Browsing by Subject "INFORMATION"

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  • Bagheri, Mehrdad; Mladenovic, Milos; Kosonen, Iisakki; Nurminen, Jukka K; Roncoli, Claudio; Ylä-Jääski, Antti (2020)
    Evaluating potential of shifting to low-carbon transport modes requires considering limited travel-time budget of travelers. Despite previous studies focusing on time-relevant modal shift, there is a lack of integrated and transferable computational frameworks, which would use emerging smartphone-based high-resolution longitudinal travel datasets. This research explains and illustrates a computational framework for this purpose. The proposed framework compares observed trips with computed alternative trips and estimates the extent to which alternatives could reduce carbon emission without a significant increase in travel time.. The framework estimates potential of substituting observed car and public-transport trips with lower-carbon modes, evaluating parameters per individual traveler as well as for the whole city, from a set of temporal and spatial viewpoints. The illustrated parameters include the size and distribution of modal shifts, emission savings, and increased active-travel growth, as clustered by target mode, departure time, trip distance, and spatial coverage throughout the city. Parameters are also evaluated based on the frequently repeated trips. We evaluate usefulness of the method by analyzing door-to-door trips of a few hundred travelers, collected from smartphone traces in the Helsinki metropolitan area, Finland, during several months. The experiment's preliminary results show that, for instance, on average, 20% of frequent car trips of each traveler have a low-carbon alternative, and if the preferred alternatives are chosen, about 8% of the carbon emissions could be saved. In addition, it is seen that the spatial potential of bike as an alternative is much more sporadic throughout the city compared to that of bus, which has relatively more trips from/to city center. With few changes, the method would be applicable to other cities, bringing possibly different quantitative results. In particular, having more thorough data from large number of participants could provide implications for transportation researchers and planners to identify groups or areas for promoting mode shift. Finally, we discuss the limitations and lessons learned, highlighting future research directions.
  • Izzo, Massimiliano; Mortola, Francesco; Arnulfo, Gabriele; Fato, Marco M.; Varesio, Luigi (2014)
    Motivation: Molecular biology laboratories require extensive metadata to improve data collection and analysis. The heterogeneity of the collected metadata grows as research is evolving in to international multi-disciplinary collaborations and increasing data sharing among institutions. Single standardization is not feasible and it becomes crucial to develop digital repositories with flexible and extensible data models, as in the case of modern integrated biobanks management. Results: We developed a novel data model in JSON format to describe heterogeneous data in a generic biomedical science scenario. The model is built on two hierarchical entities: processes and events, roughly corresponding to research studies and analysis steps within a single study. A number of sequential events can be grouped in a process building up a hierarchical structure to track patient and sample history. Each event can produce new data. Data is described by a set of user-defined metadata, and may have one or more associated files. We integrated the model in a web based digital repository with a data grid storage to manage large data sets located in geographically distinct areas. We built a graphical interface that allows authorized users to define new data types dynamically, according to their requirements. Operators compose queries on metadata fields using a flexible search interface and run them on the database and on the grid. We applied the digital repository to the integrated management of samples, patients and medical history in the BIT-Gaslini biobank. The platform currently manages 1800 samples of over 900 patients. Microarray data from 150 analyses are stored on the grid storage and replicated on two physical resources for preservation. The system is equipped with data integration capabilities with other biobanks for worldwide information sharing. Conclusions: Our data model enables users to continuously define flexible, ad hoc, and loosely structured metadata, for information sharing in specific research projects and purposes. This approach can improve sensitively interdisciplinary research collaboration and allows to track patients' clinical records, sample management information, and genomic data. The web interface allows the operators to easily manage, query, and annotate the files, without dealing with the technicalities of the data grid.
  • Nichols, Hazel J.; Arbuckle, Kevin; Sanderson, Jennifer L.; Vitikainen, Emma I. K.; Marshall, Harry H.; Thompson, Faye J.; Cant, Michael A.; Wells, David A. (2021)
    Personality traits, such as the propensity to cooperate, are often inherited from parents to offspring, but the pathway of inheritance is unclear. Traits could be inherited via genetic or parental effects, or culturally via social learning from role models. However, these pathways are difficult to disentangle in natural systems as parents are usually the source of all of these effects. Here, we exploit natural 'cross fostering' in wild banded mongooses to investigate the inheritance of cooperative behaviour. Our analysis of 800 adult helpers over 21 years showed low but significant genetic heritability of cooperative personalities in males but not females. Cross fostering revealed little evidence of cultural heritability: offspring reared by particularly cooperative helpers did not become more cooperative themselves. Our results demonstrate that cooperative personalities are not always highly heritable in wild, and that the basis of behavioural traits can vary within a species (here, by sex).
  • Walsh, Jessica C.; Dicks, Lynn V.; Raymond, Christopher M.; Sutherland, William J. (2019)
    Over the last decade, there has been an increased focus (and pressure) in conservation practice globally towards evidence-based or evidence-informed decision making. Despite calls for increased use of scientific evidence, it often remains aspirational for many conservation organizations. Contributing to this is the lack of guidance on how to identify and classify the array of complex reasons limiting research use. In this study, we collated a comprehensive inventory of 230 factors that facilitate or limit the use of scientific evidence in conservation management decisions, through interviews with conservation practitioners in South Africa and UK and a review of the healthcare literature. We used the inventory, combined with concepts from knowledge exchange and research use theories, to construct a taxonomy that categorizes the barriers and enablers. We compared the similarities and differences between the taxonomies from the conservation and the healthcare fields, and highlighted the common barriers and enablers found within conservation organizations in the United Kingdom and South Africa. The most commonly mentioned barriers limiting the use of scientific evidence in our case studies were associated with the day-to-day decision-making processes of practitioners, and the organizational structures, management processes and resource constraints of conservation organizations. The key characteristics that facilitated the use of science in conservation decisions were associated with an organization's structure, decision-making processes and culture, along with practitioners' attitudes and the relationships between scientists and practitioners. This taxonomy and inventory of barriers and enablers can help researchers, practitioners and other conservation actors to identify aspects within their organizations and cross-institutional networks that limit research use – acting as a guide on how to strengthen the science-practice interface.
  • Burunat, Iballa; Brattico, Elvira; Puoliväli, Tuomas; Ristaniemi, Tapani; Sams, Mikko; Toiviainen, Petri (2015)
    Musical training leads to sensory and motor neuroplastic changes in the human brain. Motivated by findings on enlarged corpus callosum in musicians and asymmetric somatomotor representation in string players, we investigated the relationship between musical training, callosal anatomy, and interhemispheric functional symmetry during music listening. Functional symmetry was increased in musicians compared to nonmusicians, and in keyboardists compared to string players. This increased functional symmetry was prominent in visual and motor brain networks. Callosal size did not significantly differ between groups except for the posterior callosum in musicians compared to nonmusicians. We conclude that the distinctive postural and kinematic symmetry in instrument playing cross-modally shapes information processing in sensory-motor cortical areas during music listening. This cross-modal plasticity suggests that motor training affects music perception.
  • Mattar, Marcelo G.; Olkkonen, Maria; Epstein, Russell A.; Aguirre, Geoffrey K. (2018)
    Perception and neural responses are modulated by sensory history. Visual adaptation, an example of such an effect, has been hypothesized to improve stimulus discrimination by decorrelating responses across a set of neural units. While a central theoretical model, behavioral and neural evidence for this theory is limited and inconclusive. Here, we use a parametric 3D shape-space to test whether adaptation decorrelates shape representations in humans. In a behavioral experiment with 20 subjects, we find that adaptation to a shape class improves discrimination of subsequently presented stimuli with similar features. In a BOLD fMRI experiment with 10 subjects, we observe that adaptation to a shape class decorrelates the multivariate representations of subsequently presented stimuli with similar features in object-selective cortex. These results support the long-standing proposal that adaptation improves perceptual discrimination and decorrelates neural representations, offering insights into potential underlying mechanisms.
  • Price, D.; Tyler, L. K.; Henriques, R. Neto; Campbell, K. L.; Williams, N.; Treder, M. S.; Taylor, J. R.; Henson, R. N. A.; Cam-CAN (2017)
    Slowing is a common feature of ageing, yet a direct relationship between neural slowing and brain atrophy is yet to be established in healthy humans. We combine magnetoencephalo-graphic (MEG) measures of neural processing speed with magnetic resonance imaging (MRI) measures of white and grey matter in a large population-derived cohort to investigate the relationship between age-related structural differences and visual evoked field (VEF) and auditory evoked field (AEF) delay across two different tasks. Here we use a novel technique to show that VEFs exhibit a constant delay, whereas AEFs exhibit delay that accumulates over time. White-matter (WM) microstructure in the optic radiation partially mediates visual delay, suggesting increased transmission time, whereas grey matter (GM) in auditory cortex partially mediates auditory delay, suggesting less efficient local processing. Our results demonstrate that age has dissociable effects on neural processing speed, and that these effects relate to different types of brain atrophy.
  • Bagheri, Mehrdad; Mladenović, Miloš N.; Kosonen, Iisakki; Nurminen, Jukka K (2020)
    Given the necessity to understand the modal shift potentials at the level of individual travel times, emissions, and physically active travel distances, there is a need for accurately computing such potentials from disaggregated data collection. Despite significant development in data collection technology, especially by utilizing smartphones, there are limited efforts in developing useful computational frameworks for this purpose. First, development of a computational framework requires longitudinal data collection of revealed travel behavior of individuals. Second, such a computational framework should enable scalable analysis of time-relevant low-carbon travel alternatives in the target region. To this end, this research presents an open-source computational framework, developed to explore the potential for shifting from private car to lower-carbon travel alternatives. In comparison to previous development, our computational framework estimates and illustrates the changes in travel time in relation to the potential reductions in emission and increases in physically active travel, as well as daily weather conditions. The potential usefulness of the framework was evaluated using long-term travel data of around a hundred travelers within the Helsinki Metropolitan Region, Finland. The case study outcomes also suggest that in several cases traveling by public transport or bike would not increase travel time compared to the observed car travel. Based on the case study results, we discuss potentially acceptable travel times for mode shift, and usefulness of the computational framework for decisions regarding transition to sustainable urban mobility systems. Finally, we discuss limitations and lessons learned for data collection and further development of similar computational frameworks.
  • Zheng, Zhong; Wei, Lu; Speicher, Roland; Muller, Ralf R.; Hämäläinen, Jyri; Corander, Jukka (2017)
    The Rayleigh product channel model is useful in capturing the performance degradation due to rank deficiency of MIMO channels. In this paper, such a performance degradation is investigated via the distribution of mutual information assuming the block fading channels and the uniform power transmission scheme. Using techniques of free probability theory, the asymptotic variance of mutual information is derived when the dimensions of the channel matrices approach infinity. In this asymptotic regime, the mutual information is rigorously proven to be Gaussian distributed. Using the obtained results, a fundamental tradeoff between multiplexing gain and diversity gain of Rayleigh product channels under the uniform power transmission can be characterized by the closed-form expression at any finite signal-to-noise ratio. Numerical results are provided to compare the outage performance between the Rayleigh product channels and the conventional Rayleigh MIMO channels.
  • Liu, Jia; Vanhatalo, Jarno (2020)
    In geostatistics, the spatiotemporal design for data collection is central for accurate prediction and parameter inference. An important class of geostatistical models is log-Gaussian Cox process (LGCP) but there are no formal analyses on spatial or spatiotemporal survey designs for them. In this work, we study traditional balanced and uniform random designs in situations where analyst has prior information on intensity function of LGCP and show that the traditional balanced and random designs are not efficient in such situations. We also propose a new design sampling method, a rejection sampling design, which extends the traditional balanced and random designs by directing survey sites to locations that are a priori expected to provide most information. We compare our proposal to the traditional balanced and uniform random designs using the expected average predictive variance (APV) loss and the expected Kullback-Leibler (KL) divergence between the prior and the posterior for the LGCP intensity function in simulation experiments and in a real world case study. The APV informs about expected accuracy of a survey design in point-wise predictions and the KL-divergence measures the expected gain in information about the joint distribution of the intensity field. The case study concerns planning a survey design for analyzing larval areas of two commercially important fish stocks on Finnish coastal region. Our experiments show that the designs generated by the proposed rejection sampling method clearly outperform the traditional balanced and uniform random survey designs. Moreover, the method is easily applicable to other models in general. (C) 2019 The Author(s). Published by Elsevier B.V.
  • Paukkunen, Mikko; Parkkila, Petteri; Hurnanen, Tero; Pankaala, Mikko; Koivisto, Tero; Nieminen, Tuomo; Kettunen, Raimo; Sepponen, Raimo (2016)
    The vibrations produced by the cardiovascular system that are coupled to the precordium can be noninvasively detected using accelerometers. This technique is called seismocardiography. Although clinical applications have been proposed for seismocardiography, the physiology underlying the signal is still not clear. The relationship of seismocardiograms of on the back-to-front axis and cardiac events is fairly well known. However, the 3-D seismocardiograms detectable with modern accelerometers have not been quantified in terms of cardiac cycle events. A major reason for this might be the degree of intersubject variability observed in 3-D seismocardiograms. We present a method to quantify 3-D seismocardiography in terms of cardiac cycle events. First, cardiac cycle events are identified from the seismocardiograms, and then, assigned a number based on the location in which the corresponding event was found. 396 cardiac cycle events from 9 healthy subjects and 120 cardiac cycle events from patients suffering from atrial flutter were analyzed. Despite the weak intersubject correlation of the waveforms (0.05, 0.27, and 0.15 for the x-, y-, and z-axes, respectively), the present method managed to find latent similarities in the seismocardiograms of healthy subjects. We observed that in healthy subjects the distribution of cardiac cycle event coordinates was centered on specific locations. These locations were different in patients with atrial flutter. The results suggest that spatial distribution of seismocardiographic cardiac cycle events might be used to discriminate healthy individuals and those with a failing heart.
  • Franks, V. R.; Andrews, C. E.; Ewen, J. G.; McCready, M.; Parker, K. A.; Thorogood, R. (2020)
    Reintroductions, essential to many conservation programmes, disrupt both abiotic and social environments. Despite growing recognition that social connections in animals might alter survival (e.g. social transmission of foraging skills, or transmission of disease), there has thus far been little focus on the consequences of social disruption during reintroductions. Here we investigate if moving familiar social groups may help a threatened species to adjust to its new environment and increase post-release survival. For a reintroduction of 40 juvenile hihi Notiomystis cincta (a threatened New Zealand passerine), we observed social groups before and after translocation to a new site and used social network analysis to study three levels of social change: overall group structure, network associations and individual sociality. We also tested alternate translocation strategies where birds were kept temporarily in aviaries in either a familiar group, or where their prior association was mixed. Although social structure remained similar among juveniles that remained at the source site, we detected significant changes in translocated birds at both the group- and individual- level post-release. However, our holding treatments did not affect these social bonds so we remain unable to maintain or manipulate social groups during translocation. Crucially, there was a small tendency for translocated juveniles that gained more associates during re-assortment of social groups to be more likely to survive their first year post-release. We suggest that prior sociality may not be important during translocations, but rather individuals that are most able to adapt and form associations at a new site are most likely to be the surviving founders of reintroduced populations.
  • He, Chen; Micallef, Luana; He, Liye; Peddinti, Gopal; Aittokallio, Tero; Jacucci, Giulio (2021)
    Understanding the quality of insight has become increasingly important with the trend of allowing users to post comments during visual exploration, yet approaches for qualifying insight are rare. This article presents a case study to investigate the possibility of characterizing the quality of insight via the interactions performed. To do this, we devised the interaction of a visualization tool—MediSyn—for insight generation. MediSyn supports five types of interactions: selecting, connecting, elaborating, exploring, and sharing. We evaluated MediSyn with 14 participants by allowing them to freely explore the data and generate insights. We then extracted seven interaction patterns from their interaction logs and correlated the patterns to four aspects of insight quality. The results show the possibility of qualifying insights via interactions. Among other findings, exploration actions can lead to unexpected insights; the drill-down pattern tends to increase the domain values of insights. A qualitative analysis shows that using domain knowledge to guide exploration can positively affect the domain value of derived insights. We discuss the study’s implications, lessons learned, and future research opportunities.
  • Ravikumar, Balaguru; Timonen, Sanna; Alam, Zaid; Parri, Elina; Wennerberg, Krister; Aittokallio, Tero (2019)
    Owing to the intrinsic polypharmacological nature of most small-molecule kinase inhibitors, there is a need for computational models that enable systematic exploration of the chemogenomic landscape underlying druggable kinome toward more efficient kinome-profiling strategies. We implemented Virtual-KinomeProfiler, an efficient computational platform that captures distinct representations of chemical similarity space of the druggable kinome for various drug discovery endeavors. By using the computational platform, we profiled approximately 37 million compound-kinase pairs and made predictions for 151,708 compounds in terms of their repositioning and lead molecule potential, against 248 kinases simultaneously. Experimental testing with biochemical assays validated 51 of the predicted interactions, identifying 19 small-molecule inhibitors of EGFR, HCK, FLT1, and MSK1 protein kinases. The prediction model led to a 1.5-fold increase in precision and 2.8-fold decrease in false-discovery rate, when compared with traditional single-dose biochemical screening, which demonstrates its potential to drastically expedite the kinome-specific drug discovery process.
  • Locatelli, Bruno; Pramova, Emilia; Di Gregorio, Monica; Brockhaus, Maria; Chávez, Dennis Armas; Tubbeh, Ramzi; Sotes, Juan; Perla, Javier (2020)
    Increasing attention is being given to integrating adaptation and mitigation in climate change policies. Policy network analysis is a way to explore connections between adaptation and mitigation, and the opportunities or barriers to effective integration between these two policy subdomains. This study explores climate governance and policy networks by examining collaboration and information flows in national policy processes in Peru, a country with an active climate change policy domain. In contrast to most climate policy network analyses, this study distinguishes adaptation and mitigation subdomains through a multiplex approach. We used ERGM (Exponential Random Graph Models) to explain the existence of information flows and collaborations among 76 key actors in climate change policy in Peru. We identified actors who could connect adaptation and mitigation subdomains. Results show a concentration of influence in national government actors, particularly in the mitigation subdomain, and the isolation of actor groups that matter for policy implementation, such as the private sector or subnational actors. Results highlight the predominance of mitigation over adaptation and the existence of actors well positioned to broker relationships between the subdomains. The top brokers across subdomains were, however, not only actors with high centrality and brokerage roles in the subdomains, but also several "unusual key players" that were not brokers in any of the two layers separately. Key policy insights • National government institutions are central actors in climate change policy networks in Peru, reflecting national ownership of the climate change issue. • Private sector organizations and subnational actors in Peru are the least involved in information sharing and collaboration on climate change. • Actors from different levels and sectors are active in both adaptation and mitigation, which is good for climate policy integration. • Actors with the capacity to bridge the two policy subdomains are not necessarily central to each subdomain but may be actors that close structural holes between subdomains.
  • Kalakoski, Virpi; Henelius, Andreas; Oikarinen, Emilia; Ukkonen, Antti; Puolamäki, Kai (2019)
    Today's ever-increasing amount of data places new demands on cognitive ergonomics and requires new design ideas to ensure successful human-data interaction. Our aim was to identify the cognitive factors that must be considered when designing systems to improve decision-making based on large amounts of data. We constructed a task that simulates the typical cognitive demands people encounter in data analysis situations. We demonstrate some essential cognitive limitations using a behavioural experiment with 20 participants. The studied task presented the participants with critical and noncritical attributes that contained information on two groups of people. They had to select the response option (group) with the higher level of critical attributes. The results showed that accuracy of judgement decreased as the amount of information increased, and that judgement was affected by irrelevant information. Our results thus demonstrate critical cognitive limitations when people utilise data and suggest a cognitive bias in data-based decision-making. Therefore, when designing for cognition, we should consider the human cognitive limitations that are manifested in a data analysis context. Furthermore, we need general cognitive ergonomic guidelines for design that support the utilisation of data and improve data-based decision-making.
  • Kettunen, Karoliina; Pesonen, Susanna; Lunden, Janne; Nevas, Mari (2018)
    Consistency and risk-basis are core elements of effective enforcement of food safety legislation. In Finland, inspections of food retail premises have been conducted since 2013 based on new national guidelines for evaluation and grading. According to the guidelines, food control authorities should initiate an administrative enforcement process to ensure compliance if the food business operator (FBO) is given the poorest grade in the inspection. In this study, we examined the consistency within and between local food control units on the threshold of initiating an enforcement process. The study was conducted through an analysis of inspection reports of FBOs and by an electronic survey and interviews of local food control officials. The results reveal that most officials consider the national evaluation guidelines as helpful in improving the consistency of using enforcement measures. However, inconsistencies exist between and within the local food control units in the alignments of initiating an enforcement process. Enforcement measures are mainly used on a risk-basis and gradually, as in most enforcement cases the FBO had multiple non-compliances and the FBO had been given a prior request to correct the non-compliance before initiating an enforcement process. The results, however, revealed rather weak compliance and repeated violations among some FBOs. Based on the observed persistence of non -compliances and the efficacy of enforcement measures in inducing compliance, a lower threshold of initiating an enforcement process towards FBOs with repeated violations appears beneficial in enhancing the correction of violations. Increasing the consistency of the enforcement process begins with unifying the practices within the local food control units by establishing clear procedures for enforcement and ensuring adequate orientation of personnel. Further strengthening of cooperation, peer-review and discussion on interpretations of required control actions between the units is needed for nationally consistent implementation of the evaluation and disclosure system and use of enforcement measures. (C) 2017 Elsevier Ltd. All rights reserved.
  • Puhakka, Riikka; Ollila, Sari; Valve, Raisa; Sinkkonen, Aki Tapio (2019)
    A health effect is a credence quality feature which is difficult for consumers to detect, and they need to be convinced of its trustworthiness. This study explores the role of trust-related arguments in Finnish, German, and British consumers' willingness to try a novel health-enhancing, non-edible product. Scientific evidence in particular would convince consumers, particularly Finnish ones, to try a product. Receiving recommendations from other users was more important for younger than for older respondents when it came to trying this type of product. Different marketing strategies may be needed to convince potential users of the benefits of a novel product.
  • Annila, Arto; Salthe, Stanley (2010)
  • Riikonen, Jarno M.; Guyatt, Gordon H.; Kilpeläinen, Tuomas P.; Craigie, Samantha; Agarwal, Arnav; Agoritsas, Thomas; Couban, Rachel; Dahm, Philipp; Järvinen, Petrus; Montori, Victor; Power, Nicholas; Richard, Patrick O.; Rutanen, Jarno; Santti, Henrikki; Tailly, Thomas; Violette, Philippe D.; Zhou, Qi; Tikkinen, Kari A. O. (2019)
    Key PointsQuestionWhat is the association of decision aids vs usual care with shared decision-making in men deciding whether to undergo prostate cancer screening? FindingsThis systematic review and meta-analysis of 19 randomized clinical trials comparing decision aids for prostate cancer screening (12781 men) found that decision aids are probably associated with a small reduction in decisional conflict and are possibly associated with an increase in knowledge. Decision aids are possibly not associated with whether physicians and patients discuss prostate cancer screening and are possibly not associated with actual screening decisions. MeaningRandomized clinical trials have failed to provide compelling evidence for the use of decision aids for men contemplating prostate cancer screening that have, up to now, undergone rigorous testing to determine their outcome. ImportanceUS guidelines recommend that physicians engage in shared decision-making with men considering prostate cancer screening. ObjectiveTo estimate the association of decision aids with decisional outcomes in prostate cancer screening. Data SourcesMEDLINE, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL were searched from inception through June 19, 2018. Study SelectionRandomized trials comparing decision aids for prostate cancer screening with usual care. Data Extraction and SynthesisIndependent duplicate assessment of eligibility and risk of bias, rating of quality of the decision aids, random-effects meta-analysis, and Grading of Recommendations, Assessment, Development and Evaluations rating of the quality of evidence. Main Outcomes and MeasuresKnowledge, decisional conflict, screening discussion, and screening choice. ResultsOf 19 eligible trials (12781 men), 9 adequately concealed allocation and 8 blinded outcome assessment. Of 12 decision aids with available information, only 4 reported the likelihood of a true-negative test result, and 3 presented the likelihood of false-negative test results or the next step if the screening test result was negative. Decision aids are possibly associated with improvement in knowledge (risk ratio, 1.38; 95% CI, 1.09-1.73; I-2=67%; risk difference, 12.1; low quality), are probably associated with a small decrease in decisional conflict (mean difference on a 100-point scale, -4.19; 95% CI, -7.06 to -1.33; I-2=75%; moderate quality), and are possibly not associated with whether physicians and patients discuss prostate cancer screening (risk ratio, 1.12; 95% CI, 0.90-1.39; I-2=60%; low quality) or with men's decision to undergo prostate cancer screening (risk ratio, 0.95; 95% CI, 0.88-1.03; I-2=36%; low quality). Conclusions and RelevanceThe results of this study provide moderate-quality evidence that decision aids compared with usual care are associated with a small decrease in decisional conflict and low-quality evidence that they are associated with an increase in knowledge but not with whether physicians and patients discussed prostate cancer screening or with screening choice. Results suggest that further progress in facilitating effective shared decision-making may require decision aids that not only provide education to patients but are specifically targeted to promote shared decision-making in the patient-physician encounter. This systematic review and meta-analysis of 19 randomized clinical trials estimates the association of decision aids with decisional outcomes in prostate cancer screening.