Abstract PO-045: Selected cognitive biases that influence the decision-making process in clinical trial enrollment of diverse patient populations

In today's post-bureaucratic organization, where decision-making is decentralized, most managers are confronted with highly complex situations where time-constraint and availability of information makes the decision-making process essential. Studies show that a great amount of decisions are not taken after a rational decision-making process but rather rely on instinct, emotion or quickly processed information. After briefly describing the journey of thoughts from Rational Choice Theory to the emergence of Behavioral Economics, this chapter will elaborate on the mechanisms that are at play in decision-making in an attempt to understand the root causes of cognitive biases, using the theory of Kahneman's (2011) System 1 and System 2. It will discuss the linkage between the complexity of decision-making and post-bureaucratic organization.

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Teaching Behavioral Ethics: Overcoming the Key Impediments to Ethical Behavior

Journal of Management Education ◽

10.1177/1052562917701501 ◽

2017 ◽

Vol 41 (4) ◽

pp. 497-513 ◽

Cited By ~ 5

Author(s):

Mark S. Schwartz

Keyword(s):

Decision Making ◽

Ethical Behavior ◽

Ethical Decision ◽

Cognitive Biases ◽

Ethical Decision Making ◽

Moral Judgments ◽

Decision Making Process ◽

Moral Awareness ◽

Behavioral Ethics

To better understand the ethical decision-making process and why individuals fail to act ethically, the aim of this article is to explore what are seen as the key impediments to ethical behavior and their pedagogical implications. Using the ethical decision-making process proposed by Rest as an overarching framework, the article examines the following barriers to ethical decision making: improper framing, which can preclude moral awareness; cognitive biases and psychological tendencies, which can hinder reaching proper moral judgments; and moral rationalizations, which can obstruct moral judgments from being translated into moral intentions or ethical behavior. Next, pedagogical exercises and tools for teaching behavioral ethics and ethical decision making are provided. The article concludes with its implications.

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Why Cancer Patients Enter Randomized Clinical Trials: Exploring the Factors That Influence Their Decision

Journal of Clinical Oncology ◽

10.1200/jco.2004.01.187 ◽

2004 ◽

Vol 22 (21) ◽

pp. 4312-4318 ◽

Cited By ~ 100

Author(s):

James R. Wright ◽

Timothy J. Whelan ◽

Susan Schiff ◽

Sacha Dubois ◽

Dauna Crooks ◽

...

Keyword(s):

Clinical Trial ◽

Decision Making ◽

Clinical Trials ◽

Logistic Regression ◽

Cancer Patients ◽

Randomized Clinical Trials ◽

Univariate Analysis ◽

Multivariate Logistic Regression Model ◽

Decision Making Process ◽

Trial Entry

Purpose Few interventions have been designed and tested to improve recruitment to clinical trials in oncology. The multiple factors influencing patients' decisions have made the prioritization of specific interventions challenging. The present study was undertaken to identify the independent predictors of a cancer patient's decision to enter a randomized clinical trial. Methods A list of factors from the medical literature was augmented with a series of focus groups involving cancer patients, physicians, and clinical research associates (CRAs). A series of questionnaires was developed with items based on these factors and were administered concurrently to 189 cancer patients, their physicians, and CRAs following the patient's decision regarding trial entry. Forward logistic regression modeling was performed using the items significantly correlated (by univariate analysis) with the decision to enter a clinical trial. Results A number of items were significantly correlated with the patient's decision. In the multivariate logistic regression model, the patient's perception of personal benefit was the most important, with an odds ratio (OR) of 3.08 (P < .05). CRA-related items involving supportive aspects of the decision-making process were also important. These included whether the CRA helped with the decision (OR = 1.71; P < .05), and whether the decision was hard for the patient to make (OR = 0.52; P < .05). Conclusion Strategies that better address the potential benefits of trial entry may result in improved accrual. Interventions or aids that focus on the supportive aspects of the decision-making process while respecting the need for information and patient autonomy may also lead to meaningful improvements in accrual.

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Vaccine hesitancy: evidence from an adverse events following immunization database, and the role of cognitive biases

BMC Public Health ◽

10.1186/s12889-021-11745-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hossein Azarpanah ◽

Mohsen Farhadloo ◽

Rustam Vahidov ◽

Louise Pilote

Keyword(s):

Decision Making ◽

Adverse Events ◽

Cognitive Biases ◽

Vaccine Safety ◽

Vaccine Hesitancy ◽

Decision Making Process ◽

Evidence Based ◽

Vaccine Acceptance ◽

Vaccination Decision ◽

Vaccine Information

Abstract Background Vaccine hesitancy has been a growing challenge for public health in recent decades. Among factors contributing to vaccine hesitancy, concerns regarding vaccine safety and Adverse Events (AEs) play the leading role. Moreover, cognitive biases are critical in connecting such concerns to vaccine hesitancy behaviors, but their role has not been comprehensively studied. In this study, our first objective is to address concerns regarding vaccine AEs to increase vaccine acceptance. Our second objective is to identify the potential cognitive biases connecting vaccine hesitancy concerns to vaccine-hesitant behaviors and identify the mechanism they get triggered in the vaccine decision-making process. Methods First, to mitigate concerns regarding AEs, we quantitatively analyzed the U.S. Vaccine Adverse Event Reporting System (VAERS) from 2011 to 2018 and provided evidence regarding the non-severity of the AEs that can be used as a communicable summary to increase vaccine acceptance. Second, we focused on the vaccination decision-making process. We reviewed cognitive biases and vaccine hesitancy literature to identify the most potential cognitive biases that affect vaccine hesitancy and categorized them adopting the Precaution Adoption Process Model (PAPM). Results Our results show that the top frequent AEs are expected mild reactions like injection site erythema (4.29%), pyrexia (3.66%), and injection site swelling (3.21%). 94.5% of the reports are not serious and the average population-based serious reporting rate over the 8 years was 25.3 reports per 1 million population. We also identified 15 potential cognitive biases that might affect people’s vaccination decision-making and nudge them toward vaccine hesitancy. We categorized these biases based on the factors that trigger them and discussed how they contribute to vaccine hesitancy. Conclusions This paper provided an evidence-based communicable summary of VAERS. As the most trusted sources of vaccine information, health practitioners can use this summary to provide evidence-based vaccine information to vaccine decision-makers (patients/parents) and mitigate concerns over vaccine safety and AEs. In addition, we identified 15 potential cognitive biases that might affect the vaccination decision-making process and nudge people toward vaccine hesitancy. Any plan, intervention, and message to increase vaccination uptake should be modified to decrease the effect of these potential cognitive biases.

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Detecting and Avoiding Cognitive Biases

Analyzing the Role of Cognitive Biases in the Decision-Making Process - Advances in Psychology, Mental Health, and Behavioral Studies ◽

10.4018/978-1-5225-2978-1.ch009 ◽

2018 ◽

pp. 236-258

Keyword(s):

Decision Making ◽

Cognitive Biases ◽

Clinical Population ◽

Second Step ◽

Decision Making Process ◽

Healthy Population ◽

Wrong Answer ◽

The Right

Cognitive biases affect the decision-making process. These cognitive biases can help us to make a right or effective and quick decision, but many times they can produce wrong, illogical, or unfounded decisions or judgments. For this reason, this chapter will describe some programs, games, techniques, and therapies to detect and reduce them. These programs can be used both in the clinical population and healthy population. Therefore, the first step is being aware of our biases and the second step would be doing practical exercises to reduce and avoid them in our decision making. Practicing these exercises does not help us to always choose the right option, but they inhibit the wrong answer.

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Cognitive Biases

Analyzing the Role of Cognitive Biases in the Decision-Making Process - Advances in Psychology, Mental Health, and Behavioral Studies ◽

10.4018/978-1-5225-2978-1.ch008 ◽

2018 ◽

pp. 214-235

Keyword(s):

Decision Making ◽

Cognitive Bias ◽

Cognitive Biases ◽

Legal Education ◽

Decision Making Process ◽

Strategic Decisions

This chapter will describe some implications of using cognitive biases in the decision-making process in social areas such as economic, legal, education, and political. The cognitive bias would be a pattern of deviation in judgment, in which the inferences that we make about other people and/or situations can be illogical. Moreover, different studies have found that even strategic decisions that affect the society can be influenced by these biases. Therefore, it is important to be aware of them to try to detect and reduce them. Above all, it is necessary to teach how to detect them in order to reduce them in public professionals.

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Identification of imaging selection patterns in acute ischemic stroke patients and the influence on treatment and clinical trial enrollment decision making

International Journal of Stroke ◽

10.1177/1747493015616634 ◽

2016 ◽

Vol 11 (2) ◽

pp. 180-190 ◽

Cited By ~ 4

Author(s):

Marie Luby ◽

Steven J Warach ◽

Gregory W Albers ◽

Jean-Claude Baron ◽

Christophe Cognard ◽

...

Keyword(s):

Clinical Trial ◽

Decision Making ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Stroke Patients ◽

Clinical Trial Enrollment

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When Should Re-consent of Subjects Participating in a Clinical Trial Be Requested? A Case-Oriented Algorithm to Assist in the Decision-Making Process

Clinical Pharmacology & Therapeutics ◽

10.1038/sj.clpt.6100357 ◽

2007 ◽

Vol 83 (5) ◽

pp. 788-793 ◽

Cited By ~ 8

Author(s):

R Dal-Ré ◽

C Avendaño ◽

A Gil-Aguado ◽

D Gracia ◽

AL Caplan

Keyword(s):

Clinical Trial ◽

Decision Making ◽

Decision Making Process

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Evaluating the effectiveness of serious games in facilitating strategic decisions-making under COVID-19 crisis conditions

Journal of Work-Applied Management ◽

10.1108/jwam-03-2021-0024 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Avo Schönbohm ◽

Tingyue Viktoria Zhang

Keyword(s):

Decision Making ◽

Conceptual Model ◽

Serious Games ◽

Cognitive Biases ◽

Economic Recession ◽

Strategic Decision ◽

Strategic Decision Making ◽

Decision Making Process ◽

Strategic Decisions ◽

Content Type

PurposeThis research seized the COVID-19 pandemic-induced economic recession as a strategic response background to answer whether serious games (SGs) can be effectively applied to facilitate the strategic decision-making process.Design/methodology/approachThis paper develops a conceptual model and hypotheses based on the strategic formulation and SGs literature. Virtual-gamified workshops treat four companies in a quasi-experimental framework applying an action research design approach. The data were analysed triangularly from the observations, the focus group interviews and the surveys.FindingsA SG facilitates conveying conceptual recession management knowledge and structures the decision-making process. It incentivises creativity and motivation. Meanwhile, it is a tool to mitigate human errors due to cognitive biases. More importantly, it offers a new means to improve strategic decision-making adapted to different cases. The variety of game elements expands possibilities for different needs.Originality/valueThis paper creatively bridges the gap between strategic decision facilitation and serious gaming in a crisis. It contributes a conceptual model and provides practical insights into SGs mechanics for companies.

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