C.G. Chorus
Please Note
94 records found
1
Withholding and withdrawing life-sustaining therapy (LST) is common in European ICUs but significant variations exist. Behaviour artificial intelligence technology (BAIT) may help standardize the ethical dilemma to continue or withdraw LST for patients already admitted to the ICU.
Methods
Several sessions with intensivists of an academic medical centre and a large urban teaching hospital were held to determine the criteria influencing the process. A discrete choice experiment was conducted during which 25 hypothetical cases were presented to the participants. For each case the participants had to decide whether they would continue, continue with a time limited trial of one week, or withdraw LST. The results of the experiment were used to develop a multinomial logistic regression model that was incorporated in a web-based decision-support system.
Results
Thirty-six participants (intensivists and fellows in intensive care medicine) completed the experiment. The estimated model consisted of twelve covariates and showed good model fit (McFadden’s ρ2 0.25). The most important covariates were age, patient values, expected cardiovascular and pulmonary impairment after ICU discharge and frailty at admission. The BAIT system lets intensivists view expected decisions based on documented criteria and uses color-coding to show the magnitude of the effect and its direction (i.e. to continue or withdraw LST).
Conclusions
We developed a BAIT system that may support clinicians facing the dilemma of continuing or withdrawing LST by elucidating the key criteria involved in assessing medical futility. ...
Withholding and withdrawing life-sustaining therapy (LST) is common in European ICUs but significant variations exist. Behaviour artificial intelligence technology (BAIT) may help standardize the ethical dilemma to continue or withdraw LST for patients already admitted to the ICU.
Methods
Several sessions with intensivists of an academic medical centre and a large urban teaching hospital were held to determine the criteria influencing the process. A discrete choice experiment was conducted during which 25 hypothetical cases were presented to the participants. For each case the participants had to decide whether they would continue, continue with a time limited trial of one week, or withdraw LST. The results of the experiment were used to develop a multinomial logistic regression model that was incorporated in a web-based decision-support system.
Results
Thirty-six participants (intensivists and fellows in intensive care medicine) completed the experiment. The estimated model consisted of twelve covariates and showed good model fit (McFadden’s ρ2 0.25). The most important covariates were age, patient values, expected cardiovascular and pulmonary impairment after ICU discharge and frailty at admission. The BAIT system lets intensivists view expected decisions based on documented criteria and uses color-coding to show the magnitude of the effect and its direction (i.e. to continue or withdraw LST).
Conclusions
We developed a BAIT system that may support clinicians facing the dilemma of continuing or withdrawing LST by elucidating the key criteria involved in assessing medical futility.
Gender violence encompasses a multitude of morally problematic psychological, physical, and sexual behaviors that, in most countries, constitute criminal offenses. In this study, we investigate the association between moral foundations (Care, Fairness, Loyalty, Authority, and Sanctity) and punitive responses to gender violence offenses. Our case study focuses on gender violence in Portugal, a country in which these offenses are a prevalent social problem. We collected data on gender violence legal cases decided in Portuguese courts between 2002 and 2022, and we used a latent class cluster analysis model to identify the complex patterns in the data and reduce such patterns to a distinct number of clusters. Four main clusters unravel latent relations between the foundations mapped in the legal narratives and corresponding punitive responses: (i) Affirmative with suspended prison time (moral rhetoric rooted in Authority); (ii) Mixed outcomes but no prison time (moral rhetoric rooted in Sanctity); (iii) Affirmative with lengthy prison time large compensation (moral rhetoric rooted in Loyalty and Care); and (iv) Affirmative with court fines (moral rhetoric rooted in Fairness). The moral foundations provide a valuable lens to understand the problem of gender violence, but further research is needed to establish the causal mechanisms between morality and punitive responses to gender violence.
Integral system safety for machine learning in the public sector
An empirical account
This paper introduces systems theory and system safety concepts to ongoing academic debates about the safety of Machine Learning (ML) systems in the public sector. In particular, we analyze the risk factors of ML systems and their respective institutional context, which impact the ability to control such systems. We use interview data to abductively show what risk factors of such systems are present in public professionals' perceptions and what factors are expected based on systems theory but are missing. Based on the hypothesis that ML systems are best addressed with a systems theory lens, we argue that the missing factors deserve greater attention in ongoing efforts to address ML systems safety. These factors include the explication of safety goals and constraints, the inclusion of systemic factors in system design, the development of safety control structures, and the tendency of ML systems to migrate towards higher risk. Our observations support the hypothesis that ML systems can be best regarded through a systems theory lens. Therefore, we conclude that system safety concepts can be useful aids for policymakers who aim to improve ML system safety.
Give and take
Moral aspects of travelers' intentions to participate in a hypothetical established social routing scheme
Data-driven assisted model specification for complex choice experiments data
Association rules learning and random forests for Participatory Value Evaluation experiments
Towards machine learning for moral choice analysis in health economics
A literature review and research agenda
Surgery or comfort care for neonates with surgical necrotizing enterocolitis
Lessons learned from behavioral artificial intelligence technology
In mobility panels, respondents may use a strategy of soft-refusal to lower their response burden, e.g. by claiming they did not leave their house even though they actually did. Soft-refusal leads to poor data quality and may complicate research, e.g. focused on people with actual low mobility. In this study we develop three methods to detect the presence of soft-refusal in mobility panels, based on respectively (observed and predicted) out-of-home activity, straightlining and speeding. For each indicator, we explore the relation with reported immobility and panel attrition. The results show that speeding and straightlining in a questionnaire is strongly related to reported immobility in a (self-reported) travel diary. Using a binary logit model, respondents who are predicted to leave their home but report no trips are identified as possible soft refusers. To reveal different patterns of soft-refusal and assess how these patterns influence the probability to drop out of the panel, a latent transition model is estimated. The results show four behavioral patterns with respect to soft-refusal ranging from a large class of reliable respondents who score positive on all three soft-refusal indicators, to a small ‘high-risk’ class of respondents who score poorly on all indicators. This ‘high-risk’ group also reports the highest immobility and has the highest attrition rate. The model also shows that respondents who do not drop out of the panel, tend to stay in the same behavioral pattern over time. The amount of soft-refusal expressed by a respondent therefore seems to be a stable behavioral trait.
Moral rhetoric in discrete choice models
A Natural Language Processing approach
The long road to automated trucking
Insights from driver focus groups
Decision Field Theory
Equivalence with probit models and guidance for identifiability
Economic theory is built on the assumption that people are omniscient utility maximizers. In reality, this is unlikely to be true and often people lack information about all alternatives that are available to them; either because the information is unavailable or that the cost of searching for and evaluating that information is high. In this paper, we develop a simple and tractable model that captures satisficing behavior. We show that the model can retrieve consistent parameters under a large range of experimental conditions. We test our model on synthetic data and present an empirical application. We discuss the implications of our results for the use of satisficing choice models in explaining choice.
Perceived challenges and opportunities of machine learning applications in governmental organisations
An interview-based exploration in the Netherlands
Together alone
A group-based polarization measurement