Claims by behavioural economists that our unconscious mind rules our behaviour lack sufficient scientific evidence

Psychologists and behavioural economists have been successfully arguing that the unconscious, intuitive part of the mind, as opposed to our more considered, analytical side, is what drives our behaviour. While the story sounds plausible, the evidence is worryingly unconvincing, writes Magda Osman. You can also listen Wise Choices, a recent public lecture at the LSE featuring Magda

The Role of Reward in Dynamic Decision Making

The present study investigates two aspects of decision making that have yet to be explored within a dynamic environment, (1) comparing the accuracy of cue-outcome knowledge under conditions in which knowledge acquisition is either through Prediction or Choice, and (2) examining the effects of reward on both Prediction and Choice. In the present study participants either learnt about the cue-outcome relations in the environment by choosing cue values in order to maintain an outcome to criterion (Choice-based decision making), or learnt to predict the outcome from seeing changes to the cue values (Prediction-based decision making). During training participants received outcome feedback and one of four types of reward manipulations: Positive Reward, Negative Reward, Both Positive + Negative Reward, No Reward. After training both groups of learners were tested on prediction and choice-based tasks. In the main, the findings revealed that cue-outcome knowledge was more accurate when knowledge acquisition was Choice-based rather than Prediction-based. During learning Negative Reward adversely affected Choice-based decision making while Positive Reward adversely affected predictive-based decision making. During the test phase only performance on tests of choice was adversely affected by having received Positive Reward or Negative Reward during training. This article proposes that the adverse effects of reward may reflect the additional demands placed on processing rewards which compete for cognitive resources required to perform the main goal of the task. This in turn implies that, rather than facilitate decision making, the presentation of rewards can interfere with Choice-based and Prediction-based decisions

Biased but in Doubt: Conflict and Decision Confidence

Human reasoning is often biased by intuitive heuristics. A central question is whether the bias results from a failure to detect that the intuitions conflict with traditional normative considerations or from a failure to discard the tempting intuitions. The present study addressed this unresolved debate by using people's decision confidence as a nonverbal index of conflict detection. Participants were asked to indicate how confident they were after solving classic base-rate (Experiment 1) and conjunction fallacy (Experiment 2) problems in which a cued intuitive response could be inconsistent or consistent with the traditional correct response. Results indicated that reasoners showed a clear confidence decrease when they gave an intuitive response that conflicted with the normative response. Contrary to popular belief, this establishes that people seem to acknowledge that their intuitive answers are not fully warranted. Experiment 3 established that younger reasoners did not yet show the confidence decrease, which points to the role of improved bias awareness in our reasoning development. Implications for the long standing debate on human rationality are discussed

Neoadjuvant Chemotherapy Followed By Conformal Hypofractionated Radiotherapy with Concurrent Gemcitabine in Muscle - Invasive Bladder Cancer

Purpose: The aim of this prospective, phase II trial was to determine the response of muscle-invasive bladder cancer (MIBC) to concurrent chemoradiotherapy (CRT) of weekly gemcitabine with conformal hypofractionated radiotherapy after neoadjuvant chemotherapy.Patients and Methods: Forty patients with transitional cell carcinoma, stage T2-4a, N0, M0 after magnetic resonance imaging were recruited. Transurethral resection was done and neoadjuvant chemotherapy with gemcitabine 1250 mg/m² on days 1 and 8 with cisplatin 100 mg/m2 on day1 repeated every three weeks was given. CRT phase included gemcitabine at 100 mg/m2 on days 1, 8, 15, and 22 of a 28-day RT schedule that delivered 52.5 Gy in 20 fractions. The end points were tumor response, toxicity, and survival.Results: Thirty three patients (82.5%) completed treatment protocol. Twenty five patients (75.8%) achieved a complete endoscopic response. The remaining 8 patients (24.2%) had residual disease. At a median follow-up of 23.5 months (range, 11 to 33 months), 19 patients (57.6%) had a functional and intact bladder. Four patients (12.1%) had a loco regional recurrences and 2 patients (6.1%) developed distant metastasis. By using Kaplan-Meier analysis, 2-year disease free survival was 64%, and overall survival was 77.5%. Out of the 33 patients who entered the CCRT phase, only 6 patients (18.2%) had grade 3 acute rectal or bladder toxicity. No one developed G3 late toxicity. Overall, side effects were tolerable and manageable.Conclusion: Concurrent gemcitabine-based CRT after neoadjuvant chemotherapy and TURBT is effective with high response rate, durable local control and acceptable toxicity, which allows patients to preserve their own bladder. However further investigations is needed to confirm these results in larger number in a phase III trial

Bluetooth Smartphone Apps: Are they the most private and effective solution for COVID-19 contact tracing?

Many digital solutions mainly involving Bluetooth technology are being proposed for Contact Tracing Apps (CTA) to reduce the spread of COVID-19. Concerns have been raised regarding privacy, consent, uptake required in a given population, and the degree to which use of CTAs can impact individual behaviours. However, very few groups have taken a holistic approach and presented a combined solution. None has presented their CTA in such a way as to ensure that even the most suggestible member of our community does not become complacent and assume that CTA operates as an invisible shield, making us and our families impenetrable or immune to the disease. We propose to build on some of the digital solutions already under development that, with addition of a Bayesian model that predicts likelihood for infection supplemented by traditional symptom and contact tracing, that can enable us to reach 90% of a population. When combined with an effective communication strategy and social distancing, we believe solutions like the one proposed here can have a very beneficial effect on containing the spread of this pandemic