People tend to acquire more information while making their decisions than a rational and risk-neutral benchmark would predict. We conduct a carefully designed experiment to derive five plausible reasons for pre-decision information overpurchasing. The results show that overpurchasing of information can be almost entirely explained by systematic information processing errors (misestimation or incorrect Bayesian updating), possibly caused by biased intuitive decision processes. Other factors, such as overoptimism about the validity of the new information, risk aversion, ambiguity aversion, and curiosity about (irrelevant) information, play at most a minor role. Our results imply that information overacquisitions are mainly driven by the overestimation of the usefulness of additional information.

Zusammenfassung. Viele Menschen treffen ihre Entscheidungen, wenn sie sich subjektiv sicher genug sind. Der Kurze Entscheidungs-Test Online (KETO) wurde als attraktives, komplexes und für die Teilnehmenden nicht einfach zu durchschauendes Verhaltensspiel im Sinne eines objektiven Persönlichkeitstests entwickelt, um die individuelle Höhe der angestrebten Urteilssicherheit (HAUS) prozentgenau zu erfassen. In 22 vergleichbaren Durchgängen soll eine von vier zur Auswahl stehenden Optionen gewählt werden. Dabei können auf einem Information Board 0 bis maximal 5 probabilistische Cue-Informationen aufgedeckt werden. Die individuelle HAUS wird aufgrund der probabilistischen Erstinformation und dem weiteren Suchverhalten experimentell eingegrenzt und anhand des vollständigen Informationssuchmusters post-hoc nachberechnet. Mehrere Validierungschritte wurden mit 1 008 Versuchspersonen durchgeführt und umfassten die konvergente und divergente Validität, eine Extremgruppen- und Kriteriumsvalidierung, sowie Retest-Reliabilität und Stabilität. Die HAUS korrelierte positiv mit der Risikoeinstellung und negativ mit dem Risikoverhalten (kleine Effektstärke). Die HAUS ist unter anderem unabhängig von der Teilnahmemotivation, von der Maximierungstendenz und den 5 Faktoren des NEO-FFI.

Background Multimorbidity can be defined as the co-occurrence of two or more chronic medical conditions in one person. Within the diagnostic process, accurately detecting a multimorbid disease pattern still poses a major challenge for most physicians, and is known as a source of diagnostic uncertainty. Objective We investigated, how sensitive, confident, and accurate physicians are in diagnosing multimorbid versus monomorbid patients. Methods We created eight video case-based vignettes, which differed in type of morbidity (multimorbid versus monomorbid), field of medical specialization (somatic versus mental), and relatedness of underlying diseases (causally related versus unrelated). In total, 74 physicians (GPs, residents in an emergency department and psychiatrists) watched three to five randomly allocated video cases and had to generate suspected diagnoses at the end of each of three video sequences. Additionally, participating physicians rated subjective confidence for all mentioned diagnoses and for three sequences per case with the help of confidence profiles. Results Altogether, physicians made a large number of accurate diagnoses (69%). Nevertheless, the overall number of underdiagnosed multimorbid cases (misses) was significantly higher (71%) than over-diagnosed monomorbid cases (false alarms) (7%). Discussion According to Signal Detection Theory, GPs and psychiatrists both showed lower detection performance for medical cases that lay beyond their own field of specialization. Remarkably, residents show the highest sensitivity for multimorbid cases with an approximately identically detection performance d' slightly over 1 for both field of medical specialization (somatic and mental). Furthermore, higher uncertainty in diagnosing multimorbid cases is related to lower confidence especially at the beginning of a diagnostic process, as well as to unrelated and therefore probably rare disease pattern. Several limitations of the study and the video case-based vignettes are described within the discussion section. Conclusions Physicians have to be sensitized for multimorbidity even more, and have to be taught in the prevalence of existing disease combinations. Communicating uncertainty with other specialists could be helpful when faced with a sometimes "fuzzy" pattern of symptoms.

Many people make a decision at the time they have reached enough certainty. A short decision-making online test (SDMOT) was created to accurately detect the desired level of confidence (DLC) on an individual level. SDMOT is an attractive and complex virtual game in the sense of an objective personality test -not easy to decode for participants. SDMOT includes 22 comparable decision-making trials, in which one of four options has to be chosen with the help of zero to maximal five probabilistic cues on an information board. For every individual, the DLC is experimentally detected according to a constraining procedure and is calculated ex post on the basis of the complete behavioral pattern of searched information. Several steps of validation were processed with 1,008 participants including divergent and convergent validity, between-group comparison, criterion validity, as well as retest reliability, and stability. The DLC is positively correlated with risk attitude and negatively correlated with risk behavior, showing small effect sizes overall. The DLC is independent of motivation of participation, maximization, and the Big Five.

Study Material for Manuscript: Sensitivity for Multimorbidity: The Role of Diagnostic Uncertainty of Physicians when Evaluating Multimorbid Video Case-based Vignettes (English version of study protocols)

For about 50 years, fuzzy modelling methods have prevailed in the effective treatment of vagueness and uncertainty employing scientific and real-world applications. In this paper, we propose a modelling method using multidimensional fuzzy patterns based on parametric membership functions of the potential type. We outline methodological advantages, such as the preservation of the same highly flexible and efficient membership function type in one- and multidimensional modelling and fuzzy pattern classifier sequences. Furthermore, the model accounts for cognitive aspects of human reasoning, for instance, in knowledge organization and working memory processes. We argue that this methodology is particularly convenient for modelling issues in human-machine interactions and human sciences, such as medicine, and present two multidimensional fuzzy pattern models for infectious diseases. (C) 2018 Elsevier B.V. All rights reserved.

BACKGROUND:Physicians' clinical decision-making may be influenced by non-analytical thinking, especially when perceiving uncertainty. Incidental gut feelings in general practice have been described, namely, as "a sense of alarm" and "a sense of reassurance". A Dutch Gut Feelings Questionnaire (GFQ) was developed, validated and afterwards translated into English following a linguistic validation procedure. The aims were to translate the GFQ from English into French, German and Polish; to describe uniform elements as well as differences and difficulties in the linguistic validation processes; to propose a procedural scheme for future GFQ translations into other languages.METHODS:We followed a structured, similar and equivalent procedure. Forward and backward-translations, repeated consensus procedures and cultural validations performed in six steps. Exchanges between the several research teams, the authors of the Dutch GFQ, and the translators involved continued throughout the procedure.RESULTS:12 translators, 52 GPs and 8 researchers in the field participated to the study in France, Germany, Switzerland and Poland. The collaborating research teams created three versions of the 10-item GFQ. Each research team found and agreed on compromises between comparability and similarity on one hand, and linguistic and cultural specificities on the other.CONCLUSIONS:The gut feeling questionnaire is now available in five European languages: Dutch, English, French, German and Polish. The uniform procedural validation scheme presented, and agreed upon by the teams, can be used for the translation of the GFQ into other languages. Comparing results of research into the predictive value of gut feelings and into the significance of the main determinants in five European countries is now possible.

Background: Decision-making processes in a medical setting are complex, dynamic and under time pressure, often with serious consequences for a patient's condition.Objective: The principal aim of the present study was to trace and map the individual diagnostic process of real medical cases using a Decision Process Matrix [ DPM]).Methods: The naturalistic decision-making process of 11 residents and a total of 55 medical cases were recorded in an emergency department, and a DPM was drawn up according to a semi-structured technique following four steps: 1) observing and recording relevant information throughout the entire diagnostic process, 2) assessing options in terms of suspected diagnoses, 3) drawing up an initial version of the DPM, and 4) verifying the DPM, while adding the confidence ratings.Results: The DPM comprised an average of 3.2 suspected diagnoses and 7.9 information units (cues). The following three-phase pattern could be observed: option generation, option verification, and final diagnosis determination. Residents strove for the highest possible level of confidence before making the final diagnoses (in two-thirds of the medical cases with a rating of practically certain) or excluding suspected diagnoses (with practically impossible in half of the cases).Discussion: The following challenges have to be addressed in the future: real-time capturing of emerging suspected diagnoses in the memory of the physician, definition of meaningful information units, and a more contemporary measurement of confidence.Conclusions: DPM is a useful tool for tracing real and individual diagnostic processes. The methodological approach with DPM allows further investigations into the underlying cognitive diagnostic processes on a theoretical level and improvement of individual clinical reasoning skills in practice.

Many decisions in the lives of animals and humans require a fine balance between the exploration of different options and the exploitation of their rewards. Do you buy the advertised car, or do you test drive different models? Do you continue feeding from the current patch of flowers, or do you fly off to another one? Do you marry your current partner, or try your luck with someone else? The balance required in these situations is commonly referred to as the exploration– exploitation tradeoff. It features prominently in a wide range of research traditions, including learning, foraging, and decision making literatures. Here, we integrate findings from these and other often-isolated literatures in order to gain a better understand- ing of the possible tradeoffs between exploration and exploitation, and we propose new theoretical insights that might guide future research. Specifically, we explore how potential tradeoffs depend on (a) the conceptualization of exploration and exploitation; (b) the influencing environmental, social, and individual factors; (c) the scale at which exploration and exploitation are considered; (d) the relationship and types of transitions between the 2 behaviors; and (e) the goals of the decision maker. We conclude that exploration and exploitation are best conceptualized as points on a continuum, and that the extent to which an agent’s behavior can be interpreted as exploratory or exploitative depends upon the level of abstraction at which it is considered.

Judgments and decisions under uncertainty are frequently linked to a prior sequential search for relevant information. In such cases, the subject has to decide when to stop the search for information. Evidence accumulation models from social and cognitive psychology assume an active and sequential information search until enough evidence has been accumulated to pass a decision threshold. In line with such theories, we conceptualize the evidence threshold as the “desired level of confidence” (DLC) of a person. This model is tested against a fixed stopping rule (one-reason decision making) and against the class of multi-attribute information integrating models. A series of experiments using an information board for horse race betting demonstrates an advantage of the proposed model by measuring the individual DLC of each subject and confirming its correctness in two separate stages. In addition to a better understanding of the stopping rule (within the narrow framework of simple heuristics), the results indicate that individual aspiration levels might be a relevant factor when modelling decision making by task analysis of statistical environments.

Judgments and decisions under uncertainty are frequently linked to a prior sequential search for relevant information. In such cases, the subject has to decide when to stop the search for information. Evidence accumulation models from social and cognitive psychology assume an active and sequential information search until enough evidence has been accumulated to pass a decision threshold. In line with such theories, we conceptualize the evidence threshold as the “desired level of confidence” (DLC) of a person. This model is tested against a fixed stopping rule (one-reason decision making) and against the class of multi-attribute information integrating models. A series of experiments using an information board for horse race betting demonstrates an advantage of the proposed model by measuring the individual DLC of each subject and confirming its correctness in two separate stages. In addition to a better understanding of the stopping rule (within the narrow framework of simple heuristics), the results indicate that individual aspiration levels might be a relevant factor when modelling decision making by task analysis of statistical environments.

The Quick- Estimation heuristic ( QuickEst) was introduced by Hertwig, Hoffrage, and Martignon ( 1999) as a fast and frugal method to generate numerical estimates. The heuristic posits that estimate- relevant knowledge is organised and searched according to ordered reference classes that are based on binary cue values. Two experiments tested two main predictions derived from QuickEst with respect to the memory search and estimation behaviour of human participants. The results provided no evidence that QuickEst is used in numerical estimation processes. As alternative explanation of our findings, we discuss a cyclic sampling mechanism that retrieves information from memory according to their associative strength.

Previous studies indicate that schizophrenia patients draw decisions more hastily than controls. The aim of the present study was to obtain convergent evidence with a new paradigm, designed after the Who Wants to Be a Millionaire television game show. Thirty-two schizophrenia patients and 38 healthy subjects were administered 20 knowledge questions, along with 4 response alternatives. Participants were required to provide probability estimates for each alternative. Whenever a subject was confident that one of the alternatives was correct or was wrong, the subject was asked to indicate this via a decision or rejection rating. Thus, probability estimates and decisions were independently assessed, allowing determination of the point at which probability estimates translate into decisions. Patients and controls gave comparable probability estimates for all alternatives. However, patients committed more erroneous responses, owing to their making decisions in the face of low subjective probability ratings and rejecting alternatives despite rather high probability ratings. The results provide further evidence for the claim that schizophrenia patients make strong judgments based on little information. We propose that a lowered threshold for accepting alternatives provides a parsimonious explanation for the data-gathering bias reported in the literature.

Der internationale Druck der letzten Monate auf die Schweiz hat dazu geführt, dass das Schweizer Bankkundengeheimnis gelockert wurde. Der Bundesrat hat bisher ei- genständig gehandelt, ohne die Meinung einer breiten Bevölkerung mit einzubezie- hen. Wie aber denken die Schweizer Bürgerinnen und Bürger über den anhaltenden Druck aus dem Ausland, über die Aufrechterhaltung des Bankgeheimnisses, über konkrete Verhandlungspositionen und über mögliche Gegenmassnahmen gegenüber dem Ausland? Eine für die deutschsprachige Schweiz repräsentative Online-Umfrage bei 1179 Personen gibt Einblicke und Antworten auf die Frage, inwieweit und warum das Bankgeheimnis als "schützenswert" gilt, und welche Reaktionstendenzen sich daraus ergeben. Ein besonderes Augenmerk gilt auch der Rolle des Wertekonflikts und der wahrgenommenen Bedrohung des Bankgeheimnisses. Es wird gezeigt, dass diese Faktoren mitbestimmen, ob Schweizerinnen und Schweizer das Bankgeheimnis verteidigen oder ablehnen.