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- Botvinik-Nezer, Rotem, et al.
(författare)
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Variability in the analysis of a single neuroimaging dataset by many teams
- 2020
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 582, s. 84-88
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Tidskriftsartikel (refereegranskat)abstract
- Data analysis workflows in many scientific domains have become increasingly complex and flexible. Here we assess the effect of this flexibility on the results of functional magnetic resonance imaging by asking 70 independent teams to analyse the same dataset, testing the same 9 ex-ante hypotheses(1). The flexibility of analytical approaches is exemplified by the fact that no two teams chose identical workflows to analyse the data. This flexibility resulted in sizeable variation in the results of hypothesis tests, even for teams whose statistical maps were highly correlated at intermediate stages of the analysis pipeline. Variation in reported results was related to several aspects of analysis methodology. Notably, a meta-analytical approach that aggregated information across teams yielded a significant consensus in activated regions. Furthermore, prediction markets of researchers in the field revealed an overestimation of the likelihood of significant findings, even by researchers with direct knowledge of the dataset(2-5). Our findings show that analytical flexibility can have substantial effects on scientific conclusions, and identify factors that may be related to variability in the analysis of functional magnetic resonance imaging. The results emphasize the importance of validating and sharing complex analysis workflows, and demonstrate the need for performing and reporting multiple analyses of the same data. Potential approaches that could be used to mitigate issues related to analytical variability are discussed. The results obtained by seventy different teams analysing the same functional magnetic resonance imaging dataset show substantial variation, highlighting the influence of analytical choices and the importance of sharing workflows publicly and performing multiple analyses.
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| 2. |
- Omar, Faisal, et al.
(författare)
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Attitudes towards priority-setting and rationing in healthcare - an exploratory survey of Swedish medical students
- 2009
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 37:2, s. 122-130
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healthcare priority-setting is inextricably linked to the challenge of providing publicly funded healthcare within a limited budget, which may result in difficult and potentially controversial rationing decisions. Despite priority-settings increasing prominence in policy and academic discussion, it is still unclear what the level of understanding and acceptance of priority-setting is at different levels of health care. Aims: The aim of this study is threefold. First we wish to explore the level of familiarity with different aspects of priority-setting among graduating medical students. Secondly, to gauge their acceptance of both established and proposed Swedish priority-setting principles. Finally to elucidate their attitudes towards healthcare rationing and the role of different actors in decision making, with a particular interest in comparing the attitudes of medical students with data from the literature examining the attitudes among primary care patients in Sweden. Methods: A cross-sectional survey containing 14 multiple choice items about priority-setting in healthcare was distributed to the graduating medical class at Linkoping University. The response rate was 92% (43/47). Results: Less than half of respondents have encountered the notion of open priority-setting, and the majority believed it to be somewhat or very unclear. There is a high degree of awareness and agreement with the established ethical principles for priority-setting in Swedish health care; however respondents are inconsistent in their application of the cost-effectiveness principle. A larger proportion of respondents were more favourable to physicians and other health personnel being responsible for rationing decisions as opposed to politicians. Conclusions: Future discussion about priority-setting in medical education should be contextualized within an explicit and open process. There is a need to adequately clarify the role of the cost-effectiveness principle in priority-setting. Medical students seem to acknowledge the need for rationing in healthcare to a greater extent when compared with previous results from Swedish primary care patients.
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| 4. |
- Omar, Faisal, et al.
(författare)
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Transplant tourism and compensated kidney donation : A survey of opinions amongst Swedish medical students
- 2010
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Ingår i: International Journal of Health Promotion & Education. - 1463-5240. ; 48:4, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Transplant tourism and proposals for regulated compensated donation are reactions to the global scarcity in kidneys. These areas raise unique ethical challenges in medical education and clinical practice. We aimed to elucidate the opinions of soon-to-be physicians on transplant tourism, and compensated donation. We investigated how these opinions are formed, if they are interrelated, and their impact on encounters with patients. Design and Methods: a 14 item survey was developed using cognitive interviewing techniques, and distributed to the graduating class at Linköping Medical University. Spearman's correlation coefficient and Pearson's chi-square test were employed to investigate significant associations. Results: The response rate was 43/47 (92%). The majority were strongly (64%), or somewhat (29%) against transplant tourism. Those with strong negative positions on transplant tourism were significantly (p<0.05) more likely to dissuade patients from pursuing it. More students expressed support for regulated compensation from a clinical perspective (34%) as compared with support from an ethical perspective (15%). Conclusions: The opinions of young physicians on transplant tourism are a significant indicator for their clinical approach. Young physicians balance competing ethical responsibilities such as respect for autonomy against concerns for kidney vendors in the developing world. Clinical and policy scenarios, similar to those used in this survey are useful tools for students to explore challenging ethical issues within their medical education, to provide appropriate guidance for patients and empower them through health education.
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| 5. |
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| 6. |
- Tinghög, Gustav, 1979-, et al.
(författare)
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Horizontal Inequality in Rationing by Waiting Lists
- 2014
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Ingår i: International Journal of Health Services. - : Baywood Publishing Company, Inc.. - 0020-7314 .- 1541-4469. ; 44:1, s. 169-184
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this article was to investigate the existence of horizontal inequality in access to care for six categories of elective surgery in a publicly funded system, when care is rationed through waiting lists. Administrative waiting time data on all elective surgeries (n = 4,634) performed in Östergötland, Sweden, in 2007 were linked to national registers containing variables on socioeconomic indicators. Using multiple regression, we tested five hypotheses reflecting that more resourceful groups receive priority when rationing by waiting lists. Low disposable household income predicted longer waiting times for orthopedic surgery (27%, p < 0.01) and general surgery (34%,p < 0.05). However, no significant differences on the basis of ethnicity and gender were detected. A particularly noteworthy finding was that disposable household income appeared to be an increasingly influential factor when the waiting times were longer. Our findings reveal horizontal inequalities in access to elective surgeries, but only to a limited extent. Whether this is good or bad depends on one's moral inclination. From a policymaker's perspective, it is nevertheless important to recognize that horizontal inequalities arise even though care is not rationed through ability to pay.
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| 9. |
- Andersson, David
(författare)
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Deciding Fast and Slow : How Intuitive and Reflective Thinking Influence Decision Making
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Paper I “Intuition and cooperation reconsidered”: Does intuition make people more cooperative? Rand et al. (Rand, Greene, & Nowak, 2012) reported increased cooperation in social dilemmas after forcing individuals to decide quickly. We test the robustness of this finding in a series of five experiments involving about 2,500 subjects in three countries. None of the experiments confirms the Rand et al. (2012) finding, indicating that their result was an artefact of excluding about 50% of the subjects who failed to respond on time.Paper II “Intuition and moral decision-making – the effect of time pressure and cognitive load on moral judgment and altruistic behavior”: Do individuals intuitively favor certain moral actions over others? This study explores the role of intuitive thinking — induced by time pressure and cognitive load — in moral judgment and behavior. Overall we find converging evidence that intuitive states do not influence moral decisions. Across all samples and decision tasks men were more likely to make utilitarian moral judgments and act selfishly compared to women, providing further evidence that there are robust gender differences in moral decision-making.Paper III “Public views on policies involving nudges”: When should nudging be deemed as permissible and when should it be deemed as intrusive to individuals’ freedom of choice? The main objective of this study is to elicit public views on the use of nudges in policy. In particular we investigate attitudes toward two broad categories of nudges that we label pro-self (i.e. focusing on private welfare) and pro-social (i.e. focusing on social welfare) nudges. Results show that the level of acceptance toward nudge-policies was generally high. Nudge polices classified as pro-social had a significantly lower acceptance rate compared to pro-self nudges.Paper IV “The effect of fast and slow decisions on financial risk-taking”: Are individuals financial risk taking influenced by time available? We experimentally compare fast and slow decisions in a series of experiments on financial risk taking in three countries involving over 1,700 subjects. We find that time pressure increases risk aversion for gains and risk taking for losses compared to time delay; implying that time pressure increase the reflection effect of Prospect Theory.Paper V “Incidental effect and financial risk-taking – a neural investigation: This study builds on the results from Paper IV. Here I explore the influence of incidental negative emotions on financial risk-taking in an fMRI environment in order to assess underlying neural mechanisms. I experimentally compare neutral and unpleasant valence framing on gambles involving pure monetary gain and pure monetary loss. I find a significantly increased BOLD response in left amygdala and bilateral visual cortex when contrasting when showing unpleasant pictures, a neural effect which is in line with previous neuroimaging studies on negative emotions. However the neural effect of showing unpleasant pictures did not affect choices in the risk tasks. Consequently, I did not find any support for the hypothesis that the reflection effect of Prospect theory should be more pronounced when making risky choices influenced by incidental negative emotions.
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