About

Paul Feldman is an assistant professor at Texas A&M University and a member of the Texas A&M AgriLife faculty. He holds a B.Sc. and M.Sc. from Instituto Tecnológico Autónomo de México and earned his Ph.D. from the University of California, San Diego, in 2019. His professional expertise lies in behavioral and experimental economics, with a particular focus on decision theory and how individuals make choices. As a behavioral economist, his research interests include understanding decision-making processes and behaviors.

Research topics

• Computer Science
• Economics
• Demography
• Positive economics
• Mathematical economics
• Psychology
• Mathematical optimization
• Econometrics
• Internal medicine
• Operations research
• Microeconomics
• Actuarial science
• Medicine
• Mathematics

Selected publications

• Revealed preference tests for linear probability-prize tradeoffs

  Theory and Decision · 2025-09-26

  articleOpen accessSenior author

  Abstract We provide necessary and sufficient conditions for expected utility and risk-averse expected utility to rationalize behavior when the decision maker faces linear probability-prize tradeoffs. The setting subsumes those proposed in Andreoni and Harbaugh (Unexpected utility: Five experimental tests of preferences for risk, 2009)—risk-reward budgets—and Crosetto and Filippin (J Risk Uncertain 47(1):31–65, 2013)—bomb risk elicitation tasks. The tests are intuitive and straightforward to carry out. They also make it possible to compute the Houtman–Maks Index to measure how close the models come to explaining the choice sets, although we emphasize the limitations of these measures in this setting. We implement these results empirically and show that only small portions of choice sets can be rationalized by risk-averse expected utility.

  PublisherOA PDFDOI

• From Abstract to Concrete: The State as an Unquiet Ideal

  Marxism & Sciences · 2024-01-01 · 1 citations

  articleOpen accessSenior author

  In this essay we attempt to interpret and develop Ilyenkov's pioneering investigation of the nature of the Ideal as a philosophical category in relation to state transformation in the late twentieth and early twenty-first centuries.In the first section we set out Ilyenkov's category of the Ideal and its relationship to the Universal.We propose understanding the state as an Ideal, as a "concrete universal," which, as a developing whole exists, or rather, is negated into, contradictory relationships with its various parts.In this way it is a component of social consciousness as well as social being, which constitutes the culture of any society or social system.We suggest that the category of a dialectical Ideal is vital in theorizing the nature and essence of the relationship between the contemporary state and struggles for democracy.In the second part, we outline the evolution of the capitalist form of state, touching on the conflicted history of Marxist viewpoints up to and including contemporary state theorists.The British state is analysed as an "ideal" model, given its particular nature as the oldest capitalist state with its "mother of parliaments."Rather than viewing the capitalist form of state as a simple reflection of economic categories, we see the state's relationship with capitalist production, and with its subjects (i.e. its Other), as "semi-autonomous," thus existing in a complex, uneven, simultaneously "fragile, unstable, provisional, and temporary relationship."(Jessop 2012).This is exemplified by historic class struggles in Britain and ongoing political crises, post-Brexit.We propose that grasping the state as a dynamic, changing ensemble of contradictory forces, while at the same time having its own objective existence and logic of development, is vital in the light of the present transition towards autocratic and dictatorial forms of state rule with its attendant crisis of the democratic Ideal.

  PublisherDOI

• Experimental Tests of Incomplete Preferences

  SSRN Electronic Journal · 2024-01-01

  preprintOpen access1st authorCorresponding
  PublisherDOI

• Revealing risky mistakes through revisions

  Journal of Risk and Uncertainty · 2024 · 12 citations

  Senior authorCorresponding
  • Computer Science
  • Economics
  • Psychology

  Abstract We argue that a choice that is modified, absent any informational change, is revealed to have been a mistake. In an experiment, we allow subjects to choose from budgets over binary lotteries. To identify mistakes, which we interpret as deviations from an underlying “true” preference, we allow subjects to revise a subset of their initial choices. The set of revised decisions improves under several standard definitions of optimality. These mistakes are prevalent: subjects modify over 75% of their initial choices when given the chance. Subjects make larger mistakes when inexperienced and when choosing over lotteries with small probabilities of winning.

  PublisherOA PDFDOI

• Experimental tests of incomplete preferences 

  SSRN Electronic Journal · 2024-01-01

  preprintOpen accessSenior author
  PublisherDOI

• Baseline Features and Reasons for Nonparticipation in the Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) Study, a Colorectal Cancer Screening Trial

  JAMA Network Open · 2023 · 29 citations

  • Medicine
  • Internal medicine
  • Demography

  Importance: The Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) randomized clinical trial sought to recruit 50 000 adults into a study comparing colorectal cancer (CRC) mortality outcomes after randomization to either an annual fecal immunochemical test (FIT) or colonoscopy. Objective: To (1) describe study participant characteristics and (2) examine who declined participation because of a preference for colonoscopy or stool testing (ie, fecal occult blood test [FOBT]/FIT) and assess that preference's association with geographic and temporal factors. Design, Setting, and Participants: This cross-sectional study within CONFIRM, which completed enrollment through 46 Department of Veterans Affairs medical centers between May 22, 2012, and December 1, 2017, with follow-up planned through 2028, comprised veterans aged 50 to 75 years with an average CRC risk and due for screening. Data were analyzed between March 7 and December 5, 2022. Exposure: Case report forms were used to capture enrolled participant data and reasons for declining participation among otherwise eligible individuals. Main Outcomes and Measures: Descriptive statistics were used to characterize the cohort overall and by intervention. Among individuals declining participation, logistic regression was used to compare preference for FOBT/FIT or colonoscopy by recruitment region and year. Results: A total of 50 126 participants were recruited (mean [SD] age, 59.1 [6.9] years; 46 618 [93.0%] male and 3508 [7.0%] female). The cohort was racially and ethnically diverse, with 748 (1.5%) identifying as Asian, 12 021 (24.0%) as Black, 415 (0.8%) as Native American or Alaska Native, 34 629 (69.1%) as White, and 1877 (3.7%) as other race, including multiracial; and 5734 (11.4%) as having Hispanic ethnicity. Of the 11 109 eligible individuals who declined participation (18.0%), 4824 (43.4%) declined due to a stated preference for a specific screening test, with FOBT/FIT being the most preferred method (2820 [58.5%]) vs colonoscopy (1958 [40.6%]; P < .001) or other screening tests (46 [1.0%] P < .001). Preference for FOBT/FIT was strongest in the West (963 of 1472 [65.4%]) and modest elsewhere, ranging from 199 of 371 (53.6%) in the Northeast to 884 of 1543 (57.3%) in the Midwest (P = .001). Adjusting for region, the preference for FOBT/FIT increased by 19% per recruitment year (odds ratio, 1.19; 95% CI, 1.14-1.25). Conclusions and Relevance: In this cross-sectional analysis of veterans choosing nonenrollment in the CONFIRM study, those who declined participation more often preferred FOBT or FIT over colonoscopy. This preference increased over time and was strongest in the western US and may provide insight into trends in CRC screening preferences.

  PublisherOA PDFDOI

• Revealed Preference Tests for Linear Probability-Prize Tradeoffs

  SSRN Electronic Journal · 2023 · 1 citations

  Senior authorCorresponding
  • Computer Science
  • Econometrics
  • Computer Science
  PublisherDOI

• S244 Patient-Reported Barriers to FIT Test Completion at a Single Institution

  The American Journal of Gastroenterology · 2021-10-01

  articleSenior author

  Introduction: Colorectal cancer (CRC) is the fourth most common cancer and the second-leading cause of cancer-related death in the United States. The United States Preventive Services Task Force recommends CRC screening in all adults between ages 45 and 75, as it has shown a substantial reduction in long-term CRC risk and mortality. Annual Fecal Immunohistochemistry Testing (FIT) has emerged as an acceptable first-line test for CRC screening as it is low risk and cost effective. Methods: We performed a single-center, retrospective, quality improvement (QI) study to determine barriers to FIT test completion between March 2020 and December 2020 at the Miami Veterans Affairs Medical Center (VAMC). The methodology for patient selection is outlined in Figure 1 and an intention to treat analysis was used. The electronic medical record was searched for all patients who had an outstanding FIT order. Participants were randomly selected to answer a phone survey using a random number generator. The survey was adapted from the validated survey used by Bhise et al. (2016) in order to assess patient-specific and health system barriers. Results: The baseline characteristics and reasons for failure to return FITs are shown in Table 1. Of the 120 total survey respondents, 52.5% of patient stated that they did not receive the test. Additionally, 37.5% of patients stated that they forgot about the test and of those patients, 73.5% stated that a reminder from their provider would have been helpful. Other reasons for failing to return the test included a lack of education from the provider about the benefits of CRC screening (35.8%) and not being interested in CRC screening (5%). Only 15.8% of patients would have preferred an alternative method of CRC screening and over 80% of respondents stated that they would retake an FIT test if it was made available to them. Conclusion: Colorectal cancer is a leading cause of morbidity and mortality in the United States; therefore, screening is imperative. FIT has emerged as a non-invasive first-line alternative to colonoscopy, as it is 94% specific. Despite the low risk and convenience associated with FIT testing, our study shows that many obstacles still exist for patients to complete their tests. Future resources and emphasis should be placed on patient and provider education to ensure that patients understand their options for and the benefits of CRC screening.Figure 1.: Flow chart of patient identification, inclusion and exclusion criteriaTable 1.: Patient characteristics and reported barriers to FIT test completion

  PublisherDOI

• Detection of Colorectal Neoplasm in Patients with Positive Fecal Immunohistochemistry Test After Recent Colonoscopy

  The American Journal of Gastroenterology · 2018-10-01

  article1st authorCorresponding

  Introduction: Recent recommendation, based on limited evidence, that patients who underwent colonoscopy followed by a positive Fecal Immunohistochemistry Test (FIT) should be offered a repeat colonoscopy before the individual would normally be due to a repeat endoscopic evaluation. The aim of this study is to explore whether there is evidence to suggest that repeat colonoscopy may be beneficial in such cases. Methods: Patients who had recently undergone colonoscopy screening at the Miami Veterans Affairs Medical Center who agreed to repeat colonoscopy following a subsequent positive FIT test result before the recommended screening/surveillance interval were evaluated prospectively. Results: Of a total of eighteen FIT positive patients, seven completed a repeat colonoscopy before the recommended screening interval. Two of seven patients manifested high risk adenomas. Cancer was not detected on repeat colonoscopy in any of these patients. Conclusion: No colorectal cancers were diagnosed in patients with a positive FIT result on repeat colonoscopy screening. Advanced colon adenomas, however, were identified in 28.5% of these patients. Although this study does not provide clear evidence of a benefit of repeat colonoscopy for these patients before the recommended screening interval, detection of high risk adenomas in some of them warrants further study with a significantly larger sample size.

  PublisherDOI

• Breaking Down Barriers: Using Virtual Reality to Enhance Patient Education and Improve Colorectal Cancer Screening

  The American Journal of Gastroenterology · 2018-10-01 · 3 citations

  articleSenior author

  Introduction: Colorectal cancer (CRC) is the 3rd most common cancer and 2nd leading cause of cancer death in the United States. Effective screening tests are often underused with uptake ranging from 58-76%. Numerous strategies have been employed to improve patient compliance with CRC screening with varying results. The aim of our study was to improve CRC screening rates in a Veterans Affairs (VA) population using a novel virtual reality educational demonstration (VRED). Methods: Patients at the Miami VA who were due for CRC screening and had previously declined a recommended CRC screening test ordered by the primary care provider on at least 3 occasions were selected to receive a 10 minute VRED. The VRED reviewed the risks of CRC, provided a guided tour through the inside of a virtual colon, and reviewed all USPSTF-recommended CRC screening options. Before and after the VRED, a 5 item questionnaire derived from validated surveys was used to assess patient learning, barriers to prior screening, and record patient choice of CRC screening test. Results: 24 patients viewed the VRED, of whom 23 (96%) agreed to undergo CRC screening. The CRC screening options selected were: 13 colonoscopies, 9 FIT, and 1 CT colonography. Multiple barriers to prior screening included lack of problems or symptoms (11), fear of the procedure (8), unpleasantness of preparation (4), unaware of CRC risk (4), too busy (4), fear of discomfort (3), fear of results (2), embarrassment (1), and fear of pain (1). A statistically significant increase in patient knowledge that screening for CRC reduced the risk of colon cancer was observed (p <0.05). The VRED did not significantly change the perception of risk or vulnerability to CRC. Conclusion: This pilot quality improvement analysis identified barriers to CRC screening among a VA patient population who declined a recommended CRC screening test ordered by the primary care provider on at least 3 occasions. 96% of patients agreed to proceed with CRC screening following the VRED intervention, suggesting that the VRED was helpful in addressing barriers to uptake. Additionally, VRED significantly increased patient knowledge of CRC. Further study of this VRED is needed to document its efficacy in addressing patient barriers and ultimately may lead to improved CRC screening uptake.

  PublisherDOI

Frequent coauthors

• A. Lecacheux

  Université Paris Cité

  34 shared

• James W. Richardson

  32 shared

• R. O. Redman

  32 shared

• Joe L. Outlaw

  Texas A&M University

  31 shared

• Keith D. Schumann

  Welch Foundation

  29 shared

• Steven L. Klose

  29 shared

• Robert B. Schwart

  24 shared

• C. R. Purton

  Herzberg Institute of Astrophysics

  23 shared

Education

• B.S.

  Instituto Tecnológico Autónomo de México

• M.S.

  Instituto Tecnológico Autónomo de México

• Ph.D.

  University of California, San Diego