|Year : 2002 | Volume
| Issue : 1 | Page : 99-100
Decision making process and decision bias
Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
Department of Urology, JIPMER, Pondicherry - 605 006
Source of Support: None, Conflict of Interest: None
Keywords: Decision Making; Rational Decisions; Decision Bias
|How to cite this article:|
Kumar S. Decision making process and decision bias. Indian J Urol 2002;19:99-100
| Introduction|| |
To decide means to make a choice, a decision is a choice and decision making is the process of thinking for making a choice.' Bias is a tendency to consider one person, group or idea more favourably than others. 
| Decision Making Process|| |
There are four stages in rational and logical decision making. 
1. Identify and Define Decision Stimulus and Identify Decision Objectives
A decision stimulus can be a problem (a situation that causes difficulties)  or an opportunity (a chance to do something).  Problem-solving is a type of decision making in which the decision stimulus is a problem.
After identifying the problem, sufficient information should be obtained to clearly define the problem, classify the problem (urgent or nonurgent; routine or nonroutine) and understand its causes. 
Ineffective reactions to a problem include complacency (not seeing or ignoring the problem), defensive avoidance (denying the importance of the problem or denying any responsibility for taking action) and panic reaction (becoming very upset and frantically seeking a solution).  The effective reaction to a problem is deciding to decide.  The bias of giving too much weight to readily available information precludes the search for additional information and prevents clear definition of the problem. 
After defining the problem, the desired end-results, the expected outcomes or decision objectives of problemsolv-ing should be identified.
2. Develop Decision Alternatives
Alternative courses of action that are appropriate to the problem should be identified. The more important the problem, the more time and effort should be devoted to the development of decision alternatives.  Brainstorming is a technique for creative generation of as many decision alternatives as possible without evaluating them. 
Bounded rationality means that the rationality of decision makers is limited by their beliefs, values, attitudes, education, habits and unconscious reflexes and incomplete information.  Hence, decision makers usually satisfice or accept the first satisfactory alternative they uncover, rather than maximise or search until they find the best alternative.
3. Evaluate the Decision Alternatives and Select the Best Alternative
Each decision alternative should be evaluated for its feasibility, effectiveness and efficiency (cost-effectiveness analysis). The alternative which has the highest levels of these qualities should be selected.
Decision makers use heuristics, rules of thumb or judgmental shortcuts in decision making to reduce information processing demands.  These shortcuts can lead to biased decisions. Availability heuristic is the tendency for people to base judgment on information that is readily available to them.  Recent, vivid and emotional events are more easily recalled. Representative heuristic is the tendency to assess the likelihood of an occurrence by trying to match it with a pre-existing category.  Anchoring and adjustment heuristic is the tendency to be influenced by an initial figure even when the information is largely irrelevant..  Framing is the tendency to make different decisions depending on how a problem is presented.  Prospect theory means that decision makers find the prospect of an actual loss more painful than giving up the possibility of a gain. 
Intuition is an innate belief about something without conscious consideration.  Escalation of commitment is thf staying of a decision maker with a decision even when i appears to be wrong.  Risk propensity is the extent to whicl a decision maker is willing to take risk in making a decision.  Risk averters take only low risk and gamblers tak, high risk. Other biases include seeing only one dimension of uncertainty and overestimating one's ability to predict uncertain outcomes (overconfidence). 
4. Implement the Decision and Evaluate Outcomes
The best decision alternative is implemented and its effectiveness is evaluated. If the people who implement the decision are involved in decision making they understand and accept it and are motivated to implement it.
| Decision Making Conditions|| |
Decision making conditions  range from certainty with low possibility of failure to ambiguity with high possibility of failure [Table - 1]. Most of the medical decisions should be made under the condition of risk.
| Decision Making Methods|| |
These include individual, consultative and group decision making and the Ringi system. 
1. Individual Decision Making
It is appropriate when the decision maker has necessary skills and information for decision making. Individual perceptions influence individual decision making. Perception is a process by which individuals organise and interpret their sensory impressions to give meaning to their environment.  One's attitudes, motives, interests, experiences and expectations affect one's perception. People's behaviour is based on their perception of what reality is, not on reality itself.  One's way of thinking (rational or intuitive) and one's tolerance for ambiguity (low or high) also affect individual decision making.
2. Consultative Decision Making
When the decision maker needs additional information and advice from others, he may consult others in a group setting or on a one to one basis before making the final decision. 
3. Group Decision Making
In this a group of persons takes part in decision making. Advantages include availability of more information and knowledge, generation of more alternatives and emergence of better decisions.  Disadvantages include the need for more time and cost, emergence of compromise decisions due to indecisiveness, possible dominance of the group by one person and group think.  Group decisions can be made by interactive groups in which members openly discuss, argue about and agree on the best alternative, Delphi groups in which a group is used to achieve a consensus of expert opinion and nominal groups in which a structured technique is used to generate creative and innovative alternatives and ideas. 
4. The Ringi System
It is a Japanese system of decision making in which the approval of all concerned is obtained before making a decision. 
| References|| |
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[Table - 1]