Decision Satisfaction Research Articles

Parental decisional satisfaction after hypospadias repair in the United Kingdom

In hypospadias, the aim of surgical treatment is to achieve both desirable functional and cosmetic outcomes; however, complications following surgery are common and 18% of boys require re-operation. In mild degrees of hypospadias, repair may be offered entirely to improve cosmesis, meaning parents should be fully informed of this and the potential for complications, during the consent process. Parents' decision-making may be aided by making them aware of how others in a similar position have felt about the decision that they made for their child. One method of measuring parental satisfaction is decisional regret (DR). To assess parental satisfaction following hypospadias surgery in the United Kingdom by assessing DR and to determine the feasibility of obtaining meaningful data via a mobile phone survey. The National Outcomes Audit in Hypospadias database was commissioned by the British Association of Paediatric Surgeons to capture clinical information from hypospadias repairs. Following ethical approval (16/NW/0819), a text message was sent to mobile numbers in the database inviting participation in a questionnaire incorporating the validated DR scale (DRS). The primary outcome measure was mean DRS score, which was correlated with clinical information, a score of zero indicated no regret and 100 indicated maximum regret. There were 340 (37%) responses. The median age at the primary procedure was 16 (interquartile range 13-20) months. No DR (score=0) was detected in 186 (55% [95%CI 49-60]) respondents; however, moderate-to-severe DR (score=26-100) was seen in 21 (6.2% [95%CI 3.6-8.7]) respondents. On multivariate analysis, a distal meatus, a small glans and developing complications requiring repeat surgery were all associated with increased levels of regret (Table). There was no association between DR and cases performed per surgeon. Around half of respondents demonstrated no DR and postoperative complications requiring surgery were associated with the highest levels of DR, which is similar to a Canadian study. Lorenzo etal. however found that DR was associated with circumcision, which was undertaken in all boys; however, in this UK study, around a third of boys were circumcised and regret levels between those circumcised and those not circumcised were similar. The limitations of this work include the following: surgeons submitting their own data on complications and there is potential of selection bias between respondents and non-respondents as with any survey. Data from this study can be used to improve pre-operative counselling during the consent process. Smart mobile phone technology can be used successfully to distribute and collect parent-reported outcomes.

Shared Decision Making in Surgery: A Meta-Analysis and Full Systematic Review

Shared decision-making (SDM), the process where physician and patient reach an agreed-upon choice by understanding the values, concerns, and preferences inherent within each treatment option available, has been increasingly implemented in clinical practice to better health care outcomes. Despite the proven efficacy of SDM to provide better patient-guided care in medicine, its use in surgery has not been studied widely. A search strategy was developed with a medical librarian. It included nine databases from inception until December 2018. After a 2-person title and abstract screen, full-text publications were analyzed in detail. A meta-analysis was done to quantify the impact of SDM in surgical specialties. In total 5,596 studies were retrieved. After duplicates were removed, titles and abstracts were screened, and p-values were recorded, 140 (45 RCTs and 95 cross-sectional studies) were used for the systematic review and 42 for the meta-analyses. Most of the studies noted decreased intervention rate (8 of 14), decisional conflict (13 of 16), and decisional regret (3 of 3), and an increased decisional satisfaction (9 of 12), knowledge (19 of 20), SDM preference (6 of 8), and physician trust (3 of 4) when using SDM. Time increase per patient encounter was inconclusive. The meta-analysis showed that despite high heterogeneity, the results were significant. Far from obviating surgical immediacy, these results suggest that SDM is vital for the best indicators of care. With decreased conflict and anxiety, increasing knowledge and satisfaction, and creating a more whole, trusting relationship, SDM appears to be beneficial in surgery.

"Know Thyself": A Review of True Self

Throughout the years "<i>Know Thyself</i>", as an old aphorism, has been discussed by laypeople and researchers alike. It continues to hold a vital position in contemporary psychology. According to the traditional psychoanalytic and humanistic theories, being aware of and behaving in accordance with one's true self, improves an individual's psychological health. However, what the "true self" is, and how it affects people's daily lives, continues to be explored. In the present study, we reviewed the history and definition of the true self. Based on the characteristics found in previous research, we tentatively defined the true self as "a set of mental representations of the inherent, private, and stable attributions of oneself; reflective of whom an individual thinks he/she really is." Following that, we reviewed several ways of measuring or assessing the true self, and compared advantages and disadvantages of them. We also reviewed the effects the true self has on people's meaning in life, decision satisfaction, and moral judgment, as well as psychological health. Finally, we suggested that it is crucial to define the true self more clearly, to develop methods to measure or assess it more accurately, and to investigate the fundamental mechanisms by which it benefits to people.

Mediating effect of team trust on the influence of top management team (TMT) processes against HRM decision quality and satisfaction performance

PurposeThe purpose of this paper is to test the mediating role of top management team (TMT) team trust in examining the relationship between team processes (internal and external) and human resource management (HRM) decision performance (quality and satisfaction) in the context of the People’s Republic of China.Design/methodology/approachThe sample data of this study include 524 team members from 76 TMTs in east China’s Shanghai, Jiangsu, Zhejiang, Anhui provinces. IBM SPSS AMOS 22.0 software was employed for the data analysis.FindingsThe study finds that TMT internal and external processes have significant positive effects on HRM decision quality and satisfaction. The study further finds that TMT team trust partially mediates the relationship between TMT processes (internal and external processes) and HRM decision quality and satisfaction.Practical implicationsThis research provides useful insights into the role of TMT team trust in enhancing managerial decision performance.Originality/valueThis study is among the limited studies that explore the influence of team trust in the relationship between TMT processes (internal and external processes) and HRM decision quality and satisfaction among TMTs in China. This study has extended TMT knowledge in mainstream management with guidelines on how to enhance organizational decision performance.

Shared Decision Making and Choice for Bariatric Surgery.

The number of people undergoing bariatric surgery is increasing every year, and their expectations for surgery often differ greatly. The purpose of this study was to develop a patient-centered decision-making aid to help people define their weight loss goals and assist them in discussing their surgical treatment with surgeons. Before the operation, the patients were asked to read the shared decision-making text and conduct a self-assessment. After the operation, we evaluated the program using survey questionnaires. A total of 103 patients were formally included in this study. The results show that patients were very satisfied with the use of patient decision aids (PDAs), with a score of 4.3 points (±0.6), and the postoperative decision-making satisfaction was also very high, at 4.4 points (±0.5), while the postoperative regret score was low, at 1.6 points (±0.6). Their satisfaction with surgical decision making and decision regret were statistically significantly negatively correlated (r = −0.711, p < 0.001). The experience of using PDAs was statistically significantly negatively correlated with decision regret (r = −0.451, p < 0.001); the experience of PDA use was statistically positively correlated with decision satisfaction (r = 0.522, p < 0.001). Patient decision aids are a means of helping patients make informed choices before they seek to undergo bariatric surgery.

Analyzing causal relationships of effective factors on the decision making of individual investors to purchase shares

PurposeChanges in economic markets have made it necessary to understand the psychology of individual investors. Conducting effective studies on the decision of investors to buy stock in the stock market can be useful. Therefore, it is necessary to identify and prioritize the factors affecting the decision-making of investors to purchase shares of the stock exchange. The purpose of this study was to analyze causal relationships and to weight effective factors on individual investment to purchase shares of Tehran Stock Exchange.Design/methodology/approachThe present study is applied research in the term of its purposes and a descriptive-survey one in the term of data gathering methods. The data required in this study was collected through library and field studies. The study population included 35 investment experts. In present study, multi-criteria decision-making techniques in type-2 fuzzy environments have been used to analyze the causal relationships and weighing the factors affecting individual investment in purchasing stock in the stock market.FindingsIn the study, 4 indicators and 20 sub-indicators influencing individual investors’ decision to purchase shares of Tehran Stock Exchange were selected based on the literature review in the field of investment in the stock exchange, as well as interviews with experts. Analyzing the opinions of experts showed that they have much paid attention to financial index compare to the economic, political and psychological indicators of the market in determining the priority of indicators. In analyzing sub-indicators, it was identified that Iranian investors pay special attention to economic and political developments, political news and international economic developments.Research limitations/implicationsThe present study has been carried out in Iran, and therefore, is geographically limited to Iran. In thematic terms, it is limited to effective factors of individual investments in Tehran Stock Exchange. The statistical population of present study was limited to investing experts in Tehran Stock Exchange. The difference in financial, economic, social and political conditions of individuals was another limitation of present study. The main consequences of research were the explanation of causes of investors’ higher attention to financial factors than economic, political and mental factors of market in buying stocks.Originality/valueGiven the uncertainty in the market status, using multi-criteria decision-making techniques in financial analysis can help decision-makers to make better decisions. In addition, it would be possible to take into account many variables that do not have a mathematical aspect but are important in decision-making and lead to increased decision-making satisfaction. The research initially analyzed causal relationships of determinants of individual investment on stock exchange for buying stocks through a type-2 fuzzy approach.

Exploring effective price presentation format to reduce decision difficulty and increase decision satisfaction

Variable pricing is frequently employed by service firms that adopt revenue management practices. This strategy is effective in stimulating and increasing revenue by appealing to customers with different levels of price sensitivity. However, by providing excessive price options, a company may cause choice overload for customers. Within the framework of behavioral economics, this study explores an effective price presentation strategy to mitigate choice overload due to a large assortment size of price options in the context of hotels. The findings of the experimental design study suggest that the number of categories that distinguish and organize price options positively affects consumers' perceived decision difficulty and consequent decision satisfaction when a large assortment size of price options is provided. This research extends the understanding of the effect of variable pricing on consumers' responses and provides marketers with guidance on how to manage variable pricing and its price presentation format.

为什么信息超载损害决策?基于有限认知资源的解释

<p id=C3>Information overload occurs when the current information processing requirements exceed information processing capacities. Information overload can impair the quality of decisions, prolong decision-making time, reduce decision satisfaction, and cause chronic stress. The attentional resources theory and limited working memory capacity can be used to explain why information overload damages decisions. Attention resources for filtering and managing information are consumed quickly under information overload and the allocation and utilization of attention resources can be disrupted by irrelevant information, which causes the efficiency of information processing to be reduced. Moreover, the available working memory for information processing cant process massive amounts of information in a limited time. As a result, decision performance is damaged by information overload. Future research should further explore the information processing model under information overload, the eye movement empowerment method allows us to examine attention resource usage under information overload. A dynamic coupling model of conscious and unconscious thought is required to provide a method to guide individuals to alleviate information overload. Additionally, intelligent agents and interactive memory systems should be investigated to find their potential roles in alleviating information overload within larger organizations.

OP05.01: High risk: what's next? Decisional conflict, regret and satisfaction among pregnant women making choices about further prenatal testing

OP05.01: High risk: what's next? Decisional conflict, regret and satisfaction among pregnant women making choices about further prenatal testing

Discussion of Consumers’ Body Satisfaction: Focused on Purchasing Decision and Service Satisfaction

Clothing choice has been a way for consumers to express their individuality and the possibility to boost their self-esteem. Despite the amount of prior research conducted regarding body satisfaction and individuals clothing choices, little is known about consumers’ body satisfaction and its impact on their clothing purchasing decisions. Thus, this study tries to shed light on the relationship between consumers’ body satisfaction and its impact on their purchasing intentions. The objective of this study is to identify whether consumers’ body satisfaction would influence their service satisfaction at retail stores when service failure of wrong size clothing recommendations has occurred. Additionally, in this study, gender differences in body satisfaction and purchasing intention is tested. The research identifies that body satisfaction to service satisfaction and service satisfaction to purchasing intention have a direct relationship with each other. Body satisfaction and purchasing intention do not have a direct relationship with each other. Notably, this study also finds that body satisfaction is higher in males but presented no gender difference in purchasing intention after the service failure.

CONSUMER’S SATISFACTION AND BEHAVIOUR TOWARDS PERSONAL FINANCING

The unprecedented changes in the financial market have put a great pressure on financial service providers. As more competitive financial products and services emerge in the market, financial institutions have no choice, but to enhance their competitive advantages. Thus, consumer behavior in purchasing products and services must really be understood by the service providers. Unfortunately, the literature on customer satisfaction and the purchase decision is hardly seen in the finance industry. This paper originally develops a model of the relationship between consumer satisfaction and purchase decision in the finance industry focusing on personal finance. The mediating role of customer satisfaction in the purchase decision is emphasized in this research model. This model had been used to focus purchase decisions by adapted Theory Planned Behaviour (TPB). A clear understanding of the relationship attitude, subjective norms and perceived behavioral control towards purchase behavior had found by previous research. But lack of studies focused on the small-medium enterprises (SME’s) that nowadays have become a platform for the economy in Malaysia. Hence, this conceptual model had focused on SME’s behavior in selecting personal finance. The conceptual model offers insight into the general nature of a recovery that specifically to the understanding of SME’s behavior as well as in purchase personal loan.

Effects of proactive decision making on life satisfaction

Proactive decision making, a concept recently introduced to behavioral operational research and decision analysis, addresses effective decision making during its phase of generating alternatives. It is measured on a scale comprising six dimensions grouped into two categories: proactive personality traits and proactive cognitive skills. Personality traits are grounded on theoretical constructs such as proactive attitude and proactive behavior; cognitive skills reflect value-focused thinking and decision quality. These traits and skills have been used to explain decision satisfaction, although their antecedents and other consequences have not yet been the subject of rigorous hypotheses and testing.This paper embeds proactive decision making within a model of three possible consequences. We consider—and empirically test—decision satisfaction, general self-efficacy, and life satisfaction by conducting three studies with 1300 participants. We then apply structural equation modeling to show that proactive decision making helps to account for life satisfaction, an explanation mediated by general self-efficacy and decision satisfaction. Thus proactive decision making fosters greater belief in one's abilities and increases satisfaction with one's decisions and with life more generally. These results imply that it is worthwhile to help individuals enhance their decision-making proactivity.Demonstrating the positive effects of proactive decision making at the individual level underscores how important the phase of generating alternatives is, and it also highlights the merit of employing “decision quality” principles and being proactive during that phase. Hence the findings presented here confirm the relevance of OR, and of decision-analytic principles, to the lives of ordinary people.

S11B-11 SESSION 11B: FACE MISCELLANEOUS OSSEOUS GENIOPLASTY: PREVENTION OF WITCH’S CHIN DEFORMITY WITH NO-DEGLOVING TECHNIQUE

Introduction: Osseous genioplasty is a powerful procedure that can correct chin dysmorphology; however, traditional techniques may result in chin ptosis or a ‘Witch’s Chin’ deformity. Iatrogenic chin ptosis is thought to be caused by excessive degloving of soft tissue with failure to reattach the mentalis muscle. To study if a new ‘No-degloving’ technique (using 90-degree plate with lag screw fixation) minimizes chin ptosis, we compared outcomes to the ‘Traditional’ technique. Methods: We compared consecutive patient genioplasty techniques Group 1: Traditional: degloving, stair-step plate vs Group 2: “No-degloving’ with lag-screw fixation (n=50). We compared OR time, advancement, complications; Cone beam CT scan Preop to Postop vertical height of soft tissue Pogonion and Menton (Expected-Actual less than 3mm=ptosis); Surgeon witch’s chin diagnosis; FACE-Q surveys. Results: No-degloving vs Traditional groups had similar age and sex distribution, horizontal/vertical change (5mm/2mm), EBL, length of surgery, complications (5%). Traditional had more deviation from expected position for both PG (3.4mm vs1.1mm) and ME (2.9mm vs0.8mm); and more witch’s chin (6%vs0%). No-degloving was superior for FACE-Q chin appearance/smile; quality of life, satisfaction for decision and outcome. Conclusion: No-degloving osseous genioplasty technique is safe, reproducible, technique that results in decreases soft-tissue ptosis and increased patient satisfaction.

True to which self? Lay rationalism and decision satisfaction in self-control conflicts.

Are people more satisfied with decisions to resist or to indulge temptation? We propose that the effect of restraint versus indulgence on decision satisfaction depends on individual differences in lay rationalism, that is, reliance on reason versus feelings to guide decisions. Across 2 pilot studies and 9 main studies (N = 3,264) with different methodologies and various self-control domains, we found consistent evidence that individuals experience higher satisfaction with restraint the more they rely on reason than on feelings. The proposed effect uniquely concerns individual differences in lay rationalism and is independent from individual differences in trait self-control. We also show that authenticity (feeling true to oneself) is the mechanism underlying this effect and rule out self-typicality (acting in ways typical of oneself) as an alternative account. Additionally, we examined downstream consequences of this effect for compensatory authenticity seeking. These findings advance a more nuanced view of self-control based on identity and suggest that the subjective utility of restraint is contingent upon individual differences in reliance on reason versus feelings in decision making. Our research contributes to the understudied topic of the phenomenology of self-control and provides novel insights into its potential downsides for some individuals. We discuss theoretical implications for research on self-control, lay rationalism and authenticity. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Effects of a visit prior to hospital admission on anxiety, depression and satisfaction of patients in an intensive care unit

ObjectivesTo assess the effects of a vists prior to hospital admission on anxiety, depression and satisfaction of patients admitted electively to an intensive care unit (ICU). DesignA randomised clinical trial [NCT03605407]. SettingA sample of 38 patients was recruited who were to be electively admiited to ICU divided into experimental (n = 19 patients receiving one visit prior to hospital ICU admission for surgery) and control (n = 19 patients not receiving a visit prior to hospital ICU admission for surgery) groups. Main outcome measurementsHospital Anxiety and Depression Scale (HADS) and Impact of Event Scale-Revised (IES-R) were self-reported by patients before ICU admission, at 3-days and 90-days after ICU discharge. Critical Care Family Needs Inventory (CCFNI) and Family Satisfaction with Care in the Intensive Care Unit (FS-ICU) were used to measure the users’ satisfaction before ICU admission and 3-days after ICU discharge. ResultsThere were statistically significant differences between experimental and control groups for FS-ICU, but not for HADS, IES-R and CCFNI. Indeed, control group patients were more satisfied with regard to emotional support, ease of getting information, control feeling, concerns and questions expression ability and overall score for decision-making satisfaction. ConclusionsThe visit prior to hospital admission did not seem to modify anxiety or depression, but may impair satisfaction of ICU patients.

Pilot Test of a Computer-Based System to Help Family Caregivers of Dementia Patients.

Family members absorb much of the care of dementia patients. The burden of care substantially impacts caregivers' health, further straining our healthcare system. By 2050, the incidence of Alzheimer's disease will more than double, increasing the numbers of family caregivers proportionally. Interventions that reduce their burden are needed to preserve their health as well as the viability of the healthcare system. This paper reports on the development and feasibility testing of a computer-based system intended to improve the lives of caregivers. D-CHESS (Dementia-Comprehensive Health Enhancement Support System) allows users to obtain information, communicate with other caregivers, get help with care decisions, and share information with experts. Thirty-one caregivers were randomly assigned to an intervention group receiving D-CHESS for 6 months or to a control group receiving a caregiving book. Surveys at 0, 2, 4, and 6 months evaluated caregiver burden, family conflict, satisfaction with decisions, social support, loneliness, anxiety, depression, and coping competence. Survey findings suggest D-CHESS participants may perform better on measures of social support, anxiety, loneliness, and coping competence; the groups were equivalent on caregiver burden, decision satisfaction, and depression, and the control group reported less family conflict than the intervention. D-CHESS use data suggested enhancements to system design and content to increase awareness and use of various features. This study suggests that D-CHESS has potential to positively impact family caregivers and that the system merits further development and investigation with a full-scale clinical trial.

Patient-Perceived Lack of Choice in Receipt of Radioactive Iodine for Treatment of Differentiated Thyroid Cancer.

For many patients with differentiated thyroid cancer, use of radioactive iodine (RAI) does not improve survival or reduce recurrence risk. Yet there is wide variation in RAI use, emphasizing the importance of understanding patient perspectives regarding RAI decision making. All eligible patients diagnosed with thyroid cancer from 2014 to 2015 from the Georgia and Los Angeles SEER registries were surveyed (N = 2,632; response rate, 63%). Patients in whom selective RAI use is recommended were included in this analysis (n = 1,319). Patients were asked whether they felt like they had a choice to receive RAI (yes or no), how strongly their physician recommended RAI (5-point Likert-type scale), whether they received RAI (yes or no), and how satisfied they were with their RAI decision (more [score of 4 or greater] v less). Multivariable, weighted logistic regression with multiple imputation was used to assess the associations between patient characteristics and perception of no RAI choice and between perception of no RAI choice with receipt of RAI and decision satisfaction. More than half of respondents (55.8%) perceived they did not have an RAI choice, and the majority of patients (75.9%) received RAI. The odds of perceiving no RAI choice was greater among those whose physician strongly recommended RAI (adjusted odds ratio [OR], 1.56; 95% CI, 1.13 to 2.17). Patients who perceived they did not have an RAI choice were more likely to receive RAI (adjusted OR, 2.50; 95% CI, 1.64 to 3.82) and report lower decision satisfaction (adjusted OR, 2.31; 95% CI, 1.67 to 3.20). Many patients did not feel they had a choice about whether to receive RAI. Patients who perceived they did not have a choice were more likely to receive RAI and report lower decision satisfaction, suggesting a need for more shared decision making to reduce overtreatment.

Comparison of Three Measures of Shared Decision Making: SDM Process_4, CollaboRATE, and SURE Scales.

Objective. If shared decision making (SDM) is to be part of quality assessment, it is necessary to have good measures of SDM. The purpose of this study is to compare the psychometric performance of 3 short patient-reported measures of SDM. Methods. Patients who met with a specialist to discuss possible surgery for hip or knee osteoarthritis (hips/knees), lumbar herniated disc, or lumbar spinal stenosis (backs) were surveyed shortly after the visit and again 6 months later. Some of the patients saw a patient decision aid (PDA) prior to the meeting. The 3 SDM measures were the SDM Process_4 (SDMP) survey, CollaboRATE, and SURE scale. The follow-up survey included measures of decision regret, satisfaction, and decision quality. Results. Patients in the sample (N = 649) had a mean age of 63.3 years, 51% were female, 60% were college educated, and there were more hip/knee patients than back patients (69% v. 31%). Forty-nine percent had surgery. For hips/knees, the SDMP and SURE scores were significantly associated with viewing all of the PDA compared with those who did not (P < 0.001), but not for CollaboRATE (P = 0.35). For backs, none of the scores were significantly associated with viewing all the PDA. All 3 scores were significantly associated with less regret and higher satisfaction (P < 0.001) for hips/knees. For backs, only SURE and CollaboRATE were significantly associated with less regret, and only SDMP was significantly associated with higher satisfaction. For hips/knees and backs, the SDMP and SURE scales were significantly associated with an informed patient-centered decision (P < 0.001), but this relationship was not significant for CollaboRATE (hips/knees: P = 0.24; backs: P = 0.25). Discussion. Each measure has some evidence of validity. SURE and SDMP better discriminate the use of PDAs and have higher decision quality.

The impact of frequency of contact on protégé mentoring outcomes: the moderating effects of protégé general self-efficacy and face-to-face interaction

ABSTRACT As a Human Resource Development (HRD) intervention, mentoring assists individuals in their career development. However, it is still unknown if mentoring could enhance individuals’ early career decision-making. Moreover, the literature lacks longitudinal research that investigates the role of frequency of contact in mentoring relationships. Therefore, this study examines whether frequency of contact between mentor and protégé influences protégé mentoring outcomes, namely, improvement in career decision self-efficacy (i.e. CDSE development) and satisfaction with mentoring. Data were collected at two times from 86 first-year undergraduate students who participated in a mentoring programme at a Middle Eastern business school, where email communication facilitated the contact between these protégés and their mentors. Based on regression analyses, the associfations were significant between frequency of contact and mentoring outcomes. The findings partially confirmed the effects of two moderating variables in the relationships mentioned above. This study has practical implications for HRD practitioners in higher-education institutions.

The changing landscape of vestibular schwannoma diagnosis and management: A cross-sectional study.

To assess the current state of the diagnosis and management of vestibular schwannoma (VS) as well as treatment trends, and to evaluate the role of treatment setting and various specialists in treatment plan. Patients diagnosed with VS completed a voluntary and anonymous survey. The questionnaires were distributed through Acoustic Neuroma Association website, Facebook page, and e-mail newsletters from January to March 2017. In total, 789 VS patients completed the survey. Of those, 414 (52%) underwent surgery; 224 (28%) underwent radiotherapy; and 121 (15%) were observed. General otolaryngologists diagnosed 62% of responders, followed by primary care (11%) and neurotologists (10%). Patients who underwent surgery were significantly younger and had larger tumors compared to those treated with radiation or observation. The ratio of patients having nonsurgical versus surgical resection changed from 1:2 to 1:1 for the periods of 1979 through 2006 versus 2007 through 2017, respectively. Neurosurgeons (40%) and neurotologists (38%) were the most influential in treatment discussion. Neurotologists (P < 0.001) and general otolaryngologists (P = 0.04) were more influential than neurosurgeons for the decision process in patients with smaller tumors. Patients treated at academic versus nonacademic private institutions reported similar tumor sizes (P = 0.27), treatment decisions (P = 0.09), and decision satisfaction (P = 0.78). There is a continuing trend toward nonsurgical management, with approximately half of the patients opting for nonsurgical management. In this cohort, the patients commonly presented with otologic symptoms and otolaryngologists made the most diagnoses. Neurotologists and neurosurgeons were the most influential in treatment discussion. NA Laryngoscope, 130:482-486, 2020.