Decision-making process related to treatment and management in Korean women with breast cancer: Finding the right individualized healthcare trajectory

2017 ◽  
Vol 35 ◽  
pp. 99-105
Author(s):  
Kkotbong Kim ◽  
Jinhyang Yang
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Decision Making Process ◽  
Korean Women ◽  
Healthcare Trajectory ◽  
The Right

scholarly journals Decision Making in Committees: Transparency, Reputation, and Voting Rules

2007 ◽  
Vol 97 (1) ◽  
pp. 150-168 ◽  
Author(s):  
Gilat Levy
Keyword(s):  
Decision Making ◽  
Career Concerns ◽  
Decision Making Process ◽  
Voting Rules ◽  
The Public ◽  
Voting Rule ◽  
The Right

In this paper I analyze the effect of transparency on decision making in committees. I focus on committees whose members are motivated by career concerns. The main result is that when the decision-making process is secretive (when individual votes are not revealed to the public), committee members comply with preexisting biases. For example, if the voting rule demands a supermajority to accept a reform, individuals vote more often against reforms. Transparent committees are therefore more likely to accept reforms. I also find that coupled with the right voting rule, a secretive procedure may induce better decisions than a transparent one. (JEL D71, D72)

scholarly journals MULTI CRITERIA DECISION MAKING – RANKING AND PROMOTING EMPLOYEES

2019 ◽  
Vol 31 (5) ◽  
pp. 1235-1241
Author(s):  
Marina Badarovska Mishevska
Keyword(s):  
Decision Making ◽  
Decision Problem ◽  
Decision Makers ◽  
Decision Making Process ◽  
Specific Situation ◽  
Mathematical Tool ◽  
Analytic Hierarchy ◽  
The Right ◽  
Term Performance ◽  
Hierarchy Process

The analytic hierarchy process (AHP) is a structured technique for organizing and analyzing complex decisions, based on mathematics and psychology. The method was developed by Thomas L. Saaty in the 1970s and has been extensively studied and refined since then. It has particular application in group decision making and is used around the world in a wide variety of decision situation. Rather than prescribing a "correct" decision, the AHP helps decision makers choose one that best suits their goal and their understanding of the problem. The technique provides a comprehensive and rational framework for structuring a decision problem, for representing and quantifying its elements, for relating those elements to overall goals, and for evaluating alternative solutions. Decision making is the choice of one alternative, from two or more, to which the course of the activity is directed and the problem is solved. The decision-making process is a rational attempt by the manager to achieve the goals of the organizational unit. The decision-making process can be thought of as a "brain and nervous system" of an enterprise. Decisions are made when a person wants things to be different in the future. Given each specific situation, making the right decisions is probably one of the most difficult challenges for managers. Managers in day-to-day work deliver programmed and unprogrammed decisions that solve simple or complex problems. Simple decisions have an impact on the short-term performance of the enterprise, and complex decisions have an impact on the long-term future and success of the enterprise. Users of the AHP first decompose their decision problem into a hierarchy of more easily comprehended sub-problems, each of which can be analyzed independently. Once the hierarchy is built, the decision makers systematically evaluate its various elements by comparing them to each other two at a time, with respect to their impact on an element above them in the hierarchy. The AHP converts these evaluations to numerical values that can be processed and compared over the entire range of the problem. In this article, it is explained the application of the AHP method in order to evaluate and promote employees in the enterprise "X" with several criteria. The obtained results enable the manager to evaluate the employees in an objective way and make an objective decision for their promotion. Its application for selecting the best among employees, in their assessment and promotion, allows managers to use a specific and mathematical tool to support the decision. This tool not only supports and qualifies decisions, it also allows managers to justify their choice, as well as to simulate possible results.

scholarly journals Factors Influencing Physicians' Clinical Decision-making at Upazila Health Complexes in Bangladesh

2020 ◽  
Vol 3 (4) ◽  
pp. 125-133
Author(s):  
M. Aminul Islam ◽  
M. Abdul Awal
Keyword(s):  
Decision Making ◽  
Social Networks ◽  
Clinical Decision Making ◽  
Average Length ◽  
Clinical Decision ◽  
Primary Data ◽  
Decision Making Process ◽  
Cross Sectional ◽  
The Right ◽  
Consultation Session

ABSTRACT Introduction Selecting the most appropriate treatment for each patient is the key activity in patient-physician encounters and providing healthcare services. Achieving desirable clinical goals mostly depends on making the right decision at the right time in any healthcare setting. But little is known about physicians' clinical decision-making in the primary care setting in Bangladesh. Therefore, this study explored the factors that influence decisions about prescribing medications, ordering pathologic tests, counseling patients, average length of patient visits in a consultation session, and referral of patients to other physicians or hospitals by physicians at Upazila Health Complexes (UHCs) in the country. It also explored the structure of physicians' social networks and their association with the decision-making process. Methods This was a cross-sectional descriptive study that used primary data collected from 85 physicians. The respondents, who work at UHCs in the Rajshahi Division, were selected purposively. The collected data were analyzed with descriptive statistics including frequency, percentage, one-way analysis of variance, and linear regression to understand relationships among the variables. Results The results of the study reveal that multiple factors influence physicians' decisions about prescribing medications, ordering pathologic tests, length of visits, counseling patients, and referring patients to other physicians or hospitals at the UHCs. Most physicians prescribe drugs to their patients, keeping in mind their purchasing capacity. Risk of violence by patients' relatives and better management are the two key factors that influence physicians' referral decisions. The physicians' professional and personal social networks also play an influential role in the decision-making process. It was found that physicians dedicate on average 16.17 minutes to a patient in a consultation session. The length of visits is influenced by various factors including the distance between the physicians' residence and their workplace, their level of education, and the number of colleagues with whom they have regular contact and from whom they can seek help. Conclusion The results of the study have yielded some novel insights about the complexity of physicians' everyday tasks at the UHCs in Bangladesh. The results would be of interest to public health researchers and policy makers.

scholarly journals Outsourcing energy retrofitting of hotel buildings: the decision-making process

2019 ◽  
Vol 266 ◽  
pp. 01016 ◽  
Author(s):  
M.F.F. Fasna ◽  
Sachie Gunatilake
Keyword(s):  
Decision Making ◽  
Energy Performance ◽  
Decision Making Process ◽  
Existing Buildings ◽  
Energy Retrofit ◽  
Energy Efficiency Improvement ◽  
Adoption And Implementation ◽  
Energy Service ◽  
The Right

Poor energy performance of existing buildings worldwide has led to a crucial need to retrofit existing buildings to minimise energy consumption. Among the existing buildings, hotels use as much as 50% of their total expenses on energy and offer significant opportunities for energy efficiency improvement. Yet, comparatively the level of implementation of energy retrofits found to be low, which has attributed to, inter alia, the absence of a clearly defined process for ensuring the delivery of energy retrofit projects and lack of proactive guidance for project teams to ensure that they make the right decisions at the right time to achieve the desired outcomes. Since many energy retrofit projects in existing hotels are carried out with the involvement of an external contractor, or an Energy Service Company (ESCO), this study focuses on investigating the decision-making process in implementing energy retrofits when the project is outsourced to an external party. An in-depth case study is used to obtain insights into the critical decisions to be taken and key activities to be performed throughout the decision-making process. The findings are used to propose a step-by-step decision-making process comprising of three key phases: i.e., pre-retrofit, retrofit implementation and post-retrofit. It is hoped that the decision-making process developed in this study will serve as a roadmap for the effective adoption and implementation of energy retrofits in existing hotel buildings when an external contractor is involved.

Article Commentary: Surgical Management of the Axilla in Breast Cancer

2016 ◽  
Vol 82 (6) ◽  
pp. 475-486
Author(s):  
Stephanie Mastrangelo ◽  
Kelly McMasters ◽  
Nicolas Ajkay
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Surgical Management ◽  
Axillary Dissection ◽  
Lymph Node Biopsy ◽  
Decision Making Process ◽  
Review Of The Literature ◽  
Node Negative ◽  
Node Biopsy ◽  
Clinically Node Positive

This article offers a review of the literature on current surgical management of the axilla in breast cancer. This includes the decision-making process involved in clinically node-negative patients versus clinically node-positive patients, with discussion of the indications for sentinel lymph node biopsy versus axillary dissection. It also examines the surgical axillary management of patients who receive neoadjuvant chemotherapy. This article will help update practicing surgeons on the evolving research and guidelines for the management of breast cancer axillary disease.

scholarly journals Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process

In Vivo ◽  
2020 ◽  
Vol 34 (3 suppl) ◽  
pp. 1651-1659 ◽  
Author(s):  
GIANLUCA VANNI ◽  
MARCO MATERAZZO ◽  
MARCO PELLICCIARO ◽  
SARA INGALLINELLA ◽  
MAURIZIO RHO ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Decision Making Process

The G8 frailty screening tool and the decision‐making process in older breast cancer patients

2020 ◽  
Author(s):  
Ellen R. M. Scheepers ◽  
Loes F. Molen ◽  
Frederiek Bos ◽  
Josephine P. Burgmans ◽  
Lieke H. Huis‐Tanja ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Cancer Patients ◽  
Screening Tool ◽  
Decision Making Process ◽  
Breast Cancer Patients

Mapping the Decision-Making Process for Adjuvant Endocrine Therapy for Breast Cancer

2016 ◽  
Vol 37 (1) ◽  
pp. 79-90 ◽  
Author(s):  
Louise L. Beryl ◽  
Katharine A. S. Rendle ◽  
Meghan C. Halley ◽  
Katherine A. Gillespie ◽  
Suepattra G. May ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Endocrine Therapy ◽  
Health Care Organization ◽  
Cancer Recurrence ◽  
Decisional Conflict ◽  
Adjuvant Endocrine Therapy ◽  
Decision Making Process ◽  
Care Organization ◽  
Patient Decision Making

Background. Studies show adjuvant endocrine therapy increases survival and decreases risk of breast cancer recurrence for hormone receptor–positive tumors. Yet studies also suggest that adherence rates among women taking this therapy may be as low as 50% owing largely to adverse side effects. Despite these rates, research on longitudinal patient decision making regarding this therapy is scant. Objective. We sought to map the decision-making process for women considering and initiating adjuvant endocrine therapy, paying particular attention to patterns of uncertainty and decisional change over time. Methods. A longitudinal series of semistructured interviews conducted at a multispecialty health care organization in Northern California with 35 newly diagnosed patients eligible for adjuvant endocrine therapy were analyzed. Analysis led to the identification and indexing of 3 new decision-making constructs—decisional phase, decisional direction, and decisional resolve—which were then organized using a visual matrix and examined for patterns characterizing the decision-making process. Results. Our data reveal that most patients do not make a single, discrete decision to take or not take hormone therapy but rather traverse multiple decisional states, characterized by 1) phase, 2) direction, and 3) strength of resolve. Our analysis tracks these decisional states longitudinally using a grayscale-coded matrix. Our data show that decisional resolve wavers not just when considering therapy, as the existing concept of decisional conflict suggests, but even after initiating it, which may signal future decisions to forgo therapy. Conclusions. Adjuvant endocrine therapy, like other chronic care decisions, has a longer decision-making process and implementation period. Thus, theoretical, empirical, and clinical approaches should consider further exploring the new concept and measurement of decisional resolve, as it may help to improve subsequent medication adherence.

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