Role In Decision Research Articles

Research on the application of automatic control theory in automatic driving technology

Autonomous driving technology has been widely used and studied in depth in recent years, and has become a hot field in the automotive industry. As one of the core methods to realize automatic driving, automatic control theory provides an important theoretical basis and practical guidance for automatic driving systems. This paper aims to explore the application of automatic control theory to autonomous driving and analyze its potential impact on improving driving safety, comfort and efficiency. This paper first introduces the basic principles and components of the autonomous driving system. Among them, automatic control theory plays an important role in decision-making and execution. Secondly, this paper discusses the specific application of automatic control theory in automatic driving. These include PID controller-based vehicle stability control, model predictive control (MPC) for path planning and trajectory tracking. These applications enable autonomous driving systems to respond in real time to environmental changes and maintain vehicle stability and safety. Finally, the paper discusses the challenges and future directions of automatic control theory in autonomous driving. Future research should focus on further improving the robustness and adaptability of automatic control algorithms to cope with complex driving scenarios and uncertainties. To sum up, automatic control theory plays an important role in automatic driving and has broad application prospects. Through continuous improvement and innovation, automatic control theory will make an important contribution to the realization of safer, more efficient, and more intelligent autonomous driving technology.

Genomic sequencing research in pediatric cancer care: Decision-making, attitudes, and perceived utility among adolescents and young adults and their parents.

Professional guidelines recommend engaging adolescents and young adults (AYAs) in medical decision-making (DM), including whether to undergo genomic sequencing (GS). We explored DM around GS and attitudes after return of GS results among a diverse group of AYAs with cancer and their parents. We surveyed AYAs with cancer (n=75) and their parents (n=52) six months after receiving GS results through the Texas KidsCanSeq Study. We analyzed AYAs' DM role in GS research enrollment and their satisfaction with that role. We compared AYAs' and parents' self-reported understanding of, attitudes toward, and perceived utility of the AYAs' GS results. Most AYAs reported equally sharing DM with their parents (55%) or leading DM (36%) about GS research. Compared to their cancer care DM role, 56% of AYAs reported the same level of involvement in GS research DM while 32% were more involved and 13% were less involved (p=0.011). AYAs were satisfied (99%) with their DM role regarding GS study participation. AYAs and parents had similar self-reported understanding of, attitudes toward, and perceived utility of the GS results. Our results support engaging AYAs in DM about GS research and provide insights into AYAs' DM preferences and positive attitudes toward GS.

Comparing evidence use in parliaments: the interplay of beliefs, traditions, and practices in the UK and Germany

Abstract This article draws on rich qualitative data from two national parliaments—the UK House of Commons and the German Bundestag—to examine knowledge practices in political institutions. This is an important topic, not only because parliaments play a significant role in democratic decision-making, but because it sheds light on debates about how such decision-making is based on and interacts with knowledge and evidence. By adopting an interpretive analytical approach, I analyze the ways in which those practices are shaped by the beliefs and values of parliamentary actors. Indeed, in better understanding everyday practices, beliefs, and ideational traditions, it also contributes to better explaining how components of political and parliamentary cultures contribute to knowledge use more broadly. In the House of Commons, MPs draw on a highly trusted and independent parliamentary administration; meanwhile, committees have become fruitful avenues for MPs to develop policy expertise and engage with knowledge and evidence in a non-partisan way. In the German Bundestag, MPs also develop policy expertise—in fact, they interpret their role as specialists in a “working” parliament—but their knowledge practices are more openly partisan through the structuring role of parliamentary party groups and the skepticism of “neutral” advice from research services. Consequently, committees tend to be sites of political bargaining and conflict, rather than evidence-gathering. In both cases, parliaments’ knowledge practices are shaped by wider webs of beliefs about the role of MPs within the institutions. This suggests that knowledge use in political and policy settings is shaped by broader cultural factors.

Women in innovative start-ups and regional inclusiveness: ‘green’ and socially-responsible companies

ABSTRACT We explore the link between women in business decision-making roles, regional gender equality in the workforce and start-up sustainability. We employ unique administrative data on innovative start-ups in Italy and implement a novel crawler-based semantic search of start-ups’ websites to identify ‘green’ firms. Our findings on high-tech innovative start-ups confirm established evidence in the female entrepreneurship literature: greater shares of women in decision-making roles increase the probability of a social focus but decrease the likelihood of science, technology, engineering and mathematics (STEM)-intensive green energy objectives. Instead, the board gender composition does not correlate with non-energy ‘green’ objectives. Non-energy ‘green’ firms emerge more in gender-equal regions, while social start-ups develop where women have fewer employment opportunities.

Students as partners for effective change

My journey as a student partner began in the summer of 2020, amidst overwhelming COVID-19 hysteria and an opportunity to explore a new kind of online learning. I was doing research with a professor of mine and invited to a workshop about Pedagogical Partners with Alison Cook-Sather. When I learned how impactful my work could be as a student partner, I was hooked. For many years, I had felt as though students were not listened to, heard, or respected. I wanted students to be able to play an active role in their own learning. My freshman year, I became an undergraduate teaching assistant (UTA). The experience truly changed my college experience - I mended my troubled relationship with school and learning and came to love it. Now, in my final year of college, I’ve been a UTA every semester since my freshman year. I’ve done research on the number of UTAs across the country and on campus at Syracuse University (SU). At SU, UTAs were few and far between, just about 10% of classes had one. The most common answer as to why UTAs weren’t used was that there was no money to pay them, so I created my own class that gave students 3 credits to be a UTA and partnered up with two close faculty mentors of mine to teach it. We reflected, dished out advice, and made important bonds with faculty and each other. After one very successful semester, we combined with the Partnership for Inclusive Education (PIE) Program through the Center for Teaching and Learning Excellence to merge the UTA program with a student consultant program. This semester, I am enjoying the best of both worlds as a UTA as well as a lead student consultant. Over the course of my college career, I have learned what a true partnership means, experienced the two-way learning it provides, and worked to make courses more inclusive, understanding, and student-centered. I’ve fought hard to put students in decision-making roles and mentored countless students into fantastic student partners that have changed campus for the better.

Building Trees for Probabilistic Prediction via Scoring Rules

Decision trees built with data remain in widespread use for nonparametric prediction. Predicting probability distributions is preferred over point predictions when uncertainty plays a prominent role in analysis and decision-making. We study modifying a tree to produce nonparametric predictive distributions. We find the standard method for building trees may not result in good predictive distributions and propose changing the splitting criteria for trees to one based on proper scoring rules. Analysis of both simulated data and several real datasets demonstrates that using these new splitting criteria results in trees with improved predictive properties considering the entire predictive distribution.

Soybean seedling detection and counting from UAV images based on an improved YOLOv8 Network

Abstract. The utilization of unmanned aerial vehicle (UAV) for soybean seedling detection is an effective way to estimate soybean yield, which plays a crucial role in agricultural planning and decision-making. However, the soybean seedlings objects in the UAV image are small, in clusters, and occluded each other, which makes it very challenging to achieve accurate object detection and counting. To address these issues, we optimize the YOLOv8 model and propose a GAS-YOLOv8 network, aiming to enhance the detection accuracy for the task of soybean seedling detection based on UAV images. Firstly, a global attention mechanism (GAM) is incorporated into the neck module of YOLOv8, which reallocates weights and prioritizes global information to more effectively extract soybean seedling features. Secondly, the CIOU loss function is replaced with the SIOU loss, which includes an angle loss term to guide the regression of bounding boxes. Experimental results show that, on the soybean seedling dataset, the proposed GAS-YOLOv8 model achieves a 1.3% improvement in mAP@0.5 and a 6% enhancement in detection performance in dense seedling areas, when compared to the baseline model YOLOv8s.When compared to other object detection models (YOLOv5, Faster R-CNN, etc.), the GAS-YOLOv8 model similarly achieved the best detection performance. These results demonstrate the effectiveness of the GAS-YOLOv8 in detecting dense soybean seedlings, providing more accurate theoretical support for subsequent yield estimation.

Genomic medicine advances for brain tumors.

Cancer genome profiling has revealed important genetic alterations that serve as prognostic indicators and guides for treatment decisions, enabling precision medicine. The shift to molecular diagnosis of brain tumors, as reflected in the 2021 World Health Organization Classification of Tumors of the Central Nervous System, is a crucial role for treatment decision-making. This review discusses the significance and role of cancer genome profiling in precision medicine for malignant brain tumors, particularly gliomas. Furthermore, we explore the progress in cancer genome analysis, focusing on cancer gene panel testing, integration of genomic information in brain tumor classification, and hereditary tumors. Additionally, we discuss the transformative effect of genomic medicine on early detection, risk assessment, and precision medicine strategies. The tumor mutational burden in brain tumors is considered low, but the application of molecular targeted drugs, such as isocitrate dehydrogenase inhibitors, v-raf murine sarcoma viral oncogene homolog B1 inhibitors, fibroblast growth factor receptor inhibitors, neurotrophic tyrosine receptor kinase, mechanistic target of rapamycin inhibitors, and anti-programmed death receptor-1 antibody drugs are promising for glioma treatment. We also discuss the future prospects of molecular targeted drugs.

The Insular Cortex: An Interface Between Sensation, Emotion and Cognition.

The insula is a complex brain region central to the orchestration of taste perception, interoception, emotion, and decision-making. Recent research has shed light on the intricate connections between the insula and other brain regions, revealing the crucial role of this area in integrating sensory, emotional, and cognitive information. The unique anatomical position and extensive connectivity allow the insula to serve as a critical hub in the functional network of the brain. We summarize its role in interoceptive and exteroceptive sensory processing, illustrating insular function as a bridge connecting internal and external experiences. Drawing on recent research, we delineate the insular involvement in emotional processes, highlighting its implications in psychiatric conditions, such as anxiety, depression, and addiction. We further discuss the insular contributions to cognition, focusing on its significant roles in time perception and decision-making. Collectively, the evidence underscores the insular function as a dynamic interface that synthesizes diverse inputs into coherent subjective experiences and decision-making processes. Through this review, we hope to highlight the importance of the insula as an interface between sensation, emotion, and cognition, and to inspire further research into this fascinating brain region.

Actors and structures in international relations. The US, the EU, and West Africa: from indifference and development to promotion of security

ABSTRACT It is an old debate in social science, what is most influential, actors or structures? The paper resumes the discussion by concretely asking, how can the radical policy shift towards West Africa in the wake of the terrorist attacks on the US in September 11, 2001, be explained by applying an agency-structure approach? The article applies a theoretical framework combining neo-classical realist thinking with the reasoning found in historical institutionalism. Concepts like path dependency and critical juncture are helpful. The roles and priorities of the core foreign policy actors in the United States and in the European Union are discussed before the article identifies international and domestic structures that might constrain the role and influence of the relevant foreign policy decision-makers. It is concluded that neither international nor domestic structures represented strong obstacles to the foreign policy decision makers’ ambitions to implement radical policy changes towards West Africa.

Empowerment of Women through Entrepreneurship in Gorkha District, Nepal

Promoting women’s empowerment through entrepreneurship and income-generating activities is a crucial factor in advancing the development of both families and society. This study investigates the impact of women's entrepreneurship on their empowerment, focusing on decision-making roles, reduced dependency, increased income levels, shifts in social perception, and employment generation in Gorkah District, Nepal. A sample of 150 women entrepreneurs was purposively selected for primary data collection, employing research-administered questionnaires. In this study, partial least squares structural equation modeling (PLS-SEM) was used to assess relationships between independent and dependent variables. The findings reveal that decision-making role, employment generation, and change in income levels significantly and positively influence women's empowerment, indicating that improvements in these areas are associated with increased women's empowerment. This research provides valuable insights for policymakers and practitioners and supports women’s entrepreneurship to promote women empowerment.

The Nuanced Dance of Foreknowledge: A Reflection on Events and Choices

Foreknowledge, the ability to possess knowledge or awareness of events before they happen, introduces a fascinating dimension to our understanding of time and causality. In exploring this concept, it is crucial to recognize that foreknowledge is not causative; it doesn't bring about the events it predicts. This essay delves into the predictive nature of foreknowledge, the role of human decision-making, the interplay of randomness and probability, the impact on personal responsibility, and engages in thought-provoking discussions on determinism vs. free will, ethical considerations, embracing uncertainty, impact on planning, and the psychological effects of knowing about future events.

Cui Bono? Cow Slaughter ban and its impact on business and society in India

This research investigates the impact of the cow slaughter ban on different stakeholders in India. The cow is considered a sacred animal in Hinduism, and prohibition of its slaughter prevails in several states in India. India is also a secular state, as its written constitution prescribes. However, the recent ban on cow slaughter in certain states raises several interesting and important ethical questions. We use Aristotle’s Cui Bono moral framing and stakeholder theory to investigate the causes and consequences of the cow slaughter ban on business and society. To this end, our study argues that political and religious affiliations affect stakeholders’ actions and decisions and that they comply with their actions. This has implications for businesses (such as the beef business in India) and society. Based on semi-structured in-depth interviews with key stakeholders such as beef business owners, religious leaders and opposition politicians, our findings indicate that although these stakeholders have their interests, religious and political affiliations play a significant role in shaping such decision-making.

Time and Distance Perception in Highly Dynamic Environments

Abstract Space- and time-based tasks, like flying airplanes, driving cars, or the manual controlled rendezvous and docking of spacecrafts can be very demanding for pilots, drivers, or astronauts, depending on selected trajectories, approaching speeds, or distracting information. One characteristic of highly dynamic environments is that persons have to consider their spatial position in relation to surrounding elements based on passing time, detected speed, and trajectories to avoid collisions with other objects. An inadequate perception of the own position in relation to other objects and passing time can lead to impaired decision-making processes, resulting in errors or collisions. A framework for the explanation of cognitive processes involved in perception, anticipation, and decision-making in dynamic environments is provided by the concept of situation awareness. Based on this framework persons must perceive relevant elements, integrate them in a coherent mental representation and anticipate the development of the current situation in the near future, to plan safe upcoming maneuvers. Thus, for safe maneuvers anticipation processes are playing a major role in decision-making and action selection. In this paper it is proposed that time and distance perceptions are central features of anticipation processes in dynamic situations. It is suggested to combine theories like the attentional-gate model and time-to-contact with the framework of situation awareness to explain anticipation processes in dynamic environments. The major aim is to develop precise cognitive models of persons acting in dynamic situations. Such cognitive models can be the basis for the development and parameterization of assistance systems, supporting anticipation in dynamic environments.

Abstract PO2-10-12: The devil is in the details: Workflow analysis of breast cancer treatment decision making and implications for decision support design

Abstract While numerous decision aids have been developed to support treatment decision-making in breast cancer1, widespread implementation remains limited due to challenges integrating these tools in clinical workflows2. Given these persistent issues, we need to better understand the complex workflows and needs of decision aid users - patients, their family caregivers, and breast cancer clinicians. Previous studies have explored various aspects of breast cancer team workflows3,4. Despite this work, it is still unclear how these complex workflows support or hinder decision aid use. In this study, we conducted an in-depth analysis of breast cancer team workflow to elicit design requirements for informatics tools to support patient-centered decision-making. This study was part of a larger project aimed at designing a COMputeried PAtient-centered Collaborative Technology (COMPACT) to support personalized decision-making for breast cancer patients. We conducted observations of clinicians and patients at one breast center, using a tablet computer with smart pen to take notes on all aspects of clinic workflow. We uploaded all observation notes into a qualitative data analysis software, Dedoose. Two researchers coded the observations in an inductive, consensus-based process. We met to review our codes and identify key themes emerging in the data. We observed 95 hours and 127 patient encounters across 20 clinician-centered and 8 patient-centered observations. We identified 10 themes related to the design of decision support, which we grouped into the 4 components of workflow6 (see Table 1). We identified numerous patient-specific factors communicated from the patient to the clinical team that influenced treatment decision-making. These “decision factors” covered the broader scope of the patient’s life that was important in the decision-making process (e.g., upcoming family wedding, work). Patients were frequently “knowledge brokers” and were asked to remember and relay information across members of the care team. We identified 28 different tools and technologies used to support treatment decision-making. Patient family caregivers (e.g., aunt, husband) played an important role in treatment decision-making. Based on these findings, we developed design requirements for informatics tools to better support patients (and clinicians). Our study highlights the complexity and interdependence of breast cancer treatment decision-making. Patients frequently made treatment decisions that influenced subsequent decisions. Decision aids typically focus on one decision or one care specialty and do not support consideration of several treatment options at one time1. Future research is needed to determine if and how decision support tools could incorporate the broader scope and interdependence between decisions to support patient-centered care. We highlight the need for informatics tools to consider the diverse and unique decision factors (e.g., hobbies) that are crucial to patient-centered decision-making. Decision support could help to elicit and incorporate these factors during treatment decision-making. However, the variable nature of these patient-specific factors presents a challenge to decision support design. Further research is needed to determine how to optimally incorporate such factors into decision support tools. We found inadequate system support for clinicians’ tasks including limited feedback loops to notify clinicians of completed tasks (e.g., mammogram, genetic testing). As a result, patients were often responsible for relaying information to and between different members of the clinical team. Given that patients only remember 50% of what clinicians tell them during visits7, a better system is needed to improve the reliability of information transfer. Our design guidelines can be used to improve the design of decision support tools and ultimately improve patient-centered decision-making. Table 1. Workflow components, themes, and associated challenges to decision support design Citation Format: Megan Salwei, Carrie Reale. The devil is in the details: Workflow analysis of breast cancer treatment decision making and implications for decision support design [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-10-12.

Role of Social Media in Investment Decision-making: A Comprehensive Review and Future Roadmap

In recent years, the importance of social media has grown analytically, emphasizing the importance of an appropriate framework that can clarify its role in financial investment decision-making. This essay aims to establish a link between social media use and stock market participation. We used the SPAR-4-SLR technique with theory, context, characteristics and methodology framework analysis to conduct a systematic literature review of essential journal articles published between 2013 and 2023. This review summarizes theoretical and empirical research on social media use and stock market participation. By revealing a significant association between social media use and stock market participation and explaining the impact of other elements that remain unresearched, this study has added a new perspective to the literature. This study will help financial specialists, economic institutions and policymakers design better stock market strategies, make financial decisions and add to the body of knowledge concerning the relationship between social impact and SMP.

Abstract PO5-05-04: Advancing Treatment and Management of Patients with HR+/HER2- Breast Cancer: Findings from a Quality Improvement Initiative

Abstract Background: With the advent of novel oral oncolytics, the cancer care delivery model for HR+/HER2- breast cancer (BC) is evolving, shifting the responsibility for medication adherence and monitoring and managing of side effects to patients and their caregivers. In this quality improvement (QI) initiative, we aimed to uncover and address gaps in patient and provider education, risk reduction, adverse event management, and shared decision-making in order to improve outcomes for HR+/HER2+ patients on oral oncolytics. Methods: From 9/2022 to 12/2022, 54 HCPs who treat breast cancer and 111 HR+/HER2- BC patients from 4 US community oncology clinics completed surveys assessing attitudes, values, and challenges related to practice patterns, education, and therapy adherence in HR+/HER2- BC. HCPs participated in audit-feedback sessions to reflect on survey results and their own practice, and developed action plans to improve care, which were implemented in subsequent collaborative patient-provider learning sessions. Results: Top reported HCP challenges in HR+/HER2- BC care include providing patient-centered supportive care measures (32%), patient adherence/lack of follow up (22%), and individualizing treatment plans (17%). Additionally, 43% of providers reported that improved collaboration across interprofessional teams would most improve care. Top reported patient challenges include worry about and/or difficulty managing side effects from treatment (26%), difficulty scheduling visits with many different HCPs/following up (24%), and difficulty communicating with healthcare teams (16%). In surveys, 28% of patients reported frequently or very frequently missing/skipping doses of oral breast cancer medication. Top reasons for missing/skipping doses included forgetting or not having it nearby (36%), cost (21%), and side effects (20%). To address the top challenges identified in baseline surveys, HCPs developed and implemented action plans, such as improving the identification of patients at high risk of recurrence, establishing patient-provider educational sessions, increasing the use of patient navigators, incorporating oral adherence toolkits, and educating patients and staff about available supportive care resources. After implementation of patient-provider collaborative education sessions at community clinics, patients reporting high levels of knowledge about BC treatment options and communicating side effects/symptoms increased from 27% to 57%, and 37% to 77%, respectively. At 60-day follow-up, 58% of patients reported taking a more active role in treatment decision-making, and 52% reported setting reminders/alarms/using apps to remember to take medication on time. Conclusions: Patient adherence to oral oncolytic medications remains a challenge in BC treatment. This quality improvement initiative uncovered underlying barriers to effective treatment management of HR+/HER2- breast cancer patients on oral oncolytics. Action plans and educational resources were developed and implemented to address identified barriers and optimize treatment management for HR+/HER2- BC. These methods and findings represent key opportunities for improvement that can be implemented in community oncology practices to improve adherence to oral oncolytics and overall HR+/HER2- breast cancer care. Citation Format: Jane Meisel, Chelsie Anderson, Ilona Dewald, Jeffrey Carter, Cherilyn Heggen, Kelly McKinnon. Advancing Treatment and Management of Patients with HR+/HER2- Breast Cancer: Findings from a Quality Improvement Initiative [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-05-04.

"Too young to have this kind of diagnosis": A qualitative exploration of younger adults' experiences of colorectal cancer diagnosis.

Colorectal cancer (CRC) incidence is rising among adults under the age of 50 (early- or young-onset CRC). This population is more likely to have advanced-stage disease at diagnosis, suggesting their diagnostic pathway may be prolonged. To better understand factors influencing this pathway, this study explored patients' experiences of decision-making during a diagnosis of young-onset CRC. Semi-structured interviews were conducted with 17 participants with young-onset CRC diagnosed in 2021-2022 in Victoria, Australia. Interviews were conducted online or by phone an average 7months (range 1-13) after diagnosis. Analysis was approached from a critical realist perspective, with themes developed inductively using reflexive thematic analysis. Five themes were identified: Shifting Perception of Urgency, Multidimensional Perception of Role, Making the Most of Resources, Stage of Life, and COVID Adds Complexity. Participants' decision-making evolved over the diagnostic period. As participants perceived urgency to act, they took on a more active role in decision-making, utilising personal resources to access timely care. Their decisions were shaped by stage-of-life considerations, including employment and caring for a young family, with the COVID-19 pandemic adding "…a whole other layer of complexity" to the process. Younger adults with CRC make decisions in the context of unique considerations, adapting to reduce time to diagnosis, with decisions complicated by the COVID-19 pandemic. Greater support from health care providers/systems in the diagnostic period may improve timeliness of CRC diagnosis and outcomes in younger adults.

The Covert Impact of Chiari Network and Eustachian Valves on Stroke: A Scoping Review and Meta-Analysis.

The role of Chiari network (CN) and Eustachian valves (EVs) in cardioembolic strokes is still unclear. There is inconsistency in the literature regarding clinical approach to these lesions to reduce stroke risk. We aimed to describe clinical presentation, neuroimaging and cardioimaging features, as well as management approaches for CN and EV in stroke context. A systemic search was carried out using PubMed and Web of Science following PRISMA guidelines, Supplemental Digital Content 1 ( http://links.lww.com/NRL/A123 ). We retrieved 4 case-control studies, 2 cross sectional studies as well 8 case reports, with a total of 883 patients with a mean age of 44.6 years (±13.8). The combined prevalence of EV/CN in stroke-related patent foramen ovale (PFO) patients was 50% (95% CI: 31-68). With isolated prevalence for EV and CN of 43% (95% CI: 25-63), 18% (95% CI: 12-25), respectively. Patients with history of stroke had higher prevalence of EV/CN compared with controls odds ratio=2.45 (95% CI: 1.2-5, P <0.01). All case-control and cross-sectional studies defined EV/CN by transesophageal echocardiography or intracardiac cardiography. In the 8 case reports, 7 cases were diagnosed by transesophageal echocardiography, while only 1 case was diagnosed postmortem. EV/CN are relatively common findings in stroke patients with PFO. While it appears that presence of EV/CN with a PFO increases the risk of cardioembolic stroke, they remain underrecognized. EV/CN should be considered as high-risk PFO features. There is a scarcity of research emphasizing their role in clinical decision making, especially PFO closure and antithrombotic therapy choice.

Regional differences in predictive biomarker testing rates for patients with metastatic NSCLC in the Netherlands

BackgroundPredictive biomarker testing has a key role in the treatment decision-making for patients with non-small cell lung cancer (NSCLC) and is mandated by (inter)national guidelines. The aim of this study was to establish guideline-adherent biomarker testing rates in the Netherlands in 2019 and to examine associations of demographical, clinical, and environmental factors with guideline-adherent testing. MethodsThis study involved the integration of clinical data of the Netherlands Cancer Registry with pathology reports of the Dutch Nationwide Pathology Databank. Data extracted from these reports included sample type, diagnosis, and molecular testing status of predictive biomarkers. The study population comprised all patients diagnosed with metastatic non-squamous NSCLC in the Netherlands in 2019. ResultsIn the cohort of 3,877 patients with metastatic non-squamous NSCLC under investigation, overall molecular testing rates for non-fusion predictive biomarkers (EGFR, KRAS, BRAF, ERBB2, MET) ranged from 73∙9 to 89∙0%, while molecular testing for fusion-drivers (ALK, ROS1, RET, NTRK) ranged from 12∙6% to 63∙9%. Guideline-adherent testing of EGFR, KRAS, and ALK was performed in 85∙2% of patients, with regional rates spanning from 76∙0% to 90∙8%. Demographical and clinical factors associated with guideline-adherent biomarker testing included lower age (OR=1∙05 per one year decrease; p<0∙001), female sex (OR = 1∙36; p=0∙002), diagnosis of adenocarcinoma (OR = 2∙48; p<0∙001), availability of histological tumor material (OR = 2∙46; p<0∙001), and clinical stage of metastatic disease (p=0∙002). Other factors associated with guideline-adherent biomarker testing included diagnosis at academic center (OR = 1∙87; p=0∙002) and patient’s region of residence (p<0∙001). ConclusionOptimization of the chain-of-care of predictive biomarker testing in patients with NSCLC in the Netherlands is needed to provide adequate care for these patients.