Differences In Decision-making Processes Research Articles

Investigation of Factors Considered by Health Technology Assessment Agencies in Eight Countries.

BackgroundHealth technology assessment (HTA) organizations play a crucial role in optimizing healthcare resources, but the factors influencing decision making vary by country.ObjectiveHTAs of cancer and hepatitis C drugs were evaluated across developed countries to understand differences in decision processes and criteria.MethodsThe HTA organizations evaluated are from France, Germany, Italy, Spain, the United Kingdom (UK), Australia, Canada and Japan. Economic evaluation types and 28 factors in the following categories were evaluated: clinical uncertainties/issues; disease/population/treatment consideration factors including National Institute for Health and Care Excellence’s (NICE) special circumstances factors (e.g. end-of-life and innovation); and International Society for Pharmacoeconomics and Outcomes Research (ISPOR) additional value elements. Qualitative and correspondence analyses were conducted to assess the differences across organizations.ResultsIncremental cost-effectiveness ratio (ICER) using quality-adjusted life-year (QALY) was evaluated in Canada, the UK, Australia and Japan. The highest observed clinical uncertainties were clinical benefits and comparator. For cancer drugs, correspondence analysis showed France, Australia, Canada and the UK to have common attributes observed, such as unmet needs and stakeholder persuasion. In addition, the UK reported end-of-life, issues around current treatment and innovation, whereas Germany reported manageable/insignificant adverse events more frequently. Finally, fear of contagion, equity and scientific spillover value elements were only observed in Australia.ConclusionAlthough clinical factors play a predominant role in the decision to reimburse medicine, HTA organizations consider additional aspects as well. If the methodology of HTA was clearly outlined, there would be more transparency in HTA systems leading to better understanding amongst stakeholders about decision making.Electronic supplementary materialThe online version of this article (10.1007/s41669-020-00235-6) contains supplementary material, which is available to authorized users.

Age-related differences in decision-making process in the context of healthy aging

During aging cognitive functions change differently from others. Unlike most of the body systems, there is no clear decline pattern in cognitive processes. One of the most significant cognitive processes is decision-making, which defines social interactions, economical relationships, and risky behavior. Among factors influence decisionmaking process, individual lifelong experience is considered to be an important one. Obviously, older adults have more life experience, than the younger groups. However, the former often do not tend to rational choices and beneficial strategies. In this case it is important to assess how aging processes in brain contribute into searching for the most beneficial option during decision-making. On the basis of today’s studies about risky behavior, judgement of fairness, financial games, and modern neuroimaging data this review will observe and discuss age-related differences in decision-making. Thus, a correct cognitive profile of older adult in decision-making context can be determined.

The Italian Version of the Cognitive Style Indicator and its Association with Decision-Making Preferences

The Cognitive Style Indicator (CoSI) includes 3 cognitive dimensions: creating (flexible, open-ended and inventive), knowing (emphasizing facts, details, objectivity, and rationality), and planning (guided by preferences for certainty and well-structured information). The first aim of this research was to validate the 3-factor structure of the CoSI within the Italian context. The second was to verify whether cognitive styles, as measured by the CoSI, accounted for individual differences in decision-making processes. Two studies were conducted using 2 different samples (n = 549 and n = 397). Confirmatory and multigroup factor analysis corroborated the 3-factor model and the measurement invariance of the instrument across genders. Reliability indices showed good internal consistency, as well as good levels of convergent and discriminant construct validity. Results from structural equation model revealed that cognitive styles, as measured by the CoSI, predicted individual differences in intuitive and deliberative decision-making processes. Findings gave evidence for the validity of the Italian version of the CoSI and for the causal relationship between cognitive styles and decision-making processes. Further research is needed to explore a more comprehensive model that includes, for example, personality.

The impact of stakeholder involvement in hospital policy decision-making: a study of the hospital’s business processes

Introduction: In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital’s board of directors on themes of strategic importance.Objectives: To study the internal hospital’s decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes.Methods: A retrospective analysis of the decision processes was conducted in three hospitals that implemented a stakeholder committee. The analysis consisted of process and outcome evaluation.Results: Fifteen themes were discussed in the stakeholder committees, whereof 11 resulted in a considerable change. None of these were on a strategic level. The theoretical model was not applied as initially developed, but was altered by each hospital. Consequentially, the decision processes differed between the hospitals. Despite alternation of the model, the stakeholder committee showed a meaningful impact in all hospitals on the operational level. As a result of the differences in decision processes, three factors could be identified as facilitators for success: (1) a close interaction with the board of executives, (2) the inclusion of themes with a more practical and patient-oriented nature, and (3) the elaboration of decisions on lower echelons of the organization.Conclusion: To effectively influence the organization’s public accountability, hospitals should involve stakeholders in the decision-making process of the organization. The model of a stakeholder committee was not applied as initially developed and did not affect the strategic decision-making processes in the involved hospitals. Results show only impact at the operational level in the participating hospitals. More research is needed connecting stakeholder involvement with hospital governance.

Beyond Self-Report: Emerging Methods for Capturing Individual Differences in Decision-Making Process.

People vary in the way in which they approach decision-making, which impacts real-world behavior. There has been a surge of interest in moving beyond reliance on self-report measures to capture such individual differences. Particular emphasis has been placed on devising and applying a range of methodologies that include experimental, neuroscience, and observational paradigms. This paper provides a selective review of recent studies that illustrate the methods and yield of these approaches in terms of generating a deeper understanding of decision-making style and the notable differences that can be found across individuals.

Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders

There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time—individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day.

Decision-Making Deficits Among Maltreated Children

Although maltreated children involved with child welfare services are known to exhibit elevated levels of health-risking behaviors, little is known about their decision-making processes leading to such tendencies. Research findings suggest that maltreated children exhibit developmental delays in neurocognitive and emotional regulation systems that could adversely impact their abilities to make decisions under conditions of risk. Whereas prior researchers have examined risky decision making as a global construct, maltreated children's decision making was examined in two contexts in the present study: potential gains and potential losses. Comparing maltreated children (n = 25) and a nonmaltreated community group (n = 112), it was found that the maltreated children showed decision-making impairments for both domains: This impairment was especially prominent in the loss domain. The maltreated children took excessive risks and were insensitive to changes in expected value. Follow-up analyses revealed that these differences were primarily associated with insensitivity to changes in outcome magnitude for the risky option. Finally, response latency analyses indicated that the maltreated children were slower to make choices, reinforcing underlying differences in decision processes between groups. These results have implications for basic and translational science.

Decision-Making in Individuals with Agenesis of the Corpus Callosum: Expectancy-Valence in the Iowa Gambling Task

Individuals with agenesis of the corpus callosum (ACC) can have intelligence within the normal range, but nevertheless have deficiencies in decision-making and complex novel problem-solving. The specific nature of these problems is not yet clearly understood. The Iowa Gambling Task was used to test decision-making ability and problem-solving in 40 individuals with complete or partial ACC (full-scale intelligence quotient >80) and 26 control participants. The expectancy-valence (EV) model was applied to the trial-by-trial responses of each participant to elucidate differences in decision processes utilized by each group. The ACC group had a lower overall net gain and fewer advantageous choices than controls, but these differences were not statistically significant. Within the EV model, individuals with ACC exhibited significantly higher attention to losses, less consistency in their choice strategy, and greater frequency of switching between decks. They also showed a tendency to be more influenced by recent trials. This outcome is similar to that seen in individuals with Asperger's disorder. Taken together, these results suggest that individuals with ACC have difficulty in inferring game contingencies and forming a coherent selection strategy, implicating the corpus callosum in these decision processes.

Decision Processes and Use of Decision Aids

The authors report the results of a controlled laboratory experiment comparing the decision processes of participants from Taiwan and Japan. These two nations have very close geographical, cultural, historical, and economic ties. The results show that decision processes of Taiwanese differed from those of Japanese. Specifically, decision processes adopted by Taiwanese participants were more consistent with compensatory processes than were those adopted by Japanese participants. The authors identify cultural factors that may explain the differences. These results demonstrate the danger of generalizing decision theories across national boundaries, even when the nations are seemingly closely related. The results also indicate that the differences in decision processes among nations cannot easily be characterized as East versus West.

Federalization of Local Criminal Procedures: a Study of Conflict in Values and Process

This article is an investigation into why the U.S. federal courts have failed to effectively control local police conduct by means of constitutional rules. In so doing, the article finds that the federal courts' approach to the control of police abuse of power—federalization and constiotutionalization of criminal procedures—is ill informed of the nature and essence of police work within the community context and at the grassroots level. Particularly, it fails to take into account the structural and normative forces giving rise to police abuse. The central thesis of this paper is that the federal courts' constitutional supervision of local police conduct is at odd with the police's operational reality and functional requirements, as reflecting entrenched local customs, shifting community expectations and contingent situational circumstances. The courts' right-based approach is in sharp contrast with the police's utilitarian method. At a more structural level, traditionally and by design, the court is made to stand aloof from the people. The police is required to stay in touch with the people. One of the main purpose of this paper is thus to illuminate the differences in decision-making process and clarify observable disparity in constitutional value preferences between the federal courts and the local police. This will be discussed in the context of police civil liability under Title 42, United States Code, Section 1983 of the Civil Rights Act. The article concludes in observing that the federal courts and the local police, though housed under the same criminal justice system, are two distinctive social control institutions, each with its own political legitimacy base and social utility functions. They share different values, orientation, allegiance and thinking process. These differences, more so than other behavioral or organization factors, accounted for much of the observed police misconduct to date.

Auditory reaction times for functional and nonfunctional hearing loss.

Differences in decision processes as measured by auditory reaction times of simulated or actual functional hearing-loss subjects and nonfunctional subjects were investigated. Sensation level data are presented that reflect marked differences between such individuals with regard to probability of response, and means and standard deviations of auditory reaction times. Means and standard deviations of auditory reaction times for nonfunctional subjects are greatly reduced when compared with results obtained by simulated or actual functional subjects. Probability of response data was less effective in differentiating functional from nonfunctional subjects. Individuals who were trained to simulate hearing loss responded in a manner similar to functional patients. The results of this study suggest that auditory reaction time measures can be employed to determine the existence or nonexistence of functional hearing loss with considerable accuracy.

Auditory reaction times as an index of functional hearing loss

The development and standardization of a new test for functional hearing loss will be discussed. This test is based upon differences in decision processes found between functional and nonfunctional individuals. Sensation level data are presented that reflect marked differences between the above individuals with regard to probability of response, and means of standard deviations of auditory reaction times. Group data show a much steeper slope when probability of response is plotted as a function of sensation level for nonfunctional subjects than for functional hearing loss subjects. Means and standard deviations of auditory reaction times for nonfunctionals are greatly reduced when compared with results for functionals. The above data reflect minimal overlap between individual scores for functional and nonfunctional subjects. The results of this study indicate that the preceding measures can be employed to determine the existence or nonexistence of functional hearing loss with considerable accuracy.