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1
Tan, Jerry, Dawn Stacey, Benjamin Barankin, Robert Bissonnette, Wayne Gulliver, Harvey Lui, Neil Shear, and Shahid Bhatti. "Support Needed to Involve Psoriasis Patients in Treatment Decisions: Survey of Dermatologists." Journal of Cutaneous Medicine and Surgery 15, no. 4 (July 2011): 192–97. http://dx.doi.org/10.2310/7750.2011.10067.
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Background: Little is known about the interaction between dermatologists and their patients in facilitating treatment decisions for psoriasis. Purpose: Our objective was to determine dermatologists' perceptions of the needs of psoriasis patients in treatment decisions. Methods: Dermatologists were invited to complete an 18-item online survey on the treatment of psoriasis, including questions on decision-making roles, factors they considered important to patients in treatment decisions, and patients' needs for decision support. Results: Seventy dermatologists completed the survey (15% response rate). The highest rated factors in decision making were access to physicians for discussion (86%) and information about the risks and benefits (80%); the latter was more frequently reported by those ≥ 50 years ( p = .021). Treatment-specific factors of greatest importance were side-effect profile (87%) and cost (80%). Potential hindrances were patient misconceptions about disease, inadequate patient education materials, patient indecision, and inadequate physician time. Conclusion: Although dermatologists consider accessibility to dermatologists and information on treatment risk and benefits to be important in treatment decision making, they report time with patients and educational materials to be inadequate. Limitations: The small sample size may limit the generalizability of our findings.
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Ogilvie, Ryan, and Peter Carruthers. "Better tests of consciousness are needed, but skepticism about unconscious processes is unwarranted." Behavioral and Brain Sciences 37, no. 1 (January 24, 2014): 36–37. http://dx.doi.org/10.1017/s0140525x13000800.
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AbstractWhat people report is, at times, the best evidence we have for what they experience. Newell & Shanks (N&S) do a service for debates regarding the role of unconscious influences on decision making by offering some sound methodological recommendations. We doubt, however, that those recommendations go far enough. For even if people have knowledge of the factors that influence their decisions, it does not follow that such knowledge is conscious, and plays a causal role, at the time the decision is made. Moreover, N&S fail to demonstrate that unconscious thought plays no role at all in decision making. Indeed, such a claim is quite implausible. In making these points we comment on their discussion of the literature on expertise acquisition and the Iowa Gambling Task.
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Farsi, Jahangir Yadollahi, Pouria Nouri, and Abdolah Ahmadi Kafeshani. "Identifying Decision Making Biases in Entrepreneurial Opportunity Exploitation Decisions." International Business Research 9, no. 5 (April 18, 2016): 158. http://dx.doi.org/10.5539/ibr.v9n5p158.
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<p>Opportunities are the core of entrepreneurial process. By identifying, evaluating and exploiting lucrative opportunities, not only do entrepreneurs make profits for themselves, they also propel their societies to prosperity. In order to exploit opportunities, entrepreneurs need to make various decisions based on their evaluation of opportunities as well as their own capabilities. Most of the time, theses decision are made under reverse circumstances rife with uncertainty, ambiguity, lack of needed resources as well as high time pressure. Thus, it seems reasonable to hypothesize that entrepreneurs’ decisions to exploit opportunities are prone to decision making biases. In order to test this hypothesis, this paper conducted a qualitative content analysis approach by interviewing 17 Iranian entrepreneurs. According to our findings, overconfidence, escalation of commitment, planning fallacy and illusion of control are the common decision making biases in entrepreneurs’ decisions to exploit opportunities.</p>
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Cohen-Mansfield, Jiska, and Steven Lipson. "Medical Decision-Making around the Time of Death of Cognitively Impaired Nursing Home Residents: A Pilot Study." OMEGA - Journal of Death and Dying 48, no. 2 (March 2004): 103–14. http://dx.doi.org/10.2190/4j17-px0v-wq03-cgda.
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The purpose of this article is to describe the end-of-life process in the nursing home for three groups of cognitively–impaired nursing home residents: those who died with a medical decision-making process prior to death; those who died without such a decision-making process; and those who had a status–change event and a medical decision-making process, and did not die prior to data collection. Residents had experienced a medical status–change event within the 24 hours prior to data collection, and were unable to make their own decisions due to cognitive impairment. Data on the decision-making process during the event, including the type of event, the considerations used in making the decisions, and who was involved in making these decisions were collected from the residents' charts and through interviews with their physicians or nurse practitioners. When there was no decision-making process immediately prior to death, a decision-making process was usually reported to have occurred previously, with most decisions calling either for comfort care or limitation of care. When comparing those events leading to death with other status–change events, those who died were more likely to have suffered from troubled breathing than those who remained alive. Hospitalization was used only among those who survived, whereas diagnostic tests and comfort care were used more often with those who died. Those who died had more treatments considered and chosen than did those who remained alive. For half of those who died, physicians felt that they would have preferred less treatment for themselves if they were in the place of the decedents. The results represent preliminary data concerning decision-making processes surrounding death of the cognitively–impaired in the nursing home. Additional research is needed to elucidate the trends uncovered in this study.
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Yadav, Juhi, and Shalini Gupta. "New age issues in medical ethics - time to address." International Journal Of Community Medicine And Public Health 8, no. 2 (January 27, 2021): 998. http://dx.doi.org/10.18203/2394-6040.ijcmph20210256.
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Medical technology advancements and understanding along with constricted resources in provision of care to the needed, has arised ethical dilemmas. These are associated with the necessity of making decisions dependent on conflicting priorities, in the absence of established polices about the choice of the decision maker and the guiding principles checklist. Varying values and ethical models conflict current code of medical ethics making it inadequate. This article summarises key issues in contemporary medical ethics and a special note of medical negligence.
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Hahlweg, Pola, Martin Härter, Yvonne Nestoriuc, and Isabelle Scholl. "How are decisions made in cancer care? A qualitative study using participant observation of current practice." BMJ Open 7, no. 9 (September 2017): e016360. http://dx.doi.org/10.1136/bmjopen-2017-016360.
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ObjectivesShared decision-making has continuously gained importance over the last years. However, few studies have investigated the current state of shared decision-making implementation in routine cancer care. This study aimed to investigate how treatment decisions are made in routine cancer care and to explore barriers and facilitators to shared decision-making using an observational approach (three independent observers). Furthermore, the study aimed to extend the understanding of current decision-making processes beyond the dyadic physician–patient interaction.DesignCross-sectional qualitative study using participant observation with semistructured field notes, which were analysed using qualitative content analysis as described by Hsieh and Shannon.Setting and participantsField notes from participant observations were collected at n=54 outpatient consultations and during two 1-week-long observations at two inpatient wards in different clinics of one comprehensive cancer centre in Germany.ResultsMost of the time, either one physician alone or a group of physicians made the treatment decisions. Patients were seldom actively involved. Patients who were ‘active’ (ie, asked questions, demanded participation, opposed treatment recommendations) facilitated shared decision-making. Time pressure, frequent alternation of responsible physicians and poor coordination of care were the main observed barriers for shared decision-making. We found high variation in decision-making behaviour between different physicians as well as the same physician with different patients.ConclusionMost of the time physicians made the treatment decisions. Shared decision-making was very rarely implemented in current routine cancer care. The entire decision-making process was not observed to follow the principles of shared decision-making. However, some aspects of shared decision-making were occasionally incorporated. Individual as well as organisational factors were found to influence the degree of shared decision-making. If future routine cancer care wishes to follow the principles of shared decision-making, strategies are needed to foster shared decision-making in routine cancer care.
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Li, Wen-Chin. "The Investigation of Suitability of Aeronautical Decision-making Mnemonics in Tactical Environments." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 49, no. 25 (September 2005): 2187–91. http://dx.doi.org/10.1177/154193120504902515.
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The purpose of this research was to evaluate the suitability of ADM mnemonics for training decision making in cadet pilots. Sixty instructor pilots and forty-seven cadet pilots in the Republic of China Air Force Academy participated. They assessed the suitability of five different ADM mnemonics (SHOR -Wohl, 1981; PASS -Maher, 1989; FOR-DEC -Hormann, 1995; SOAR -Oldaker, 1995; and DESIDE - Murray, 1997) in the 6 different basic types of decision-making situation described by Orasanu (1993). These included go/no go decisions; recognition-primed decisions; response selection decisions; resource management decisions; non-diagnostic procedural decisions, and problem-solving. The findings indicated that SHOR was regarded as the most suitable mnemonic for application in time-limited and critical, urgent situations and DESIDE was thought to be superior for knowledge-based decisions which needed more comprehensive consideration but were less time limited.
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Hidayat, Moch Charis, and Abdul Wahab. "UTILIZATION OF EDUCATION MANAGEMENT INFORMATION IN DECISION MAKING." Humanities & Social Sciences Reviews 7, no. 3 (April 30, 2019): 349–55. http://dx.doi.org/10.18510/hssr.2019.7352.
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Purpose of Study: The undeniable fact that information at this time has been viewed as a very potential resource. Infor- mation is the only source needed by a leader of an educational institution. Information can be processed from other sources that are influenced by very complex organizations and owned computer devices.
Methodology: Information processed using a computer can be used by an organizational leader and an individual with expertise as a means of communication and problem solving, as well as valuable information in the decision making the process.
Results: In general from the results of research that researchers do indeed the combination of human resources and infor- mation technology applications that are tried to apply have been done. But this is not an easy matter, of course, depending on the focus of the development of management information systems individually sees the needs that are needed now.
Implications/Applications: After studying and analyzing about the utilization of education management information sys- tem in decision making hence writer concludes that; first, decision making needs good information, second, irrelevant information will cause wrong judgment in making decision, third, the main basis of framework of information system utilization in taking decisions all information presented by the information system should be aimed at supporting certain phases of the decision-making process; fourth, the utilization framework of management information systems in decision making can also be used to assess an ongoing reporting system, fifth, decision making in education is an important part that should be done well by managers or other officials.
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Mertoguno, J. Sukarno. "Human Decision Making Model for Autonomic Cyber Systems." International Journal on Artificial Intelligence Tools 23, no. 06 (December 2014): 1460023. http://dx.doi.org/10.1142/s0218213014600239.
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Real-time autonomy is a key element for system which closes the loop between observation, interpretation, planning, and action, commonly found in UxV, robotics, smart vehicle technologies, automated industrial machineries, and autonomic computing. Real-time autonomic cyber system requires timely and accurate decision making and adaptive planning. Autonomic decision making understands its own state and the perceived state of its environment. It is capable of anticipating changes and future states and projecting the effects of actions into future states. Understanding of current state and the knowledge/model of the world are needed for extrapolating actions and deriving action plans. This position paper proposes a hybrid, statistical-formal approach toward achieving realtime autonomy.
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Anderson, Natalie Elizabeth, Julia Slark, and Merryn Gott. "Unlocking intuition and expertise: using interpretative phenomenological analysis to explore clinical decision making." Journal of Research in Nursing 24, no. 1-2 (March 2019): 88–101. http://dx.doi.org/10.1177/1744987118809528.
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Background Clinical decision making is a complex, but important, research area. Decision-making theories have evolved to recognise that, although heuristics and biases can lead to error, expert clinician decision makers can also use intuition to good effect. More research is needed to understand how nurses and other clinicians make sense of complexity and uncertainty. Aim This paper discusses the utility of interpretative phenomenological analysis to elucidate clinical decision making, expertise and intuition. Methods A narrative review of published interpretative phenomenological analysis studies exploring clinical decision-making, and discussion of an exemplar study. Results A limited number of interpretative phenomenological analysis studies have been published in this area. By seeking out descriptions of real-world decision making, interpretative phenomenological analysis research provides ecologically valid insights into what it is like to make time-critical, high-stakes decisions with limited information. Conclusion Contributing to the study of complex clinical decision making in combination with other research approaches, interpretative phenomenological analysis research has significant unrealised potential to inform education, assessment and support interventions and the development of clinical guidelines. Future applications could enhance understanding of multi-disciplinary decision-making and the development of expertise and intuition, over time.
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Shojaie, Danielle, Aubri S. Hoffman, Ruth Amaku, Maria E. Cabanillas, Julie Ann Sosa, Steven G. Waguespack, Mark E. Zafereo, Mimi I. Hu, and Elizabeth E. Grubbs. "Decision Making When Cancer Becomes Chronic: Needs Assessment for a Web-Based Medullary Thyroid Carcinoma Patient Decision Aid." JMIR Formative Research 5, no. 7 (July 16, 2021): e27484. http://dx.doi.org/10.2196/27484.
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Background In cancers with a chronic phase, patients and family caregivers face difficult decisions such as whether to start a novel therapy, whether to enroll in a clinical trial, and when to stop treatment. These decisions are complex, require an understanding of uncertainty, and necessitate the consideration of patients’ informed preferences. For some cancers, such as medullary thyroid carcinoma, these decisions may also involve significant out-of-pocket costs and effects on family members. Providers have expressed a need for web-based interventions that can be delivered between consultations to provide education and prepare patients and families to discuss these decisions. To ensure that these tools are effective, usable, and understandable, studies are needed to identify patients’, families’, and providers’ decision-making needs and optimal design strategies for a web-based patient decision aid. Objective Following the international guidelines for the development of a web-based patient decision aid, the objectives of this study are to engage potential users to guide development; review the existing literature and available tools; assess users’ decision-making experiences, needs, and design recommendations; and identify shared decision-making approaches to address each need. Methods This study used the decisional needs assessment approach, which included creating a stakeholder advisory panel, mapping decision pathways, conducting an environmental scan of existing materials, and administering a decisional needs assessment questionnaire. Thematic analyses identified current decision-making pathways, unmet decision-making needs, and decision support strategies for meeting each need. Results The stakeholders reported wide heterogeneity in decision timing and pathways. Relevant existing materials included 2 systematic reviews, 9 additional papers, and multiple educational websites, but none of these met the criteria for a patient decision aid. Patients and family members (n=54) emphasized the need for plain language (46/54, 85%), shared decision making (45/54, 83%), and help with family discussions (39/54, 72%). Additional needs included information about uncertainty, lived experience, and costs. Providers (n=10) reported needing interventions that address misinformation (9/10, 90%), foster realistic expectations (9/10, 90%), and address mistrust in clinical trials (5/10, 50%). Additional needs included provider tools that support shared decision making. Both groups recommended designing a web-based patient decision aid that can be tailored to (64/64, 100%) and delivered on a hospital website (53/64, 83%), focuses on quality of life (45/64, 70%), and provides step-by-step guidance (43/64, 67%). The study team identified best practices to meet each need, which are presented in the proposed decision support design guide. Conclusions Patients, families, and providers report multifaceted decision support needs during the chronic phase of cancer. Web-based patient decision aids that provide tailored support over time and explicitly address uncertainty, quality of life, realistic expectations, and effects on families are needed.
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Koporcic, Nikolina, Miika Nietola, and John D. Nicholson. "IMP: it’s time to get emotional! Understanding the role of negative emotions in dynamic decision-making processes." Journal of Business & Industrial Marketing 35, no. 12 (May 25, 2020): 2151–63. http://dx.doi.org/10.1108/jbim-12-2019-0520.
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Purpose The purpose of this paper is to investigate the current industrial marketing and purchasing (IMP) research that has a vague positioning of the bounded rationality of an actor. By borrowing insights from other disciplines, this study aims to develop the IMP approach further by acknowledging the importance of individuals who act and make decisions on behalf of their companies. Design/methodology/approach This study is conceptual. By examining the IMP studies in combination with decision-making literature from behavioral economics and psychology, this paper provides a new understanding of the phenomenon in question. Findings This study demonstrates that individual decision-making is not as rational as has previously been thought, thus indicating the bounded rationality of the actor. After examining the most common negative emotions that influence the decision-making process, the paper presents a research agenda. It provides a series of research topics and methodological choices for future IMP research endeavors. Research limitations/implications As this paper is conceptual, empirical research is needed to examine the role of negative emotions in dynamic decision-making processes. Practical implications Managerial implications of this paper are focused on providing instructions for managers on how to deal with negative emotions in dynamic decision-making processes. Originality/value To the best of the authors’ knowledge, this paper is one of the first papers that attempts to connect the IMP studies with the dynamics of decision-making by examining negative emotions in the business world.
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Stone, Merlin, Eleni Aravopoulou, Yuksel Ekinci, Geraint Evans, Matt Hobbs, Ashraf Labib, Paul Laughlin, Jon Machtynger, and Liz Machtynger. "Artificial intelligence (AI) in strategic marketing decision-making: a research agenda." Bottom Line 33, no. 2 (April 13, 2020): 183–200. http://dx.doi.org/10.1108/bl-03-2020-0022.
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Purpose The purpose of this paper is to review literature about the applications of artificial intelligence (AI) in strategic situations and identify the research that is needed in the area of applying AI to strategic marketing decisions. Design/methodology/approach The approach was to carry out a literature review and to consult with marketing experts who were invited to contribute to the paper. Findings There is little research into applying AI to strategic marketing decision-making. This research is needed, as the frontier of AI application to decision-making is moving in many management areas from operational to strategic. Given the competitive nature of such decisions and the insights from applying AI to defence and similar areas, it is time to focus on applying AI to strategic marketing decisions. Research limitations/implications The application of AI to strategic marketing decision-making is known to be taking place, but as it is commercially sensitive, data is not available to the authors. Practical implications There are strong implications for all businesses, particularly large businesses in competitive industries, where failure to deploy AI in the face of competition from firms, who have deployed AI to improve their decision-making could be dangerous. Social implications The public sector is a very important marketing decision maker. Although in most cases it does not operate competitively, it must make decisions about making different services available to different citizens and identify the risks of not providing services to certain citizens; so, this paper is relevant to the public sector. Originality/value To the best of the authors’ knowledge, this is one of the first papers to probe deployment of AI in strategic marketing decision-making.
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Jarmasz, Jerzy. "Accelerated Training with Microworlds for Command Decision Making." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 51, no. 25 (October 2007): 1578–82. http://dx.doi.org/10.1177/154193120705102503.
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Microworlds, simple simulations that strip away tactical details, have been proposed as tools for training strategic-level command decision making. In microworlds, scenarios lasting days or weeks play out in a matter of hours. Though time acceleration has been studied in other training areas, little is known about its effects on decision making, especially regarding transfer of training. In the current study, participants were asked to perform a simple decision task modeled on peace support operations. Before performing the task, they received training on the task at a time compression ratio of either 15:1 or 5:1. While both groups achieved similar performance in training, the performance of the 15:1 training group improved when transitioning to the target task, whereas the 5:1 training group saw its performance decrease. The results suggest that time acceleration can benefit training for decision making, but more study is needed to determine optimal acceleration ratios.
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Hia, Priantoni, Hardianto Hardianto, and Ratih Adinda Destari. "SISTEM PENDUKUNG KEPUTUSAN MENENTUKAN KENAIKAN KELAS DENGAN MENGGUNAKAN METODE TOPSIS PADA SMK YAPIM MABAR." CCIT Journal 11, no. 2 (August 18, 2018): 171–81. http://dx.doi.org/10.33050/ccit.v11i2.585.
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The most important decision-making in schools is class decision making. The old way with the manual system can lead to slow decision-making. This is of course caused by a very basic problem, namely the decision-making is not appropriate. Therefore a decision support system is needed that can help the teacher to determine the class increase. The design of decision support system in this study aims to apply the application to determine the increase of class, To overcome the problem, required a decision support system of computerized class increase which later can produce quality decisions that can process data and student values effectively and efficiently and can measure the ability of students both academically and non academic so that activities that have been done manually can be done using the computer and mistakes in decision-making class increase can be avoided as well as time in determining decision-making class increase much faster and effective. Decision support system is designed using visual basic programming languages 2010 and SQL Server 2008. The process in this study using Topsis method.
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Dexter, Franklin, Richard H. Epstein, Rodney D. Traub, Yan Xiao, and David C. Warltier. "Making Management Decisions on the Day of Surgery Based on Operating Room Efficiency and Patient Waiting Times." Anesthesiology 101, no. 6 (December 1, 2004): 1444–53. http://dx.doi.org/10.1097/00000542-200412000-00027.
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The authors review the scientific literature on operating room management operational decision making on the day of surgery. (1) Some decisions should rely on the expected (mean) duration of the scheduled case. Other decisions should use upper prediction bounds, lower prediction bounds, and other measures reflecting the uncertainty of case duration estimates. One single number cannot be used for good decision making, because durations are uncertain. (2) Operational decisions can be made on the day of surgery based on four ordered priorities. (3) Decisions to reduce overutilized operating room time rely on mean durations. Limited additional data are needed to make these decisions well, specifically, whether a patient is in each operating room and which cases are about to finish. (4) Decisions involving reducing patient (and surgeon) waiting times rely on quantifying uncertainties in case durations, which are affected highly by small sample sizes. Future studies should focus on using real-time display of data to reduce patient waiting.
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Sullivan, Jane Elizabeth, Lynn Heather Gillam, and Paul Terence Monagle. "The enactment stage of end-of-life decision-making for children." Palliative and Supportive Care 17, no. 2 (January 11, 2018): 165–71. http://dx.doi.org/10.1017/s1478951517001110.
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AbstractObjectivesTypically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors’ and parents’ roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents’ experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process.MethodsA qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed.ResultsTwenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child’s condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people’s actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention.Significance of resultsA novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular emotional and practical implications for parents. Greater understanding of this stage can improve clinician’s support for parents as they care for their child.
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Limoges, Camille. "Expert knowledge and decision-making in controversy contexts." Public Understanding of Science 2, no. 4 (October 1993): 417–26. http://dx.doi.org/10.1088/0963-6625/2/4/009.
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There was a time when the mobilization of experts was a taken-for-granted, unproblematic aspect of decision-making processes. That confidence has vanished. Ascertaining the significance of expertise now requires a reconsideration of the dynamics of controversies. The current view still assimilates controversy to the medieval exercise of the disputatio in which two parties argue one against the other. A non-reductionist view is needed to take fully into account the diversity of worlds of relevance involved in the dynamics of any public controversy. Only then is it possible to understand how decision making is predicated upon associations of worlds of relevance, and how expertise is actually a collective learning process which sets the boundary conditions for the efficacy of individual experts.
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Izonin, Ivan. "AIoT Data Management, Analytics and Decision Making (Artificial Intelligence of Things Data Management, Analytics and Decision Making)." International Journal of Sensors, Wireless Communications and Control 11, no. 5 (June 24, 2021): 496–97. http://dx.doi.org/10.2174/221032791105210401153652.
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Nowadays, the fast development of hardware for IoT-based systems creates appropriate conditions for the development of services for different application areas. As we know, the large number of multifunctional devices, which are connected to the Internet is constantly increasing. Today, most of the IoT devices just only collect and transmit data. The huge amount of data produced by these devices requires efficient and fast approaches to its analysis. This task can be solved by combining Artificial Intelligence and IoT tools. Essentially, AI accelerators can be used as a universal sensor in IoT systems, that is, we can create Artificial Intelligence of Things (AIoT). AIoT can be considered like a movement from data collection to knowledge aggregation. AIoT-based systems are being widely implemented in many high-tech industrial and infrastructure systems. Such systems are capable of providing not only the ability to collect but also analyse various aspects of data for identification, planning, diagnostics, evaluation, monitoring, optimization, etc., at the lower level in the entire system's hierarchy. That is, they are able to work more efficiently and effectively by generating the knowledge that is needed for real-time analytics and decision-making in some application areas.
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Meisman, Andrea, Nancy M. Daraiseh, Phil Minar, Marlee Saxe, and Ellen A. Lipstein. "The Gray Zone: Adolescent and Young Adult Decision Support Needs for Ulcerative Colitis." MDM Policy & Practice 5, no. 2 (July 2020): 238146832094070. http://dx.doi.org/10.1177/2381468320940708.
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Purpose. To understand the medical decision support needs specific to adolescents and young adults (AYAs) with ulcerative colitis (UC) and inform development of a decision support tool addressing AYAs’ preferences. Methods. We conducted focus groups with AYAs with UC and mentors from a pediatric inflammatory bowel disease clinic’s peer mentoring program. Focus groups were led by a single trained facilitator using a semistructured guide aimed at eliciting AYAs’ roles in medical decision making and perceived decision support needs. All focus groups were audio recorded, transcribed, and coded by the research team. Data were analyzed using content analysis and the immersion crystallization method. Results. The facilitator led six focus groups: one group with peer mentors aged 18 to 24 years, three groups with patients aged 14 to 17 years, and two groups with patients aged 18 to 24 years. Decision timing and those involved in decision making were identified as interacting components of treatment decision making. Treatment decisions by AYAs were further based on timing, location (inpatient v. outpatient), and family preference for making decisions during or outside of clinic. AYAs involved parents and health care providers in medical decisions, with older participants describing themselves as “final decision makers.” Knowledge and experience were facilitators identified to participating in medical decision making. Conclusions. AYAs with UC experience changes to their roles in medical decisions over time. The support needs identified will inform the development of strategies, such as decision support tools, to help AYAs with chronic conditions develop and use skills needed for participating in medical decision making.
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Marović, Ivan, Monika Perić, and Tomaš Hanak. "A Multi-Criteria Decision Support Concept for Selecting the Optimal Contractor." Applied Sciences 11, no. 4 (February 12, 2021): 1660. http://dx.doi.org/10.3390/app11041660.
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A way to minimize uncertainty and achieve the best possible project performance in construction project management can be achieved during the procurement process, which involves selecting an optimal contractor according to “the most economically advantageous tender.” As resources are limited, decision-makers are often pulled apart by conflicting demands coming from various stakeholders. The challenge of addressing them at the same time can be modelled as a multi-criteria decision-making problem. The aim of this paper is to show that the analytic hierarchy process (AHP) together with PROMETHEE could cope with such a problem. As a result of their synergy, a decision support concept for selecting the optimal contractor (DSC-CONT) is proposed that: (a) allows the incorporation of opposing stakeholders’ demands; (b) increases the transparency of decision-making and the consistency of the decision-making process; (c) enhances the legitimacy of the final outcome; and (d) is a scientific approach with great potential for application to similar decision-making problems where sustainable decisions are needed.
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Rogers, Hunter, Maher Al Ghalayini, and Kapil Chalil Madathil. "A Preliminary Study to Investigate the Sensemaking Process of UAV Reports by Operators after Periods of Disconnect for Threat Assessment." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 62, no. 1 (September 2018): 1796–800. http://dx.doi.org/10.1177/1541931218621407.
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Teleoperated robots have been used to minimize human presence and interaction in dangerous or difficult areas or to enhance human capabilities. One of the challenges that still needs investigation is human-robot communication regarding making decisions based on extracted information. As such, the purpose of this research is to address issues of decision making after communication disconnections through interface design by focusing on improving sensemaking. Analyzing the effects of interface design in a UAV threat assessment scenario is ideal to examine not only the sensemaking process but also how that process defines decision making in an environment where efficient decision making and low clutter displays are needed. The data from this study will serve determine elements of an optimal interface for information assimilation. Twenty participants were recruited to complete a series of sixteen threat assessment decisions with different interface designs, varying amounts of information and layouts of information. It was observed that level of detailed information had a significant effect on the subjective trust and decision selected and display layout had a significant effect on the time taken to complete a decision.
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Luthfiarta, Ardytha, Junta Zeniarja, Edi Faisal, and Wibowo Wicaksono. "Prediction on Deposit Subscription of Customer based on Bank Telemarketing using Decision Tree with Entropy Comparison." Journal of Applied Intelligent System 4, no. 2 (March 6, 2020): 57–66. http://dx.doi.org/10.33633/jais.v4i2.2772.
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Banking system collect enormous amounts of data every day. This data can be in the form of customer information, transaction details, risk profiles, credit card details, limits and collateral details, compliance Anti Money Laundering (AML) related information, trade finance data, SWIFT and telex messages. In addition, Thousands of decision are made in Banking system. For example, banks everyday creates credit decisions, relationship start up, investment decisions, AML and Illegal financing related decision. To create this decision, comprehensive review on various reports and drills down tools provided by the banking systems is needed. However, this is a manual process which is error prone and time consuming due to large volume of transactional and historical data available. Hence, automatic knowledge mining is needed to ease the decision making process. This research focuses on data mining techniques to handle the mentioned problem. The technique will focus on classification method using Decision Tree algorithms. This research provides an overview of the data mining techniques and procedures will be performed. It also provides an insight into how these techniques can be used in deposit subscription in banking system to make a decision making process easier and more productive. Keywords - Telemarketing, bank deposit, decision tree, classification, data mining, entropy.
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Turnock, Rick, Will Weston, Nicki Murdock, Amel Alghrani, Conor Mallucci, Andrew Selby, Andy Darbyshire, and Adrian Hughes. "Rapid development of a Clinical Decision-Making Committee in a UK paediatric hospital during the COVID-19 pandemic." Medical Law International 20, no. 2 (June 2020): 167–80. http://dx.doi.org/10.1177/0968533220953185.
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To date, the Government has not issued any national ethical guidance to support clinical decision-making in England during periods of potentially reduced healthcare resources in the context of the evolving COVID-19 1 pandemic at the time of writing. In the ensuing vacuum left by a lack of national guidance, ethical frameworks and approaches have been drafted by professional bodies, individual hospitals and trusts. It is clear that in delivering healthcare during this pandemic, more specific guidance is needed to ensure fair and consistent allocation policies, to attain public trust and confidence and to support clinicians so that decisions do not fall on them to make alone and unsupported. This article sets out how we in our institution, a UK tertiary and secondary level stand-alone paediatric provider Trust, set up a Clinical Decision-Making Committee to inform proactive clinical and ethical decision-making, to ensure that all patients are treated appropriately and fairly during these unprecedented times.
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Hutyra, Carolyn A., Stephen Smiley, Dean C. Taylor, Lori A. Orlando, and Richard C. Mather. "Efficacy of a Preference-Based Decision Tool on Treatment Decisions for a First-Time Anterior Shoulder Dislocation: A Randomized Controlled Trial of At-Risk Patients." Medical Decision Making 39, no. 3 (March 5, 2019): 253–63. http://dx.doi.org/10.1177/0272989x19832915.
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Background. First-time anterior shoulder dislocations (FTASD) provide an opportunity to examine the value of integrating stated-preference data with decision modeling to differentiate between patients whose preferred management strategy involves operative or nonoperative treatment. The objective of this study was to evaluate the efficacy of a FTASD decision tool intervention with individual preference measurement compared with a text-based control in a randomized controlled trial. Methods. Two hundred respondents between 18 and 35 years of age at risk for experiencing an FTASD were enrolled from the orthopedic clinics and randomized to receive either an interactive decision tool intervention capable of eliciting patient preferences for treatment of an FTASD or a text-based control on shoulder dislocations and treatments. The primary outcome was preference for operative or nonoperative treatment choice. Secondary outcomes included the decisional conflict scale (DCS), stage of decision making, patient activation and engagement, awareness of preference sensitive decisions, knowledge retention, and instrument acceptability. Results. One hundred respondents were randomized to the intervention and 100 to the control. A total of 154 men and 46 women with an average age of 23.6 years completed the survey. Participants in the intervention group made treatment decisions that aligned more closely with evidence-based recommendations than those in the control group ( P = 0.016). Secondary outcomes showed no difference between intervention and control, excluding several DCS subscales. Discussion. An interactive, preference-based decision tool for treatment of FTASD affects patient decision making by guiding respondents toward treatment decisions that align more closely with evidence-based recommendations in the absence of a consultation with an orthopedic provider compared with a standard-of-care control tool. Additional study is needed to evaluate the long-term effects of this tool on treatment outcomes, patient adherence, and satisfaction. LEVEL OF EVIDENCE: 2
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Armstrong, Melissa J. "Shared decision-making in stroke: an evolving approach to improved patient care." Stroke and Vascular Neurology 2, no. 2 (April 16, 2017): 84–87. http://dx.doi.org/10.1136/svn-2017-000081.
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Shared decision-making (SDM) occurs when patients, families and clinicians consider patients’ values and preferences alongside the best medical evidence and partner to make the best decision for a given patient in a specific scenario. SDM is increasingly promoted within Western contexts and is also being explored outside such settings, including in China. SDM and tools to promote SDM can improve patients’ knowledge/understanding, participation in the decision-making process, satisfaction and trust in the healthcare team. SDM has also proposed long-term benefits to patients, clinicians, organisations and healthcare systems. To successfully perform SDM, clinicians must know their patients’ values and goals and the evidence underlying different diagnostic and treatment options. This is relevant for decisions throughout stroke care, from thrombolysis to goals of care, diagnostic assessments, rehabilitation strategies, and secondary stroke prevention. Various physician, patient, family, cultural and system barriers to SDM exist. Strategies to overcome these barriers and facilitate SDM include clinician motivation, patient participation, adequate time and tools to support the process, such as decision aids. Although research about SDM in stroke care is lacking, decision aids are available for select decisions, such as anticoagulation for stroke prevention in atrial fibrillation. Future research is needed regarding both cultural aspects of successful SDM and application of SDM to stroke-specific contexts.
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Anderson, Emma C., Joanna May Kesten, Isabel Lane, Alastair D. Hay, Timothy Moss, and Christie Cabral. "Primary care clinicians’ views of paediatric respiratory infection surveillance information to inform clinical decision-making: a qualitative study." BMJ Paediatrics Open 3, no. 1 (May 2019): e000418. http://dx.doi.org/10.1136/bmjpo-2018-000418.
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AimTo investigate primary care clinicians’ views of a prototype locally relevant, real-time viral surveillance system to assist diagnostic decision-making and antibiotic prescribing for paediatric respiratory tract infections (RTI). Clinicians’ perspectives on the content, anticipated use and impact were explored to inform intervention development.BackgroundChildren with RTIs are overprescribed antibiotics. Pressures on primary care and diagnostic uncertainty can lead to decisional biases towards prescribing. We hypothesise that real-time paediatric RTI surveillance data could reduce diagnostic uncertainty and help reduce unnecessary antibiotic prescribing.MethodologySemistructured one-to-one interviews with 21 clinicians from a range of urban general practitioner surgeries explored the clinical context and views of the prototype system. Transcripts were analysed using thematic analysis.ResultsThough clinicians self-identified as rational (not over)prescribers, cognitive biases influenced antibiotic prescribing decisions. Clinicians sought to avoid ‘anticipated regret’ around not prescribing for a child who then deteriorated. Clinicians were not aware of formal infection surveillance information sources (tending to assume many viruses are around), perceiving the information as novel and potentially useful. Perceptions of surveillance information as presented included: not relevant to decision-making/management; useful to confirm decisions post hoc; and increasing risks of missing sick children. Clinicians expressed wariness of using population-level data to influence individual patient decision-making and expressed preference for threat (high-risk) information identified by surveillance, rather than reassuring information about viral RTIs.ConclusionsMore work is needed to develop a surveillance intervention if it is to beneficially influence decision-making and antibiotic prescribing in primary care. Key challenges for developing interventions are how to address cognitive biases and how to communicate reassuring information to risk-oriented clinicians.
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Samuelson, Marissa, Franziska Trede, and Joy Higgs. "Engaging with Diversity and Complexity using Collaborative Approaches to Decision Making." Critical Dietetics 3, no. 2 (December 31, 2016): 43–55. http://dx.doi.org/10.32920/cd.v3i2.1011.
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A key challenge in contemporary dietetic practice is making collaborative decisions about dietary behaviours with a diverse range of patients. Contemporary decision making frameworks for clinical dietetic practice give value to working in a collaborative manner with patients, however, there remains uncertainty with regards to how and when dietitians might apply this approach in their practice.In this doctoral research project, Author 1 used a philosophical hermeneutic approach to deepen understanding of a collaborative approach to decision making in dietetic practice. She also explored the core capabilities required to enact such an approach in early career dietetic practice. The experiences and perceptions of patients and dietitians were explored using in depth interviews and individualized reflective practice activities.The findings suggest that collaborative decision making in dietetic practice is situational and requires the development of a caring and trusting professional relationship to be effective. Other core capabilities needed to enact this approach relate to developing self awareness, establishing an open and transparent dialogue, identifying and exploring common ground and finding the time to think and talk.The final product of the research, the Interpretive Engagement Model of Collaborative Decision Making (Author 1, 2013), can be used as a framework to help practitioners to reflect on their decision making practice.Early exposure in tertiary education to critical dialogues and questioning current practices will cultivate early career dietitians’ capabilities to develop their collaborative decision making practice in future.
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Ali, Md Monsur. "Impact of Management Information Systems (MIS) on Decision Making." Global Disclosure of Economics and Business 8, no. 2 (December 31, 2019): 83–90. http://dx.doi.org/10.18034/gdeb.v8i2.100.
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Today’s business environment is unpredictable, dynamic, unstable and, necessitates the growing demand for accurate, relevant, complete, timely and, economical information needed to drive the decision-making process. The quick developments of information technology coupled with the development of telecommunications technologies, have modernized all areas of business and human activities. In today’s business world, there are different types of information systems. Each plays a unique role for a manager decision-making functions. In this paper, the decision maker’s satisfaction, contents of information and information access quality have been analyzed and studied. Here identified necessary variables aiming to evaluate the influence of management information systems in decision support capabilities and side by side discuss the concept, characteristics, types of MIS, the MIS model, and in particular it will highlight the impact of MIS in decision making. At the same time, different models and figures are presented to enrich the discussion and to highlight the status of each MIS and DSS information systems in an organization decision-making process.
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Korporaal, Michelle, and Sara Irina Fabrikant. "How are map-based decisions influenced by uncertainty visualization in risky and time-critical situations?" Abstracts of the ICA 1 (July 15, 2019): 1–3. http://dx.doi.org/10.5194/ica-abs-1-184-2019.
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<p><strong>Abstract.</strong> Most of our daily activities in a highly mobile digital information society require timely spatial decision making. Much of such decision-making is supported by map displays on various devices and with different modalities. Spatial information visualized on maps, however, is always subject to a multitude of uncertainties. If space-time decision-makers are not informed about potential uncertainties inherent to maps, misleading, false, or at worst, life-threatening outcomes might result from the map-based decision making process. Therefore, data uncertainties should be communicated to decision-makers (Hope and Hunter, 2007), especially when they are made with limited time resources (Riveiro et al., 2014), and/or decision outcomes can have dramatic consequences (Ruginski et al., 2016). We thus wished to empirically study how data uncertainty visualized in maps might influence the process and outcomes of spatial decision making (Kübler et al., 2017), especially when made under time pressure in risky situations (Wilkening and Fabrikant, 2011). Although there is very little empirical evidence from prior uncertainty visualization research that considered decision time constraints, we hypothesized that uncertainty visualization would also have an effect under time critical and complex decision contexts.</p><p>We report on a mixed factorial (2&thinsp;&times;&thinsp;2) map-based experiment to investigate whether and how the depiction of uncertainty in map displays (within-subject: with vs. without uncertainty) used in time-critical decision situations (between subject: with vs. without decision time constraints) might influence complex spatial decision making processes supported with maps (dependent variable: eye movement patterns), and respective decision outcomes (dependent variable: accuracy of response). For this we developed an extended version of a helicopter landing scenario in mountainous terrain for our study (Wilkening and Fabrikant, 2011). We told participants to imagine being helicopter pilots on a rescue mission. We told participants in a training session (and had them practise the task in a warm-up trial) that there are several requirements that needed to be considered to safely land a helicopter in such emergency situations (AuLaV, 2014). We asked them to safely land a helicopter on one of six potential landing spots marked on a map (Figure 1) to rescue a person in need. Map stimuli were based on randomly chosen and anonymized locations in Switzerland with varying terrain. The person to be rescued was always marked near the center of the map; in a zone unsuitable for land a helicopter. We systematically controlled four criteria that needed to be considered by decision makers: (1) slope categories (&deg;), including slope uncertainty, (2) distance (m) to an air aviation obstacle, (3) distance (m) to a ski lift, and (4) distance (m) to the person to be rescued. We developed eight map stimuli, and a ninth for the warm-up trial. To increase the map set, we additionally rotated and flipped the eight original maps to generate 16 map stimuli in total. We randomized the labeling of the potential landing spots, to avoid potential response bias. Prior to the main experiment, we ran an online study (with the identical test scenario) recruiting 11 participants (females: 6, males: 7; 34,8 yrs. on average) by Email, with broadly varying backgrounds, to empirically identify a suitable decision time limit for the main experiment, and to assess the suitability of the decision scenario. We also tested two map-inherent (within-subject) uncertainty depiction methods, already proposed in the literature: hatching density and point density textures (Retchless and Brewer 2016, Johannsen and Fabrikant, 2018). Based on the pilot study results, we chose the point-density pattern (Figure 1) for the main experiment, as it not only yielded faster decision times, but it was also preferred by participants. Based on participants’ average decision times, we also set the time limit to 25s for the main experiment. </p><p>We then invited 34 participants (females: 18, males: 16; 27,7 yrs. on average) to our eye-tracking laboratory at the Geography Department of the University of Zurich for the controlled portion of the study. They were again recruited broadly, without any specific training or background relevant for the chosen multivariate decision making scenario. Participants were randomly assigned to the time-pressure group, and they did not differ in spatial ability, assessed with the paper-folding test (Ekstrom et al., 1976).</p><p>As hypothesized, we find that visualized slope uncertainty information influences both, participants’ decision making processes, and the decision outcomes, depending on whether the available decision time is constrained. We are thus able to replicate prior own uncertainty visualization research that did not consider any decision time constraints (Kübler et al, 2017), and map-based decision making under time pressure without any uncertainty depictions (Wilkening and Fabrikant, 2011). Without depiction of slope uncertainty, participants selected landing spots that were closer to the person to be rescued, but not necessarily at locations with ideal slope conditions. For decisions supported by visualized slope uncertainty, participants opted for the <i>safer</i> landing location, but further away as necessary from the person to be rescued. <i>Safer</i> in this case means that participants who were not under decision time constraints chose to land the helicopter at a location which they knew would be suitable for landing in any case.</p><p>We interpret this result pattern with <i>loss aversion</i> (Kahnemann &amp; Tversky, 1979). Participants weighed the landing spot in an uncertain slope zone that could potentially yield the loss of lives more negatively, as the gain of being closer to the person to be rescued. Replicating Kübler et al. (2017) we also find that the depiction of uncertainty in maps modifies the to date under-researched map-based decision-making <i>processes</i>. Contrasting prior cartographic research, though, participants without time pressure took longer for their decisions when slope uncertainty was depicted on the maps. The collected eye movement data reveals that maps were indeed viewed in different ways, depending on whether slope uncertainty was depicted. This sheds new light on how decision time matters in map-based decision making (Wilkening and Fabrikant, 2011). As decision <i>outcomes</i> are similar across the two decision time groups, the visualization of uncertainty, ultimately, had the same effect. Taking advantage of eye movement recordings, we are thus able to provide new insights in how humans arrive at complex map-based decisions when uncertainty is depicted on maps, especially when they are used in time-critical and risky decision making contexts.</p>
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Si Mohammed, Antar, Rachid Smail, and Mourad Chebila. "Decision making under uncertainty in the alarm systems response." International Journal of Quality & Reliability Management 37, no. 8 (November 25, 2019): 1151–61. http://dx.doi.org/10.1108/ijqrm-03-2019-0078.
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Purpose The purpose of this paper is to develop an advanced decision-making support for the appropriate responding to critical alarms in the hazardous industrial facilities. Design/methodology/approach A fuzzy analytical hierarchy process is suggested by considering three alternatives and four criteria using triangular fuzzy numbers to handle the associated uncertainty. A logarithmic fuzzy preference programming (LFPP)-based nonlinear priority method is employed to analyze the suggested model. Findings A quantitative decision-making support is not only a necessity in responding to critical alarms but also easy to implement even in a relatively short reaction time. Confirmation may not be the appropriate option to deal with a critical alarm, even with the availability of the needed resources. Practical implications A situation related to a flammable gas alarm in a gas plant is treated using the developed model showing its practical efficiency and practicality. Originality/value The proposed model provides a rational, simple and holistic fuzzy multi criteria tool with a refined number of criteria and alternatives using an LFPP method to handle process alarms.
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Colón-Morales, Coralys M., Wayne C. W. Giang, and Michelle Alvarado. "Informed Decision-making for Health Insurance Enrollment: Survey Study." JMIR Formative Research 5, no. 8 (August 12, 2021): e27477. http://dx.doi.org/10.2196/27477.
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Background Health insurance enrollment is a difficult financial decision with large health impacts. Challenges such as low health insurance literacy and lack of knowledge about choosing a plan further complicate this decision-making process. Therefore, to support consumers in their choice of a health insurance plan, it is essential to understand how individuals go about making this decision. Objective This study aims to understand the sources of information used by individuals to support their employer-provided health insurance enrollment decisions. It seeks to describe how individual descriptive factors lead to choosing a particular type of information source. Methods An introduction was presented on health insurance plan selection and the sources of information used to support these decisions from the 1980s to the present. Subsequently, an electronic survey of 151 full-time faculty and staff members was conducted. The survey consisted of four sections: demographics, sources of information, health insurance literacy, and technology acceptance. Descriptive statistics were used to show the demographic characteristics of the 126 eligible respondents and to study the response behaviors in the remaining survey sections. Proportion data analysis was performed using the Cochran-Armitage trend test to understand the strength of the association between our variables and the types of sources used by the respondents. Results In terms of demographics, most of the respondents were women (103/126, 81.7%), represented a small household (1-2 persons; 87/126, 69%), and used their insurance 3-12 times a year (52/126, 41.3%). They assessed themselves as having moderate to high health insurance literacy and high acceptance of technology. The most selected and top-ranked sources were Official employer or state websites and Official Human Resources Virtual Benefits Counselor Alex. From our data analysis, we found that the use of official primary sources was constant across age groups and health insurance use groups. Meanwhile, the use of friends or family as a primary source slightly decreased as age and use increased. Conclusions In this exploratory study, we identified the main sources of health insurance information among full-time employees from a large state university and found that most of the respondents needed 2-3 sources to gather all the information that they desired. We also studied and identified the relationships between individual factors (such as age, gender, and literacy) and 2 dependent variables on the types of primary sources of information. We encountered several limitations, which will be addressed in future studies.
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Senftleben, Ulrike, Martin Schoemann, Matthias Rudolf, and Stefan Scherbaum. "To stay or not to stay: The stability of choice perseveration in value-based decision making." Quarterly Journal of Experimental Psychology 74, no. 1 (October 22, 2020): 199–217. http://dx.doi.org/10.1177/1747021820964330.
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In real life, decisions are often naturally embedded in decision sequences. In contrast, in the laboratory, decisions are oftentimes analysed in isolation. Here, we investigated the influence of decision sequences in value-based decision making and whether the stability of such effects can be modulated. In our decision task, participants needed to collect rewards in a virtual two-dimensional world. We presented a series of two reward options that were either quick to collect but were smaller in value or took longer to collect but were larger in value. The subjective value of each option was driven by the options’ value and how quickly they could be reached. We manipulated the subjective values of the options so that one option became gradually less valuable over the course of a sequence, which allowed us to measure choice perseveration (i.e., how long participants stick to this option). In two experiments, we further manipulated the time interval between two trials (inter-trial interval), and the time delay between the onsets of both reward options (stimulus onset asynchrony). We predicted how these manipulations would affect choice perseveration using a computational attractor model. Our results indicate that both the inter-trial interval and the stimulus onset asynchrony modulate choice perseveration as predicted by the model. We discuss how our findings extend to research on cognitive stability and flexibility.
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Grauslytė, Lina, Gonzalo De La Cerda, and Tomas Jovaiša. "ECCO2R as a bridge to a decision in type II respiratory failure." Acta medica Lituanica 26, no. 1 (May 7, 2019): 101–6. http://dx.doi.org/10.6001/actamedica.v26i1.3962.
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Introduction. End-of-life decisions are often time consuming and difficult for everyone involved. In some of these cases extracorporeal life support systems could potentially be used not only as a bridge to treatment but as a tool to buy time to allow patient’s participation in decision making and to avoid further futile invasive procedures. Case report. A previously healthy 53-year-old female patient presented with respiratory failure of unknown cause. In the course of treatment her condition was deemed irreversible and the only option for any chance of long-term survival was a lung transplant. During this whole time the patient’s condition was managed with extracorporeal carbon dioxide removal system (ECCO2R). She remained compos mentis and expressed the wish to stop all the treatment as the option of lung transplant was not acceptable to her. Treatment was withdrawn and she passed away. Discussion. In cases of end-of-life decisions, time can play an essential role. Even though extracorporeal life support systems have been conceptualised to be a bridge to treatment, they could be beneficial in a situation when time is needed to make a decision. ECCO2R has been used as a treatment method in different settings, however, in this case it served as a tool to maintain the patient alive and conscious for a sufficient time for her to participate in decision making. Conclusions. Our case report demonstrated that ECCO2R could serve as a bridge to decision in situations when time is limited and the decisions that need to be made are difficult.
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Fargen, Kyle M., Thabele M. Leslie-Mazwi, Michael Chen, and Joshua A. Hirsch. "Physician, know thyself: implicit and explicit decision-making for mechanical thrombectomy in stroke." Journal of NeuroInterventional Surgery 12, no. 10 (May 4, 2020): 952–56. http://dx.doi.org/10.1136/neurintsurg-2020-015973.
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Few clinical situations in medical practice are as time-sensitive and and have such profound ramifications as selection of patients with acute stroke for mechanical thrombectomy (MT). Emergent large vessel occlusion has become a treatable disease with minimal numbers needed to treat to achieve a functional, long-term neurologic outcome. However, MT carries risk and many patients who are appropriately reperfused continue to have significant neurologic deficits and disability despite a successful procedure. The decision to offer or withhold MT can be complex. Frequently decisions must be made based on incomplete information or emergently while the physician is awoken from sleep or distracted while performing other procedures. A growing number of studies have examined cognitive errors and biases as they pertain to patient diagnosis and treatment in medicine. Dual process theory identifies two decision-making processes as system 1 ('implicit') and system 2 ('explicit') and describes the patterns through which decisions are formulated. The implicit system is the default pathway as it requires little effort or focus, uses mental short cuts, and is rapid; however, this pathway is subject to considerable bias and error. This manuscript reviews the mechanisms underlying the way in which physician decisions about MT are made, specifically highlighting prominent biases that may affect judgment, and reviews other important principles, such as confidence in decisions, aggressiveness to pursue MT, and strategies to improve decisions.
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Eby, D., and J. Woods. "P052: The importance of structured ambulance radio patches during termination of resuscitation calls." CJEM 19, S1 (May 2017): S95. http://dx.doi.org/10.1017/cem.2017.254.
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Introduction: Pre-hospital telecommunication (patches) requires a special type of conversation. Receiving and processing correct information is critical when making clinical decisions, such as a termination of resuscitation (ToR). In a study of radio patches, a common patch structure emerged from the data analysis. Use of this standard structure resulted in shorter and less confusing patches. We sought to understand patch structure to be able to target interventions to improve the quality and efficiency of communication needed for critical clinical decisions. Methods: We undertook a retrospective analysis of all ToR patches between physicians and paramedics from 4 paramedic services, recorded by the Ambulance Dispatch Centre between Jan 01-Dec 31, 2014. Four services used Primary Care Paramedics and 1 service also used Advanced Care Paramedics. MP3 patch recording files were anonymized, transcribed, and read multiple times by the authors. Transcripts were coded and analyzed using mixed methods-quantitative descriptive statistics and qualitative thematic framework analysis. Results: The data set was 127 ToR patches-466 pages of transcripts. 116 patches (91.3%) had a standard structure (SS): participant introduction, clinical data presentation, clarification of data, making the decision, exchange of administrative information, and sign off. Paramedics used a mean of 81 words (95CI 74,88) to present the ‘clinical data’. Enough data was presented to meet ToR rule criteria in 52 cases (44.8%). Before making a decision to terminate resuscitation, physicians sought clarification in 100 cases (78.7%). After making the ToR decision, some physicians needed to justify their decision by seeking more data in 17 cases (13.4%). Exchange of non-clinical information (numbers, times, name spellings) took a mean of 200 words (95CI 172,228) and averaged 84 seconds or 35% of the average patch time. SS patches used a mean of 558 words, and lasted 234 sec (95CI 215,252). Non-SS patches used a mean of 654 words and lasted 286 sec (95CI 240,332). Conclusion: The most common patch structure consisted of participant introduction, data presentation, clarification of data, making the clinical decision, exchange of administrative information, and a sign off. Deviation from this SS resulted in longer patches. When a non-SS patch structure was used, the patching paramedic was tied up 25% longer and unavailable to provide patient care.
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Lawlor, Victoria M., Christian A. Webb, Thomas V. Wiecki, Michael J. Frank, Madhukar Trivedi, Diego A. Pizzagalli, and Daniel G. Dillon. "Dissecting the impact of depression on decision-making." Psychological Medicine 50, no. 10 (July 8, 2019): 1613–22. http://dx.doi.org/10.1017/s0033291719001570.
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AbstractBackgroundCognitive deficits in depressed adults may reflect impaired decision-making. To investigate this possibility, we analyzed data from unmedicated adults with Major Depressive Disorder (MDD) and healthy controls as they performed a probabilistic reward task. The Hierarchical Drift Diffusion Model (HDDM) was used to quantify decision-making mechanisms recruited by the task, to determine if any such mechanism was disrupted by depression.MethodsData came from two samples (Study 1: 258 MDD, 36 controls; Study 2: 23 MDD, 25 controls). On each trial, participants indicated which of two similar stimuli was presented; correct identifications were rewarded. Quantile-probability plots and the HDDM quantified the impact of MDD on response times (RT), speed of evidence accumulation (drift rate), and the width of decision thresholds, among other parameters.ResultsRTs were more positively skewed in depressed v. healthy adults, and the HDDM revealed that drift rates were reduced—and decision thresholds were wider—in the MDD groups. This pattern suggests that depressed adults accumulated the evidence needed to make decisions more slowly than controls did.ConclusionsDepressed adults responded slower than controls in both studies, and poorer performance led the MDD group to receive fewer rewards than controls in Study 1. These results did not reflect a sensorimotor deficit but were instead due to sluggish evidence accumulation. Thus, slowed decision-making—not slowed perception or response execution—caused the performance deficit in MDD. If these results generalize to other tasks, they may help explain the broad cognitive deficits seen in depression.
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Lee, Min Ji, Jeong-eun Park, Miseong Kim, Eunkyo Park, and Jooyeon Park. "VP10 Impact Of Health Technology Assessment On Policy And Clinical Decision Making In Korea." International Journal of Technology Assessment in Health Care 34, S1 (2018): 162. http://dx.doi.org/10.1017/s0266462318003409.
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Introduction:Since established in 2009, the National Evidence-based healthcare Collaborating Agency (NECA) has been the sole government-funded Health Technology Assessment (HTA) institution in Korea, yet little effort has been made to systematically evaluate the influence of its products. In this study, we aimed to measure the impact of the HTA products of NECA on clinical and policy decisions by introducing a systematic framework.Methods:We included HTA reports published from 2009 to 2015. Among the 141 research reports published during this period, there were 67 HTA reports. We gathered data on the influence by literature and news article search, review of administrative documents and directly listening to the decision makers. The influence was categorized into three decision types: changes in clinical guidelines, administrative decision on investment/disinvestment and healthcare policy making. Whether a research report was used directly in decision making, or followed by subsequent researches or round-table conference, was recorded to examine the knowledge transfer process.Results:In total, 67.2 percent of the included HTA reports were used to support clinical and policy decisions. Twenty-seven reports had influenced administrative decisions on investment/disinvestment. Ten provided evidence for new health policies or legislation. Eight were reflected in clinical guidelines. The impact of HTA reports published by NECA was more evident when the research was directly requested by decision-making bodies such as government institutions. Although most HTA reports were conducted in collaboration with clinicians, the use of results by clinicians was limited. Definitive results were more likely to be used, but reports with competing interests had fewer impacts.Conclusions:HTA by NECA had impacts on the rational use of healthcare resources in Korea, and NECA has established its role as an intermediary between governmental decision-making bodies and clinicians. However, more continuous approaches rather than one-time HTA research are needed for HTA on controversial topics to have impacts on decision making.
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Minazuki, Akinori, and Hidehiko Hayashi. "Analysis of Decision-Making Process in Helicopter Emergency Medical Service." International Journal of Organizational and Collective Intelligence 4, no. 1 (January 2014): 57–63. http://dx.doi.org/10.4018/ijoci.2014010105.
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In the helicopter emergency medical service (HEMS), the captain flies without using visual assistance to keep some distance between the helicopter and clouds or obstacles. Under the present conditions, the communication specialist (CS) and the captain of HEMS contact each other and select the safest flight path. With the increase in future requests, conducting safe and effective navigation is a challenge of the CS. However, it is difficult to say that all CSs conduct their duties with profound knowledge and experience about the detailed weather and land forms. In addition, a reasonable amount of time is needed to standardize their knowledge and experience. Consequently in this research, the authors focused on the understanding and assessment of the situation and the process of the decision-making and then analyzed them. The authors also interviewed the CS directly, and proposed to develop a system which can make up for the differences in the knowledge and experience of individual CSs.
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Nagpal, R., and V. G. Jhanwar. "Surreptitious Drug Administration: Collective Decision Making Over Riding Personal Autonomy." European Psychiatry 41, S1 (April 2017): S612. http://dx.doi.org/10.1016/j.eurpsy.2017.01.972.
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A quaint problem indeed. This is an issue where ethical and practical management issues lock horns. An individual with no insight on a rampage, a threat to self and others cannot be given medicines without consent except in an indoor facility and admitted under a specific provision of the current statute. Contrary to the law, the mental health policy envisages community care of the individual. For a time defined interval, surreptitious medication can be administered providing much needed relief to the caregivers and calms the recipient. Surreptitious medication can of course be an instrument of control and hence would necessitate a system of checks and balances. Surreptitious medication tests legal and ethical boundaries. It offers relief to caregivers but can be an instrument of abuse. The act of administering a drug without the individual's consent is prima facie wrong but if the context is woven in, a whole new dimension arises.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Migliore, Simone, Giulia D’Aurizio, Francesca Parisi, Sabrina Maffi, Barbara Squitieri, Giuseppe Curcio, and Francesco Mancini. "Moral Judgment and Empathic/Deontological Guilt." Psychological Reports 122, no. 4 (July 19, 2018): 1395–411. http://dx.doi.org/10.1177/0033294118787500.
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Background People often make complicated decisions to help or to punish perfect strangers. Harming someone or breaking some moral imperative is usually linked to feeling guilt, and several researches suggested the existence of two different kinds of guilt: altruistic/empathic and deontological. Aim Our study aimed to investigate the decision-making processes in moral and nonmoral judgments and assess how specific situations in which the subject is close to the victim or flanked by an authority can influence his decisions. Methods We used three different moral conditions: Empathic Moral (the decision has made while physically close to the potential victims), Deontological Moral (the decision has made while flanked by an “authority”), and Standard Moral (without any influence); a fourth condition is represented by Nonmoral dilemmas (the subject must make a choice between two different things and this does not cause any harm or victims). Previously, a pilot study was carried out for validating the experimental stories to be used in the main study. Results We observed a higher number of utilitarian/positive responses when individuals had to respond to Empathic Moral condition, with respect to Deontological Moral and Nonmoral dilemmas. Moreover, looking at the time needed to read the dilemma, under empathic guilt condition, people tended to be slower in reading the dilemmas than in other conditions and this both in case of positive and negative responses. No significant differences in time needed to effectively respond emerged. Conclusions These findings suggested that be physically close to potential victims or be flanked by an “authority” differentially influence the decision-making processes in moral judgment, inducing slower decisions and more utilitarian answers, particularly in the scenario of physical proximity.
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Khalil, Ayman, Hussein Al Haj Hassan, Maryline Hélard, and Jean-Francois Hélard. "New QoS-based Decision Making Approach for Heterogeneous Networks." INTERNATIONAL JOURNAL OF COMPUTERS & TECHNOLOGY 10, no. 10 (September 30, 2013): 2109–20. http://dx.doi.org/10.24297/ijct.v10i10.1198.
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Next generation wireless networks will provide seamless high bandwidth connectivity with high quality of service (QoS) support to mobile users, where a mobile will be able to connect to several wireless access networks simultaneously. In this environment, heterogeneity of networks and heterogeneity of applications are presented as challenging problems, where an efficient architecture is needed to integrate different technologies. In addition, deciding the serving network is essential to avoid resource wastage and provide QoS for users. In this paper, we propose new integration architecture based on a virtual operator that rents or invests resources from a physical operator, and sells services to customers. The virtual operator will monitor the network’s conditions and QoS parameters, and then provide the user requesting access with useful information to decide the serving network. In this context, we modify four well-known decision mechanisms (load balance, minimum distance, minimum price and minimum delay) by adding the QoS as a hard constraint. We also propose a new decision mechanism, where we consider new decision criteria that improves the overall system performance. Simulation results show that the new proposed mechanism outperforms the modified mechanisms, where the blocking probability is clearly reduced and a good level of QoS is provided to real-time applications or high-priority users.
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Uzezi Philomena, Omodafe. "Determinants of Children’s Role in Family Buying Decision-Making: The Case of South-South, Nigeria." International Journal of Management Science and Business Administration 1, no. 7 (2015): 30–38. http://dx.doi.org/10.18775/ijmsba.1849-5664-5419.2014.17.1003.
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This study examines the role of children in family buying decision-making and investigates factors that seem to have effect on children’s level of involvement in family buying decisions. The study was conducted using two samples (children and parent respondents). The respondents’ choice and justification thereof was shown in a detailed manner. Data for the study were collected with the instrument of questionnaire, personal interview and secondary sources. The data collected has been empirically analysed through ANOVA, correlation and regression as well as cross tabulation procedure with SPSS. The findings of the study revealed that family-buying decisions in contemporary times is more of an outcome of a joint effort in which children play significant and multiple roles in relation to a wide variety of products needed by their families, not just to the items that directly relate to their needs. It was also found that there exists a nexus between perceived level of children involvement in buying decision making and some selected demographic, socio-cultural and economic factors. The study recommended that parents should adopt a democratic approach in arriving at family purchase decisions in order to avoid family conflict. It is also imperative that marketers understand the changing dynamics of family buying decision-making process and the elevated power of children’s roles and influences in order to design better marketing strategies that can effectively serve and satisfy the needs of emerging market segment for improved marketing performance.
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Wolf, Sarah, Ingrid Zechmeister-Koss, Nicole Grössmann, and Claudia Wild. "Evaluating options for decision making on costly hospital drugs in Austria." International Journal of Technology Assessment in Health Care 36, no. 3 (May 14, 2020): 277–84. http://dx.doi.org/10.1017/s0266462320000276.
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ObjectivesThe aim of this study was to suggest options for a national and standardized process for the reimbursement of costly drugs provided in Austrian hospitals.MethodsFor answering the research questions, reimbursement processes of ten countries were investigated and the strengths and weaknesses of elaborated options of actions were analyzed, resulting in suggestions for solutions in the Austrian reimbursement processes for hospital drugs.ResultsBased on the information derived from the international analysis and the deliberation of the strengths and weaknesses on optional approaches, as well as, on the consideration of the existing reimbursement processes in Austria, three options to reorganize the current decentralized inpatient reimbursement process in Austria were suggested. The first option presents a process following the established processes of the decision making for outpatient drugs. The second option suggests stronger coordination of and cooperation across the existing processes of the nine regional “Pharmaceutical and Therapeutics Committees”. The third option proposes to expand the already established reimbursement process for non-drug interventions.ConclusionsEvidence-based, transparent, fair and efficient resource allocations are needed for priority setting decisions. However, a decision process can be based on the best available evidence, can be fair and transparent, although it might be substantially more time-consuming. Thus, a pragmatic balance between quality, transparency and timeliness is crucial.
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Murray, Janice, Yvonne Lynch, Juliet Goldbart, Liz Moulam, Simon Judge, Edward Webb, Mark Jayes, et al. "The decision-making process in recommending electronic communication aids for children and young people who are non-speaking: the I-ASC mixed-methods study." Health Services and Delivery Research 8, no. 45 (November 2020): 1–158. http://dx.doi.org/10.3310/hsdr08450.
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Background This project [Identifying Appropriate Symbol Communication (I-ASC)] explored UK decision-making practices related to communication aid recommendations for children and young people who are non-speaking. Research evidence related to communication aid decision-making is limited. The research aims were to increase understanding of influencers on the decision-making process in recommending electronic communication aids, and to develop guidance tools to support decision-making. An additional, post hoc aim was to evaluate the public involvement contribution to the I-ASC project. The research focused on the identification of attributes and characteristics that professionals, family members and those who use communication aids considered important in the recommendation process. Findings informed the development of guidance resources. The evaluation of public involvement focused on what could be learned from a nationally funded project with involvement from public contributors typically regarded as hard to include. Methodology For the clinical decision-making component, the methodological investigation adopted a three-tier approach with three systematic reviews, a qualitative exploration of stakeholder perspectives through focus groups and interviews, and a quantitative investigation surveying professionals’ perspectives. The public involvement evaluation adopted a mixed-methods approach. A total of 354 participants contributed to the decision-making data set, including professionals, family members, and children, young people and adults who use communication aids; 22 participants contributed to the public involvement evaluation. The literature review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thematic analysis and framework approach supported the analysis of qualitative data. Two stated preference surveys, a best–worst scaling and a discrete choice experiment, allowed the relative importance of factors in decision-making to be determined. Analysis was grounded in random utility theory. Public involvement Two public involvement co-researchers, an adult using a symbol communication aid and a parent of a communication aid user, were core members of the research team. The I-ASC public involvement resulted in an additional award to evaluate the impact of public involvement across the project. Results Factors influencing decision-making are not always under the control of the decision-makers, for example professional knowledge, referral criteria and service structure. Findings suggest that real clinical decisions contrast with hypothetical decisions. Survey responses indicated that children’s physical characteristics are less important than their language, communication and learning abilities; however, during real-time decision-making, the opposite appeared to be true, with access needs featuring most prominently. In contrast to professionals’ decisions, users and family members prioritise differing aesthetic attributes of communication aids. Time allocated to system learning remains underspecified. The research informed the development of decision-making guidance tools (https://iasc.mmu.ac.uk/; accessed 8 June 2020). A public involvement evaluation suggests that successful public involvement of individuals with disabilities requires significant resources that include staff time, training and personal support (https://iasc.mmu.ac.uk/publicinvolvement; accessed 8 June 2020). Future work Further research is needed in the areas of language assessment, communication aid attributes, types of decision-making episodes and service user perspectives. These data highlight the need for mechanisms that enable public involvement co-researchers to be paid for their contributions to research bid preparation. Limitations Individuals who benefit from communication aids are a heterogeneous group. We cannot guarantee that this study has captured all relevant components of decision-making. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 45. See the NIHR Journals Library website for further project information.
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Neumann, Jessica L., Louise Arnal, Rebecca E. Emerton, Helen Griffith, Stuart Hyslop, Sofia Theofanidi, and Hannah L. Cloke. "Can seasonal hydrological forecasts inform local decisions and actions? A decision-making activity." Geoscience Communication 1, no. 1 (December 6, 2018): 35–57. http://dx.doi.org/10.5194/gc-1-35-2018.
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Abstract. While this paper has a hydrological focus (a glossary of terms highlighted by asterisks in the text is included in Appendix A), the concept of our decision-making activity will be of wider interest and applicable to those involved in all aspects of geoscience communication. Seasonal hydrological forecasts (SHF) provide insight into the river and groundwater levels that might be expected over the coming months. This is valuable for informing future flood or drought risk and water availability, yet studies investigating how SHF are used for decision-making are limited. Our activity was designed to capture how different water sector users, broadly flood and drought forecasters, water resource managers, and groundwater hydrologists, interpret and act on SHF to inform decisions in the West Thames, UK. Using a combination of operational and hypothetical forecasts, participants were provided with three sets of progressively confident and locally tailored SHF for a flood event in 3 months' time. Participants played with their “day-job” hat on and were not informed whether the SHF represented a flood, drought, or business-as-usual scenario. Participants increased their decision/action choice in response to more confident and locally tailored forecasts. Forecasters and groundwater hydrologists were most likely to request further information about the situation, inform other organizations, and implement actions for preparedness. Water resource managers more consistently adopted a “watch and wait” approach. Local knowledge, risk appetite, and experience of previous flood events were important for informing decisions. Discussions highlighted that forecast uncertainty does not necessarily pose a barrier to use, but SHF need to be presented at a finer spatial resolution to aid local decision-making. SHF information that is visualized using combinations of maps, text, hydrographs, and tables is beneficial for interpretation, and better communication of SHF that are tailored to different user groups is needed. Decision-making activities are a great way of creating realistic scenarios that participants can identify with whilst allowing the activity creators to observe different thought processes. In this case, participants stated that the activity complemented their everyday work, introduced them to ongoing scientific developments, and enhanced their understanding of how different organizations are engaging with and using SHF to aid decision-making across the West Thames.
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Scherer, Laura D., Daniel D. Matlock, Larry A. Allen, Chris E. Knoepke, Colleen K. McIlvennan, Monica D. Fitzgerald, Vinay Kini, Channing E. Tate, Grace Lin, and Hillary D. Lum. "Patient Roadmaps for Chronic Illness: Introducing a New Approach for Fostering Patient-Centered Care." MDM Policy & Practice 6, no. 1 (January 2021): 238146832110199. http://dx.doi.org/10.1177/23814683211019947.
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Background. Too frequently, patients with chronic illnesses are surprised by disease-related changes and are unprepared to make decisions based on their values. Many patients are not activated and do not see a role for themselves in decision making, which is a key barrier to shared decision making and patient-centered care. Patient decision aids can educate and activate patients at the time of key decisions, and yet, for patients diagnosed with chronic illness, it would be advantageous to activate patients in advance of critical decisions. In this article, we describe and formalize the concept of the Patient Roadmap, a novel approach for promoting patient-centered care that aims to activate patients earlier in the care trajectory and provide them with anticipatory guidance. Methods. We first identify the gap that the Patient Roadmap fills, and describe theory underlying its approach. Then we describe what information a Patient Roadmap might include. Examples are provided, as well as a review comparing the Patient Roadmap concept to existing tools that aim to promote patient-centered care (e.g., patient decision aids). Results and Conclusions. New approaches for promoting patient-centered care are needed. This article provides an introduction and overview of the Patient Roadmap concept for promoting patient-centered care in the context of chronic illness. [Box: see text]
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S, Susliansyah, Annisa Dwi Wijayanti, Heny Sumarno, Hendro Priyono, and Linda Maulida. "Penerapan Metode Profile Matching pada Pemilihan Guru Terbaik SMK Madani." J-SAKTI (Jurnal Sains Komputer dan Informatika) 4, no. 1 (March 30, 2020): 179. http://dx.doi.org/10.30645/j-sakti.v4i1.197.
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Depok Madani Vocational School is a Vocational High School consisting of 2 majors namely Light Vehicle Engineering (TKR) and Computer and Network Engineering (TKJ) with 20 teachers as instructors from class X to class XII. The selection of the best teachers is done once a month to motivate the teacher in conducting teaching and learning activities. Schools in making decisions are often influenced by subjectivity and are done manually. Resulting in social jealousy among teachers and inaccurate decision results. Therefore, in assessing the best teachers a decision support system is needed in order to obtain accurate results. Decision Support System methods used in this study is Profile Matching. The method determines the value of weights on each criterion, which is to be present on time, responsibility, dress neatly and politely, participate and contribute, be active and productive, and help fellow teachers, which is followed by a ranking process. The result of the comparison of the two methods above is to produce the same chosen alternative, so that both methods can be applied to help the school's decision making.
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Scolobig, Anna, Luigi Pellizzoni, and Chiara Bianchizza. "Public Participation and Trade-Offs in Flood Risk Mitigation: Evidence from Two Case Studies in the Alps." Nature and Culture 11, no. 1 (March 1, 2016): 93–118. http://dx.doi.org/10.3167/nc.2016.110105.
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There is an increasing demand for improvement of the quality of decisions about flood risk mitigation by fostering public participation in decision-making. However, the extent and way in which formalized participation guarantees good outcomes is still a matter of discussion. This article analyzes different approaches to decision-making for flood risk mitigation by comparing two experiences in the Italian Alps. In Vipiteno-Sterzing, decisions were made by involving citizens in a structured participatory process. In Malborghetto-Valbruna, a formally technocratic (yet substantially inclusive) approach was adopted after the flood that affected the municipality in 2003. Our results critically review the perspective that structured participation is always something "good." In this regard, the way relevant trade-offs between public and private goods were acknowledged and dealt with turned out to be crucial. At the same time, effective participation is closely related to citizens' actual engagement, institutional responsiveness to residents' needs and expectations, and the capacity to harmonize different views and types of knowledge in the development of risk mitigation options. Policy context, choice of approach and quality of outcomes appear as "nested" issues. Further research is needed in order to assess different experiences of decision-making and to set robust conditions for better outcomes in public participation.
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Muhammad Faizal, Mochammad Rizki Romdoni, and Gunawan Pratama. "Sistem Pendukung Keputusan Teknisi Terbaik PT.Telkom Indonesia Tanjungpinang Menggunakan Metode TOPSIS." Jurnal Bangkit Indonesia 7, no. 2 (October 4, 2018): 57–61. http://dx.doi.org/10.52771/bangkitindonesia.v8i1.163.
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Information is needed in the decision making process. Good and right decisions need to be supported by the availability of accurate, fast and relevant information. With such information, the head of an office or head of an institution or organization can get a complex and specific picture of a decision to be formulated. The decision will be efficient in terms of time because the data can be accessed instantly. In addition, the accuracy of the data is more guaranteed, so that decisions that are formulated will be more precise and can be formulated in a relatively short time. So far, PT Telkom Indonesia Tanjungpinang in making the decision to choose the best technician is not based on qualitative data comparing each existing criterion, so that the assessment is only carried out by the head of the office or asman by selecting the technician who he thinks is the best without considering the required criteria. So the assessment is only based on the results of voting votes and also the calculations carried out are also not computerized, so that old data is often lost from the books. With the Web-Based Best Technician Decision Support System to help the Head of the Office in dealing with the above problems, this system was created using the TOPSIS (Technique For Others Reference by Similarity to Ideal Solution) method with the PHP and Mysql programming languages as the database, as well as the software modeling method using UML.