the reversible decision condition relate to increased levels of counterfactual thinking and anticipated regret. In addition, counterfactual thinking can play a mediating role alone, indicating that this variable may be critical in understanding the mechanisms by which decision reversibility affects satisfaction. This knowledge may be used to help people optimize their decision-making behavior.

Development and Pilot Evaluation of a Decision Aid for Small Kidney Masses.

To develop and pilot test a patient decision aid (DA) describing small kidney masses and risks and benefits of treatment for the masses. An expert committee iteratively designed a small kidney mass DA, incorporating evidence-based risk communication and informational needs for treatment options and shared decision-making. After literature review and drafting content with the feedback of urologists, radiologists, and an internist, a rapid qualitative assessment was conducted using two patient focus groups to inform user-centered design. In a pilot study, 30 patients were randomized at the initial urologic consultation to receive the DA or existing institutional patient educational material (PEM). Preconsultation questionnaires captured patient knowledge and shared decision-making preferences. After review of the DA and subsequent clinician consultation, patients completed questionnaires on discussion content and satisfaction. Proportions between arms were compared using Fisher exact tests, and decision measures were compared using Mann-Whitney tests. Patient informational needs included risk of tumor growth during active surveillance and ablation, significance of comorbidities, and posttreatment recovery. For the DA, 84% of patients viewed all content, and mean viewing time was 20 min. Significant improvements in knowledge about small mass risks and treatments were observed (mean total scores: 52.6% DA versus 22.3% PEM, P<.001). DA use also increased the proportion of patients discussing ablation (66.7% DA versus 18.2% PEM, P= .02). Decision satisfaction measures were similar in both arms. Patients receiving a small kidney mass DA are likely to gain knowledge and preparedness to discuss all treatment options over standard educational materials.

Does default organ donation registration compromise autonomous choice? Public responses to a new donor registration system

Defaults have been shown to increase the number of organ donor registrations but it is unclear whether they violate personal autonomy of the people being registered. The implementation of a new Donor Act in the Netherlands, providing people with the opportunity for active registration before being defaulted, allowed for examining to what extent default registration affects personal autonomy and associated concepts. In an online survey among a representative sample (N = 1259), four groups were compared regarding autonomy, decision-making competence, decision satisfaction, and being pressured to register as a donor: people (1) who had registered their status prior to the Donor Act, (2) who had not yet received an invitation for default registration, (3) who had received an invitation and then registered their choice, and (4) who had received an invitation but took no action and were defaulted into donor registration. We found that among the three groups who were the target population of the new arrangement, people who registered their status reported relatively high levels of autonomy and related concepts. However, people who were invited to register but passed the opportunity to respond reported lower scores on these outcomes. We conclude that default organ donation registration may bear negative consequences for a minority of people who feel unable to take action after having been invited to make a choice for registration.

Factors associated with US and Canadian genetic counselors' testing decisions during pregnancy.

Decision-making regarding prenatal screening and diagnostic testing has become more complex as the number of options has increased, with pregnant patients having access to more information about their pregnancies than ever before. Genetic counselors have extensive training in prenatal genetic screening and testing options, but personal decision-making in this well-informed population remains largely unstudied. This study describes the prenatal testing decisions genetic counselors made during their own pregnancies, and the factors identified as important when making those decisions. A web-based, mixed-methods survey was distributed to members of multiple professional societies for genetic counselors. A total of 318 genetic counselors across numerous specialties in the United States and Canada participated in this study. The satisfaction with decision scale was modified and applied to measure participants' decisional satisfaction. In their most recent pregnancies, most genetic counselors pursued carrier screening (77%) and aneuploidy and/or open neural tube defect screening (88%). A minority of genetic counselors (15%) utilized diagnostic testing. Common factors considered when making testing decisions included wanting information that could impact future decisions, test specifics (e.g., accuracy, methodology, and content), and knowledge gained from participants' genetic counseling background. The uptake of diagnostic testing among prenatal genetic counselors was significantly greater (p < 0.05) than the uptake among genetic counselors in other specialties. This informed study population largely self-directed their own prenatal care, leading to high satisfaction with their decisions. Data in this study provide evidence for promoting participation in prenatal screening and testing decision-making to maximize decisional satisfaction.

The authentic catch-22: Following the true self promotes decision satisfaction in moral dilemmas

The current research presents five experiments (N = 1298) that examine what decision-making strategies lead to satisfying decisions in moral dilemmas. Past research in other contexts suggests that when people believe that they are using the true self as a guide (TSAG) to make decisions, they experience more decision satisfaction. However, it was unclear whether this past work would generalize to moral dilemmas given that people believe their true selves are morally good and moral dilemmas require a violation of at least one moral code to be resolved. However, results of five studies suggested that TSAG effects extend to moral dilemmas. Studies 1–3 indicated that when participants were given instructions for how to solve moral dilemmas, TSAG instructions led to more satisfying decisions relative to rational thinking, intuition, or no instruction conditions. In Study 4, all participants received non-true self instructions (rational thinking or intuition) during the decision-making process, but half were asked to reframe their decision as being guided by the true self after the decision was made. We found that this reframing facilitated decision satisfaction even though the decision was actually made using alternative instructions, suggesting that perceptions of TSAG may directly drive the observed effects on decision satisfaction as opposed to actual use of the true self per se. Finally, in Study 5, we found evidence that the effect of TSAG instructions was more robust in moral (vs. nonmoral) dilemmas and not contingent on the dilemmas being easy or difficult.

Effects of a smartphone application named “Shared Decision Making Assistant” for informed patients with primary liver cancer in decision-making in China: a quasi-experimental study

BackgroundIt is well known that decision aids can promote patients’ participation in decision-making, increase patients’ decision preparation and reduce decision conflict. The goal of this study is to explore the effects of a “Shared Decision Making Assistant” smartphone application on the decision-making of informed patients with Primary Liver Cancer (PLC) in China.MethodsIn this quasi-experimental study, 180 PLC patients who knew their real diagnoses in the Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China, from April to December 2020 were randomly assigned to a control group and an intervention group. Patients in the intervention group had an access to the “Shared Decision Making Assistant” application in decision-making, which included primary liver cancer treatment knowledge, decision aids path, continuing nursing care video clips, latest information browsing and interactive platforms. The study used decision conflict scores to evaluate the primary outcome, and the data of decision preparation, decision self-efficacy, decision satisfaction and regret, and knowledge of PLC treatment for secondary outcomes. Then, the data were entered into the SPSS 22.0 software and were analyzed by descriptive statistics, Chi-square, independent t-test, paired t-test, and Mann–Whitney tests.ResultsInformed PLC patients in the intervention group (“SDM Assistant” group) had significantly lower decision conflict scores than those in the control group. (“SDM Assistant” group: 16.89 ± 8.80 vs. control group: 26.75 ± 9.79, P < 0.05). Meanwhile, the decision preparation score (80.73 ± 8.16), decision self-efficacy score (87.75 ± 6.87), decision satisfaction score (25.68 ± 2.10) and knowledge of PLC treatment score (14.52 ± 1.91) of the intervention group were significantly higher than those of the control group patients (P < 0.05) at the end of the study. However, the scores of “regret of decision making” between the two groups had no statistical significance after 3 months (P > 0.05).ConclusionsAccess to the “Shared Decision Making Assistant” enhanced the PLC patients’ performance and improved their quality of decision making in the areas of decision conflict, decision preparation, decision self-efficacy, knowledge of PLC treatment and satisfaction. Therefore, we recommend promoting and updating the “Shared Decision Making Assistant” in clinical employment and future studies.

Outlier identification and group satisfaction of rating experts: density-based spatial clustering of applications with noise based on multi-objective large-scale group decision-making evaluation

Group satisfaction is a trending issue in large-scale group decision-making (LSGDM) but most existing studies maximize the group satisfaction of LSGDM from the perspective of consensus. However, the clustering algorithm in LSGDM also has an impact on group satisfaction. Hence, this paper proposes a density-based spatial clustering of applications with noise (DBSCAN)-based LSGDM approach in an intuitionistic fuzzy set (IFS) environment. The DBSCAN algorithm is used to identify experts with outlier ratings that can reduce the time consumption and iterations of the LSGDM process and maximize the satisfaction of the group decision. An easy-to-use function is then provided to estimate group satisfaction. Finally, a numerical example of data centre supplier evaluation and comparative analysis is constructed to validate the rationality and feasibility of the proposed DBSCAN-based LSGDM approach in an IFS environment. The results demonstrate that the proposed method can effectively identify outliers in expert ratings and improve group satisfaction in the LSGDM process.

Decision Support Algorithm for Discipline Construction of Comparative Pedagogy Based on Evolutionary Graph Data Mining

The traditional pedagogy discipline construction decision support algorithm has the problems of poor discipline construction decision satisfaction, high decision time, and low decision recall rate. Therefore, a decision support algorithm for discipline construction of comparative pedagogy based on evolutionary graph data mining is designed. First, the programme call graph is created based on the programme execution path, and then the graph reduction method is used to decrease the call graph set and create the weighted behavior graph set. The original graph set is then reduced using the subtree reduction procedure. The interference of weights in the graph must be eliminated while mining closed subgraphs using a close graph method. The most frequent subgraph of comparative pedagogy discipline construction is then mined, and an SVM classifier is created to accomplish information mining of comparative pedagogy discipline construction in evolutionary graph data mining. Then, using the complete weighing approach, the attribute classification of comparative pedagogy discipline construction is accomplished, and the decision weight of comparative pedagogy discipline construction is established. Finally, the weight distribution scheme of comparative pedagogy discipline construction is obtained by using European distance, so as to realize the decision support of comparative pedagogy discipline construction. The experimental results show that the decision-making satisfaction of comparative pedagogy discipline construction of this method is 97.32%, the decision-making time is only 0.9 min, and the decision-making recall rate is as high as 98.66%, indicating that the decision-making effect of comparative pedagogy discipline construction of this method is good.

Uterine Fibroids ‐ Why Aren't We Talking About Them?

ProblemUterine fibroids (UFs) are smooth muscle tumors that are located in the uterus. Even though these tumors are mostly benign, they are the most common gynecological disorder; estimated to affect 70‐80% of women by the age of 50. Black women are disproportionately affected by UFs as UFs appear earlier in black women, the symptoms are often more severe and black women often wait longer to receive treatment and have more surgical complications relative to non‐black women. The epidemiology for UFs is unclear, however being of black race, hypertensive, obese, and pre‐menopausal increases the risk of developing UFs.DataData from the COMPARE‐UF (Comparing Options for Management: Patient‐centered Results for UF) multi‐site observational registry indicated that black women with UFs who received hysterectomy’s (uterus removal) for treatment had a lower health related quality of life (HRQoL) compared to white women receiving the same procedure. In a separate analysis from this same population we also published data indicating that black women with UFs were more likely to have a surgery that was not a hysterectomy, unless they were treated in Mississippi (MS). We have previously published data from patients treated for UFs in MS and have reported that relative to women with abnormal uterine bleeding but no UF’s, women with UFs had significantly more hypertension but no change in body mass index. We also reported that circulating factors associated with hypertension (ET‐1 and sFlt‐1) were significantly increased among women with UF's relative to women with abnormal uterine bleeding.RationaleAs MS ranks among the highest in the nation for hypertension, and black people per capita the likelihood for an increased prevalence of UFs is high. The combination of these studies and our own studies indicate that black women with UFs who reside in the rural South may be more affected and have lower HRQoL to black women with UFs who live in more urban areas. While the medical and surgical options are limited for UFs, data is beginning to emerge indicating geographical differences that elude to a different problem.Proposed SolutionHere in MS, we have proposed a patient navigator program (EMPOWER‐UF) to help educate women on the different treatment options available and to help women navigate the health care system. It is our belief that the combination of a patient navigator and a patience decision aid, adapted for women with UFs, could increase health literacy and improve the shared decision making process. The combination of these events will lead to an increased satisfaction in decision making regarding UF treatment choice and an increase in HRQoL.

Perspectives and Experiences of Parents and Adolescents Who Participate in a Pediatric Precision Oncology Program: "When You Feel Helpless, This Kind of Thing Is Very Helpful".

The SickKids Cancer Sequencing (KiCS) Program, launched in 2016, evaluates the clinical utility of paired tumor/germline Next-Generation Sequencing (NGS) in pediatric oncology patients with hard-to-cure and rare cancers. In anticipation of further widespread adoption of NGS, we aimed to characterize the experiences and perspectives of adolescents and parents of patients who have already undergone NGS evaluation, focusing on the psychosocial impact and personal utility. Parents of patients with pediatric cancer and adolescent patients who have participated in KiCS were invited to participate in semistructured interviews. Transcripts were analyzed using an inductive content analytic approach. Of 45 individuals invited, 22 parents and 10 adolescents were interviewed (71% response rate). Prominent psychosocial themes were low distress, relief, and sense of control; some expressed fear of the unknown. In exploring constructs of personal utility, parents highlighted hope for treatment options despite low expectations for results with clinical impact, whereas adolescents articulated altruistic motivations and less hope for personal clinical benefit. Bringing closure and answering the question of why the cancer occurred was a salient theme among both groups. Both parents and adolescents find benefit and clear decisional satisfaction with participation. No participants expressed regret. This study suggests that parents and adolescents benefit from NGS evaluation beyond the return of clinically relevant results. Our findings lay the framework for future work evaluating the value of NGS in pediatric precision oncology care through assessment of patient-reported outcomes and experiences. These results also guide provision of pre- and post-test education and support, which will facilitate patient-centered delivery of NGS practices.