Indian Journal of Urology
: 2002  |  Volume : 19  |  Issue : 1  |  Page : 99--100

Decision making process and decision bias

Santosh Kumar 
 Department of Urology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India

Correspondence Address:
Santosh Kumar
Department of Urology, JIPMER, Pondicherry - 605 006

How to cite this article:
Kumar S. Decision making process and decision bias.Indian J Urol 2002;19:99-100

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Kumar S. Decision making process and decision bias. Indian J Urol [serial online] 2002 [cited 2021 Dec 3 ];19:99-100
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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. [1]

 Decision Making Process

There are four stages in rational and logical decision making. [2]

1. Identify and Define Decision Stimulus and Iden­tify Decision Objectives

A decision stimulus can be a problem (a situation that causes difficulties) [1] or an opportunity (a chance to do something). [1] 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. [2]

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). [3] The effective reaction to a problem is deciding to decide. [3] The bias of giving too much weight to readily available infor­mation precludes the search for additional information and prevents clear definition of the problem. [4]

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. [4] Brainstorming is a technique for creative generation of as many decision al­ternatives as possible without evaluating them. [3]

Bounded rationality means that the rationality of deci­sion makers is limited by their beliefs, values, attitudes, education, habits and unconscious reflexes and incomplete information. [4] Hence, decision makers usually satisfice or accept the first satisfactory alternative they uncover, rather than maximise or search until they find the best alterna­tive.­[2]

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. [5] 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. [5] 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. [2] Anchoring and adjustment heuristic is the tendency to be influenced by an initial figure even when the information is largely irrelevant.. [3] Framing is the tendency to make different decisions de­pending on how a problem is presented. [3] Prospect theory means that decision makers find the prospect of an actual loss more painful than giving up the possibility of a gain. [3]

Intuition is an innate belief about something without conscious consideration. [6] Escalation of commitment is thf staying of a decision maker with a decision even when i appears to be wrong. [6] Risk propensity is the extent to whicl a decision maker is willing to take risk in making a decision. [6] 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]

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 [4] 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. [4]

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. [5] 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. [5] 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. [4]

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. [6] 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. [6] 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. [6]

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. [4]


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3Bartol KM, Martin DC. Managerial decision making. In : Management, 2nd ed, New York : McGraw Hill, 1994: 229.
4Burton G, Thakur M. Managerial decision making. In : Management Today, New Delhi : Tata McGraw Hill, 1995: 92.
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