Making better decisions in groups

Mixed-species flock sizes and compositions influence flock members' success in three field experiments with novel feeders

Mixed-species groups and aggregations are quite common and may provide substantial fitness-related benefits to group members. Individuals may benefit from the overall size of the mixed-species group or from the diversity of species present, or both. Here we exposed mixed-species flocks of songbirds (Carolina chickadees, Poecile carolinensis, tufted titmice, Baeolophus bicolor, and the satellite species attracted to these two species) to three different novel feeder experiments to assess the influence of mixed-species flock size and composition on ability to solve the feeder tasks. We also assessed the potential role of habitat density and traffic noise on birds' ability to solve these tasks. We found that likelihood of solving a novel feeder task was associated with mixed-species flock size and composition, though the specific social factor involved depended on the particular species and on the novel feeder. We did not find an influence of habitat density or background traffic noise on likelihood of solving novel feeder tasks. Overall, our results reveal the importance of variation in mixed-species group size and diversity on foraging success in these songbirds.

Collective Intelligence Increases Diagnostic Accuracy in a General Practice Setting

BACKGROUND

General practitioners (GPs) work in an ill-defined environment where diagnostic errors are prevalent. Previous research indicates that aggregating independent diagnoses can improve diagnostic accuracy in a range of settings. We examined whether aggregating independent diagnoses can also improve diagnostic accuracy for GP decision making. In addition, we investigated the potential benefit of such an approach in combination with a decision support system (DSS).

METHODS

We simulated virtual groups using data sets from 2 previously published studies. In study 1, 260 GPs independently diagnosed 9 patient cases in a vignette-based study. In study 2, 30 GPs independently diagnosed 12 patient actors in a patient-facing study. In both data sets, GPs provided diagnoses in a control condition and/or DSS condition(s). Each GP's diagnosis, confidence rating, and years of experience were entered into a computer simulation. Virtual groups of varying sizes (range: 3-9) were created, and different collective intelligence rules (plurality, confidence, and seniority) were applied to determine each group's final diagnosis. Diagnostic accuracy was used as the performance measure.

RESULTS

Aggregating independent diagnoses by weighing them equally (i.e., the plurality rule) substantially outperformed average individual accuracy, and this effect increased with increasing group size. Selecting diagnoses based on confidence only led to marginal improvements, while selecting based on seniority reduced accuracy. Combining the plurality rule with a DSS further boosted performance.

DISCUSSION

Combining independent diagnoses may substantially improve a GP's diagnostic accuracy and subsequent patient outcomes. This approach did, however, not improve accuracy in all patient cases. Therefore, future work should focus on uncovering the conditions under which collective intelligence is most beneficial in general practice.

HIGHLIGHTS

We examined whether aggregating independent diagnoses of GPs can improve diagnostic accuracy.Using data sets of 2 previously published studies, we composed virtual groups of GPs and combined their independent diagnoses using 3 collective intelligence rules (plurality, confidence, and seniority).Aggregating independent diagnoses by weighing them equally substantially outperformed average individual GP accuracy, and this effect increased with increasing group size.Combining independent diagnoses may substantially improve GP's diagnostic accuracy and subsequent patient outcomes.

The nature of anchor-biased estimates and its application to the wisdom of crowds

We propose a method to achieve better wisdom of crowds by utilizing anchoring effects. In this method, people are first asked to make a comparative judgment such as "Is the number of new COVID-19 infections one month later more or less than 10 (or 200,000)?" As in this example, two sufficiently different anchors (e.g., "10" or "200,000") are set in the comparative judgment. After this comparative judgment, people are asked to make their own estimates. These estimates are then aggregated. We hypothesized that the aggregated estimates using this method would be more accurate than those without anchor presentation. To examine the effectiveness of the proposed method, we conducted three studies: a computer simulation and two behavioral experiments (numerical estimation of perceptual stimuli and estimation of new COVID-19 infections by physicians). Through computer simulations, we could identify situations in which the proposed method is effective. Although the proposed method is not always effective (e.g., when a group can make fairly accurate estimations), on average, the proposed method is more likely to achieve better wisdom of crowds. In particular, when a group cannot make accurate estimations (i.e., shows biases such as overestimation or underestimation), the proposed method can achieve better wisdom of crowds. The results of the behavioral experiments were consistent with the computer simulation findings. The proposed method achieved better wisdom of crowds. We discuss new insights into anchoring effects and methods for inducing diverse opinions from group members.

Earlier social information has a stronger influence on judgments

People's decisions are often informed by the choices of others. Evidence accumulation models provide a mechanistic account of how such social information enters the choice process. Previous research taking this approach has suggested two fundamentally different cognitive mechanisms by which people incorporate social information. On the one hand, individuals may update their evidence level instantaneously when observing social information. On the other hand, they may gradually integrate social information over time. These accounts make different predictions on how the timing of social information impacts its influence. The former predicts that timing has no impact on social information uptake. The latter predicts that social information which arrives earlier has a stronger impact because its impact increases over time. We tested both predictions in two studies in which participants first observed a perceptual stimulus. They then entered a deliberation phase in which social information arrived either early or late before reporting their judgment. In Experiment 1, early social information remained visible until the end and was thus displayed for longer than late social information. In Experiment 2, which was preregistered, early and late social information were displayed for an equal duration. In both studies, early social information had a larger impact on individuals' judgments. Further, an evidence accumulation analysis found that social information integration was best explained by both an immediate update of evidence and continuous integration over time. Because in social systems, timing plays a key role (e.g., propagation of information in social networks), our findings inform theories explaining the temporal evolution of social impact and the emergent social dynamics.

Bullied: Exploring the concepts of territorialism and groupthink involvement in workplace bullying

AIMS

To educate nurse managers on territorialism and groupthink as being factors within workplace bullying among nurses within the clinical and academic settings that can psychologically and physically harm affected persons.

DESIGN

Territorialism and groupthink are explored as being factors within workplace bullying used by a bully or bullies to target others for personal gain and power. Workplace bullying has become habitual practice in nursing and nursing academia. Workplace bullying is identified not only as unethical behaviour but also as a dangerous practice that can lead to depression, anxiety, stress, and posttraumatic distress syndrome. Persons affected are subjected to emotional abuse that can lead to isolation, low self-esteem, and self-doubt.

METHODS

Methods by which persons in the workplace can identify bullying that involves territorialism and groupthink are examined. Nurse managers are identified as being instrumental in the identification of workplace bullying involving territorialism and groupthink, and in working with the affected person(s) and bully or bullies to seek mediation through a human resource representative. For nursing managers, it is imperative that workplace bullying is immediately addressed. Workplace bullying creates a hostile and intimidating working environment that affects the physical and mental health of affected persons.

RESULTS

Early identification and resolution of workplace bullying could alleviate the development of physiological and psychological health problems by affected persons. After workplace bullying has been reported, the affected persons should focus on the healing of mind, spirit, and body. New circumstances (e.g., a new place of employment or a promotion) may trigger feelings of anger, intimidation or fear; therefore, it' is important for persons who have experienced bullying in the workplace to understand the abusive environment itself was not directly associated with any wrongdoing by them.

NO PATIENT OR PUBLIC CONTRIBUTION

Workplace bullying is disruptive to the workplace and affects productivity, absenteeism from work and turnover intentions. Persons impacted by territorialism and groupthink within the context of workplace bullying can develop psychological and physiological health problems.

Social interoception: Perceiving events during cardiac afferent activity makes people more suggestible to other people's influence

Our judgements are often influenced by other people's views and opinions. Interoception also influences decision making, but little is known about its role in social influence and particularly, the extent to which other people may influence our decisions. Across two experiments, using different forms of social influence, participants judged the trustworthiness of faces presented either during the systolic phase of the cardiac cycle, when baroreceptors convey information from the heart to the brain, or during diastolic phase, when baroreceptors are quiescent. We quantified the extent to which participants changed their minds (as an index of social influence) following the social feedback, in order to compare two competing hypotheses. According to the Arousal-Confidence Hypothesis, cardiac signals create a context of heightened bodily arousal that increases confidence in perceptual judgements. People should, therefore, be less subject to social influence during systole. By contrast, according to the Uncertainty-Conformity Hypothesis, cardiac signals increase neural noise and sensory attenuation, such that people should display greater effects of social influence during systole, as they then underweight private interoceptive signals in favour of the external social information. Across two studies that used different kind of social interactions, we found that participants changed their minds more when faces were presented at systole. Our results, therefore, support the Uncertainly-Conformity hypothesis and highlight how cardiac afferent signals contribute to shape our social decision-making in different types of social interactions.

The Social Route to Abstraction: Interaction and Diversity Enhance Performance and Transfer in a Rule-Based Categorization Task

Capacities for abstract thinking and problem-solving are central to human cognition. Processes of abstraction allow the transfer of experiences and knowledge between contexts helping us make informed decisions in new or changing contexts. While we are often inclined to relate such reasoning capacities to individual minds and brains, they may in fact be contingent on human-specific modes of collaboration, dialogue, and shared attention. In an experimental study, we test the hypothesis that social interaction enhances cognitive processes of rule-induction, which in turn improves problem-solving performance. Through three sessions of increasing complexity, individuals and groups were presented with a problem-solving task requiring them to categorize a set of visual stimuli. To assess the character of participants' problem representations, after each training session, they were presented with a transfer task involving stimuli that differed in appearance, but shared relations among features with the training set. Besides, we compared participants' categorization behaviors to simulated agents relying on exemplar learning. We found that groups performed superior to individuals and agents in the training sessions and were more likely to correctly generalize their observations in the transfer phase, especially in the high complexity session, suggesting that groups more effectively induced underlying categorization rules from the stimuli than individuals and agents. Crucially, variation in performance among groups was predicted by semantic diversity in members' dialogical contributions, suggesting a link between social interaction, cognitive diversity, and abstraction.

Comparison of methods to engage diverse stakeholder populations in prioritizing PrEP implementation strategies for testing in resource-limited settings: a cross-sectional study

BACKGROUND

There is a lack of consensus about how to prioritize potential implementation strategies for HIV pre-exposure prophylaxis (PrEP) delivery. We compared several prioritization methods for their agreement and pragmatism in practice in a resource-limited setting.

METHODS

We engaged diverse stakeholders with clinical PrEP delivery and PrEP decision-making experience across 55 facilities in Kenya to prioritize 16 PrEP delivery strategies. We compared four strategy prioritization methods: (1) "past experience surveys" with experienced practitioners reflecting on implementation experience (N = 182); (2 and 3) "pre- and post-small-group ranking" surveys before and after group discussion (N = 44 and 40); (4) "go-zone" quadrant plots of perceived effectiveness vs feasibility. Kendall's correlation analysis was used to compare strategy prioritization using the four methods. Additionally, participants were requested to group strategies into three bundles with up to four strategies/bundle by phone and online survey.

RESULTS

The strategy ranking correlation was strongest between the pre- and post-small-group rankings (Tau: 0.648; p < 0.001). There was moderate correlation between go-zone plots and post-small-group rankings (Tau: 0.363; p = 0.079) and between past-experience surveys and post-small-group rankings (Tau: 0.385; p = 0.062). For strategy bundling, participants primarily chose bundles of strategies in the order in which they were listed, reflecting option ordering bias. Neither the phone nor online approach was effective in selecting strategy bundles. Participants agreed that the strategy ranking activities conducted during the workshop were useful in prioritizing a final set of strategies.

CONCLUSIONS

Both experienced and inexperienced stakeholder participants' strategy rankings tended to prioritize strategies perceived as feasible. Small group discussions focused on feasibility and effectiveness revealed moderately different priorities than individual rankings. The strategy bundling approach, though less time- and resource-intensive, was not effective. Future research should further compare the relative effectiveness and pragmatism of methodologies to prioritize implementation strategies.

On the social nature of abstraction: cognitive implications of interaction and diversity

The human capacity for abstraction is remarkable. We effortlessly form abstract representations from varied experiences, generalizing and flexibly transferring experiences and knowledge between contexts, which can facilitate reasoning, problem solving and learning across many domains. The cognitive process of abstraction, however, is often portrayed and investigated as an individual process. This paper addresses how cognitive processes of abstraction-together with other aspects of human reasoning and problem solving-are fundamentally shaped and modulated by online social interaction. Starting from a general distinction between convergent thinking, divergent thinking and processes of abstraction, we address how social interaction shapes information processing differently depending on cognitive demands, social coordination and task ecologies. In particular, we suggest that processes of abstraction are facilitated by the interactive sharing and integration of varied individual experiences. To this end, we also discuss how the dynamics of group interactions vary as a function of group composition; that is, in terms of the similarity and diversity between the group members. We conclude by outlining the role of cognitive diversity in interactive processes and consider the importance of group diversity in processes of abstraction. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.

Auditing the quality of epidemic decision-making in Somalia: a pilot evaluation

OBJECTIVE

To assess decision-making quality through piloting an audit tool among decision-makers responding to the COVID-19 epidemic in Somalia.

DESIGN AND SETTING

We utilised a mixed-methods programme evaluation design comprising quantitative and qualitative methods. Decision-makers in Somalia piloted the audit tool generating a scorecard for decision-making in epidemic response. They also participated in key informant interviews discussing their experience with the audit process and results.

PARTICIPANTS

A total of 18 decision-makers from two humanitarian agencies responding to COVID-19 in Somalia were recruited to pilot the audit tool.

OUTCOME MEASURES AND ANALYSIS

We used thematic analysis to assess the feasibility and perceived utility of the audit tool by intended users (decision-makers). We also calculated Fleiss' Kappa to assess inter-rater agreement in the audit scorecard.

RESULTS

The audit highlighted areas of improvement in decision-making among both organisations including in the dimensions of accountability and transparency. Despite the audit occurring in a highly complex operating environment, decision-makers found the process to be feasible and of high utility. The flexibility of the audit approach allowed for organisations to adapt the audit to their needs. As a result, organisation reported a high level of acceptance of the findings.

CONCLUSION

Strengthening decision-making processes is key to realising the objectives of epidemic response. This pilot evaluation contributes towards this goal by the testing what, to our knowledge, may be the first tool designed specifically to assess quality of decision-making processes in epidemic response. The tool has proven feasible and acceptable in assessing decision-making quality in an ongoing response and has potential applicability in assessing decision-making in broader humanitarian response.

A case study of the Ancientbiotics collaboration

Interdisciplinary collaboration is regarded as a desirable way of researching and, in some instances, even a requirement for academic teams and funding proposals. This paper explores the possibilities, but also the problems, of collaboration between different disciplines through a case study of the Ancientbiotics team. This team explores the potential of natural products contained in historical medical recipes. The search for clinically useful natural products in unusual places, such as historical medical practices, is a well-established endeavor in the scientific disciplines. The Ancientbiotics collaboration, largely based across UK institutions, takes this path a step forward in combining modern scientific knowledge of natural products with expertise from humanities to identify ingredient combinations. After 7 years of practice, the research has produced a variety of outcomes. This perspective will explore how the team worked within an interdisciplinary framework to advance investigation and application of historical medical recipes.

Pivotal voting: The opportunity to tip group decisions skews juries and other voting outcomes

Many important social and policy decisions are made by small groups of people (e.g., juries, college admissions officers, or corporate boards) with the hope that a collective process will yield better and fairer decisions. In many instances, it is possible for these groups to fail to reach a decision by not garnering a minimum number of votes (e.g., hung juries). Our research finds that pivotal voters vote to avoid such decision failure-voters who can "tip" their group into a punishment decision will be more likely to do so. This effect is distinct from well-known social pressures to simply conform with others or reach unanimity. Using observational data from Louisiana court cases, we find a sharp discontinuity in juries' voting decisions at the threshold between indecision and conviction (Study 1). In a third-party punishment paradigm, pivotal voters were more likely to vote to punish a target than nonpivotal voters, even when holding social information constant (Study 2), and adopted harsher views about the target's deservingness of punishment (Study 3). Using vignettes, we find that pivotal voters are judged to be differentially responsible for the outcomes of their votes-those who "block" the group from reaching a punishment decision are deemed more responsible for the outcome than those who "fall in line" (Study 4). These findings provide insight into how we might improve group decision-making environments to ensure that their outcomes accurately reflect group members' actual beliefs and not the influence of social pressures.

Students With High Metacognition Are Favourable Towards Individualism When Anxious

Metacognitive ability has been described as an important predictor of several processes involved in learning, including problem-solving. Although this relationship is fairly documented, little is known about the mechanisms that could modulate it. Given its relationship with both constructs, we decided to evaluate the impact of self-knowledge on PS. In addition, we inspected whether emotional (self-reported anxiety) and interpersonal (attitudes towards social interdependence) variables could affect the relationship between metacognition and problem-solving. We tested a sample of 32 undergraduate students and used behavioural tasks and self-report questionnaires. Contrary to the literature, we found no significant relationship between metacognition and problem-solving performance, nor a significant moderating effect when including emotional and interpersonal variables in the model. In contrast, we observed a significant moderating model combining metacognition, self-reported anxiety and attitudes towards social interdependence. It was found that participants with high metacognition reported attitudes unfavourable towards interdependence when they felt high anxiety. These results suggest that already anxious individuals with high metacognition would prefer to work alone rather than with others, as a coping mechanism against further anxiety derived from cooperation. We hypothesise that in anxiogenic contexts, metacognition is used as a tool to compare possible threats with one's own skills and act accordingly, in order to maximise one's own performance. Further studies are needed to understand how metacognition works in contexts adverse to learning.

How Do You Like Me Now? The Influence of "Likes" and Followers on Social Media in Plastic Surgery

BACKGROUND

The number of "likes" and followers on social media is a surrogate marker for peer acceptance and popularity, but the influence of likes and followers on prospective plastic surgery patients has not been studied. The aim of this study was to evaluate whether the number of followers or likes on social media has an impact on perceived surgeon competence or likelihood of recruiting new patients.

METHODS

A fictitious Instagram page was created with different permutations displaying different numbers of followers on the page. Similarly, fictitious Instagram posts were created displaying before-and-after results of ideal and suboptimal breast augmentation and gynecomastia surgery results, with the number of likes being the only variable. Using a crowdsourcing platform, survey responders rated surgeon competence and likelihood of patient recruitment based on the Instagram post.

RESULTS

A total of 4284 responses were collected. The number of followers or likes did not impact perceived surgeon competence or patient recruitment scores. Optimal surgical results consistently scored higher than suboptimal results, regardless of the number of likes. Almost half the responders were unable to identify the American Board of Plastic Surgery as the appropriate board certification for performing aesthetic breast or body surgery.

CONCLUSIONS

A high number of followers or likes, by itself, is unlikely to translate into higher likelihood of recruiting new patients. Overall, aesthetic results seem to be the most important driving force in receiving high competence scores and recruiting new patients, rather than social media presence or board certification.

Development of a core outcome set for the evaluation of interventions to enhance trial participation decisions on behalf of adults who lack capacity to consent: a mixed methods study (COnSiDER Study)

BACKGROUND

Trials involving adults who lack capacity to provide consent rely on proxy or surrogate decision-makers, usually a family member, to make decisions about participation. Interventions to enhance proxy decisions about trial participation are now being developed. However, a lack of standardised outcome measures limits evaluation of these interventions. The aim of this study was to establish an agreed standardised core outcome set (COS) for use when evaluating interventions to improve proxy decisions about trial participation.

METHODS

We used established methods to develop the COS including a consensus study with key stakeholder groups comprising those who will use the COS in research (researchers and healthcare professionals) and patients or their representatives. Following a scoping review to identify candidate items, we used a modified two-round Delphi survey to achieve consensus on core outcomes, with equivocal items taken to a consensus meeting for discussion. The COS was finalised following an online consensus meeting in October 2020.

RESULTS

A total of 28 UK stakeholders (5 researchers, 10 trialists, 3 patient/family representatives, 7 recruiters and 3 advisors/approvers) participated in the online Delphi survey to rank candidate items from the scoping review (n = 36) and additional items proposed by participants (n = 1). Items were broadly grouped into three categories: how family members make decisions, their experiences of making decisions, and the personal aspects that influence the decision. Following the Delphi survey, 27 items were included and ten items exhibited no consensus which required discussion at the consensus meeting. Sixteen participants attended the meeting, including additional patient/family representatives invited to increase representation from this key group (n = 2). We reached consensus for the inclusion of 28 outcome items, including one selected at the consensus meeting.

CONCLUSIONS

The study identified outcomes that should be measured as a minimum in all evaluations of interventions to enhance proxy decisions about trials. These relate to the process of decision-making, proxies' experience of decision-making, and factors that influence decision-making such as understanding. Further work with people with impairing conditions and their families is needed to explore their views about the COS and to identify appropriate outcome measures and timing of measurement.

TRIAL REGISTRATION

The study is registered on the COMET database ( https://www.comet-initiative.org/Studies/Details/1409 ).

Many heads are more utilitarian than one

Moral judgments have a very prominent social nature, and in everyday life, they are continually shaped by discussions with others. Psychological investigations of these judgments, however, have rarely addressed the impact of social interactions. To examine the role of social interaction on moral judgments within small groups, we had groups of 4 to 5 participants judge moral dilemmas first individually and privately, then collectively and interactively, and finally individually a second time. We employed both real-life and sacrificial moral dilemmas in which the character's action or inaction violated a moral principle to benefit the greatest number of people. Participants decided if these utilitarian decisions were morally acceptable or not. In Experiment 1, we found that collective judgments in face-to-face interactions were more utilitarian than the statistical aggregate of their members compared to both first and second individual judgments. This observation supported the hypothesis that deliberation and consensus within a group transiently reduce the emotional burden of norm violation. In Experiment 2, we tested this hypothesis more directly: measuring participants' state anxiety in addition to their moral judgments before, during, and after online interactions, we found again that collectives were more utilitarian than those of individuals and that state anxiety level was reduced during and after social interaction. The utilitarian boost in collective moral judgments is probably due to the reduction of stress in the social setting.

Anytime collaborative brain-computer interfaces for enhancing perceptual group decision-making

In this paper we present, and test in two realistic environments, collaborative Brain-Computer Interfaces (cBCIs) that can significantly increase both the speed and the accuracy of perceptual group decision-making. The key distinguishing features of this work are: (1) our cBCIs combine behavioural, physiological and neural data in such a way as to be able to provide a group decision at any time after the quickest team member casts their vote, but the quality of a cBCI-assisted decision improves monotonically the longer the group decision can wait; (2) we apply our cBCIs to two realistic scenarios of military relevance (patrolling a dark corridor and manning an outpost at night where users need to identify any unidentified characters that appear) in which decisions are based on information conveyed through video feeds; and (3) our cBCIs exploit Event-Related Potentials (ERPs) elicited in brain activity by the appearance of potential threats but, uniquely, the appearance time is estimated automatically by the system (rather than being unrealistically provided to it). As a result of these elements, in the two test environments, groups assisted by our cBCIs make both more accurate and faster decisions than when individual decisions are integrated in more traditional manners.

The Cognitive Science of Technology

Technology is central to human life but hard to define and study. This review synthesizes advances in fields from anthropology to evolutionary biology and neuroscience to propose an interdisciplinary cognitive science of technology. The foundation of this effort is an evolutionarily motivated definition of technology that highlights three key features: material production, social collaboration, and cultural reproduction. This broad scope respects the complexity of the subject but poses a challenge for theoretical unification. Addressing this challenge requires a comparative approach to reduce the diversity of real-world technological cognition to a smaller number of recurring processes and relationships. To this end, a synthetic perceptual-motor hypothesis (PMH) for the evolutionary-developmental-cultural construction of technological cognition is advanced as an initial target for investigation.

Pooling decisions decreases variation in response bias and accuracy

Decision makers in contexts as diverse as medical, judicial, and political decision making are known to differ substantially in response bias and accuracy, and these differences are a major factor undermining the reliability and fairness of the respective decision systems. Using theoretical modeling and empirical testing across five domains, we show that collective systems based on pooling decisions robustly overcome this important but as of now unresolved problem of experts' heterogeneity. In breast and skin cancer diagnostics and fingerprint analysis, we find that pooling the decisions of five experts reduces the variation in sensitivity among decision makers by 52%, 54%, and 41%, respectively. Similar reductions are achieved for specificity and response bias, and in other domains. Thus, although outcomes in individual decision systems are highly variable and at the mercy of individual decision makers, collective systems based on pooling decrease this variation, thereby promoting reliability, fairness, and possibly even trust.

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Professional decision makers typically differ in their response bias and accuracy

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Such differences undermine the reliability and fairness of decision systems

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Pooling decisions reduces such variation in response bias and accuracy

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This occurred in cancer diagnostics, fingerprint analysis, and forecasting

Accreditation and Certification: Do They Improve Hospital Financial and Quality Performance?

The relationship between healthcare organizational accreditation and their leaders’ professional certification in healthcare management is of specific interest to institutions of higher education and individuals in the healthcare management field. Since academic program accreditation is one piece of evidence of high-quality education, and since professional certification is an attestation to the knowledge, skills, and abilities of those who are certified, we expect alumni who graduated from accredited programs and obtained professional certification to have a positive impact on the organizations that they lead, compared with alumni who did not graduate from accredited programs and who did not obtain professional certification. The authors’ analysis examined the impact of hiring graduates from higher education programs that held external accreditation from the Commission on Accreditation of Healthcare Management Education (CAHME). Graduates’ affiliation with the American College of Healthcare Executives (ACHE) professional healthcare leadership organization was also assessed as an independent variable. Study outcomes focused on these graduates’ respective healthcare organization’s performance measures (cost, quality, and access) to assess the researchers’ inquiry into the perceived value of a CAHME-accredited graduate degree in healthcare administration and a professional ACHE affiliation. The results from this study found no effect of CAHME accreditation or ACHE affiliation on healthcare organization performance outcomes. The study findings support the need for future research surrounding healthcare administration professional graduate degree program characteristics and leader development affiliations, as perceived by various industry stakeholders.

In search of a Goldilocks zone for credible AI

If artificial intelligence (AI) is to help solve individual, societal and global problems, humans should neither underestimate nor overestimate its trustworthiness. Situated in-between these two extremes is an ideal 'Goldilocks' zone of credibility. But what will keep trust in this zone? We hypothesise that this role ultimately falls to the social cognition mechanisms which adaptively regulate conformity between humans. This novel hypothesis predicts that human-like functional biases in conformity should occur during interactions with AI. We examined multiple tests of this prediction using a collaborative remembering paradigm, where participants viewed household scenes for 30 s vs. 2 min, then saw 2-alternative forced-choice decisions about scene content originating either from AI- or human-sources. We manipulated the credibility of different sources (Experiment 1) and, from a single source, the estimated-likelihood (Experiment 2) and objective accuracy (Experiment 3) of specific decisions. As predicted, each manipulation produced functional biases for AI-sources mirroring those found for human-sources. Participants conformed more to higher credibility sources, and higher-likelihood or more objectively accurate decisions, becoming increasingly sensitive to source accuracy when their own capability was reduced. These findings support the hypothesised role of social cognition in regulating AI's influence, raising important implications and new directions for research on human-AI interaction.

Determinants and modulators of human social decisions

Social decision making is a highly complex process that involves diverse cognitive mechanisms, and it is driven by the precise processing of information from both the environment and from the internal state. On the one hand, successful social decisions require close monitoring of others' behavior, in order to track their intentions; this can guide not only decisions involving other people, but also one's own choices and preferences. On the other hand, internal states such as own reward or changes in hormonal and neurotransmitter states shape social decisions and their underlying neural function. Here, we review the current literature on modulators and determinants of human social decisions.

Group decisions based on confidence weighted majority voting

Background

It has repeatedly been reported that, when making decisions under uncertainty, groups outperform individuals. Real groups are often replaced by simulated groups: Instead of performing an actual group discussion, individual responses are aggregated by a numerical computation. While studies have typically used unweighted majority voting (MV) for this aggregation, the theoretically optimal method is confidence weighted majority voting (CWMV)—if independent and accurate confidence ratings from the individual group members are available. To determine which simulations (MV vs. CWMV) reflect real group processes better, we applied formal cognitive modeling and compared simulated group responses to real group responses.

Results

Simulated group decisions based on CWMV matched the accuracy of real group decisions, while simulated group decisions based on MV showed lower accuracy. CWMV predicted the confidence that groups put into their group decisions well. However, real groups treated individual votes to some extent more equally weighted than suggested by CWMV. Additionally, real groups tend to put lower confidence into their decisions compared to CWMV simulations.

Conclusion

Our results highlight the importance of taking individual confidences into account when simulating group decisions: We found that real groups can aggregate individual confidences in a way that matches statistical aggregations given by CWMV to some extent. This implies that research using simulated group decisions should use CWMV instead of MV as a benchmark to compare real groups to.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41235-021-00279-0.

Haptic communication optimises joint decisions and affords implicit confidence sharing

Group decisions can outperform the choices of the best individual group members. Previous research suggested that optimal group decisions require individuals to communicate explicitly (e.g., verbally) their confidence levels. Our study addresses the untested hypothesis that implicit communication using a sensorimotor channel—haptic coupling—may afford optimal group decisions, too. We report that haptically coupled dyads solve a perceptual discrimination task more accurately than their best individual members; and five times faster than dyads using explicit communication. Furthermore, our computational analyses indicate that the haptic channel affords implicit confidence sharing. We found that dyads take leadership over the choice and communicate their confidence in it by modulating both the timing and the force of their movements. Our findings may pave the way to negotiation technologies using fast sensorimotor communication to solve problems in groups.

Equine pituitary pars intermedia dysfunction: Identifying research priorities for diagnosis, treatment and prognosis through a priority setting partnership

Pituitary pars intermedia dysfunction (PPID) is the most prevalent endocrine disorder of older equids. To date, key research areas likely to have the greatest impact on equine health have not been identified. In human medicine, public and patient involvement is widely used to inform research agendas. This study aimed to engage with veterinary surgeons and horse owners to identify evidence gaps ('uncertainties') and prioritise these into a list of the 10 most important PPID research questions. The James Lind Alliance (JLA) Priority Setting Partnership (PSP) Framework was adapted. Questions about the diagnosis, treatment and prognosis of PPID were gathered via an online survey targeting veterinary surgeons and horse owners with experience of PPID. Thematic analysis was used to form a longlist of collated indicative research questions (CIRQs), defined by the JLA as true 'evidence uncertainties' when not answered by a published, clinically relevant, up-to-date systematic review. In an interim prioritisation survey, questions were ranked by weighted scores creating a shortlist of 25 that were taken forward to the PSP workshop, where participants reached a consensus on the top 10. Useable responses containing ≥1 question were received from 524 respondents (92.6% owners, n = 485; 7.4% veterinary surgeons, n = 39). After screening for relevance, 1,260 individual questions were included in thematic analysis, resulting in 47 CIRQs. Interim prioritisation votes for the CIRQs were received from 360 respondents. The top 10 questions prioritised at the PSP workshop focused on long-term prognosis, diagnostic accuracy, efficacy of pergolide treatment, alternative treatment/management strategies and potential treatment options for poor responders to pergolide. The quantity of questions generated indicates an extensive number of uncertainties regarding the diagnosis, treatment and prognosis of PPID. The top 10 research questions will help to inform key areas for evidence synthesis and knowledge translation, and to direct future research into areas most important to end users involved in caring for and treating animals with PPID.

Pathogen Incursions - Integrating Technical Expertise in a Socio-Political Context

The incursion of a plant pathogen into a new geographic area initiates a series of decisions about appropriate control or eradication efforts. Incomplete, erroneous, and/or selective information may be used by diverse stakeholders to support individual goals and positions on how an incursion should be managed. We discuss the complex social, political, and technical factors that shape a biosecurity response prior to reviewing information needs and common stakeholder misunderstandings. Selected examples focus on the rust fungi (order Pucciniales). We then explore how plant pathologists, as technical experts, can interact with biosecurity stakeholders to build empathy and understanding that in turn allows a shift from being a distant subject matter expert to an active participant helping to structure problems and shape knowledge flows for better outcomes.

Derationalizing Delusions

Because of the traditional conceptualization of delusion as “irrational belief,” cognitive models of delusions largely focus on impairments to domain-general reasoning. Nevertheless, current rationality-impairment models do not account for the fact that (a) equivalently irrational beliefs can be induced through adaptive social cognitive processes, reflecting social integration rather than impairment; (b) delusions are overwhelmingly socially themed; and (c) delusions show a reduced sensitivity to social context both in terms of how they are shaped and how they are communicated. Consequently, we argue that models of delusions need to include alteration to coalitional cognition—processes involved in affiliation, group perception, and the strategic management of relationships. This approach has the advantage of better accounting for both content (social themes) and form (fixity) of delusion. It is also supported by the established role of mesolimbic dopamine in both delusions and social organization and the ongoing reconceptualization of belief as serving a social organizational function.

Collaborative interdepartmental teams: benefits, challenges, alternatives, and the ingredients for team success

Radiology practices often employ collaborative interdepartmental teams to address complex projects. These teams benefit from their diversity of viewpoints and the potential for innovative, high-quality solutions. However, collaborative interdepartmental teams also suffer from challenges: interpersonal conflicts, team member mistrust, competing individual priorities, and obstructive turf concerns. When tackling projects, radiologists should consider alternative group models such as single department teams, two-person partnerships, and small workgroups. Each of these group models has strengths and weaknesses relative to collaborative interdepartmental teams and may be more efficient in some scenarios. Finally, when radiologists launch collaborative interdepartmental teams, four key ingredients should be optimized to improve team performance: right goal, right culture, right leadership, and right people.

Wise or mad crowds? The cognitive mechanisms underlying information cascades

Whether getting vaccinated, buying stocks, or crossing streets, people rarely make decisions alone. Rather, multiple people decide sequentially, setting the stage for information cascades whereby early-deciding individuals can influence others' choices. To understand how information cascades through social systems, it is essential to capture the dynamics of the decision-making process. We introduce the social drift-diffusion model to capture these dynamics. We tested our model using a sequential choice task. The model was able to recover the dynamics of the social decision-making process, accurately capturing how individuals integrate personal and social information dynamically over time and when their decisions were timed. Our results show the importance of the interrelationships between accuracy, confidence, and response time in shaping the quality of information cascades. The model reveals the importance of capturing the dynamics of decision processes to understand how information cascades in social systems, paving the way for applications in other social systems.

Knowing Ourselves Together: The Cultural Origins of Metacognition

Metacognition - the ability to represent, monitor and control ongoing cognitive processes - helps us perform many tasks, both when acting alone and when working with others. While metacognition is adaptive, and found in other animals, we should not assume that all human forms of metacognition are gene-based adaptations. Instead, some forms may have a social origin, including the discrimination, interpretation, and broadcasting of metacognitive representations. There is evidence that each of these abilities depends on cultural learning and therefore that cultural selection might shape human metacognition. The cultural origins hypothesis is a plausible and testable alternative that directs us towards a substantial new programme of research.

Development of LactaPedia: A lactation glossary for science and medicine

During the last decade, there have been several publications highlighting the need for consistent terminology in breastfeeding research. Standard terms and definitions are essential for the comparison and interpretation of scientific studies that, in turn, support evidence‐based education, consistency of health care, and breastfeeding policy. Inconsistent advice is commonly reported by mothers to contribute to early weaning. A standard language is the fundamental starting point required for the provision of consistent advice. LactaPedia (www.lactapedia.com) is a comprehensive lactation glossary of over 500 terms and definitions created during the development of LactaMap (www.lactamap.com), an online lactation care support system. This paper describes the development of LactaPedia, a website that is accessible free of charge to anyone with access to the Internet. Multiple methodological frameworks were incorporated in LactaPedia's development in order to meet the needs of a glossary to support both consistent health care and scientific research. The resulting LactaPedia methodology is a six‐stage process that was developed inductively and includes framework to guide vetting and extension of its content using public feedback via discussion forums. The discussion forums support ongoing usability and refinement of the glossary. The development of LactaPedia provides a fundamental first step towards improving breastfeeding outcomes that are currently well below World Health Organisation recommendations globally.

The psychology of experimental psychologists: Overcoming cognitive constraints to improve research: The 47th Sir Frederic Bartlett Lecture

Like many other areas of science, experimental psychology is affected by a "replication crisis" that is causing concern in many fields of research. Approaches to tackling this crisis include better training in statistical methods, greater transparency and openness, and changes to the incentives created by funding agencies, journals, and institutions. Here, I argue that if proposed solutions are to be effective, we also need to take into account human cognitive constraints that can distort all stages of the research process, including design and execution of experiments, analysis of data, and writing up findings for publication. I focus specifically on cognitive schemata in perception and memory, confirmation bias, systematic misunderstanding of statistics, and asymmetry in moral judgements of errors of commission and omission. Finally, I consider methods that may help mitigate the effect of cognitive constraints: better training, including use of simulations to overcome statistical misunderstanding; specific programmes directed at inoculating against cognitive biases; adoption of Registered Reports to encourage more critical reflection in planning studies; and using methods such as triangulation and "pre mortem" evaluation of study design to foster a culture of dialogue and criticism.

Fast Lane to Slow Science

Fast Science is bad for scientists and bad for science. Slow Science may actually help us to make faster progress, but how can we slow down? Here, I offer preliminary suggestions for how we can transition to a healthier and more sustainable research culture.

Agreeableness modulates group member risky decision-making behavior and brain activity

When facing difficult decisions, people typically believe that "two heads are better than one". However, findings from previous studies are inconsistent regarding the advantages of decision-making in groups as compared to individual decision-making. We hypothesize that personality traits may modulate risk-taking behavior and brain activity changes during group decision-making. In this study, we used event-related potentials (ERP) with a well-validated balloon analogue risk task (BART) paradigm to examine the relationships between personality traits, decision-making behavior, and brain activity patterns when a cohort of male participants make decisions and take risks both in groups and in isolation. We found significantly increased risk-taking behavior and reduced P300 component during group decision-making as compared to individual decision-making only for participants with high Agreeableness, but not for those with low Agreeableness. Moreover, Agreeableness scores correlated with risk-taking behavior and P300 amplitude changes in group decisions. These findings suggest that Agreeableness personality modulates risk-taking behavior and brain activity when people make decisions in groups, which have implications for future group decision research and practice.

How to detect high-performing individuals and groups: Decision similarity predicts accuracy

Distinguishing between high- and low-performing individuals and groups is of prime importance in a wide range of high-stakes contexts. While this is straightforward when accurate records of past performance exist, these records are unavailable in most real-world contexts. Focusing on the class of binary decision problems, we use a combined theoretical and empirical approach to develop and test a approach to this important problem. First, we use a general mathematical argument and numerical simulations to show that the similarity of an individual's decisions to others is a powerful predictor of that individual's decision accuracy. Second, testing this prediction with several large datasets on breast and skin cancer diagnostics, geopolitical forecasting, and a general knowledge task, we find that decision similarity robustly permits the identification of high-performing individuals and groups. Our findings offer a simple, yet broadly applicable, heuristic for improving real-world decision-making systems.

Collaborative Brain-Computer Interfaces to Enhance Group Decisions in an Outpost Surveillance Task

We present a two-layered collaborative Brain-Computer Interface (cBCI) to aid groups making decisions under time constraints in a realistic video surveillance setting - the very first cBCI application of this type. The cBCI first uses response times (RTs) to estimate the decision confidence the user would report after each decision. Such an estimate is then used with neural features extracted from EEG to refine the decision confidence so that it better correlates with the correctness of the decision. The refined confidence is then used to weigh individual responses and obtain group decisions. Results obtained with 10 participants indicate that cBCI-assisted groups are significantly more accurate than groups using standard majority or weighing decisions using reported confidence values. This two-layer architecture allows the cBCI to not only further enhance group performance but also speed up the decision process, as the cBCI does not have to wait for all users to report their confidence after each decision.

Shared responsibility in collective decisions

Research investigating collective decision-making has focused primarily on the improvement of accuracy in collective decisions and less on the motives that drive individuals to make these decisions. We argue that a strong but neglected motive for making collective decisions is minimizing the material and psychological burden of an individual's responsibility. Making difficult decisions with others shields individuals from the consequences of negative outcomes by reducing regret, punishment and stress. Considering shared responsibility as a another key motivation to join groups helps understand behaviours with societal implications such as political voting, committing norm violations, predicting natural disasters and making health-related decisions.

Cyborg groups enhance face recognition in crowded environments

Recognizing a person in a crowded environment is a challenging, yet critical, visual-search task for both humans and machine-vision algorithms. This paper explores the possibility of combining a residual neural network (ResNet), brain-computer interfaces (BCIs) and human participants to create “cyborgs” that improve decision making. Human participants and a ResNet undertook the same face-recognition experiment. BCIs were used to decode the decision confidence of humans from their EEG signals. Different types of cyborg groups were created, including either only humans (with or without the BCI) or groups of humans and the ResNet. Cyborg groups decisions were obtained weighing individual decisions by confidence estimates. Results show that groups of cyborgs are significantly more accurate (up to 35%) than the ResNet, the average participant, and equally-sized groups of humans not assisted by technology. These results suggest that melding humans, BCI, and machine-vision technology could significantly improve decision-making in realistic scenarios.

Wisdom of the caregivers: pooling individual subjective reports to diagnose states of consciousness in brain-injured patients, a monocentric prospective study

OBJECTIVES

The clinical distinction between vegetative state/unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) is a key step to elaborate a prognosis and formulate an appropriate medical plan for any patient suffering from disorders of consciousness (DoC). However, this assessment is often challenging and may require specialised expertise. In this study, we hypothesised that pooling subjective reports of the level of consciousness of a given patient across several nursing staff members can be used to clinically detect MCS.

SETTING AND PARTICIPANTS

Patients referred to consciousness assessment were prospectively screened. MCS (target condition) was defined according to the best Coma Recovery Scale-Revised score (CRS-R) obtained from expert physicians (reference standard). 'DoC-feeling' score was defined as the median of individual subjective reports pooled from multiple staff members during a week of hospitalisation (index test). Individual ratings were collected at the end of each shift using a 100 mm Visual Analogue Scale, blinded from the reference standard. Diagnostic accuracy was evaluated using area under the receiver operating characteristic curve (AUC), sensitivity and specificity metrics.

RESULTS

692 ratings performed by 83 nursing staff members were collected from 47 patients. Twenty patients were diagnosed with UWS and 27 with MCS. DoC-feeling scores obtained by pooling all individual ratings obtained for a given patient were significantly greater in patients with MCS than with UWS (59.2 mm (IQR: 27.3-77.3) vs 7.2 mm (IQR: 2.4-11.4); p<0.001) yielding an AUC of 0.92 (95% CI 0.84 to 0.99).

CONCLUSIONS

DoC-feeling capitalises on the expertise of nursing staff to evaluate patients' consciousness. Together with the CRS-R as well as with brain imaging, DoC-feeling might improve diagnostic and prognostic accuracy of patients with DoC.

Setting the top 10 research priorities to improve the health of people with Type 2 diabetes: a Diabetes UK-James Lind Alliance Priority Setting Partnership

AIMS

To describe processes and outcomes of a priority setting partnership to identify the 'top 10 research priorities' in Type 2 diabetes, involving people living with the condition, their carers, and healthcare professionals.

METHODS

We followed the four-step James Lind Alliance Priority Setting Partnership process which involved: gathering uncertainties using a questionnaire survey distributed to 70 000 people living with Type 2 diabetes and their carers, and healthcare professionals; organizing the uncertainties; interim priority setting by resampling of participants with a second survey; and final priority setting in an independent group of participants, using the nominal group technique. At each step the steering group closely monitored and guided the process.

RESULTS

In the first survey, 8227 uncertainties were proposed by 2587 participants, of whom 18% were from black, Asian and minority ethnic groups. Uncertainties were formatted and collated into 114 indicative questions. A total of 1506 people contributed to a second survey, generating a shortlist of 24 questions equally weighted to the contributions of people living with diabetes and their carers and those of healthcare professionals. In the final step the 'top 10 research priorities' were selected, including questions on cure and reversal, risk identification and prevention, and self-management approaches in Type 2 diabetes.

CONCLUSION

Systematic and transparent methodology was used to identify research priorities in a large and genuine partnership of people with lived and professional experience of Type 2 diabetes. The top 10 questions represent consensus areas of research priority to guide future research, deliver responsive and strategic allocation of research resources, and improve the future health and well-being of people living with, and at risk of, Type 2 diabetes.

Stochastic satisficing account of confidence in uncertain value-based decisions

Every day we make choices under uncertainty; choosing what route to work or which queue in a supermarket to take, for example. It is unclear how outcome variance, e.g. uncertainty about waiting time in a queue, affects decisions and confidence when outcome is stochastic and continuous. How does one evaluate and choose between an option with unreliable but high expected reward, and an option with more certain but lower expected reward? Here we used an experimental design where two choices’ payoffs took continuous values, to examine the effect of outcome variance on decision and confidence. We found that our participants’ probability of choosing the good (high expected reward) option decreased when the good or the bad options’ payoffs were more variable. Their confidence ratings were affected by outcome variability, but only when choosing the good option. Unlike perceptual detection tasks, confidence ratings correlated only weakly with decisions’ time, but correlated with the consistency of trial-by-trial choices. Inspired by the satisficing heuristic, we propose a “stochastic satisficing” (SSAT) model for evaluating options with continuous uncertain outcomes. In this model, options are evaluated by their probability of exceeding an acceptability threshold, and confidence reports scale with the chosen option’s thus-defined satisficing probability. Participants’ decisions were best explained by an expected reward model, while the SSAT model provided the best prediction of decision confidence. We further tested and verified the predictions of this model in a second experiment. Our model and experimental results generalize the models of metacognition from perceptual detection tasks to continuous-value based decisions. Finally, we discuss how the stochastic satisficing account of decision confidence serves psychological and social purposes associated with the evaluation, communication and justification of decision-making.

The Active Inference Approach to Ecological Perception: General Information Dynamics for Natural and Artificial Embodied Cognition

The emerging neurocomputational vision of humans as embodied, ecologically embedded, social agents—who shape and are shaped by their environment—offers a golden opportunity to revisit and revise ideas about the physical and information-theoretic underpinnings of life, mind, and consciousness itself. In particular, the active inference framework (AIF) makes it possible to bridge connections from computational neuroscience and robotics/AI to ecological psychology and phenomenology, revealing common underpinnings and overcoming key limitations. AIF opposes the mechanistic to the reductive, while staying fully grounded in a naturalistic and information-theoretic foundation, using the principle of free energy minimization. The latter provides a theoretical basis for a unified treatment of particles, organisms, and interactive machines, spanning from the inorganic to organic, non-life to life, and natural to artificial agents. We provide a brief introduction to AIF, then explore its implications for evolutionary theory, ecological psychology, embodied phenomenology, and robotics/AI research. We conclude the paper by considering implications for machine consciousness.