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At least 19 recordsLinked to original sources
PubMed1975

Patterns of involvement with malignant lymphoma and implications for treatment decision making.

Decision making in cancer therapy has traditionally evolved through careful observation of the clinical course subsequent to various treatment approaches. This method has also served to delineate the wide spectrum of primary manifestations and patterns of biological behaviour characterizing the malignant lymphomata. Marked disparity has been consistently appreciated between the natural history of lymphomata originating in lymph nodes in contrast to those primary in extranodal sites. The former are usually anatomically generalized at diagnosis whereas primary extranodal lymphomata are commonly localized and more closely resemble carcinomata of the respective organs with their propensity for both regional lymphatic extension and haematogenous spread. Prospective staging of 100 consecutive patients with previously untreated malignant lymphoma has been consistent with this past experience in demonstrating the presence of disseminated involvement in the majority of patients. It has also become apparent that reliance upon either clinical or surgical staging of disease extent is often misleading since widespread disease frequently develops even in those patients staged as having localized involvement and thereby treated with local irradiation. High dose, wide field lymphatic irradiation "á la Hodgkin's disease" seldom constitutes appropriate treatment for patients having lymph node presentations of lymphoma. There is rather a need to recognize the importance of systemic treatment for most cases, negating the utility of routine exhaustive staging since treatment decisions can be based upon readily assessed clinicohistological determinants in the majority of cases.

Adolescent↗
PubMed1979

Decision making.

Explore the source record for details and available documents.

Decision Making↗
PubMed1978

General problems in medical decision making with comments on ROC analysis.

Medical decision-making studies continue to focus on two questions: How do physicians make decisions? How should physicians make decisions? Researchers pursuing the first question emphasize human cognitive processes and the programming of symbol systems to model observed human behavior. Those researchers concentrating on the second question assume that there is a standard of performance against which the physician's decisions can be judged, and to help the physician improve his performance, an array of tools is proposed. These tools include decision trees, Bayesian analysis, decision matrices, receiver operating characteristics (ROC) analysis, and cost-benefit considerations including utility measures. Medical decision-making questions must be answered in an ethical context where ethics and decision analysis are interviewed.

Bayes Theorem↗
PubMed2024

Offering complex genomic screening in acute pediatric settings: Family decision-making and outcomes.

PURPOSE: Families of children in pediatric acute care who are offered ultrarapid genomic sequencing are making complex decisions during a high-stress period. To reduce complexity for families and clinicians, we offered genomic screening for the child and parents after the completion of diagnostic testing. We evaluated uptake, understanding, and service delivery preferences. METHODS: A cohort of 235 families who had completed ultrarapid diagnostic genomic sequencing at 17 Australian hospitals were offered up to 3 screens on their genomic data: pediatric-onset, adult-onset, and expanded couple carrier screening. We investigated decision making, understanding, and service delivery preferences using surveys at 3 time points (pre counseling, post counseling, and post result) and performed inductive content analysis of pretest genetic counseling transcripts. RESULTS: A total of 119 families (51%) attended genetic counseling with 115 (49%) accepting genomic screening. Survey respondents were more likely to find decisions about couple carrier screening easy (87%) compared with adult (68%; P = .002) or pediatric (71%; P = .01) screening decisions. All respondents with newly detected pathogenic variants accurately recalled this 1 month later. A delayed offer of screening was acceptable to most respondents (78%). CONCLUSION: Separating genomic screening from the stressful diagnostic period is supported by families who demonstrate good knowledge and recall. Our results suggest delaying genomic screening should be trialed more widely.

Humans↗
PubMed1978

Decision making in nursing: an analytical approach.

Decision making is a basic function of all nurse leaders. Because of the complex nature of many decision situations faced by nurses, problem solving and decision making in nursing are as much an art as a science. The Vroom and Yetton model of decision making is an appropriate tool through which nurses involved in patient care management can examine their decision making and improve their decision behavior. Use of this model is suggested as an approach to teaching decision making at the undergraduate and graduate level of nursing education. Case material has been presented to help readers identify their favored methods of decision making and to point out possible deficiencies in these methods.

Administrative Personnel↗
PubMed1979

Bioethical decision making: an approach to improve the process.

Current problems with the decision-making process for bioethical dilemmas are described, with emphasis on the social roles taken in this process by medical experts and laypersons. An approach is presented to improve bioethical decision making. Two consecutive steps are required. First, branching logic is used to separate the bioethical dilemmas into a series of independent, sequential decision points along a decision-making tree. This allows complex dilemmas to be dealt with more easily by resolving the individual component issues in a logical, stepwise fashion. Secondly, explicit criteria are used to decide whether each individual component is ethical or technical in nature. Using these two steps increases the likelihood that the professional and the layperson will assume their appropriate social roles and improve the overall decision-making process. How this approach can be applied to policy-making decisions, in addition to case-by-case deciding, is discussed, as are some of the settings in which the approach might be particularly helpful.

Amniocentesis↗
PubMed1979

Sociologic influences on decision-making by clinicians.

Recent articles on clinical decision-making have proposed sophisticated quantitative methods for improving the physician's clinical judgment. Actual clinical decisions, however, are influenced by interactions between the clinician, the patient, and the sociocultural milieu as well as by biomedical considerations. This paper explores these sociologic influences on the decision-making process. Four types of sociologic factors influence the clinician's judgment: the characteristics of the patient; the characteristics of the clinician; the clinician's interaction with his profession and the health care system; and the clinician's relationship with the patient. To illustrate sociologic influences on clinical decision-making, this paper presents observations from the literature of sociology, clinical psychology, psychiatry, and medicine. Further studies are needed to provide additional empirical information.

Attitude of Health Personnel↗
PubMed1975

Evoked brain potentials as indicators of decision-making.

The effects of decision-making processes on evoked brain potentials recorded at the vertex were studied in human subjects. Significantly different visual evoked potentials to the same physical stimulus were obtained in trails that resulted in different behavioral decisions. The results suggest that certain characteristics of evoked potentials may perhaps be used as indicators of specific behavioral outcomes.

Decision Making↗
PubMed1976

Participatory governance: a model for shared decision making.

The sharing in departmental decision making is viewed as a responsibility to be borne collaterally with the director by practitioners delivering direct services. While the process is viewed as consonant with professional growth and therefore properly evolutionary, the authors after facilitating premises and structures as well as a delineation of risks and rewards.

Decision Making↗
PubMed2026

Artificial Intelligence Technologies in Nursing Clinical Decision-Making: An Umbrella Review.

AIM: To describe contemporary peer-reviewed literature on artificial intelligence in nurses' clinical decision-making. METHODS: An umbrella review of literature reviews. DATA SOURCES: Four major databases were searched for reviews published between 2019 and 2024. RESULTS: Sixteen literature reviews reported on 965 nursing artificial intelligence primary studies. The studies focused on technology development and emerging performance evaluations, whilst real-world testing or implementation in nursing clinical settings was rare. Rigorous comparative analyses were lacking. While artificial intelligence demonstrates promise in decision-making, challenges such as a lack of controlled studies, algorithmic bias, limited reproducibility and insufficient clinical trials hinder its practical impact. Ethical concerns, transparency and patient data privacy issues pose barriers to AI integration in nursing practice. Ethical and legal guidelines for patient privacy are needed and should be taught along with AI literacy training for nurses. CONCLUSIONS: Artificial intelligence has the potential to enhance clinical nursing decision-making, although evidence is limited by too few examples of nurse participation during development. Underutilisation in administrative nursing functions hinders implementation. Nurses should assume a central role in the design and development of AI applications to ensure that these technologies address the realities of nursing practice. With such improvements, artificial intelligence can transform nursing practice, improve nurses' clinical decision-making and ultimately enhance consumer healthcare outcomes. PATIENT OR PUBLIC INVOLVEMENT: No Patient or Public Involvement. REPORTING METHOD: While there is no reporting checklist for umbrella reviews, the PRISMA guide for systematic reviews was followed.

Artificial Intelligence↗
PubMedDate not supplied

[Reflection of the decision making process in evoked cortical electrical activity in man].

Averaged evoked potentials to visual stimuli of different significance were recorded in healthy adult subjects. The magnitude of the late positive potential (component P300), recorded in response to visual stimulus, greatly increases at the vertex, if the stimulus is given a significance for decision making (the choice of reaction). No such changes are recorded in the occipital area. In the case of decision making, the magnitude of the component P300 is clearly greater at the vertex as compared with the occipital area. No correlation has been found between the latency of the P300 and the reaction time, hence one should not refer to any coincidence between the temporal parameters of the potential and the process of decision making. The authors believe that the component P300 reflects not the very process of decision making, but a local cortical "non-specific" activation which is an indispensable element of the neural mechanism of decision making.

Adolescent↗
PubMed1975

Decision making theory: a consultant's guide to getting technical information used.

A simple model of the decision making process of a consultee can help clarify his data needs, and thus can guide a consultant in how to present and how to obtain better use of his technical information. Seven characteristics of developing countries which affect decision making are described. An approach to advising, matched to the nine elements of decision making, is suggested.

Choice Behavior↗
PubMed1975

Reflex epilepsy evoked by decision making.

A patient had seizures while playing chess or cards or when filling out complex forms, doing complex mathematical problems, and during certain parts of the neuropsychological testing. Seizures were myoclonic and accompanied and electroencephalographic dysrhythmia of the atypical spike and wave type. Evoked seizures were not related to visual, tactile, or auditory stimuli or clues. In chess, seizures occurred when he was on the defense and threatened. Simple decision making or physiologic stress did not evoke seizures nor did nonsequential decision making under verbal pressure. Evoking factors were complex decision making in a sequential fashion and with an element of stress or concern regarding the outcome of the decision making. Stimulus was usually nonverbal. Three major factors--decision complexity, sequential factor, and related stress or concern--may have some reciprocal relationships.

Adult↗
PubMed2026

The role of simulator immersion on learning and transfer of decision-making skill in sport.

Virtual reality has become popular in sport and other domains because it can immerse the user within a sporting context and solve logistical problems for additional off-field training. There is limited evidence, however, of whether immersion is crucial for learning and transfer. This study compared training of decision-making skill between 360-degree video virtual reality (360VR) and two-dimensional video. Twenty-eight Australian Rules Football players were randomly assigned to one of three training groups: 360VR, two-dimensional video, and control. Across four weeks, participants in the training groups were exposed to decision-making scenarios consisting of visual, contextual and auditory cues. Performance was assessed pre- and post-training with virtual reality and field-based decision-making tests. Results indicated that the two-dimensional video training group showed significantly superior decision-making in the field-based transfer test compared to 360VR and control groups post intervention. There was also indication that two-dimensional video training was superior to the control post intervention in the virtual reality test. Findings indicate that immersion created in virtual reality is not an underpinning mechanism for learning and transfer, rather the use of perceptual information is crucial. 360VR may facilitate uptake through engagement, but two-dimensional video is adequate for learning and transfer of decision-making to the field.

Humans↗