Cognitive abilities affect decision errors but not risk preferences: A meta-analysis

Physicians' responses to time pressure: Experimental evidence on treatment quality and documentation behaviour

BACKGROUND

In hospitals, decisions are often made under time pressure. There is, however, little evidence on how time pressure affects the quality of treatment and the documentation behaviour of physicians.

SETTING

We implemented a controlled laboratory experiment with a healthcare framing in which international medical students in the Czech Republic treated patients in the role of hospital physicians. We varied the presence of time pressure and a documentation task.

RESULTS

We observed worse treatment quality when individuals were faced with a combination of a documentation task and time pressure. In line with the concept of the speed-accuracy trade-off, we showed that quality changes are likely driven by less accuracy. Finally, we showed that while documentation quality was relatively high overall, time pressure significantly lowered the latter leading to a higher hypothetical profit loss for the hospital.

CONCLUSIONS

Our results suggest that policy reforms aimed at increasing staffing and promoting novel technologies that facilitate physicians' treatment decisions and support their documentation work in the hospital sector might be promising means of improving the treatment quality and reducing inefficiencies potentially caused by documentation errors.

Decision-making under risk and its correlates in schizophrenia

Schizophrenia spectrum disorders (SSD) are associated with pervasive cognitive impairments, including deficits in decision-making under risk. However, there is inconclusive evidence regarding specific mechanisms underlying altered decision-making patterns. In this study, participants (33 SSD and 28 non-SSD) completed the Columbia Card Task, an explicit risk-taking task, to better understand risk preference and adjustment in dynamic decision-making. We found that while there is no group difference in overall risk-taking, risk preference, or optimal decision-making, risk adjustment to contextual factors (e.g., loss probability) is blunted in SSD. We also found associations between risk-taking/suboptimal decision-making and disorganized symptoms, excited symptoms, and role functioning, but no associations between decision-making and working memory. These results suggest that during a complex, dynamic risk-taking task, individuals with SSD exhibit less adaption to changing information about risk, which may reflect risk imperception.

Fast & slow decisions under risk: Intuition rather than deliberation drives advantageous choices

Would you take a gamble with a 10% chance to gain $100 and a 90% chance to lose $10? Even though this gamble has a positive expected value, most people would avoid taking it given the high chance of losing money. Popular "fast-and-slow" dual process theories of risky decision making assume that to take expected value into account and avoid a loss aversion bias, people need to deliberate. In this paper we directly test whether reasoners can also consider expected value benefit intuitively, in the absence of deliberation. To do so, we presented participants with bets and lotteries in which they could choose between a risky expected-value-based choice and a safe loss averse option. We used a two-response paradigm where participants made two choices in every trial: an initial intuitive choice under time-pressure and cognitive load and a final choice without constraints where they could freely deliberate. Results showed that in most trials participants were loss averse, both in the intuitive and deliberate stages. However, when people opted for the expected-value-based choice after deliberating, they had predominantly already arrived at this choice intuitively. Additionally, loss averse participants often showed an intuitive sensitivity to expected value (as reflected in decreased confidence). Overall, these results suggest that deliberation is not the primary route for expected-value-based responding in risky decision making. Risky decisions may be better conceptualized as an interplay between different types of "fast" intuitions rather than between two different types of "fast" and "slow" thinking per se.

Functional brain network properties correlate with individual risk tolerance in young adults

Background

Individuals differ substantially in their degree of acceptance of risks, referred to as risk tolerance, and these differences are associated with real-life outcomes such as risky health-related behaviors. While previous studies have identified brain regions that are functionally associated with individual risk tolerance, little is known about the relationship between individual risk tolerance and whole-brain functional organization.

Methods

This study investigated whether the topological properties of individual functional brain networks in healthy young adults (n = 67) are associated with individual risk tolerance using resting-state fMRI data in conjunction with a graph theoretical analysis approach.

Results

The analysis revealed that individual risk tolerance was positively associated with global topological properties, including the normalized clustering coefficient and small-worldness, which represent the degree of information segregation and the balance between information segregation and integration in a network, respectively. Additionally, individuals with higher risk tolerance exhibited greater centrality in the ventromedial prefrontal cortex (vmPFC), which is associated with the subjective value of the available options.

Conclusion

These results extend our understanding of how individual differences in risk tolerance, especially in young adults, are associated with functional brain organization, particularly regarding the balance between segregation and integration in functional networks, and highlight the important role of the connections between the vmPFC and the rest of the brain in the functional networks in relation to risk tolerance.

The link between cognitive abilities and risk preference depends on measurement

Risk preference is an important construct for understanding individual differences in risk taking throughout the behavioral sciences. An active stream of research has focused on better understanding risk preference through its connection to other psychological constructs, in particular, cognitive abilities. Here, we examine two large-scale multimethod data sets and demonstrate that the method used to measure risk preference is an important moderator. In self-report measures, we found small but consistent positive correlations between working memory capacity/numeracy, facets of cognitive abilities, and risk tolerance. In behavioral measures, we found, on average, no correlation and large intermethod heterogeneity. This heterogeneity can be explained by the choice architecture that is created in behavioral methods-in particular, the relation between risk and reward and the impact of decision error in a task. Consequently, investigating how risk preference relates to psychological constructs such as cognitive abilities require a profound understanding of the choice architecture in measurements of risk preference and in the real world.