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Decision-making with multiple alternatives.

ABSTRACT: Simple perceptual tasks have laid the groundwork for understanding the neurobiology of decision-making. Here, we examined this foundation to explain how decision-making circuitry adjusts in the face of a more difficult task. We measured behavioral and physiological responses of monkeys on a two- and four-choice direction-discrimination decision task. For both tasks, firing rates in the lateral intraparietal area appeared to reflect the accumulation of evidence for or against each choice. Evidence accumulation began at a lower firing rate for the four-choice task, but reached a common level by the end of the decision process. The larger excursion suggests that the subjects required more evidence before making a choice. Furthermore, on both tasks, we observed a time-dependent rise in firing rates that may impose a deadline for deciding. These physiological observations constitute an effective strategy for handling increased task difficulty. The differences appear to explain subjects' accuracy and reaction times.

SUBMITTER: Churchland AK

PROVIDER: S-EPMC2453226 | biostudies-literature | 2008 Jun

REPOSITORIES: biostudies-literature

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Decision-making with multiple alternatives.

Churchland Anne K AK Kiani Roozbeh R Shadlen Michael N MN

Nature neuroscience 20080518 6

Simple perceptual tasks have laid the groundwork for understanding the neurobiology of decision-making. Here, we examined this foundation to explain how decision-making circuitry adjusts in the face of a more difficult task. We measured behavioral and physiological responses of monkeys on a two- and four-choice direction-discrimination decision task. For both tasks, firing rates in the lateral intraparietal area appeared to reflect the accumulation of evidence for or against each choice. Evidenc ...[more]

PMID: 18488024

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Project description:Background:Despite similar survival rates, breast-conserving therapy (BCT) remains a distant second choice after simple mastectomy for patients with early-stage breast cancer in Singapore. Uptake of reconstruction after mastectomy is also low (18 per cent). The aim of this study was to explore the factors influencing a patient's choice for mastectomy when eligible for BCT, and why patients decline reconstruction after mastectomy. Methods:Patients from the National Cancer Centre Singapore, who were eligible for BCT but chose mastectomy without reconstruction, between December 2014 and December 2015 were included. An interviewer-administered questionnaire focusing on patients' reasons for choosing mastectomy over BCT and not opting for immediate breast reconstruction after mastectomy was used. Tumour characteristics were retrieved from medical records. Spearman's rank correlation coefficient, Mann-Whitney U and Kruskal-Wallis tests were used to analyse the correlation between the patient's self-rated influential factors and variables. Statistical significance was taken as P < 0·050. Results:Ninety-one patients were included (90·1 per cent response rate). The main reasons for choosing mastectomy over BCT were: fear of cancer recurrence (considered very important in 74 per cent), the perception that health outweighs breast retention (49 per cent) and the possibility of second surgery for margins (40 per cent). Key factors for rejecting immediate reconstruction after mastectomy were: patient-perceived 'old age' (very important in 53 per cent), concern about two sites of surgery (42 per cent) and financial cost (29 per cent). Given a second chance, 19·8 per cent of patients would undergo BCT instead of mastectomy. Conclusion:This study has identified the considerations that women in Singapore have when deciding on breast cancer surgery. Some perceptions need to be addressed for women to make a fully informed decision, especially as one-fifth regret their initial choice.

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Decision-making with multiple alternatives.

Publications

Decision-making with multiple alternatives.

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