Displaying publications 1 - 20 of 312 in total

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  1. Chew KS, Durning SJ, van Merriënboer JJ
    Singapore Med J, 2016 Dec;57(12):694-700.
    PMID: 26778635 DOI: 10.11622/smedj.2016015
    INTRODUCTION: Metacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions.

    METHODS: Two groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.

    RESULTS: The mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.

    CONCLUSION: The results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.

    Matched MeSH terms: Clinical Decision-Making/methods*
  2. Wan Ahmad WN, Rezaei J, Tavasszy LA, de Brito MP
    J Environ Manage, 2016 Sep 15;180:202-13.
    PMID: 27233046 DOI: 10.1016/j.jenvman.2016.04.056
    Our current dependency on the oil and gas (O&G) industry for economic development and social activities necessitates research into the sustainability of the industry's supply chains. At present, studies on sustainable supply chain management (SSCM) practices in the industry do not include firm-internal factors that affect the sustainability strategies employed by different functional areas of its supply chains. Our study aims to address this gap by identifying the relevant internal factors and exploring their relationship with SSCM strategies. Specifically, we discuss the commitment to and preparedness for sustainable practices of companies that operate in upstream and downstream O&G supply chain. We study the impact of these factors on their sustainability strategies of four key supply chain functions: supplier management, production management, product stewardship and logistics management. The analyses of data collected through a survey among 81 companies show that management preparedness may enhance sustainable supply chain strategies in the O&G industry more than commitment does. Among the preparedness measures, management of supply chain operational risks is found to be vital to the sustainability of all supply chain functions except for production management practices. The findings also highlight the central importance of supplier and logistics management to the achievement of sustainable O&G supply chains. Companies must also develop an organizational culture that encourages, for example, team collaboration and proactive behaviour to finding innovative sustainability solutions in order to translate commitment to sustainable practices into actions that can produce actual difference to their SSCM practices.
    Matched MeSH terms: Decision Making, Organizational*
  3. Albahri OS, Al-Obaidi JR, Zaidan AA, Albahri AS, Zaidan BB, Salih MM, et al.
    Comput Methods Programs Biomed, 2020 Nov;196:105617.
    PMID: 32593060 DOI: 10.1016/j.cmpb.2020.105617
    CONTEXT: People who have recently recovered from the threat of deteriorating coronavirus disease-2019 (COVID-19) have antibodies to the coronavirus circulating in their blood. Thus, the transfusion of these antibodies to deteriorating patients could theoretically help boost their immune system. Biologically, two challenges need to be surmounted to allow convalescent plasma (CP) transfusion to rescue the most severe COVID-19 patients. First, convalescent subjects must meet donor selection plasma criteria and comply with national health requirements and known standard routine procedures. Second, multi-criteria decision-making (MCDM) problems should be considered in the selection of the most suitable CP and the prioritisation of patients with COVID-19.

    OBJECTIVE: This paper presents a rescue framework for the transfusion of the best CP to the most critical patients with COVID-19 on the basis of biological requirements by using machine learning and novel MCDM methods.

    METHOD: The proposed framework is illustrated on the basis of two distinct and consecutive phases (i.e. testing and development). In testing, ABO compatibility is assessed after classifying donors into the four blood types, namely, A, B, AB and O, to indicate the suitability and safety of plasma for administration in order to refine the CP tested list repository. The development phase includes patient and donor sides. In the patient side, prioritisation is performed using a contracted patient decision matrix constructed between 'serological/protein biomarkers and the ratio of the partial pressure of oxygen in arterial blood to fractional inspired oxygen criteria' and 'patient list based on novel MCDM method known as subjective and objective decision by opinion score method'. Then, the patients with the most urgent need are classified into the four blood types and matched with a tested CP list from the test phase in the donor side. Thereafter, the prioritisation of CP tested list is performed using the contracted CP decision matrix.

    RESULT: An intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19 to help doctors hasten treatments.

    DISCUSSION: The proposed framework implies the benefits of providing effective care and prevention of the extremely rapidly spreading COVID-19 from affecting patients and the medical sector.

    Matched MeSH terms: Decision Making
  4. Rogayah J, Zulkifli A
    Med J Malaysia, 2001 Sep;56(3):324-30.
    PMID: 11732078
    A total of 356 doctors responded to a survey on the timing and stability of choice of medical specialty. The majority of doctors made their final decision while working as a medical officer. One hundred (48.5%) of the doctors had made an earlier choice as medical students, 63 (30.6%) during their internship and 43 (20.9%) made their final choice while they were medical officers. Working experience in the specialty was the most important factor in determining final choice of specialty. Advice from consultants/seniors, better financial prospects and parental influence were more important for the male doctors while marriage and family considerations were more important for the female doctors in making their final choice.
    Matched MeSH terms: Decision Making
  5. Mohammed Shuaib, Zarita Zainuddin
    Sains Malaysiana, 2017;46:1997-2005.
    Integrating an exit choice model into a microscopic crowd dynamics model is an essential approach for obtaining more
    efficient evacuation model. We describe various aspects of decision-making capability of an existing rule-based exit
    choice model for evacuation processes. In simulations, however, the simulated evacuees clogging at exits have behaved
    non-intelligently, namely they do not give up their exits for better ones for safer egress. We refine the model to endow
    the individuals with the ability to leave their exits due to dynamic changes by modifying the model of their excitement
    resulted from the source of panic. This facilitates the approximately equal crowd size at exits for being until the end
    of the evacuation process, and thereby the model accomplishes more optimal evacuation. For further intelligence, we
    introduce the prediction factor that enables higher probability of equally distributing evacuees at exits. A simulation to
    validate the contribution is performed, and the results are analyzed and compared with the original model.
    Matched MeSH terms: Decision Making
  6. Voorhoeve A, Edejer TTT, Kapiriri L, Norheim OF, Snowden J, Basenya O, et al.
    Health Hum Rights, 2016 Dec;18(2):11-22.
    PMID: 28559673
    The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity, and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for those who are worse off in a number of dimensions (including health, access to health services, and social and economic status), and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting.
    Matched MeSH terms: Decision Making*
  7. Syed A, Mohd Don Z, Ng CJ, Lee YK, Khoo EM, Lee PY, et al.
    BMJ Open, 2017 05 09;7(5):e014260.
    PMID: 28490553 DOI: 10.1136/bmjopen-2016-014260
    OBJECTIVE: To investigate whether the use of apatient decision aid (PDA) for insulin initiation fulfils its purpose of facilitating patient-centred decision-making through identifying how doctors and patients interact when using the PDA during primary care consultations.
    DESIGN: Conversation analysis of seven single cases of audio-recorded/video-recorded consultations between doctors and patients with type 2 diabetes, using a PDA on starting insulin.
    SETTING: Primary care in three healthcare settings: (1) one private clinic; (2) two public community clinics and (3) one primary care clinic in a public university hospital, in Negeri Sembilan and the Klang Valley in Malaysia.
    PARTICIPANTS: Clinicians and seven patients with type 2 diabetes to whom insulin had been recommended. Purposive sampling was used to select a sample high in variance across healthcare settings, participant demographics and perspectives on insulin.
    PRIMARY OUTCOME MEASURES: Interaction between doctors and patients in a clinical consultation involving the use of a PDA about starting insulin.
    RESULTS: Doctors brought the PDA into the conversation mainly by asking information-focused 'yes/no' questions, and used the PDA for information exchange only if patients said they had not read it. While their contributions were limited by doctors' questions, some patients disclosed issues or concerns. Although doctors' PDA-related questions acted as a presequence to deliberation on starting insulin, their interactional practices raised questions on whether patients were informed and their preferences prioritised.
    CONCLUSIONS: Interactional practices can hinder effective PDA implementation, with habits from ordinary conversation potentially influencing doctors' practices and complicating their implementation of patient-centred decision-making. Effective interaction should therefore be emphasised in the design and delivery of PDAs and in training clinicians to use them.
    Matched MeSH terms: Decision Making
  8. Norhaiza K, Rozainee K, Mohd Noor Abdul H, Phillip H, McGill T, Zainah Ahmad Z
    Jurnal Psikologi Malaysia, 2016;30:102-113.
    This research examined how managers in universities incorporate non-financial measures in their Learning Management Systems decision-making processes and particularly focused on the importance of the Human Capital perspective in LMS decision making processes. A mixed-methods approach to data collection was used involving both interviews and questionnaires. The qualitative data from the interviews were coded and analysed. A descriptive coding method using thematic analysis was used for the data coding. The qualitative data were analysed using an inductive approach where the categories of criteria and indicators were not determined before the interview. The participants in this research were five members of LMS decision-making teams at two different universities in Australia and 24 participants from different universities in Malaysia who were involved in LMS decision- making processes at their universities. The results of this research indicated that there was substantial support for using a multi-dimensional decision making model among IT decision makers at universities, particularly the Human Capital perspective and they believed that Human Capital measures are important and should be considered in a LMS decision making process.The research has both implications for theory and for practitioners where it contributes to the knowledge on LMS decision making in universities and IT decision making in general, and also in improving actual decision making practices.
    Matched MeSH terms: Decision Making
  9. Fashiham Taib, Nur Arzuar Abdul Rahim, Mohd Rizal Mohd Zain, Mohamad Ikram Ilias, Nik Mohd Rizal Mohd Fakri, Zabidi Azhar Hussin
    MyJurnal
    The paper discusses on the complexity of the issues surrounding a patient with subluxation of cervical spine in a Down syndrome child. Several relevant issues are discussed including consent in a minor, conflicting decision making between parents and doctors, end-of-life issues, supporting handicapped child with minimal co-morbidities, community ethics, neglect of care by the caregiver and decision making after allowing zonal of parental discretion. Despite the difficulties surrounding parental actions, there are still ethical priorities which have to be considered individually to alleviate the suffering of the patients and the family members. Dealing with patients with chronic illnesses is a challenge for any medical doctors. The case warrants sensitive approach to allow appropriate respect for parental decision despite in disagreement with the clinical team. The term ‘zone of parental discretion’ refers to a controversial area of decision making; and has still many potential conflicts on day to day clinical cases, especially among the conservative society in the East Coast of Peninsular Malaysia.
    Matched MeSH terms: Decision Making
  10. Memon MA, Khan S, Alam K, Rahman MM, Yunus RM
    Surg Laparosc Endosc Percutan Tech, 2020 Dec 04;31(2):234-240.
    PMID: 33284258 DOI: 10.1097/SLE.0000000000000889
    In the era of evidence-based decision-making, systematic reviews (SRs) are being widely used in many health care policies, government programs, and academic disciplines. SRs are detailed and comprehensive literature review of a specific research topic with a view to identifying, appraising, and synthesizing the research findings from various relevant primary studies. A SR therefore extracts the relevant summary information from the selected studies without bias by strictly adhering to the review procedures and protocols. This paper presents all underlying concepts, stages, steps, and procedures in conducting and publishing SRs. Unlike the findings of narrative reviews, the synthesized results of any SRs are reproducible, not subjective and bias free. However, there are a number of issues related to SRs that directly impact on the quality of the end results. If the selected studies are of high quality, the criteria of the SRs are fully satisfied, and the results constitute the highest level of evidence. It is therefore essential that the end users of SRs are aware of the weaknesses and strengths of the underlying processes and techniques so that they could assess the results in the correct perspective within the context of the research question.
    Matched MeSH terms: Clinical Decision-Making*
  11. Partridge JC, Martinez AM, Nishida H, Boo NY, Tan KW, Yeung CY, et al.
    Pediatrics, 2005 Aug;116(2):e263-71.
    PMID: 16061579
    To characterize parent perceptions and satisfaction with physician counseling and delivery-room resuscitation of very low birth weight infants in countries with neonatal intensive care capacity.
    Matched MeSH terms: Decision Making*
  12. Nikpay F, Ahmad R, Yin Kia C
    Eval Program Plann, 2017 02;60:1-16.
    PMID: 27665066 DOI: 10.1016/j.evalprogplan.2016.09.001
    Enterprise Architecture (EA) implementation evaluation provides a set of methods and practices for evaluating the EA implementation artefacts within an EA implementation project. There are insufficient practices in existing EA evaluation models in terms of considering all EA functions and processes, using structured methods in developing EA implementation, employing matured practices, and using appropriate metrics to achieve proper evaluation. The aim of this research is to develop a hybrid evaluation method that supports achieving the objectives of EA implementation. To attain this aim, the first step is to identify EA implementation evaluation practices. To this end, a Systematic Literature Review (SLR) was conducted. Second, the proposed hybrid method was developed based on the foundation and information extracted from the SLR, semi-structured interviews with EA practitioners, program theory evaluation and Information Systems (ISs) evaluation. Finally, the proposed method was validated by means of a case study and expert reviews. This research provides a suitable foundation for researchers who wish to extend and continue this research topic with further analysis and exploration, and for practitioners who would like to employ an effective and lightweight evaluation method for EA projects.
    Matched MeSH terms: Decision Making
  13. Arasteh MA, Shamshirband S, Yee PL
    Technol Health Care, 2018;26(2):279-295.
    PMID: 29309042 DOI: 10.3233/THC-170947
    The most appropriate organizational software is always a real challenge for managers, especially, the IT directors. The illustration of the term "enterprise software selection", is to purchase, create, or order a software that; first, is best adapted to require of the organization; and second, has suitable price and technical support. Specifying selection criteria and ranking them, is the primary prerequisite for this action. This article provides a method to evaluate, rank, and compare the available enterprise software for choosing the apt one. The prior mentioned method is constituted of three-stage processes. First, the method identifies the organizational requires and assesses them. Second, it selects the best method throughout three possibilities; indoor-production, buying software, and ordering special software for the native use. Third, the method evaluates, compares and ranks the alternative software. The third process uses different methods of multi attribute decision making (MADM), and compares the consequent results. Based on different characteristics of the problem; several methods had been tested, namely, Analytic Hierarchy Process (AHP), Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), Elimination and Choice Expressing Reality (ELECTURE), and easy weight method. After all, we propose the most practical method for same problems.
    Matched MeSH terms: Decision Making*
  14. Miura F, Okamoto K, Takada T, Strasberg SM, Asbun HJ, Pitt HA, et al.
    J Hepatobiliary Pancreat Sci, 2018 Jan;25(1):31-40.
    PMID: 28941329 DOI: 10.1002/jhbp.509
    The initial management of patients with suspected acute biliary infection starts with the measurement of vital signs to assess whether or not the situation is urgent. If the case is judged to be urgent, initial medical treatment should be started immediately including respiratory/circulatory management if required, without waiting for a definitive diagnosis. The patient's medical history is then taken; an abdominal examination is performed; blood tests, urinalysis, and diagnostic imaging are carried out; and a diagnosis is made using the diagnostic criteria for cholangitis/cholecystitis. Once the diagnosis has been confirmed, initial medical treatment should be started immediately, severity should be assessed according to the severity grading criteria for acute cholangitis/cholecystitis, and the patient's general status should be evaluated. For mild acute cholangitis, in most cases initial treatment including antibiotics is sufficient, and most patients do not require biliary drainage. However, biliary drainage should be considered if a patient does not respond to initial treatment. For moderate acute cholangitis, early endoscopic or percutaneous transhepatic biliary drainage is indicated. If the underlying etiology requires treatment, this should be provided after the patient's general condition has improved; endoscopic sphincterotomy and subsequent choledocholithotomy may be performed together with biliary drainage. For severe acute cholangitis, appropriate respiratory/circulatory management is required. Biliary drainage should be performed as soon as possible after the patient's general condition has been improved by initial treatment and respiratory/circulatory management. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.
    Matched MeSH terms: Clinical Decision-Making
  15. Kumurasamy V, Ahmad Fairuz M, Taib F, Mat Pa MN, Mohd Nazri S, Norzila Z, et al.
    MyJurnal
    This paper discusses the ethical issues of patient autonomy based on a case of a patient who refused medication during Ramadhan fasting period. Issues on patient autonomy include the right of a patient to refuse medication, informed decision making, the importance of effective communication and the physician roles and responsibilities are discussed. In conclusion, patient autonomy must be respected and valued. However, the need of effective communication in facilitating informed decision making to improve doctor-patient relationship, should not be overlooked and compromised.
    Matched MeSH terms: Decision Making
  16. Aljunid SM, Srithamrongsawat S, Chen W, Bae SJ, Pwu RF, Ikeda S, et al.
    Value Health, 2012 2 1;15(1 Suppl):S132-8.
    PMID: 22265060 DOI: 10.1016/j.jval.2011.11.004
    This article sought to describe the health-care data situation in six selected economies in the Asia-Pacific region. Authors from Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia present their analyses in three parts. The first part of the article describes the data-collection process and the sources of data. The second part of the article presents issues around policies of data sharing with the stakeholders. The third and final part of the article focuses on the extent of health-care data use for policy reform in these different economies. Even though these economies differ in their economic structure and population size, they share some similarities on issues related to health-care data. There are two main institutions that collect and manage the health-care data in these economies. In Thailand, China mainland, Taiwan, and Malaysia, the Ministry of Health is responsible through its various agencies for collecting and managing the health-care data. On the other hand, health insurance is the main institution that collects and stores health-care data in South Korea and Japan. In all economies, sharing of and access to data is an issue. The reasons for limited access to some data are privacy protection, fragmented health-care system, poor quality of routinely collected data, unclear policies and procedures to access the data, and control on the freedom on publication. The primary objective of collecting health-care data in these economies is to aid the policymakers and researchers in policy decision making as well as create an awareness on health-care issues for the general public. The usage of data in monitoring the performance of the heath system is still in the process of development. In conclusion, for the region under discussion, health-care data collection is under the responsibility of the Ministry of Health and health insurance agencies. Data are collected from health-care providers mainly from the public sector. Routinely collected data are supplemented by national surveys. Accessibility to the data is a major issue in most of the economies under discussion. Accurate health-care data are required mainly to support policy making and evidence-based decisions.
    Matched MeSH terms: Decision Making
  17. Marshall N, Adger N, Attwood S, Brown K, Crissman C, Cvitanovic C, et al.
    PLoS One, 2017;12(3):e0171950.
    PMID: 28278238 DOI: 10.1371/journal.pone.0171950
    Failure to stem trends of ecological disruption and associated loss of ecosystem services worldwide is partly due to the inadequate integration of the human dimension into environmental decision-making. Decision-makers need knowledge of the human dimension of resource systems and of the social consequences of decision-making if environmental management is to be effective and adaptive. Social scientists have a central role to play, but little guidance exists to help them influence decision-making processes. We distil 348 years of cumulative experience shared by 31 environmental experts across three continents into advice for social scientists seeking to increase their influence in the environmental policy arena. Results focus on the importance of process, engagement, empathy and acumen and reveal the importance of understanding and actively participating in policy processes through co-producing knowledge and building trust. The insights gained during this research might empower a science-driven cultural change in science-policy relations for the routine integration of the human dimension in environmental decision making; ultimately for an improved outlook for earth's ecosystems and the billions of people that depend on them.
    Matched MeSH terms: Decision Making*
  18. Woo KT
    Ann Acad Med Singap, 1992 May;21(3):421-7.
    PMID: 1416796
    In Asian countries, it is more difficult to obtain cadaver kidneys for renal transplantation because of certain socio-cultural beliefs and customs. The issues affecting living related kidney donation are more social than cultural. This is due to the web of family pressures and personal conflicts for both donor and recipient surrounding the donation. Important misconceptions and fears are: fear of death, the belief that removal of organ violates sanctity of decreased, concern about being cut up after death, desire to be buried whole, dislike of idea of kidneys inside another person, wrong concept of brain death, and the idea of donation being against religious conviction. In Singapore, with the introduction of the Human Organ Transplant Act (HOTA) in 1988, the number of cadaveric transplants have increased, including those from the Medical Therapy Act (MTA). HOTA and education have played pivotal roles in bringing about an increased yield of cadaveric kidneys. With the availability of living unrelated donor (LUD) transplants in India, our living related donor (LRD) transplant programme has suffered, because patients would rather buy a kidney from overseas than get a relative to donate one. Patients are also going to China for overseas cadaveric transplants where the kidneys come from executed convicts. People in countries like Hong Kong, Japan and the Philippines share the same Asian tradition of not parting with their organs after death. Muslim countries like Malaysia require the deceased to have earlier pledged his kidneys for donation prior to death before they can be harvested for transplantation at death.
    Matched MeSH terms: Decision Making*
  19. Chamran MK, Yau KA, Noor RMD, Wong R
    Sensors (Basel), 2019 Dec 19;20(1).
    PMID: 31861500 DOI: 10.3390/s20010018
    This paper demonstrates the use of Universal Software Radio Peripheral (USRP), together with Raspberry Pi3 B+ (RP3) as the brain (or the decision making engine), to develop a distributed wireless network in which nodes can communicate with other nodes independently and make decision autonomously. In other words, each USRP node (i.e., sensor) is embedded with separate processing units (i.e., RP3), which has not been investigated in the literature, so that each node can make independent decisions in a distributed manner. The proposed testbed in this paper is compared with the traditional distributed testbed, which has been widely used in the literature. In the traditional distributed testbed, there is a single processing unit (i.e., a personal computer) that makes decisions in a centralized manner, and each node (i.e., USRP) is connected to the processing unit via a switch. The single processing unit exchanges control messages with nodes via the switch, while the nodes exchange data packets among themselves using a wireless medium in a distributed manner. The main disadvantage of the traditional testbed is that, despite the network being distributed in nature, decisions are made in a centralized manner. Hence, the response delay of the control message exchange is always neglected. The use of such testbed is mainly due to the limited hardware and monetary cost to acquire a separate processing unit for each node. The experiment in our testbed has shown the increase of end-to-end delay and decrease of packet delivery ratio due to software and hardware delays. The observed multihop transmission is performed using device-to-device (D2D) communication, which has been enabled in 5G. Therefore, nodes can either communicate with other nodes via: (a) a direct communication with the base station at the macrocell, which helps to improve network performance; or (b) D2D that improve spectrum efficiency, whereby traffic is offloaded from macrocell to small cells. Our testbed is the first of its kind in this scale, and it uses RP3 as the distributed decision-making engine incorporated into the USRP/GNU radio platform. This work provides an insight to the development of a 5G network.
    Matched MeSH terms: Decision Making
  20. Lee SL, Azmi S, Wong PS
    Med J Malaysia, 2012 Apr;67(2):190-8.
    PMID: 22822642 MyJurnal
    A cross-sectional study was conducted to explore clincians' baseline knowledge, practice beliefs and acceptance of intravenous (IV)-to-oral antibiotic switching practice in Hospital Pulau Pinang. The factors most highly rated for antibiotic conversion were the ability to maintain oral intake (85.6%) and microbiology etiology (85.0%). Majority of the clinicians (76%) agreed with the traditional clinical rule that "patient should be afebrile for 24 hours before IV-to-oral switch". Specialists and consultants had the highest knowledge score among the clinicians. However, they were generally less positive about a guideline being integrated into practice.
    Matched MeSH terms: Decision Making*
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