The chapters of this dissertation analyze the choice decisions of various groups of individuals. Chapter 1 examines the choices of consumers regarding movie videos. We utilize weekly video sales data, encompassing digital videos from online platforms and physical discs from retail stores, to investigate the director's backward spillover effect, factors influencing consumer preferences, and the market structure. Our findings confirm the presence of backward spillover effects on video sales and provide an estimation of the movie video market's cost structure. Additionally, we analyze the impact of structural changes in the market using a merger simulation. Chapter 2 investigates household choices related to leisure activities. We consider both the time spent and the associated expenditure measurements to offer a comprehensive analysis of time allocations and costs for leisure pursuits. By combining a time-use survey with mobile app scanner data, we categorize activities and products into 14 leisure categories. Then we uncover the geography of leisure, constructing leisure price indexes and estimating the time spent and expenditure variations in income. Our study further probes choice sensitivity, employing a causal inference framework to estimate heterogeneous elasticity and leisure substitution patterns. Chapter 3 focuses on the choices made by refugees regarding their destination cities during migration. This analysis focuses on those escaping the Russia-Ukraine war that erupted in February 2022. We use data from Hornet, a Queer Social Network, to classify refugee users into three groups: Ukrainians, Russians, and Foreigners. An interactive map has been developed to visualize the daily aggregated movements of the refugees. Subsequently, we investigate the factors that influence refugee preferences when choosing destination cities. We also analyze the elements that impact both the number of refugees in these cities and the migration movements between them due to the conflict. Lastly, we estimate the average migration patterns of the refugees.

Introduction: Research suggests that pain assessment involves a complex interaction between patients and clinicians. We sought to assess the agreement between pain scores reported by the patients themselves and the clinician’s perception of a patient’s pain in the emergency department (ED). In addition, we attempted to identify patient and physician factors that lead to greater discrepancies in pain assessment.

Methods: We conducted a prospective observational study in the ED of a tertiary academic medical center. Using a standard protocol, trained research personnel prospectively enrolled adult patients who presented to the ED. The entire triage process was recorded, and triage data were collected. Pain scores were obtained from patients on a numeric rating scale of 0 to 10. Five physician raters provided their perception of pain ratings after reviewing videos. 

Results: A total of 279 patients were enrolled. The mean age was 53 years. There were 141 (50.5%) female patients. The median self-reported pain score was 4 (interquartile range 0-6). There was a moderately positive correlation between self-reported pain scores and physician ratings of pain (correlation coefficient, 0.46; P <0.001), with a weighted kappa coefficient of 0.39. Some discrepancies were noted: 102 (37%) patients were rated at a much lower pain score, whereas 52 (19%) patients were given a much higher pain score from physician review. The distributions of chief complaints were different between the two groups. Physician raters tended to provide lower pain scores to younger (P = 0.02) and less ill patients (P = 0.008). Additionally, attending-level physician raters were more likely to provide a higher pain score than resident-level raters (P <0.001).

Conclusion: Patients’ self-reported pain scores correlate positively with the pain score provided by physicians, with only a moderate agreement between the two. Under- and over-estimations of pain in ED patients occur in different clinical scenarios. Pain assessment in the ED should consider both patient and physician factors.