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Across two experiments (N=799) we demonstrate that people's use of quantitative information (e.g., base-rates) when making a judgment varies as the causal link of qualitative information (e.g., stereotypes) changes. That is, when a clear causal link for stereotypes is provided, people make judgments that are far more in line with them. When the causal link is heavily diminished, people readily incorporate non-causal base-rates into their judgments instead. We suggest that people use and integrate all of the information that is provided to them to make judgements, but heavily prioritize information that is causal in nature. Further, people are sensitive to the underlying causal structures in their environment and adapt their decision making as such.

Conditional power combines the findings of a partially completed study with assumptions about the future. The goal is to estimate the probability that the eventual study result will be incompatible with a criterion value, such as acceptable risk or the null hypothesis. Some history and motivation for conditional power calculations are provided, with examples illustrating the application to drug safety studies. This is an expository article suggesting that conditional power, which is well-established in clinical trials research, also has application to observational studies. The utility may be highest in regulatory settings where resources are limited and interim decisions have to be made accurately in the shortest possible time.

Objectives: The aim of this study was to determine the aspects of expert advice that decision makers find most useful in the development of evidence-based guidance and to identify the characteristics of experts providing the most useful advice., Methods: First, semi-structured interviews were conducted with seventeen members of the Interventional Procedures Advisory Committee of the UK's National Institute of Health and Care Excellence. Interviews examined the usefulness of expert advice during guidance development. Transcripts were analyzed inductively to identify themes. Second, data were extracted from 211 experts' questionnaires for forty-one consecutive procedures. Usefulness of advice was scored using an index developed through the qualitative work. Associations between usefulness score and characteristics of the expert advisor were investigated using univariate and multivariate analyses., Results: Expert opinion was seen as a valued complement to empirical evidence, providing context and tacit knowledge unavailable in published literature, but helpful for interpreting it. Interviewees also valued advice on the training and experience required to perform a procedure, on patient selection criteria and the place of a procedure within a clinical management pathway. Limitations of bias in expert opinion were widely acknowledged and skepticism expressed regarding the anecdotal nature of advice on safety or efficacy outcomes. Quantitative analysis demonstrated that the most useful advice was given by clinical experts with direct personal experience of the procedure, particularly research experience., Conclusions: Evidence-based guidance production is often characterized as a rational, pipeline process. This ignores the valuable role that expert opinion plays in guidance development, complementing and supporting the interpretation of empirical data.

Objectives: To investigate the factors that influence women's decisions about hormone therapy use and the duration of use, in particular the effect of women's reasons for initiating hormone therapy, the source of information about hormones, women's symptom experience, and their concerns about side effects from hormone therapy., Methods: Eight hundred and sixteen women aged 45-59 who began hormone therapy between July 1993 and June 1995 in a Massachusetts health maintenance organization were followed for two years from the day they received a prescription for estrogen. This cohort has been previously studied for health, treatment and demographic determinants of hormone therapy discontinuation. In March 1999, these women were mailed a questionnaire containing closed and open-ended questions. 449 women (55%) completed the survey. Discrete-time hazards models were used to identify determinants of discontinuation, controlling for medical predictors of survey nonresponse., Results: Women's assessment of the difficulty of their decision to use hormone therapy (RR=1.25 for each point on a 7-point scale, 95% CI: 1.16, 1.35) was associated with discontinuation. Women who described their decision as extremely difficult had the greatest likelihood of discontinuing. The importance placed on preventing osteoporosis (RR=0.93 for each point on a 7-point scale, 95% CI: 0.86, 0.99) and cardiovascular disease (RR=0.94 for each point on a 7-point scale, 95% CI: 0.88, 0.99) were also statistically significant predictors of discontinuation. Women for whom the prevention of osteoporosis and cardiovascular disease were extremely important in deciding to use hormone therapy were the most likely to continue using hormones. Concerns about the return of monthly bleeding (RR=3.00, 95% CI: 1.45, 6.17) and weight gain (RR=2.06, 95% CI: 1.16, 3.67) at the time hormone therapy was initiated, but not the actual experience of these side effects while using hormones, were associated with a higher rate of discontinuation. Symptoms around the time of initiating hormone therapy, including the perceived severity of the symptom, were not statistically associated with discontinuation., Conclusions: Discontinuation of hormone therapy is the result of a complex process of decision-making that is influenced by the value placed on the prevention of osteoporosis and cardiovascular disease at the time of initiation and women's perceptions and interpretations of side effects. Concerns about the potential side effects of hormone therapy, in particular weight gain and monthly bleeding, lead women to discontinue hormone therapy.

The present work examined the extent to which evaluations of actions could be biased by the strategic use of euphemistic (agreeable) and dysphemistic (disagreeable) terms. Across multiple studies, we demonstrate that evaluations of actions are made more favorable by replacing a disagreeable term (e.g., torture) with a semantically related agreeable term (e.g., enhanced interrogation) in an act’s description. Notably, the influence of these terms was reduced (but not eliminated) when actions were described in a less ambiguous (i.e., more detailed) manner. Despite their influence, participants judged both agreeable and disagreeable action descriptions as largely truthful and distinct from lies, and judged agents using such descriptions as more trustworthy and moral than liars. Overall, the present findings suggest that a strategic speaker can, through the careful use of language, sway the opinions of others while avoiding many of the reputational costs associated with less subtle forms of linguistic manipulation (e.g., lying).

Lobular neoplasia (LN) involves proliferative changes within the breast lobules. LN is divided into lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH). LCIS can be further subdivided into three subtypes: classic LCIS, pleomorphic LCIS, and LCIS with necrosis (florid type). Because classic LCIS is now considered as a benign etiology, current guidelines recommend close follow-up with imaging versus surgical excision. The goal of our study was to determine if the diagnosis of classic LN on core needle biopsy (CNB) merits surgical excision. This is a retrospective, observational study conducted at Mount Auburn Hospital, Cambridge, MA, from May 17, 2017, through June 30, 2020. We reviewed the data of breast biopsies conducted at our hospital over this period and included patients who were diagnosed with classic LN (LCIS and/or ALH) and excluded patients having any other atypical lesions on CNB. All known cancer patients were excluded. Of the 2707 CNBs performed during the study period, we identified 68 women who were diagnosed with ALH or LCIS on CNB. CNB was performed for an abnormal mammogram in the majority of patients (60; 88%) while 7(10.3%) had an abnormal breast magnetic resonance imaging study (MRI), and 1 had an abnormal ultrasound (US). A total of 58 patients (85%) underwent excisional biopsy, of which 3 (5.2%) showed malignancy, including 2 cases of DCIS and 1 invasive carcinoma. In addition, there was 1 case (1.7%) with pleomorphic LCIS and 11 cases with ADH (15.5%). The management of LN found on core biopsy is evolving, with some advocating surgical excision and others recommending observation. Our data show a change in diagnosis with excisional biopsy in 13 (22.4%) of patients with 2 cases of DCIS, 1 invasive carcinoma, 1 pleomorphic LCIS, and 9 cases of ADH, diagnosed on excisional biopsy. While ALH and classic LCIS are considered benign, the choice of ongoing surveillance versus excisional biopsy should be made with shared decision making with the patient, with consideration of personal and family history, as well as patient preferences. [ABSTRACT FROM AUTHOR]

Previous research suggests that intuitively appealing, yet uninformative unclaimed prize information is capable of biasing gambling-related judgments when people compare scratch cards that vary in the number of unclaimed prizes. However, it is unknown if the mere presence of unclaimed prize information alters a game's attractiveness. Using an online crowdsourcing platform, we recruited 402 U.S. residents to participate in an online study. In a within-subjects design, participants made four gambling-related judgments (likelihood of winning, excitement to play, urge to gamble, and hypothetical card purchasing) for scratch cards presented with and without unclaimed prize information. Compared to cards presented without unclaimed prize information, those with unclaimed prize information were judged as more likely to win, produced more excitement to play, a greater urge to gamble, and were chosen more often during a hypothetical purchasing task. Therefore, unclaimed prize information increases the appeal of scratch card games, and may be an important aspect of the scratch card gambling environment to consider from a harm reduction perspective. [ABSTRACT FROM AUTHOR]

Previous work has demonstrated that peoples' gambling-related judgments (e.g., perceived likelihood of winning) are often biased by non-diagnostic unclaimed prize information (i.e., the number of prizes still available to be won) resulting in non-optimal scratch card preferences. Another line of research suggests that people make less biased decisions (e.g., are less affected by the framing of a gamble) when using a foreign language. In the current study, we investigated whether using a foreign language (as opposed to one's native language) reduced the biasing effects of unclaimed prize information and consequently led to more optimal scratch card preferences. Across three experiments (N = 409), we found that people were equally biased by unclaimed prize information regardless of whether they completed our scratch card gambling task in their native (Polish) or foreign (English) language. In conclusion, it appears that using a foreign language does not help people be less biased in utilizing gambling-related information, and consequently does not lead to more optimal scratch card preferences. [ABSTRACT FROM AUTHOR]

Increasing the consumption of fruit and vegetables is a central component of improving population health. Reasons people give for choosing one food over another suggest health is of lower importance than taste. This study assesses the impact of using a simple descriptive label to highlight the taste as opposed to the health value of fruit on the likelihood of its selection. Participants (N=439) were randomly allocated to one of five groups that varied in the label added to an apple: apple; healthy apple; succulent apple; healthy and succulent apple; succulent and healthy apple. The primary outcome measure was selection of either an apple or a chocolate bar as a dessert. Measures of the perceived qualities of the apple (taste, health, value, quality, satiety) and of participant characteristics (restraint, belief that tasty foods are unhealthy, BMI) were also taken. When compared with apple selection without any descriptor (50%), the labels combining both health and taste descriptors significantly increased selection of the apple (’healthy & succulent’ 65.9% and ‘succulent & healthy’ 62.4%), while the use of a single descriptor had no impact on the rate of apple selection (‘healthy’ 50.5% and ‘succulent’ 52%). The strongest predictors of individual dessert choice were the taste score given to the apple, and the lack of belief that healthy foods are not tasty. Interventions that emphasize the taste attributes of healthier foods are likely to be more effective at achieving healthier diets than those emphasizing health alone. [ABSTRACT FROM AUTHOR]