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PURPOSE: To evaluate the effect of preference assessment method on treatment recommended by an individualized decision-analytic model for early prostate cancer. METHODS: Health state preferences were elicited by time tradeoff, rating scale, and a power transformation of the rating scale from 63 men ages 55 to 75. The authors used these values in a Markov model to determine whether radical prostatectomy or watchful waiting yielded the greater quality-adjusted life expectancy. RESULTS: Time tradeoff and transformed rating scale recommendations differed widely. Time tradeoff and transformed rating scale utilities differed in their treatment recommendation for 21% to 52% of men, and the mean difference in quality-adjusted life years varied from less than 0.5 to greater than 1.0. CONCLUSIONS: Treatment recommendations from the prostate cancer decision model were sensitive to the method of preference assessment. If decision analysis is used to counsel individual patients, careful consideration must be given to the method of preference elicitation. [ABSTRACT FROM AUTHOR]

The authors examine how a constructive preferences perspective might change the prevailing view of medical decision making by suggesting that the methods used to measure preferences for medical treatments can change the preferences that are reported. The authors focus on 2 possible techniques that they believe would result in better outcomes. The 1st is the wise selection of default options. Defaults may be best applied when strong clinical evidence suggests a treatment option to be correct for most people but preserving patient choice is appropriate. The 2nd is the use of environments that explicitly facilitate the optimal construction of preferences. This seems most appropriate when choice depends on a patient's ability to understand and represent probabilities and outcomes. For each technique, the authors describe the background and literature, provide a case study, and discuss applications. ((c) 2005 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

Importance: Policy makers have sought to discourage concurrent prescribing of opioids and benzodiazepines (coprescribing) because it is associated with overdose. Email alerts sent by pharmacists may reduce coprescribing, but this intervention lacks randomized evidence., Objective: To investigate whether pharmacist emails to practitioners caring for patients who recently received opioids and benzodiazepines reduce coprescribing of these medications., Design, Setting, and Participants: Randomized clinical trial (intention to treat) conducted in 2019-2021 of patients and their practitioners (prescribers and primary care managers) in the National Capital Region of the Military Health System. Participants were 2237 patients who were recently coprescribed opioids and benzodiazepines. These patients had 789 practitioners eligible for emails., Interventions: Patients were randomized to email alerts to their practitioners or as-usual care. Clinical pharmacists sent the email alert. Messages were standardized and designed to facilitate coordination between practitioners, increase awareness of guidelines, and provide action steps and resources., Main Outcomes and Measures: The primary outcomes were patients' days received of opioids, benzodiazepines, and concurrent opioids and benzodiazepines during the 90 days following enrollment evaluated using 1-sided hypothesis tests. Secondary outcomes included total prescribing of opioids and benzodiazepines by patients' practitioners, including to patients outside the study, to test for broader outcomes on their prescribing., Results: Of 2237 patients, 1187 were assigned to treatment and 1050 to control; 1275 (57%) were women. Patients received a mean (SD) of 31 (44) days of opioids and 33 (34) days of benzodiazepines in the 90 days before enrollment. There were no detected differences in the primary end points, including patients' receipt of opioids (adjusted difference, 1.1 days; 95% CI, -∞ to 3.0; P = .81), benzodiazepines (adjusted difference, -0.6 days; 95% CI, -∞ to 1.4; P = .30), and opioids and benzodiazepines together (adjusted difference, -0.1 days; 95% CI, -∞ to 0.7; P = .41). Of 789 practitioners, 429 were considered the treatment group, 325 were considered controls, and 35 were excluded. There were no detected differences in practitioners' total prescribing of opioids, benzodiazepines, or both drug classes together., Conclusions and Relevance: In this randomized clinical trial of pharmacist emails to practitioners, email alerts failed to detectably reduce coprescribing, highlighting the value of alternative approaches. Combining randomization with quality improvement activities may help stakeholders seeking evidence-based interventions to encourage guideline-concordant care., Trial Registration: ClinicalTrials.gov Identifier: NCT03887247.

Taking another person's perspective is widely presumed to increase interpersonal understanding. Very few experiments, however, have actually tested whether perspective taking increases accuracy when predicting another person's thoughts, feelings, attitudes, or other mental states. Those that do yield inconsistent results, or they confound accuracy with egocentrism. Here we report 25 experiments testing whether being instructed to adopt another person's perspective increases interpersonal insight. These experiments include a wide range of accuracy tests that disentangle egocentrism and accuracy, such as predicting another person's emotions from facial expressions and body postures, predicting fake versus genuine smiles, predicting when a person is lying or telling the truth, and predicting a spouse's activity preferences and consumer attitudes. Although a large majority of pretest participants believed that perspective taking would systematically increase accuracy on these tasks, we failed to find any consistent evidence that it actually did so. If anything, perspective taking decreased accuracy overall while occasionally increasing confidence in judgment. Perspective taking reduced egocentric biases, but the information used in its place was not systematically more accurate. A final experiment confirmed that getting another person's perspective directly, through conversation, increased accuracy but that perspective taking did not. Increasing interpersonal accuracy seems to require gaining new information rather than utilizing existing knowledge about another person. Understanding the mind of another person is therefore enabled by getting perspective, not simply taking perspective. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

In interpersonal interactions ranging from job interviews to romantic dates, it is common for people to tell each other about what they care about and value. Six experiments explored the general hypothesis that people view their disclosures about what they value as more revealing of themselves than do others. This effect is demonstrated across a variety of contexts, ranging from the brief and anonymous to the more in-depth and social. A source of it is explored in actors' feeling that their most important values are especially important to them. Studies suggest that this feeling involves actors' sense of the intensity with which they hold their values, as opposed to their beliefs about the uniqueness of those values. Studies also show that actors' tendency to view value disclosures as more revealing than do observers is somewhat specific to value disclosures--that is, actors do not view their relatively off-the-cuff responses (Study 4) or their disclosures of their nonvalues (Study 6) as more revealing. Implications of this research for self-other differences and for interpersonal intimacy are discussed.