Multiparameter evidence synthesis in epidemiology and medical decision-making: current approaches

Summary.  Alongside the development of meta-analysis as a tool for summarizing research literature, there is renewed interest in broader forms of quantitative synthesis that are aimed at combining evidence from different study designs or evidence on multiple parameters. These have been proposed under various headings: the confidence profile method, cross-design synthesis, hierarchical models and generalized evidence synthesis. Models that are used in health technology assessment are also referred to as representing a synthesis of evidence in a mathematical structure. Here we review alternative approaches to statistical evidence synthesis, and their implications for epidemiology and medical decision-making. The methods include hierarchical models, models informed by evidence on different functions of several parameters and models incorporating both of these features. The need to check for consistency of evidence when using these powerful methods is emphasized. We develop a rationale for evidence synthesis that is based on Bayesian decision modelling and expected value of information theory, which stresses not only the need for a lack of bias in estimates of treatment effects but also a lack of bias in assessments of uncertainty. The increasing reliance of governmental bodies like the UK National Institute for Clinical Excellence on complex evidence synthesis in decision modelling is discussed.     

伊拉克战争与公众参与中国中东外交政策制定

伊拉克战争为公众参与中国中东外交政策制定提供了机会,参与群体前所未有地扩大,参与途径全面拓展,不同意见的表达开始涌现,公众主动对外交建言献策,开始有意施加民意压力。更为重要的是,公众意见开始成为外交部门对外传播国家主张的背景支撑和参考因素。公众因素开始成为中国制定中东外交决策时需要考虑的重要参数之一,但其影响力有限,更多是参考和制约作用,其影响正处于发展之中。     

What drives a tough call: Determining the importance of contingency factors and individual characteristics in communication executives’ stance decision-making through a conjoint analysis

To further the understanding of how communication executives make tough calls in times of organizational-public conflict, we use a conjoint analysis to identify key drivers for organizational stance decision-making. This is the first-ever conjoint analysis applied to advancing the contingency theory of strategic conflict management by examining the relative importance of key contingency factors as determined by practitioners with varied individual characteristics. This study investigates: 1) the relevant importance of and dynamics between three key contingency factors (i.e., external threats, organizational characteristics, and dominant coalition characteristics); 2) the influence of individual characteristics (e.g., gender, experience, and personal ethics) in stance decision-making process; and 3) how different types of organizational stances (i.e., general stance, action-based accommodation, and qualified-rhetoric-mixed accommodation) are determined by these contingency factors and individual characteristics in different conflict situations. Results generated among our communication executive participants include: individual characteristics (i.e., gender, ethics and social responsibility, whistleblowing tendencies, and over 20 years in the communications field) are influential for their strategic conflict management decision-making. Implications for refining the contingency theory and unearthing complex public relations decision-making processes via novel statistical techniques are discussed.     

Because they were there: Access,deliberation, and the mobilization of networks for support

When people need help, what is the process through which they decide whom in their network to turn to? Research on social support has described a process that is deliberative in nature: people determine their needs, assess who in their network has the needed attributes—such as skill, trustworthiness, intimacy, and accessibility—and then activate that tie. Nevertheless, research in behavioral economics and other fields has shown that people make many decisions not deliberatively but intuitively. We examine this possibility in the context of social support by focusing on one factor: accessibility. Although researchers have argued that people weigh the accessibility of potential helpers as they do any other attribute, accessibility may be not only an attribute of the helper but also a condition of the situation. We develop a framework to make this question tractable for survey research and evaluate competing hypotheses using original data on an analytically strategic sample of ∼2000 college students, probing concrete instances of social support. We identify and document not one but three decision processes, reflective, incidental, and spontaneous activation, which differ in the extent to which actors had deliberated on whether to seek help and on whom to approach before activating the tie. We find that while the process was reflective (consistent with existing theory) when skill or trustworthiness played a role, it was significantly less so (consistent with the alternative) when accessibility did. Findings suggest that actors decide whom in their network to mobilize through at least three systematically different processes, two of which are consistent less with either active “mobilization” or explicit “help seeking” than with responsiveness to opportunity and context.     

阿拉伯国家联盟决策机制研究

阿盟采取不同的决策程序和方式来满足成员国复杂的利益关系和要求,其决策机制由多种要素构成,拥有多层次决策机构.阿盟决策机制既具有自身的特点,又存在一定的缺陷.从阿盟决策机制的历史变迁、决策要素的权责分配、决策程序与方式等方面进行分析,有利于系统理解阿盟决策机制的本质,也有助于理解阿盟在阿拉伯国家间以及中阿关系中所能起到的真正作用.     

Demand for decision autonomy and the desire to avoid responsibility in risky environments: Experimental evidence

This paper experimentally studies individuals’ willingness to pay for the authority to make risky decisions for themselves, and the willingness to take responsibility for others, as primary determinants of leadership willingness. We consider a setup involving a pair of individuals, where one individual is designated to make both parties’ decisions by default. Depending on treatment, either party can express a willingness to pay to change this situation. If one’s willingness to pay to make her own decision herself is positive (negative), we interpret it as a demand for autonomy (a desire to delegate). On the flip side, if one’s willingness to pay to avoid making a decision on behalf of another person is positive (negative), we interpret it as a desire to avoid responsibility (a demand for authority). We find that on average, individuals are willing to pay positive amounts of money to make their decisions themselves, and incur positive but smaller opportunity costs for the right to make decisions for others. Certain individual and contextual characteristics emerge as important predictors. Notably, (1) men are more likely to demand both autonomy and authority at the same time, (2) individuals with other regarding preferences are more likely to pay to avoid taking responsibility for others’ decisions when the probability of loss is high. Exploring differences between individuals’ own decisions and the decisions they make on behalf of others, we find that subjects with other-regarding preferences tend to “cautious-shift” when making decisions on behalf of others. Also, we find that individuals who would like to avoid responsibility also tend to “shift” their decisions when put in a decision-making role. The results have implications for the allocation of decision-making authority in pairs and leadership.     

第三方物流企业逆向物流服务决策分析

在网络经济快速发展的今天,企业如何处理产品逆向物流,已经成为一个影响自身发展的棘手问题。目前,企业降低成本的空间越来越小,要想生存发展,谋求新的利润增长点,利用在网络、成本、技术等具有优势的第三方物流企业进行业务外包是一个不错的选择。因此,为促进资源的回收利用和企业的发展,需大力发展第三方逆向物流。     

决策与发展:中国五年计划的比较与解析

中国已经从计划模式的效仿国逐渐成长为计划模式的创新国,并在计划的发展演变中呈现出与其他有计划国家的显著差异性。为了解析中国五年计划的独特性,进而探讨计划工作的经验与教训,文章着重从决策哲学的视角进行了研究,认为中国计划决策哲学的核心是实事求是。文章分析了实事求是思想的实质,并比较了实事求是思想与实用主义哲学的异同,同时强调了在实事求是思想指导下坚持科学决策的重要性。     

Social workers' assessments of needs and interventions for adolescents with substance misuse problems,criminal behaviour and mental health difficulties: a vignette study

The aim of the current vignette study was to examine how social workers assess adolescents with substance misuse problems, criminal behaviour and mental health difficulties, and how they make decisions about treatment interventions to reduce these problems. Earlier research has shown lack of knowledge concerning factors and processes that govern assessments and decisions in social work practice. In this anonymously administered survey, social workers in Stockholm, Sweden, were invited to assess fictitious youth issues. We found that social workers recognise the problems and needs of young people, but that they find it harder to link needs to evidence-based interventions. Also, there is a tendency to overrate alleged non-serious problems in the vignettes. We conclude that there is a need for increased knowledge about evidence-based methods and more structured procedures to broaden the basis for decisions.     

产品组合决策模型的适用性比较分析﹡

目前广泛使用的产品组合决策模型包括矩阵模型和定量模型两大类别。二者各有其使用价值,其中矩阵模型更适合做产品组合经营战略选择的工具,而定量模型特别适合投资组合的投资优先顺序的确定决策。但是传统产品组合决策定量模型及其现代使用的作业成本法和约束理论都存在一定缺陷而影响其使用效力。为了使决策定量模型更为合理化和适用化,尚需综合考虑产品的市场受欢迎度和不受欢迎产品的处理成本等综合市场竞争因素,优化决策模型,使改进后的决策模型更适应强烈市场竞争下的企业产品组合决策。