Decision Support to Masters, Mates on Watch, and Pilots: The Piloting Expert System

1990 ◽  
Vol 43 (03) ◽  
pp. 364-384 ◽  
Author(s):  
Martha Grabowski
Keyword(s):  
Decision Making ◽  
New York ◽  
Decision Support ◽  
Expert System ◽  
Decision Aid ◽  
Decision Aids ◽  
Gulf Of Alaska ◽  
Lessons Learned ◽  
Simple Task ◽  
Cognitive Decision

Piloting large vessels in increasingly congested waterways is no simple task. As in many ‘decision-making under uncertainty’ scenarios, masters, mates and pilots engaged in piloting are inundated with much information and required to make crucial decisions in real time. Piloting is also an inherently judgmental activity. Pilots and ships' captains invariably develop heuristics for transiting particular waterways. As vessels become larger, cargoes more hazardous, and the waterways more congested, decision aid technology is being considered to improve piloting decision-making. This paper describes one approach to providing improved on-board decision support to masters, mates on watch, and pilots navigating in restricted waters. We discuss (1) the use of cognitive decision aids in piloting, (2) the design of such a decision aid developed for New York harbour, (3) simulator experiments evaluating the expert system, and (4) plans to apply the approach and ‘lessons learned’ to the development of an expert system for tankers transiting the Gulf of Alaska.

The Effects of Pedigree and Source Type on Trust in a Dual Adviser Context

2017 ◽  
Vol 61 (1) ◽  
pp. 319-323 ◽  
Author(s):  
Carl J. Pearson ◽  
Christopher B. Mayhorn
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Decision Aid ◽  
Decision Aids ◽  
Decision Makers ◽  
Influential Factor ◽  
Trust Development ◽  
Conflicting Information ◽  
Source Type ◽  
Human Decision

In a world with increasing ubiquity of automated decision aids, human decision makers often find themselves receiving input from automation and another human simultaneously. Previous research has shown how certain characteristics of a human or automated decision aid affect the development of trust. Little research has investigated how these factors of trust development are involved when more than one adviser is present. This study explored how pedigree (perceived expertise) and source type (human or automated) was related to trust and reliance in a decision-making task with conflicting information from two advisers. Results from this study indicate the pedigree is an influential factor across both human and automated decision aids. This study also found a relationship between trust attitudes and behavioral reliance. These findings are relevant for designing decision support systems that involve multiple advisers or for informing the effects of introducing decision aids in a manner with respect to decision aid pedigree.

scholarly journals Decision support for customers in electronic environments

2011 ◽  
Vol 59 (2) ◽  
pp. 51-58
Author(s):  
František Dařena
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Information Overload ◽  
Decision Aids ◽  
Cost Savings ◽  
Network Systems ◽  
Knowledge Based ◽  
Decision Supporting ◽  
Cognitive Decision ◽  
Electronic Environments

Due to the rapid spread of computer technologies into day-to-day lives many purchases or purchase-related decisions are made in the electronic environment of the Web. In order to handle information overload that is the result of the availability of many web-based stores, products and services, consumers use decision support aids that help with need recognition, information retrieval, filtering, comparisons and choice making. Decision support systems (DSS) discipline spreads about 40 years back and was mostly focused on assisting managers. However, online environments and decision support in such environments bring new opportunities also to the customers. The focus on decision support for consumers is also not investigated to the large extent and not documented in the literature. Providing customers with well designed decision aids can lead to lower cognitive decision effort associated with the purchase decision which results in significant increase of consumer’s confidence, satisfaction, and cost savings. During decision making process the subjects can chose from several methods (optimizing, reasoning, analogizing, and creating), DSS types (data-, model-, communication-, document-driven, and knowledge-based) and benefit from different modern technologies. The paper investigates popular customer decision making aids, such as search, filtering, comparison, ­e-negotiations and auctions, recommendation systems, social network systems, product design applications, communication support etc. which are frequently related to e-commerce applications. Results include the overview of such decision supporting tools, specific examples, classification according the way how the decisions are supported, and possibilities of applications of progressive technologies. The paper thus contributes to the process of development of the interface between companies and the customers where customer decisions take place.

scholarly journals Current Status and Future Prospects for Shared Decision Making before and after Total Knee Replacement Surgery—A Scoping Review

2021 ◽  
Vol 18 (2) ◽  
pp. 668
Author(s):  
Geert van der Sluis ◽  
Jelmer Jager ◽  
Ilona Punt ◽  
Alexandra Goldbohm ◽  
Marjan J. Meinders ◽  
...  
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Total Knee Replacement ◽  
Shared Decision Making ◽  
Knee Replacement ◽  
Study Design ◽  
Scoping Review ◽  
Decision Aids ◽  
Shared Decision ◽  
Total Knee

Background. To gain insight into the current state-of-the-art of shared decision making (SDM) during decisions related to pre and postoperative care process regarding primary total knee replacement (TKR). Methods. A scoping review was performed to synthesize existing scientific research regarding (1) decisional needs and preferences of patients preparing for, undergoing and recovering from TKR surgery, (2) the relation between TKR decision-support interventions and SDM elements (i.e., team talk, option talk, and decision talk), (3) the extent to which TKR decision-support interventions address patients’ decisional needs and preferences. Results. 2526 articles were identified, of which 17 articles met the inclusion criteria. Of the 17 articles, ten had a qualitative study design and seven had a quantitative study design. All included articles focused on the decision whether to undergo TKR surgery or not. Ten articles (all qualitative) examined patients’ decisional needs and preferences. From these, we identified four domains that affected the patients’ decision to undergo TKR: (1) personal factors, (2) external factors, (3) information sources and (4) preferences towards outcome prediction. Seven studies (5) randomized controlled trials and 2 cohort studies) used quantitative analyses to probe the effect of decision aids on SDM and/or clinical outcomes. In general, existing decision aids did not appear to be tailored to patient needs and preferences, nor were the principles of SDM well-articulated in the design of decision aids. Conclusions. SDM in TKR care is understudied; existing research appears to be narrow in scope with limited relevance to established SDM principles and the decisional needs of patients undertaking TKR surgery.

scholarly journals Experts' views on the implementation of the prenatal screening decision aid in Iran: A qualitative study

2021 ◽  
Author(s):  
Razieh Zahedi ◽  
Leila Nemati-Anaraki ◽  
Shahram Sedghi ◽  
Mamak Shariat
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Decision Aid ◽  
Prenatal Screening ◽  
Decision Aids ◽  
Personal Factors ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Patient Decision Aids ◽  
Patient Decision

Background & Aim: Patient decision aids are detailed and personalized health education materials that assist patients in decision making. According to expert viewpoints, this study aimed to determine important factors in implementing the prenatal screening decision aid in Iran. Methods & Materials: In this qualitative study, 24 experts, including seven obstetricians, four information scientists, five managers or policymakers, and eight midwives, were selected using purposive and snowball sampling approaches. Semi-structured interviews were conducted to collect the data between January 2020 and June 2020 in Tehran, Iran. A prenatal screening decision aid was presented to the participants, and we asked them to raise their concerns and thoughts regarding the factors influencing the implementation of patient decision aids. We used MAXQDA 10 and applied conventional content analysis for data analysis. Results: Two organizational and personal factors themes were identified to implement Iran's prenatal screening decision aids. Conclusion: We identified the viewpoints of experts regarding major factors in patient decision aids implementation for prenatal screening. Before implementing prenatal screening decision aids in Iran, it would be helpful to consider these organizational and personal factors. Prenatal screening decision aids can provide better information for pregnant women and strengthen their decision-making ability.

Abstract 27: Patients' Perspectives on a Decision Aid to Facilitate Cost-sensitive Decisions for Sacubitril-Valsartan

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Andrea R Mitchell ◽  
Grace Venechuk ◽  
Larry A Allen ◽  
Dan D Matlock ◽  
Miranda Moore ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Decision Aids ◽  
Descriptive Analysis ◽  
Patient Specific ◽  
Shared Decision ◽  
Cost Information ◽  
Reduced Ejection Fraction ◽  
The Impact

Background: Decision aids frequently focus on decisions that are preference-sensitive due to an absence of superior medical option or qualitative differences in treatments. Out of pocket cost can also make decisions preference-sensitive. However, cost is infrequently discussed with patients, and cost has not typically been considered in developing approaches to shared decision-making or decision aids. Determining a therapy’s value to a patient requires an individualized assessment of both benefits and cost. A decision aid addressing cost for sacubitril-valsartan in heart failure with reduced ejection fraction (HFrEF) was developed because this medication has clear medical benefits but can entail appreciable out-of-pocket cost. Objective: To explore patients’ perspectives on a decision aid for sacubitril-valsartan in HFrEF. Methods: Twenty adults, ages 32-73, with HFrEF who met general eligibility for sacubitril-valsartan were recruited from outpatient HF clinics and inpatient services at 2 geographically-distinct academic health systems. In-depth interviews were conducted by trained interviewers using a semi-structured guide after patients reviewed the decision aid. Interviews were audio-recorded and transcribed; qualitative descriptive analysis was conducted using a template analytic method. Results: Participants confirmed that cost was relevant to this decision and that cost discussions with clinicians are infrequent but welcomed. Participants cited multiple ways that this decision aid could be helpful beyond informing a choice; these included serving as a conversation starter, helping inform questions, and serving as a reference later. The decision aid seemed balanced; several participants felt that it was promotional, while others wanted a more “positive” presentation. Participants valued the display of benefits of sacubitril-valsartan but had variable views about how to apply data to themselves and heterogenous interpretations of a 3% absolute reduction in mortality over 2 years. None felt this benefit was overwhelming; about half felt it was very small. The decision aid incorporated a novel “gist statement” to contextualize benefits and counter tendencies to dismiss this mortality reduction as trivial. Several participants liked this statement; few had strong impressions. Conclusion: Out of pocket cost should be part of shared decision-making. These data suggest patients are receptive to inclusion of cost in decision aids and that a “middle ground” between being promotional and negative may exist. The data, however, raise concerns regarding potential dismissal of clinically meaningful benefits and illustrate challenges identifying appropriate contextualizing language. The impact of various framings warrants further study, as does integration of decision aids with patient-specific out-of-pocket cost information during clinical encounters.

The Effects of Exclusive User Choice of Decision Aid Features on Decision Making

2003 ◽  
Vol 17 (1) ◽  
pp. 63-83 ◽  
Author(s):  
Patrick R. Wheeler ◽  
Donald R. Jones
Keyword(s):  
Decision Making ◽  
Decision Aid ◽  
Choice Behavior ◽  
Positive Relationship ◽  
Decision Aids ◽  
Technology Choice ◽  
User Choice ◽  
Loan Officers ◽  
Positive Effect ◽  
Exclusive Choice

Decision Support Systems (DSS) frequently have multiple decision aid (DA) features, causing users to engage in exclusive choice behavior; i.e., choice between alternative DA features that results in one feature being used to the exclusion of all others. We hypothesize that: (1) users choose the least effective (least accurate) DA feature in certain predictability environments; (2) users choose the DA feature that they believe they are most competent with; and (3) choice between DA features improves performance compared to those assigned the same DA feature. We test these hypotheses in an experiment in which 164 participants act as loan officers who chose between two decision aids (a database aid and a regression aid). The results support our hypotheses. Users employed a choice heuristic that caused them to choose the least effective DA feature for the task more than or as often as the most effective DA feature. Results also indicate a positive relationship between perceived competence and DA feature choice, and the positive effect of DA choice. We conclude by describing the insights provided by the results into the heuristics of information technology choice.

A Study of Organizational Narrative Simulation for Decision Support

2013 ◽  
pp. 179-192
Author(s):  
C. L. Yeung ◽  
C. F. Cheung ◽  
W. M. Wang ◽  
E. Tsui
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Pilot Study ◽  
Reference Site ◽  
Lessons Learned ◽  
Implementation Processes ◽  
Organizational Narrative ◽  
Decision Making Processes ◽  
New Challenges ◽  
Narrative Simulation

This paper presents an overview of current decision making approaches. For some approaches abstract information is provided, whereas others require a large amount of labor and time resources to facilitate decision making. However, few address the issues of assisting participants in learning how to make decisions and provide prompt responses to the situations. Harnessing lessons learned from making inappropriate decisions is expensive. To redress this problem, this paper presents a pilot study of the investigation of the psychological behaviors of humans to improve decision making processes with the use of organizational narrative simulation (ONS). By using the ONS method, possible and plausible narrative-based environments can be simulated. Participants can take actions based on their decisions; they can also observe the changes and the consequences. The decisions for handling new challenges generated purposely are validated in a trial that allows prompt responses to the situations. The ONS method is implemented in a selected reference site. The implementation processes, findings, and benefits are presented.

A Study of Organizational Narrative Simulation for Decision Support

2011 ◽  
Vol 2 (3) ◽  
pp. 26-41
Author(s):  
C. L. Yeung ◽  
C. F. Cheung ◽  
W. M. Wang ◽  
E. Tsui
Keyword(s):  
Decision Making ◽  
Decision Support ◽  
Pilot Study ◽  
Reference Site ◽  
Lessons Learned ◽  
Implementation Processes ◽  
Organizational Narrative ◽  
Decision Making Processes ◽  
New Challenges ◽  
Narrative Simulation

This paper presents an overview of current decision making approaches. For some approaches abstract information is provided, whereas others require a large amount of labor and time resources to facilitate decision making. However, few address the issues of assisting participants in learning how to make decisions and provide prompt responses to the situations. Harnessing lessons learned from making inappropriate decisions is expensive. To redress this problem, this paper presents a pilot study of the investigation of the psychological behaviors of humans to improve decision making processes with the use of organizational narrative simulation (ONS). By using the ONS method, possible and plausible narrative-based environments can be simulated. Participants can take actions based on their decisions; they can also observe the changes and the consequences. The decisions for handling new challenges generated purposely are validated in a trial that allows prompt responses to the situations. The ONS method is implemented in a selected reference site. The implementation processes, findings, and benefits are presented.

scholarly journals Do published patient decision aids for end-of-life care address patients’ decision-making needs? A systematic review and critical appraisal

2019 ◽  
Vol 33 (8) ◽  
pp. 985-1002 ◽  
Author(s):  
Georgina Phillips ◽  
Kate Lifford ◽  
Adrian Edwards ◽  
Marlise Poolman ◽  
Natalie Joseph-Williams
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Decision Aid ◽  
Decision Aids ◽  
Patient Needs ◽  
Patient Decision Making ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
End Of Life Decision ◽  
Life Decision

Background: Many decisions are made by patients in their last months of life, creating complex decision-making needs for these individuals. Identifying whether currently existing patient decision aids address the full range of these patient decision-making needs will better inform end-of-life decision support in clinical practice. Aims and design: This systematic review aimed to (a) identify the range of patients’ decision-making needs and (b) assess the extent to which patient decision aids address these needs. Data sources: MEDLINE, PsycINFO and CINAHL electronic literature databases were searched (January 1990–January 2017), supplemented by hand-searching strategies. Eligible literature reported patient decision-making needs throughout end-of-life decision-making or were evaluations of patient decision aids. Identified decision aid content was mapped onto and assessed against all patient decision-making needs that were deemed ‘addressable’. Results: Twenty-two studies described patient needs, and seven end-of-life patient decision aids were identified. Patient needs were categorised, resulting in 48 ‘addressable’ needs. Mapping needs to patient decision aid content showed that 17 patient needs were insufficiently addressed by current patient decision aids. The most substantial gaps included inconsistent acknowledgement, elicitation and documentation of how patient needs varied individually for the level of information provided, the extent patients wanted to participate in decision-making, and the extent they wanted their families and associated healthcare professionals to participate. Conclusion: Patient decision-making needs are broad and varied. Currently developed patient decision aids are insufficiently addressing patient decision-making needs. Improving future end-of-life patient decision aid content through five key suggestions could improve patient-focused decision-making support at the end of life.

Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations

2018 ◽  
Vol 42 (4) ◽  
pp. 378-386 ◽  
Author(s):  
Matthew Quigley ◽  
Michael P Dillon ◽  
Stefania Fatone
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Development Process ◽  
Decision Aids ◽  
Treatment Options ◽  
International Standards ◽  
Shared Decision ◽  
Patient Decision ◽  
Partial Foot Amputation

Background: Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. Objectives: To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Conclusion: Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important as the approach is introduced in prosthetic-/orthotic-related practice.

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