Farzane Saeidifard, Akbar Soltani, Fereshteh Ghadiri, Sahar Manavi, Motahareh Taleba, Moein Foroughi, Parvaneh Ansari, Mostafa Qorbani, Hamideh Moosapour,
Volume 17, Issue 4 (5-2018)
Abstract
Background: It is critical to understand how accurately physicians can estimate the importance of each clinical finding in estimating the probability of a specific diagnosis in the process of clinical decision making. This study aimed to investigate whether physicians’ estimates of the importance of various clinical findings of ascites correlated with the positive likelihood ratios of these findings in diagnosis of ascites.
Methods: One hundred and ten physicians were asked to respond to a questionnaire. In this questionnaire they were presented with a clinical scenario about a patient suspected of having ascites followed by a list of clinical findings. Participants were asked to assign a weight (between 0 and 100%) to each clinical finding based on their perception of how much the presence of that finding changed the probability of ascites for the patient. Positive likelihood ratios of those findings were extracted from current best evidence. We investigated if the weights assigned by physicians were associated with the positive likelihood ratios of those findings.
Results: Significant differences were discovered between the weights assigned by the physicians and the positive likelihood ratios for each clinical finding. Significant positive correlation was observed between the weights assigned by different groups of physicians.
Conclusion: Physicians inaccurately estimated the importance of various clinical findings in the diagnosis of ascites. Further research is needed to determine if such inaccurate estimations would lead to any adverse clinical outcomes.
Nasim Rezaei Javan, Mehrnoush Bahmani, Amir Mohammad Teymorzadeh Najjar, Soodabeh Soltanzadeh, Alireza Falakdin, Mahmoud Feizipour Namaghi, Mahnoosh Kamranvand, Mohammad Hossein Mohammadi, Maryam Nouriyengejeh, Elahe Elahe Najafali Ghandehari, Ata Pourabbasi ,
Volume 26, Issue 1 (4-2026)
Abstract
Background: Decision-making is a cognitive process with complex neural underpinnings, fundamental to all human behavior. This study reviewed existing research to present a comprehensive model of this process, integrating the functions of specific brain regions with cognitive and emotional factors to create a complete framework.
Methods: Using a qualitative approach, we conducted a literature review across reputable databases. Neurocognitive factors were extracted and validated through a series of expert panel sessions with eight specialists. The final conceptual model was designed, and its validity was confirmed through a multi-stage consensus process.
Results: The model provides a comprehensive framework for understanding the neurocognitive mechanisms of decision-making. It integrates cognitive, emotional, and motivational factors—such as intention, emotion, and cognitive reserve—to explain how choices are made and outcomes are evaluated. The model emphasizes the key roles of the prefrontal cortex and the limbic system, and demonstrates how external stimuli influence this process.
Conclusion: This validated model offers an integrated framework for the decision-making process, highlighting the interplay between key brain regions and cognitive and emotional factors. The model has important applications in education, psychotherapy, and designing interventions to improve decision-making skills.
