Ubiquitous cognitive biases hinder optimal decision making. Recent calls to assist decision makers in mitigating these biases—via interventions commonly called “nudges”—have been criticized as infringing upon individual autonomy. We tested the hypothesis that such “decisional enhancement” programs that target overt decision making—i.e., conscious, higher-order cognitive processes—would be more acceptable than similar programs that affect covert decision making—i.e., subconscious, lower-order processes. We presented respondents with vignettes in which they chose between an option that included a decisional enhancement program and a neutral option. In order to assess preferences for overt or covert decisional enhancement, we used the contrastive vignette technique in which different groups of respondents were presented with one of a pair of vignettes that targeted either conscious or subconscious processes. Other than the nature of the decisional enhancement, the vignettes were identical, allowing us to isolate the influence of the type of decisional enhancement on preferences. Overall, we found support for the hypothesis that people prefer conscious decisional enhancement. Further, respondents who perceived the influence of the program as more conscious than subconscious reported that their decisions under the program would be more “authentic”. However, this relative favorability was somewhat contingent upon context. We discuss our results with respect to the implementation and ethics of decisional enhancement.

An experienced decision aider reflects on how misaligned priorities produce decision research that is less useful than it could be. Scientific interest and professional standing may motivate researchers — and their funders and publishers — more powerfully than concern to help people make better

When people find it difficult to make a decision, they may opt to let chance decide. Flipping a coin, rolling a die, or using a counting-out rhyme are well-known decision aids. When individuals directly follow the aid’s suggestion, the decision aid acts as a decider. But when the decision aid elicits a felt response, such as liking or disliking the aid’s suggestion, and individuals act upon this response, the decision aid serves as a catalyst. This manuscript investigates whether and how many individuals apply these two strategies. In four studies (total N = 1135), we focus on coin flips as one of the most common decision aids and place an emphasis on the catalyst strategy. We examine (1) the frequency of previous experiences and future willingness to use a coin flip to make decisions, (2) which affective reactions accompany the coin flip when using it as catalyst, and (3) the circumstances under which individuals are more versus less likely to accept the use of a random decision-making aid to come to a decision. These results illustrate the catalyst phenomenon but also highlight the boundary conditions of individuals’ willingness to use randomness as an aid for decision making. We discuss directions for future research as well as potential applications.

We clarify two points made in our commentary (Pezzo & Beckstead, 2020, this issue) on a recent paper by Longoni, Bonezzi, and Morewedge (2019). In both Experiments 1 and 4 from their paper, it is not possible to determine whether accuracy can compensate for algorithm aversion. Experiments 3A-C, however, do show a strong effect of accuracy such that AI that is superior to a human provider is embraced by patients. Many papers, including Longoni et al. tend to minimize the role of this compensatory process, apparently because it seems obvious to the authors (Longoni, Bonezzi, Morewedge, 2020, this issue). Such minimization, however, can lead to (mis)citations in which research that clearly demonstrates a compensatory role of AI accuracy is cited as non-compensatory.

Shared decision-making has become a new focus of health policy. Though its core elements are largely agreed upon, there is little consensus regarding which outcomes to prioritize for policy-mandated shared decision-making.

Respecting a person’s choices about the mental health services they do or do not use is a mark of quality support, and is often pursued for moral reasons, as a rights imperative and to improve outcomes. Yet, providing information and assistance for people making decisions about the mental health services can be a complex process, and has been approached in various ways. Two prominent approaches to this end are ‘shared decision-making’ and ‘supported decision-making’. This article considers each of these approaches, discussing points of similarity and difference and considering how the two might complement one another. By exploring the contribution that each approach can make, we conclude by proposing how future application of these approaches can account for the broader context of decisions, including support for ongoing decision-making; the multitude of service settings where decision-making occurs; and the diversity in supportive practices required to promote active involvement.

Secale cereale is a serious weed problem in winter Triticum aestivum–producing regions. The interference relationships and economic thresholds of S. cereale in winter T. aestivum in Colorado, Kansas, Nebraska, and Wyoming were determined over 4 yr. Winter T. aestivum density was held constant at recommended planting densities for each site. Target S. cereale densities were 0, 5, 10, 25, 50, or 100 plants m−2. Secale cereale–winter T. aestivum interference relationships across locations and years were determined using a negative hyperbolic yield loss function. Two parameters—I, which represents the percent yield loss as S. cereale density approaches zero, and A, the maximum percent yield loss as S. cereale density increases—were estimated for each data set using nonlinear regression. Parameter I was more stable among years within locations than among locations within years, whereas maximum percentage yield loss was more stable across locations and years. Environmental conditions appeared to have a role in the stability of these relationships. Parameter estimates for I and A were incorporated into a second model to determine economic thresholds. On average, threshold values were between 4 and 5 S. cereale plants m−2; however, the large variation in these threshold values signifies considerable risk in making economic weed management decisions based upon these values.

Objectives: The aim of this study was to describe the process and challenges of developing a decision aid for the national public breast cancer screening program in Finland.

Methods: An expert team with stakeholder representation used European guidelines and other literature as basis for selecting relevant content and format for the decision aid for breast cancer screening. Feedback from women was sought for the draft documents.

Results: A decision aid attached to the invitation letter for screening was considered the best way to ensure access to information. In addition, tailored letter templates for all phases of the screening program, a poster, and a public website were developed. Initial feedback from users (women, professionals, and service providers), was mainly positive. Six months after publishing, the implementation of the decision aid was still incomplete.

Conclusions: Providing balanced information for women invited to breast cancer screening is demanding and requires careful planning. Professionals and service providers need to be engaged in the HTA process to ensure proper dissemination and implementation of the information. End user participation is essential in the formulation of information. There is a need to follow up the implementation of the decision aid.