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Sample records for computerized decision support

  1. Computerized Clinical Decision Support: Contributions from 2015

    Science.gov (United States)

    Bouaud, J.

    2016-01-01

    Summary Objective To summarize recent research and select the best papers published in 2015 in the field of computerized clinical decision support for the Decision Support section of the IMIA yearbook. Method A literature review was performed by searching two bibliographic databases for papers related to clinical decision support systems (CDSSs) and computerized provider order entry (CPOE) systems. The aim was to identify a list of candidate best papers from the retrieved papers that were then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the IMIA editorial team was finally conducted to conclude in the best paper selection. Results Among the 974 retrieved papers, the entire review process resulted in the selection of four best papers. One paper reports on a CDSS routinely applied in pediatrics for more than 10 years, relying on adaptations of the Arden Syntax. Another paper assessed the acceptability and feasibility of an important CPOE evaluation tool in hospitals outside the US where it was developed. The third paper is a systematic, qualitative review, concerning usability flaws of medication-related alerting functions, providing an important evidence-based, methodological contribution in the domain of CDSS design and development in general. Lastly, the fourth paper describes a study quantifying the effect of a complex, continuous-care, guideline-based CDSS on the correctness and completeness of clinicians’ decisions. Conclusions While there are notable examples of routinely used decision support systems, this 2015 review on CDSSs and CPOE systems still shows that, despite methodological contributions, theoretical frameworks, and prototype developments, these technologies are not yet widely spread (at least with their full functionalities) in routine clinical practice. Further research, testing, evaluation, and training are still needed for these tools to be adopted in clinical practice and, ultimately, illustrate

  2. A computerized decision support system for depression in primary care.

    Science.gov (United States)

    Kurian, Benji T; Trivedi, Madhukar H; Grannemann, Bruce D; Claassen, Cynthia A; Daly, Ella J; Sunderajan, Prabha

    2009-01-01

    In 2004, results from The Texas Medication Algorithm Project (TMAP) showed better clinical outcomes for patients whose physicians adhered to a paper-and-pencil algorithm compared to patients who received standard clinical treatment for major depressive disorder (MDD). However, implementation of and fidelity to the treatment algorithm among various providers was observed to be inadequate. A computerized decision support system (CDSS) for the implementation of the TMAP algorithm for depression has since been developed to improve fidelity and adherence to the algorithm. This was a 2-group, parallel design, clinical trial (one patient group receiving MDD treatment from physicians using the CDSS and the other patient group receiving usual care) conducted at 2 separate primary care clinics in Texas from March 2005 through June 2006. Fifty-five patients with MDD (DSM-IV criteria) with no significant difference in disease characteristics were enrolled, 32 of whom were treated by physicians using CDSS and 23 were treated by physicians using usual care. The study's objective was to evaluate the feasibility and efficacy of implementing a CDSS to assist physicians acutely treating patients with MDD compared to usual care in primary care. Primary efficacy outcomes for depression symptom severity were based on the 17-item Hamilton Depression Rating Scale (HDRS(17)) evaluated by an independent rater. Patients treated by physicians employing CDSS had significantly greater symptom reduction, based on the HDRS(17), than patients treated with usual care (P < .001). The CDSS algorithm, utilizing measurement-based care, was superior to usual care for patients with MDD in primary care settings. Larger randomized controlled trials are needed to confirm these findings. clinicaltrials.gov Identifier: NCT00551083.

  3. Computerized Adaptive Test vs. decision trees: Development of a support decision system to identify suicidal behavior.

    Science.gov (United States)

    Delgado-Gomez, D; Baca-Garcia, E; Aguado, D; Courtet, P; Lopez-Castroman, J

    2016-12-01

    Several Computerized Adaptive Tests (CATs) have been proposed to facilitate assessments in mental health. These tests are built in a standard way, disregarding useful and usually available information not included in the assessment scales that could increase the precision and utility of CATs, such as the history of suicide attempts. Using the items of a previously developed scale for suicidal risk, we compared the performance of a standard CAT and a decision tree in a support decision system to identify suicidal behavior. We included the history of past suicide attempts as a class for the separation of patients in the decision tree. The decision tree needed an average of four items to achieve a similar accuracy than a standard CAT with nine items. The accuracy of the decision tree, obtained after 25 cross-validations, was 81.4%. A shortened test adapted for the separation of suicidal and non-suicidal patients was developed. CATs can be very useful tools for the assessment of suicidal risk. However, standard CATs do not use all the information that is available. A decision tree can improve the precision of the assessment since they are constructed using a priori information. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Evaluation of computerized decision support for oral anticoagulation management based in primary care.

    OpenAIRE

    Fitzmaurice, D A; Hobbs, F D; Murray, E T; Bradley, C P; Holder, R

    1996-01-01

    BACKGROUND: Increasing indications for oral anticoagulation has led to pressure on general practices to undertake therapeutic monitoring. Computerized decision support (DSS) has been shown to be effective in hospitals for improving clinical management. Its usefulness in primary care has previously not been investigated. AIM: To test the effectiveness of using DSS for oral anticoagulation monitoring in primary care by measuring the proportions of patients adequately controlled, defined as with...

  5. Increasing Personal Value Congruence in Computerized Decision Support Using System Feedback

    Directory of Open Access Journals (Sweden)

    Bryan Hosack

    2014-02-01

    Full Text Available The Theory of Universals in Values (TUV, a reliable and validated conceptualization of personal values used in psychology, is used to examine the effect of system feedback delivered by a Decision Support System (DSS on personal values. The results indicate that value-based decision-making behavior can be influenced by DSS feedback to address value congruence in decision-making. User behavior was shown to follow the outcomes expected by operant theory when feedback was supportive and to follow the outcomes of reactance theory when feedback was challenging. This result suggests that practitioners and Information System (IS researchers should consider user values when designing computerized decision feedback to adjust a system’s design such that the potential user backlash is avoided or congruence between organizational and personal values is achieved.

  6. The evolution of the market for commercial computerized physician order entry and computerized decision support systems for prescribing.

    Science.gov (United States)

    Mozaffar, Hajar; Williams, Robin; Cresswell, Kathrin; Morrison, Zoe; Bates, David W; Sheikh, Aziz

    2016-03-01

    To understand the evolving market of commercial off-the-shelf Computerized Physician Order Entry (CPOE) and Computerized Decision Support (CDS) applications and its effects on their uptake and implementation in English hospitals. Although CPOE and CDS vendors have been quick to enter the English market, uptake has been slow and uneven. To investigate this, the authors undertook qualitative ethnography of vendors and adopters of hospital CPOE/CDS systems in England. The authors collected data from semi-structured interviews with 11 individuals from 4 vendors, including the 2 most entrenched suppliers, and 6 adopter hospitals, and 21 h of ethnographic observation of 2 user groups, and 1 vendor event. The research and analysis was informed by insights from studies of the evolution of technology fields and the emergence of generic COTS enterprise solutions. Four key themes emerged: (1) adoption of systems that had been developed outside of England, (2) vendors' configuration and customization strategies, (3) localized adopter practices vs generic systems, and (4) unrealistic adopter demands. Evidence for our over-arching finding concerning the current immaturity of the market was derived from vendors' strategies, adopters' reactions to the technology, and policy makers' incomplete insights. The CPOE/CDS market in England is still in an emergent phase. The rapid entrance of diverse products, triggered by federal policy initiatives, has resulted in premature adoption of systems that do not yet adequately meet the needs of hospitals. Vendors and adopters lacked understanding of how to design and implement generic solutions to meet diverse user needs. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Computerized operator decision aids

    International Nuclear Information System (INIS)

    Long, A.B.

    1984-01-01

    This article explores the potential benefits associated with the use of computers in nuclear plants by the operating crew as an aid in making decisions. Pertinent findings are presented from recently completed projects to establish the context in which operating decisions have to be made. Key factors influencing the decision-making process itself are also identified. Safety parameter display systems, which are being implemented in various forms by the nuclear industry, are described within the context of decision making. In addition, relevant worldwide research and development activities are examined as potential enhancements to computerized operator decision aids to further improve plant safety and availability

  8. Evaluation of computerized decision support for oral anticoagulation management based in primary care.

    Science.gov (United States)

    Fitzmaurice, D A; Hobbs, F D; Murray, E T; Bradley, C P; Holder, R

    1996-09-01

    Increasing indications for oral anticoagulation has led to pressure on general practices to undertake therapeutic monitoring. Computerized decision support (DSS) has been shown to be effective in hospitals for improving clinical management. Its usefulness in primary care has previously not been investigated. To test the effectiveness of using DSS for oral anticoagulation monitoring in primary care by measuring the proportions of patients adequately controlled, defined as within the appropriate therapeutic range of International Normalised Ratio (INR). All patients receiving warfarin from two Birmingham inner city general practices were invited to attend a practice-based anticoagulation clinic. In practice A all patients were managed using DSS. In practice B patients were randomized to receive dosing advice either through DSS or through the local hospital laboratory. Clinical outcomes, adverse events and patient acceptability were recorded. Forty-nine patients were seen in total. There were significant improvements in INR control from 23% to 86% (P > 0.001) in the practice where all patients received dosing through DSS. In the practice where patients were randomized to either DSS or hospital dosing, logistic regression showed a significant trend for improvement in intervention patients which was not apparent in the hospital-dosed patients (P DSS through the full 12 months (24 days to 36 days) (P = 0.033). Adverse events were comparable between hospital and practice-dosed patients, although a number of esoteric events occurred. Patient satisfaction with the practice clinics was high. Computerized DSS enables the safe and effective transfer of anticoagulation management from hospital to primary care and may result in improved patient outcome in terms of the level of control, frequency of review and general acceptability.

  9. Effects of computerized decision support systems on blood glucose regulation in critically ill surgical patients.

    Science.gov (United States)

    Fogel, Sandy L; Baker, Christopher C

    2013-04-01

    The use of computerized decision support systems (CDSS) in glucose control for critically ill surgical patients has been reported in both diabetic and nondiabetic patients. Prospective studies evaluating its effect on glucose control are, however, lacking. The objective of this study was to evaluate patient-specific computerized IV insulin dosing on blood glucose levels (BGLs) by comparing patients treated pre-CDSS with those treated post-CDSS. A prospective study was performed in 4 surgical ICUs and 1 progressive care unit comparing patient data pre- and post-implementation of CDSS. The primary outcomes measures were the impact of the CDSS on glycemic control in this population and on reducing the incidence of severe hypoglycemia. Data on 1,682 patient admissions were evaluated, which corresponded to 73,290 BGLs post-CDSS compared with 44,972 BGLs pre-CDSS. The percentage of hyperglycemic events improved, with BGLs of >150 mg/dL decreasing by 50% compared with 6-month historical controls during the 18-month study period from July 2010 through December 2011. This was true for all 5 units individually (p < 0.0001, by one sample sign test). In addition, severe hypoglycemia (defined as BGL <40 mg/dL) decreased from 1% to 0.05% after implementing CDSS (p < 0.0001 by 2-sided binomial test). Patients whose BGLs were managed using CDSS were statistically significantly more likely to have a glucose reading under control (<150 mg/dL) than in the 6-month historical controls and to avoid serious hypoglycemia (p < 0.0001). Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. An Evaluation of the Usability of a Computerized Decision Support System for Nursing Homes

    Science.gov (United States)

    Fossum, M.; Ehnfors, M.; Fruhling, A.; Ehrenberg, A.

    2011-01-01

    Background Computerized decision support systems (CDSSs) have the potential to significantly improve the quality of nursing care of older people by enhancing the decision making of nursing personnel. Despite this potential, health care organizations have been slow to incorporate CDSSs into nursing home practices. Objective This study describes facilitators and barriers that impact the ability of nursing personnel to effectively use a clinical CDSS for planning and treating pressure ulcers (PUs) and malnutrition and for following the suggested risk assessment guidelines for the care of nursing home residents. Methods We employed a qualitative descriptive design using varied methods, including structured group interviews, cognitive walkthrough observations and a graphical user interface (GUI) usability evaluation. Group interviews were conducted with 25 nursing personnel from four nursing homes in southern Norway. Five nursing personnel participated in cognitive walkthrough observations and the GUI usability evaluation. Text transcripts were analyzed using qualitative content analysis. Results Group interview participants reported that ease of use, usefulness and a supportive work environment were key facilitators of CDSS use. The barriers identified were lack of training, resistance to using computers and limited integration of the CDSS with the facility’s electronic health record (EHR) system. Key findings from the usability evaluation also identified the difficulty of using the CDSS within the EHR and the poorly designed GUI integration as barriers. Conclusion Overall, we found disconnect between two types of nursing personnel. Those who were comfortable with computer technology reported positive feedback about the CDSS, while others expressed resistance to using the CDSS for various reasons. This study revealed that organizations must invest more resources in educating nursing personnel on the seriousness of PUs and poor nutrition in the elderly, providing

  11. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

    OpenAIRE

    Wilczynski Nancy L; Haynes R Brian

    2010-01-01

    Abstract Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this...

  12. Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

    Science.gov (United States)

    Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

  13. Reduced Clostridium difficile Tests and Laboratory-Identified Events With a Computerized Clinical Decision Support Tool and Financial Incentive.

    Science.gov (United States)

    Madden, Gregory R; German Mesner, Ian; Cox, Heather L; Mathers, Amy J; Lyman, Jason A; Sifri, Costi D; Enfield, Kyle B

    2018-06-01

    We hypothesized that a computerized clinical decision support tool for Clostridium difficile testing would reduce unnecessary inpatient tests, resulting in fewer laboratory-identified events. Census-adjusted interrupted time-series analyses demonstrated significant reductions of 41% fewer tests and 31% fewer hospital-onset C. difficile infection laboratory-identified events following this intervention.Infect Control Hosp Epidemiol 2018;39:737-740.

  14. Computerized clinical decision support systems for therapeutic drug monitoring and dosing: A decision-maker-researcher partnership systematic review

    Directory of Open Access Journals (Sweden)

    Weise-Kelly Lorraine

    2011-08-01

    Full Text Available Abstract Background Some drugs have a narrow therapeutic range and require monitoring and dose adjustments to optimize their efficacy and safety. Computerized clinical decision support systems (CCDSSs may improve the net benefit of these drugs. The objective of this review was to determine if CCDSSs improve processes of care or patient outcomes for therapeutic drug monitoring and dosing. Methods We conducted a decision-maker-researcher partnership systematic review. Studies from our previous review were included, and new studies were sought until January 2010 in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Inspec databases. Randomized controlled trials assessing the effect of a CCDSS on process of care or patient outcomes were selected by pairs of independent reviewers. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results Thirty-three randomized controlled trials were identified, assessing the effect of a CCDSS on management of vitamin K antagonists (14, insulin (6, theophylline/aminophylline (4, aminoglycosides (3, digoxin (2, lidocaine (1, or as part of a multifaceted approach (3. Cluster randomization was rarely used (18% and CCDSSs were usually stand-alone systems (76% primarily used by physicians (85%. Overall, 18 of 30 studies (60% showed an improvement in the process of care and 4 of 19 (21% an improvement in patient outcomes. All evaluable studies assessing insulin dosing for glycaemic control showed an improvement. In meta-analysis, CCDSSs for vitamin K antagonist dosing significantly improved time in therapeutic range. Conclusions CCDSSs have potential for improving process of care for therapeutic drug monitoring and dosing, specifically insulin and vitamin K antagonist dosing. However, studies were small and generally of modest quality, and effects on patient outcomes were uncertain, with no convincing

  15. The EVS: a computerized decision support system for GPs in the Netherlands.

    NARCIS (Netherlands)

    Wolters, I.; Hoogen, H. van den; Bakker, D. de

    2003-01-01

    Background: In 1998 a project was started to introduce nationally a decision support system in general practice in the Netherlands, called EVS (electronic prescription support system). The system contains national guidelines developed by the Dutch Council of GPs (NHG) for approximately 80 diagnoses.

  16. 'Too much, too late': mixed methods multi-channel video recording study of computerized decision support systems and GP prescribing.

    Science.gov (United States)

    Hayward, James; Thomson, Fionagh; Milne, Heather; Buckingham, Susan; Sheikh, Aziz; Fernando, Bernard; Cresswell, Kathrin; Williams, Robin; Pinnock, Hilary

    2013-06-01

    Computerized decision support systems (CDSS) are commonly deployed to support prescribing, although over-riding of alerts by prescribers remains a concern. We aimed to understand how general practitioners (GPs) interact with prescribing CDSS in order to inform deliberation on how better to support prescribing decisions in primary care. Quantitative and qualitative analysis of interactions between GPs, patients, and computer systems using multi-channel video recordings of 112 primary care consultations with eight GPs in three UK practices. 132 prescriptions were issued in the course of 73 of the consultations, of which 81 (61%) attracted at least one alert. Of the total of 117 alerts, only three resulted in the GP checking, but not altering, the prescription. CDSS provided information and safety alerts at the point of generating a prescription. This was 'too much, too late' as the majority of the 'work' of prescribing occurred prior to using the computer. By the time an alert appeared, the GP had formulated the problem(s), potentially spent several minutes considering, explaining, negotiating, and reaching agreement with the patient about the proposed treatment, and had possibly given instructions and printed an information leaflet. CDSS alerts do not coincide with the prescribing workflow throughout the whole GP consultation. Current systems interrupt to correct decisions that have already been taken, rather than assisting formulation of the management plan. CDSS are likely to be more acceptable and effective if the prescribing support is provided much earlier in the process of generating a prescription.

  17. Use of web services for computerized medical decision support, including infection control and antibiotic management, in the intensive care unit.

    Science.gov (United States)

    Steurbaut, Kristof; Van Hoecke, Sofie; Colpaert, Kirsten; Lamont, Kristof; Taveirne, Kristof; Depuydt, Pieter; Benoit, Dominique; Decruyenaere, Johan; De Turck, Filip

    2010-01-01

    The increasing complexity of procedures in the intensive care unit (ICU) requires complex software services, to reduce improper use of antibiotics and inappropriate therapies, and to offer earlier and more accurate detection of infections and antibiotic resistance. We investigated whether web-based software can facilitate the computerization of complex medical processes in the ICU. The COSARA application contains the following modules: Infection overview, Thorax, Microbiology, Antibiotic therapy overview, Admission cause with comorbidity and admission diagnosis, Infection linking and registration, and Feedback. After the implementation and test phase, the COSARA software was installed on a physician's office PC and then on the bedside PCs of the patients. Initial evaluation indicated that the services had been integrated easily into the daily clinical workflow of the medical staff. The use of a service oriented architecture with web service technology for the development of advanced decision support in the ICU offers several advantages over classical software design approaches.

  18. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: methods of a decision-maker-researcher partnership systematic review.

    Science.gov (United States)

    Haynes, R Brian; Wilczynski, Nancy L

    2010-02-05

    Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions

  19. Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: Methods of a decision-maker-researcher partnership systematic review

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2010-02-01

    Full Text Available Abstract Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. Methods The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Results Data will be summarized

  20. Effectiveness of computerized clinical decision support systems for asthma and chronic obstructive pulmonary disease in primary care: a systematic review.

    Science.gov (United States)

    Fathima, Mariam; Peiris, David; Naik-Panvelkar, Pradnya; Saini, Bandana; Armour, Carol Lyn

    2014-12-02

    The use of computerized clinical decision support systems may improve the diagnosis and ongoing management of chronic diseases, which requires recurrent visits to multiple health professionals, disease and medication monitoring and modification of patient behavior. The aim of this review was to systematically review randomized controlled trials evaluating the effectiveness of computerized clinical decision systems (CCDSS) in the care of people with asthma and COPD. Randomized controlled trials published between 2003 and 2013 were searched using multiple electronic databases Medline, EMBASE, CINAHL, IPA, Informit, PsychINFO, Compendex, and Cochrane Clinical Controlled Trials Register databases. To be included, RCTs had to evaluate the role of the CCDSSs for asthma and/or COPD in primary care. Nineteen studies representing 16 RCTs met our inclusion criteria. The majority of the trials were conducted in patients with asthma. Study quality was generally high. Meta-analysis was not conducted because of methodological and clinical heterogeneity. The use of CCDSS improved asthma and COPD care in 14 of the 19 studies reviewed (74%). Nine of the nineteen studies showed statistically significant (p < 0.05) improvement in the primary outcomes measured. The majority of the studies evaluated health care process measures as their primary outcomes (10/19). Evidence supports the effectiveness of CCDSS in the care of people with asthma. However there is very little information of its use in COPD care. Although there is considerable improvement in the health care process measures and clinical outcomes through the use of CCDSSs, its effects on user workload and efficiency, safety, costs of care, provider and patient satisfaction remain understudied.

  1. Return on investment for vendor computerized physician order entry in four community hospitals: the importance of decision support.

    Science.gov (United States)

    Zimlichman, Eyal; Keohane, Carol; Franz, Calvin; Everett, Wendy L; Seger, Diane L; Yoon, Catherine; Leung, Alexander A; Cadet, Bismarck; Coffey, Michael; Kaufman, Nathan E; Bates, David W

    2013-07-01

    In-hospital adverse events are a major cause of morbidity and mortality and represent a major cost burden to health care systems. A study was conducted to evaluate the return on investment (ROI) for the adoption of vendor-developed computerized physician oder entry (CPOE) systems in four community hospitals in Massachusetts. Of the four hospitals, two were under one management structure and implemented the same vendor-developed CPOE system (Hospital Group A), while the other two were under a second management structure and implemented another vendor-developed CPOE system (Hospital Group B). Cost savings were calculated on the basis of reduction in preventable adverse drug event (ADE) rates as measured previously. ROI, net cash flow, and the breakeven point during a 10-year cost-and-benefit model were calculated. At the time of the study, none of the participating hospitals had implemented more than a rudimentary decision support system together with CPOE. Implementation costs were lower for Hospital Group A than B ($7,130,894 total or $83/admission versus $19,293,379 total or $113/admission, respectively), as were preventable ADE-related avoided costs ($7,937,651 and $16,557,056, respectively). A cost-benefit analysis demonstrated that Hospital Group A had an ROI of 11.3%, breaking even on the investment eight years following implementation. Hospital Group B showed a negative return, with an ROI of -3.1%. Adoption of vendor CPOE systems in community hospitals was associated with a modest ROI at best when applying cost savings attributable to prevention of ADEs only. The modest financial returns can beattributed to the lack of clinical decision support tools.

  2. Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests.

    Science.gov (United States)

    Claret, Pierre-Géraud; Bobbia, Xavier; Macri, Francesco; Stowell, Andrew; Motté, Antony; Landais, Paul; Beregi, Jean-Paul; de La Coussaye, Jean-Emmanuel

    2016-06-01

    The adoption of computerized physician order entry is an important cornerstone of using health information technology (HIT) in health care. The transition from paper to computer forms presents a change in physicians' practices. The main objective of this study was to investigate the impact of implementing a computer-based order entry (CPOE) system without clinical decision support on the number of radiographs ordered for patients admitted in the emergency department. This single-center pre-/post-intervention study was conducted in January, 2013 (before CPOE period) and January, 2014 (after CPOE period) at the emergency department at Nîmes University Hospital. All patients admitted in the emergency department who had undergone medical imaging were included in the study. Emergency department admissions have increased since the implementation of CPOE (5388 in the period before CPOE implementation vs. 5808 patients after CPOE implementation, p=.008). In the period before CPOE implementation, 2345 patients (44%) had undergone medical imaging; in the period after CPOE implementation, 2306 patients (40%) had undergone medical imaging (p=.008). In the period before CPOE, 2916 medical imaging procedures were ordered; in the period after CPOE, 2876 medical imaging procedures were ordered (p=.006). In the period before CPOE, 1885 radiographs were ordered; in the period after CPOE, 1776 radiographs were ordered (pmedical imaging did not vary between the two periods. Our results show a decrease in the number of radiograph requests after a CPOE system without clinical decision support was implemented in our emergency department. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Impact of monitoring surgical prophylactic antibiotics and a computerized decision support system on antimicrobial use and antimicrobial resistance.

    Science.gov (United States)

    Huh, Kyungmin; Chung, Doo Ryeon; Park, Hyo Jung; Kim, Min-Ji; Lee, Nam Yong; Ha, Young Eun; Kang, Cheol-In; Peck, Kyong Ran; Song, Jae-Hoon

    2016-09-01

    Monitoring of performance indicators and implementation of a computerized decision support system (CDSS) have been suggested as effective measures to improve quality of care. We conducted this study to evaluate the effect of monitoring of surgical prophylactic antibiotics (SPAs) and the CDSS on the antimicrobial use and resistance rate of major nosocomial pathogens. An interrupted time series with segmented regression analysis in 3 periods (preintervention, SPAs monitoring, and CDSS) was conducted in a tertiary care hospital. Immediate change and change in trends of antimicrobial use density, resistance rate of nosocomial pathogens, and cost of antibiotics in each intervention period were compared with those of the preintervention period. Compared with the preintervention period, the change in the slope of the total use of antibiotics was -8.71 defined daily dose (DDD) per 1,000 patient days per month (95% confidence interval [CI], -11.43 to -5.98; P resistant Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus have been reversed or decreased in slope in the CDSS period. Length of hospital stay also showed a negative change in slope in the CDSS period. Monitoring of SPAs and implementation of the CDSS can be effective measures for antimicrobial stewardship. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

    Science.gov (United States)

    Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

    2016-09-01

    To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

  5. What hinders the uptake of computerized decision support systems in hospitals? A qualitative study and framework for implementation.

    Science.gov (United States)

    Liberati, Elisa G; Ruggiero, Francesca; Galuppo, Laura; Gorli, Mara; González-Lorenzo, Marien; Maraldi, Marco; Ruggieri, Pietro; Polo Friz, Hernan; Scaratti, Giuseppe; Kwag, Koren H; Vespignani, Roberto; Moja, Lorenzo

    2017-09-15

    Advanced Computerized Decision Support Systems (CDSSs) assist clinicians in their decision-making process, generating recommendations based on up-to-date scientific evidence. Although this technology has the potential to improve the quality of patient care, its mere provision does not guarantee uptake: even where CDSSs are available, clinicians often fail to adopt their recommendations. This study examines the barriers and facilitators to the uptake of an evidence-based CDSS as perceived by diverse health professionals in hospitals at different stages of CDSS adoption. Qualitative study conducted as part of a series of randomized controlled trials of CDSSs. The sample includes two hospitals using a CDSS and two hospitals that aim to adopt a CDSS in the future. We interviewed physicians, nurses, information technology staff, and members of the boards of directors (n = 30). We used a constant comparative approach to develop a framework for guiding implementation. We identified six clusters of experiences of, and attitudes towards CDSSs, which we label as "positions." The six positions represent a gradient of acquisition of control over CDSSs (from low to high) and are characterized by different types of barriers to CDSS uptake. The most severe barriers (prevalent in the first positions) include clinicians' perception that the CDSSs may reduce their professional autonomy or may be used against them in the event of medical-legal controversies. Moving towards the last positions, these barriers are substituted by technical and usability problems related to the technology interface. When all barriers are overcome, CDSSs are perceived as a working tool at the service of its users, integrating clinicians' reasoning and fostering organizational learning. Barriers and facilitators to the use of CDSSs are dynamic and may exist prior to their introduction in clinical contexts; providing a static list of obstacles and facilitators, irrespective of the specific implementation

  6. Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes.

    Science.gov (United States)

    Souza, Nathan M; Sebaldt, Rolf J; Mackay, Jean A; Prorok, Jeanette C; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian

    2011-08-03

    Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive. We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63%) RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34%) trials assessed patient outcomes, and four (29%) reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15%) and two (5%) trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Evidence supports the effectiveness of CCDSSs for screening and

  7. Computerized clinical decision support systems for primary preventive care: A decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes

    Directory of Open Access Journals (Sweden)

    Wilczynski Nancy L

    2011-08-01

    Full Text Available Abstract Background Computerized clinical decision support systems (CCDSSs are claimed to improve processes and outcomes of primary preventive care (PPC, but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs. Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews Database, Inspec, and other databases, as well as reference lists through January 2010. We contacted authors to confirm data or provide additional information. We included RCTs that assessed the effect of a CCDSS for PPC on process of care and patient outcomes compared to care provided without a CCDSS. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results We added 17 new RCTs to our 2005 review for a total of 41 studies. RCT quality improved over time. CCDSSs improved process of care in 25 of 40 (63% RCTs. Cumulative scientifically strong evidence supports the effectiveness of CCDSSs for screening and management of dyslipidaemia in primary care. There is mixed evidence for effectiveness in screening for cancer and mental health conditions, multiple preventive care activities, vaccination, and other preventive care interventions. Fourteen (34% trials assessed patient outcomes, and four (29% reported improvements with the CCDSS. Most trials were not powered to evaluate patient-important outcomes. CCDSS costs and adverse events were reported in only six (15% and two (5% trials, respectively. Information on study duration was often missing, limiting our ability to assess sustainability of CCDSS effects. Conclusions

  8. Barriers to implementation of a computerized decision support system for depression: an observational report on lessons learned in "real world" clinical settings

    Directory of Open Access Journals (Sweden)

    Sunderajan Prabha

    2009-01-01

    Full Text Available Abstract Background Despite wide promotion, clinical practice guidelines have had limited effect in changing physician behavior. Effective implementation strategies to date have included: multifaceted interventions involving audit and feedback, local consensus processes, marketing; reminder systems, either manual or computerized; and interactive educational meetings. In addition, there is now growing evidence that contextual factors affecting implementation must be addressed such as organizational support (leadership procedures and resources for the change and strategies to implement and maintain new systems. Methods To examine the feasibility and effectiveness of implementation of a computerized decision support system for depression (CDSS-D in routine public mental health care in Texas, fifteen study clinicians (thirteen physicians and two advanced nurse practitioners participated across five sites, accruing over 300 outpatient visits on 168 patients. Results Issues regarding computer literacy and hardware/software requirements were identified as initial barriers. Clinicians also reported concerns about negative impact on workflow and the potential need for duplication during the transition from paper to electronic systems of medical record keeping. Conclusion The following narrative report based on observations obtained during the initial testing and use of a CDSS-D in clinical settings further emphasizes the importance of taking into account organizational factors when planning implementation of evidence-based guidelines or decision support within a system.

  9. Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

    Science.gov (United States)

    North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

    2014-03-20

    Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed

  10. Protocol for implementation of family health history collection and decision support into primary care using a computerized family health history system

    Directory of Open Access Journals (Sweden)

    Agbaje Astrid B

    2011-10-01

    Full Text Available Abstract Background The CDC's Family History Public Health Initiative encourages adoption and increase awareness of family health history. To meet these goals and develop a personalized medicine implementation science research agenda, the Genomedical Connection is using an implementation research (T3 research framework to develop and integrate a self-administered computerized family history system with built-in decision support into 2 primary care clinics in North Carolina. Methods/Design The family health history system collects a three generation family history on 48 conditions and provides decision support (pedigree and tabular family history, provider recommendation report and patient summary report for 4 pilot conditions: breast cancer, ovarian cancer, colon cancer, and thrombosis. All adult English-speaking, non-adopted, patients scheduled for well-visits are invited to complete the family health system prior to their appointment. Decision support documents are entered into the medical record and available to provider's prior to the appointment. In order to optimize integration, components were piloted by stakeholders prior to and during implementation. Primary outcomes are change in appropriate testing for hereditary thrombophilia and screening for breast cancer, colon cancer, and ovarian cancer one year after study enrollment. Secondary outcomes include implementation measures related to the benefits and burdens of the family health system and its impact on clinic workflow, patients' risk perception, and intention to change health related behaviors. Outcomes are assessed through chart review, patient surveys at baseline and follow-up, and provider surveys. Clinical validity of the decision support is calculated by comparing its recommendations to those made by a genetic counselor reviewing the same pedigree; and clinical utility is demonstrated through reclassification rates and changes in appropriate screening (the primary outcome

  11. Use of a computerized decision support system for primary and secondary prevention of work-related MSD disability.

    Science.gov (United States)

    Womack, Sarah K; Armstrong, Thomas J

    2005-09-01

    The present study evaluates the effectiveness of a decision support system used to evaluate and control physical job stresses and prevent re-injury of workers who have experienced or are concerned about work-related musculoskeletal disorders. The software program is a database that stores detailed job information such as standardized work data, videos, and upper-extremity physical stress ratings for over 400 jobs in the plant. Additionally, the database users were able to record comments about the jobs and related control issues. The researchers investigated the utility and effectiveness of the software by analyzing its use over a 20-month period. Of the 197 comments entered by the users, 25% pertained to primary prevention, 75% pertained to secondary prevention, and 94 comments (47.7%) described ergonomic interventions. Use of the software tool improved primary and secondary prevention by improving the quality and efficiency of the ergonomic job analysis process.

  12. Decision support, analytics, and business intelligence

    CERN Document Server

    Power, Daniel J

    2013-01-01

    Competition is becoming more intense and decision makers are encountering increasing complexity, rapid change, and higher levels of risk. In many situations, the solution is more and better computerized decision support, especially analytics and business intelligence. Today managers need to learn about and understand computerized decision support. If a business is to succeed, managers must know much more about information technology solutions. This second edition of a powerful introductory book is targeted at busy managers and MBA students who need to grasp the basics of computerized decision support, including the following: What are analytics? What is a decision support system? How can managers identify opportunities to create innovative computerized support? Inside, the author addresses these questions and some 60 more fundamental questions that are key to understanding the rapidly changing realm of computerized decision support. In a short period of time, you'll "get up to speed" on decision support, anal...

  13. Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: the CODES study protocol for a randomized controlled trial.

    Science.gov (United States)

    Moja, Lorenzo; Polo Friz, Hernan; Capobussi, Matteo; Kwag, Koren; Banzi, Rita; Ruggiero, Francesca; González-Lorenzo, Marien; Liberati, Elisa Giulia; Mangia, Massimo; Nyberg, Peter; Kunnamo, Ilkka; Cimminiello, Claudio; Vighi, Giuseppe; Grimshaw, Jeremy; Bonovas, Stefanos

    2016-07-07

    Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. These messages are intelligently filtered to enhance the health and clinical care of patients. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge. We designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, evidence-based reminders generated at the point-of-care by a multi-specialty decision support system on clinical practice and the quality of care. We will include all the patients admitted to the internal medicine department of one large general hospital. The primary outcome is the rate at which medical problems, which are detected by the decision support software and reported through the reminders, are resolved (i.e., resolution rates). Secondary outcomes are resolution rates for reminders specific to venous thromboembolism (VTE) prevention, in-hospital all causes and VTE-related mortality, and the length of hospital stay during the study period. The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous demands for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings, thereby informing future research and healthcare policy questions related to the feasibility and value of CDSS use in healthcare systems. This trial is seconded by a specialty trial randomizing patients in an oncology setting (ONCO-CODES). ClinicalTrials.gov, https://clinicaltrials.gov/ct2

  14. A COMPUTERIZED OPERATOR SUPPORT SYSTEM PROTOTYPE

    Energy Technology Data Exchange (ETDEWEB)

    Thomas A. Ulrich; Roger Lew; Ronald L. Boring; Ken Thomas

    2015-03-01

    A computerized operator support system (COSS) is proposed for use in nuclear power plants to assist control room operators in addressing time-critical plant upsets. A COSS is a collection of technologies to assist operators in monitoring overall plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. A prototype COSS was developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based on four underlying elements consisting of a digital alarm system, computer-based procedures, piping and instrumentation diagram system representations, and a recommender module for mitigation actions. The initial version of the prototype is now operational at the Idaho National Laboratory using the Human System Simulation Laboratory.

  15. Effectiveness of a real-time clinical decision support system for computerized physician order entry of plasma orders.

    Science.gov (United States)

    Yazer, Mark H; Triulzi, Darrell J; Reddy, Vivek; Waters, Jonathan H

    2013-12-01

    We investigated the effect of implementing adaptive plasma ordering criteria in the computerized physician order entry (CPOE) system, with alerts that were automatically generated if the recipient's antecedent international normalized ratio (INR) did not meet the institutional criteria. In a regional health care system consisting of 11 hospitals using a common CPOE, data on the number of plasma orders and alerts that were generated were collected over a 4-month period before prescribers were required to select an indication for plasma. When adaptive ordering was implemented prescribers had to choose from prepopulated indications for plasma: INR of 1.6 or greater with bleeding, INR of 1.6 or greater before an invasive procedure, therapeutic exchange, massive transfusion, and other. Regardless of the antecedent INR the alert did not trigger if massive transfusion or plasmapheresis was selected. Information on prescribers and recipients was collected during this 5-month period. In the 4-month period before the adaptive alerts were implemented, 42.9% of the plasma orders generated an alert; in the 5-month period thereafter the alert rate was significantly lower at 27.9% (p plasma orders were for periprocedure or bleeding patients whose antecedent INR was less than 1.6. There were significant differences in prescriber specialties among those who ordered plasma using the other indication compared to all plasma orders. Electronic interventions improve compliance with plasma guidelines but as implemented are not sufficient to completely curtail non-evidence-based ordering. © 2013 American Association of Blood Banks.

  16. Usability evaluation of pharmacogenomics clinical decision support aids and clinical knowledge resources in a computerized provider order entry system: a mixed methods approach.

    Science.gov (United States)

    Devine, Emily Beth; Lee, Chia-Ju; Overby, Casey L; Abernethy, Neil; McCune, Jeannine; Smith, Joe W; Tarczy-Hornoch, Peter

    2014-07-01

    Pharmacogenomics (PGx) is positioned to have a widespread impact on the practice of medicine, yet physician acceptance is low. The presentation of context-specific PGx information, in the form of clinical decision support (CDS) alerts embedded in a computerized provider order entry (CPOE) system, can aid uptake. Usability evaluations can inform optimal design, which, in turn, can spur adoption. The study objectives were to: (1) evaluate an early prototype, commercial CPOE system with PGx-CDS alerts in a simulated environment, (2) identify potential improvements to the system user interface, and (3) understand the contexts under which PGx knowledge embedded in an electronic health record is useful to prescribers. Using a mixed methods approach, we presented seven cardiologists and three oncologists with five hypothetical clinical case scenarios. Each scenario featured a drug for which a gene encoding drug metabolizing enzyme required consideration of dosage adjustment. We used Morae(®) to capture comments and on-screen movements as participants prescribed each drug. In addition to PGx-CDS alerts, 'Infobutton(®)' and 'Evidence' icons provided participants with clinical knowledge resources to aid decision-making. Nine themes emerged. Five suggested minor improvements to the CPOE user interface; two suggested presenting PGx information through PGx-CDS alerts using an 'Infobutton' or 'Evidence' icon. The remaining themes were strong recommendations to provide succinct, relevant guidelines and dosing recommendations of phenotypic information from credible and trustworthy sources; any more information was overwhelming. Participants' median rating of PGx-CDS system usability was 2 on a Likert scale ranging from 1 (strongly agree) to 7 (strongly disagree). Usability evaluation results suggest that participants considered PGx information important for improving prescribing decisions; and that they would incorporate PGx-CDS when information is presented in relevant and

  17. Guidelines for maternal and neonatal "point of care": needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso.

    Science.gov (United States)

    Zakane, S Alphonse; Gustafsson, Lars L; Tomson, Göran; Loukanova, Svetla; Sié, Ali; Nasiell, Josefine; Bastholm-Rahmner, Pia

    2014-06-01

    In 2010, 245,000 women died due to pregnancy-related causes in sub-Saharan Africa and southern Asia. Our study is nested into the QUALMAT project and seeks to improve the quality of maternal care services through the introduction of a computerized clinical decision support system (CDSS) to help healthcare workers in rural areas. Healthcare information technology applications in low-income countries may improve healthcare provision but recent studies demonstrate unintended consequences with underuse or resistance to CDSS and that the fit between the system and the clinical needs does present challenges. To explore and describe perceived needs and attitudes among healthcare workers to access WHO guidelines using CDSS in maternal and neonatal care in rural Burkina Faso. Data were collected with semi-structured interviews in two rural districts in Burkina Faso with 45 informants. Descriptive statistics were used for the analysis of the quantitative part of the interview corresponding to informants' background. Qualitative data were analyzed using manifest content analysis. Four main findings emerged: (a) an appreciable willingness among healthcare workers for and a great interest to adapt and use modern technologies like computers to learn more in the workplace, (b) a positive attitude to easy access of guidelines and implementation of decision-support using computers in the workplace, (c) a fear that the CDSS would require more working time and lead to double-work, and (d) that the CDSS is complicated and requires substantial computer training and extensive instructions to fully implement. The findings can be divided into aspects of motivators and barriers in relation to how the CDSS is perceived and to be used. These aspects are closely connected to each other as the motivating aspects can easily be turned into barriers if not taken care of properly in the final design, during implementation and maintenance of the CDSS at point of care. Copyright © 2014 Elsevier

  18. C-A4-01: Computerized Clinical Decision Support During Drug Ordering for Long-term Care Residents With Renal Insufficiency

    Science.gov (United States)

    Field, Terry S; Rochon, Paula; Lee, Monica; Gavendo, Linda; Baril, Joann L; Gurwitz, Jerry H

    2010-01-01

    Objective: To determine whether a computerized clinical decision support system (CDSS) providing patient specific recommendations in real- time improves the quality of prescribing for long-term care residents with renal insufficiency. Design: A randomized trial within the long-stay units of a large long-term care facility. Randomization was within blocks by unit type. Alerts related to medication prescribing for residents with renal insufficiency were displayed to prescribers in the intervention units and hidden but tracked in control units. Measurement: The proportions of final drug orders that were appropriate were compared between intervention and control units within alert categories: recommended medication doses; recommended administration frequencies; recommendations to avoid the drug; 4) warnings of missing information. Results: The rates of alerts were nearly equal in the intervention and control units: 2.5 per 1000 resident days in the intervention units and 2.4 in the control units. The proportions of dose alerts for which the final drug orders were appropriate were similar between the intervention and control units (relative risk 0.95, 95% confidence interval 0.83, 1.1). For the remaining alert categories significantly higher proportions of final drug orders were appropriate in the intervention units: relative risk 2.4 for maximum frequency (1.4, 4.4); 2.6 for drugs that should be avoided (1.4, 5.0); and 1.8 for alerts to acquire missing information (1.1, 3.4). Overall, final drug orders were appropriate significantly more often than a relative risk 1.2 (1.0, 1.4). By tracking personnel time and expenditures, we estimated the cost of developing the CDSS as $48,668.57. Drug costs saved during the 12 months of the trial are estimated at $2,137. Conclusion: Clinical decision support for physicians prescribing medications for long-term care residents with renal insufficiency can improve the quality of prescribing decisions. However, patient well-being and

  19. Computerized management support for swine breeding farms

    NARCIS (Netherlands)

    Huirne, R.B.M.

    1990-01-01

    1. INTRODUCTION

    The investigations described in this thesis have been directed towards computerized management support for swine breeding farms, focused on sow productivity and profitability. The study is composed of three basic parts: (1) basic description and

  20. Group Decision Process Support

    DEFF Research Database (Denmark)

    Gøtze, John; Hijikata, Masao

    1997-01-01

    Introducing the notion of Group Decision Process Support Systems (GDPSS) to traditional decision-support theorists.......Introducing the notion of Group Decision Process Support Systems (GDPSS) to traditional decision-support theorists....

  1. Strategy generator in computerized accident management support system

    International Nuclear Information System (INIS)

    Sirola, M.

    1994-02-01

    An increased interest for research in the field of accident management of nuclear power plants can be noted. Several international programmes have been started in order to be able to understand the basic physical and chemical phenomena in accident conditions. A feasibility study has shown that it would be possible to design and develop a computerized support system for plant staff in accident situations. To achieve this goal the Halden Project has initiated a research programme on Computerized Accident Management Support (CAMS project). The aim is to utilize the capabilities of computerized tools to support the plant staff during the various accident stages. The system will include identification of the accident state, assessment of the future development of the accident and planning of accident mitigation strategies. A prototype is developed to support operators and the Technical Support Centre in decision making during serious accidents in nuclear power plants. A rule based system has been built to take care of the strategy generation. This system assists plant personnel in planning control proposals and mitigation strategies from normal operation to severe accident conditions. The idea of a safety objective tree and knowledge from the emergency procedures have been used. Future prediction requires good state identification of the plant status and some knowledge about the history of some critical variables. The information needs to be validated as well. Accurate calculations in simulators and a large database including all important information from the plant will help the strategy planning. (orig.). (40 refs., 20 figs.)

  2. Computerization of the safeguards analysis decision process

    International Nuclear Information System (INIS)

    Ehinger, M.H.

    1990-01-01

    This paper reports that safeguards regulations are evolving to meet new demands for timeliness and sensitivity in detecting the loss or unauthorized use of sensitive nuclear materials. The opportunities to meet new rules, particularly in bulk processing plants, involve developing techniques which use modern, computerized process control and information systems. Using these computerized systems in the safeguards analysis involves all the challenges of the man-machine interface experienced in the typical process control application and adds new dimensions to accuracy requirements, data analysis, and alarm resolution in the regulatory environment

  3. The Future of Computerized Decision Making

    Science.gov (United States)

    2014-12-01

    professionals will be becoming more adept at scripting, modeling, graphical and statistical displays. Decision makers may, similarly, be less likely to shy...elsewhere in this proceedings (Sanchez 2014) simulation can be the core for model-driven big data and inferential decision-making. We need to stake... descriptive , not prescriptive.” In our field, we deal with prospective decision making. We have an advantage in this area: since our output data are

  4. The Importance of Data Warehouses in the Development of Computerized Decision Support Solutions. A Comparison between Data Warehouses and Data Marts

    Directory of Open Access Journals (Sweden)

    Alexandru Adrian ŢOLE

    2016-05-01

    Full Text Available In the last decade, the amount of data that an organization processes and stores has grown exponentially. In most cases, the data stored is used to support the business process through accurate and up-to-date information about the business environment and activity of the company. In order for a company's managers to be capable of generating the reports they need to make decisions, one needs a computer system able to store complex and very large quantities of data. At the same time, for the development of such an information system, one must take into account the cost of it.

  5. Sustained User Engagement in Health Information Technology: The Long Road from Implementation to System Optimization of Computerized Physician Order Entry and Clinical Decision Support Systems for Prescribing in Hospitals in England.

    Science.gov (United States)

    Cresswell, Kathrin M; Lee, Lisa; Mozaffar, Hajar; Williams, Robin; Sheikh, Aziz

    2017-10-01

    To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. Six hospitals in England, United Kingdom. Qualitative case study. We undertook qualitative semi-structured interviews, non-participant observations of meetings and system use, and collected organizational documents over three time periods from six hospitals. Thematic analysis was initially undertaken within individual cases, followed by cross-case comparisons. We conducted 173 interviews, conducted 24 observations, and collected 17 documents between 2011 and 2015. We found that perceived individual and safety benefits among different user groups tended to facilitate engagement in some, while other less engaged groups developed resistance and unsanctioned workarounds if systems were perceived to be inadequate. We identified both the opportunity and need for sustained engagement across user groups around system enhancement (e.g., through customizing software) and the development of user competencies and effective use. There is an urgent need to move away from an episodic view of engagement focused on the preimplementation phase, to more continuous holistic attempts to engage with and respond to end-users. © Health Research and Educational Trust.

  6. Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

    Science.gov (United States)

    Staszewska, Anna; Zaki, Pearl; Lee, Joon

    2017-10-06

    Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious

  7. Physicians’ use of computerized clinical decision supports to improve medication management in the elderly – the Seniors Medication Alert and Review Technology intervention

    Directory of Open Access Journals (Sweden)

    Alagiakrishnan K

    2016-01-01

    Full Text Available Kannayiram Alagiakrishnan,1 Patricia Wilson,2 Cheryl A Sadowski,3 Darryl Rolfson,1 Mark Ballermann,4,5 Allen Ausford,6,7 Karla Vermeer,7 Kunal Mohindra,8 Jacques Romney,9 Robert S Hayward10 1Department of Medicine, Division of Geriatric Medicine, 2Department of Medicine, 3Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 4Chief Medical Information Office, Alberta Health Services, 5Division of Critical Care, Department of Medicine, University of Alberta, 6Department of Family Medicine, University of Alberta, 7Lynwood Family Physician, 8eClinician EMR, Alberta Health Services-Information Systems, 9Department of Medicine, Division of Endocrinology, 10Division of General Internal Medicine, University of Alberta, Edmonton, AB, Canada Background: Elderly people (aged 65 years or more are at increased risk of polypharmacy (five or more medications, inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS within an electronic medical record (EMR could improve medication safety.Methods: Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR. The “Seniors Medication Alert and Review Technologies” (SMART intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages and active (order-entry alerts prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed.Results: Analysis of

  8. Physicians’ use of computerized clinical decision supports to improve medication management in the elderly – the Seniors Medication Alert and Review Technology intervention

    Science.gov (United States)

    Alagiakrishnan, Kannayiram; Wilson, Patricia; Sadowski, Cheryl A; Rolfson, Darryl; Ballermann, Mark; Ausford, Allen; Vermeer, Karla; Mohindra, Kunal; Romney, Jacques; Hayward, Robert S

    2016-01-01

    Background Elderly people (aged 65 years or more) are at increased risk of polypharmacy (five or more medications), inappropriate medication use, and associated increased health care costs. The use of clinical decision support (CDS) within an electronic medical record (EMR) could improve medication safety. Methods Participatory action research methods were applied to preproduction design and development and postproduction optimization of an EMR-embedded CDS implementation of the Beers’ Criteria for medication management and the Cockcroft–Gault formula for estimating glomerular filtration rates (GFR). The “Seniors Medication Alert and Review Technologies” (SMART) intervention was used in primary care and geriatrics specialty clinics. Passive (chart messages) and active (order-entry alerts) prompts exposed potentially inappropriate medications, decreased GFR, and the possible need for medication adjustments. Physician reactions were assessed using surveys, EMR simulations, focus groups, and semi-structured interviews. EMR audit data were used to identify eligible patient encounters, the frequency of CDS events, how alerts were managed, and when evidence links were followed. Results Analysis of subjective data revealed that most clinicians agreed that CDS appeared at appropriate times during patient care. Although managing alerts incurred a modest time burden, most also agreed that workflow was not disrupted. Prevalent concerns related to clinician accountability and potential liability. Approximately 36% of eligible encounters triggered at least one SMART alert, with GFR alert, and most frequent medication warnings were with hypnotics and anticholinergics. Approximately 25% of alerts were overridden and ~15% elicited an evidence check. Conclusion While most SMART alerts validated clinician choices, they were received as valuable reminders for evidence-informed care and education. Data from this study may aid other attempts to implement Beers’ Criteria in

  9. Review of trends in computerized systems for operator support

    International Nuclear Information System (INIS)

    Cain, D.G.

    1985-01-01

    The major trends shaping the development of computerized operator support systems in nuclear power plants are reviewed. These trends are the result of prior research in disturbance analysis systems that provided the technology base, and the SPDS requirement, which has been the impetus for change. The process is expected to result in hybrid control rooms with computer-driven supervisory workstations that complement conventional control board lay-outs. In the next three to five year period substantial upgrading of computer hardware will allow new and more sophisticated applications routines to be developed for operator support. Greater attention is being given to on-line validation of input signals for computer applications. A general movement towards operating strategies that are not based upon pre-analyzed event sequences is expected to influence the development of operator aids. The integration of displays with operating procedures will enable the computer system to a better coupling between problem detection and its resolution. Improved design methodology will assure that computer applications are accepted and used by operations personnel. Greater on-line analysis capability is stimulating the trend towards more on-site analysis and decision-making at nuclear power plants. Software standardization reflects the high cost of software development and the desire by utilities to gain greater independence from suppliers. There is growing realization that control rooms are beset by many of the demands and limitations of other office settings and that some of these may be addressed by the burgeoning office automation technology. Trends beyond the next five years are difficult to predict; however, there will be a trend towards more intelligent software. Artificial intelligence technology may play a pivotal role in future applications. Taking these trends into perspective, the author concludes that a promising future exists for computerized operator support in nuclear

  10. Computerized systems of NPP operators support. (Psychological problems)

    International Nuclear Information System (INIS)

    Mashin, V.A.

    1995-01-01

    Operator psychological problems arising in the work with NPP operators support computerized systems (OSCS) are considered. The conclusion is made that the OSCS intellectual application will bring the operator into dangerous dependence on his computerized assistant. To avoid this danger it is necessary by creation of the OSCS to divide specially the tasks areas of the operator and OSCS in order to assure the active role of the operator in the NPP control

  11. The Initial Development of a Computerized Operator Support System

    Energy Technology Data Exchange (ETDEWEB)

    Roger Lew; Ronald L Boring; Thomas A Ulrich; Ken Thomas

    2014-08-01

    A computerized operator support system (COSS) is a collection of resilient software technologies to assist operators in monitoring overall nuclear power plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. The COSS provides rapid assessments, computations, and recommendations to reduce workload and augment operator judgment and decision-making during fast- moving, complex events. A prototype COSS for a chemical volume control system at a nuclear power plant has been developed in order to demonstrate the concept and provide a test bed for further research. The development process identified four underlying elements necessary for the prototype, which consist of a digital alarm system, computer-based procedures, piping and instrumentation diagram system representations, and a recommender module for mitigation actions. An operational prototype resides at the Idaho National Laboratory (INL) using the U.S. Department of Energy’s (DOE) Light Water Reactor Sustainability (LWRS) Human Systems Simulation Laboratory (HSSL). Several human-machine interface (HMI) considerations are identified and incorporated in the prototype during this initial round of development.

  12. PP167. A process evaluation of an innovative implementation strategy of the Dutch guidelines on hypertensive disorders in pregnancy using a computerized decision support system

    DEFF Research Database (Denmark)

    Luitjes, S.H.E.; Mesri, K; Wouters, M

    2012-01-01

    strategy of professional audit and feedback. In this study a process evaluation of BOS has been done, analyzing its efficiency, barriers and formulate improvement points.OBJECTIVES: Gynecologists, residents and clinical midwives from seven hospitals using BOS were asked to fill in the questionnaire...... by the respondents were mainly regarding the lay-out. Most respondents (85.3%) found it useful to make a computer based support system for other guidelines and 79.4% would also use this.CONCLUSION: BOS is regarded suitable as an instrument for implementing guidelines and respondents find it useful to develop...

  13. Computerized systems for high level information processing and decision making in the field of PSA

    International Nuclear Information System (INIS)

    Kafka, P.; Kunitz, H.

    1990-01-01

    A comprehensive review of Probabilistic Safety Assessment (PSA) related program packages is made. Three fields in methodological succession are covered: plant modeling, data quantification procedures and decision-making support. Packages for fault tree construction and minimal cut sets evaluation are referred to and the performances of three of them: RALLY, ORCHARD and SALP-PC, are discussed and compared. Notions on the raw data sources are presented and the Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR) is given as an example for data base management system generating PSA data. Aggregated risk models for support in safety assessment, plant operation and accident management (SARA, ESSM, PRISIM) are cited. Examples of systems supporting 'living PSA' (SAIS, SUPER-NET, LESSEPS 1300, NUPRA, SPSA) are given. The concluding remarks outline the state-of-the-art developments of computerized systems for reliability analyses. 1 fig., 1 tab., 51 refs. (R.Ts)

  14. A Computerized Clinical Support System and Psychological Laboratory.

    Science.gov (United States)

    Cassel, Russell N.

    1978-01-01

    Advocating "holistic" medicine, this article details the benefits to be derived from using a computerized clinical support system in a psychological laboratory focusing on internal healing where the client/patient becomes a committed partner utilizing biofeedback equipment, gaming, and simulation to achieve self-understanding and…

  15. Radwaste Decision Support System

    International Nuclear Information System (INIS)

    Westrom, G.; Vance, J.N.; Gelhaus, F.E.

    1989-01-01

    The purpose of the Radwaste Decision Support System (RDSS) is to provide expert advice, analysis results and instructional material relative to the treatment, handling, transport and disposal of low-level radioactive waste produced in nuclear power plants. This functional specification addresses the following topics: Functions of the RDSS, Relationships and interfaces between the function, Development of the decisions and logic tree structures embodied in waste management, Elements of the database and the characteristics required to support the decision-making process, Specific User requirements for the RDSS, Development of the user interface, Basic software architecture, and Concepts for the RDSS usage including updating and maintenance

  16. Decision support systems

    DEFF Research Database (Denmark)

    Jørgensen, L.N.; Noe, E.; Langvad, A.M.

    2007-01-01

    system Crop Protection Online is widely used by advisors and as a learning tool for students. Although the system has been validated in many field trials over the years and has shown reliable results, the number of end-users among farmers has been relatively low during the last 10 years (approximately...... 1000 farmers). A sociological investigation of farmers' decision-making styles in the area of crop protection has shown that arable farmers can be divided into three major groups: (a) system-orientated farmers, (b) experience-based farmers and (c) advisory-orientated farmers. The information required...... by these three groups to make their decisions varies and therefore different ways of using decision support systems need to be provided. Decision support systems need to be developed in close dialogue and collaboration with user groups....

  17. MOODLE – COMPUTERIZED DISTANT LEARNING SUPPORT SYSTEM

    Directory of Open Access Journals (Sweden)

    V. A. Tunda

    2014-01-01

    Full Text Available Moodle (Modular Object-Oriented Dynamic Learning Environment is the system developed by the English-speaking community around the world for more than 10 years, supports both, offline and online training. In most cases, Moodle is used to support and connect learning face-to-face with online training, as well as with other types of learning. Moodle allows you to ask all sorts of questions and assess responses in a variety of ways. The central concept of Moodle is a course in which one or more teachers offer students resources (such as files, folders, Web pages and participate in interactive activities (such as forums, wikis, blogging, lessons, seminars, assignments, examinations. Students and teachers can change roles, mutually assess each other, share knowledge on the topics of study in the glossary and database system.In the English-speaking world, there are public sites with detailed documentation on Moodle, which is constantly verified and modified in accordance with emerging new versions of the system; Russian versions do not have public sites with detailed translation of the English-language documentation. On what and to whom you want to perform actions in the daily practice of the modern versions, only the barest of outlines on paid seminars and presentations to those who started the implementation of Moodle in your organization are given. And this despite the fact that the system has a great variety of Moodle (over 500 settings with different levels of functionality to be performed, to maintain and develop specially organized by the team of specialists. The question is not only about creating a training course in Moodle. It's about maintaining the health of the system within the institution, such as a University. Under the "health maintenance" means: availability and preservation of up-to-date documentation on system and manuals on Moodle separately for administrators, managers, teachers and students at their level, training consultants

  18. 45 CFR 307.25 - Review and certification of computerized support enforcement systems.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.25 Review and certification of computerized support enforcement systems. The Office will review, assess and inspect the... 45 Public Welfare 2 2010-10-01 2010-10-01 false Review and certification of computerized support...

  19. Computerized operator support system for the JMTR: ARGUS

    International Nuclear Information System (INIS)

    Oyamada, R.; Yamamoto, K.; Ishii, Y.; Sekine, N.; Nemoto, N.

    1988-01-01

    ARGUS is computerized operator support system developed for the JMTR Function keybords, alphanumic keybords, and colour display terminals serve as comminication interface between ARGUS and operating personnel. ARGUS serves the following purposes; 1) data logging, 2) early abnormality detection, 3) presenting relevant and concentrated information to the operators to support their accurate judgment in case of abnormality occurrence, 4) save of time-historical data for diagnostics, and 5) data base necessary for JMTR operation and maintenance. ARGUS has been implemented on a VAX-11/750 with mos memories of 7.25 MB. (author)

  20. Knowledge representation for decision support systems

    International Nuclear Information System (INIS)

    Methlie, L.B.

    1985-01-01

    This book is organized into three sections in accordance with the structure of the conference program. First section contains four major papers which were commissioned by the Programme Committee to set the tone for the conference and to provide a structured source of relevant material from contributing disciplines. The second section contains specific papers submitted to the conference, and concerned with the following topics of specific interest: epistemological issues for decision support systems (DSS), capturing organizational knowledge for DSS, complementarity between human and formal DSS, and representations for adaption. The third section contains the short papers on any topic of relevance to the theme of the conference. It is hoped that the two working conferences organized by WG 8.3 will contribute to the development of a coherent knowledge and understanding of the class of computerized information systems called Decision Support Systems. (Auth.)

  1. Use of a computerized medication shared decision making tool in community mental health settings: impact on psychotropic medication adherence.

    Science.gov (United States)

    Stein, Bradley D; Kogan, Jane N; Mihalyo, Mark J; Schuster, James; Deegan, Patricia E; Sorbero, Mark J; Drake, Robert E

    2013-04-01

    Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.

  2. Impact decision support diagrams

    Science.gov (United States)

    Boslough, Mark

    2014-10-01

    One way to frame the job of planetary defense is to “find the optimal approach for finding the optimal approach” to NEO mitigation. This requires a framework for defining in advance what should be done under various circumstances. The two-dimensional action matrix from the recent NRC report “Defending Planet Earth” can be generalized to a notional “Impact Decision Support Diagram” by extending it into a third dimension. The NRC action matrix incorporated two important axes: size and time-to-impact, but probability of impact is also critical (it is part of the definitions of both the Torino and Palermo scales). Uncertainty has been neglected, but is also crucial. It can be incorporated by subsuming it into the NEO size axis by redefining size to be three standard deviations greater than the best estimate, thereby providing a built-in conservative margin. The independent variable is time-to-impact, which is known with high precision. The other two axes are both quantitative assessments of uncertainty and are both time dependent. Thus, the diagram is entirely an expression of uncertainty. The true impact probability is either one or zero, and the true size does not change. The domain contains information about the current uncertainty, which changes with time (as opposed to reality, which does not change).

  3. Computerized Operator Support System – Phase II Development

    Energy Technology Data Exchange (ETDEWEB)

    Ulrich, Thomas A.; Boring, Ronald L.; Lew, Roger T.; Thomas, Kenneth D.

    2015-02-01

    A computerized operator support system (COSS) prototype for nuclear control room process control is proposed and discussed. The COSS aids operators in addressing rapid plant upsets that would otherwise result in the shutdown of the power plant and interrupt electrical power generation, representing significant costs to the owning utility. In its current stage of development the prototype demonstrates four advanced functions operators can use to more efficiently monitor and control the plant. These advanced functions consist of: (1) a synthesized and intuitive high level overview display of system components and interrelations, (2) an enthalpy-based mathematical chemical and volume control system (CVCS) model to detect and diagnose component failures, (3) recommended strategies to mitigate component failure effects and return the plant back to pre-fault status, and (4) computer-based procedures to walk the operator through the recommended mitigation actions. The COSS was demonstrated to a group of operators and their feedback was collected. The operators responded positively to the COSS capabilities and features and indicated the system would be an effective operator aid. The operators also suggested several additional features and capabilities for the next iteration of development. Future versions of the COSS prototype will include additional plant systems, flexible computer-based procedure presentation formats, and support for simultaneous component fault diagnosis and dual fault synergistic mitigation action strategies to more efficiently arrest any plant upsets.

  4. Spatial Decision Support Systems

    Directory of Open Access Journals (Sweden)

    Silviu Ioan Bejinariu

    2015-10-01

    Full Text Available The satellite image processing is an important tool for decision making in domains like agriculture, forestry, hydrology, for normal activity tracking but also in special situations caused by natural disasters. In this paper it is proposed a method for forestry surface evaluation in terms of occupied surface and also as number of trees. The segmentation method is based on watershed transform which offers good performances in case the objects to detect have connected borders. The method is applied for automatic multi-temporal analysis of forestry areas and represents a useful instrument for decision makers.

  5. A Framework of a Computerized Decision Aid to Improve Group Judgments

    Directory of Open Access Journals (Sweden)

    Utpal Bose

    2009-09-01

    Full Text Available In organizations, groups of decision makers often meet to make judgments as a group on issues and tasks such as, hiring a person who best fits an open position. In such tasks called cognitive conflict tasks, where there is no conflict of interest, group members attempting to reach a common solution often differ on their perspectives to the problem. Cognitive conflicts have been studied in the context of Social Judgment Theory, which posits that persons or judges make a set of judgments about a set of events based on observation of a set of cues related to the events. Disagreement arises because the judges fail to understand each other’s judgment making policies. In order to reduce disagreement and move the group towards a group judgment policy that has the consensus of the group members and is applied consistently, a computerized decision aid is proposed that can be built around a Group Support System using cognitive mapping as a method of providing cognitive feedback and the Analytic Hierarchy Process to process the conflicting criteria and help an individual formulate a judgment policy, as well as aggregate the individual policies into a group judgment policy. It is argued that such as decision aid by supporting every decision maker in the group to effectively use information about the task so that they have a good understanding of the judgment policy they form, to communicate their evaluation policies accurately to other members, and by providing an iterative mechanism through which members can arrive at a compromise solution to the task, is expected to improve the quality of group judgments.

  6. Computerized accident management support system: development for severe accident management

    International Nuclear Information System (INIS)

    Garcia, V.; Saiz, J.; Gomez, C.

    1998-01-01

    The activities involved in the international Halden Reactor Project (HRP), sponsored by the OECD, include the development of a Computerized Accident Management Support System (CAMS). The system was initially designed for its operation under normal conditions, operational transients and non severe accidents. Its purpose is to detect the plant status, analyzing the future evolution of the sequence (initially using the APROS simulation code) and the possible recovery and mitigation actions in case of an accident occurs. In order to widen the scope of CAMS to severe accident management issues, the integration of the MAAP code in the system has been proposed, as the contribution of the Spanish Electrical Sector to the project (with the coordination of DTN). To include this new capacity in CAMS is necessary to modify the system structure, including two new modules (Diagnosis and Adjustment). These modules are being developed currently for Pressurized Water Reactors and Boiling Water REactors, by the engineering of UNION FENOSA and IBERDROLA companies (respectively). This motion presents the characteristics of the new structure of the CAMS, as well as the general characteristics of the modules, developed by these companies in the framework of the Halden Reactor Project. (Author)

  7. Development of BWR computerized operator support system for emergency conditions

    International Nuclear Information System (INIS)

    Murata, F.

    1984-01-01

    A BWR computerized operator support system (COSS) for emergency conditions has been under development for three years. The conceptual design of the system has been settled and some of the subsystems are in the detailed design or manufacturing stage. The principal functions are technical specification monitoring, diagnosis, guidance during emergency conditions, predictive simulation and safety monitoring. Before a reactor trip, alternative operational guidance for anomalous events is provided by utilization of the CTT (cause consequence tree) and FPS (failure propagation simulator). After the trip, operational guidance is based on event-oriented and symptom-oriented methods in association with the safety function monitor. The technical specification monitor controls the readiness monitor and performs surveillance tests of safety systems to maintain plant operational reliability and to ensure correct performance when initiated. The predictive simulator gives the future trends of significant plant parameters. These subsystems are expected to assist the operational personnel. The feasibility of the COSS functions is confirmed separately by off-line simulation. The paper considers the conceptual design, the functions of the subsystems and the off-line simulation results. Each subsystem has shown that useful information to operational personnel is provided. Henceforth these functions will be integrated into a single system and the feasibility will be thoroughly evaluated using a plant simulator which is being separately developed to verify the COSS. (author)

  8. Continuous Decision Support

    Science.gov (United States)

    2015-12-24

    typically either a corporate finance perspective such as net present value, an operations research perspective that treats the issue as a knapsack...117 6.6 +Resources Reactive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 6.7 ++Resources Reactive with Pearson -Tukey...applying financial methods deals with a class of techniques known as real options methods. [11, 80] In a real options framework, “any corporate decision

  9. 45 CFR 307.13 - Security and confidentiality for computerized support enforcement systems in operation after...

    Science.gov (United States)

    2010-10-01

    ... ENFORCEMENT SYSTEMS § 307.13 Security and confidentiality for computerized support enforcement systems in... systems in operation after October 1, 1997. (a) Information integrity and security. Have safeguards... 45 Public Welfare 2 2010-10-01 2010-10-01 false Security and confidentiality for computerized...

  10. Decision support for emergency management

    International Nuclear Information System (INIS)

    Andersen, V.

    1989-05-01

    A short introduction will be given to the Nordic project ''NKA/INF: Information Technology for Accident and Emergency Management'', which is now in its final phase. To perform evaluation of the project, special scenarious have been developed, and experiments based on these will be fulfilled and compared with experiments without use of the decision support system. Furthermore, the succeeding European project, ''IT Support for Emergency Management - ISEM'', with the purpose of developing a decision support system for complex and distributed decision making in emergency management in full scale, will be described and the preliminary conceptual model for the system will be presented. (author)

  11. Clinical Decision Support (CDS) Inventory

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Clinical Decision Support (CDS) Inventory contains descriptions of past and present CDS projects across the Federal Government. It includes Federal projects,...

  12. Operator decision support system for sodium loop

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kwang Hyeang; Park, Kyu Ho; Kim, Tak Kon; Jo, Choong Ho; Seong, Kyeong A; Lee, Keon Myeong; Kim, Yeong Dal; Kim, Chang Beom; Kim, Jong Kyu; Jo, Hee Chang; Lee, Ji Hyeong; Jeong, Yoon Soo; Chio, Jong Hyeong; Jeong, Bong Joon; Hong, Joon Seong; Kim, Bong Wan; Seong, Byeong Hak [Korea Advanced Institute Science and Technology, Taejon (Korea, Republic of)

    1994-07-01

    The objective of this study is to develop an operator decision support system by computerizing the sodium circuit. This study developed graphical display interface for the control panel which provides the safety control of equipment, the recognition of experimental process states and sodium circuit states. In this study, basic work to develop an operator decision support real-time expert system for sodium loop was carried out. Simplification of control commands and effective operation of various real-time data and signals by equipment code standardization are studied. The cost ineffectiveness of the single processor structure provides the ground for the development of cost effective parallel processing system. The important tasks of this study are (1) design and implementation of control state surveillance panel of sodium loop, (2) requirement analysis of operator support real-time expert system for sodium loop, (3) design of standard code rule for operating equipment and research on the cost effective all purpose parallel processing system and (4) requirement analysis of expert system and design of control state variables and user interface for experimental process. 10 refs., 36 figs., 20 tabs.

  13. Decision Strategy Research: Policy Support

    International Nuclear Information System (INIS)

    Hardeman, F.

    2000-01-01

    The objective of SCK-CEN's R and D programme on decision strategy research are (1) to support and advise the Belgian authorities on specific problems concerning existing and potential hazards from exposure to ionising radiation, both in normal and emergency situations; (2) to perform research on relevant topics that might have an important impact on decision making related to nuclear applications, including social and economic sciences. Main achievements in this area in 1999 are described

  14. Web-Based Group Decision Support System: an Economic Application

    Directory of Open Access Journals (Sweden)

    Ion ISTUDOR

    2010-01-01

    Full Text Available Decision Support Systems (DSS form a specific class of computerized information systems that support business and managerial decision-making activities. Making the right decision in business primarily depends on the quality of data. It also depends on the ability to analyze the data with a view to identifying trends that can suggest solutions and strategies. A “cooperative” decision support system means the data are collected, analyzed and then provided to a human agent who can help the system to revise or refine the data. It means that both a human component and computer component work together to come up with the best solution. This paper describes the usage of a software product (Vanguard System to a specific economic application (evaluating the financial risk assuming that the rate of the economic profitability can be under the value of the interest rate.

  15. Decision support using nonparametric statistics

    CERN Document Server

    Beatty, Warren

    2018-01-01

    This concise volume covers nonparametric statistics topics that most are most likely to be seen and used from a practical decision support perspective. While many degree programs require a course in parametric statistics, these methods are often inadequate for real-world decision making in business environments. Much of the data collected today by business executives (for example, customer satisfaction opinions) requires nonparametric statistics for valid analysis, and this book provides the reader with a set of tools that can be used to validly analyze all data, regardless of type. Through numerous examples and exercises, this book explains why nonparametric statistics will lead to better decisions and how they are used to reach a decision, with a wide array of business applications. Online resources include exercise data, spreadsheets, and solutions.

  16. Instrumentation and control activities at the electric power research institute to support computerized support systems

    International Nuclear Information System (INIS)

    Naser, J.

    1996-01-01

    Most nuclear power plants in the United States are operating with their original analog I and C equipment. This equipment requires increasing maintenance efforts to sustain systems performance. Decreasing availability of replacement parts and support organization for analog technology accentuate obsolescence problems and resultant O and M cost increases. Modern technology, especially digital systems, offers improved functionality, performance, and reliability; solutions to obsolescence of equipment; reduction in O and M costs; and the potential to enhance safety. Digital systems, including computerized support systems, with their inherent advantages will be implemented only if reliable and cost-effective implementation and licensing acceptance is achieved and if the upgraded systems supports reduced power production costs. EPRI and its member utilities are working together under the Integrated I and C Upgrade Initiative to address I and C issues. (author). 23 refs

  17. Optimization-based decision support systems for planning problems in processing industries

    OpenAIRE

    Claassen, G.D.H.

    2014-01-01

    Summary Optimization-based decision support systems for planning problems in processing industries Nowadays, efficient planning of material flows within and between supply chains is of vital importance and has become one of the most challenging problems for decision support in practice. The tremendous progress in hard- and software of the past decades was an important gateway for developing computerized systems that are able to support decision making on different levels within enterprises. T...

  18. Development of computerized supporting system for emergency response in nuclear power plant

    International Nuclear Information System (INIS)

    Lee, Jae Il

    1992-02-01

    In emergency situation of nuclear power plants, effective use of emergency operating procedures (EOPs) is a crucial part of the emergency response process. However, there are several problems in the emergency operating procedures because of the form of the written procedures. They are voluminous and complicate for effective references under high stress situation. Inevitably, it takes time that could be better spent employing measures to control and stabilize to select the correct procedures and apply the decision logic. In this study, a computerized supporting system has been developed to reduce the operator error possibility under emergency situations of nuclear power plant. Using on-line input parameters, the system can determine the status of the critical safety functions and can find appropriate procedures and necessary operator actions automatically. Moreover, the system can help the operator decision making in the core melt accident situation. By tracking the EOP in an on-line mode, most steps concerning checking or verifying plant state are processed automatically without operator participations. Therefore, the interactions between the system and the operator are simplified significantly and the possibility of human error is reduced

  19. Implications of Decision Making Research for Decision Support and Displays

    OpenAIRE

    Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.

    1998-01-01

    To appear in J. A. Cannon-Bowers & E. Salas (Eds.), Decision Making Under Stress: Implications for Training and Simulation. A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes, and cognitive analysis was conducted of the decision making problems faced by Navy ...

  20. INTELLIGENT DECISION SUPPORT ON FOREX

    Directory of Open Access Journals (Sweden)

    V. A. Rybak

    2014-01-01

    Full Text Available A new technology of intelligent decision support on Forex, including forming algorithms of trading signals, rules for the training sample based on technical indicators, which have the highest correlation with the price, the method of reducing the number of losing trades, is proposed. The last is based on an analysis of the wave structure of the market, while the beginning of the cycle (the wave number one is offered to be identified using Bill Williams Oscillator (Awesome oscillator. The process chain of constructing neuro-fuzzy model using software package MatLab is described.

  1. The Intelligent Ventilator Project: Application of Physiological Models in Decision Support

    DEFF Research Database (Denmark)

    Rees, Stephen Edward; Karbing, Dan Stieper; Allerød, Charlotte

    2011-01-01

    Management of mechanical ventilation in intensive care patients is complicated by conflicting clinical goals. Decision support systems (DSS) may support clinicians in finding the correct balance. The objective of this study was to evaluate a computerized model-based DSS for its advice on inspired...

  2. Decision Support System for Hepatitis Disease Diagnosis using Bayesian Network

    Directory of Open Access Journals (Sweden)

    Shamshad Lakho

    2017-12-01

    Full Text Available Medical judgments are tough and challenging as the decisions are often based on the deficient and ambiguous information. Moreover, the result of decision process has direct effects on human lives. The act of human decision declines in emergency situations due to the complication, time limit, and high risks. Therefore, provision of medical diagnosis plays a dynamic role, specifically in the preliminary stage when a physician has limited diagnosis experience and identifies the directions to be taken for the treatment process. Computerized Decision Support Systems have brought a revolution in the medical diagnosis. These automatic systems support the diagnosticians in the course of diagnosis. The major role of Decision Support Systems is to support the medical personnel in decision-making procedures regarding disease diagnosis and treatment recommendation. The proposed system provides easy support in Hepatitis disease recognition. The system is developed using the Bayesian network model. The physician provides the input to the system in the form of symptoms stated by the patient. These signs and symptoms match with the casual relationships present in the knowledge model. The Bayesian network infers conclusion from the knowledge model and calculates the probability of occurrence of Hepatitis B, C and D disorders.

  3. Tactical decision making under stress (TADMUS) decision support system

    OpenAIRE

    Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.

    1996-01-01

    A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes and cognitive analysis of the decision making problems faced by Navy tactical officers in a shipboard Combat Information Center. Baseline testing in high intensity, peace keeping, littoral scenarios indicated...

  4. 45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Functional requirements for computerized support... ENFORCEMENT SYSTEMS § 307.10 Functional requirements for computerized support enforcement systems in operation... necessary to meet Federal Reporting Requirements on a timely basis as prescribed by the Office; (4...

  5. Advanced decision support for winter road maintenance

    Science.gov (United States)

    2008-01-01

    This document provides an overview of the Federal Highway Administration's winter Maintenance Decision Support System (MDSS). The MDSS is a decision support tool that has the ability to provide weather predictions focused toward the road surface. The...

  6. Visual Decision Support Tool for Supporting Asset ...

    Science.gov (United States)

    Abstract:Managing urban water infrastructures faces the challenge of jointly dealing with assets of diverse types, useful life, cost, ages and condition. Service quality and sustainability require sound long-term planning, well aligned with tactical and operational planning and management. In summary, the objective of an integrated approach to infrastructure asset management is to assist utilities answer the following questions:•Who are we at present?•What service do we deliver?•What do we own?•Where do we want to be in the long-term?•How do we get there?The AWARE-P approach (www.aware-p.org) offers a coherent methodological framework and a valuable portfolio of software tools. It is designed to assist water supply and wastewater utility decision-makers in their analyses and planning processes. It is based on a Plan-Do-Check-Act process and is in accordance with the key principles of the International Standards Organization (ISO) 55000 standards on asset management. It is compatible with, and complementary to WERF’s SIMPLE framework. The software assists in strategic, tactical, and operational planning, through a non-intrusive, web-based, collaborative environment where objectives and metrics drive IAM planning. It is aimed at industry professionals and managers, as well as at the consultants and technical experts that support them. It is easy to use and maximizes the value of information from multiple existing data sources, both in da

  7. Role of computerized operator support system in nuclear industry

    International Nuclear Information System (INIS)

    Kossilov, A.

    1994-01-01

    Many existing and all new nuclear stations have a high degree of automation leading to substantial safety and operational benefits. Various operator support systems (OSSs) for nuclear power plants are already operational or under development in the Member States. OSSs are based on intelligent data processing and in addition to plant operation, they are becoming more important for safety also. A key feature of OSSs is their availability to structure data to increase its relevance to a given situation. This can improve the user's ability to identify plant function, systems and component state and to identify faults and diagnose them. OSSs can also assist the user to plan and implement corrective actions to improve NPP availability and safety. The paper describes several such systems or functions either in operation or under development phase as well as a way in which new artificial intelligence-based software techniques will enhance the support possible for providing to the operator. (author). 4 refs

  8. Decisions at hand: a decision support system on handhelds.

    Science.gov (United States)

    Zupan, B; Porenta, A; Vidmar, G; Aoki, N; Bratko, I; Beck, J R

    2001-01-01

    One of the applications of clinical information systems is decision support. Although the advantages of utilizing such aids have never been theoretically disputed, they have been rarely used in practice. The factor that probably often limits the utility of clinical decision support systems is the need for computing power at the very site of decision making--at the place where the patient is interviewed, in discussion rooms, etc. The paper reports on a possible solution to this problem. A decision-support shell LogReg is presented, which runs on a handheld computer. A general schema for handheld-based decision support is also proposed, where decision models are developed on personal computers/workstations, encoded in XML and then transferred to handhelds, where the models are used within a decision support shell. A use case where LogReg has been applied to clinical outcome prediction in crush injury is presented.

  9. Development of PSA module for computerized accident management support (CAMS)

    International Nuclear Information System (INIS)

    Iguchi, Yukihiro

    1996-10-01

    CAMS (Computerised Accident Management Support) is a system that will provide assistance in case of the accidents in a nuclear power plant. The PSA module was developed in order to give useful information in this situation applying the PSA method, which is a comprehensive source of safety knowledge. This module contains plant-specific PSA data, comprising event trees, failure probabilities etc. It has several event trees categorised according to the initiating events. Each event tree has an initiating event frequency and branching probabilities. The various support systems for branches are considered and their dependencies are calculated logically. This module can be activated by data from the state identification (SI) module of CAMS. If an initiating event occurs, the event tree is re-calculated and the PSA module shows which systems of the plant should be activated to bring the plant to a safe state. If the plant responds to the event in the normal way, the plant will be shut down and come to a safe state. However, if some functions do not work, the PSA module generates another path and gives information about the critical systems. If the state of the plant is changed, either by the operators or automatically by the control system, the PSA module follows the new path. Because the estimation of the core damage frequency should be very quick in the accident situation, a simplified model of the event tree and fault trees was adopted. It enabled the PSA module to calculates the CDF within 5 seconds on a standard type work station. The development of the module has been successful. However, further development of the functionality of the module is suggested like real connection to a plant and to the strategy generator module of CAMS, applications for operational support, low power operation optimisation, etc. (author)

  10. Flexible Decision Support in Dynamic Interorganizational Networks

    NARCIS (Netherlands)

    J. Collins (John); W. Ketter (Wolfgang); M. Gini (Maria)

    2008-01-01

    textabstractAn effective Decision Support System (DSS) should help its users improve decision-making in complex, information-rich, environments. We present a feature gap analysis that shows that current decision support technologies lack important qualities for a new generation of agile business

  11. Development of a guideline-based decision support system with explanation facilities for outpatient therapy

    NARCIS (Netherlands)

    Goud, Rick; Hasman, Arie; Peek, Niels

    2008-01-01

    For effective guideline implementation it is recommended to develop and apply carefully designed implementation strategies and instruments. Computerized decision support systems (CDSSs) are such instruments as they can improve guideline adherence by providing advice at the point of care. To improve

  12. Formal Verification of Computerized Procedure with Colored Petri Nets

    International Nuclear Information System (INIS)

    Kim, Yun Goo; Shin, Yeong Cheol

    2008-01-01

    Computerized Procedure System (CPS) supports nuclear power plant operators in performing operating procedures which are instructions to guide in monitoring, decision making and controlling nuclear power plants. Computerized Procedure (CP) should be loaded to CPS. Due to its execution characteristic, computerized procedure acts like a software in CPS. For example, procedure flows are determined by operator evaluation and computerized procedure logic which are pre-defined. So the verification of Computerized Procedure logic and execution flow is needed before computerized procedures are installed in the system. Formal verification methods are proposed and the modeling of operating procedures with Coloured Petri Nets(CP-nets) is presented

  13. Man-mashine communication improvements in computerized operator support system by new technologies

    International Nuclear Information System (INIS)

    Tai, I.; Seki, E.; Fukumoto, A.; Mori, N.; Tsuchida, M.; Itoh, J.; Tanaka, K.

    1984-01-01

    Improvement of the man-machine interface performance is under way as Computerized Operator Support System for nuclear power plants in Japan. This paper describes several improved points in the design of man-mashine interface, especially on the console, based on the evaluation of the conventional design and by taking into account the performance test results of new man-machine interfacing tools. (author)

  14. On the article of V. A. Mashin 'Computerized systems of NPP operators support. (Psychological problems)'

    International Nuclear Information System (INIS)

    Prushinskij, B.Ya.

    1995-01-01

    Basic aspects of V.A. Mashin's article on NPP operator support computerized systems and problems of man-machine interrelation are analyzed. Sharing in the significant degree Mashin's point of view the author of this article considers that the most important aspects of this problem consist in dividing the responsibility for NPP safe operation between all participants of the NPP creation and operation and in the area of practical experience in assuring control functions reliability

  15. Decision support in vaccination policies.

    Science.gov (United States)

    Piso, B; Wild, C

    2009-10-09

    Looking across boarders reveals that the national immunization programs of various countries differ in their vaccination schedules and decisions regarding the implementation and funding of new vaccines. The aim of this review is to identify decision aids and crucial criteria for a rational decision-making process on vaccine introduction and to develop a theoretical framework for decision-making based on available literature. Systematic literature search supplemented by hand-search. We identified five published decision aids for vaccine introduction and program planning in industrialized countries. Their comparison revealed an overall similarity with some differences in the approach as well as criteria. Burden of disease and vaccine characteristics play a key role in all decision aids, but authors vary in their views on the significance of cost-effectiveness analyses. Other relevant factors that should be considered before vaccine introduction are discussed to highly differing extents. These factors include the immunization program itself as well as its conformity with other programs, its feasibility, acceptability, and equity, as well as ethical, legal and political considerations. Assuming that the most comprehensive framework possible will not provide a feasible tool for decision-makers, we suggest a stepwise procedure. Though even the best rational approach and most comprehensive evaluation is limited by remaining uncertainties, frameworks provide at least a structured approach to evaluate the various aspects of vaccine implementation decision-making. This process is essential in making consistently sound decisions and will facilitate the public's confidence in the decision and its realization.

  16. Uncertainty modeling and decision support

    International Nuclear Information System (INIS)

    Yager, Ronald R.

    2004-01-01

    We first formulate the problem of decision making under uncertainty. The importance of the representation of our knowledge about the uncertainty in formulating a decision process is pointed out. We begin with a brief discussion of the case of probabilistic uncertainty. Next, in considerable detail, we discuss the case of decision making under ignorance. For this case the fundamental role of the attitude of the decision maker is noted and its subjective nature is emphasized. Next the case in which a Dempster-Shafer belief structure is used to model our knowledge of the uncertainty is considered. Here we also emphasize the subjective choices the decision maker must make in formulating a decision function. The case in which the uncertainty is represented by a fuzzy measure (monotonic set function) is then investigated. We then return to the Dempster-Shafer belief structure and show its relationship to the fuzzy measure. This relationship allows us to get a deeper understanding of the formulation the decision function used Dempster- Shafer framework. We discuss how this deeper understanding allows a decision analyst to better make the subjective choices needed in the formulation of the decision function

  17. Customer Decision Support Systems: Resources for Student Decision Making

    Directory of Open Access Journals (Sweden)

    Cara Okleshen Peters, Ph.D.

    2005-07-01

    Full Text Available This paper highlights the potential of customer decision support systems (CDSS to assist students in education-related decision making. Faculty can use these resources to more effectively advise students on various elements of college life, while students can employ them to more actively participate in their own learning and improve their academic experience. This conceptual paper summarizes consumer decision support systems (CDSS concepts and presents exemplar websites students could utilize to support their education-related decision making. Finally, the authors discuss the potential benefits and drawbacks such resources engender from a student perspective and conclude with directions for future research.

  18. Toward the Modularization of Decision Support Systems

    Science.gov (United States)

    Raskin, R. G.

    2009-12-01

    Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.

  19. Risk-based emergency decision support

    International Nuclear Information System (INIS)

    Koerte, Jens

    2003-01-01

    In the present paper we discuss how to assist critical decisions taken under complex, contingent circumstances, with a high degree of uncertainty and short time frames. In such sharp-end decision regimes, standard rule-based decision support systems do not capture the complexity of the situation. At the same time, traditional risk analysis is of little use due to variability in the specific circumstances. How then, can an organisation provide assistance to, e.g. pilots in dealing with such emergencies? A method called 'contingent risk and decision analysis' is presented, to provide decision support for decisions under variable circumstances and short available time scales. The method consists of nine steps of definition, modelling, analysis and criteria definition to be performed 'off-line' by analysts, and procedure generation to transform the analysis result into an operational decision aid. Examples of pilots' decisions in response to sudden vibration in offshore helicopter transport method are used to illustrate the approach

  20. Decision support for customers in electronic environments

    Directory of Open Access Journals (Sweden)

    František Dařena

    2011-01-01

    Full Text Available Due to the rapid spread of computer technologies into day-to-day lives many purchases or purchase-related decisions are made in the electronic environment of the Web. In order to handle information overload that is the result of the availability of many web-based stores, products and services, consumers use decision support aids that help with need recognition, information retrieval, filtering, comparisons and choice making. Decision support systems (DSS discipline spreads about 40 years back and was mostly focused on assisting managers. However, online environments and decision support in such environments bring new opportunities also to the customers. The focus on decision support for consumers is also not investigated to the large extent and not documented in the literature. Providing customers with well designed decision aids can lead to lower cognitive decision effort associated with the purchase decision which results in significant increase of consumer’s confidence, satisfaction, and cost savings. During decision making process the subjects can chose from several methods (optimizing, reasoning, analogizing, and creating, DSS types (data-, model-, communication-, document-driven, and knowledge-based and benefit from different modern technologies. The paper investigates popular customer decision making aids, such as search, filtering, comparison, ­e-negotiations and auctions, recommendation systems, social network systems, product design applications, communication support etc. which are frequently related to e-commerce applications. Results include the overview of such decision supporting tools, specific examples, classification according the way how the decisions are supported, and possibilities of applications of progressive technologies. The paper thus contributes to the process of development of the interface between companies and the customers where customer decisions take place.

  1. DECISIONS, METHODS AND TECHNIQUES RELATED TO DECISION SUPPORT SYSTEMS (DSS

    Directory of Open Access Journals (Sweden)

    Boghean Florin

    2015-07-01

    Full Text Available Generalised uncertainty, a phenomenon that today’s managers are facing as part of their professional experience, makes it impossible to anticipate the way the business environment will evolve or what will be the consequences of the decisions they plan to implement. Any decision making process within the company entails the simultaneous presence of a number of economic, technical, juridical, human and managerial variables. The development and the approval of a decision is the result of decision making activities developed by the decision maker and sometimes by a decision support team or/and a decision support system (DSS. These aspects related to specific applications of decision support systems in risk management will be approached in this research paper. Decisions in general and management decisions in particular are associated with numerous risks, due to their complexity and increasing contextual orientation. In each business entity, there are concerns with the implementation of risk management in order to improve the likelihood of meeting objectives, the trust of the parties involved, increase the operational safety and security as well as the protection of the environment, minimise losses, improve organisational resilience in order to diminish the negative impact on the organisation and provide a solid foundation for decision making. Since any business entity is considered to be a wealth generator, the analysis of their performance should not be restricted to financial efficiency alone, but will also encompass their economic efficiency as well. The type of research developed in this paper entails different dimensions: conceptual, methodological, as well as empirical testing. Subsequently, the conducted research entails a methodological side, since the conducted activities have resulted in the presentation of a simulation model that is useful in decision making processes on the capital market. The research conducted in the present paper

  2. Decision support system for Wamakersvallei Winery

    CSIR Research Space (South Africa)

    Van Der Merwe, A

    2007-09-01

    Full Text Available The goal of the study is to lend decision support to management a a wine cellar in three areas of expertise, with Wamakersvallei Winery serving as a special case study. This decision support system is to be delivered in the form of Excel spreadsheet...

  3. Decision support in supervisory control

    International Nuclear Information System (INIS)

    Rasmussen, J.; Goodstein, L.P.

    1985-08-01

    It is argued that the supervisory control of complex industrial processes having a potential for serious consequences in case of accidents requires careful consideration of the allocation of decision making between the three main agents of control; namely the designer, the operator and the automatic control system. In particular, it is advocated that instead of continuing their efforts to make their preplanning of responses and countermeasures more and more complete and restricting the operator's initiative, designers should take advantage of modern information technology to make available to the operators their conceptual models and their processing resources so as to allow the operators to function as their extended arm in coping with the plant. Such an interactive decision making activity would thus benefit from this simultaneous availability of the design basis, up-to-date knowledge of plant status and accumualted operational experience. (author)

  4. PROMO: a computerized tool to support process monitoring activities -application in CANDU simulators

    International Nuclear Information System (INIS)

    Singh, D.T.; Singh, P.P.

    1995-01-01

    PROMO, a prototype computerized PROcess MOnitoring tool, has been designed for the resolution of perceived complexity under conditions of time constraints and criticality. It is suggested that this makes it uniquely suitable for applications such as nuclear power plant operator training and support. This paper describes the tool, the theory underlying its design, and results from preliminary laboratory experiments. While field tests are necessary prior to the drawing of conclusions, the results from the laboratory trials are promising. Efforts are currently underway to extend the research setting to power plant operator training centers. (author). 57 refs., 1 fig

  5. PROMO: a computerized tool to support process monitoring activities -application in CANDU simulators

    Energy Technology Data Exchange (ETDEWEB)

    Singh, D T [York Univ., Toronto, ON (Canada); Singh, P P [Case Western Reserve Univ., Cleveland, OH (United States)

    1996-12-31

    PROMO, a prototype computerized PROcess MOnitoring tool, has been designed for the resolution of perceived complexity under conditions of time constraints and criticality. It is suggested that this makes it uniquely suitable for applications such as nuclear power plant operator training and support. This paper describes the tool, the theory underlying its design, and results from preliminary laboratory experiments. While field tests are necessary prior to the drawing of conclusions, the results from the laboratory trials are promising. Efforts are currently underway to extend the research setting to power plant operator training centers. (author). 57 refs., 1 fig.

  6. Using Visualization in Cockpit Decision Support Systems

    Energy Technology Data Exchange (ETDEWEB)

    Aragon, Cecilia R.

    2005-07-01

    In order to safely operate their aircraft, pilots must makerapid decisions based on integrating and processing large amounts ofheterogeneous information. Visual displays are often the most efficientmethod of presenting safety-critical data to pilots in real time.However, care must be taken to ensure the pilot is provided with theappropriate amount of information to make effective decisions and notbecome cognitively overloaded. The results of two usability studies of aprototype airflow hazard visualization cockpit decision support systemare summarized. The studies demonstrate that such a system significantlyimproves the performance of helicopter pilots landing under turbulentconditions. Based on these results, design principles and implicationsfor cockpit decision support systems using visualization arepresented.

  7. Platform decisions supported by gaming

    DEFF Research Database (Denmark)

    Hansen, Poul H. Kyvsgård; Mikkola, Juliana Hsuan

    2007-01-01

    Platform is an ambiguous multidisciplinary concept. The philosophy behind it is easy to communicate and makes intuitively sense. However, the ease in communication does overshadow the high complexity when the concept is implemented. The practical industrial platform implementation challenge can...... be described as being a configuration problem with a high number of variables. These variables are different in nature; they have contradictory influence on the total performance, and, their importance change over time. Consequently, the specific platform decisions become highly complex and the consequences...

  8. DECISION SUPPORT SYSTEM TO SUPPORT DECISION PROCESSES WITH DATA MINING

    OpenAIRE

    Rupnik, Rok; Kukar, Matjaž

    2007-01-01

    Traditional techniques of data analysis do not enable the solution of all kind of problems and for that reason they have become insufficient. This caused a newinterdisciplinary field of data mining to arise, encompassing both classical statistical, and modern machine learning techniques to support the data analysis and knowledge discovery from data. Data mining methods are powerful in dealing with large quantities of data, but on the other hand they are difficult to master by business users t...

  9. 'My kidneys, my choice, decision aid': supporting shared decision making.

    Science.gov (United States)

    Fortnum, Debbie; Smolonogov, Tatiana; Walker, Rachael; Kairaitis, Luke; Pugh, Debbie

    2015-06-01

    For patients with chronic kidney disease (CKD) who are progressing to end-stage kidney disease (ESKD) a decision of whether to undertake dialysis or conservative care is a critical component of the patient journey. Shared decision making for complex decisions such as this could be enhanced by a decision aid, a practice which is well utilised in other disciplines but limited for nephrology. A multidisciplinary team in Australia and New Zealand (ANZ) utilised current decision-making theory and best practice to develop the 'My Kidneys, My Choice', a decision aid for the treatment of kidney disease. A patient-centred, five-sectioned tool is now complete and freely available to all ANZ units to support the ESKD education and shared decision-making process. Distribution and education have occurred across ANZ and evaluation of the decision aid in practice is in the first phase. Development of a new tool such as an ESKD decision aid requires vision, multidisciplinary input and ongoing implementation resources. This tool is being integrated into ANZ, ESKD education practice and is promoting the philosophy of shared decision making. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  10. Decision support for utility environmental risk management

    International Nuclear Information System (INIS)

    Balson, W.E.; Wilson, D.S.

    1991-01-01

    This paper reviews a number of decision support methods developed and applied by Decision Focus Incorporated to help utility personnel manage current environmental problems. This work has been performed for the Environmental Risk Analysis Program of EPRI's Environment Division, and also for a number of electric utilities across the country. These are two distinct types of decision support software tools that have been created: economic risk management and environmental risk analysis. These types differ primarily in the identification of who will make a decision. Economic risk management tools are directed primarily at decisions made by electric utilities. Environmental risk analysis tools are directed primarily at decisions made by legislative or regulatory agencies, about which a utility may wish to comment

  11. Development of a computerized operator support system for BWR power plant

    International Nuclear Information System (INIS)

    Monta, K.; Sekimizu, K.; Sato, N.; Araki, T.; Mori, N.

    1985-01-01

    A computerized operator support system for BWR power plant has been developed since 1980 supported by the Japanese government. The main functions of the systems are post trip operational guidance, disturbance analysis, standby system management, operational margin monitoring and control rod operational guidance. The former two functions aim at protection against incidents during operation of nuclear power plants and the latter three functions aim at their prevention. As the final stage of the development, these functions are combined with the plant supervision function and are organized as an advanced man-machine interface for BWR power plant. During the above process, operator task analyses are performed to enable synthesis of these support functions for right fit to operator tasks and to realize a hierarchical structure for CRT displays for right fit to operators cognitive needs. (author)

  12. Evaluation of selected environmental decision support software

    International Nuclear Information System (INIS)

    Sullivan, T.M.; Moskowitz, P.D.; Gitten, M.

    1997-06-01

    Decision Support Software (DSS) continues to be developed to support analysis of decisions pertaining to environmental management. Decision support systems are computer-based systems that facilitate the use of data, models, and structured decision processes in decision making. The optimal DSS should attempt to integrate, analyze, and present environmental information to remediation project managers in order to select cost-effective cleanup strategies. The optimal system should have a balance between the sophistication needed to address the wide range of complicated sites and site conditions present at DOE facilities, and ease of use (e.g., the system should not require data that is typically unknown and should have robust error checking of problem definition through input, etc.). In the first phase of this study, an extensive review of the literature, the Internet, and discussions with sponsors and developers of DSS led to identification of approximately fifty software packages that met the preceding definition

  13. Decision support tool for diagnosing the source of variation

    Science.gov (United States)

    Masood, Ibrahim; Azrul Azhad Haizan, Mohamad; Norbaya Jumali, Siti; Ghazali, Farah Najihah Mohd; Razali, Hazlin Syafinaz Md; Shahir Yahya, Mohd; Azlan, Mohd Azwir bin

    2017-08-01

    Identifying the source of unnatural variation (SOV) in manufacturing process is essential for quality control. The Shewhart control chart patterns (CCPs) are commonly used to monitor the SOV. However, a proper interpretation of CCPs associated to its SOV requires a high skill industrial practitioner. Lack of knowledge in process engineering will lead to erroneous corrective action. The objective of this study is to design the operating procedures of computerized decision support tool (DST) for process diagnosis. The DST is an embedded tool in CCPs recognition scheme. Design methodology involves analysis of relationship between geometrical features, manufacturing process and CCPs. The DST contents information about CCPs and its possible root cause error and description on SOV phenomenon such as process deterioration in tool bluntness, offsetting tool, loading error, and changes in materials hardness. The DST will be useful for an industrial practitioner in making effective troubleshooting.

  14. Duplicate laboratory test reduction using a clinical decision support tool.

    Science.gov (United States)

    Procop, Gary W; Yerian, Lisa M; Wyllie, Robert; Harrison, A Marc; Kottke-Marchant, Kandice

    2014-05-01

    Duplicate laboratory tests that are unwarranted increase unnecessary phlebotomy, which contributes to iatrogenic anemia, decreased patient satisfaction, and increased health care costs. We employed a clinical decision support tool (CDST) to block unnecessary duplicate test orders during the computerized physician order entry (CPOE) process. We assessed laboratory cost savings after 2 years and searched for untoward patient events associated with this intervention. This CDST blocked 11,790 unnecessary duplicate test orders in these 2 years, which resulted in a cost savings of $183,586. There were no untoward effects reported associated with this intervention. The movement to CPOE affords real-time interaction between the laboratory and the physician through CDSTs that signal duplicate orders. These interactions save health care dollars and should also increase patient satisfaction and well-being.

  15. A Hyperknowledge Framework of Decision Support Systems.

    Science.gov (United States)

    Chang, Ai-Mei; And Others

    1994-01-01

    Presents a hyperknowledge framework of decision support systems (DSS). This framework formalizes specifics about system functionality, representation of knowledge, navigation of the knowledge system, and user-interface traits as elements of a DSS environment that conforms closely to human cognitive processes in decision making. (Contains 52…

  16. MINDS - Medical Information Network Decision Support System

    National Research Council Canada - National Science Library

    Armenian, H. K

    2008-01-01

    .... The increase in and complexity of medical data at various levels of resolution has increased the need for system level advancements in clinical decision support systems that provide computer-aided...

  17. Geospatial decision support systems for societal decision making

    Science.gov (United States)

    Bernknopf, R.L.

    2005-01-01

    While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the

  18. Aggregate assessments support improved operational decision making

    International Nuclear Information System (INIS)

    Bauer, R.

    2003-01-01

    At Darlington Nuclear aggregate assessment of plant conditions is carried out in support of Operational Decision Making. This paper discusses how aggregate assessments have been applied to Operator Workarounds leading to improved prioritisation and alignment of work programs in different departments. As well, aggregate assessment of plant and human performance factors has been carried out to identify criteria which support conservative decision making in the main control room during unit transients. (author)

  19. Fault Isolation for Shipboard Decision Support

    DEFF Research Database (Denmark)

    Lajic, Zoran; Blanke, Mogens; Nielsen, Ulrik Dam

    2010-01-01

    Fault detection and fault isolation for in-service decision support systems for marine surface vehicles will be presented in this paper. The stochastic wave elevation and the associated ship responses are modeled in the frequency domain. The paper takes as an example fault isolation of a containe......Fault detection and fault isolation for in-service decision support systems for marine surface vehicles will be presented in this paper. The stochastic wave elevation and the associated ship responses are modeled in the frequency domain. The paper takes as an example fault isolation...... to the quality of decisions given to navigators....

  20. Solutions for decision support in university management

    Directory of Open Access Journals (Sweden)

    Andrei STANCIU

    2009-06-01

    Full Text Available The paper proposes an overview of decision support systems in order to define the role of a system to assist decision in university management. The authors present new technologies and the basic concepts of multidimensional data analysis using models of business processes within the universities. Based on information provided by scientific literature and on the authors’ experience, the study aims to define selection criteria in choosing a development environment for designing a support system dedicated to university management. The contributions consist in designing a data warehouse model and models of OLAP analysis to assist decision in university management.

  1. Evaluating Ethical Responsibility in Inverse Decision Support

    Directory of Open Access Journals (Sweden)

    Ahmad M. Kabil

    2012-01-01

    Full Text Available Decision makers have considerable autonomy on how they make decisions and what type of support they receive. This situation places the DSS analyst in a different relationship with the client than his colleagues who support regular MIS applications. This paper addresses an ethical dilemma in “Inverse Decision Support,” when the analyst supports a decision maker who requires justification for a preconceived selection that does not correspond to the best option that resulted from the professional resolution of the problem. An extended application of the AHP model is proposed for evaluating the ethical responsibility in selecting a suboptimal alternative. The extended application is consistent with the Inverse Decision Theory that is used extensively in medical decision making. A survey of decision analysts is used to assess their perspective of using the proposed extended application. The results show that 80% of the respondents felt that the proposed extended application is useful in business practices. 14% of them expanded the usability of the extended application to academic teaching of the ethics theory. The extended application is considered more usable in a country with a higher Transparency International Corruption Perceptions Index (TICPI than in a country with a lower one.

  2. Computerized operator support system with new man-machine interface for BWR power plants

    International Nuclear Information System (INIS)

    Monta, K.; Naito, N.; Sugawara, M.; Sato, N.; Mori, N.; Tai, I.; Fukumoto, A.; Tsuchida, M.

    1984-01-01

    Improvement of the man-machine interface of nuclear power plants is an important contribution to the further enhancement of operational safety. In addition, recent advances in computer technology seem to offer the greatest opportunity to date for achieving improvement in the man-machine interface. The development of a computerized operator support system for BWRs has been undertaken since 1980 with the support of the Japanese Government. The conceptual design of this system is based on the role of the operators. The main functions are standby system management, disturbance analysis and post-trip operational guidance. The objective of the standby system management is to monitor the standby status of the engineered safety feature during normal operation to assure its proper functioning at the onset of emergency situations. The disturbance analysis system detects disturbances in the plant in their early stages and informs the plant operators about, for example, the cause of the disturbances, the plant status and possible propagations. Consequently, operators can take corrective actions to prevent unnecessary plant shutdown. The objective of the post trip operational guide is to support operators in diagnosis and corrective action after a plant trip. Its functions are to monitor the performance of the engineered safety feature, to identify the plant status and to guide the appropriate corrective action to achieve safe plant shutdown. The information from the computerized operator support system is supplied to operators through a colour CRT operator console. The authors have evaluated the performance of various new man-machine interfacing tools and proposed a new operator console design. A prototype system has been developed and verification/validation is proceeding with a BWR plant simulator. (author)

  3. COMPUTERIZATION OF EDUCATION AS A TOOL OF UNIVERSITY TEACHER’S BASIC FUNCTIONS SUPPORT

    Directory of Open Access Journals (Sweden)

    V. V. Denysenko

    2014-04-01

    Full Text Available The intensive process of education computerization confronts modern educators a number of economic, technical, social, psychological and educational problems that need to be solved. The use of computer technology in educational process opens enormous opportunities for the development of cognitive abilities – from sensory and perceptual to speech and mental forms. In broad dissemination and use of technical aids, optical and acoustic techniques, programmed education, cinema, television, computer, the modern scientists and researchers see one of the main factors to enhance education and upbringing level both at regular and higher education institutions. Unfortunately, the process of the organic combination of technical and pedagogical sciences in terms of theory and practice introducing computer (multimedia teaching aids is not as powerful as expected; and as it has been dictated by the needs of the modern society. The slow pace of computerization’s implementation of the learning process at high school has been caused by the reasons of different nature and scale. The main objective of the article is to highlight the problems of computer teaching aids using in teaching process at higher education institutions. The conducted analysis of studying computerization allowed us determining the impact and role in providing the university teacher’s basic functions. It has been established that the teacher is one of the management leading objects of educational and cognitive students’ activity and all its functions practically may have computer support.

  4. Preparing for a decision support system.

    Science.gov (United States)

    Callan, K

    2000-08-01

    The increasing pressure to reduce costs and improve outcomes is driving the health care industry to view information as a competitive advantage. Timely information is required to help reduce inefficiencies and improve patient care. Numerous disparate operational or transactional information systems with inconsistent and often conflicting data are no longer adequate to meet the information needs of integrated care delivery systems and networks in competitive managed care environments. This article reviews decision support system characteristics and describes a process to assess the preparedness of an organization to implement and use decision support systems to achieve a more effective, information-based decision process. Decision support tools included in this article range from reports to data mining.

  5. Formalisation for decision support in anaesthesiology

    NARCIS (Netherlands)

    Renardel de Lavalette, G R; Groenboom, R.; Rotterdam, E; van Harmelen, F; ten Teije, A; de Geus, F.

    1997-01-01

    This paper reports on research for decision support for anaesthesiologists at the University Hospital in Groningen, the Netherlands. Based on CAROLA, an existing automated operation documentation system, we designed a support environment that will assist in real-time diagnosis. The core of the work

  6. Clinical Decision Support: Statistical Hopes and Challenges

    Czech Academy of Sciences Publication Activity Database

    Kalina, Jan; Zvárová, Jana

    2016-01-01

    Roč. 4, č. 1 (2016), s. 30-34 ISSN 1805-8698 Grant - others:Nadační fond na opdporu vědy(CZ) Neuron Institutional support: RVO:67985807 Keywords : decision support * data mining * multivariate statistics * psychiatry * information based medicine Subject RIV: BB - Applied Statistics, Operational Research

  7. Development and implementation of computerized operator support systems in nuclear installations

    International Nuclear Information System (INIS)

    1994-01-01

    This report has been prepared to address the development and implementation of computerized operator support systems (COSS) in nuclear installations. The requirements of operators in information management and job performance in a control room environment are discussed. These requirements, which must be agreed to by the operators, provide a focus for the developers of COSS for implementation in an operational environment. The design methodology presents good practice approaches derived from the experience gained and the lessons learned during actual development of the COSS. The team concept, pilot study and structured step by step phases of software development and implementation should help COSS developers to achieve the level of quality and reliability required. 8 figs, 1 tab

  8. The use of inverse systems in computerized operator support systems for load-following control

    International Nuclear Information System (INIS)

    Klebau, J.; Hentschel, B.; Ziegenbein, D.

    1987-01-01

    The basic problem in load-following control of nuclear power reactors consists in calculation of control rod movement to realize desired local power density distribution in the reactor. Well-known solutions are based on optimal control theory. The paper describes the concept of systems inverses which makes it possible to solve the load-following control problem not in an optimal but in an 'ideal' way, vanishing the optimization criterion of the classical approaches. The advantages of inverse systems are simple calculation procedures, low on-line-storage capacity and low on-line computational amount. This makes it attractive to use inverse systems in computerized operator support systems. 19 refs. (author)

  9. Establishment of computerized support system for the assessment of radiation exposure in a nuclear emergency

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hui; Lee, Yeong Bok; Kim, Eun Han; Seo, Kyeong Seok; Hwang, Won Tae [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of); Kim, Byeong Woo [Sungkyunkwan Univ., Seoul (Korea, Republic of)

    1994-12-15

    For the development of a real-time dose assessment, the knowledge over several fields is necessary. For the establishment of the computerized support system for radiation dose assessment, the followings activities have been carried out in this first year. The first test operation of FADAS on HP workstation has been done by editing the basic modules which had been developed as a nuclear long-term project of Korea Atomic Energy Research Institute. The environmental information around the Kori site have been investigated and the information related to the emergency planning such as population density, road network, and socio-environmental data have been displayed on the computer screen. For the automatic control of the basic modules of FADAS, a first-step control program has been organized.

  10. Using Visualization in Cockpit Decision Support Systems

    Science.gov (United States)

    Aragon, Cecilia R.

    2005-01-01

    In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.

  11. Decision support system for surface irrigation design

    OpenAIRE

    Gonçalves, José M.; Pereira, L.S.

    2009-01-01

    The SADREG decision support system was developed to help decision makers in the process of design and selection of farm surface irrigation systems to respond to requirements of modernization of surface irrigation—furrow, basin, and border irrigation. It includes a database, simulation models, user-friendly interfaces, and multicriteria analysis models. SADREG is comprised of two components: design and selection. The first component applies database information, and through several si...

  12. Biometric and intelligent decision making support

    CERN Document Server

    Kaklauskas, Arturas

    2015-01-01

    This book presents different methods for analyzing the body language (movement, position, use of personal space, silences, pauses and tone, the eyes, pupil dilation or constriction, smiles, body temperature and the like) for better understanding people’s needs and actions, including biometric data gathering and reading. Different studies described in this book indicate that sufficiently much data, information and knowledge can be gained by utilizing biometric technologies. This is the first, wide-ranging book that is devoted completely to the area of intelligent decision support systems, biometrics technologies and their integrations. This book is designated for scholars, practitioners and doctoral and master’s degree students in various areas and those who are interested in the latest biometric and intelligent decision making support problems and means for their resolutions, biometric and intelligent decision making support systems and the theory and practice of their integration and the opportunities fo...

  13. Effect of a clinical decision support system on adherence to a lower tidal volume mechanical ventilation strategy

    NARCIS (Netherlands)

    Eslami, Saeid; de Keizer, Nicolette F.; Abu-Hanna, Ameen; de Jonge, Evert; Schultz, Marcus J.

    2009-01-01

    PURPOSE: The purpose of the study was to measure the effect of a computerized decision support system (CDSS) on adherence to tidal volume (V(T)) recommendations. MATERIALS AND METHODS: We performed a prospective before-after evaluation study on applied V(T) to examine the impact of a CDSS on

  14. RODOS: a comprehensive European - integrated decision support system for Romania

    International Nuclear Information System (INIS)

    Mateescu, Gh.; Gheorghiu, Adriana; Gheorghiu, Dorina; Slavnicu, Dan; Craciunescu, Teddy

    1998-01-01

    This work is basically dedicated to RODOS (Real-time On-line DecisiOn support System), a comprehensive (computerized) decision support system ((C)DSS), integrated at European scale, which is in progress to be customized and implemented also for Romania to cope with the off-site response to nuclear emergencies. The first part deals with a short introduction regarding the need for a decision support system especially in case of a nuclear accident; there are also briefly reviewed the criteria one could demand that a CDSS should fulfill and the need for CDSS to give unequivocal answers to all encountered matters. Subsequently, there are mentioned some of the most known DSS in the world for off-site response to nuclear emergencies together with certain recent accomplishment of the IAEA in this field. The next chapter is dedicated to the four basic related projects (ECURIE, EURDEP, OSEP and RODOS) of the European Commission whose purpose consists in the optimisation of the nuclear emergency preparedness and response everywhere in Europe. Further on there are presented the basic features (the overall structure and functions), along with component software subsystems of the RODOS and, then, the background of RODOS implementation in Romania is reviewed (Romanian reasons to adhere to the RODOS project, needs, national legal framework and competent authorities in the nuclear domain, national radiological and meteorological networks. Finally, it is shortly reported the present status of RODOS customization and implementation in Romania (RODOS dedicated technical environment, collection of data and their transfer into RoGIS database, real-time on-line connection to networks, collection of data for countermeasure modules, source term assessment for CANDU-reactor, other related achievements) together with some concluding remarks. (authors)

  15. Decision support frameworks and tools for conservation

    Science.gov (United States)

    Schwartz, Mark W.; Cook, Carly N.; Pressey, Robert L.; Pullin, Andrew S.; Runge, Michael C.; Salafsky, Nick; Sutherland, William J.; Williamson, Matthew A.

    2018-01-01

    The practice of conservation occurs within complex socioecological systems fraught with challenges that require transparent, defensible, and often socially engaged project planning and management. Planning and decision support frameworks are designed to help conservation practitioners increase planning rigor, project accountability, stakeholder participation, transparency in decisions, and learning. We describe and contrast five common frameworks within the context of six fundamental questions (why, who, what, where, when, how) at each of three planning stages of adaptive management (project scoping, operational planning, learning). We demonstrate that decision support frameworks provide varied and extensive tools for conservation planning and management. However, using any framework in isolation risks diminishing potential benefits since no one framework covers the full spectrum of potential conservation planning and decision challenges. We describe two case studies that have effectively deployed tools from across conservation frameworks to improve conservation actions and outcomes. Attention to the critical questions for conservation project planning should allow practitioners to operate within any framework and adapt tools to suit their specific management context. We call on conservation researchers and practitioners to regularly use decision support tools as standard practice for framing both practice and research.

  16. The Design and Development of a Computerized Tool Support for Conducting Senior Projects in Software Engineering Education

    Science.gov (United States)

    Chen, Chung-Yang; Teng, Kao-Chiuan

    2011-01-01

    This paper presents a computerized tool support, the Meetings-Flow Project Collaboration System (MFS), for designing, directing and sustaining the collaborative teamwork required in senior projects in software engineering (SE) education. Among many schools' SE curricula, senior projects serve as a capstone course that provides comprehensive…

  17. 45 CFR 307.11 - Functional requirements for computerized support enforcement systems in operation by October 1...

    Science.gov (United States)

    2010-10-01

    ...), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT... accounting for the use of Federal, State and local funds in carrying out the program either directly, through... (3) Activities described in the Act that were added by the Personal Responsibility and Work...

  18. Modem: data exchange among decision support systems

    International Nuclear Information System (INIS)

    Baig, S.; Zaehringer, M.

    2003-01-01

    The aim of the European Research and Development project MODEM (Monitoring Data and Information Exchange Among Decision Support Systems) is to achieve practical improvements for data exchange among decision support systems (DSS). Hence, the results of model calculations become comparable. This is a precondition for harmonised decision making. Based on the analysis of existing procedures, it was decided to use the PUSH-PULL concept. Notifications are actively and automatically sent by the DSS (PUSH). The data can then be downloaded form an in-formation server (PULL). The format of the data is defined in XML (extended markup language). Participants of the project are the DSS: RODOS, ARGOS and RECASS. First, the data is comprised of the source term and meteorological information. Results of the prognoses and measurement data are also to be exchanged. Exercises testing and improving the pro-cedures form an integral part of the project. (orig.)

  19. Healthcare performance turned into decision support

    DEFF Research Database (Denmark)

    Sørup, Christian Michel; Jacobsen, Peter

    2013-01-01

    from the healthcare sector, the results obtained could be restricted to this sector. Inclusion of data from Arbejdsmarkedets Tillægspension (ATP) showed no deviation from the results in the healthcare sector. Practical implications – The product of the study is a decision support tool for leaders...

  20. Development of an ecological decision support system

    NARCIS (Netherlands)

    van Beusekom, Frits; Brazier, Frances; Schipper, Piet; Treur, Jan; del Pobil, A.P.

    1998-01-01

    In this paper a knowledge-based decision support system is described that determines the abiotic (chemical and physical) characteristics of a site on the basis of in-homogeneous samples of plant species. Techniques from the area of non-monotonic reasoning are applied to model multi-interpretable

  1. Modeling uncertainty in requirements engineering decision support

    Science.gov (United States)

    Feather, Martin S.; Maynard-Zhang, Pedrito; Kiper, James D.

    2005-01-01

    One inherent characteristic of requrements engineering is a lack of certainty during this early phase of a project. Nevertheless, decisions about requirements must be made in spite of this uncertainty. Here we describe the context in which we are exploring this, and some initial work to support elicitation of uncertain requirements, and to deal with the combination of such information from multiple stakeholders.

  2. Scalable software architectures for decision support.

    Science.gov (United States)

    Musen, M A

    1999-12-01

    Interest in decision-support programs for clinical medicine soared in the 1970s. Since that time, workers in medical informatics have been particularly attracted to rule-based systems as a means of providing clinical decision support. Although developers have built many successful applications using production rules, they also have discovered that creation and maintenance of large rule bases is quite problematic. In the 1980s, several groups of investigators began to explore alternative programming abstractions that can be used to build decision-support systems. As a result, the notions of "generic tasks" and of reusable problem-solving methods became extremely influential. By the 1990s, academic centers were experimenting with architectures for intelligent systems based on two classes of reusable components: (1) problem-solving methods--domain-independent algorithms for automating stereotypical tasks--and (2) domain ontologies that captured the essential concepts (and relationships among those concepts) in particular application areas. This paper highlights how developers can construct large, maintainable decision-support systems using these kinds of building blocks. The creation of domain ontologies and problem-solving methods is the fundamental end product of basic research in medical informatics. Consequently, these concepts need more attention by our scientific community.

  3. Text summarization as a decision support aid

    Directory of Open Access Journals (Sweden)

    Workman T

    2012-05-01

    Full Text Available Abstract Background PubMed data potentially can provide decision support information, but PubMed was not exclusively designed to be a point-of-care tool. Natural language processing applications that summarize PubMed citations hold promise for extracting decision support information. The objective of this study was to evaluate the efficiency of a text summarization application called Semantic MEDLINE, enhanced with a novel dynamic summarization method, in identifying decision support data. Methods We downloaded PubMed citations addressing the prevention and drug treatment of four disease topics. We then processed the citations with Semantic MEDLINE, enhanced with the dynamic summarization method. We also processed the citations with a conventional summarization method, as well as with a baseline procedure. We evaluated the results using clinician-vetted reference standards built from recommendations in a commercial decision support product, DynaMed. Results For the drug treatment data, Semantic MEDLINE enhanced with dynamic summarization achieved average recall and precision scores of 0.848 and 0.377, while conventional summarization produced 0.583 average recall and 0.712 average precision, and the baseline method yielded average recall and precision values of 0.252 and 0.277. For the prevention data, Semantic MEDLINE enhanced with dynamic summarization achieved average recall and precision scores of 0.655 and 0.329. The baseline technique resulted in recall and precision scores of 0.269 and 0.247. No conventional Semantic MEDLINE method accommodating summarization for prevention exists. Conclusion Semantic MEDLINE with dynamic summarization outperformed conventional summarization in terms of recall, and outperformed the baseline method in both recall and precision. This new approach to text summarization demonstrates potential in identifying decision support data for multiple needs.

  4. The conceptual foundation of environmental decision support.

    Science.gov (United States)

    Reichert, Peter; Langhans, Simone D; Lienert, Judit; Schuwirth, Nele

    2015-05-01

    Environmental decision support intends to use the best available scientific knowledge to help decision makers find and evaluate management alternatives. The goal of this process is to achieve the best fulfillment of societal objectives. This requires a careful analysis of (i) how scientific knowledge can be represented and quantified, (ii) how societal preferences can be described and elicited, and (iii) how these concepts can best be used to support communication with authorities, politicians, and the public in environmental management. The goal of this paper is to discuss key requirements for a conceptual framework to address these issues and to suggest how these can best be met. We argue that a combination of probability theory and scenario planning with multi-attribute utility theory fulfills these requirements, and discuss adaptations and extensions of these theories to improve their application for supporting environmental decision making. With respect to (i) we suggest the use of intersubjective probabilities, if required extended to imprecise probabilities, to describe the current state of scientific knowledge. To address (ii), we emphasize the importance of value functions, in addition to utilities, to support decisions under risk. We discuss the need for testing "non-standard" value aggregation techniques, the usefulness of flexibility of value functions regarding attribute data availability, the elicitation of value functions for sub-objectives from experts, and the consideration of uncertainty in value and utility elicitation. With respect to (iii), we outline a well-structured procedure for transparent environmental decision support that is based on a clear separation of scientific prediction and societal valuation. We illustrate aspects of the suggested methodology by its application to river management in general and with a small, didactical case study on spatial river rehabilitation prioritization. Copyright © 2015 The Authors. Published by

  5. Disease Profiling for Computerized Peer Support of Ménière's Disease.

    Science.gov (United States)

    Rasku, Jyrki; Pyykkö, Ilmari; Levo, Hilla; Kentala, Erna; Manchaiah, Vinaya

    2015-09-03

    Peer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière's disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects. The aim of this study was to design a computerized data collection system for the peer support of Menière's disease that is capable in profiling the subject for diagnosis and in assisting with problem solving. The expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière's Federation and utilized in the construction and evaluation of the program. The program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person's attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process. This computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person's complaints for hearing loss, tinnitus, and vertigo. ©Jyrki Rasku, Ilmari Pyykkö, Hilla Levo, Erna Kentala, Vinaya Manchaiah. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 03.09.2015.

  6. Plant state identification using fuzzy logic in the framework of computerized accident management support (CAMS)

    International Nuclear Information System (INIS)

    Van Dyck, Claude

    1997-05-01

    CAMS (computerized accident management support) is a system that will provide assistance in case of accident in a nuclear power plant. In order to support the user in evaluating the plant state, it contains a state identification module. The state identification module provides high-level, qualitative information about the status of critical safety functions, about the availability of safety systems and about the occurrence of initiating events. This information is sent to the man-machine interface and to other CAMS modules. The state identification module is developed using a specific tool: GPS (Goal Processing System) which is based on the Goal Tree - Success Tree formalism. GPS is a tool designed to manage ''process related'' knowledge and aimed at process supervision via real-time acquisition of process variables. Fuzzy logic has been introduced in GPS in order to have smoother transitions between different states of critical safety functions and systems changes and to have a truth value associated to each piece of information provided to the user. The whole system has been tested, integrated with the rest of CAMS, on several accident scenarios. The test results are satisfactory. A brief comparison is made between the present work and previous related work at the HRP. (author)

  7. Decision support for patient care: implementing cybernetics.

    Science.gov (United States)

    Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A

    2004-01-01

    The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.

  8. Decision support tools for policy and planning

    International Nuclear Information System (INIS)

    Jacyk, P.; Schultz, D.; Spangenberg, L.

    1995-01-01

    A decision support system (DSS) is being developed at the Radioactive Liquid Waste Treatment Facility, Los Alamos National Laboratory (LANL). The DSS will be used to evaluate alternatives for improving LANL's existing central radioactive waste water treatment plant and to evaluate new site-wide liquid waste treatment schemes that are required in order to handle the diverse waste streams produced at LANL. The decision support system consists of interacting modules that perform the following tasks: rigorous process simulation, configuration management, performance analysis, cost analysis, risk analysis, environmental impact assessment, transportation modeling, and local, state, and federal regulation compliance checking. Uncertainty handling techniques are used with these modules and also with a decision synthesis module which combines results from the modules listed above. We believe the DSS being developed can be applied to almost any other industrial water treatment facility with little modification because in most situations the waste streams are less complex, fewer regulations apply, and the political environment is simpler. The techniques being developed are also generally applicable to policy and planning decision support systems in the chemical process industry

  9. Tsunami early warning and decision support

    Directory of Open Access Journals (Sweden)

    T. Steinmetz

    2010-09-01

    Full Text Available An innovative newly developed modular and standards based Decision Support System (DSS is presented which forms part of the German Indonesian Tsunami Early Warning System (GITEWS. The GITEWS project stems from the effort to implement an effective and efficient Tsunami Early Warning and Mitigation System for the coast of Indonesia facing the Sunda Arc along the islands of Sumatra, Java and Bali. The geological setting along an active continental margin which is very close to densely populated areas is a particularly difficult one to cope with, because potential tsunamis' travel times are thus inherently short. National policies require an initial warning to be issued within the first five minutes after an earthquake has occurred. There is an urgent requirement for an end-to-end solution where the decision support takes the entire warning chain into account. The system of choice is based on pre-computed scenario simulations and rule-based decision support which is delivered to the decision maker through a sophisticated graphical user interface (GUI using information fusion and fast information aggregation to create situational awareness in the shortest time possible. The system also contains risk and vulnerability information which was designed with the far end of the warning chain in mind – it enables the decision maker to base his acceptance (or refusal of the supported decision also on regionally differentiated risk and vulnerability information (see Strunz et al., 2010. While the system strives to provide a warning as quickly as possible, it is not in its proper responsibility to send and disseminate the warning to the recipients. The DSS only broadcasts its messages to a dissemination system (and possibly any other dissemination system which is operated under the responsibility of BMKG – the meteorological, climatological and geophysical service of Indonesia – which also hosts the tsunami early warning center. The system is to be seen

  10. Supporting multi-stakeholder environmental decisions.

    Science.gov (United States)

    Hajkowicz, Stefan A

    2008-09-01

    This paper examines how multiple criteria analysis (MCA) can be used to support multi-stakeholder environmental management decisions. It presents a study through which 48 stakeholders from environmental, primary production and community interest groups used MCA to prioritise 30 environmental management problems in the Mackay-Whitsunday region of Queensland, Australia. The MCA model, with procedures for aggregating multi-stakeholder output, was used to inform a final decision on the priority of the region's environmental management problems. The result was used in the region's environmental management plan as required under Australia's Natural Heritage Trust programme. The study shows how relatively simple MCA methods can help stakeholders make group decisions, even when they hold strongly conflicting preferences.

  11. Decision Strategy Research and Policy Support

    International Nuclear Information System (INIS)

    Hardeman, F.

    2002-01-01

    The objective of SCK-CEN's R and D programme on decision strategies and policy support is: (1) to investigate the decision making process, with all its relevant dimensions, in the context of radiation protection or other nuclear issues (with particular emphasis on emergency preparedness); (2) to disseminate knowledge on decision making and nuclear emergencies, including the organisation of training courses, the contribution to manuals or guidelines, the participation in working groups or discussion forums; (3) to assist the authorities and the industry on any topic related to radiation protection and to make expertise and infrastructure available; (4) to participate in and contribute to initiatives related to social sciences and their implementation into SCK-CEN; (5) to co-ordinate efforts of SCK-CEN related to medical applications of ionising radiation. Principal achievements in 2001 are described

  12. Decision Strategy Research and Policy Support

    Energy Technology Data Exchange (ETDEWEB)

    Hardeman, F

    2002-04-01

    The objective of SCK-CEN's R and D programme on decision strategies and policy support is: (1) to investigate the decision making process, with all its relevant dimensions, in the context of radiation protection or other nuclear issues (with particular emphasis on emergency preparedness); (2) to disseminate knowledge on decision making and nuclear emergencies, including the organisation of training courses, the contribution to manuals or guidelines, the participation in working groups or discussion forums; (3) to assist the authorities and the industry on any topic related to radiation protection and to make expertise and infrastructure available; (4) to participate in and contribute to initiatives related to social sciences and their implementation into SCK-CEN; (5) to co-ordinate efforts of SCK-CEN related to medical applications of ionising radiation. Principal achievements in 2001 are described.

  13. Spill operation system decision support system

    International Nuclear Information System (INIS)

    Clark, R.

    1992-01-01

    The MSRC Spill Operation System (SOS) is a tool for the support of decision-making at the time of a catastrophic oil spill. SOS provides MSRC decision-makers with access to information about the source of the spill, the spill environment, and the availability of spill response resources. This system is designed to meet the information needs of a Response Supervisor, an Environmental Advisor, Logistics/Maintenance Supervisor, Operations Supervisor, and the MSRC Regional General Manager. The SOS project Objectives are: (1) integrate currently available data, systems, and technologies; (2) develop an application that effectively supports mobilized operations and can be adapted to support normal operations; (3) ensure that the development of computer applications is driven by user needs and not by technology; and (4) coordinate with government and other industry organizations to avoid duplication of effort. Design Objectives for SOS are: (1) centralize management information storage while decentralizing decision making capabilities; (2) boost User confidence by providing a system that is easy to learn, easy to use, and is open-quotes Sailor Proofclose quotes; and (3) use visualization technology in providing spill related information. This approach includes the use of Geographic Information System (GIS) technology for maps and geographically associated resource; and support MSRC's concept of operation which includes - a swift notification of response personnel; fast mobilization of response resources; and accurate tracking of resources during a spill. MSRC is organized into five responsibility regions

  14. Temporal reasoning for decision support in medicine.

    Science.gov (United States)

    Augusto, Juan Carlos

    2005-01-01

    Handling time-related concepts is essential in medicine. During diagnosis it can make a substantial difference to know the temporal order in which some symptoms occurred or for how long they lasted. During prognosis the potential evolutions of a disease are conceived as a description of events unfolding in time. In therapy planning the different steps of treatment must be applied in a precise order, with a given frequency and for a certain span of time in order to be effective. This article offers a survey on the use of temporal reasoning for decision support-related tasks in medicine. Key publications of the area, mainly circumscribed to the latest two decades, are reviewed and classified according to three important stages of patient treatment requiring decision support: diagnosis, prognosis and therapy planning/management. Other complementary publications, like those on time-centered information storage and retrieval, are also considered as they provide valuable support to the above mentioned three stages. Key areas are highlighted and used to organize the latest contributions. The survey of previous research is followed by an analysis of what can still be improved and what is needed to make the next generation of decision support systems for medicine more effective. It can be observed that although the area has been considerably developed, there are still areas where more research is needed to make time-based systems of widespread use in decision support-related areas of medicine. Several suggestions for further exploration are proposed as a result of the survey.

  15. Recommendations on future development of decision support systems

    DEFF Research Database (Denmark)

    MCarthur, Stephen; Chen, Minjiang; Marinelli, Mattia

    Deliverable 8.3 reports on the consolidation of experiences from visualisation, decision support prototypes experiments and recommendations on future developments of decision support systems......Deliverable 8.3 reports on the consolidation of experiences from visualisation, decision support prototypes experiments and recommendations on future developments of decision support systems...

  16. Towards ethical decision support and knowledge management in neonatal intensive care.

    Science.gov (United States)

    Yang, L; Frize, M; Eng, P; Walker, R; Catley, C

    2004-01-01

    Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.

  17. Computer-supported collaborative decision-making

    CERN Document Server

    Filip, Florin Gheorghe; Ciurea, Cristian

    2017-01-01

    This is a book about how management and control decisions are made by persons who collaborate and possibly use the support of an information system. The decision is the result of human conscious activities aiming at choosing a course of action for attaining a certain objective (or a set of objectives). The act of collaboration implies that several entities who work together and share responsibilities to jointly plan, implement and evaluate a program of activities to achieve the common goals. The book is intended to present a balanced view of the domain to include both well-established concepts and a selection of new results in the domains of methods and key technologies. It is meant to answer several questions, such as: a) “How are evolving the business models towards the ever more collaborative schemes?”; b) “What is the role of the decision-maker in the new context?” c) “What are the basic attributes and trends in the domain of decision-supporting information systems?”; d) “Which are the basic...

  18. Decision Support System for Fighter Pilots

    DEFF Research Database (Denmark)

    Randleff, Lars Rosenberg

    2007-01-01

    During a mission over enemy territory a fighter aircraft may be engaged by ground based threats. The pilot can use different measures to avoid the aircraft from being detected by e.g. enemy radar systems. If the enemy detects the aircraft a missile may be fired to seek and destroy the aircraft...... and countermeasures that can be applied to mitigate threats. This work is concerned with finding proper evasive actions when a fighter aircraft is engaged by ground based threats. To help the pilot in deciding on these actions a decision support system may be implemented. The environment in which such a system must....... When new threats occur the decision support system must be able to provide suggestions within a fraction of a second. Since the time it takes to find an optimal solution to the mathematical model can not comply with this requirement solutions are sought using a metaheuristic....

  19. Decision support system to select cover systems

    International Nuclear Information System (INIS)

    Bostick, K.V.

    1995-01-01

    The objective of this technology is to provide risk managers with a defensible, objective way to select capping alternatives for remediating radioactive and mixed waste landfills. The process of selecting containment cover technologies for mixed waste landfills requires consideration of many complex and interrelated technical, regulatory, and economic issues. A Decision Support System (DSS) is needed to integrate the knowledge of experts from scientific, engineering, and management disciplines to help in selecting the best capping practice for the site

  20. A decision support system for forensic entomology

    OpenAIRE

    Morvan , Gildas; Jolly , Daniel; Dupont , Daniel; Kubiak , Philippe

    2007-01-01

    International audience; This paper presents a multiagent-based model of insect development on a dead body and a three layers Decision Support System architecture able to perform retrodictive (abductive) reasoning from multiagent-based models or more generally, complex systems models. This architecture is used in order to compute post-mortem intervals from entomological data sampled on cadavers. Knowing the exact time of a death is fundamental in criminal investigations. Thus, it is necessary ...

  1. The Intelligent Ventilator Project: Application of Physiological Models in Decision Support

    DEFF Research Database (Denmark)

    Rees, Stephen Edward; Karbing, Dan Stieper; Allerød, Charlotte

    2011-01-01

    Management of mechanical ventilation in intensive care patients is complicated by conflicting clinical goals. Decision support systems (DSS) may support clinicians in finding the correct balance. The objective of this study was to evaluate a computerized model-based DSS for its advice on inspired...... in cardiac output (CO) was evaluated. Compared to the baseline ventilator settings set as part of routine clinical care, the system suggested lower tidal volumes and inspired oxygen fraction, but higher frequency, with all suggestions and the model simulated outcome comparing well with the respiratory goals...

  2. Using the Five-Level Taiwan Triage and Acuity Scale Computerized System: Factors in Decision Making by Emergency Department Triage Nurses.

    Science.gov (United States)

    Chang, Wen; Liu, Hsueh-Erh; Goopy, Suzanne; Chen, Li-Chin; Chen, Hsiao-Jung; Han, Chin-Yen

    2017-10-01

    Triage classifies and prioritizes patients' care based on the acuity of the illness in emergency departments (EDs). In Taiwan, the five-level Taiwan Triage and Acuity Scale (TTAS) computerized system was implemented nationally in 2010. The purpose of this study was to understand which factors affect decision-making practices of triage nurses in the light of the implementation of the new TTAS tool and computerized system. The qualitative data were collected by in-depth interviews. Data saturation was reached with 16 participants. Content analysis was used. The results demonstrated that the factors affecting nurses' decision making in the light of the newly implemented computerized system sit within three main categories: external environmental, patients' health status, and nurses' experiences. This study suggests ensuring the patient's privacy while attending the triage desk, improving the critical thinking of triage nurses, and strengthening the public's understanding of the ED visits. These will make ED triage more efficient.

  3. Decision support models for natural gas dispatch

    International Nuclear Information System (INIS)

    Chin, L.; Vollmann, T.E.

    1992-01-01

    A decision support model is presented which will give utilities the support tools to manage the purchasing of natural gas supplies in the most cost effective manner without reducing winter safety stocks to below minimum levels. In Business As Usual (BAU) purchasing quantities vary with the daily forecasts. With Material Requirements Planning (MRP) and Linear Programming (LP), two types of factors are used: seasonal weather and decision rule. Under current practices, BAU simulation uses the least expensive gas source first, then adding successively more expensive sources. Material Requirements Planning is a production planning technique which uses a parent item master production schedule to determine time phased requirements for component points. Where the MPS is the aggregate gas demand forecasts for the contract year. This satisfies daily demand with least expensive gas and uses more expensive when necessary with automatic computation of available-to-promise (ATP) gas a dispacher knows daily when extra gas supplies may be ATP. Linear Programming is a mathematical algorithm used to determine optimal allocations of scarce resources to achieve a desired result. The LP model determines optimal daily gas purchase decisions with respect to supply cost minimization. Using these models, it appears possible to raise gross income margins 6 to 10% with minimal additions of customers and no new gas supply

  4. Decision support models for natural gas dispatch

    Energy Technology Data Exchange (ETDEWEB)

    Chin, L. (Bentley College, Waltham, MA (United States)); Vollmann, T.E. (International Inst. for Management Development, Lausanne (Switzerland))

    A decision support model is presented which will give utilities the support tools to manage the purchasing of natural gas supplies in the most cost effective manner without reducing winter safety stocks to below minimum levels. In Business As Usual (BAU) purchasing quantities vary with the daily forecasts. With Material Requirements Planning (MRP) and Linear Programming (LP), two types of factors are used: seasonal weather and decision rule. Under current practices, BAU simulation uses the least expensive gas source first, then adding successively more expensive sources. Material Requirements Planning is a production planning technique which uses a parent item master production schedule to determine time phased requirements for component points. Where the MPS is the aggregate gas demand forecasts for the contract year. This satisfies daily demand with least expensive gas and uses more expensive when necessary with automatic computation of available-to-promise (ATP) gas a dispacher knows daily when extra gas supplies may be ATP. Linear Programming is a mathematical algorithm used to determine optimal allocations of scarce resources to achieve a desired result. The LP model determines optimal daily gas purchase decisions with respect to supply cost minimization. Using these models, it appears possible to raise gross income margins 6 to 10% with minimal additions of customers and no new gas supply.

  5. A distributed clinical decision support system architecture

    Directory of Open Access Journals (Sweden)

    Shaker H. El-Sappagh

    2014-01-01

    Full Text Available This paper proposes an open and distributed clinical decision support system architecture. This technical architecture takes advantage of Electronic Health Record (EHR, data mining techniques, clinical databases, domain expert knowledge bases, available technologies and standards to provide decision-making support for healthcare professionals. The architecture will work extremely well in distributed EHR environments in which each hospital has its own local EHR, and it satisfies the compatibility, interoperability and scalability objectives of an EHR. The system will also have a set of distributed knowledge bases. Each knowledge base will be specialized in a specific domain (i.e., heart disease, and the model achieves cooperation, integration and interoperability between these knowledge bases. Moreover, the model ensures that all knowledge bases are up-to-date by connecting data mining engines to each local knowledge base. These data mining engines continuously mine EHR databases to extract the most recent knowledge, to standardize it and to add it to the knowledge bases. This framework is expected to improve the quality of healthcare, reducing medical errors and guaranteeing the safety of patients by helping clinicians to make correct, accurate, knowledgeable and timely decisions.

  6. Modelling and Decision Support of Clinical Pathways

    Science.gov (United States)

    Gabriel, Roland; Lux, Thomas

    The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.

  7. DECISION SUPPORT SYSTEMS FOR NEW PROJECT DEVELOPMENT IN FAST MOVING CONSUMER GOODS INDUSTRIES

    Directory of Open Access Journals (Sweden)

    NINKO KOSTOVSKI

    2017-10-01

    Full Text Available In any contemporary business, decision makers are confronted with increasing amount of information, not necessarily incorporated properly into decision making process. Moreover, decision makers show several cognitive limitations and biases. Managerial decision support systems are intended to assist decision makers in taking advantage of available information. Research proved that that these systems could compensate for the relative weaknesses of the managers as decision makers. They prevent common biases of human decision-making and foster objective and reliable information. With number of variables that must be taken into consideration, internal and external, technological, financial and market related, the new product development and the specifics of that process in fast moving consumer goods industries is perfect for application of computerized decision support system. The results of implementation of such system based on Exsys Corvid in processed food industry are presented with review of overall impressions for the usefulness of the new software, provided by the managers involved in the process. They found that the system consistently offers realistic decisions, that the system is convenient for capturing the institutional knowledge of the process, but also that the system not always follows the standard procedure. They think that the system is user-friendly. However, the implemented system will be useful and consistently outperform expectations only if the company is ready to continuously upgrade the embedded tacit institutional knowledge and experience. However, doing so, the company should never neglect the consumers changing preferences as the most important environmental domain of information critical for new product development.

  8. Human Factors and Technical Considerations for a Computerized Operator Support System Prototype

    Energy Technology Data Exchange (ETDEWEB)

    Ulrich, Thomas Anthony [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lew, Roger Thomas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Medema, Heather Dawne [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald Laurids [Idaho National Lab. (INL), Idaho Falls, ID (United States); Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    A prototype computerized operator support system (COSS) has been developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based on four underlying elements consisting of a digital alarm system, computer-based procedures, PI&D system representations, and a recommender module for mitigation actions. At this point, the prototype simulates an interface to a sensor validation module and a fault diagnosis module. These two modules will be fully integrated in the next version of the prototype. The initial version of the prototype is now operational at the Idaho National Laboratory using the U.S. Department of Energy’s Light Water Reactor Sustainability (LWRS) Human Systems Simulation Laboratory (HSSL). The HSSL is a full-scope, full-scale glass top simulator capable of simulating existing and future nuclear power plant main control rooms. The COSS is interfaced to the Generic Pressurized Water Reactor (gPWR) simulator with industry-typical control board layouts. The glass top panels display realistic images of the control boards that can be operated by touch gestures. A section of the simulated control board was dedicated to the COSS human-system interface (HSI), which resulted in a seamless integration of the COSS into the normal control room environment. A COSS demonstration scenario has been developed for the prototype involving the Chemical & Volume Control System (CVCS) of the PWR simulator. It involves a primary coolant leak outside of containment that would require tripping the reactor if not mitigated in a very short timeframe. The COSS prototype presents a series of operator screens that provide the needed information and soft controls to successfully mitigate the event.

  9. Making cognitive decision support work: Facilitating adoption, knowledge and behavior change through QI.

    Science.gov (United States)

    Weir, Charlene; Brunker, Cherie; Butler, Jorie; Supiano, Mark A

    2017-07-01

    This paper evaluates the role of facilitation in the successful implementation of Computerized Decision Support (CDS). Facilitation processes include education, specialized computerized decision support, and work process reengineering. These techniques, as well as modeling and feedback enhance self-efficacy, which we propose is one of the factors that mediate the effectiveness of any CDS. In this study, outpatient clinics implemented quality improvement (QI) projects focused on improving geriatric care. Quality Improvement is the systematic process of improving quality through continuous measurement and targeted actions. The program, entitled "Advancing Geriatric Education through Quality Improvement" (AGE QI), consisted of a 6-month, QI based, intervention: (1) 2h didactic session, (2) 1h QI planning session, (3) computerized decision support design and implementation, (4) QI facilitation activities, (5) outcome feedback, and (6) 20h of CME. Specifically, we examined the impact of the QI based program on clinician's perceived self-efficacy in caring for older adults and the relationship of implementation support and facilitation on perceived success. The intervention was implemented at 3 institutions, 27 community healthcare system clinics, and 134 providers. This study reports the results of pre/post surveys for the forty-nine clinicians who completed the full CME program. Self-efficacy ratings for specific clinical behaviors related to care of older adults were assessed using a Likert based instrument. Self-ratings of efficacy improved across the following domains (depression, falls, end-of-life, functional status and medication management) and specifically in QI targeted domains and were associated with overall clinic improvements. Published by Elsevier Inc.

  10. Handling risk attitudes for preference learning and intelligent decision support

    DEFF Research Database (Denmark)

    Franco de los Ríos, Camilo; Hougaard, Jens Leth; Nielsen, Kurt

    2015-01-01

    Intelligent decision support should allow integrating human knowledge with efficient algorithms for making interpretable and useful recommendations on real world decision problems. Attitudes and preferences articulate and come together under a decision process that should be explicitly modeled...

  11. Decision support software technology demonstration plan

    Energy Technology Data Exchange (ETDEWEB)

    SULLIVAN,T.; ARMSTRONG,A.

    1998-09-01

    The performance evaluation of innovative and alternative environmental technologies is an integral part of the US Environmental Protection Agency's (EPA) mission. Early efforts focused on evaluating technologies that supported the implementation of the Clean Air and Clean Water Acts. In 1986 the Agency began to demonstrate and evaluate the cost and performance of remediation and monitoring technologies under the Superfund Innovative Technology Evaluation (SITE) program (in response to the mandate in the Superfund Amendments and Reauthorization Act of 1986 (SARA)). In 1990, the US Technology Policy was announced. This policy placed a renewed emphasis on making the best use of technology in achieving the national goals of improved quality of life for all Americans, continued economic growth, and national security. In the spirit of the technology policy, the Agency began to direct a portion of its resources toward the promotion, recognition, acceptance, and use of US-developed innovative environmental technologies both domestically and abroad. Decision Support Software (DSS) packages integrate environmental data and simulation models into a framework for making site characterization, monitoring, and cleanup decisions. To limit the scope which will be addressed in this demonstration, three endpoints have been selected for evaluation: Visualization; Sample Optimization; and Cost/Benefit Analysis. Five topics are covered in this report: the objectives of the demonstration; the elements of the demonstration plan; an overview of the Site Characterization and Monitoring Technology Pilot; an overview of the technology verification process; and the purpose of this demonstration plan.

  12. Significant reduction in red blood cell transfusions in a general hospital after successful implementation of a restrictive transfusion policy supported by prospective computerized order auditing.

    Science.gov (United States)

    Yerrabothala, Swaroopa; Desrosiers, Kevin P; Szczepiorkowski, Zbigniew M; Dunbar, Nancy M

    2014-10-01

    Our hospital transfusion policy was recently revised to recommend single-unit red blood cell transfusion (RBC TXN) for nonbleeding inpatients when the hemoglobin (Hb) level is not more than 7 g/dL. Our computerized provider order entry system was reconfigured to provide real-time decision support using prospective computerized order auditing based on the most recent Hb level and to remove the single-click ordering option for 2-unit RBC TXNs to enhance compliance. This study was undertaken to assess the impact of these changes on hospital transfusion practice. This study analyzed the total number of transfusion events, proportion of single and 2-unit transfusions and the Hb transfusion trigger in the preimplementation period (October 2011-March 2012) compared to the postimplementation period (October 2012-March 2013). In the postimplementation period the total number of RBC units transfused/1000 patient-days decreased from 60.8 to 44.2 (p auditing has resulted in significantly decreased RBC utilization at our institution. © 2014 AABB.

  13. Using a group decision support system to make investment prioritisation decisions

    OpenAIRE

    Read, Martin; Gear, Tony; Minkes, Leonard; Irving, Ann

    2013-01-01

    This paper is concerned with how decision making groups involved in making investment prioritisation decisions involving funding of technology and science projects may be supported by a group decision support system (GDSS). While interested in decision outcomes, the primary focus of this paper is the role of a group support system as an aid to developing shared understanding within a group. The paper develops the conceptual framework of decision-making, communication and group support, and de...

  14. Development of transportation asset management decision support tools : final report.

    Science.gov (United States)

    2017-08-09

    This study developed a web-based prototype decision support platform to demonstrate the benefits of transportation asset management in monitoring asset performance, supporting asset funding decisions, planning budget tradeoffs, and optimizing resourc...

  15. Clinical Decision Support Tools: The Evolution of a Revolution

    NARCIS (Netherlands)

    Mould, D. R.; D'Haens, G.; Upton, R. N.

    2016-01-01

    Dashboard systems for clinical decision support integrate data from multiple sources. These systems, the newest in a long line of dose calculators and other decision support tools, utilize Bayesian approaches to fully individualize dosing using information gathered through therapeutic drug

  16. Computer-Based Support of Decision Making Processes during Biological Incidents

    Directory of Open Access Journals (Sweden)

    Karel Antos

    2010-04-01

    Full Text Available The paper describes contextual analysis of a general system that should provide a computerized support of decision making processes related to response operations in case of a biological incident. This analysis is focused on information systems and information resources perspective and their integration using appropriate tools and technology. In the contextual design the basic modules of BioDSS system are suggested and further elaborated. The modules deal with incident description, scenarios development and recommendation of appropriate countermeasures. Proposals for further research are also included.

  17. Reactive Software Agent Anesthesia Decision Support System

    Directory of Open Access Journals (Sweden)

    Grant H. Kruger

    2011-12-01

    Full Text Available Information overload of the anesthesiologist through technological advances have threatened the safety of patients under anesthesia in the operating room (OR. Traditional monitoring and alarm systems provide independent, spatially distributed indices of patient physiological state. This creates the potential to distract caregivers from direct patient care tasks. To address this situation, a novel reactive agent decision support system with graphical human machine interface was developed. The system integrates the disparate data sources available in the operating room, passes the data though a decision matrix comprising a deterministic physiologic rule base established through medical research. Patient care is improved by effecting change to the care environment by displaying risk factors and alerts as an intuitive color coded animation. The system presents a unified, contextually appropriate snapshot of the patient state including current and potential risk factors, and alerts of critical patient events to the operating room team without requiring any user intervention. To validate the efficacy of the system, a retrospective analysis focusing on the hypotension rules were performed. Results show that even with vigilant and highly trained clinicians, deviations from ideal patient care exist and it is here that the proposed system may allow more standardized and improved patient care and potentially outcomes.

  18. Marketing Decision Making and Decision Support: Challenges and Perspectives for Successful Marketing Management Support Systems

    NARCIS (Netherlands)

    G.H. van Bruggen (Gerrit); B. Wierenga (Berend)

    2009-01-01

    textabstractMarketing management support systems (MMSS) are computer-enabled devices that help marketers to make better decisions. Marketing processes can be quite complex, involving large numbers of variables and mostly outcomes are the results of the actions of many different stakeholders (e.g.,

  19. Semantic technologies in a decision support system

    Science.gov (United States)

    Wasielewska, K.; Ganzha, M.; Paprzycki, M.; Bǎdicǎ, C.; Ivanovic, M.; Lirkov, I.

    2015-10-01

    The aim of our work is to design a decision support system based on ontological representation of domain(s) and semantic technologies. Specifically, we consider the case when Grid / Cloud user describes his/her requirements regarding a "resource" as a class expression from an ontology, while the instances of (the same) ontology represent available resources. The goal is to help the user to find the best option with respect to his/her requirements, while remembering that user's knowledge may be "limited." In this context, we discuss multiple approaches based on semantic data processing, which involve different "forms" of user interaction with the system. Specifically, we consider: (a) ontological matchmaking based on SPARQL queries and class expression, (b) graph-based semantic closeness of instances representing user requirements (constructed from the class expression) and available resources, and (c) multicriterial analysis based on the AHP method, which utilizes expert domain knowledge (also ontologically represented).

  20. THE DECISION SUPPORT SYSTEM IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Ana V.Monica POP

    2013-10-01

    Full Text Available In the present paper we will try to analyze the Decision Support System (DSS and the way in which it is applied or not in the Romanian Small and Medium Sized Enterprises (SMEs (with examples. We also will see if the system is beneficial for these Romanian Enterprises. We analyzed through interviews 50 small and medium-sized Romanian enterprises. They do not accept their name to be published. As a consequence, we will present only the results. It is underlined in the conclusions the differences between the small and the medium size enterprises in respect of the models they are using. The most important benefits of DSS (generally are represented by increased efficiency, competitive advantages and better managerial process.

  1. Computerized tomography

    International Nuclear Information System (INIS)

    Rubashov, I.B.

    1985-01-01

    Operating principle is described for the devices of computerized tomography used in medicine for diagnosis of brain diseases. Computerized tomography is considered as a part of computerized diagnosis, as a part of information science. It is shown that computerized tomography is a real existed field of investigations in medicine and industrial production

  2. Decision support system for diagnosis and treatment of hearing disorders the case of tinnitus

    CERN Document Server

    Tarnowska, Katarzyna A; Jastreboff, Pawel J

    2017-01-01

    The book presents a knowledge discovery based approach to build a recommender system supporting a physician in treating tinnitus patients with the highly successful method called Tinnitus Retraining Therapy. It describes experiments on extracting novel knowledge from the historical dataset of patients treated by Dr. P. Jastreboff so that to better understand factors behind therapy's effectiveness and better personalize treatments for different profiles of patients. The book is a response for a growing demand of an advanced data analytics in the healthcare industry in order to provide better care with the data driven decision-making solutions. The potential economic benefits of applying computerized clinical decision support systems include not only improved efficiency in health care delivery (by reducing costs, improving quality of care and patient safety), but also enhancement in treatment's standardization, objectivity and availability in places of scarce expert's knowledge on this difficult to treat hearin...

  3. Theory, Software and Testing Examples for Decision Support Systems

    OpenAIRE

    Lewandowski, A.; Wierzbicki, A.P.

    1987-01-01

    Research in methodology of Decision Support Systems is one of the activities within the System and Decision Sciences Program which was initiated seven years ago and is still in the center of interests of SDS. During these years several methodological approaches and software tools have been developed; among others the DIDAS (Dynamic Interactive Decision Analysis and Support) and SCDAS (Selection Committed Decision Analysis and Support). Both methodologies gained a certain level of popularity a...

  4. Quantitative Decision Support Requires Quantitative User Guidance

    Science.gov (United States)

    Smith, L. A.

    2009-12-01

    Is it conceivable that models run on 2007 computer hardware could provide robust and credible probabilistic information for decision support and user guidance at the ZIP code level for sub-daily meteorological events in 2060? In 2090? Retrospectively, how informative would output from today’s models have proven in 2003? or the 1930’s? Consultancies in the United Kingdom, including the Met Office, are offering services to “future-proof” their customers from climate change. How is a US or European based user or policy maker to determine the extent to which exciting new Bayesian methods are relevant here? or when a commercial supplier is vastly overselling the insights of today’s climate science? How are policy makers and academic economists to make the closely related decisions facing them? How can we communicate deep uncertainty in the future at small length-scales without undermining the firm foundation established by climate science regarding global trends? Three distinct aspects of the communication of the uses of climate model output targeting users and policy makers, as well as other specialist adaptation scientists, are discussed. First, a brief scientific evaluation of the length and time scales at which climate model output is likely to become uninformative is provided, including a note on the applicability the latest Bayesian methodology to current state-of-the-art general circulation models output. Second, a critical evaluation of the language often employed in communication of climate model output, a language which accurately states that models are “better”, have “improved” and now “include” and “simulate” relevant meteorological processed, without clearly identifying where the current information is thought to be uninformative and misleads, both for the current climate and as a function of the state of the (each) climate simulation. And thirdly, a general approach for evaluating the relevance of quantitative climate model output

  5. Evaluation of a Computerized Problem-Oriented Medical Record in a Hospital Department: Does it Support Daily Clinical Practice?

    DEFF Research Database (Denmark)

    Bossen, Claus

    2007-01-01

    led to more time spent documenting clinical work, fragmentation of patient situation into separate problems, and lack of overview.Conclusion: The problem-oriented method for structuring a computerized medical record may provide a description of how physicians think or ought to think, but does...... not adequately support complex clinical work. While the CPOMR can be used for patients with few, simple problems who are admitted for only a short time, the CPOMR is not useful for patients with a complex set of problems or for patients admitted for longer periods of time. This is in accordance with criticism...

  6. Decision support to enable sustainability in development projects

    CSIR Research Space (South Africa)

    Meyer, IA

    2014-10-01

    Full Text Available that are not always explicitly linked to development outcomes. Throughout this process, scope exists to aid decision makers, through a simplistic set of decision models, to make better decisions. The emphasis is on decisions that support long-term value creation...

  7. Decision Support for Environmental Management of Industrial ...

    Science.gov (United States)

    Non-hazardous solid materials from industrial processes, once regarded as waste and disposed in landfills, offer numerous environmental and economic advantages when put to beneficial uses (BUs). Proper management of these industrial non-hazardous secondary materials (INSM) requires estimates of their probable environmental impacts among disposal as well as BU options. The U.S. Environmental Protection Agency (EPA) has recently approved new analytical methods (EPA Methods 1313–1316) to assess leachability of constituents of potential concern in these materials. These new methods are more realistic for many disposal and BU options than historical methods, such as the toxicity characteristic leaching protocol. Experimental data from these new methods are used to parameterize a chemical fate and transport (F&T) model to simulate long-term environmental releases from flue gas desulfurization gypsum (FGDG) when disposed of in an industrial landfill or beneficially used as an agricultural soil amendment. The F&T model is also coupled with optimization algorithms, the Beneficial Use Decision Support System (BUDSS), under development by EPA to enhance INSM management. The objective of this paper is to demonstrate the methodologies and encourage similar applications to improve environmental management and BUs of INSM through F&T simulation coupled with optimization, using realistic model parameterization.

  8. Global Turbulence Decision Support for Aviation

    Science.gov (United States)

    Williams, J.; Sharman, R.; Kessinger, C.; Feltz, W.; Wimmers, A.

    2009-09-01

    Turbulence is widely recognized as the leading cause of injuries to flight attendants and passengers on commercial air carriers, yet legacy decision support products such as SIGMETs and SIGWX charts provide relatively low spatial- and temporal-resolution assessments and forecasts of turbulence, with limited usefulness for strategic planning and tactical turbulence avoidance. A new effort is underway to develop an automated, rapid-update, gridded global turbulence diagnosis and forecast system that addresses upper-level clear-air turbulence, mountain-wave turbulence, and convectively-induced turbulence. This NASA-funded effort, modeled on the U.S. Federal Aviation Administration's Graphical Turbulence Guidance (GTG) and GTG Nowcast systems, employs NCEP Global Forecast System (GFS) model output and data from NASA and operational satellites to produce quantitative turbulence nowcasts and forecasts. A convective nowcast element based on GFS forecasts and satellite data provides a basis for diagnosing convective turbulence. An operational prototype "Global GTG” system has been running in real-time at the U.S. National Center for Atmospheric Research since the spring of 2009. Initial verification based on data from TRMM, Cloudsat and MODIS (for the convection nowcasting) and AIREPs and AMDAR data (for turbulence) are presented. This product aims to provide the "single authoritative source” for global turbulence information for the U.S. Next Generation Air Transportation System.

  9. Decision support tools for advanced energy management

    International Nuclear Information System (INIS)

    Marik, Karel; Schindler, Zdenek; Stluka, Petr

    2008-01-01

    Rising fuel costs boost energy prices, which is a driving force for improving efficiency of operation of any energy generation facility. This paper focuses on enhancing the operation of distributed integrated energy systems (IES), system that bring together all forms of cooling, heating and power (CCHP) technologies. Described methodology can be applied in power generation and district heating companies, as well as in small-scale systems that supply multiple types of utilities to consumers in industrial, commercial, residential and governmental spheres. Dispatching of such system in an optimal way needs to assess large number of production and purchasing schemes in conditions of continually changing market and variable utility demands influenced by many external factors, very often by weather conditions. The paper describes a combination of forecasting and optimization methods that supports effective decisions in IES system management. The forecaster generates the future most probable utility demand several hours or days ahead, derived from the past energy consumer behaviour. The optimizer generates economically most efficient operating schedule for the IES system that matches these forecasted energy demands and respects expected purchased energy prices. (author)

  10. Post Disaster Assessment with Decision Support System

    Directory of Open Access Journals (Sweden)

    May Florence J. Franco

    2016-05-01

    Full Text Available The study aimed to develop an online system that would expedite the response of agencies after disaster strikes; generate a list of the kinds and volume of relief aids needed per family affected for a fair, precise and timely distribution; implement community-based ICT by remotely gathering all the necessary data needed for disaster assessment; and adhere to ISO 9126 standards. The system was designed to calculate the effects of disaster in human lives and economy. Integrated into the system were Goggle Maps, Mines and GeoSciences Bureau Hazard Maps, SMS sending features, best passable routes calculations, and decision support on the needs that has to be addressed. The system was made live at pdrrmcguimaras.herokuapp.com to allow remote data entry. The functionality and usability of the system were evaluated by 19 potential users by computing for the arithmetic Mean and Standard Deviation of the survey. The result showed that most of them strongly agreed that the system is acceptable based on these criteria. A group of IT experts also evaluated the system’s conformance to ISO 9126 standards using the same method. The result showed that majority of them strongly agreed that the system conforms to this international standard. The system is seen as a valuable tool for the Provincial Disaster Risk Reduction Management Council (PDRRMC and the National Disaster Risk Reduction Management Council (NDRRMC for it could help expedite the assessment of the effects of disasters and the formulation of response plans and strategies.

  11. A generic accounting model to support operations management decisions

    NARCIS (Netherlands)

    Verdaasdonk, P.J.A.; Wouters, M.J.F.

    2001-01-01

    Information systems are generally unable to generate information about the financial consequences of operations management decisions. This is because the procedures for determining the relevant accounting information for decision support are not formalised in ways that can be implemented in

  12. On Decision Support for Sustainability and Resilience of Infrastructure

    DEFF Research Database (Denmark)

    Nielsen, Michael Havbro Faber; Qin, J.; Miragliaa, S.

    2017-01-01

    in Bayesian decision analysis and probabilistic systems performance modelling. A principal example for decision support at regulatory level is presented for a coupled system comprised of infrastructure, social, hazard and environmental subsystems. The infrastructure systems is modelled as multi...

  13. Integration of computerized operation support systems on a nuclear power plant environment

    International Nuclear Information System (INIS)

    Jaime, Guilherme D.G.; Almeida, Jose C.S.; Oliveira, Mauro V.

    2015-01-01

    Automation of certain tasks in a Nuclear Power Plant (NPP) control room is expected to result in reduced operators' mental workload, which may induce other benefits such as enhanced situation awareness and improved system performance. The final goal should be higher level of operational safety. Thus, recent works are increasingly assessing automation. The LABIHS compact NPP simulator, though, still operates under strictly manual printed hard-copy procedures, despite of the fact that the simulator incorporates several advancements in design of digitalized Human-Interfaces (HSIs). This work presents the development, implementation and integration of selected components to achieve increased level of computerized/automated operation of the LABIHS compact NPP simulator. Specifically, we discuss three components: (I) Automatic Plant Mode Detection, (II) Automatic Alarm Filtering, and (III) Computerized Procedures. Each one of these components has to be carefully designed/integrated so that one can avoid the undesired effects of some known implementations of automated systems on NPP, such as the reduction in the operator's system awareness, an increase in monitoring workload, and the degradation in manual skills, which could lead to automation-induced system failures. (author)

  14. Integration of computerized operation support systems on a nuclear power plant environment

    Energy Technology Data Exchange (ETDEWEB)

    Jaime, Guilherme D.G.; Almeida, Jose C.S.; Oliveira, Mauro V., E-mail: gdjaime@ien.gov.br, E-mail: jcsa@ien.gov.br, E-mail: mvitor@ien.gov.br [Instituto Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Servico de Sistemas Complexos. Divisao de Engenharia Nuclear

    2015-07-01

    Automation of certain tasks in a Nuclear Power Plant (NPP) control room is expected to result in reduced operators' mental workload, which may induce other benefits such as enhanced situation awareness and improved system performance. The final goal should be higher level of operational safety. Thus, recent works are increasingly assessing automation. The LABIHS compact NPP simulator, though, still operates under strictly manual printed hard-copy procedures, despite of the fact that the simulator incorporates several advancements in design of digitalized Human-Interfaces (HSIs). This work presents the development, implementation and integration of selected components to achieve increased level of computerized/automated operation of the LABIHS compact NPP simulator. Specifically, we discuss three components: (I) Automatic Plant Mode Detection, (II) Automatic Alarm Filtering, and (III) Computerized Procedures. Each one of these components has to be carefully designed/integrated so that one can avoid the undesired effects of some known implementations of automated systems on NPP, such as the reduction in the operator's system awareness, an increase in monitoring workload, and the degradation in manual skills, which could lead to automation-induced system failures. (author)

  15. Healthcare performance turned into decision support.

    Science.gov (United States)

    Sørup, Christian Michel; Jacobsen, Peter

    2013-01-01

    The purpose of this study is to first create an overview of relevant factors directly influencing employee absence in the healthcare sector. The overview is used to further investigate the factors identified using employee satisfaction survey scores exclusively. The result of the overall objective is a management framework that allows managers to gain insight into the current status of risk factors with high influence on employee absence levels. The research consists of a quantitative literature study supported by formal and semi-formal interviews conducted at the case organisations. Employee satisfaction surveys were applied to analyse the development over time of selected factors correlated with concurrent employee absence rates. Checking for causal results, comparisons with the included published literature findings were also carried out. Four major clustered factors, three of which constitute the term "social capital", showed a high degree of connection with employee absence rates. The factors are general satisfaction, fairness, reliance and co-operation. Integrating the four elements in a management framework will provide valuable and holistic information about the determinants with regard to current levels of employee absence. The framework will be a valuable support for leaders with the authority to alter the determinants of employee absence. Since a great part of the empirical material is supplied from the healthcare sector, the results obtained could be restricted to this sector. Inclusion of data from Arbejdsmarkedets Tillaegspension (ATP) showed no deviation from the results in the healthcare sector. The product of the study is a decision support tool for leaders to cope with levels of employee absence. The framework is holistic and can prove to be a valuable tool to take a bearing of where to focus future initiatives. Gathering former observational studies in a complete overview embracing many relevant factors that influence sickness absence has not yet

  16. Towards meaningful medication-related clinical decision support: recommendations for an initial implementation.

    Science.gov (United States)

    Phansalkar, S; Wright, A; Kuperman, G J; Vaida, A J; Bobb, A M; Jenders, R A; Payne, T H; Halamka, J; Bloomrosen, M; Bates, D W

    2011-01-01

    Clinical decision support (CDS) can improve safety, quality, and cost-effectiveness of patient care, especially when implemented in computerized provider order entry (CPOE) applications. Medication-related decision support logic forms a large component of the CDS logic in any CPOE system. However, organizations wishing to implement CDS must either purchase the computable clinical content or develop it themselves. Content provided by vendors does not always meet local expectations. Most organizations lack the resources to customize the clinical content and the expertise to implement it effectively. In this paper, we describe the recommendations of a national expert panel on two basic medication-related CDS areas, specifically, drug-drug interaction (DDI) checking and duplicate therapy checking. The goals of this study were to define a starter set of medication-related alerts that healthcare organizations can implement in their clinical information systems. We also draw on the experiences of diverse institutions to highlight the realities of implementing medication decision support. These findings represent the experiences of institutions with a long history in the domain of medication decision support, and the hope is that this guidance may improve the feasibility and efficiency CDS adoption across healthcare settings.

  17. Developing a Support Tool for Global Product Development Decisions

    DEFF Research Database (Denmark)

    Søndergaard, Erik Stefan; Ahmed-Kristensen, Saeema

    2016-01-01

    This paper investigates how global product development decisions are made through a multiple-case study in three Danish engineering. The paper identifies which information and methods are applied for making decisions and how decision-making can be supported based on previous experience. The paper...... presents results from 51 decisions made in the three companies, and based on the results of the studies a framework for a decision-support tool is outlined and discussed. The paper rounds off with an identification of future research opportunities in the area of global product development and decision-making....

  18. Development of the Supported Decision Making Inventory System.

    Science.gov (United States)

    Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

    2017-12-01

    Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

  19. An online infertility clinical decision support system

    Directory of Open Access Journals (Sweden)

    Fabio Diniz de Souza

    2017-01-01

    Full Text Available Objective: To explore some possibilities of computer applications in medicine, and to discuss an online infertility clinical decision support system.Methods: Retrospective data were obtained from 52 couples, and then entered into the online tool. Both its results and the initial diagnoses obtained by the treating physicians were compared with the final diagnoses established by laparoscopy and other diagnostic tests (semen analysis, hormone analysis, endometrial biopsy, ultrasound and hysteroscopy. The initial hypothesis of the research was that the online tool's output was statistically associated with the final diagnoses. In order to verify that hypothesis, a chi-square (χ2 test with Yates' correction for continuity (P<0.05 was performed to verify if the online tool's and the doctor's diagnoses were statistically associated with the final diagnoses.Results: Four etiological factors were present in more than 50% of the couples (ovarian, tubal-peritoneal, uterine, and endometriosis. The statistical results confirmed the research hypothesis for eight out of the nine etiological factors (ovarian, tubal-peritoneal, uterine, cervical, male, vaginal, psychosomatic, and endometriosis; P<0.05. Since there were no cases related to the immune factor in the sample, further clinical data are necessary in order to assess the online tool's performance for that factor.Conclusions: The online tool tends to present more false-positives than false-negatives, whereas the expert physician tends to present more false-negatives than false-positives. Therefore, the online tool and the doctor seem to complement each other. Finally, the obtained results suggest that the infertility online tool discussed herein might be a useful research and instructional tool.

  20. An online infertility clinical decision support system

    Directory of Open Access Journals (Sweden)

    Fabio Diniz de Souza

    2017-09-01

    Full Text Available Objective: To explore some possibilities of computer applications in medicine, and to discuss an online infertility clinical decision support system. Methods: Retrospective data were obtained from 52 couples, and then entered into the online tool. Both its results and the initial diagnoses obtained by the treating physicians were compared with the final diagnoses established by laparoscopy and other diagnostic tests (semen analysis, hormone analysis, endometrial biopsy, ultrasound and hysteroscopy. The initial hypothesis of the research was that the online tool’s output was statistically associated with the final diagnoses. In order to verify that hypothesis, a chi-square (氈2 test with Yates’ correction for continuity (P<0.05 was performed to verify if the online tool’s and the doctor’s diagnoses were statistically associated with the final diagnoses. Results: Four etiological factors were present in more than 50% of the couples (ovarian, tubal-peritoneal, uterine, and endometriosis. The statistical results confirmed the research hypothesis for eight out of the nine etiological factors (ovarian, tubal-peritoneal, uterine, cervical, male, vaginal, psychosomatic, and endometriosis; P<0.05. Since there were no cases related to the immune factor in the sample, further clinical data are necessary in order to assess the online tool’s performance for that factor. Conclusions: The online tool tends to present more false-positives than false negatives, whereas the expert physician tends to present more false-negatives than false-positives. Therefore, the online tool and the doctor seem to complement each other. Finally, the obtained results suggest that the infertility online tool discussed herein might be a useful research and instructional tool.

  1. Fault Detection for Shipboard Monitoring and Decision Support Systems

    DEFF Research Database (Denmark)

    Lajic, Zoran; Nielsen, Ulrik Dam

    2009-01-01

    In this paper a basic idea of a fault-tolerant monitoring and decision support system will be explained. Fault detection is an important part of the fault-tolerant design for in-service monitoring and decision support systems for ships. In the paper, a virtual example of fault detection...... will be presented for a containership with a real decision support system onboard. All possible faults can be simulated and detected using residuals and the generalized likelihood ratio (GLR) algorithm....

  2. Checklist and Decision Support in Nutritional Care for Burned Patients

    Science.gov (United States)

    2016-10-01

    able to construct a checklist of a clinical and physiologic model and then a computerised decision support system that will perform two functions: the...the provision of nutritional therapy, and assessment of use by nursing and physician staff KEYWORDS Nutrition, severe burn, decision support... clinical testing. Checklist and Decision Support in Nutritional Care for Burned Patients Proposal Number: 12340011 W81XWH-12-2-0074 PI: Steven E

  3. The Use of Advanced Warfighting Experiments to Support Acquisition Decisions

    National Research Council Canada - National Science Library

    Strayer, Kenneth

    1999-01-01

    .... Specifically, the thesis evaluated the effectiveness of the Army Task Force XXI AWE in providing information to support investment decisions and refinement of requirements for information age technologies...

  4. Modeling Based Decision Support Environment, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Phoenix Integration's vision is the creation of an intuitive human-in-the-loop engineering environment called Decision Navigator that leverages recent advances in...

  5. A Review of Automated Decision Support System

    African Journals Online (AJOL)

    pc

    2018-03-05

    Mar 5, 2018 ... Intelligence AI that enable decision automation based on existing facts, knowledge ... The growing reliance on data impacts dynamic data extraction and retrieval of the ... entertainment, medical, and the web. III. DECISION ...

  6. A systematic review of decision support needs of parents making child health decisions

    Science.gov (United States)

    Jackson, Cath; Cheater, Francine M.; Reid, Innes

    2008-01-01

    Abstract Objective  To identify the decision support needs of parents attempting to make an informed health decision on behalf of a child. Context  The first step towards implementing patient decision support is to assess patients’ information and decision‐making needs. Search strategy  A systematic search of key bibliographic databases for decision support studies was performed in 2005. Reference lists of relevant review articles and key authors were searched. Three relevant journals were hand searched. Inclusion criteria  Non‐intervention studies containing data on decision support needs of parents making child health decisions. Data extraction and synthesis  Data were extracted on study characteristics, decision focus and decision support needs. Studies were quality assessed using a pre‐defined set of criteria. Data synthesis used the UK Evidence for Policy and Practice Information and Co‐ordinating Centre approach. Main results  One‐hundred and forty nine studies were included across various child health decisions, settings and study designs. Thematic analysis of decision support needs indicated three key issues: (i) information (including suggestions about the content, delivery, source, timing); (ii) talking to others (including concerns about pressure from others); and (iii) feeling a sense of control over the process that could be influenced by emotionally charged decisions, the consultation process, and structural or service barriers. These were consistent across decision type, study design and whether or not the study focused on informed decision making. PMID:18816320

  7. A Benchmark Usability Study of the Tactical Decision Making Under Stress Decision Support System

    National Research Council Canada - National Science Library

    Schmorrow, Dylan

    1998-01-01

    This study evaluates the usability of a U.S. Navy Decision Support System (DSS). The DSS was developed to enhance the performance of tactical decision makers within a Navy Combat Information Center...

  8. Making interactive decision support for patients a reality.

    NARCIS (Netherlands)

    Evans, R.W.; Elwyn, G.; Edwards, A.

    2004-01-01

    Interactive decision support applications might help patients to make difficult decisions about their health care. They lie in the context of traditional decision aids, which are known to have effects on a number of patient outcomes, including knowledge and decisional conflict. The problem of

  9. A Multi-criterial Decision Support System for Forest Management

    Science.gov (United States)

    Donald Nute; Geneho Kim; Walter D. Potter; Mark J. Twery; H. Michael Rauscher; Scott Thomasma; Deborah Bennett; Peter Kollasch

    1999-01-01

    We describe a research project that has as its goal development of a full-featured decision support system for managing forested land to satisfy multiple criteria represented as timber, wildlife, water, ecological, and wildlife objectives. The decision process proposed for what was originally conceived of as a Northeast Decision Model (NED) includes data acquisition,...

  10. A multicriteria decision support methodology for evaluating airport expansion plans

    NARCIS (Netherlands)

    Vreeker, R.; Nijkamp, P.; ter Welle, C.

    2001-01-01

    Rational decision-making requires an assessment of advantages and disadvantages of choice possibilities, including non-market effects (such as externalities). This also applies to strategic decision-making in the transport sector (including aviation). In the past decades various decision support and

  11. A conceptual evolutionary aseismic decision support framework for hospitals

    Science.gov (United States)

    Hu, Yufeng; Dargush, Gary F.; Shao, Xiaoyun

    2012-12-01

    In this paper, aconceptual evolutionary framework for aseismic decision support for hospitalsthat attempts to integrate a range of engineering and sociotechnical models is presented. Genetic algorithms are applied to find the optimal decision sets. A case study is completed to demonstrate how the frameworkmay applytoa specific hospital.The simulations show that the proposed evolutionary decision support framework is able to discover robust policy sets in either uncertain or fixed environments. The framework also qualitatively identifies some of the characteristicbehavior of the critical care organization. Thus, by utilizing the proposedframework, the decision makers are able to make more informed decisions, especially toenhance the seismic safety of the hospitals.

  12. MOIDSS?- Mobile Online Intelligent Decision Support System, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — GRID has had a successfully completed Phase I 'Mobile Online Intelligent Decision Support System' (MOIDSS). The system developed into a total solution that supports...

  13. Future of electronic health records: implications for decision support.

    Science.gov (United States)

    Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

    2012-01-01

    The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data

  14. Becoming a Mother: Supported Decision-Making in Context

    Science.gov (United States)

    Jamieson, Rhiann; Theodore, Kate; Raczka, Roman

    2016-01-01

    Little is known about how women with intellectual disabilities make decisions in relation to pregnancy. Social support is important for mothers with intellectual disabilities in many areas. This study explored how the support network influenced the decision-making of women with intellectual disabilities in relation to pregnancy. The study extended…

  15. Intelligent decision support system for operators of the supply ...

    African Journals Online (AJOL)

    Intelligent decision support system for operators of the supply department of oil and gas extracting industry. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... abnormal situations, pre-crash sensing, industrial drilling, decision-making support systems. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  16. Parametric vs. Nonparametric Regression Modelling within Clinical Decision Support

    Czech Academy of Sciences Publication Activity Database

    Kalina, Jan; Zvárová, Jana

    2017-01-01

    Roč. 5, č. 1 (2017), s. 21-27 ISSN 1805-8698 R&D Projects: GA ČR GA17-01251S Institutional support: RVO:67985807 Keywords : decision support systems * decision rules * statistical analysis * nonparametric regression Subject RIV: IN - Informatics, Computer Science OBOR OECD: Statistics and probability

  17. Demonstration of decision support for real time operation

    DEFF Research Database (Denmark)

    Catterson, Victoria; MCarthur, Stephen; Chen, Minjiang

    ELECTRA Deliverable 8.2 reports on the demonstration of decision support within the future control room in light of voltage and frequency control in the 2030+ power system. The decision support must identify key threats and vulnerabilities, and propose and prioritise appropriate interventions....

  18. Decision support modeling for milk valorization

    NARCIS (Netherlands)

    Banaszewska, A.

    2014-01-01

    The research presented in this thesis concerns decision problems in practice that require structured, precise, scientific studies to provide strong, reliable answers. An opportunity to contribute to both practice and science emerged in 2008 when two large, Dutch dairy companies merged, creating

  19. Cost Decision Support in Product Design

    NARCIS (Netherlands)

    Liebers, A.; Kals, H.J.J.

    1997-01-01

    The constraints addressed in decision making during product design, process planning and production planning determine the admissible solution space for the manufacture of products. The solution space determines largely the costs that are incurred in the production process. In order to be able to

  20. Decision-support tools for climate change mitigation planning

    DEFF Research Database (Denmark)

    Puig, Daniel; Aparcana Robles, Sandra Roxana

    . For example, in the case of life-cycle analysis, the evaluation criterion entails that the impacts of interest are examined across the entire life-cycle of the product under study, from extraction of raw materials, to product disposal. Effectively, then, the choice of decision-support tool directs......This document describes three decision-support tools that can aid the process of planning climate change mitigation actions. The phrase ‘decision-support tools’ refers to science-based analytical procedures that facilitate the evaluation of planning options (individually or compared to alternative...... options) against a particular evaluation criterion or set of criteria. Most often decision-support tools are applied with the help of purpose-designed software packages and drawing on specialised databases.The evaluation criteria alluded to above define and characterise each decision-support tool...

  1. QLIKVIEW APPLICATION - SUPPORT IN DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Luminita SERBANESCU

    2017-12-01

    Full Text Available Control over the company, an objective that any manager wants, can only be exercised on the basis of real and complex business data. For this, a higher level of application is required, with Business Intelligence applications that provide information that no one else can offer faster. Winning time can be used to identify other issues related to available information or activities that add value to the company. After all, management time is a decision, and the decision is valuable only if it occurs at the right time. In this article I presented the benefits of implementing a business intelligence solution in a company, as well as how to design analytical reports using the QlikView application.

  2. Decision support for redesigning wastewater treatment technologies.

    Science.gov (United States)

    McConville, Jennifer R; Künzle, Rahel; Messmer, Ulrike; Udert, Kai M; Larsen, Tove A

    2014-10-21

    This paper offers a methodology for structuring the design space for innovative process engineering technology development. The methodology is exemplified in the evaluation of a wide variety of treatment technologies for source-separated domestic wastewater within the scope of the Reinvent the Toilet Challenge. It offers a methodology for narrowing down the decision-making field based on a strict interpretation of treatment objectives for undiluted urine and dry feces and macroenvironmental factors (STEEPLED analysis) which influence decision criteria. Such an evaluation identifies promising paths for technology development such as focusing on space-saving processes or the need for more innovation in low-cost, energy-efficient urine treatment methods. Critical macroenvironmental factors, such as housing density, transportation infrastructure, and climate conditions were found to affect technology decisions regarding reactor volume, weight of outputs, energy consumption, atmospheric emissions, investment cost, and net revenue. The analysis also identified a number of qualitative factors that should be carefully weighed when pursuing technology development; such as availability of O&M resources, health and safety goals, and other ethical issues. Use of this methodology allows for coevolution of innovative technology within context constraints; however, for full-scale technology choices in the field, only very mature technologies can be evaluated.

  3. Intelligent Information System to support decision making.

    Directory of Open Access Journals (Sweden)

    Kathrin Rodríguez Llanes

    2010-06-01

    Full Text Available Making decisions is complicated in a generalized way, the materials and humans resources of the entity we belong to depends on it, such as the fulfillment of its goals. But when the situations are complex, making decisions turns into a very difficult work, due to the great amount of aspects to consider when making the right choice. To make this efficiently the administration must to consult an important volume of information, which generally, is scattered and in any different formats. That’s why appears the need of developing software that crowd together all that information and be capable of, by using powerful search engines and process algorithms improve the good decisions making process. Considering previous explanation, a complete freeware developed product is proposed, this constitutes a generic and multi-platform solution, that using artificial intelligence techniques, specifically the cases based reasoning, gives the possibility to leaders of any institution or organism of making the right choice in any situation.With client-server architecture, this system is consumed from web as a service and it can be perfectly integrated with a management system or the geographic information system to facilitate the business process.

  4. Decision Performance Using Spatial Decision Support Systems: A Geospatial Reasoning Ability Perspective

    Science.gov (United States)

    Erskine, Michael A.

    2013-01-01

    As many consumer and business decision makers are utilizing Spatial Decision Support Systems (SDSS), a thorough understanding of how such decisions are made is crucial for the information systems domain. This dissertation presents six chapters encompassing a comprehensive analysis of the impact of geospatial reasoning ability on…

  5. TUW @ TREC Clinical Decision Support Track

    Science.gov (United States)

    2014-11-01

    and the ShARe/CLEF eHealth Evaluation Lab [8,3] running in 2013 and 2014. Here we briefly describe the goals of the first TREC Clinical Decision...Wendy W. Chapman, David Mart́ınez, Guido Zuccon, and João R. M. Palotti. Overview of the share/clef ehealth evalu- ation lab 2014. In Information Access...Zuccon. Overview of the share/clef ehealth evaluation lab 2013. In Information Access Evaluation. Multilinguality, Multimodality, and Visualization

  6. Supporting Informed Decision Making in Prevention of Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Constantino MARTINS

    2015-05-01

    Full Text Available Identifying and making the correct decision on the best health treatment or screening test option can become a difficult task. Therefore is important that the patients get all types of information appropriate to manage their health. Decision aids can be very useful when there is more than one reasonable option about a treatment or uncertain associated with screening tests. The decision aids tools help people to understand their clinical condition, through the description of the different options available. The purpose of this paper is to present the project “Supporting Informed Decision Making In Prevention of Prostate Cancer” (SIDEMP. This project is focused on the creation of a Web-based decision platform specifically directed to screening prostate cancer, that will support the patient in the process of making an informed decision

  7. Intelligent decision technology support in practice

    CERN Document Server

    Neves-Silva, Rui; Jain, Lakhmi; Phillips-Wren, Gloria; Watada, Junzo; Howlett, Robert

    2016-01-01

    This book contains a collection of innovative chapters emanating from topics raised during the 5th KES International Conference on Intelligent Decision Technologies (IDT), held during 2013 at Sesimbra, Portugal. The authors were invited to expand their original papers into a plethora of innovative chapters espousing IDT methodologies and applications. This book documents leading-edge contributions, representing advances in Knowledge-Based and Intelligent Information and Engineering System. It acknowledges that researchers recognize that society is familiar with modern Advanced Information Processing and increasingly expect richer IDT systems. Each chapter concentrates on the theory, design, development, implementation, testing or evaluation of IDT techniques or applications.  Anyone that wants to work with IDT or simply process knowledge should consider reading one or more chapters and focus on their technique of choice. Most readers will benefit from reading additional chapters to access alternative techniq...

  8. Towards an integrated approach in supporting microbiological food safety decisions

    NARCIS (Netherlands)

    Havelaar, A.H.; Bräunig, J.; Christiansen, K.; Cornu, M.; Hald, T.; Mangen, M.J.J.; Molbak, K.; Pielaat, A.; Snary, E.; Pelt, van W.; Velthuis, A.G.J.; Wahlström, H.

    2007-01-01

    Decisions on food safety involve consideration of a wide range of concerns including the public health impact of foodborne illness, the economic importance of the agricultural sector and the food industry, and the effectiveness and efficiency of interventions. To support such decisions, we propose

  9. A Gaussian decision-support tool for engineering design process

    NARCIS (Netherlands)

    Rajabali Nejad, Mohammadreza; Spitas, Christos

    2013-01-01

    Decision-making in design is of great importance, resulting in success or failure of a system (Liu et al., 2010; Roozenburg and Eekels, 1995; Spitas, 2011a). This paper describes a robust decision-support tool for engineering design process, which can be used throughout the design process in either

  10. A Decision Support System for Corporations Cybersecurity Management

    OpenAIRE

    Roldán-Molina, G.; Almache-Cueva, M.; Silva-Rabadão, C.; Yevseyeva, Iryna; Basto-Fernandes, V.

    2017-01-01

    This paper presents ongoing work on a decision aiding software intended to support cyber risks and cyber threats analysis of an information and communications technological infrastructure. The software will help corporations Chief Information Security Officers on cyber security risk analysis, decision-making, prevention measures and risk strategies for the infrastructure and information assets protection.

  11. A spatial decision support system for pipe-break susceptibility ...

    African Journals Online (AJOL)

    lying properties. Existing decision support systems available in the field of water distribution system maintenance mainly focus on leak detection and pipe rehabilitation/replacement strategies. These existing systems, however, do not address the ...

  12. Spreadsheet Decision Support Model for Training Exercise Material Requirements Planning

    National Research Council Canada - National Science Library

    Tringali, Arthur

    1997-01-01

    This thesis focuses on developing a spreadsheet decision support model that can be used by combat engineer platoon and company commanders in determining the material requirements and estimated costs...

  13. Marketing Decision Support Systems: Adoption, Use and Satisfaction

    NARCIS (Netherlands)

    B. Wierenga (Berend); P.A.M. Oude Ophuis (Peter)

    1997-01-01

    textabstractThis paper deals with marketing decision support systems (MDSS) in companies. In a conceptual framework five categories of factors are distinguished that potentially affect adoption, use, and satisfaction: external environment factors, organizational factors, task environment factors,

  14. A decision support system-based procedure for evaluation and ...

    Indian Academy of Sciences (India)

    with an overview of the web-based Decision Support System (DSS) developed to facilitate its wide adop- tion. .... contributes significant catchment management and water supply functions .... experience in engagement and facilitation methods.

  15. Combining morphological analysis and Bayesian Networks for strategic decision support

    CSIR Research Space (South Africa)

    De Waal, AJ

    2007-12-01

    Full Text Available Morphological analysis (MA) and Bayesian networks (BN) are two closely related modelling methods, each of which has its advantages and disadvantages for strategic decision support modelling. MA is a method for defining, linking and evaluating...

  16. Mobile Contextualized learning games for decision support training

    NARCIS (Netherlands)

    Klemke, Roland

    2014-01-01

    This interactive workshop session introduces mobile serious games as situated, contextualized learning games. Example cases for mobile serious games for decision support training are introduced and discussed. Participants will get to know contextualization techniques used in modern mobile devices

  17. Mobile Contextualized learning games for decision support training

    NARCIS (Netherlands)

    Klemke, Roland; Börner, Dirk; Suarez, Angel; Schneider, Jan; Antonaci, Alessandra

    2015-01-01

    This interactive workshop session introduces mobile serious games as situated, contextualized learning games. Example cases for mobile serious games for decision support training are introduced and discussed. Participants will get to know contextualization techniques used in modern mobile

  18. Choices: An Interactive Decision Support Program for Breast Cancer Treatment

    National Research Council Canada - National Science Library

    Pierce, Penny Fay

    1998-01-01

    This project is developing a computer-assisted prototype of an individualized decision support system, called Choices, to assist women newly diagnosed with breast cancer in making stressful treatment...

  19. Marketing decision support systems: Adoption, use and satisfaction.

    NARCIS (Netherlands)

    Wierenga, B.; Oude Ophuis, P.A.M.

    1997-01-01

    This paper deals with marketing decision support systems (MDSS) in companies. In a conceptual framework five categories of factors are distinguished that potentially affect adoption, use, and satisfaction: external environment factors, organizational factors, task environment factors, user factors

  20. A Geospatial Decision Support System Toolkit, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose to build and commercialize a working prototype Geospatial Decision Support Toolkit (GeoKit). GeoKit will enable scientists, agencies, and stakeholders to...

  1. Evaluation of decision support systems for nuclear accidents

    International Nuclear Information System (INIS)

    Sdouz, G.; Mueck, K.

    1998-05-01

    In order to adopt countermeasures to protect the public after an accident in a nuclear power plant in an appropriate and optimum way, decision support systems offer a valuable assistance in supporting the decision maker in choosing and optimizing protective actions. Such decision support systems may range from simple systems to accumulate relevant parameters for the evaluation of the situation over prediction models for the rapid evaluation of the dose to be expected to systems which permit the evaluation and comparison of possible countermeasures. Since the establishment of a decision support systems obviously is also required in Austria, an evaluation of systems available or in the state of development in other countries or unions was performed. The aim was to determine the availability of decision support systems in various countries and to evaluate them with regard to depth and extent of the system. The evaluation showed that in most industrialized countries the requirement for a decision support system was realized, but in only few countries actual systems are readily available and operable. Most systems are limited to early phase consequences, i.e. dispersion calculations of calculated source terms and the estimation of exposure in the vicinity of the plant. Only few systems offer the possibility to predict long-term exposures by ingestion. Few systems permit also an evaluation of potential countermeasures, in most cases, however, limited to a few short-term countermeasures. Only one system which is presently not operable allows the evaluation of a large number of agricultural countermeasures. In this report the different systems are compared. The requirements with regard to an Austrian decision support system are defined and consequences for a possible utilization of a DSS or parts thereof for the Austrian decision support system are derived. (author)

  2. A decision support system for on-line leakage localization

    OpenAIRE

    Meseguer, Jordi; Mirats-Tur, Josep M.; Cembrano, Gabriela; Puig, Vicenç; Quevedo, Joseba; Pérez, Ramon; Sanz, Gerard; Ibarra, David

    2014-01-01

    This paper describes a model-driven decision-support system (software tool) implementing a model-based methodology for on-line leakage detection and localization which is useful for a large class of water distribution networks. Since these methods present a certain degree of complexity which limits their use to experts, the proposed software tool focuses on the integration of a method emphasizing its use by water network managers as a decision support system. The proposed software tool integr...

  3. Whose decision is it anyway? How clinicians support decision-making participation after acquired brain injury.

    Science.gov (United States)

    Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

    2013-01-01

    To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.

  4. Radioecology and Environmental Decision Support Systems

    International Nuclear Information System (INIS)

    Semioshkina, N.; Voigt, G.; Fiedler, I.

    2015-01-01

    According to Wikipedia Radioecology is a branch of ecology, which studies how radioactive substances interact with nature; how different mechanisms affect the substances’ migration and uptake in food chains and ecosystems. Investigations in radioecology might include aspects of field sampling, designed field and laboratory experiments and the development of predictive simulation models. This science combines techniques from some of the more basic, traditional fields, such as physics, chemistry, mathematics, biology, and ecology, with applied concepts in radiation protection. Radioecological studies form the basis for estimating doses and assessing the consequences of radioactive pollution for human health and the environment. Significant economic and social disruptions arise after radioactive contamination of land as a result of releases of radioactivity into the environment be it from accidents, routine and war operations or during decommissioning and waste management of nuclear facilities. Measures carried out to reduce and minimise radiation doses to the public can give rise to even more concerns as often they are not understood and the stakeholders are often not involved into the decision making process. Countermeasures are needed to reduce population exposure, at the same time minimising economic and social costs. The effectiveness of countermeasures is not only highly dependent on factors which are connected to environmental transfer, but also to special behaviour and consumption behaviours in varying food production systems. A central aspect of radioecology is the identification of vulnerable areas which, by virtue of the processes governing the transfer of radiocaesium through food chains, deliver high individual, or collective doses to man. Social factors (e.g. dietary preferences) and agricultural production techniques also contribute to vulnerability. (author)

  5. What influences parents' decisions to limit or withdraw life support?

    Science.gov (United States)

    Sharman, Mahesh; Meert, Kathleen L; Sarnaik, Ashok P

    2005-09-01

    Decisions to forgo life support from critically ill children are commonly faced by parents and physicians. Previous research regarding parents' perspectives on the decision-making process has been limited by retrospective methods and the use of closed-ended questionnaires. We prospectively identified and described parents' self-reported influences on decisions to forgo life support from their children. Deeper understanding of parents' views will allow physicians to focus end-of-life discussions on factors important to parents and help resolve conflicts. Prospective, qualitative pilot study. Pediatric intensive care unit of a university-affiliated children's hospital. A total of 14 parents of ten children whose pediatric intensive care unit physician had made a recommendation to limit or withdraw life support. : In-depth, semistructured interviews were conducted with parents during their decision-making process. Factors influencing the parents in this study in their decision to forgo life support included their previous experience with death and end-of-life decision making for others, their personal observations of their child's suffering, their perceptions of their child's will to survive, their need to protect and advocate for their child, and the family's financial resources and concerns regarding life-long care. Parents in this study expressed the desire to do what is best for their child but struggled with feelings of selfishness, guilt, and the need to avoid agony and sorrow. Physician recommendations, review of options, and joint formulation of a plan helped parents gain a sense of control over their situation. Parents of eight children agreed to forgo life support and parents of two did not. Prospective interviews with open-ended questions identified factors influencing parents' decision making not previously described in the critical care literature such as parents' past experiences with end-of-life decisions and their anticipated emotional adjustments and

  6. Decision support systems for recovery of endangered species

    International Nuclear Information System (INIS)

    Armstrong, C.E.

    1995-01-01

    The listing of a species as endangered under the Endangered Species Act invokes a suite of responses to help improve conditions for the recovery of that species, to include identification of stressors contributing to population loss, decision analysis of the impacts of proposed recovery options, and implementation of optimal recovery measures. The ability of a decision support system to quantify inherent stressor uncertainties and to identify the key stressors that can be controlled or eliminated becomes key to ensuring the recovery of an endangered species. The listing of the Snake River sockeye, spring/summer chinook, and fall chinook salmon species in the Snake River as endangered provides a vivid example of the importance of sophisticated decision support systems. Operational and physical changes under consideration at eight of the hydroelectric dams along the Columbia and Lower Snake River pose significant financial impacts to a variety of stakeholders involved in the salmon population recovery process and carry significant uncertainties of outcome. A decision support system is presented to assist in the identification of optimal recovery actions for this example that includes the following: creation of datamarts of information on environmental, engineering, and ecological values that influence species survival; incorporation of decision analysis tools to determine optimal decision policies; and the use of geographic information systems (GIS) to provide a context for decision analysis and to communicate the impacts of decision policies

  7. The analytic hierarchy process as a support for decision making

    Directory of Open Access Journals (Sweden)

    Filipović Milanka

    2007-01-01

    Full Text Available The first part of this text deals with a convention site selection as one of the most lucrative areas in the tourism industry. The second part gives a further description of a method for decision making - the analytic hierarchy process. The basic characteristics: hierarchy constructions and pair wise comparison on the given level of the hierarchy are allured. The third part offers an example of application. This example is solved using the Super - Decision software, which is developed as a computer support for the analytic hierarchy process. This indicates that the AHP approach is a useful tool to help support a decision of convention site selection. .

  8. Group decision support system for customer-driven product design

    Science.gov (United States)

    Lin, Zhihang; Chen, Hang; Chen, Kuen; Che, Ada

    2000-10-01

    This paper describes the work on the development of a group decision support system for customer driven product design. The customer driven is to develop products, which meet all customer requirements in whole life cycle of products. A process model of decision during product primary design is proposed to formulate the structured, semi-structured and unstructured decision problems. The framework for the decision support system is presented that integrated both advances in the group decision making and distributed artificial intelligent. The system consists of the product primary design tool kit and the collaborative platform with multi-agent structure. The collaborative platform of the system and the product primary design tool kit, including the VOC (Voice of Customer) tool, QFD (Quality Function Deployment) tool, the Conceptual design tool, Reliability analysis tool and the cost and profit forecasting tool, are indicated.

  9. A crisis management decision support system to reduce ingestion dose

    International Nuclear Information System (INIS)

    Schenker-Wicki, A.; Gibbert, R.

    1993-01-01

    Environmental accidents such as extensive radioactive or chemical contamination can have more serious consequences for a population than any other kind of accidents known before. Owing to the serious consequences and the high number of people who may be affected, the selection of the best countermeasures to ameliorate the imminent impact is very difficult and the political responsibility is enormous. To help overcome such problems the National Emergency Operations Center in Zurich (Switzerland) has developed a decision support system to evaluate acceptable countermeasures for reducing ingestion dose after an accidental release of radioactive material. The system involves all the necessary modules and techniques for efficient decision making, based on the most recent developments in decision theory as well as the necessary structuring of the decision-making process. The decision-making concept comprehends decision making on two different levels, a technical and a political one. (author)

  10. Computerized Decision Support Improves Medication Review Effectiveness : An Experiment Evaluating the STRIP Assistant's Usability

    NARCIS (Netherlands)

    Meulendijk, Michiel C; Spruit, Marco R; Drenth-van Maanen, A Clara; Numans, Mattijs E; Brinkkemper, Sjaak; Jansen, Paul A F; Knol, Wilma

    BACKGROUND: Polypharmacy poses threats to patients' health. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) is a drug optimization process for conducting medication reviews in primary care. To effectively and efficiently incorporate this method into daily practice, the STRIP

  11. Computerized decision support improves medication review effectiveness: an experiment evaluating the STRIP Assistant’s usability

    NARCIS (Netherlands)

    Meulendijk, M.; Spruit, M.; Drenth-van Maanen, C.; Numans, M.; Brinkkemper, S.; Jansen, P.; Knol, W

    2015-01-01

    Background Polypharmacy poses threats to patients’ health. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) is a drug optimization process for conducting medication reviews in primary care. To effectively and efficiently incorporate this method into daily practice, the STRIP

  12. Diagnosis techniques of the computerized operator support system (COSS) for PWR plants

    International Nuclear Information System (INIS)

    Tani, Mamoru; Yoshimura, Tokuji; Morimoto, Haruki; Fujiwara, Toshitaka; Okamoto, Yoshizo; Masui, Takao.

    1985-01-01

    Aiming at the enhancement of abnormal plant operation reliability, COSS has been developed through the support of the Japanese ministry of International Trade and Industry. The validation test was performed by the plant operators using a plant simulator and the result shows that COSS is useful as operator support aids during abnormal plant conditions. This paper presents two methods of diagnosis used in the COSS. (1) Cause-Consequence Tree: This is a logical treewise expression between cause and it's effect to plant variables. When plant variables exceed the predetermined values of alarm, diagnosis is performed by CCT. (2) Model reference method: In this method, the plant dynamic model is applied as a reference. Diagnosis is performed by comparing the measured values with the output values of the corresponding model. (author)

  13. Decision support tools to support the operations of traffic management centers (TMC)

    Science.gov (United States)

    2011-01-31

    The goal of this project is to develop decision support tools to support traffic management operations based on collected intelligent transportation system (ITS) data. The project developments are in accordance with the needs of traffic management ce...

  14. Computerised decision support systems for healthcare professionals: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz

    2012-01-01

    Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may

  15. Decision-making on olympic urban development - multi-actor decision support tool

    NARCIS (Netherlands)

    Heurkens, E.W.T.M.

    Subject of study is the possible organisation of the Olympic Games of 2028 in the Netherlands, as seen from an urban development viewpoint. The project focuses on the decision-making process in the initiative phase. Aim of the project is the development of a decision support tool for the complex,

  16. Composite decision support by combining cost-benefit and multi-criteria decision

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn; Salling, Kim Bang; Leleur, Steen

    2011-01-01

    This paper concerns composite decision support based on combining cost-benefit analysis (CBA) with multi-criteria decision analysis (MCDA) for the assessment of economic as well as strategic impacts within transport projects. Specifically a composite model for assessment (COSIMA) is presented...

  17. Bayesian networks for clinical decision support: A rational approach to dynamic decision-making under uncertainty

    NARCIS (Netherlands)

    Gerven, M.A.J. van

    2007-01-01

    This dissertation deals with decision support in the context of clinical oncology. (Dynamic) Bayesian networks are used as a framework for (dynamic) decision-making under uncertainty and applied to a variety of diagnostic, prognostic, and treatment problems in medicine. It is shown that the proposed

  18. The Mass Tracking System -- Computerized support for MC and A and operations at FCF

    International Nuclear Information System (INIS)

    Adams, C.H.; Beitel, J.C.; Birgersson, G.; Bucher, R.G.; Derstine, K.L.; Toppel, B.J.; Goin, R.W.; Keyes, R.W.; Vollmer, M.A.

    1996-01-01

    As part of Argonne National Laboratory's Fuel Conditioning Facility (FCF), a computer-based Mass-Tracking (MTG) System has been developed. The MTG System collects, stores, retrieves and processes data on all operations which directly affect the flow of process material through FCF and supports such activities as process modeling, compliance with operating limits (e.g., criticality safety), material control and accountability and operational information services. Its architecture is client/server, with input and output connections to operator's equipment-control stations on the floor of FCF as well as to dumb terminals and terminal emulators. Its heterogeneous database includes a relational-database manager as well as both binary and ASCII data files. The design of the database, and the software that supports it, is based on a model of discrete accountable items distributed in space and time and constitutes a complete historical record of the material processed in FCF. Although still under development, much of the MTG system has been qualified and is in production use

  19. DECISION SUPPORT SYSTEMS IN MILITARY ACTIONS: NECESSITY, POSSIBILITIES AND CONSTRAINTS

    Directory of Open Access Journals (Sweden)

    Elena ŞUŞNEA

    2012-01-01

    Full Text Available Nowadays, modern organizations cannot resort to the decision-making process without relying on information and communication technology if they want to be successful. Thus, besides information as an important input of this process, the tools and techniques used by decision-makers are equally important in the support and validation of their decisions. All this is also valid for the military organizations and their specific tasks and activities. A fortiori military commanders face some of the most diff cult and high-stake decision issues meaningful not only at the level of the military, but also for the humankind. Under these circumstances and as a result of an increase in the diversity and complexity of conflict situations, in the information and technology means employed by opponents in warfare and in the amount of information needed to be processed in real time, decision support systems become a necessity. Starting from the aforementioned inevitable requirement, the aim of this article is to emphasize the possibilities and constraints in developing an intelligent decision support system that assists commanders in making scientific decisions on time, under the right circumstances, for the right costs.

  20. Reviewing model application to support animal health decision making.

    Science.gov (United States)

    Singer, Alexander; Salman, Mo; Thulke, Hans-Hermann

    2011-04-01

    Animal health is of societal importance as it affects human welfare, and anthropogenic interests shape decision making to assure animal health. Scientific advice to support decision making is manifold. Modelling, as one piece of the scientific toolbox, is appreciated for its ability to describe and structure data, to give insight in complex processes and to predict future outcome. In this paper we study the application of scientific modelling to support practical animal health decisions. We reviewed the 35 animal health related scientific opinions adopted by the Animal Health and Animal Welfare Panel of the European Food Safety Authority (EFSA). Thirteen of these documents were based on the application of models. The review took two viewpoints, the decision maker's need and the modeller's approach. In the reviewed material three types of modelling questions were addressed by four specific model types. The correspondence between tasks and models underpinned the importance of the modelling question in triggering the modelling approach. End point quantifications were the dominating request from decision makers, implying that prediction of risk is a major need. However, due to knowledge gaps corresponding modelling studies often shed away from providing exact numbers. Instead, comparative scenario analyses were performed, furthering the understanding of the decision problem and effects of alternative management options. In conclusion, the most adequate scientific support for decision making - including available modelling capacity - might be expected if the required advice is clearly stated. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Education for Medical Decision Support at EuroMISE Centre

    Czech Academy of Sciences Publication Activity Database

    Martinková, Patrícia; Zvára Jr., Karel; Dostálová, T.; Zvárová, Jana

    2013-01-01

    Roč. 1, č. 1 (2013), s. 40-40 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : education * decision support * knowledge evaluation * e-learning Subject RIV: IN - Informatics, Computer Science

  2. System for Selection of Relevant Information for Decision Support

    Czech Academy of Sciences Publication Activity Database

    Kalina, Jan; Seidl, L.; Zvára, K.; Grünfeldová, H.; Slovák, Dalibor; Zvárová, Jana

    2013-01-01

    Roč. 1, č. 1 (2013), s. 46-46 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : decision support system * web-service * information extraction * high-dimension * gene expressions Subject RIV: IN - Informatics, Computer Science

  3. Advancing clinical decision support using lessons from outside of healthcare: an interdisciplinary systematic review

    Directory of Open Access Journals (Sweden)

    Wu Helen W

    2012-08-01

    Full Text Available Abstract Background Greater use of computerized decision support (DS systems could address continuing safety and quality problems in healthcare, but the healthcare field has struggled to implement DS technology. This study surveys DS experience across multiple non-healthcare disciplines for new insights that are generalizable to healthcare provider decisions. In particular, it sought design principles and lessons learned from the other disciplines that could inform efforts to accelerate the adoption of clinical decision support (CDS. Methods Our systematic review drew broadly from non-healthcare databases in the basic sciences, social sciences, humanities, engineering, business, and defense: PsychINFO, BusinessSource Premier, Social Sciences Abstracts, Web of Science, and Defense Technical Information Center. Because our interest was in DS that could apply to clinical decisions, we selected articles that (1 provided a review, overview, discussion of lessons learned, or an evaluation of design or implementation aspects of DS within a non-healthcare discipline and (2 involved an element of human judgment at the individual level, as opposed to decisions that can be fully automated or that are made at the organizational level. Results Clinical decisions share some similarities with decisions made by military commanders, business managers, and other leaders: they involve assessing new situations and choosing courses of action with major consequences, under time pressure, and with incomplete information. We identified seven high-level DS system design features from the non-healthcare literature that could be applied to CDS: providing broad, system-level perspectives; customizing interfaces to specific users and roles; making the DS reasoning transparent; presenting data effectively; generating multiple scenarios covering disparate outcomes (e.g., effective; effective with side effects; ineffective; allowing for contingent adaptations; and facilitating

  4. Advancing clinical decision support using lessons from outside of healthcare: an interdisciplinary systematic review.

    Science.gov (United States)

    Wu, Helen W; Davis, Paul K; Bell, Douglas S

    2012-08-17

    Greater use of computerized decision support (DS) systems could address continuing safety and quality problems in healthcare, but the healthcare field has struggled to implement DS technology. This study surveys DS experience across multiple non-healthcare disciplines for new insights that are generalizable to healthcare provider decisions. In particular, it sought design principles and lessons learned from the other disciplines that could inform efforts to accelerate the adoption of clinical decision support (CDS). Our systematic review drew broadly from non-healthcare databases in the basic sciences, social sciences, humanities, engineering, business, and defense: PsychINFO, BusinessSource Premier, Social Sciences Abstracts, Web of Science, and Defense Technical Information Center. Because our interest was in DS that could apply to clinical decisions, we selected articles that (1) provided a review, overview, discussion of lessons learned, or an evaluation of design or implementation aspects of DS within a non-healthcare discipline and (2) involved an element of human judgment at the individual level, as opposed to decisions that can be fully automated or that are made at the organizational level. Clinical decisions share some similarities with decisions made by military commanders, business managers, and other leaders: they involve assessing new situations and choosing courses of action with major consequences, under time pressure, and with incomplete information. We identified seven high-level DS system design features from the non-healthcare literature that could be applied to CDS: providing broad, system-level perspectives; customizing interfaces to specific users and roles; making the DS reasoning transparent; presenting data effectively; generating multiple scenarios covering disparate outcomes (e.g., effective; effective with side effects; ineffective); allowing for contingent adaptations; and facilitating collaboration. The article provides examples of

  5. Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

    Science.gov (United States)

    Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

    2016-04-01

    To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

  6. A Newly Designed Mobile-Based Computerized Cognitive Addiction Therapy App for the Improvement of Cognition Impairments and Risk Decision Making in Methamphetamine Use Disorder: Randomized Controlled Trial.

    Science.gov (United States)

    Zhu, Youwei; Jiang, Haifeng; Su, Hang; Zhong, Na; Li, Runji; Li, Xiaotong; Chen, Tianzhen; Tan, Haoye; Du, Jiang; Xu, Ding; Yan, Huan; Xu, Dawen; Zhao, Min

    2018-06-20

    Cognitive rehabilitation therapy has been found to improve cognitive deficits and impulse control problems in methamphetamine use disorder (MUD). However, there is limited research regarding this therapy's feasibility when using mobile-based health technologies in supporting recovery from MUD in China. The main aim of this study was to test whether 4 weeks of a newly designed computerized cognitive addiction therapy (CCAT) app can improve cognitive impairments, eliminate drug-related attention bias, and attenuate risk decision-making behaviors in participants with MUD. Forty MUD participants were assigned randomly to either the CCAT group (n=20), who received 4 weeks of CCAT plus regular detoxification treatment as usual, or the control group (n=20), who only received the regular detoxification treatment as usual, in drug rehabilitation centers in Shanghai. The CCAT was designed by combine methamphetamine use-related picture stimuli with cognitive training with the aim of improving cognitive function and eliminating drug-related attention bias. The CogState Battery, Delay Discounting Task (DDT), Iowa Gambling Task (IGT), and Balloon Analog Risk Task (BART) were administered face-to-face to all participants before and after CCAT interventions. Forty male patients were recruited. The mean age was 32.70 (SD 5.27) years in the CCAT group and mean 35.05 (SD 8.02) years in the control group. Compared to the control group, CCAT improved working memory in the CCAT group (P=.01). Group×time interactions were observed among DDT, IGT, and BART tasks, with rates of discounting delayed rewards, IGT, and BART scores (Pcognitive impairment and impulsive control in MUD. Further study is needed to understand the underlying brain mechanisms of the cognitive therapy. ClinicalTrials.gov NCT03318081; https://clinicaltrials.gov/ct2/show/NCT03318081 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT03318081). ©Youwei Zhu, Haifeng Jiang, Hang Su, Na Zhong, Runji Li

  7. Direct and Electronic Health Record Access to the Clinical Decision Support for Immunizations in the Minnesota Immunization Information System.

    Science.gov (United States)

    Rajamani, Sripriya; Bieringer, Aaron; Wallerius, Stephanie; Jensen, Daniel; Winden, Tamara; Muscoplat, Miriam Halstead

    2016-01-01

    Immunization information systems (IIS) are population-based and confidential computerized systems maintained by public health agencies containing individual data on immunizations from participating health care providers. IIS hold comprehensive vaccination histories given across providers and over time. An important aspect to IIS is the clinical decision support for immunizations (CDSi), consisting of vaccine forecasting algorithms to determine needed immunizations. The study objective was to analyze the CDSi presentation by IIS in Minnesota (Minnesota Immunization Information Connection [MIIC]) through direct access by IIS interface and by access through electronic health records (EHRs) to outline similarities and differences. The immunization data presented were similar across the three systems examined, but with varying ability to integrate data across MIIC and EHR, which impacts immunization data reconciliation. Study findings will lead to better understanding of immunization data display, clinical decision support, and user functionalities with the ultimate goal of promoting IIS CDSi to improve vaccination rates.

  8. Grand Challenges in Clinical Decision Support v10

    Science.gov (United States)

    Sittig, Dean F.; Wright, Adam; Osheroff, Jerome A.; Middleton, Blackford; Teich, Jonathan M.; Ash, Joan S.; Campbell, Emily; Bates, David W.

    2008-01-01

    There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: Improve the human-computer interface; Disseminate best practices in CDS design, development, and implementation; Summarize patient-level information; Prioritize and filter recommendations to the user; Create an architecture for sharing executable CDS modules and services; Combine recommendations for patients with co-morbidities; Prioritize CDS content development and implementation; Create internet-accessible clinical decision support repositories; Use freetext information to drive clinical decision support; Mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare. PMID:18029232

  9. IBM’s Health Analytics and Clinical Decision Support

    Science.gov (United States)

    Sun, J.; Knoop, S.; Shabo, A.; Carmeli, B.; Sow, D.; Syed-Mahmood, T.; Rapp, W.

    2014-01-01

    Summary Objectives This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Methods Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. Results There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Conclusion Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation. PMID:25123736

  10. Improving clinical decision support using data mining techniques

    Science.gov (United States)

    Burn-Thornton, Kath E.; Thorpe, Simon I.

    1999-02-01

    Physicians, in their ever-demanding jobs, are looking to decision support systems for aid in clinical diagnosis. However, clinical decision support systems need to be of sufficiently high accuracy that they help, rather than hinder, the physician in his/her diagnosis. Decision support systems with accuracies, of patient state determination, of greater than 80 percent, are generally perceived to be sufficiently accurate to fulfill the role of helping the physician. We have previously shown that data mining techniques have the potential to provide the underpinning technology for clinical decision support systems. In this paper, an extension of the work in reverence 2, we describe how changes in data mining methodologies, for the analysis of 12-lead ECG data, improve the accuracy by which data mining algorithms determine which patients are suffering from heart disease. We show that the accuracy of patient state prediction, for all the algorithms, which we investigated, can be increased by up to 6 percent, using the combination of appropriate test training ratios and 5-fold cross-validation. The use of cross-validation greater than 5-fold, appears to reduce the improvement in algorithm classification accuracy gained by the use of this validation method. The accuracy of 84 percent in patient state predictions, obtained using the algorithm OCI, suggests that this algorithm will be capable of providing the required accuracy for clinical decision support systems.

  11. Decision Support Systems: Usage And Applications In Logistics Services

    Directory of Open Access Journals (Sweden)

    Eyüp AKÇETİN

    2014-06-01

    Full Text Available Competitive advantage in logistics operations is possible by analyzing data to create information and turning that information into decision. Supply chain optimization depends on effective management of chain knowledge. Analyzing data from supply chain and making a decision creates complex operations. Therefore, these operations require benefitting from information technology. In today’s global world, businesses use outsourcing for logistics services to focus on their own field, so are seeking to achieve competitive advantage against competitors. Outsourcing requires sharing of various information and data with companies that provide logistical support. Effective strategies are based on well-analyzed the data and information. Best options for right decisions can be created only from good analysis. That’s why companies that supply logistics services achieve competitive advantage using decision support systems (DSS in industrial competition. In short, DSS has become driving force for every business in today’s knowledge-based economy.

  12. A decision support system for strategic planning on pig farms

    OpenAIRE

    Backus, Ge B.C.; Timmer, G. Th.; Dijkhuizen, A.A.; Eidman, V.R.; Vos, F.

    1995-01-01

    This paper reported on a decision support system (DSS) for strategic planning on pig farms. The DSS was based . on a stochastic simulation model of investment decisions (ISM). ISM described a farm with one loan and one building using 23 variables. The simulation model calculated the results of a strategic plan for an individual pig farm over a time horizon of a maximum of 20 years for a given scenario. For six distinct replacement strategies, regression metamodels were specified to describe t...

  13. New threats and new challenges for radiological decision support

    DEFF Research Database (Denmark)

    Andersson, Kasper Grann; Astrup, Poul; Mikkelsen, Torben

    2011-01-01

    It is described how ongoing work will extend European standard decision support systems currently integrated in the nuclear power plant preparedness in many countries, to enable estimation of the radiological consequences of atmospheric dispersion of contaminants following a terror attack in a city....... Factors relating to the contaminant release processes, dispersion, deposition and post deposition migration are discussed, and non-radiological issues are highlighted in relation to decision making....

  14. Relational Algebra in Spatial Decision Support Systems Ontologies.

    Science.gov (United States)

    Diomidous, Marianna; Chardalias, Kostis; Koutonias, Panagiotis; Magnita, Adrianna; Andrianopoulos, Charalampos; Zimeras, Stelios; Mechili, Enkeleint Aggelos

    2017-01-01

    Decision Support Systems (DSS) is a powerful tool, for facilitates researchers to choose the correct decision based on their final results. Especially in medical cases where doctors could use these systems, to overcome the problem with the clinical misunderstanding. Based on these systems, queries must be constructed based on the particular questions that doctors must answer. In this work, combination between questions and queries would be presented via relational algebra.

  15. A decision support system for corporations cyber security risk management

    OpenAIRE

    Molina, Gabriela del Rocio Roldan

    2017-01-01

    This thesis presents a decision aiding system named C3-SEC (Contex-aware Corporative Cyber Security), developed in the context of a master program at Polytechnic Institute of Leiria, Portugal. The research dimension and the corresponding software development process that followed are presented and validated with an application scenario and case study performed at Universidad de las Fuerzas Armadas ESPE – Ecuador. C3-SEC is a decision aiding software intended to support cyber ri...

  16. Intelligent Decision Support in Proportional–Stop-Loss Reinsurance Using Multiple Attribute Decision-Making (MADM

    Directory of Open Access Journals (Sweden)

    Shirley Jie Xuan Wang

    2017-11-01

    Full Text Available This article addresses the possibility of incorporating intelligent decision support systems into reinsurance decision-making. This involves the insurance company and the reinsurance company, and is negotiated through reinsurance intermediaries. The article proposes a decision flow to model the reinsurance design and selection process. This article focuses on adopting more than one optimality criteria under a more generic combinational design of commonly used reinsurance products, i.e., proportional reinsurance and stop-loss reinsurance. In terms of methodology, the significant contribution of the study the incorporation of the well-established decision analysis tool multiple-attribute decision-making (MADM into the modelling of reinsurance selection. To illustrate the feasibility of incorporating intelligent decision supporting systems in the reinsurance market, the study includes a numerical case study using the simulation software @Risk in modeling insurance claims, as well as programming in MATLAB to realize MADM. A list of managerial implications could be drawn from the case study results. Most importantly, when choosing the most appropriate type of reinsurance, insurance companies should base their decisions on multiple measurements instead of single-criteria decision-making models so that their decisions may be more robust.

  17. Promoting Shared Decision Making in Disorders of Sex Development (DSD): Decision Aids and Support Tools.

    Science.gov (United States)

    Siminoff, L A; Sandberg, D E

    2015-05-01

    Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Application of GIS in foreign direct investment decision support system

    Science.gov (United States)

    Zhou, Jianlan; Sun, Koumei

    2007-06-01

    It is important to make decisions on how to attract foreign direct investment (FDI) to China and know how the inequality of FDI introduction by locational different provinces. Following background descriptions on China's FDI economic environments and FDI-related policies, this paper demonstrates the uses of geographical information system (GIS) and multi-criterion decision-making (MCDM) framework in solving a spatial multi-objective problem of evaluating and ranking China's provinces for FDI introduction. It implements a foreign direct investment decision support system, which reveals the main determinants of FDI in China and gives some results of regional geographical analysis over spatial data.

  19. Decision Making Based On Management Information System and Decision Support System

    Directory of Open Access Journals (Sweden)

    Şükrü Ada

    2015-04-01

    Full Text Available Information hasbecome an essentialresource for managing modern organizations. This is so because today’sbusiness environment is volatile, dynamic, turbulent and necessitates the burgeoning demand for accurate, relevant, complete,timely and economical information needed to drive the decision-making process in order to accentuate organizational abilities to manage opportunities and threat. MIS work on online mode with an average processing speed. Generally, it is used by low level management. Decision support system are powerful tool that assist corporate executives, administrators and other senior officials in making decision regarding the problem. Management Information Systems is a useful tool that provided organized and summarized information in a proper time to decision makers and enable making accurate decision for managers in organizations. This paper will discuss the concept, characteristics, types of MIS, the MIS model, and in particular it will highlight the impact and role of MIS on decision making.

  20. Evolution of Decision Support Systems Research Field in Numbers

    Directory of Open Access Journals (Sweden)

    Ana-Maria SUDUC

    2010-01-01

    Full Text Available The scientific production in a certain field shows, in great extent, the research interests in that field. Decision Support Systems are a particular class of information systems which are gaining more popularity in various domains. In order to identify the evolution in time of the publications number, authors, subjects, publications in the Decision Support Systems (DSS field, and therefore the scientific world interest for this field, in November 2010 there have been organized a series of queries on three major international scientific databases: ScienceDirect, IEEE Xplore Digital Library and ACM Digital Library. The results presented in this paper shows that, even the decision support systems research field started in 1960s, the interests for this type of systems grew exponentially with each year in the last decades.

  1. System for selecting relevant information for decision support.

    Science.gov (United States)

    Kalina, Jan; Seidl, Libor; Zvára, Karel; Grünfeldová, Hana; Slovák, Dalibor; Zvárová, Jana

    2013-01-01

    We implemented a prototype of a decision support system called SIR which has a form of a web-based classification service for diagnostic decision support. The system has the ability to select the most relevant variables and to learn a classification rule, which is guaranteed to be suitable also for high-dimensional measurements. The classification system can be useful for clinicians in primary care to support their decision-making tasks with relevant information extracted from any available clinical study. The implemented prototype was tested on a sample of patients in a cardiological study and performs an information extraction from a high-dimensional set containing both clinical and gene expression data.

  2. Data Mining for Education Decision Support: A Review

    Directory of Open Access Journals (Sweden)

    Suhirman Suhirman

    2014-12-01

    Full Text Available Management of higher education must continue to evaluate on an ongoing basis in order to improve the quality of institutions. This will be able to do the necessary evaluation of various data, information, and knowledge of both internal and external institutions. They plan to use more efficiently the collected data, develop tools so that to collect and direct management information, in order to support managerial decision making. The collected data could be utilized to evaluate quality, perform analyses and diagnoses, evaluate dependability to the standards and practices of curricula and syllabi, and suggest alternatives in decision processes. Data minings to support decision making are well suited methods to provide decision support in the education environments, by generating and presenting relevant information and knowledge towards quality improvement of education processes. In educational domain, this information is very useful since it can be used as a base for investigating and enhancing the current educational standards and managements. In this paper, a review on data mining for academic decision support in education field is presented. The details of this paper will review on recent data mining in educational field and outlines future researches in educational data mining.

  3. Nurses' Clinical Decision Making on Adopting a Wound Clinical Decision Support System.

    Science.gov (United States)

    Khong, Peck Chui Betty; Hoi, Shu Yin; Holroyd, Eleanor; Wang, Wenru

    2015-07-01

    Healthcare information technology systems are considered the ideal tool to inculcate evidence-based nursing practices. The wound clinical decision support system was built locally to support nurses to manage pressure ulcer wounds in their daily practice. However, its adoption rate is not optimal. The study's objective was to discover the concepts that informed the RNs' decisions to adopt the wound clinical decision support system as an evidence-based technology in their nursing practice. This was an exploratory, descriptive, and qualitative design using face-to-face interviews, individual interviews, and active participatory observation. A purposive, theoretical sample of 14 RNs was recruited from one of the largest public tertiary hospitals in Singapore after obtaining ethics approval. After consenting, the nurses were interviewed and observed separately. Recruitment stopped when data saturation was reached. All transcribed interview data underwent a concurrent thematic analysis, whereas observational data were content analyzed independently and subsequently triangulated with the interview data. Eight emerging themes were identified, namely, use of the wound clinical decision support system, beliefs in the wound clinical decision support system, influences of the workplace culture, extent of the benefits, professional control over nursing practices, use of knowledge, gut feelings, and emotions (fear, doubt, and frustration). These themes represented the nurses' mental outlook as they made decisions on adopting the wound clinical decision support system in light of the complexities of their roles and workloads. This research has provided insight on the nurses' thoughts regarding their decision to interact with the computer environment in a Singapore context. It captured the nurses' complex thoughts when deciding whether to adopt or reject information technology as they practice in a clinical setting.

  4. Decision Support Systems for Research and Management in Advanced Life Support

    Science.gov (United States)

    Rodriquez, Luis F.

    2004-01-01

    Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

  5. Fault-Tolerant Onboard Monitoring and Decision Support Systems

    DEFF Research Database (Denmark)

    Lajic, Zoran

    a crude and simple estimation of the actual sea state (Hs and Tz), information about the longitudinal hull girder loading, seakeeping performance of the ship, and decision support on how to operate the ship within acceptable limits. The system is able to identify critical forthcoming events and to give...... advice regarding speed and course changes to decrease the wave-induced loads. The SeaSense system is based on the combined use of a mathematical model and measurements from a set of sensors. The overall dependability of a shipboard monitoring and decision support system such as the SeaSense system can...

  6. Data warehouse based decision support system in nuclear power plants

    International Nuclear Information System (INIS)

    Nadinic, B.

    2004-01-01

    Safety is an important element in business decision making processes in nuclear power plants. Information about component reliability, structures and systems, data recorded during the nuclear power plant's operation and outage periods, as well as experiences from other power plants are located in different database systems throughout the power plant. It would be possible to create a decision support system which would collect data, transform it into a standardized form and store it in a single location in a format more suitable for analyses and knowledge discovery. This single location where the data would be stored would be a data warehouse. Such data warehouse based decision support system could help make decision making processes more efficient by providing more information about business processes and predicting possible consequences of different decisions. Two main functionalities in this decision support system would be an OLAP (On Line Analytical Processing) and a data mining system. An OLAP system would enable the users to perform fast, simple and efficient multidimensional analysis of existing data and identify trends. Data mining techniques and algorithms would help discover new, previously unknown information from the data as well as hidden dependencies between various parameters. Data mining would also enable analysts to create relevant prediction models that could predict behaviour of different systems during operation and inspection results during outages. The basic characteristics and theoretical foundations of such decision support system are described and the reasons for choosing a data warehouse as the underlying structure are explained. The article analyzes obvious business benefits of such system as well as potential uses of OLAP and data mining technologies. Possible implementation methodologies and problems that may arise, especially in the field of data integration, are discussed and analyzed.(author)

  7. Website as Co-Created Decision Support System Towards Enhanced Experience of Solo City Tourism

    Directory of Open Access Journals (Sweden)

    Utomo Sarjono Putro

    2016-12-01

    Full Text Available Abstract. The linkage among information-intensive era, technology, and tourism industry build inseparable genetic relationship which is supposed to be realized in practice. Let alone in this digital era, the urgency to exploit information to the next level resulted in the need to bring a higher game on the technology in order to manage information effectively and efficiently. Tourism industry is categorized as complex system regarding the components substituted it. The diverse elements which interact with dynamics pace give birth to complex tasks to manage by the responsible parties and consequently enhance experience in tourism industry. Competing with complex situation, computerized decision system is urgently needed to collect and also distribute accurate knowledge of tourism industry, collaborate with both supporting public and private sectors, and gain rationality for all stakeholders in the system. Solo city, known also as Surakarta and located in Central Java (Indonesia, is obliged to do its tourism industry justice as it is an important vehicle for regional development of the city. Tourism industry of Solo city represents the major and significant contributor to the local economy to the point where tourism is the brand of Solo city. Taking the prior research finding, value orchestration platform to promote tourism in batik Solo industrial cluster into the reference, this study improves the model by highlighting the duality function the tourism website supposed to have using hashtag (# minings principle as the latest user interface technology. This study proposes a collaborative website platform as a co-created decision support system to enhance tourism experience for tourist as consumer and optimize management process for Department of Culture and Tourism of Solo city as provider. Keywords: Decision support system, hashtag mining, service-dominant logic, solo city, tourism experience

  8. E-DECIDER Decision Support Gateway For Earthquake Disaster Response

    Science.gov (United States)

    Glasscoe, M. T.; Stough, T. M.; Parker, J. W.; Burl, M. C.; Donnellan, A.; Blom, R. G.; Pierce, M. E.; Wang, J.; Ma, Y.; Rundle, J. B.; Yoder, M. R.

    2013-12-01

    Earthquake Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response (E-DECIDER) is a NASA-funded project developing capabilities for decision-making utilizing remote sensing data and modeling software in order to provide decision support for earthquake disaster management and response. E-DECIDER incorporates earthquake forecasting methodology and geophysical modeling tools developed through NASA's QuakeSim project in order to produce standards-compliant map data products to aid in decision-making following an earthquake. Remote sensing and geodetic data, in conjunction with modeling and forecasting tools, help provide both long-term planning information for disaster management decision makers as well as short-term information following earthquake events (i.e. identifying areas where the greatest deformation and damage has occurred and emergency services may need to be focused). E-DECIDER utilizes a service-based GIS model for its cyber-infrastructure in order to produce standards-compliant products for different user types with multiple service protocols (such as KML, WMS, WFS, and WCS). The goal is to make complex GIS processing and domain-specific analysis tools more accessible to general users through software services as well as provide system sustainability through infrastructure services. The system comprises several components, which include: a GeoServer for thematic mapping and data distribution, a geospatial database for storage and spatial analysis, web service APIs, including simple-to-use REST APIs for complex GIS functionalities, and geoprocessing tools including python scripts to produce standards-compliant data products. These are then served to the E-DECIDER decision support gateway (http://e-decider.org), the E-DECIDER mobile interface, and to the Department of Homeland Security decision support middleware UICDS (Unified Incident Command and Decision Support). The E-DECIDER decision support gateway features a web interface that

  9. Improving the Slum Planning Through Geospatial Decision Support System

    Science.gov (United States)

    Shekhar, S.

    2014-11-01

    In India, a number of schemes and programmes have been launched from time to time in order to promote integrated city development and to enable the slum dwellers to gain access to the basic services. Despite the use of geospatial technologies in planning, the local, state and central governments have only been partially successful in dealing with these problems. The study on existing policies and programmes also proved that when the government is the sole provider or mediator, GIS can become a tool of coercion rather than participatory decision-making. It has also been observed that local level administrators who have adopted Geospatial technology for local planning continue to base decision-making on existing political processes. In this juncture, geospatial decision support system (GSDSS) can provide a framework for integrating database management systems with analytical models, graphical display, tabular reporting capabilities and the expert knowledge of decision makers. This assists decision-makers to generate and evaluate alternative solutions to spatial problems. During this process, decision-makers undertake a process of decision research - producing a large number of possible decision alternatives and provide opportunities to involve the community in decision making. The objective is to help decision makers and planners to find solutions through a quantitative spatial evaluation and verification process. The study investigates the options for slum development in a formal framework of RAY (Rajiv Awas Yojana), an ambitious program of Indian Government for slum development. The software modules for realizing the GSDSS were developed using the ArcGIS and Community -VIZ software for Gulbarga city.

  10. Simulation-based decision support for evaluating operational plans

    Directory of Open Access Journals (Sweden)

    Johan Schubert

    2015-12-01

    Full Text Available In this article, we describe simulation-based decision support techniques for evaluation of operational plans within effects-based planning. Using a decision support tool, developers of operational plans are able to evaluate thousands of alternative plans against possible courses of events and decide which of these plans are capable of achieving a desired end state. The objective of this study is to examine the potential of a decision support system that helps operational analysts understand the consequences of numerous alternative plans through simulation and evaluation. Operational plans are described in the effects-based approach to operations concept as a set of actions and effects. For each action, we examine several different alternative ways to perform the action. We use a representation where a plan consists of several actions that should be performed. Each action may be performed in one of several different alternative ways. Together these action alternatives make up all possible plan instances, which are represented as a tree of action alternatives that may be searched for the most effective sequence of alternative actions. As a test case, we use an expeditionary operation with a plan of 43 actions and several alternatives for these actions, as well as a scenario of 40 group actors. Decision support for planners is provided by several methods that analyze the impact of a plan on the 40 actors, e.g., by visualizing time series of plan performance. Detailed decision support for finding the most influential actions of a plan is presented by using sensitivity analysis and regression tree analysis. Finally, a decision maker may use the tool to determine the boundaries of an operation that it must not move beyond without risk of drastic failure. The significant contribution of this study is the presentation of an integrated approach for evaluation of operational plans.

  11. Technology Infusion Challenges from a Decision Support Perspective

    Science.gov (United States)

    Adumitroaie, V.; Weisbin, C. R.

    2009-01-01

    In a restricted science budget environment and increasingly numerous required technology developments, the technology investment decisions within NASA are objectively more and more difficult to make such that the end results are satisfying the technical objectives and all the organizational constraints. Under these conditions it is rationally desirable to build an investment portfolio, which has the highest possible technology infusion rate. Arguably the path to infusion is subject to many influencing factors, but here only the challenges associated with the very initial stages are addressed: defining the needs and the subsequent investment decision-support process. It is conceivable that decision consistency and possibly its quality suffer when the decision-making process has limited or no traceability. This paper presents a structured decision-support framework aiming to provide traceable, auditable, infusion- driven recommendations towards a selection process in which these recommendations are used as reference points in further discussions among stakeholders. In this framework addressing well-defined requirements, different measures of success can be defined based on traceability to specific selection criteria. As a direct result, even by using simplified decision models the likelihood of infusion can be probed and consequently improved.

  12. Decision Support Model for Introduction of Gamification Solution Using AHP

    Science.gov (United States)

    2014-01-01

    Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform. PMID:24892075

  13. Decision support model for introduction of gamification solution using AHP.

    Science.gov (United States)

    Kim, Sangkyun

    2014-01-01

    Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.

  14. Decision Support Model for Introduction of Gamification Solution Using AHP

    Directory of Open Access Journals (Sweden)

    Sangkyun Kim

    2014-01-01

    Full Text Available Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.

  15. An object-oriented approach to site characterization decision support

    International Nuclear Information System (INIS)

    Johnson, R.

    1995-01-01

    Effective decision support for site characterization is key to determining the nature and extent of contamination and the associated human and environmental risks. Site characterization data, however, present particular problems to technical analysts and decision-makers. Such data are four dimensional, incorporating temporal and spatial components. Their sheer volume can be daunting -- sites with hundreds of monitoring wells and thousands of samples sent for laboratory analyses are not uncommon. Data are derived from a variety of sources including laboratory analyses, non-intrusive geophysical surveys, historical information, bore logs, in-field estimates of key physical parameters such as aquifer transmissivity, soil moisture content, depth-to-water table, etc. Ultimately, decisions have to be made based on data that are always incomplete, often confusing, inaccurate, or inappropriate, and occasionally wrong. In response to this challenge, two approaches to environmental decision support have arisen, Data Quality Objectives (DQOS) and the Observational Approach (OA). DQOs establish criteria for data collection by clearly defining the decisions that need to be made, the uncertainty that can be tolerated, and the type and amount of data that needs to be collected to satisfy the uncertainty requirements. In practice, DQOs are typically based on statistical measures. The OA accepts the fact that the process of characterizing and remediating contaminated sites is always uncertain. Decision-making with the OA is based on what is known about a site, with contingencies developed for potential future deviations from the original assumptions about contamination nature, extent, and risks posed

  16. SOCOM Training and Rehearsal System (STRS) Process Improvement and Decision Support System (DSS) Development

    National Research Council Canada - National Science Library

    Crossland, Neal; Broussard, Steve

    2005-01-01

    ...) Process Improvement and Decision Support System (DSS) Development. Discussion sequence is: Why the study? Objectives; Areas of inquiry; Study products; Observations; Recommendations; Decision Support System.

  17. Critical care nurse practitioners and clinical nurse specialists interface patterns with computer-based decision support systems.

    Science.gov (United States)

    Weber, Scott

    2007-11-01

    The purposes of this review are to examine the types of clinical decision support systems in use and to identify patterns of how critical care advanced practice nurses (APNs) have integrated these systems into their nursing care patient management practices. The decision-making process itself is analyzed with a focus on how automated systems attempt to capture and reflect human decisional processes in critical care nursing, including how systems actually organize and process information to create outcome estimations based on patient clinical indicators and prognosis logarithms. Characteristics of APN clinicians and implications of these characteristics on decision system use, based on the body of decision system user research, are introduced. A review of the Medline, Ovid, CINAHL, and PubMed literature databases was conducted using "clinical decision support systems,"computerized clinical decision making," and "APNs"; an examination of components of several major clinical decision systems was also undertaken. Use patterns among APNs and other clinicians appear to vary; there is a need for original research to examine how APNs actually use these systems in their practices in critical care settings. Because APNs are increasingly responsible for admission to, and transfer from, critical care settings, more understanding is needed on how they interact with this technology and how they see automated decision systems impacting their practices. APNs who practice in critical care settings vary significantly in how they use the clinical decision systems that are in operation in their practice settings. These APNs must have an understanding of their use patterns with these systems and should critically assess whether their patient care decision making is affected by the technology.

  18. Data Mining and Data Fusion for Enhanced Decision Support

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Shiraj [ORNL; Ganguly, Auroop R [ORNL; Gupta, Amar [University of Arizona

    2008-01-01

    The process of Data Mining converts information to knowledge by utilizing tools from the disciplines of computational statistics, database technologies, machine learning, signal processing, nonlinear dynamics, process modeling, simulation, and allied disciplines. Data Mining allows business problems to be analyzed from diverse perspectives, including dimensionality reduction, correlation and co-occurrence, clustering and classification, regression and forecasting, anomaly detection, and change analysis. The predictive insights generated from Data Mining can be further utilized through real-time analysis and decision sciences, as well as through human-driven analysis based on management by exceptions or by objectives, to generate actionable knowledge. The tools that enable the transformation of raw data to actionable predictive insights are collectively referred as Decision Support tools. This chapter presents a new formalization of the decision process, leading to a new Decision Superiority model, partially motivated by the Joint Directors of Laboratories (JDL) Data Fusion Model. In addition, it examines the growing importance of Data Fusion concepts.

  19. Knowledge Management Technology for Decision Support: an empirical examination

    Directory of Open Access Journals (Sweden)

    Meliha Handzic

    2001-11-01

    Full Text Available This paper reports the results of an empirical examination of the effectiveness of one type of knowledge management technology, namely 'contextual knowledge repository', for supporting individual decision makers in a predictive judgement task context. 31 volunteer subjects participated in the study. The results indicate that a given technology was fairly useful, but insufficient to maximally enhance individual decision making. On one hand, subjects were found to extract more knowledge and make significantly smaller decision errors than their notional naive counterparts. On the other hand, subjects tended to extract less knowledge and make significantly larger decision errors compared to notional optimal counterparts. These findings suggest that individuals could potentially benefit from those knowledge management technologies that would provide additional explicit analytical and procedural knowledge, or those that would facilitate sharing of tacit knowledge through interaction with others. Future research is necessary to address these issues.

  20. ENABLING SMART MANUFACTURING TECHNOLOGIES FOR DECISION-MAKING SUPPORT

    Science.gov (United States)

    Helu, Moneer; Libes, Don; Lubell, Joshua; Lyons, Kevin; Morris, KC

    2017-01-01

    Smart manufacturing combines advanced manufacturing capabilities and digital technologies throughout the product lifecycle. These technologies can provide decision-making support to manufacturers through improved monitoring, analysis, modeling, and simulation that generate more and better intelligence about manufacturing systems. However, challenges and barriers have impeded the adoption of smart manufacturing technologies. To begin to address this need, this paper defines requirements for data-driven decision making in manufacturing based on a generalized description of decision making. Using these requirements, we then focus on identifying key barriers that prevent the development and use of data-driven decision making in industry as well as examples of technologies and standards that have the potential to overcome these barriers. The goal of this research is to promote a common understanding among the manufacturing community that can enable standardization efforts and innovation needed to continue adoption and use of smart manufacturing technologies. PMID:28649678

  1. Modular Architecture for Integrated Model-Based Decision Support.

    Science.gov (United States)

    Gaebel, Jan; Schreiber, Erik; Oeser, Alexander; Oeltze-Jafra, Steffen

    2018-01-01

    Model-based decision support systems promise to be a valuable addition to oncological treatments and the implementation of personalized therapies. For the integration and sharing of decision models, the involved systems must be able to communicate with each other. In this paper, we propose a modularized architecture of dedicated systems for the integration of probabilistic decision models into existing hospital environments. These systems interconnect via web services and provide model sharing and processing capabilities for clinical information systems. Along the lines of IHE integration profiles from other disciplines and the meaningful reuse of routinely recorded patient data, our approach aims for the seamless integration of decision models into hospital infrastructure and the physicians' daily work.

  2. Decision Support Systems and the Conflict Model of Decision Making: A Stimulus for New Computer-Assisted Careers Guidance Systems.

    Science.gov (United States)

    Ballantine, R. Malcolm

    Decision Support Systems (DSSs) are computer-based decision aids to use when making decisions which are partially amenable to rational decision-making procedures but contain elements where intuitive judgment is an essential component. In such situations, DSSs are used to improve the quality of decision-making. The DSS approach is based on Simon's…

  3. Decision Support for Flood Event Prediction and Monitoring

    DEFF Research Database (Denmark)

    Mioc, Darka; Anton, François; Liang, Gengsheng

    2007-01-01

    In this paper the development of Web GIS based decision support system for flood events is presented. To improve flood prediction we developed the decision support system for flood prediction and monitoring that integrates hydrological modelling and CARIS GIS. We present the methodology for data...... integration, floodplain delineation, and online map interfaces. Our Web-based GIS model can dynamically display observed and predicted flood extents for decision makers and the general public. The users can access Web-based GIS that models current flood events and displays satellite imagery and digital...... elevation model integrated with flood plain area. The system can show how the flooding prediction based on the output from hydrological modeling for the next 48 hours along the lower Saint John River Valley....

  4. Confronting Uncertainty in Life Cycle Assessment Used for Decision Support

    DEFF Research Database (Denmark)

    Herrmann, Ivan Tengbjerg; Hauschild, Michael Zwicky; Sohn, Michael D.

    2014-01-01

    the decision maker (DM) in making the best possible choice for the environment. At present, some DMs do not trust the LCA to be a reliable decisionsupport tool—often because DMs consider the uncertainty of an LCA to be too large. The standard evaluation of uncertainty in LCAs is an ex-post approach that can...... regarding which type of LCA study to employ for the decision context at hand. This taxonomy enables the derivation of an LCA classification matrix to clearly identify and communicate the type of a given LCA. By relating the LCA classification matrix to statistical principles, we can also rank the different......The aim of this article is to help confront uncertainty in life cycle assessments (LCAs) used for decision support. LCAs offer a quantitative approach to assess environmental effects of products, technologies, and services and are conducted by an LCA practitioner or analyst (AN) to support...

  5. Green Decision Making: How Systemic Planning can support Strategic Decision Making for Sustainable Transport Development

    DEFF Research Database (Denmark)

    Leleur, Steen

    for Strategic Management. The book was published in 2012 by Springer-Verlag, London, as a research monograph in the publisher’s series about Decision Engineering. The intention behind this new book – with its focus upon ‘greening’ of strategic decisions – is to provide a general and less technical description......The book is based on my participation in the SUSTAIN research project 2012-2017 about National Sustainable Transport Planning funded by the Danish Research Council (Innovationsfonden). Many of the issues treated here have a backdrop in my book Complex Strategic Choices – Applying Systemic Planning...... to this application area. In fact a company relocation decision case has been used to introduce the potential of SP as regards providing decision support for strategic decision making. A main concern in this presentation of SP, which deviates from the Springer book referred to above, is to highlight that ‘greening...

  6. Behavior-aware decision support systems : LDRD final report.

    Energy Technology Data Exchange (ETDEWEB)

    Hirsch, Gary B.; Homer, Jack (Homer Consulting); Chenoweth, Brooke N.; Backus, George A.; Strip, David R.

    2007-11-01

    As Sandia National Laboratories serves its mission to provide support for the security-related interests of the United States, it is faced with considering the behavioral responses that drive problems, mitigate interventions, or lead to unintended consequences. The effort described here expands earlier works in using healthcare simulation to develop behavior-aware decision support systems. This report focuses on using qualitative choice techniques and enhancing two analysis models developed in a sister project.

  7. A safety-critical decision support system evaluation using situation awareness and workload measures

    International Nuclear Information System (INIS)

    Naderpour, Mohsen; Lu, Jie; Zhang, Guangquan

    2016-01-01

    To ensure the safety of operations in safety-critical systems, it is necessary to maintain operators' situation awareness (SA) at a high level. A situation awareness support system (SASS) has therefore been developed to handle uncertain situations [1]. This paper aims to systematically evaluate the enhancement of SA in SASS by applying a multi-perspective approach. The approach consists of two SA metrics, SAGAT and SART, and one workload metric, NASA-TLX. The first two metrics are used for the direct objective and subjective measurement of SA, while the third is used to estimate operator workload. The approach is applied in a safety-critical environment called residue treater, located at a chemical plant in which a poor human-system interface reduced the operator's SA and caused one of the worst accidents in US history. A counterbalanced within-subjects experiment is performed using a virtual environment interface with and without the support of SASS. The results indicate that SASS improves operators' SA, and specifically has benefits for SA levels 2 and 3. In addition, it is concluded that SASS reduces operator workload, although further investigations in different environments with a larger number of participants have been suggested. - Highlights: • The suitability of a cognitive decision support system is investigated. • An evaluation approach considering situation awareness and workload measures is proposed. • A computerized system based on the proposed approach is implemented. • The implemented system is used in a safety-critical environment.

  8. Free and open source enabling technologies for patient-centric, guideline-based clinical decision support: a survey.

    Science.gov (United States)

    Leong, T Y; Kaiser, K; Miksch, S

    2007-01-01

    Guideline-based clinical decision support is an emerging paradigm to help reduce error, lower cost, and improve quality in evidence-based medicine. The free and open source (FOS) approach is a promising alternative for delivering cost-effective information technology (IT) solutions in health care. In this paper, we survey the current FOS enabling technologies for patient-centric, guideline-based care, and discuss the current trends and future directions of their role in clinical decision support. We searched PubMed, major biomedical informatics websites, and the web in general for papers and links related to FOS health care IT systems. We also relied on our background and knowledge for specific subtopics. We focused on the functionalities of guideline modeling tools, and briefly examined the supporting technologies for terminology, data exchange and electronic health record (EHR) standards. To effectively support patient-centric, guideline-based care, the computerized guidelines and protocols need to be integrated with existing clinical information systems or EHRs. Technologies that enable such integration should be accessible, interoperable, and scalable. A plethora of FOS tools and techniques for supporting different knowledge management and quality assurance tasks involved are available. Many challenges, however, remain in their implementation. There are active and growing trends of deploying FOS enabling technologies for integrating clinical guidelines, protocols, and pathways into the main care processes. The continuing development and maturation of such technologies are likely to make increasingly significant contributions to patient-centric, guideline-based clinical decision support.

  9. Supporting risk-informed decisions during business process execution

    NARCIS (Netherlands)

    Conforti, R.; Leoni, de M.; La Rosa, M.; Aalst, van der W.M.P.; Salinesi, C.; Norrie, M.C.; Pastor, O.

    2013-01-01

    This paper proposes a technique that supports process participants in making risk-informed decisions, with the aim to reduce the process risks. Risk reduction involves decreasing the likelihood and severity of a process fault from occurring. Given a process exposed to risks, e.g. a financial process

  10. Safety analysis in support of regulatory decision marking

    International Nuclear Information System (INIS)

    Pomier Baez, L.; Troncoso Fleitas, M.; Valhuerdi Debesa, C.; Valle Cepero, R.; Hernandez, J.L.

    1996-01-01

    Features of different safety analysis techniques by means of calculation thermohydraulic a probabilistic and severe accidents used in the safety assessment, as well as the development of these techniques in Cuba and their use in support of regulatory decision making are presented

  11. A Decision Support System for Predicting Students' Performance

    Science.gov (United States)

    Livieris, Ioannis E.; Mikropoulos, Tassos A.; Pintelas, Panagiotis

    2016-01-01

    Educational data mining is an emerging research field concerned with developing methods for exploring the unique types of data that come from educational context. These data allow the educational stakeholders to discover new, interesting and valuable knowledge about students. In this paper, we present a new user-friendly decision support tool for…

  12. Making Risk Models Operational for Situational Awareness and Decision Support

    International Nuclear Information System (INIS)

    Paulson, P.R.; Coles, G.; Shoemaker, S.

    2012-01-01

    We present CARIM, a decision support tool to aid in the evaluation of plans for converting control systems to digital instruments. The model provides the capability to optimize planning and resource allocation to reduce risk from multiple safety and economic perspectives. (author)

  13. Decision support for sustainable forestry: enhancing the basic rational model.

    Science.gov (United States)

    H.R. Ekbia; K.M. Reynolds

    2007-01-01

    Decision-support systems (DSS) have been extensively used in the management of natural resources for nearly two decades. However, practical difficulties with the application of DSS in real-world situations have become increasingly apparent. Complexities of decisionmaking, encountered in the context of ecosystem management, are equally present in sustainable forestry....

  14. Revisiting the dose calculation methodologies in European decision support systems

    DEFF Research Database (Denmark)

    Andersson, Kasper Grann; Roos, Per; Hou, Xiaolin

    2012-01-01

    The paper presents examples of current needs for improvement and extended applicability of the European decision support systems. The systems were originally created for prediction of the radiological consequences of accidents at nuclear installations. They could however also be of great value in...... for, to introduce new knowledge and thereby improve prognoses....

  15. A decision support system for firebase location in a nature ...

    African Journals Online (AJOL)

    2017-04-19

    Apr 19, 2017 ... implemented in the form of a computerised decision support system ... seven Department of Water Affairs and Forestry reserves (spanning an area of 118km2), ... and the solution methodology of §4 are then incorporated into a ...

  16. Real time traffic models, decision support for traffic management

    NARCIS (Netherlands)

    Wismans, Luc Johannes Josephus; de Romph, E.; Friso, K.; Zantema, K.

    2014-01-01

    Reliable and accurate short-term traffic state prediction can improve the performance of real-time traffic management systems significantly. Using this short-time prediction based on current measurements delivered by advanced surveillance systems will support decision-making processes on various

  17. Real Time Traffic Models, Decision Support for Traffic Management

    NARCIS (Netherlands)

    Wismans, L.; De Romph, E.; Friso, K.; Zantema, K.

    2014-01-01

    Reliable and accurate short-term traffic state prediction can improve the performance of real-time traffic management systems significantly. Using this short-time prediction based on current measurements delivered by advanced surveillance systems will support decision-making processes on various

  18. Threat evaluation and weapon assignment decision support: A ...

    African Journals Online (AJOL)

    ... stands within the context of a ground based air defence system (GBADS) at the turn of the twenty first century. However, much of the contents of the paper maye generalized to military environments other than a GBADS one. Keywords: Threat evaluation, weapon assignment, decision support. ORiON Vol. 23 (2) 2007: pp.

  19. PROBLEM DESCRIPTIONS FOR THE DECISION SUPPORT SOFTWARE DEMONSTRATION

    Energy Technology Data Exchange (ETDEWEB)

    SULLIVAN,T.; ARMSTRONG,A.; OSLEEB,J.

    1998-09-14

    This demonstration is focused on evaluating the utility of decision support software in addressing environmental problems. Three endpoints have been selected for evaluation: (1) Visualization, (2) Sample Optimization, and (3) Cost/Benefit Analysis. The definitions for these three areas in this program are listed.

  20. DECISION SUPPORT TOOL FOR RETAIL SHELF SPACE OPTIMIZATION

    OpenAIRE

    B. RAMASESHAN; N. R. ACHUTHAN; R. COLLINSON

    2008-01-01

    Efficient allocation of shelf space and product assortment can significantly improve a retailer's profitability. This paper addresses the problem from the perspective of an independent franchise retailer. A Category Management Decision Support Tool (CMDST) is proposed that efficiently generates optimal shelf space allocations and product assortments by using the existing scarce resources, resulting in increased profitability. CMDST utilizes two practical integrated category management models ...

  1. Data assimilation in the decision support system RODOS

    DEFF Research Database (Denmark)

    Rojas-Palma, C.; Madsen, H.; Gering, F.

    2003-01-01

    . The process of combining model predictions and observations, usually referred to as data assimilation, is described in this article within the framework of the real time on-line decision support system (RODOS) for off-site nuclear emergency management in Europe. Data assimilation capabilities, based on Kalman...

  2. A strategic decision support system for logistics and supply chain ...

    Indian Academy of Sciences (India)

    T Biswas

    strategic decision support model in achieving better utilization of network and resources to fulfil the ... demand is demonstrated using illustrative scenarios inspired from the real case of a logistics company. ... performance, because they determine the supply chain ..... to accurately measure the desirability of the features.

  3. Decision support for natural resource management; models and evaluation methods

    NARCIS (Netherlands)

    Wessels, J.; Makowski, M.; Nakayama, H.

    2001-01-01

    When managing natural resources or agrobusinesses, one always has to deal with autonomous processes. These autonomous processes play a core role in designing model-based decision support systems. This chapter tries to give insight into the question of which types of models might be used in which

  4. The impact of an electronic clinical decision support for pulmonary ...

    African Journals Online (AJOL)

    State-of-the-art electronic radiology workflow can provide clinical decision support (CDS) for specialised imaging requests, but there has been limited work on the clinical impact of CDS in PE, particularly in resource-constrained environments. Objective. To determine the impact of an electronic CDS for PE on the efficiency ...

  5. A Decision Support System for Ship Maintenance Capacity Planning

    NARCIS (Netherlands)

    de Boer, R.; Schutten, Johannes M.J.; Zijm, Willem H.M.

    1997-01-01

    In this paper, the basic framework and algorithms of a decision support system are discussed, which enhance process and capacity planning at a large repair shop. The research is strongly motivated by experiences in a project carried out at a dockyard, which performs repair, overhaul and modification

  6. Computer Supported Decision Making in Therapy of Arterial Hypertension

    Czech Academy of Sciences Publication Activity Database

    Peleška, Jan; Švejda, David; Zvárová, Jana

    1997-01-01

    Roč. 45, 1/2 (1997), s. 25-29 ISSN 1386-5056 R&D Projects: GA ČR GA313/93/0616 Grant - others:COPERNICUS(XE) JRP-10053 Keywords : computer supported decision making * microsoft access language * therapy of arterial hypertension

  7. Using Clinical Decision Support Software in Health Insurance Company

    Science.gov (United States)

    Konovalov, R.; Kumlander, Deniss

    This paper proposes the idea to use Clinical Decision Support software in Health Insurance Company as a tool to reduce the expenses related to Medication Errors. As a prove that this class of software will help insurance companies reducing the expenses, the research was conducted in eight hospitals in United Arab Emirates to analyze the amount of preventable common Medication Errors in drug prescription.

  8. Decision support for dynamic greenhouse climate control strategies

    NARCIS (Netherlands)

    Körner, O.; Straten, van G.

    2008-01-01

    Earlier, different dynamic greenhouse climate regimes were designed with various aims as energy saving, biocide reduction or reduction of chemical growth retardants that are used for quality improvement. The aim of this research was to create a decision support tool in order to decide at which week

  9. ADDIS: A decision support system for evidence-based medicine

    NARCIS (Netherlands)

    G. van Valkenhoef (Gert); T. Tervonen (Tommi); T. Zwinkels (Tijs); B. de Brock (Bert); H.L. Hillege (Hans)

    2013-01-01

    textabstractClinical trials are the main source of information for the efficacy and safety evaluation of medical treatments. Although they are of pivotal importance in evidence-based medicine, there is a lack of usable information systems providing data-analysis and decision support capabilities for

  10. An operational decision support framework for monitoring business constraints

    NARCIS (Netherlands)

    Maggi, F.M.; Montali, M.; Aalst, van der W.M.P.; Lara, de J.; Zisman, A.

    2012-01-01

    Only recently, process mining techniques emerged that can be used for Operational decision Support (OS), i.e., knowledge extracted from event logs is used to handle running process instances better. In the process mining tool ProM, a generic OS service has been developed that allows ProM to

  11. Model based decision support for planning of road maintenance

    NARCIS (Netherlands)

    van Harten, Aart; Worm, J.M.; Worm, J.M.

    1996-01-01

    In this article we describe a Decision Support Model, based on Operational Research methods, for the multi-period planning of maintenance of bituminous pavements. This model is a tool for the road manager to assist in generating an optimal maintenance plan for a road. Optimal means: minimising the

  12. The value of participatory development to support antimicrobial stewardship with a clinical decision support system

    NARCIS (Netherlands)

    Beerlage-de Jong, Nienke; Wentzel, Jobke; Hendrix, Ron; van Gemert-Pijnen, Lisette

    2017-01-01

    Background: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

  13. The value of participatory development to support antimicrobial stewardship with a clinical decision support system

    NARCIS (Netherlands)

    Beerlage-de Jong, Nienke; Wentzel, M.J.; Hendrix, Ron; van Gemert-Pijnen, Julia E.W.C.

    Background Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

  14. Decision support system for containment and release management

    Energy Technology Data Exchange (ETDEWEB)

    Oosterhuis, B [Twente Univ., Enschede (Netherlands). Computer Science Dept.

    1995-09-01

    The Containment and Release Management project was carried out within the Reinforced Concerted Action Programme for Accident Management Support and partly financed by the European Union. In this report a prototype of an accident management support system is presented. The support system integrates several concepts from accident management research, like safety objective trees, severe accident phenomena, calculation models and an emergency response data system. These concepts are provided by the prototype in such a way that the decision making process of accident management is supported. The prototype application is demonstrated by process data taken from a severe accident scenario for a pressurized water reactor (PWR) that was simulated with the thermohydraulic computer program MAAP. The prototype was derived from a decision support framework based on a decision theory. For established and innovative concepts from accident management research it is pointed out in which way these concepts can support accident management and how these concepts can be integrated. This approach is generic in two ways; it applies to both pressurized and boiling water reactors and it applies to both in vessel management and containment and release management. The prototype application was developed in Multimedia Toolbox 3.0 and requires at least a 386 PC with 4 MB memory, 6 MB free disk space and MS Windows 3.1. (orig.).

  15. Decision support system for containment and release management

    International Nuclear Information System (INIS)

    Oosterhuis, B.

    1995-09-01

    The Containment and Release Management project was carried out within the Reinforced Concerted Action Programme for Accident Management Support and partly financed by the European Union. In this report a prototype of an accident management support system is presented. The support system integrates several concepts from accident management research, like safety objective trees, severe accident phenomena, calculation models and an emergency response data system. These concepts are provided by the prototype in such a way that the decision making process of accident management is supported. The prototype application is demonstrated by process data taken from a severe accident scenario for a pressurized water reactor (PWR) that was simulated with the thermohydraulic computer program MAAP. The prototype was derived from a decision support framework based on a decision theory. For established and innovative concepts from accident management research it is pointed out in which way these concepts can support accident management and how these concepts can be integrated. This approach is generic in two ways; it applies to both pressurized and boiling water reactors and it applies to both in vessel management and containment and release management. The prototype application was developed in Multimedia Toolbox 3.0 and requires at least a 386 PC with 4 MB memory, 6 MB free disk space and MS Windows 3.1. (orig.)

  16. Computerised decision support systems for healthcare professionals: an interpretative review

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2013-03-01

    Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular

  17. Nuclear Waste Management Decision-Making Support with MCDA

    Directory of Open Access Journals (Sweden)

    A. Schwenk-Ferrero

    2017-01-01

    Full Text Available The paper proposes a multicriteria decision analysis (MCDA framework for a comparative evaluation of nuclear waste management strategies taking into account different local perspectives (expert and stakeholder opinions. Of note, a novel approach is taken using a multiple-criteria formulation that is methodologically adapted to tackle various conflicting criteria and a large number of expert/stakeholder groups involved in the decision-making process. The purpose is to develop a framework and to show its application to qualitative comparison and ranking of options in a hypothetical case of three waste management alternatives: interim storage at and/or away from the reactor site for the next 100 years, interim decay storage followed in midterm by disposal in a national repository, and disposal in a multinational repository. Additionally, major aspects of a decision-making aid are identified and discussed in separate paper sections dedicated to application context, decision supporting process, in particular problem structuring, objective hierarchy, performance evaluation modeling, sensitivity/robustness analyses, and interpretation of results (practical impact. The aim of the paper is to demonstrate the application of the MCDA framework developed to a generic hypothetical case and indicate how MCDA could support a decision on nuclear waste management policies in a “small” newcomer country embarking on nuclear technology in the future.

  18. Business Rules Definition for Decision Support System Using Matrix Grammar

    Directory of Open Access Journals (Sweden)

    Eva Zámečníková

    2016-06-01

    Full Text Available This paper deals with formalization of business rules by formal grammars. In our work we focus on methods for high frequency data processing. We process data by using complex event platforms (CEP which allow to process high volume of data in nearly real time. Decision making process is contained by one level of processing of CEP. Business rules are used for decision making process description. For the business rules formalization we chose matrix grammar. The use of formal grammars is quite natural as the structure of rules and its rewriting is very similar both for the business rules and for formal grammar. In addition the matrix grammar allows to simulate dependencies and correlations between the rules. The result of this work is a model for data processing of knowledge-based decision support system described by the rules of formal grammar. This system will support the decision making in CEP. This solution may contribute to the speedup of decision making process in complex event processing and also to the formal verification of these systems.

  19. Supporting End of Life Decision Making: Case Studies of Relational Closeness in Supported Decision Making for People with Severe or Profound Intellectual Disability

    Science.gov (United States)

    Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

    2017-01-01

    Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…

  20. Design document for landfill capping Prototype Decision Support System

    International Nuclear Information System (INIS)

    Stone, J.J.; Paige, G.; Hakonson, T.E.; Lane, L.J.

    1994-01-01

    The overall objective of the Prototype Decision Support System for shallow land burial project is to ''Develop a Decision Support System tool which incorporates simulation modeling and multi-objective decision theory for the purpose of designing and evaluating alternative trench cap designs for mixed waste landfill covers. The goal is to improve the quality of technical information used by the risk manager to select landfill cover designs while taking into account technological, economical, and regulatory factors.'' The complexity of the technical and non-technical information, and how the information varies in importance across sites, points to the need for decision analysis tools that provide a common basis for integrating, synthesizing, and valuing the decision input. Because the cost of remediating thousands of contaminated DOE sites is projected to be in the 10's--100's of billions of dollars, methods will be needed to establish cleanup priorities and to help in the selection and evaluation of cost effective remediation alternatives. Even at this early stage in DOE's cleanup program, it is certain that capping technologies will be heavily relied upon to remediate the 3000+ landfills on DOE property. Capping is favored in remediating most DOE landfills because, based on preliminary baseline risk assessments, human and ecological risks are considered to be low at most of these sites and the regulatory requirements for final closure of old landfills can be met using a well designed cap to isolate the buried waste. This report describes a program plan to design, develop, and test a decision support system (DSS) for assisting the DOE risk manager in evaluating capping alternatives for radioactive and hazardous waste landfills. The DOE DSS will incorporate methods for calculating, integrating and valuing technical, regulatory, and economic criteria

  1. Fuzzy logic in clinical practice decision support systems

    NARCIS (Netherlands)

    Warren, Jim; Beliakov, Gleb; van der Zwaag, B.J.

    Computerized clinical guidelines can provide significant benefits to health outcomes and costs, however, their effective implementation presents significant problems. Vagueness and ambiguity inherent in natural (textual) clinical guidelines is not readily amenable to formulating automated alerts or

  2. Food chain data customization for decision support systems in Austria

    Energy Technology Data Exchange (ETDEWEB)

    Gert, Sdouz; Manfred, Pachole [ARC Seibersdorf research, Seibersdorf (Austria)

    2006-07-01

    In the case of a nuclear accident in Europe the integral decision support system R.O.D.O.S. ( real-time on-line decision support system for off-site emergency management) supplies comprehensive information on the present and future radiological situation, and the consequences of measures to protect the population. These data comprise mainly map information such as population distribution, rivers, roads, vegetation areas and production data of various food products. This work concentrates on the customization of the data for the food chain and dose module for terrestrial pathways. During the last fifteen years two different codes have been used in Austria for support during accidents with radioactive releases: O.E.C.O.S.Y.S. and R.O.D.O.S.. Adaptations and improvements have been performed to give better tools, they are detailed in this paper. (N.C.)

  3. Food chain data customization for decision support systems in Austria

    International Nuclear Information System (INIS)

    Gert, Sdouz; Manfred, Pachole

    2006-01-01

    In the case of a nuclear accident in Europe the integral decision support system R.O.D.O.S. ( real-time on-line decision support system for off-site emergency management) supplies comprehensive information on the present and future radiological situation, and the consequences of measures to protect the population. These data comprise mainly map information such as population distribution, rivers, roads, vegetation areas and production data of various food products. This work concentrates on the customization of the data for the food chain and dose module for terrestrial pathways. During the last fifteen years two different codes have been used in Austria for support during accidents with radioactive releases: O.E.C.O.S.Y.S. and R.O.D.O.S.. Adaptations and improvements have been performed to give better tools, they are detailed in this paper. (N.C.)

  4. Decision aids that support decisions about prenatal testing for Down syndrome: an environmental scan.

    Science.gov (United States)

    Leiva Portocarrero, Maria Esther; Garvelink, Mirjam M; Becerra Perez, Maria Margarita; Giguère, Anik; Robitaille, Hubert; Wilson, Brenda J; Rousseau, François; Légaré, France

    2015-09-24

    Prenatal screening tests for Down syndrome (DS) are routine in many developed countries and new tests are rapidly becoming available. Decisions about prenatal screening are increasingly complex with each successive test, and pregnant women need information about risks and benefits as well as clarity about their values. Decision aids (DAs) can help healthcare providers support women in this decision. Using an environmental scan, we aimed to identify publicly available DAs focusing on prenatal screening/diagnosis for Down syndrome that provide effective support for decision making. Data sources searched were the Decision Aids Library Inventory (DALI) of the Ottawa Patient Decision Aids Research Group at the Ottawa Health Research Institute; Google searches on the internet; professional organizations, academic institutions and other experts in the field; and references in existing systematic reviews on DAs. Eligible DAs targeted pregnant women, focused on prenatal screening and/or diagnosis, applied to tests for fetal abnormalities or aneuploidies, and were in French, English, Spanish or Portuguese. Pairs of reviewers independently identified eligible DAs and extracted characteristics including the presence of practical decision support tools and features to aid comprehension. They then performed quality assessment using the 16 minimum standards established by the International Patient Decision Aids Standards (IPDASi v4.0). Of 543 potentially eligible DAs (512 in DALI, 27 from experts, and four on the internet), 23 were eligible and 20 were available for data extraction. DAs were developed from 1996 to 2013 in six countries (UK, USA, Canada, Australia, Sweden, and France). Five DAs were for prenatal screening, three for prenatal diagnosis and 12 for both). Eight contained values clarification methods (personal worksheets). The 20 DAs scored a median of 10/16 (range 6-15) on the 16 IPDAS minimum standards. None of the 20 included DAs met all 16 IPDAS minimum standards

  5. Decision support system for health care resources allocation.

    Science.gov (United States)

    Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab

    2017-06-01

    A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.

  6. Modelling and simulation-based acquisition decision support: present & future

    CSIR Research Space (South Africa)

    Naidoo, S

    2009-10-01

    Full Text Available stream_source_info Naidoo1_2009.pdf.txt stream_content_type text/plain stream_size 24551 Content-Encoding UTF-8 stream_name Naidoo1_2009.pdf.txt Content-Type text/plain; charset=UTF-8 1 Modelling & Simulation...-Based Acquisition Decision Support: Present & Future Shahen Naidoo Abstract The Ground Based Air Defence System (GBADS) Programme, of the South African Army has been applying modelling and simulation (M&S) to provide acquisition decision and doctrine...

  7. Decision Support System for Optimized Herbicide Dose in Spring Barley

    DEFF Research Database (Denmark)

    Sønderskov, Mette; Kudsk, Per; Mathiassen, Solvejg K

    2014-01-01

    Crop Protection Online (CPO) is a decision support system, which integrates decision algorithms quantifying the requirement for weed control and a herbicide dose model. CPO was designed to be used by advisors and farmers to optimize the choice of herbicide and dose. The recommendations from CPO...... as the Treatment Frequency Index (TFI)) compared to a high level of required weed control. The observations indicated that the current level of weed control required is robust for a range of weed scenarios. Weed plant numbers 3 wk after spraying indicated that the growth of the weed species were inhibited...

  8. Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi.

    Directory of Open Access Journals (Sweden)

    Glyn Elwyn

    Full Text Available To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids.Scale development study, involving construct, item and scale development, validation and reliability testing.There has been increasing use of decision support technologies--adjuncts to the discussions clinicians have with patients about difficult decisions. A global interest in developing these interventions exists among both for-profit and not-for-profit organisations. It is therefore essential to have internationally accepted standards to assess the quality of their development, process, content, potential bias and method of field testing and evaluation.Scale development study, involving construct, item and scale development, validation and reliability testing.Twenty-five researcher-members of the International Patient Decision Aid Standards Collaboration worked together to develop the instrument (IPDASi. In the fourth Stage (reliability study, eight raters assessed thirty randomly selected decision support technologies.IPDASi measures quality in 10 dimensions, using 47 items, and provides an overall quality score (scaled from 0 to 100 for each intervention. Overall IPDASi scores ranged from 33 to 82 across the decision support technologies sampled (n = 30, enabling discrimination. The inter-rater intraclass correlation for the overall quality score was 0.80. Correlations of dimension scores with the overall score were all positive (0.31 to 0.68. Cronbach's alpha values for the 8 raters ranged from 0.72 to 0.93. Cronbach's alphas based on the dimension means ranged from 0.50 to 0.81, indicating that the dimensions, although well correlated, measure different aspects of decision support technology quality. A short version (19 items was also developed that had very similar mean scores to IPDASi and high correlation between short score and overall score 0.87 (CI 0.79 to 0.92.This work

  9. Prioritization of engineering support requests and advanced technology projects using decision support and industrial engineering models

    Science.gov (United States)

    Tavana, Madjid

    1995-01-01

    The evaluation and prioritization of Engineering Support Requests (ESR's) is a particularly difficult task at the Kennedy Space Center (KSC) -- Shuttle Project Engineering Office. This difficulty is due to the complexities inherent in the evaluation process and the lack of structured information. The evaluation process must consider a multitude of relevant pieces of information concerning Safety, Supportability, O&M Cost Savings, Process Enhancement, Reliability, and Implementation. Various analytical and normative models developed over the past have helped decision makers at KSC utilize large volumes of information in the evaluation of ESR's. The purpose of this project is to build on the existing methodologies and develop a multiple criteria decision support system that captures the decision maker's beliefs through a series of sequential, rational, and analytical processes. The model utilizes the Analytic Hierarchy Process (AHP), subjective probabilities, the entropy concept, and Maximize Agreement Heuristic (MAH) to enhance the decision maker's intuition in evaluating a set of ESR's.

  10. A Framework for a Decision Support System in a Hierarchical Extended Enterprise Decision Context

    Science.gov (United States)

    Boza, Andrés; Ortiz, Angel; Vicens, Eduardo; Poler, Raul

    Decision Support System (DSS) tools provide useful information to decision makers. In an Extended Enterprise, a new goal, changes in the current objectives or small changes in the extended enterprise configuration produce a necessary adjustment in its decision system. A DSS in this context must be flexible and agile to make suitable an easy and quickly adaptation to this new context. This paper proposes to extend the Hierarchical Production Planning (HPP) structure to an Extended Enterprise decision making context. In this way, a framework for DSS in Extended Enterprise context is defined using components of HPP. Interoperability details have been reviewed to identify the impact in this framework. The proposed framework allows overcoming some interoperability barriers, identifying and organizing components for a DSS in Extended Enterprise context, and working in the definition of an architecture to be used in the design process of a flexible DSS in Extended Enterprise context which can reuse components for futures Extended Enterprise configurations.

  11. A Decision Support System for Optimum Use of Fertilizers

    Energy Technology Data Exchange (ETDEWEB)

    R. L. Hoskinson; J. R. Hess; R. K. Fink

    1999-07-01

    The Decision Support System for Agriculture (DSS4Ag) is an expert system being developed by the Site-Specific Technologies for Agriculture (SST4Ag) precision farming research project at the INEEL. DSS4Ag uses state-of-the-art artificial intelligence and computer science technologies to make spatially variable, site-specific, economically optimum decisions on fertilizer use. The DSS4Ag has an open architecture that allows for external input and addition of new requirements and integrates its results with existing agricultural systems' infrastructures. The DSS4Ag reflects a paradigm shift in the information revolution in agriculture that is precision farming. We depict this information revolution in agriculture as an historic trend in the agricultural decision-making process.

  12. A Decision Support System for Optimum Use of Fertilizers

    Energy Technology Data Exchange (ETDEWEB)

    Hoskinson, Reed Louis; Hess, John Richard; Fink, Raymond Keith

    1999-07-01

    The Decision Support System for Agriculture (DSS4Ag) is an expert system being developed by the Site-Specific Technologies for Agriculture (SST4Ag) precision farming research project at the INEEL. DSS4Ag uses state-of-the-art artificial intelligence and computer science technologies to make spatially variable, site-specific, economically optimum decisions on fertilizer use. The DSS4Ag has an open architecture that allows for external input and addition of new requirements and integrates its results with existing agricultural systems’ infrastructures. The DSS4Ag reflects a paradigm shift in the information revolution in agriculture that is precision farming. We depict this information revolution in agriculture as an historic trend in the agricultural decision-making process.

  13. Functional specifications for a radioactive waste decision support system

    International Nuclear Information System (INIS)

    Westrom, G.B.; Kurrasch, E.R.; Carlton, R.E.; Vance, J.N.

    1989-09-01

    It is generally recognized that decisions relative to the treatment, handling, transportation and disposal of low-level wastes produced in nuclear power plants involve a complex array of many inter-related elements or considerations. Complex decision processes can be aided through the use of computer-based expert systems which are based on the knowledge of experts and the inferencing of that knowledge to provide advice to an end-user. To determine the feasibility of developing and applying an expert system in nuclear plant low level waste operations, a Functional Specification for a Radwaste Decision Support System (RDSS) was developed. All areas of radwaste management, from the point of waste generation to the disposition of the waste in the final disposal location were considered for inclusion within the scope of the RDSS. 27 figs., 8 tabs

  14. Perspectives on Spatial Decision Support Concerning Location of Biogas Production

    DEFF Research Database (Denmark)

    Bojesen, Mikkel

    in biogas production. This ambition requires that more than 20 new large scale centralised biogas plants are built. The location of these plants is associated with a number of externalities and uncertainties and the existing biogas sector struggles to establish itself as a viable energy producing sector....... Meanwhile planners and decision makers struggle to find sustainable locations that comprehensively balance the multiple concerns the location of biogas facilities includes. This PhD project examines how spatial decision support models can be used to ensure sustainable locations of future biogas plants......, understand the industrial economic aspects of such a role. Through the use of spatial multi-criteria evaluation models stakeholder preferences to decision criteria are included in a sustainable biogas facility location analysis. By the use of these models it is demonstrated how overall biogas production...

  15. Decision support for organ offers in liver transplantation.

    Science.gov (United States)

    Volk, Michael L; Goodrich, Nathan; Lai, Jennifer C; Sonnenday, Christopher; Shedden, Kerby

    2015-06-01

    Organ offers in liver transplantation are high-risk medical decisions with a low certainty of whether a better liver offer will come along before death. We hypothesized that decision support could improve the decision to accept or decline. With data from the Scientific Registry of Transplant Recipients, survival models were constructed for 42,857 waiting-list patients and 28,653 posttransplant patients from 2002 to 2008. Daily covariate-adjusted survival probabilities from these 2 models were combined into a 5-year area under the curve to create an individualized prediction of whether an organ offer should be accepted for a given patient. Among 650,832 organ offers from 2008 to 2013, patient survival was compared by whether the clinical decision was concordant or discordant with model predictions. The acceptance benefit (AB)--the predicted gain or loss of life by accepting a given organ versus waiting for the next organ--ranged from 3 to -22 years (harm) and varied geographically; for example, the average benefit of accepting a donation after cardiac death organ ranged from 0.47 to -0.71 years by donation service area. Among organ offers, even when AB was >1 year, the offer was only accepted 10% of the time. Patient survival from the time of the organ offer was better if the model recommendations and the clinical decision were concordant: for offers with AB > 0, the 3-year survival was 80% if the offer was accepted and 66% if it was declined (P decision support may improve patient survival in liver transplantation. © 2015 American Association for the Study of Liver Diseases.

  16. Applying the Wildland Fire Decision Support System (WFDSS) to support risk-informed decision making: The Gold Pan Fire, Bitterroot National Forest, Montana, USA

    Science.gov (United States)

    Erin K. Noonan-Wright; Tonja S. Opperman

    2015-01-01

    In response to federal wildfire policy changes, risk-informed decision-making by way of improved decision support, is increasingly becoming a component of managing wildfires. As fire incidents escalate in size and complexity, the Wildland Fire Decision Support System (WFDSS) provides support with different analytical tools as fire conditions change. We demonstrate the...

  17. Human Decision Processes: Implications for SSA Support Tools

    Science.gov (United States)

    Picciano, P.

    2013-09-01

    paper), one opinion shared is that the rational, economic, deliberate listing/evaluation of all options is NOT representative of how many decision are made. A framework gaining interest lately describes two systems predominantly at work: intuition and reasoning (Kahneman, 2003). Intuition is fast, automatic, and parallel contrasted with the more effortful, deliberative, and sequential reasoning. One of the issues of contention is that considerable research is stacked supporting both sides claiming that intuition is: • A hallmark of expertise responsible for rapid, optimal decisions in the face of adversity • A vulnerability where biases serve as decision traps leading to wrong choices Using seminal studies from a range of domains and tasking, potential solutions for SSA decision support will be offered. Important issues such as managing uncertainty, framing inquiries, and information architecture, and contextual cues will be discussed. The purpose is to provide awareness of the human limitations and capabilities in complex decision making so engineers and designers can consider such factors in their development of SSA tools.

  18. Mixed results in the safety performance of computerized physician order entry.

    Science.gov (United States)

    Metzger, Jane; Welebob, Emily; Bates, David W; Lipsitz, Stuart; Classen, David C

    2010-04-01

    Computerized physician order entry is a required feature for hospitals seeking to demonstrate meaningful use of electronic medical record systems and qualify for federal financial incentives. A national sample of sixty-two hospitals voluntarily used a simulation tool designed to assess how well safety decision support worked when applied to medication orders in computerized order entry. The simulation detected only 53 percent of the medication orders that would have resulted in fatalities and 10-82 percent of the test orders that would have caused serious adverse drug events. It is important to ascertain whether actual implementations of computerized physician order entry are achieving goals such as improved patient safety.

  19. A Decision Support Model and Tool to Assist Financial Decision-Making in Universities

    Science.gov (United States)

    Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive

    2015-01-01

    In this paper, a model and tool is proposed to assist universities and other mission-based organisations to ascertain systematically the optimal portfolio of projects, in any year, meeting the organisations risk tolerances and available funds. The model and tool presented build on previous work on university operations and decision support systems…

  20. A Customized Drought Decision Support Tool for Hsinchu Science Park

    Science.gov (United States)

    Huang, Jung; Tien, Yu-Chuan; Lin, Hsuan-Te; Liu, Tzu-Ming; Tung, Ching-Pin

    2016-04-01

    Climate change creates more challenges for water resources management. Due to the lack of sufficient precipitation in Taiwan in fall of 2014, many cities and counties suffered from water shortage during early 2015. Many companies in Hsinchu Science Park were significantly influenced and realized that they need a decision support tool to help them managing water resources. Therefore, a customized computer program was developed, which is capable of predicting the future status of public water supply system and water storage of factories when the water rationing is announced by the government. This program presented in this study for drought decision support (DDSS) is a customized model for a semiconductor company in the Hsinchu Science Park. The DDSS is programmed in Java which is a platform-independent language. System requirements are any PC with the operating system above Windows XP and an installed Java SE Runtime Environment 7. The DDSS serves two main functions. First function is to predict the future storage of Baoshan Reservoir and Second Baoshan Reservoir, so to determine the time point of water use restriction in Hsinchu Science Park. Second function is to use the results to help the company to make decisions to trigger their response plans. The DDSS can conduct real-time scenario simulations calculating the possible storage of water tank for each factory with pre-implementation and post-implementation of those response plans. In addition, DDSS can create reports in Excel to help decision makers to compare results between different scenarios.

  1. Dashboard visualizations: Supporting real-time throughput decision-making.

    Science.gov (United States)

    Franklin, Amy; Gantela, Swaroop; Shifarraw, Salsawit; Johnson, Todd R; Robinson, David J; King, Brent R; Mehta, Amit M; Maddow, Charles L; Hoot, Nathan R; Nguyen, Vickie; Rubio, Adriana; Zhang, Jiajie; Okafor, Nnaemeka G

    2017-07-01

    Providing timely and effective care in the emergency department (ED) requires the management of individual patients as well as the flow and demands of the entire department. Strategic changes to work processes, such as adding a flow coordination nurse or a physician in triage, have demonstrated improvements in throughput times. However, such global strategic changes do not address the real-time, often opportunistic workflow decisions of individual clinicians in the ED. We believe that real-time representation of the status of the entire emergency department and each patient within it through information visualizations will better support clinical decision-making in-the-moment and provide for rapid intervention to improve ED flow. This notion is based on previous work where we found that clinicians' workflow decisions were often based on an in-the-moment local perspective, rather than a global perspective. Here, we discuss the challenges of designing and implementing visualizations for ED through a discussion of the development of our prototype Throughput Dashboard and the potential it holds for supporting real-time decision-making. Copyright © 2017. Published by Elsevier Inc.

  2. Overcoming barriers to development of cooperative medical decision support models.

    Science.gov (United States)

    Hudson, Donna L; Cohen, Maurice E

    2012-01-01

    Attempts to automate the medical decision making process have been underway for the at least fifty years, beginning with data-based approaches that relied chiefly on statistically-based methods. Approaches expanded to include knowledge-based systems, both linear and non-linear neural networks, agent-based systems, and hybrid methods. While some of these models produced excellent results none have been used extensively in medical practice. In order to move these methods forward into practical use, a number of obstacles must be overcome, including validation of existing systems on large data sets, development of methods for including new knowledge as it becomes available, construction of a broad range of decision models, and development of non-intrusive methods that allow the physician to use these decision aids in conjunction with, not instead of, his or her own medical knowledge. None of these four requirements will come easily. A cooperative effort among researchers, including practicing MDs, is vital, particularly as more information on diseases and their contributing factors continues to expand resulting in more parameters than the human decision maker can process effectively. In this article some of the basic structures that are necessary to facilitate the use of an automated decision support system are discussed, along with potential methods for overcoming existing barriers.

  3. Encounter Decision Aid vs. Clinical Decision Support or Usual Care to Support Patient-Centered Treatment Decisions in Osteoporosis: The Osteoporosis Choice Randomized Trial II.

    Directory of Open Access Journals (Sweden)

    Annie LeBlanc

    Full Text Available Osteoporosis Choice, an encounter decision aid, can engage patients and clinicians in shared decision making about osteoporosis treatment. Its effectiveness compared to the routine provision to clinicians of the patient's estimated risk of fracture using the FRAX calculator is unknown.Patient-level, randomized, three-arm trial enrolling women over 50 with osteopenia or osteoporosis eligible for treatment with bisphosphonates, where the use of Osteoporosis Choice was compared to FRAX only and to usual care to determine impact on patient knowledge, decisional conflict, involvement in the decision-making process, decision to start and adherence to bisphosphonates.We enrolled 79 women in the three arms. Because FRAX estimation alone and usual care produced similar results, we grouped them for analysis. Compared to these, use of Osteoporosis Choice increased patient knowledge (median score 6 vs. 4, p = .01, improved understanding of fracture risk and risk reduction with bisphosphonates (p = .01 and p<.0001, respectively, had no effect on decision conflict, and increased patient engagement in the decision making process (OPTION scores 57% vs. 43%, p = .001. Encounters with the decision aid were 0.8 minutes longer (range: 33 minutes shorter to 3.0 minutes longer. There were twice as many patients receiving and filling prescriptions in the decision aid arm (83% vs. 40%, p = .07; medication adherence at 6 months was no different across arms.Supporting both patients and clinicians during the clinical encounter with the Osteoporosis Choice decision aid efficiently improves treatment decision making when compared to usual care with or without clinical decision support with FRAX results.clinical trials.gov NCT00949611.

  4. Use of computerized, 3-dimensional solids modeling and data base management to support radiation mapping and ALARA planning

    International Nuclear Information System (INIS)

    Schauss, R.D.; Slobodien, M.S.

    1986-01-01

    The RADiation Mapping and ALARA Planning System (RADMAPS) under development by GPU Nuclear Corporation in conjunction with Construction Systems Associates, Inc., integrates computerized solids modeling and data base management to provide an automated, integrated systems solution to the problems associated with acquiring, managing, and communicating plant radiological data at nuclear facilities. This presentation describes the status of the RADMAPS development and outlines plans for future expansion

  5. Clinical decision support must be useful, functional is not enough

    DEFF Research Database (Denmark)

    Kortteisto, Tiina; Komulainen, Jorma; Mäkelä, Marjukka

    2012-01-01

    the use of computer-based clinical decision support (eCDS) in primary care and how different professional groups experience it. Our aim was to describe specific reasons for using or not using eCDS among primary care professionals. METHODS: The setting was a Finnish primary health care organization with 48......ABSTRACT: BACKGROUND: Health information technology, particularly electronic decision support systems, can reduce the existing gap between evidence-based knowledge and health care practice but professionals have to accept and use this information. Evidence is scant on which features influence...... professionals receiving patient-specific guidance at the point of care. Multiple data (focus groups, questionnaire and spontaneous feedback) were analyzed using deductive content analysis and descriptive statistics. RESULTS: The content of the guidance is a significant feature of the primary care professional...

  6. Advanced intelligent computational technologies and decision support systems

    CERN Document Server

    Kountchev, Roumen

    2014-01-01

    This book offers a state of the art collection covering themes related to Advanced Intelligent Computational Technologies and Decision Support Systems which can be applied to fields like healthcare assisting the humans in solving problems. The book brings forward a wealth of ideas, algorithms and case studies in themes like: intelligent predictive diagnosis; intelligent analyzing of medical images; new format for coding of single and sequences of medical images; Medical Decision Support Systems; diagnosis of Down’s syndrome; computational perspectives for electronic fetal monitoring; efficient compression of CT Images; adaptive interpolation and halftoning for medical images; applications of artificial neural networks for real-life problems solving; present and perspectives for Electronic Healthcare Record Systems; adaptive approaches for noise reduction in sequences of CT images etc.

  7. Computational intelligence for decision support in cyber-physical systems

    CERN Document Server

    Ali, A; Riaz, Zahid

    2014-01-01

    This book is dedicated to applied computational intelligence and soft computing techniques with special reference to decision support in Cyber Physical Systems (CPS), where the physical as well as the communication segment of the networked entities interact with each other. The joint dynamics of such systems result in a complex combination of computers, software, networks and physical processes all combined to establish a process flow at system level. This volume provides the audience with an in-depth vision about how to ensure dependability, safety, security and efficiency in real time by making use of computational intelligence in various CPS applications ranging from the nano-world to large scale wide area systems of systems. Key application areas include healthcare, transportation, energy, process control and robotics where intelligent decision support has key significance in establishing dynamic, ever-changing and high confidence future technologies. A recommended text for graduate students and researche...

  8. Compromise decision support problems for hierarchical design involving uncertainty

    Science.gov (United States)

    Vadde, S.; Allen, J. K.; Mistree, F.

    1994-08-01

    In this paper an extension to the traditional compromise Decision Support Problem (DSP) formulation is presented. Bayesian statistics is used in the formulation to model uncertainties associated with the information being used. In an earlier paper a compromise DSP that accounts for uncertainty using fuzzy set theory was introduced. The Bayesian Decision Support Problem is described in this paper. The method for hierarchical design is demonstrated by using this formulation to design a portal frame. The results are discussed and comparisons are made with those obtained using the fuzzy DSP. Finally, the efficacy of incorporating Bayesian statistics into the traditional compromise DSP formulation is discussed and some pending research issues are described. Our emphasis in this paper is on the method rather than the results per se.

  9. Designing decision support tools for targeted N-regulation

    DEFF Research Database (Denmark)

    Christensen, Andreas Aagaard; Piil, Kristoffer; Andersen, Peter Stubkjær

    2017-01-01

    data model for land use data – the dNmark landscape model. Based on input data which is corrected and edited by workshop participants, the tool estimates the effect of potential land use scenarios on nutrient emissions. The tool was tested in 5 scenario workshops in case areas in Denmark in 2016...... in Denmark to develop and improve a functioning decision support tool for landscape scale N-management. The aim of the study is to evaluate how a decision support tool can best be designed in order to enable landscape scale strategic N-management practices. Methods: A prototype GIS-tool for capturing......, storing, editing, displaying and modelling landscape scale farming practices and associated emission consequences was developed. The tool was designed to integrate locally held knowledge with national scale datasets in live scenario situations through the implementation of a flexible, uniform and editable...

  10. A Mechanized Decision Support System for Academic Scheduling.

    Science.gov (United States)

    1986-03-01

    an operational system called software. The first step in the development phase is Design . Designers destribute software control by factoring the Data...SUBJECT TERMS (Continue on reverse if necessary and identify by block number) ELD GROUP SUB-GROUP Scheduling, Decision Support System , Software Design ...scheduling system . It will also examine software - design techniques to identify the most appropriate method- ology for this problem. " - Chapter 3 will

  11. Ecological user interface for emergency management decision support systems

    DEFF Research Database (Denmark)

    Andersen, V.

    2003-01-01

    The user interface for decision support systems is normally structured for presenting relevant data for the skilled user in order to allow fast assessment and action of the hazardous situation, or for more complex situations to present the relevant rules and procedures to be followed in order to ...... of this paper is to discuss the possibility of using the same principles for emergency management with the aim of improved performance in complex and unanticipated situations....

  12. Intelligent Decision Support System for Bank Loans Risk Classification

    Institute of Scientific and Technical Information of China (English)

    杨保安; 马云飞; 俞莲

    2001-01-01

    Intelligent Decision Support System (IISS) for Bank Loans Risk Classification (BLRC), based on the way of integration Artificial Neural Network (ANN) and Expert System (ES), is proposed. According to the feature of BLRC, the key financial and non-financial factors are analyzed. Meanwhile, ES and Model Base (MB) which contain ANN are designed . The general framework,interaction and integration of the system are given. In addition, how the system realizes BLRC is elucidated in detail.

  13. A Knowledge Management and Decision Support Model for Enterprises

    Directory of Open Access Journals (Sweden)

    Patrizia Ribino

    2011-01-01

    Full Text Available We propose a novel knowledge management system (KMS for enterprises. Our system exploits two different approaches for knowledge representation and reasoning: a document-based approach based on data-driven creation of a semantic space and an ontology-based model. Furthermore, we provide an expert system capable of supporting the enterprise decisional processes and a semantic engine which performs intelligent search on the enterprise knowledge bases. The decision support process exploits the Bayesian networks model to improve business planning process when performed under uncertainty.

  14. Developing eHealth technology for people with dementia : towards a supportive decision tool facilitating shared decision making in dementia

    NARCIS (Netherlands)

    Span, M.; Smits, C.; Groen-van der Ven, L.; Jukema, J.; Cremers, A.H.M.; Vernooij-Dassen, M.; Eefsting, J.; Hettinga, M.

    2013-01-01

    People with dementia are confronted with many decisions. However, they are often not involved in the process of the decision-making. Shared Decision-Making (SDM) enables involvement of persons with dementia in the decision-making process. In our study, we develop a supportive IT application aiming

  15. Experimental studies of computerized procedures and team size in nuclear power plant operations

    International Nuclear Information System (INIS)

    Huang, F.-H.; Hwang, S.-L.

    2009-01-01

    The operation of a nuclear power plant is so complex that it requires teamwork. To support team performance, a system need to provide all team members integrated information displays as well as decision aids (e.g., computerized procedures). Two experiments were conducted to investigate the effects of computerized procedures and team size on operating performance. Forty-five participants were involved in the experiments. Each participant executed decision and action tasks to deal with alarm signals, while detecting occasional system errors in the interface. Results showed that effects of computerized procedures were significant on various performance indicators, such as operation time, operation errors, and learning effect, and that two operators would be a satisfactory size in the teamwork system providing computerized procedures

  16. The potential for intelligent decision support systems to improve the quality and consistency of medication reviews.

    Science.gov (United States)

    Bindoff, I; Stafford, A; Peterson, G; Kang, B H; Tenni, P

    2012-08-01

    Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided. The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into

  17. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

    2017-01-01

    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  18. Design of decision support interventions for medication prescribing.

    Science.gov (United States)

    Horsky, Jan; Phansalkar, Shobha; Desai, Amrita; Bell, Douglas; Middleton, Blackford

    2013-06-01

    Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety. Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort. Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks. Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians

  19. Demonstration of Decision Support Tools for Sustainable Development

    Energy Technology Data Exchange (ETDEWEB)

    Shropshire, David Earl; Jacobson, Jacob Jordan; Berrett, Sharon; Cobb, D. A.; Worhach, P.

    2000-11-01

    The Demonstration of Decision Support Tools for Sustainable Development project integrated the Bechtel/Nexant Industrial Materials Exchange Planner and the Idaho National Engineering and Environmental Laboratory System Dynamic models, demonstrating their capabilities on alternative fuel applications in the Greater Yellowstone-Teton Park system. The combined model, called the Dynamic Industrial Material Exchange, was used on selected test cases in the Greater Yellow Teton Parks region to evaluate economic, environmental, and social implications of alternative fuel applications, and identifying primary and secondary industries. The test cases included looking at compressed natural gas applications in Teton National Park and Jackson, Wyoming, and studying ethanol use in Yellowstone National Park and gateway cities in Montana. With further development, the system could be used to assist decision-makers (local government, planners, vehicle purchasers, and fuel suppliers) in selecting alternative fuels, vehicles, and developing AF infrastructures. The system could become a regional AF market assessment tool that could help decision-makers understand the behavior of the AF market and conditions in which the market would grow. Based on this high level market assessment, investors and decision-makers would become more knowledgeable of the AF market opportunity before developing detailed plans and preparing financial analysis.

  20. Towards decision support for waiting lists: an operations management view.

    Science.gov (United States)

    Vissers, J M; Van Der Bij, J D; Kusters, R J

    2001-06-01

    This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare--national, regional, hospital and process--that each contributes to the existence of waiting lists through managerial decision making. In addition, different underlying mechanisms in demand and supply are distinguished, which together explain the development of waiting lists. It is our contention that within this framework a series of situation specific models should be designed to support communication and decision making. This is illustrated by the modelling of the demand for cataract treatment in a regional setting in the south-eastern part of the Netherlands. An input-output model was developed to support decisions regarding waiting lists. The model projects the demand for treatment at a regional level and makes it possible to evaluate waiting list impacts for different scenarios to meet this demand.

  1. North Slope Decision Support for Water Resource Planning and Management

    Energy Technology Data Exchange (ETDEWEB)

    Schnabel, William; Brumbelow, Kelly

    2013-03-31

    The objective of this project was to enhance the water resource decision-making process with respect to oil and gas exploration/production activities on Alaska’s North Slope. To this end, a web-based software tool was developed to allow stakeholders to assemble, evaluate, and communicate relevant information between and amongst themselves. The software, termed North Slope Decision Support System (NSDSS), is a visually-referenced database that provides a platform for running complex natural system, planning, and optimization models. The NSDSS design was based upon community input garnered during a series of stakeholder workshops, and the end product software is freely available to all stakeholders via the project website. The tool now resides on servers hosted by the UAF Water and Environmental Research Center, and will remain accessible and free-of-charge for all interested stakeholders. The development of the tool fostered new advances in the area of data evaluation and decision support technologies, and the finished product is envisioned to enhance water resource planning activities on Alaska’s North Slope.

  2. Designing an Information System for Decision Support Lending

    Directory of Open Access Journals (Sweden)

    Adrian LUPASC

    2017-04-01

    Full Text Available The successful development of financial and banking activities requires a strong information support to ensure the competitive edge over the other competitors on the market. The exponential growth in the volume of lending financial operations made the use of modern information technology in banking has become fundamental to improving lending activity. Thus, the design and use of a computer system adapted to specific requirements of bank lending will provide opportunities to diversify and modernize the procedures for granting, repayment and credit guarantee to correlate products offer credit demands and customer needs. In this regard, the related objectives of this work are oriented to emphasize the positive impact of the adoption of modern information technologies in decision making in the banking field. The proposed objectives are justified by presenting solutions support system of credit decision which aims to automate ongoing operations specific to a banking allowing bank clerks to process a large number of loan applications in a time very short and to the right decisions and substantiated.

  3. Experiential Knowledge Complements an LCA-Based Decision Support Framework

    Directory of Open Access Journals (Sweden)

    Heng Yi Teah

    2015-09-01

    Full Text Available A shrimp farmer in Taiwan practices innovation through trial-and-error for better income and a better environment, but such farmer-based innovation sometimes fails because the biological mechanism is unclear. Systematic field experimentation and laboratory research are often too costly, and simulating ground conditions is often too challenging. To solve this dilemma, we propose a decision support framework that explicitly utilizes farmer experiential knowledge through a participatory approach to alternatively estimate prospective change in shrimp farming productivity, and to co-design options for improvement. Data obtained from the farmer enable us to quantitatively analyze the production cost and greenhouse gas (GHG emission with a life cycle assessment (LCA methodology. We used semi-quantitative graphical representations of indifference curves and mixing triangles to compare and show better options for the farmer. Our results empower the farmer to make decisions more systematically and reliably based on the frequency of heterotrophic bacteria application and the revision of feed input. We argue that experiential knowledge may be less accurate due to its dependence on varying levels of farmer experience, but this knowledge is a reasonable alternative for immediate decision-making. More importantly, our developed framework advances the scope of LCA application to support practically important yet scientifically uncertain cases.

  4. Decision support for integrated water-energy planning.

    Energy Technology Data Exchange (ETDEWEB)

    Tidwell, Vincent Carroll; Malczynski, Leonard A.; Kobos, Peter Holmes; Castillo, Cesar; Hart, William Eugene; Klise, Geoffrey T.

    2009-10-01

    Currently, electrical power generation uses about 140 billion gallons of water per day accounting for over 39% of all freshwater withdrawals thus competing with irrigated agriculture as the leading user of water. Coupled to this water use is the required pumping, conveyance, treatment, storage and distribution of the water which requires on average 3% of all electric power generated. While water and energy use are tightly coupled, planning and management of these fundamental resources are rarely treated in an integrated fashion. Toward this need, a decision support framework has been developed that targets the shared needs of energy and water producers, resource managers, regulators, and decision makers at the federal, state and local levels. The framework integrates analysis and optimization capabilities to identify trade-offs, and 'best' alternatives among a broad list of energy/water options and objectives. The decision support framework is formulated in a modular architecture, facilitating tailored analyses over different geographical regions and scales (e.g., national, state, county, watershed, NERC region). An interactive interface allows direct control of the model and access to real-time results displayed as charts, graphs and maps. Ultimately, this open and interactive modeling framework provides a tool for evaluating competing policy and technical options relevant to the energy-water nexus.

  5. A decision support system for emergency response to major nuclear accidents

    International Nuclear Information System (INIS)

    Papazoglou, I.A.; Christou, M.D.

    1997-01-01

    A methodology for the optimization of the short-term emergency response in the event of a nuclear accident is presented. The method seeks an optimum combination of protective actions in the presence of a multitude of conflicting objectives and under uncertainty. Conflicting objectives arise in the attempt to minimize simultaneously the potential adverse effects of an accident and the associated socioeconomic impacts. Additional conflicting objectives arise whenever an emergency plan tends to decrease a particular health effect, such as acute deaths, while it increases another, such as latent deaths. The uncertainty is due to the multitude of possible accident scenarios and their respective probability of occurrence, the stochastic variability in the weather conditions, and the variability and/or lack of knowledge of the parameters of the risk assessment models. A multiobjective optimization approach is adopted. An emergency protection plan consists of defining a protective action at each spatial cell around the plant. Three criteria are used as the objective functions of the problem, namely, acute fatalities, latent effects, and socioeconomic cost. The optimization procedure defines the efficient frontier, i.e., all emergency plans that are not dominated by another in all three criteria. No value trade-offs are necessary up to this point. The most preferred emergency plan is then chosen among the set of efficient plans. Finally, the methodology is integrated into a computerized decision support system, and its use is demonstrated in a realistic application

  6. Reducing duplicate testing: a comparison of two clinical decision support tools.

    Science.gov (United States)

    Procop, Gary W; Keating, Catherine; Stagno, Paul; Kottke-Marchant, Kandice; Partin, Mary; Tuttle, Robert; Wyllie, Robert

    2015-05-01

    Unnecessary duplicate laboratory testing is common and costly. Systems-based means to avert unnecessary testing should be investigated and employed. We compared the effectiveness and cost savings associated with two clinical decision support tools to stop duplicate testing. The Hard Stop required telephone contact with the laboratory and justification to have the duplicate test performed, whereas the Smart Alert allowed the provider to bypass the alert at the point of order entry without justification. The Hard Stop alert was significantly more effective than the Smart Alert (92.3% vs 42.6%, respectively; P < .0001). The cost savings realized per alert activation was $16.08/alert for the Hard Stop alert vs $3.52/alert for the Smart Alert. Structural and process changes that require laboratory contact and justification for duplicate testing are more effective than interventions that allow providers to bypass alerts without justification at point of computerized physician order entry. Copyright© by the American Society for Clinical Pathology.

  7. Evaluation of real-time clinical decision support systems for platelet and cryoprecipitate orders.

    Science.gov (United States)

    Collins, Ryan A; Triulzi, Darrell J; Waters, Jonathan H; Reddy, Vivek; Yazer, Mark H

    2014-01-01

    To evaluate cryoprecipitate and platelet ordering practices after the implementation of real-time clinical decision support systems (CDSSs) in a computerized physician order entry (CPOE) system. Uniform platelet and cryoprecipitate transfusion thresholds were implemented at 11 hospitals in a regional health care system with a common CPOE system. Over 6 months, a variety of information was collected on the ordering physicians and the number of alerts generated by the CDSSs when these products were ordered outside of the institutional guidelines. There were 1,889 orders for platelets and 152 orders for cryoprecipitate placed in 6 months. Of these, 1,102 (58.3%) platelet and 74 (48.7%) cryoprecipitate orders triggered an alert. The proportion of orders canceled after an alert was generated ranged from 13.5% to 17.9% for platelets and 0% to 50.0% for cryoprecipitate orders. CDSS alerts reduce, but do not eliminate, platelet and cryoprecipitate transfusions that do not meet institutional guidelines.

  8. A model-referenced procedure to support adversarial decision processes

    International Nuclear Information System (INIS)

    Bunn, D.W.; Vlahos, K.

    1992-01-01

    In public enquiries concerning major facilities, such as the construction of a new electric power plant, it is observed that a useable decision model should be made commonly available alongside the open provision of data and assumptions. The protagonist, eg the electric utility, generally makes use of a complex, proprietary model for detailed evaluation of options. A simple emulator of this, based upon a regression analysis of numerous scenarios, and validated by further simulations is shown to be feasible and potentially attractive. It would be in the interests of the utility to make such a model-referenced decision support method generally available. The approach is considered in relation to the recent Hinkley Point C public enquiry for a new nuclear power plant in the UK. (Author)

  9. A public health decision support system model using reasoning methods.

    Science.gov (United States)

    Mera, Maritza; González, Carolina; Blobel, Bernd

    2015-01-01

    Public health programs must be based on the real health needs of the population. However, the design of efficient and effective public health programs is subject to availability of information that can allow users to identify, at the right time, the health issues that require special attention. The objective of this paper is to propose a case-based reasoning model for the support of decision-making in public health. The model integrates a decision-making process and case-based reasoning, reusing past experiences for promptly identifying new population health priorities. A prototype implementation of the model was performed, deploying the case-based reasoning framework jColibri. The proposed model contributes to solve problems found today when designing public health programs in Colombia. Current programs are developed under uncertain environments, as the underlying analyses are carried out on the basis of outdated and unreliable data.

  10. System for decision analysis support on complex waste management issues

    International Nuclear Information System (INIS)

    Shropshire, D.E.

    1997-01-01

    A software system called the Waste Flow Analysis has been developed and applied to complex environmental management processes for the United States Department of Energy (US DOE). The system can evaluate proposed methods of waste retrieval, treatment, storage, transportation, and disposal. Analysts can evaluate various scenarios to see the impacts to waste slows and schedules, costs, and health and safety risks. Decision analysis capabilities have been integrated into the system to help identify preferred alternatives based on a specific objectives may be to maximize the waste moved to final disposition during a given time period, minimize health risks, minimize costs, or combinations of objectives. The decision analysis capabilities can support evaluation of large and complex problems rapidly, and under conditions of variable uncertainty. The system is being used to evaluate environmental management strategies to safely disposition wastes in the next ten years and reduce the environmental legacy resulting from nuclear material production over the past forty years

  11. A Decision Support Framework for Automated Screening of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available The early signs of diabetic retinopathy (DR are depicted by microaneurysms among other signs. A prompt diagnosis when the disease is at the early stage can help prevent irreversible damages to the diabetic eye. In this paper, we propose a decision support system (DSS for automated screening of early signs of diabetic retinopathy. Classification schemes for deducing the presence or absence of DR are developed and tested. The detection rule is based on binary-hypothesis testing problem which simplifies the problem to yes/no decisions. An analysis of the performance of the Bayes optimality criteria applied to DR is also presented. The proposed DSS is evaluated on the real-world data. The results suggest that by biasing the classifier towards DR detection, it is possible to make the classifier achieve good sensitivity.

  12. Use of Remote Sensing for Decision Support in Africa

    Science.gov (United States)

    Policelli, Frederick S.

    2007-01-01

    Over the past 30 years, the scientific community has learned a great deal about the Earth as an integrated system. Much of this research has been enabled by the development of remote sensing technologies and their operation from space. Decision makers in many nations have begun to make use of remote sensing data for resource management, policy making, and sustainable development planning. This paper makes an attempt to provide a survey of the current state of the requirements and use of remote sensing for sustainable development in Africa. This activity has shown that there are not many climate data ready decision support tools already functioning in Africa. There are, however, endusers with known requirements who could benefit from remote sensing data.

  13. Online decision support system for surface irrigation management

    Science.gov (United States)

    Wang, Wenchao; Cui, Yuanlai

    2017-04-01

    Irrigation has played an important role in agricultural production. Irrigation decision support system is developed for irrigation water management, which can raise irrigation efficiency with few added engineering services. An online irrigation decision support system (OIDSS), in consist of in-field sensors and central computer system, is designed for surface irrigation management in large irrigation district. Many functions have acquired in OIDSS, such as data acquisition and detection, real-time irrigation forecast, water allocation decision and irrigation information management. The OIDSS contains four parts: Data acquisition terminals, Web server, Client browser and Communication system. Data acquisition terminals are designed to measure paddy water level, soil water content in dry land, ponds water level, underground water level, and canals water level. A web server is responsible for collecting meteorological data, weather forecast data, the real-time field data, and manager's feedback data. Water allocation decisions are made in the web server. Client browser is responsible for friendly displaying, interacting with managers, and collecting managers' irrigation intention. Communication system includes internet and the GPRS network used by monitoring stations. The OIDSS's model is based on water balance approach for both lowland paddy and upland crops. Considering basic database of different crops water demands in the whole growth stages and irrigation system engineering information, the OIDSS can make efficient decision of water allocation with the help of real-time field water detection and weather forecast. This system uses technical methods to reduce requirements of user's specialized knowledge and can also take user's managerial experience into account. As the system is developed by the Browser/Server model, it is possible to make full use of the internet resources, to facilitate users at any place where internet exists. The OIDSS has been applied in

  14. Fast Interactive Decision Support for Modifying Stowage Plans Using Binary Decision Diagrams

    DEFF Research Database (Denmark)

    Jensen, Rune Møller; Leknes, Eilif; Bebbington, Thomas

    Low cost containerized shipping requires high quality stowage plans. Scalable stowage planning optimization algorithms have been developed recently. All of these algorithms, however, produce monolithic solutions that are hard for stowage coordinators to modify, which is necessary in practice due ...... fast, complete, and backtrack-free decision support. Our computational results show that the approach can solve real-sized instances when breaking symmetries among similar containers...

  15. New Decision Support for Landslide and Other Disaster Events

    Science.gov (United States)

    Nair, U. S.; Keiser, K.; Wu, Y.; Kaulfus, A.; Srinivasan, K.; Anderson, E. R.; McEniry, M.

    2013-12-01

    An Event-Driven Data delivery (ED3) framework has been created that provides reusable services and configurations to support better data preparedness for decision support of disasters and other events by rapidly providing pre-planned access to data, special processing, modeling and other capabilities, all executed in response to criteria-based events. ED3 facilitates decision makers to plan in advance of disasters and other types of events for the data necessary for decisions and response activities. A layer of services provided in the ED3 framework allows systems to support user definition of subscriptions for data plans that will be triggered when events matching specified criteria occur. Pre-planning for data in response to events lessens the burden on decision makers in the aftermath of an event and allows planners to think through the desired processing for specialized data products. Additionally the ED3 framework provides support for listening for event alerts and support for multiple workflow managers that provide data and processing functionality in response to events. Landslides are often costly and, at times, deadly disaster events. Whereas intense and/or sustained rainfall is often the primary trigger for landslides, soil type and slope are also important factors in determining the location and timing of slope failure. Accounting for the substantial spatial variability of these factors is one of the major difficulties when predicting the timing and location of slope failures. A wireless sensor network (WSN), developed by NASA SERVIR and USRA, with peer-to-peer communication capability and low power consumption, is ideal for high spatial in situ monitoring in remote locations. In collaboration with the University of Huntsville at Alabama, WSN equipped with accelerometer, rainfall and soil moisture sensors is being integrated into an end-to-end landslide warning system. The WSN is being tested to ascertain communication capabilities and the density of

  16. Decision support for off-site emergency preparedness in Europe

    International Nuclear Information System (INIS)

    Kelly, G.N.; Ehrhardt, J.

    1996-01-01

    The decision support system, RODOS, for off-site emergency management in the event of a future accident is being developed with support from the European Commission. The development is being carried out within a large and fully integrated international project involving about forty institutes from sixteen countries in Eastern and Western Europe. RODOS has been designed to provide comprehensive (i.e. applicable at all distances, at all times and to all important countermeasures) decision support and to be applicable throughout Europe. The background to the development of RODOS is described in this paper together with its basic features, its current status and plans for its further development. Given the context of this Special Issue, particular attention is given to the contribution made by institutes in the former Soviet Union to the development of RODOS and plans for its implementation in these countries. The benefits of the system are increasingly being recognised following the completion of the pilot version in 1995. Of particular importance is its potential role as part of a wider European network, the existence of which would promote a more effective and coherent response to any future nuclear accident that might affect Europe. (Author)

  17. Coordinating complex decision support activities across distributed applications

    Science.gov (United States)

    Adler, Richard M.

    1994-01-01

    Knowledge-based technologies have been applied successfully to automate planning and scheduling in many problem domains. Automation of decision support can be increased further by integrating task-specific applications with supporting database systems, and by coordinating interactions between such tools to facilitate collaborative activities. Unfortunately, the technical obstacles that must be overcome to achieve this vision of transparent, cooperative problem-solving are daunting. Intelligent decision support tools are typically developed for standalone use, rely on incompatible, task-specific representational models and application programming interfaces (API's), and run on heterogeneous computing platforms. Getting such applications to interact freely calls for platform independent capabilities for distributed communication, as well as tools for mapping information across disparate representations. Symbiotics is developing a layered set of software tools (called NetWorks! for integrating and coordinating heterogeneous distributed applications. he top layer of tools consists of an extensible set of generic, programmable coordination services. Developers access these services via high-level API's to implement the desired interactions between distributed applications.

  18. Impact of generic substitution decision support on electronic prescribing behavior.

    Science.gov (United States)

    Stenner, Shane P; Chen, Qingxia; Johnson, Kevin B

    2010-01-01

    To evaluate the impact of generic substitution decision support on electronic (e-) prescribing of generic medications. The authors analyzed retrospective outpatient e-prescribing data from an academic medical center and affiliated network for July 1, 2005-September 30, 2008 using an interrupted time-series design to assess the rate of generic prescribing before and after implementing generic substitution decision support. To assess background secular trends, e-prescribing was compared with a concurrent random sample of hand-generated prescriptions. Proportion of generic medications prescribed before and after the intervention, evaluated over time, and compared with a sample of prescriptions generated without e-prescribing. The proportion of generic medication prescriptions increased from 32.1% to 54.2% after the intervention (22.1% increase, 95% CI 21.9% to 22.3%), with no diminution in magnitude of improvement post-intervention. In the concurrent control group, increases in proportion of generic prescriptions (29.3% to 31.4% to 37.4% in the pre-intervention, post-intervention, and end-of-study periods, respectively) were not commensurate with the intervention. There was a larger change in generic prescribing rates among authorized prescribers (24.6%) than nurses (18.5%; adjusted OR 1.38, 95% CI 1.17 to 1.63). Two years after the intervention, the proportion of generic prescribing remained significantly higher for e-prescriptions (58.1%; 95% CI 57.5% to 58.7%) than for hand-generated prescriptions ordered at the same time (37.4%; 95% CI 34.9% to 39.9%) (p<0.0001). Generic prescribing increased significantly in every specialty. Implementation of generic substitution decision support was associated with dramatic and sustained improvements in the rate of outpatient generic e-prescribing across all specialties.

  19. Harnessing the Frontline Employee Sensing of Capabilities for Decision Support

    DEFF Research Database (Denmark)

    Hallin, Carina Antonia; Andersen, Torben Juul; Tveterås, Sigbjørn

    2017-01-01

    The ability to sense developments in operational (steady-state) and dynamic (growth) capabilities provides early signals about how the firm adapts its operations to ongoing changes in the environment. Frontline employees engage in the daily transactions and sense the firm's operating conditions......, this article develops a sensing instrument an employee-sensed operational conduct (ESOC) index for updated information as an essential decision support mechanism. This sensing capacity is firm-specific and difficult to replicate once in place and thus can provide a basis for sustainable competitive advantage....

  20. A Decision Support Tool for Transient Stability Preventive Control

    DEFF Research Database (Denmark)

    Pertl, Michael; Weckesser, Johannes Tilman Gabriel; Rezkalla, Michel M.N.

    2017-01-01

    The paper presents a decision support tool for transient stability preventive control contributing to increased situation awareness of control room operators by providing additional information about the state of the power system in terms of transient stability. A time-domain approach is used...... a predefined minimum critical clearing time for faults at all buses is proposed, while costs are minimized. The results of the assessment are presented to the control room operator, who decides to accept the suggested dispatch or to repeat the assessment considering additional user-specific constraints...

  1. Artificial intelligence based decision support for trumpeter swan management

    Science.gov (United States)

    Sojda, Richard S.

    2002-01-01

    The number of trumpeter swans (Cygnus buccinator) breeding in the Tri-State area where Montana, Idaho, and Wyoming come together has declined to just a few hundred pairs. However, these birds are part of the Rocky Mountain Population which additionally has over 3,500 birds breeding in Alberta, British Columbia, Northwest Territories, and Yukon Territory. To a large degree, these birds seem to have abandoned traditional migratory pathways in the flyway. Waterfowl managers have been interested in decision support tools that would help them explore simulated management scenarios in their quest towards reaching population recovery and the reestablishment of traditional migratory pathways. I have developed a decision support system to assist biologists with such management, especially related to wetland ecology. Decision support systems use a combination of models, analytical techniques, and information retrieval to help develop and evaluate appropriate alternatives. Swan management is a domain that is ecologically complex, and this complexity is compounded by spatial and temporal issues. As such, swan management is an inherently distributed problem. Therefore, the ecological context for modeling swan movements in response to management actions was built as a multiagent system of interacting intelligent agents that implements a queuing model representing swan migration. These agents accessed ecological knowledge about swans, their habitats, and flyway management principles from three independent expert systems. The agents were autonomous, had some sensory capability, and could respond to changing conditions. A key problem when developing ecological decision support systems is empirically determining that the recommendations provided are valid. Because Rocky Mountain trumpeter swans have been surveyed for a long period of time, I was able to compare simulated distributions provided by the system with actual field observations across 20 areas for the period 1988

  2. A water management decision support system contributing to sustainability

    Science.gov (United States)

    Horváth, Klaudia; van Esch, Bart; Baayen, Jorn; Pothof, Ivo; Talsma, Jan; van Heeringen, Klaas-Jan

    2017-04-01

    Deltares and Eindhoven University of Technology are developing a new decision support system (DSS) for regional water authorities. In order to maintain water levels in the Dutch polder system, water should be drained and pumped out from the polders to the sea. The time and amount of pumping depends on the current sea level, the water level in the polder, the weather forecast and the electricity price forecast and possibly local renewable power production. This is a multivariable optimisation problem, where the goal is to keep the water level in the polder within certain bounds. By optimizing the operation of the pumps the energy usage and costs can be reduced, hence the operation of the regional water authorities can be more sustainable, while also anticipating on increasing share of renewables in the energy mix in a cost-effective way. The decision support system, based on Delft-FEWS as operational data-integration platform, is running an optimization model built in RTC-Tools 2, which is performing real-time optimization in order to calculate the pumping strategy. It is taking into account the present and future circumstances. As being the core of the real time decision support system, RTC-Tools 2 fulfils the key requirements to a DSS: it is fast, robust and always finds the optimal solution. These properties are associated with convex optimization. In such problems the global optimum can always be found. The challenge in the development is to maintain the convex formulation of all the non-linear components in the system, i.e. open channels, hydraulic structures, and pumps. The system is introduced through 4 pilot projects, one of which is a pilot of the Dutch Water Authority Rivierenland. This is a typical Dutch polder system: several polders are drained to the main water system, the Linge. The water from the Linge can be released to the main rivers that are subject to tidal fluctuations. In case of low tide, water can be released via the gates. In case of high

  3. Calculating Outcrossing Rates used in Decision Support Systems for Ships

    DEFF Research Database (Denmark)

    Nielsen, Ulrik Dam

    2008-01-01

    Onboard decision support systems (DSS) are used to increase the operational safety of ships. Ideally, DSS can estimate - in the statistical sense - future ship responses on a time scale of the order of 1-3 hours taking into account speed and course changes. The calculations depend on both...... analysis, and the paper derives and describes the main ideas. The concept is illustrated by an example, where the limit state of a non-linear ship response is considered. The results from the parallel system analysis are in agreement with corresponding Monte Carlo simulations. However, the computational...

  4. Knowledge-based dialogue in Intelligent Decision Support Systems

    International Nuclear Information System (INIS)

    Hollnagel, E.

    1987-01-01

    The overall goal for the design of Intelligent Decision Support Systems (IDSS) is to enhance understanding of the process under all operating conditions. For an IDSS to be effective, it must: select or generate the right information; produce reliable and consistent information; allow flexible and effective operator interaction; relate information presentation to current plant status and problems; and make the presentation at the right time. Several ongoing R and D programs try to design and build IDSSs. A particular example is the ESPRIT project Graphics and Knowledge Based Diaglogue for Dynamic Systems (GRADIENT). This project, the problems it addresses, and its uses, are discussed here

  5. Design of Graph Analysis Model to support Decision Making

    International Nuclear Information System (INIS)

    An, Sang Ha; Lee, Sung Jin; Chang, Soon Heung; Kim, Sung Ho; Kim, Tae Woon

    2005-01-01

    Korea is meeting the growing electric power needs by using nuclear, fissile, hydro energy and so on. But we can not use fissile energy forever, and the people's consideration about nature has been changed. So we have to prepare appropriate energy by the conditions before people need more energy. And we should prepare dynamic response because people's need would be changed as the time goes on. So we designed graphic analysis model (GAM) for the dynamic analysis of decision on the energy sources. It can support Analytic Hierarchy Process (AHP) analysis based on Graphic User Interface

  6. Radiological emergency assessment of local decision support system

    International Nuclear Information System (INIS)

    Breznik, B.; Kusar, A.; Boznar, M.Z.; Mlakar, P.

    2003-01-01

    Local decision support system has been developed based on the needs of Krsko Nuclear Power Plant for quick dose projection and it is one of important features required for proposal of intervention before actual release may occur. Radiological emergency assessment in the case of nuclear accident is based on plant status analysis, radiation monitoring data and on prediction of release of radioactive sources to the environment. There are possibilities to use automatic features to predict release source term and manual options for selection of release parameters. Advanced environmental modelling is used for assessment of atmospheric dispersion of radioactive contamination in the environment. (author)

  7. Computerized tomography

    International Nuclear Information System (INIS)

    1980-01-01

    Improvements in the design of computerized tomographic X-ray equipment are described which lead to improvements in the mechanical properties, speed and size of scanning areas. The method envisages the body being scanned as a two-dimensional matrix of elements arising from a plurality of concentric rings. The concentric centre need not coincide with the axis of rotation. The procedures for rotation of the X-ray beam and detectors around the patient and for translating the measured information into attenuation coefficients for each matrix element of the body are described in detail. Explicit derivations are given for the mathematical formulae used. (U.K.)

  8. Decision support system for the operating room rescheduling problem.

    Science.gov (United States)

    van Essen, J Theresia; Hurink, Johann L; Hartholt, Woutske; van den Akker, Bernd J

    2012-12-01

    Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.

  9. The approaches for the decision support in case natural hazards

    Science.gov (United States)

    Vyazilov, Evgeny; Chunyaev, Nikita

    2013-04-01

    In spite of using highly automated systems of measurement, collecting, storing, handling, prediction and delivery of information on the marine environment, including natural hazards, the amount of damage from natural phenomena increases. Because information on the marine environment delivered to the industrial facilities not effectively used. To such information pays little attention by individual decision-makers and not always perform preventive measures necessary for reduce and prevent damage. Automation of information support will improve the efficiency management of the marine activities. In Russia develops "The Unified system of the information about World ocean" (ESIMO, http://esimo.ru/), that integrates observation, analysis, prognostic and climate data. Necessary to create tools to automatic selection natural disasters through all integrated data; notification decision-makers about arising natural hazards - software agent; provision of information in a compact form for the decision-makers; assessment of possible damage and costs to the preventive measures; providing information on the impacts of environment on economic facilities and recommendations for decision-making; the use of maps, diagrams, tables for reporting. Tools for automatic selection designed for identification of natural phenomena based on the resources ESIMO and corresponding critical values of the indicators environment. The result of this module will be constantly updated database of critical situations of environment for each object or technological process. To operational notify and provide current information about natural hazards proposes using a software agent that is installed on the computer decision-makers, which is activated in case critical situations and provides a minimum of information. In the event of natural disaster software agent should be able to inform decision-makers about this, providing information on the current situation, and the possibility for more and detailed

  10. A Mashup Application to Support Complex Decision Making for Retail Consumers

    OpenAIRE

    Steven Walczak; Deborah L. Kellogg; Dawn G. Gregg

    2010-01-01

    Purchase processes often require complex decision making and consumers frequently use Web information sources to support these decisions. However, increasing amounts of information can make finding appropriate information problematic. This information overload, coupled with decision complexity, can increase time required to make a decision and reduce decision quality. This creates a need for tools that support these decision-making processes. Online tools that bring together data and partial ...

  11. Evaluation of RxNorm for Medication Clinical Decision Support.

    Science.gov (United States)

    Freimuth, Robert R; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G

    2014-01-01

    We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS.

  12. Real-Time Clinical Decision Support Decreases Inappropriate Plasma Transfusion.

    Science.gov (United States)

    Shah, Neil; Baker, Steven A; Spain, David; Shieh, Lisa; Shepard, John; Hadhazy, Eric; Maggio, Paul; Goodnough, Lawrence T

    2017-08-01

    To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less. The alert was suppressed for massive transfusion and within operative or apheresis settings. The plasma order was automatically removed upon alert acceptance while clinical exception reasons allowed for continued transfusion. Alert impact was studied comparing a 7-month control period with a 4-month intervention period. Monthly plasma utilization decreased 17.4%, from a mean ± SD of 3.40 ± 0.48 to 2.82 ± 0.6 plasma units per hundred patient days (95% confidence interval [CI] of difference, -0.1 to 1.3). Plasma transfused below an INR of 1.7 or less decreased from 47.6% to 41.6% (P = .0002; odds ratio, 0.78; 95% CI, 0.69-0.89). The alert recommendation was accepted 33% of the time while clinical exceptions were chosen in the remaining cases (active bleeding, 31%; other clinical indication, 33%; and apheresis, 2%). Alert acceptance rate varied significantly among different provider specialties. Clinical decision support can help curtail inappropriate plasma use but needs to be part of a comprehensive strategy including audit and feedback for comprehensive, long-term changes. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  13. Comparing decision-support systems in adopting sustainable intensification criteria

    Directory of Open Access Journals (Sweden)

    Bouda eVosough Ahmadi

    2015-02-01

    Full Text Available Sustainable intensification (SI is a multifaceted concept incorporating the ambition to increase or maintain the current level of agricultural yields while reduce negative ecological and environmental impacts. Decision-support systems (DSS that use integrated analytical methods are often used to support decision making processes in agriculture. However, DSS often consist of set of values, objectives and assumptions that may be inconsistent or in conflict with merits and objectives of SI. These potential conflicts will have consequences for adoption and up-take of agricultural research, technologies and related policies and regulations such as genetic technology in pursuit of SI. This perspective paper aimed at comparing a number of frequently used socio-economic DSS with respect to their capacity in incorporating various dimensions of SI, and discussing their application to analyzing farm animal genetic resources (FAnGR policies. The case of FAnGR policies was chosen because of its great potential in delivering merits of SI. It was concluded that flexible DSS, with great integration capacity with various natural and social sciences, are needed to provide guidance on feasibility, practicality and policy implementation for SI.

  14. Combining morphological analysis and Bayesian networks for strategic decision support

    Directory of Open Access Journals (Sweden)

    A de Waal

    2007-12-01

    Full Text Available Morphological analysis (MA and Bayesian networks (BN are two closely related modelling methods, each of which has its advantages and disadvantages for strategic decision support modelling. MA is a method for defining, linking and evaluating problem spaces. BNs are graphical models which consist of a qualitative and quantitative part. The qualitative part is a cause-and-effect, or causal graph. The quantitative part depicts the strength of the causal relationships between variables. Combining MA and BN, as two phases in a modelling process, allows us to gain the benefits of both of these methods. The strength of MA lies in defining, linking and internally evaluating the parameters of problem spaces and BN modelling allows for the definition and quantification of causal relationships between variables. Short summaries of MA and BN are provided in this paper, followed by discussions how these two computer aided methods may be combined to better facilitate modelling procedures. A simple example is presented, concerning a recent application in the field of environmental decision support.

  15. A Decision Support System for Preventing Falls in Elderly People

    Directory of Open Access Journals (Sweden)

    Estelle Courtial

    2015-12-01

    Full Text Available Preventing falls in older people is a real challenge for Public Health. This paper addresses this issue by designing a decision support system which provides a fall risk index. The proposed approach is based on three selected tests (the Timed up and go (TUG, the 30s sit-to-stand and the 4-stage balance tests, which are widely used in the medical sector for assessing mobility and balance of the elderly. During the tests, a video records the older person performing the test and thanks to an image processing algorithm, kinematics and biomechanics parameters are extracted. Based on fuzzy logic, a decision support system fuses all these data and estimates a fall risk index according to the senior's age and gender. It can also assist the Health Professional in making improved medical diagnosis relied on targeted measurements. Simulation results drawing on experimental data of 12 older persons performing the TUG test illustrate the feasibility and the effectiveness of the proposed approach. Objectively assessing the senior's motor functions and the fall risk is possible in less than 10 minutes, at low cost and in an easy and non invasive way.

  16. Integrated Decision Support for Global Environmental Change Adaptation

    Science.gov (United States)

    Kumar, S.; Cantrell, S.; Higgins, G. J.; Marshall, J.; VanWijngaarden, F.

    2011-12-01

    Environmental changes are happening now that has caused concern in many parts of the world; particularly vulnerable are the countries and communities with limited resources and with natural environments that are more susceptible to climate change impacts. Global leaders are concerned about the observed phenomena and events such as Amazon deforestation, shifting monsoon patterns affecting agriculture in the mountain slopes of Peru, floods in Pakistan, water shortages in Middle East, droughts impacting water supplies and wildlife migration in Africa, and sea level rise impacts on low lying coastal communities in Bangladesh. These environmental changes are likely to get exacerbated as the temperatures rise, the weather and climate patterns change, and sea level rise continues. Large populations and billions of dollars of infrastructure could be affected. At Northrop Grumman, we have developed an integrated decision support framework for providing necessary information to stakeholders and planners to adapt to the impacts of climate variability and change at the regional and local levels. This integrated approach takes into account assimilation and exploitation of large and disparate weather and climate data sets, regional downscaling (dynamic and statistical), uncertainty quantification and reduction, and a synthesis of scientific data with demographic and economic data to generate actionable information for the stakeholders and decision makers. Utilizing a flexible service oriented architecture and state-of-the-art visualization techniques, this information can be delivered via tailored GIS portals to meet diverse set of user needs and expectations. This integrated approach can be applied to regional and local risk assessments, predictions and decadal projections, and proactive adaptation planning for vulnerable communities. In this paper we will describe this comprehensive decision support approach with selected applications and case studies to illustrate how this

  17. Decision support system for the diagnosis of schizophrenia disorders

    Directory of Open Access Journals (Sweden)

    D. Razzouk

    2006-01-01

    Full Text Available Clinical decision support systems are useful tools for assisting physicians to diagnose complex illnesses. Schizophrenia is a complex, heterogeneous and incapacitating mental disorder that should be detected as early as possible to avoid a most serious outcome. These artificial intelligence systems might be useful in the early detection of schizophrenia disorder. The objective of the present study was to describe the development of such a clinical decision support system for the diagnosis of schizophrenia spectrum disorders (SADDESQ. The development of this system is described in four stages: knowledge acquisition, knowledge organization, the development of a computer-assisted model, and the evaluation of the system's performance. The knowledge was extracted from an expert through open interviews. These interviews aimed to explore the expert's diagnostic decision-making process for the diagnosis of schizophrenia. A graph methodology was employed to identify the elements involved in the reasoning process. Knowledge was first organized and modeled by means of algorithms and then transferred to a computational model created by the covering approach. The performance assessment involved the comparison of the diagnoses of 38 clinical vignettes between an expert and the SADDESQ. The results showed a relatively low rate of misclassification (18-34% and a good performance by SADDESQ in the diagnosis of schizophrenia, with an accuracy of 66-82%. The accuracy was higher when schizophreniform disorder was considered as the presence of schizophrenia disorder. Although these results are preliminary, the SADDESQ has exhibited a satisfactory performance, which needs to be further evaluated within a clinical setting.

  18. Using basic geographic information systems functionality to support sustainable forest management decision making and post-decision assessments

    Science.gov (United States)

    Ronald E. McRoberts; R. James Barbour; Krista M. Gebert; Greg C. Liknes; Mark D. Nelson; Dacia M. Meneguzzo; et al.

    2006-01-01

    Sustainable management of natural resources requires informed decision making and post-decision assessments of the results of those decisions. Increasingly, both activities rely on analyses of spatial data in the forms of maps and digital data layers. Fortunately, a variety of supporting maps and data layers rapidly are becoming available. Unfortunately, however, user-...

  19. Decision-Making Amplification under Uncertainty: An Exploratory Study of Behavioral Similarity and Intelligent Decision Support Systems

    Science.gov (United States)

    Campbell, Merle Wayne

    2013-01-01

    Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…

  20. Support Vector Machines for decision support in electricity markets׳ strategic bidding

    DEFF Research Database (Denmark)

    Pinto, Tiago; Sousa, Tiago M.; Praça, Isabel

    2015-01-01

    . The ALBidS system allows MASCEM market negotiating players to take the best possible advantages from the market context. This paper presents the application of a Support Vector Machines (SVM) based approach to provide decision support to electricity market players. This strategy is tested and validated...... by being included in ALBidS and then compared with the application of an Artificial Neural Network (ANN), originating promising results: an effective electricity market price forecast in a fast execution time. The proposed approach is tested and validated using real electricity markets data from MIBEL......׳ research group has developed a multi-agent system: Multi-Agent System for Competitive Electricity Markets (MASCEM), which simulates the electricity markets environment. MASCEM is integrated with Adaptive Learning Strategic Bidding System (ALBidS) that works as a decision support system for market players...

  1. Supporting management decisions with ex ante accounting information

    NARCIS (Netherlands)

    Wouters, Marc; Verdaasdonk, Peter

    2002-01-01

    This paper is about the relationship between management decisions and accounting information. Management decisions have consequences in different functional areas, departments, and different companies along the value chain. Accounting information regarding decisions aims to translate as many as

  2. A Methodology to Support Decision Making in Flood Plan Mitigation

    Science.gov (United States)

    Biscarini, C.; di Francesco, S.; Manciola, P.

    2009-04-01

    The focus of the present document is on specific decision-making aspects of flood risk analysis. A flood is the result of runoff from rainfall in quantities too great to be confined in the low-water channels of streams. Little can be done to prevent a major flood, but we may be able to minimize damage within the flood plain of the river. This broad definition encompasses many possible mitigation measures. Floodplain management considers the integrated view of all engineering, nonstructural, and administrative measures for managing (minimizing) losses due to flooding on a comprehensive scale. The structural measures are the flood-control facilities designed according to flood characteristics and they include reservoirs, diversions, levees or dikes, and channel modifications. Flood-control measures that modify the damage susceptibility of floodplains are usually referred to as nonstructural measures and may require minor engineering works. On the other hand, those measures designed to modify the damage potential of permanent facilities are called non-structural and allow reducing potential damage during a flood event. Technical information is required to support the tasks of problem definition, plan formulation, and plan evaluation. The specific information needed and the related level of detail are dependent on the nature of the problem, the potential solutions, and the sensitivity of the findings to the basic information. Actions performed to set up and lay out the study are preliminary to the detailed analysis. They include: defining the study scope and detail, the field data collection, a review of previous studies and reports, and the assembly of needed maps and surveys. Risk analysis can be viewed as having many components: risk assessment, risk communication and risk management. Risk assessment comprises an analysis of the technical aspects of the problem, risk communication deals with conveying the information and risk management involves the decision process

  3. The role of depression pharmacogenetic decision support tools in shared decision making.

    Science.gov (United States)

    Arandjelovic, Katarina; Eyre, Harris A; Lenze, Eric; Singh, Ajeet B; Berk, Michael; Bousman, Chad

    2017-10-29

    Patients discontinue antidepressant medications due to lack of knowledge, unrealistic expectations, and/or unacceptable side effects. Shared decision making (SDM) invites patients to play an active role in their treatment and may indirectly improve outcomes through enhanced engagement in care, adherence to treatment, and positive expectancy of medication outcomes. We believe decisional aids, such as pharmacogenetic decision support tools (PDSTs), facilitate SDM in the clinical setting. PDSTs may likewise predict drug tolerance and efficacy, and therefore adherence and effectiveness on an individual-patient level. There are several important ethical considerations to be navigated when integrating PDSTs into clinical practice. The field requires greater empirical research to demonstrate clinical utility, and the mechanisms thereof, as well as exploration of the ethical use of these technologies.

  4. Adoption of web-based group decision support systems: Experiences from the field and future developments

    NARCIS (Netherlands)

    van Hillegersberg, Jos; Koenen, Sebastiaan

    2016-01-01

    While organizations have massively adopted enterprise information systems to support business processes, business meetings in which key decisions are made about products, services and processes, are usually held without much support of information systems. This is remarkable as group decision

  5. Development of a decision analytic model to support decision making and risk communication about thrombolytic treatment.

    Science.gov (United States)

    McMeekin, Peter; Flynn, Darren; Ford, Gary A; Rodgers, Helen; Gray, Jo; Thomson, Richard G

    2015-11-11

    Individualised prediction of outcomes can support clinical and shared decision making. This paper describes the building of such a model to predict outcomes with and without intravenous thrombolysis treatment following ischaemic stroke. A decision analytic model (DAM) was constructed to establish the likely balance of benefits and risks of treating acute ischaemic stroke with thrombolysis. Probability of independence, (modified Rankin score mRS ≤ 2), dependence (mRS 3 to 5) and death at three months post-stroke was based on a calibrated version of the Stroke-Thrombolytic Predictive Instrument using data from routinely treated stroke patients in the Safe Implementation of Treatments in Stroke (SITS-UK) registry. Predictions in untreated patients were validated using data from the Virtual International Stroke Trials Archive (VISTA). The probability of symptomatic intracerebral haemorrhage in treated patients was incorporated using a scoring model from Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) data. The model predicts probabilities of haemorrhage, death, independence and dependence at 3-months, with and without thrombolysis, as a function of 13 patient characteristics. Calibration (and inclusion of additional predictors) of the Stroke-Thrombolytic Predictive Instrument (S-TPI) addressed issues of under and over prediction. Validation with VISTA data confirmed that assumptions about treatment effect were just. The C-statistics for independence and death in treated patients in the DAM were 0.793 and 0.771 respectively, and 0.776 for independence in untreated patients from VISTA. We have produced a DAM that provides an estimation of the likely benefits and risks of thrombolysis for individual patients, which has subsequently been embedded in a computerised decision aid to support better decision-making and informed consent.

  6. Risk and uncertainty in the structure of management decision support

    International Nuclear Information System (INIS)

    Valeca, Serban Constantin

    2002-01-01

    The monograph is structured into five chapters addressing the following subject matters: 1 - The risk descriptor implied by the power systems with nuclear injection; 1.1 - Concepts and operators for describing the nuclear power risk; 1.2 - Risk approach in a holistic conception; 2 - Modelling the risk in the frame of re-engineering concept; 2.1 - Defining and interpreting the power re-engineering; 2.2 - Managerial re-engineering of power production systems; 3 - Informatics system of managing the power objectives with nuclear injection; 3.1 - Informatics systems for risk at the level of CANDU - 600 nuclear plant; 3.2. - Expert function structure applicable to the management of power objectives with nuclear injection; 4 - Assisting support in the operation of nuclear facilities; 4.1 - Assisting support system for nuclear plant operation; 4.2 - Program products for dedicated drivers; 5 - The management decision activities at the level of power systems with nuclear injection; 5.1 - Preliminaries in making power decision; 5.2 - Applications of decision models of sustainable power systems with nuclear injection; 5.3 - Re-engineering of power decision in the frame of maximal utility theory. The successful application of re-engineering concept is based on knowledge and managing capacity of design leadership and its ability of dealing the error generating sources. The main stages of implementing successfully the re-engineering are: - Replacing the pollution processes instead of adjusting measures; - Raising the designer responsibility by radical innovation of processes' architecture; - Re-designing the processes by basic changes at the level of the management functions and structures; - Raising the personnel professionalism by motivation as optimal way of improving the workers mentalities; - Accurate definition of objectives in the frame of re-engineering program; - Application of re-engineering in industrial units starting from the management level; - Selecting as general

  7. Devils Lake Climate, Weather, and Water Decision Support System

    Science.gov (United States)

    Horsfall, F. M.; Kluck, D. R.; Brewer, M.; Timofeyeva, M. M.; Symonds, J.; Dummer, S.; Frazier, M.; Shulski, M.; Akyuz, A.

    2010-12-01

    North Dakota’s Devils Lake area represents an example of a community struggling with a serious climate-related problem. The Devils Lake water level elevation has been rising since 1993 due to a prolonged wet period, and it is now approaching the spill stage into the Cheyenne River and ultimately into the Red River of the North. The impacts of the rising water have already caused significant disruption to the surrounding communities, and even greater impacts will be seen if the lake reaches the spill elevation. These impacts include flooding, water quality issues, impacts to agriculture and ecosystems, and impacts to local and regional economies. National Oceanic and Atmospheric Administration (NOAA), through the National Weather Service (NWS), the National Environmental Satellite, Data, and Information Service (NESDIS), and the Office of Oceanic and Atmospheric Research (OAR), provides the U.S. public with climate, water, and weather services, including meteorological, hydrological and climate data, warnings, and forecasts of weather and climate from near- to longer-term timescales. In support of the people of Devils Lake, the surrounding communities, the people of North Dakota, and the other Federal agencies with responsibilities in the area, NOAA launched the first ever climate-sensitive decision support web site (www.devilslake.noaa.gov) in July 2010. The website is providing integrated weather, water, and climate information for the area, and has links to information from other agencies, such as USGS, to help decision makers as they address this ongoing challenge. This paper will describe the website and other ongoing activities by NOAA in support of this community.

  8. Computerized procedures system

    Science.gov (United States)

    Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.

    2010-10-12

    An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

  9. Tools to support GHG emissions reduction : a regional effort, part 1 - carbon footprint estimation and decision support.

    Science.gov (United States)

    2010-09-01

    Tools are proposed for carbon footprint estimation of transportation construction projects and decision support : for construction firms that must make equipment choice and usage decisions that affect profits, project duration : and greenhouse gas em...

  10. Modelling of the costs of decision support for small and medium-sized enterprises

    Directory of Open Access Journals (Sweden)

    Viera Tomišová

    2017-01-01

    Full Text Available The support of decision-making activities in small and medium-sized enterprises (SME has its specific features. When suggesting steps for the implementation of decision-support tools in the enterprise, we identified two main ways of decision-making support based on the data analysis: ERP (Enterprise Resource Planning without BI (Business Intelligence and ERP with BI. In our contribution, we present costs models of both mentioned decision support systems and their practical interpretation.

  11. SANDS: an architecture for clinical decision support in a National Health Information Network.

    Science.gov (United States)

    Wright, Adam; Sittig, Dean F

    2007-10-11

    A new architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support) is introduced and its performance evaluated. The architecture provides a method for performing clinical decision support across a network, as in a health information exchange. Using the prototype we demonstrated that, first, a number of useful types of decision support can be carried out using our architecture; and, second, that the architecture exhibits desirable reliability and performance characteristics.

  12. Assessment of readiness for clinical decision support to aid laboratory monitoring of immunosuppressive care at U.S. liver transplant centers.

    Science.gov (United States)

    Jacobs, J; Weir, C; Evans, R S; Staes, C

    2014-01-01

    Following liver transplantation, patients require lifelong immunosuppressive care and monitoring. Computerized clinical decision support (CDS) has been shown to improve post-transplant immunosuppressive care processes and outcomes. The readiness of transplant information systems to implement computerized CDS to support post-transplant care is unknown. a) Describe the current clinical information system functionality and manual and automated processes for laboratory monitoring of immunosuppressive care, b) describe the use of guidelines that may be used to produce computable logic and the use of computerized alerts to support guideline adherence, and c) explore barriers to implementation of CDS in U.S. liver transplant centers. We developed a web-based survey using cognitive interviewing techniques. We surveyed 119 U.S. transplant programs that performed at least five liver transplantations per year during 2010-2012. Responses were summarized using descriptive analyses; barriers were identified using qualitative methods. Respondents from 80 programs (67% response rate) completed the survey. While 98% of programs reported having an electronic health record (EHR), all programs used paper-based manual processes to receive or track immunosuppressive laboratory results. Most programs (85%) reported that 30% or more of their patients used external laboratories for routine testing. Few programs (19%) received most external laboratory results as discrete data via electronic interfaces while most (80%) manually entered laboratory results into the EHR; less than half (42%) could integrate internal and external laboratory results. Nearly all programs had guidelines regarding pre-specified target ranges (92%) or testing schedules (97%) for managing immunosuppressive care. Few programs used computerized alerting to notify transplant coordinators of out-of-range (27%) or overdue laboratory results (20%). Use of EHRs is common, yet all liver transplant programs were largely

  13. Evaluating online diagnostic decision support tools for the clinical setting.

    Science.gov (United States)

    Pryor, Marie; White, David; Potter, Bronwyn; Traill, Roger

    2012-01-01

    Clinical decision support tools available at the point of care are an effective adjunct to support clinicians to make clinical decisions and improve patient outcomes. We developed a methodology and applied it to evaluate commercially available online clinical diagnostic decision support (DDS) tools for use at the point of care. We identified 11 commercially available DDS tools and assessed these against an evaluation instrument that included 6 categories; general information, content, quality control, search, clinical results and other features. We developed diagnostically challenging clinical case scenarios based on real patient experience that were commonly missed by junior medical staff. The evaluation was divided into 2 phases; an initial evaluation of all identified and accessible DDS tools conducted by the Clinical Information Access Portal (CIAP) team and a second phase that further assessed the top 3 tools identified in the initial evaluation phase. An evaluation panel consisting of senior and junior medical clinicians from NSW Health conducted the second phase. Of the eleven tools that were assessed against the evaluation instrument only 4 tools completely met the DDS definition that was adopted for this evaluation and were able to produce a differential diagnosis. From the initial phase of the evaluation 4 DDS tools scored 70% or more (maximum score 96%) for the content category, 8 tools scored 65% or more (maximum 100%) for the quality control category, 5 tools scored 65% or more (maximum 94%) for the search category, and 4 tools score 70% or more (maximum 81%) for the clinical results category. The second phase of the evaluation was focused on assessing diagnostic accuracy for the top 3 tools identified in the initial phase. Best Practice ranked highest overall against the 6 clinical case scenarios used. Overall the differentiating factor between the top 3 DDS tools was determined by diagnostic accuracy ranking, ease of use and the confidence and

  14. Supportive families versus support from families: The decision to have a child in the Netherlands

    Directory of Open Access Journals (Sweden)

    Susan Schaffnit

    2017-08-01

    Full Text Available Background: Support from families can reduce costs of reproduction and may therefore be associated with higher fertility for men and women. Family supportiveness, however, varies both between families - some families are more supportive than others - and within families over time - as the needs of recipients and the abilities of support givers change. Distinguishing the effects of time-invariant between-family supportiveness and time-varying within-family supportiveness on fertility can help contribute to an understanding of how family support influences fertility. Objective: We distinguish 'between' and 'within' families for several types of support shared between parents and adult children and test whether between- and within-family variation in support associates with birth timings. Methods: We use seven years of annually collected LISS panel data from the Netherlands on 2,288 reproductive-aged men and women to investigate the timing of first and subsequent births. Results: We find between-family support is more often associated with fertility than is within-family support, particularly for first births and for women. Emotional support is generally associated with earlier first births for both men and women, while results for financial and reciprocal emotional support are mixed. There is some indication that the latter kind of support positively predicts births for men and negatively for women. Conclusions: Our results suggest that feeling supported may be more important than actual support in reproductive decision-making in this high-income setting. Contribution: We apply a method novel to human demography to address both a conceptual and methodological issue in studies of families and fertility.

  15. The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

    Science.gov (United States)

    Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

    2013-06-01

    The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

  16. Merging Air Quality and Public Health Decision Support Systems

    Science.gov (United States)

    Hudspeth, W. B.; Bales, C. L.

    2003-12-01

    The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.

  17. Decision Support Systems in Forest Management: An Integrated ...

    African Journals Online (AJOL)

    Decision making process - especially in natural resources management, encounters myriad of challenges to objective decisions, significant decision depends on amount of information and capability of decision makers to handle massive data. In forest management, these challenges such as lack of enough data and cost ...

  18. Tools to support important technical decisions during accident conditions

    International Nuclear Information System (INIS)

    Tenschert, J.; Bergiers, C.

    2008-01-01

    To handle design basis and beyond design basis accidents with intact reactor core, Nuclear Power Plants are using Emergency Operating Procedures (EOP) that they may have developed based on the generic Westinghouse Emergency Response Guidelines. Even though the EOPs are very directive, some questions are left to external support, i.e. to a team of persons constituting the so-called Technical Support Center (TSC). The Pressurized Water Reactor Owner Group (PWROG, previously Westinghouse Owner Group, WOG) has developed a TSC manual to support this group in their decision making process. Because of the specific and particular design of the Beznau NPP (KKB) Safety Systems, development of a plant-specific TSC manual required a lot of additions compared to the generic material. This plant-specific TSC manual is a helpful tool for the Site Emergency Director (SED) of the KKB to better evaluate issues and potential concerns arising while executing the EOPs. The majority of considered issues are relevant for beyond design basis accidents and external events. (orig.)

  19. Data assimilation in the decision support system RODOS

    International Nuclear Information System (INIS)

    Rojas-Palma, C.; Madsen, H.; Gering, F.; Puch, R.; Turcanu, C.; Astrup, P.; Mueller, H.; Richter, K.; Zheleznyak, M.; Treebushny, D.; Kolomeev, M.; Kamaev, D.; Wynn, H.

    2003-01-01

    Model predictions for a rapid assessment and prognosis of possible radiological consequences after an accidental release of radionuclides play an important role in nuclear emergency management. Radiological observations, e.g. dose rate measurements, can be used to improve such model predictions. The process of combining model predictions and observations, usually referred to as data assimilation, is described in this article within the framework of the real time on-line decision support system (RODOS) for off-site nuclear emergency management in Europe. Data assimilation capabilities, based on Kalman filters,are under development for several modules of the RODOS system, including the atmospheric dispersion, deposition, food chain and hydrological models. The use of such a generic data assimilation methodology enables the propagation of uncertainties throughout the various modules of the system. This would in turn provide decision makers with uncertainty estimates taking into account both model and observation errors. This paper describes the methodology employed as well as results of some preliminary studies based on simulated data. (author)

  20. Mining multi-dimensional data for decision support

    Energy Technology Data Exchange (ETDEWEB)

    Donato, J.M.; Schryver, J.C.; Hinkel, G.C.; Schmoyer, R.L. Jr. [Oak Ridge National Lab., TN (United States); Grady, N.W.; Leuze, M.R. [Oak Ridge National Lab., TN (United States)]|[Joint Inst. for Computational Science, Knoxville, TN (United States)

    1998-06-01

    While it is widely recognized that data can be a valuable resource for any organization, extracting information contained within the data is often a difficult problem. Attempts to obtain information from data may be limited by legacy data storage formats, lack of expert knowledge about the data, difficulty in viewing the data, or the volume of data needing to be processed. The rapidly developing field of Data Mining or Knowledge Data Discovery is a blending of Artificial Intelligence, Statistics, and Human-Computer Interaction. Sophisticated data navigation tools to obtain the information needed for decision support do not yet exist. Each data mining task requires a custom solution that depends upon the character and quantity of the data. This paper presents a two-stage approach for handling the prediction of personal bankruptcy using credit card account data, combining decision tree and artificial neural network technologies. Topics to be discussed include the pre-processing of data, including data cleansing, the filtering of data for pertinent records, and the reduction of data for attributes contributing to the prediction of bankruptcy, and the two steps in the mining process itself.

  1. Ensemble Artifact Design For Context Sensitive Decision Support

    Directory of Open Access Journals (Sweden)

    Shah J Miah

    2014-06-01

    Full Text Available Although an improvement of design knowledge is an essential goal of design research, current design research predominantly focuses on knowledge concerning the IT artifact (tool design process, rather than a more holistic understanding encompassing the dynamic usage contexts of a technological artifact. Conceptualising a design in context as an “ensemble artifact” (Sein et al., 2011 provides the basis for a more rigorous treatment. This paper describes an IS artifact design framework that has been generated from the development of several practitioner-oriented decision support systems (DSS in which contextual aspects relevant to practitioners’ decision making are considered as integral design themes. We describe five key dimensions of an ensemble artifact design and show their value in designing practitioner-oriented DSS. The features are user centredness, knowledge sharing, situation-specific customisation, reduced model orientation, and practice based secondary design abilities. It is argued that this understanding can contribute to design research knowledge more effectively both to develop dynamic DSS, and by its extensibility to other artifact designs.

  2. Decision Support Model for Optimal Management of Coastal Gate

    Science.gov (United States)

    Ditthakit, Pakorn; Chittaladakorn, Suwatana

    2010-05-01

    The coastal areas are intensely settled by human beings owing to their fertility of natural resources. However, at present those areas are facing with water scarcity problems: inadequate water and poor water quality as a result of saltwater intrusion and inappropriate land-use management. To solve these problems, several measures have been exploited. The coastal gate construction is a structural measure widely performed in several countries. This manner requires the plan for suitably operating coastal gates. Coastal gate operation is a complicated task and usually concerns with the management of multiple purposes, which are generally conflicted one another. This paper delineates the methodology and used theories for developing decision support modeling for coastal gate operation scheduling. The developed model was based on coupling simulation and optimization model. The weighting optimization technique based on Differential Evolution (DE) was selected herein for solving multiple objective problems. The hydrodynamic and water quality models were repeatedly invoked during searching the optimal gate operations. In addition, two forecasting models:- Auto Regressive model (AR model) and Harmonic Analysis model (HA model) were applied for forecasting water levels and tide levels, respectively. To demonstrate the applicability of the developed model, it was applied to plan the operations for hypothetical system of Pak Phanang coastal gate system, located in Nakhon Si Thammarat province, southern part of Thailand. It was found that the proposed model could satisfyingly assist decision-makers for operating coastal gates under various environmental, ecological and hydraulic conditions.

  3. Assessing survivability to support power grid investment decisions

    International Nuclear Information System (INIS)

    Koziolek, Anne; Avritzer, Alberto; Suresh, Sindhu; Menasché, Daniel S.; Diniz, Morganna; Souza e Silva, Edmundo de; Leão, Rosa M.; Trivedi, Kishor; Happe, Lucia

    2016-01-01

    The reliability of power grids has been subject of study for the past few decades. Traditionally, detailed models are used to assess how the system behaves after failures. Such models, based on power flow analysis and detailed simulations, yield accurate characterizations of the system under study. However, they fall short on scalability. In this paper, we propose an efficient and scalable approach to assess the survivability of power systems. Our approach takes into account the phased-recovery of the system after a failure occurs. The proposed phased-recovery model yields metrics such as the expected accumulated energy not supplied between failure and full recovery. Leveraging the predictive power of the model, we use it as part of an optimization framework to assist in investment decisions. Given a budget and an initial circuit to be upgraded, we propose heuristics to sample the solution space in a principled way accounting for survivability-related metrics. We have evaluated the feasibility of this approach by applying it to the design of a benchmark distribution automation circuit. Our empirical results indicate that the combination of survivability and power flow analysis can provide meaningful investment decision support for power systems engineers. - Highlights: • We propose metrics and models for scalable survivability analysis of power systems. • The survivability model captures the system phased-recovery, from failure to repair. • The survivability model is used as a building block of an optimization framework. • Heuristics assist in investment options accounting for survivability-related metrics.

  4. Integrated environmental decision support tool based on GIS technology

    International Nuclear Information System (INIS)

    Doctor, P.G.; O'Neil, T.K.; Sackschewsky, M.R.; Becker, J.M.; Rykiel, E.J.; Walters, T.B.; Brandt, C.A.; Hall, J.A.

    1995-01-01

    Environmental restoration and management decisions facing the US Department of Energy require balancing trade-offs between diverse land uses and impacts over multiple spatial and temporal scales. Many types of environmental data have been collected for the Hanford Site and the Columbia River in Washington State over the past fifty years. Pacific Northwest National Laboratory (PNNL) is integrating these data into a Geographic Information System (GIS) based computer decision support tool. This tool provides a comprehensive and concise description of the current environmental landscape that can be used to evaluate the ecological and monetary trade-offs between future land use, restoration and remediation options before action is taken. Ecological impacts evaluated include effects to individual species of concern and habitat loss and fragmentation. Monetary impacts include those associated with habitat mitigation. The tool is organized as both a browsing tool for educational purposes, and as a framework that leads a project manager through the steps needed to be in compliance with environmental requirements

  5. ANALYSIS AND COMPARISON OF EXISTING DECISION SUPPORT TECHNOLOGY

    Directory of Open Access Journals (Sweden)

    V. A. Rybak

    2016-01-01

    Full Text Available The article presents the results of an analytical review and comparison of the most common managerial decision support technologies: the analytic hierarchy method, neural networks, fuzzy set theory, genetic algorithms and neural-fuzzy modeling. The advantages and disadvantages of these approaches are shown. Determine the scope of their application. It is shown that the hierarchy analysis method works well with the full initial information, but due to the need for expert comparison of alternatives and the selection of evaluation criteria has a high proportion of subjectivity. For problems in the conditions of risk and uncertainty prediction seems reasonable use of the theory of fuzzy sets and neural networks. It is also considered technology collective decision applied both in the general election, and the group of experts. It reduces the time for conciliation meetings to reach a consensus by the preliminary analysis of all views submitted for the plane in the form of points. At the same time the consistency of opinion is determined by the distance between them.

  6. Therapy Decision Support Based on Recommender System Methods.

    Science.gov (United States)

    Gräßer, Felix; Beckert, Stefanie; Küster, Denise; Schmitt, Jochen; Abraham, Susanne; Malberg, Hagen; Zaunseder, Sebastian

    2017-01-01

    We present a system for data-driven therapy decision support based on techniques from the field of recommender systems. Two methods for therapy recommendation, namely, Collaborative Recommender and Demographic-based Recommender , are proposed. Both algorithms aim to predict the individual response to different therapy options using diverse patient data and recommend the therapy which is assumed to provide the best outcome for a specific patient and time, that is, consultation. The proposed methods are evaluated using a clinical database incorporating patients suffering from the autoimmune skin disease psoriasis. The Collaborative Recommender proves to generate both better outcome predictions and recommendation quality. However, due to sparsity in the data, this approach cannot provide recommendations for the entire database. In contrast, the Demographic-based Recommender performs worse on average but covers more consultations. Consequently, both methods profit from a combination into an overall recommender system.

  7. Clinical Decision Support Knowledge Management: Strategies for Success.

    Science.gov (United States)

    Khalifa, Mohamed; Alswailem, Osama

    2015-01-01

    Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital.

  8. Assessment of Wearable Technology for Integrated Decision Support

    Science.gov (United States)

    2016-05-01

    absorption of red  light by oxygen‐bound (or unbound)  hemoglobin   in the blood (see figure 9).  The measurement  is achieved by  shining both  red  light...Leadership  &  Education , Personnel, and Facilities (DOTMLPF) assessment. There may, however, be a clear  value  in keeping these decision support tools closer...Soldier mission sets.  The “Signature TrRacking for Optimized  Nutrition  and traininG” (STRONG) Lab at Air Force Research Labs at Wright Patterson Air

  9. NOAA Climate Information and Tools for Decision Support Services

    Science.gov (United States)

    Timofeyeva, M. M.; Higgins, W.; Strager, C.; Horsfall, F. M.

    2013-12-01

    NOAA is an active participant of the Global Framework for Climate Services (GFCS) contributing data, information, analytical capabilities, forecasts, and decision support services to the Climate Services Partnership (CSP). These contributions emerge from NOAA's own climate services, which have evolved to respond to the urgent and growing need for reliable, trusted, transparent, and timely climate information across all sectors of the U.S. economy. Climate services not only enhance development opportunities in many regions, but also reduce vulnerability to climate change around the world. The NOAA contribution lies within the NOAA Climate Goal mission, which is focusing its efforts on four key climate priority areas: water, extremes, coastal inundation, and marine ecosystems. In order to make progress in these areas, NOAA is exploiting its fundamental capabilities, including foundational research to advance understanding of the Earth system, observations to preserve and build the climate data record and monitor changes in climate conditions, climate models to predict and project future climate across space and time scales, and the development and delivery of decision support services focused on risk management. NOAA's National Weather Services (NWS) is moving toward provision of Decision Support Services (DSS) as a part of the Roadmap on the way to achieving a Weather Ready National (WRN) strategy. Both short-term and long-term weather, water, and climate information are critical for DSS and emergency services and have been integrated into NWS in the form of pilot projects run by National and Regional Operations Centers (NOC and ROCs respectively) as well as several local offices. Local offices with pilot projects have been focusing their efforts on provision of timely and actionable guidance for specific tasks such as DSS in support of Coastal Environments and Integrated Environmental Studies. Climate information in DSS extends the concept of climate services to

  10. Therapy Decision Support Based on Recommender System Methods

    Directory of Open Access Journals (Sweden)

    Felix Gräßer

    2017-01-01

    Full Text Available We present a system for data-driven therapy decision support based on techniques from the field of recommender systems. Two methods for therapy recommendation, namely, Collaborative Recommender and Demographic-based Recommender, are proposed. Both algorithms aim to predict the individual response to different therapy options using diverse patient data and recommend the therapy which is assumed to provide the best outcome for a specific patient and time, that is, consultation. The proposed methods are evaluated using a clinical database incorporating patients suffering from the autoimmune skin disease psoriasis. The Collaborative Recommender proves to generate both better outcome predictions and recommendation quality. However, due to sparsity in the data, this approach cannot provide recommendations for the entire database. In contrast, the Demographic-based Recommender performs worse on average but covers more consultations. Consequently, both methods profit from a combination into an overall recommender system.

  11. New decision support tool for acute lymphoblastic leukemia classification

    Science.gov (United States)

    Madhukar, Monica; Agaian, Sos; Chronopoulos, Anthony T.

    2012-03-01

    In this paper, we build up a new decision support tool to improve treatment intensity choice in childhood ALL. The developed system includes different methods to accurately measure furthermore cell properties in microscope blood film images. The blood images are exposed to series of pre-processing steps which include color correlation, and contrast enhancement. By performing K-means clustering on the resultant images, the nuclei of the cells under consideration are obtained. Shape features and texture features are then extracted for classification. The system is further tested on the classification of spectra measured from the cell nuclei in blood samples in order to distinguish normal cells from those affected by Acute Lymphoblastic Leukemia. The results show that the proposed system robustly segments and classifies acute lymphoblastic leukemia based on complete microscopic blood images.

  12. PATHway: Decision Support in Exercise Programmes for Cardiac Rehabilitation.

    Science.gov (United States)

    Filos, Dimitris; Triantafyllidis, Andreas; Chouvarda, Ioanna; Buys, Roselien; Cornelissen, Véronique; Budts, Werner; Walsh, Deirdre; Woods, Catherine; Moran, Kieran; Maglaveras, Nicos

    2016-01-01

    Rehabilitation is important for patients with cardiovascular diseases (CVD) to improve health outcomes and quality of life. However, adherence to current exercise programmes in cardiac rehabilitation is limited. We present the design and development of a Decision Support System (DSS) for telerehabilitation, aiming to enhance exercise programmes for CVD patients through ensuring their safety, personalising the programme according to their needs and performance, and motivating them toward meeting their physical activity goals. The DSS processes data originated from a Microsoft Kinect camera, a blood pressure monitor, a heart rate sensor and questionnaires, in order to generate a highly individualised exercise programme and improve patient adherence. Initial results within the EU-funded PATHway project show the potential of our approach.

  13. A decision support system for the reading of ancient documents

    DEFF Research Database (Denmark)

    Roued-Cunliffe, Henriette

    2011-01-01

    The research presented in this thesis is based in the Humanities discipline of Ancient History and begins by attempting to understand the interpretation process involved in reading ancient documents and how this process can be aided by computer systems such as Decision Support Systems (DSS...... this process in the five areas: remembering complex reasoning, searching huge datasets, international collaboration, publishing editions, and image enhancement. This research contains a large practical element involving the development of a DSS prototype. The prototype is used to illustrate how a DSS......, by remembering complex reasoning, can aid the process of interpretation that is reading ancient documents. It is based on the idea that the interpretation process goes through a network of interpretation. The network of interpretation illustrates a recursive process where scholars move between reading levels...

  14. Decision Support System for Blockage Management in Fire Service

    Directory of Open Access Journals (Sweden)

    Krasuski Adam

    2014-08-01

    Full Text Available In this article we present the foundations of a decision support system for blockage management in Fire Service. Blockage refers to the situation when all fire units are out and a new incident occurs. The approach is based on two phases: off-line data preparation and online blockage estimation. The off-line phase consists of methods from data mining and natural language processing and results in semantically coherent information granules. The online phase is about building the probabilistic models that estimate the block-age probability based on these granules. Finally, the selected classifier judges whether a blockage can occur and whether the resources from neighbour fire stations should be asked for assistance.

  15. Intelligent decision support systems for sustainable computing paradigms and applications

    CERN Document Server

    Abraham, Ajith; Siarry, Patrick; Sheng, Michael

    2017-01-01

    This unique book dicusses the latest research, innovative ideas, challenges and computational intelligence (CI) solutions in sustainable computing. It presents novel, in-depth fundamental research on achieving a sustainable lifestyle for society, either from a methodological or from an application perspective. Sustainable computing has expanded to become a significant research area covering the fields of computer science and engineering, electrical engineering and other engineering disciplines, and there has been an increase in the amount of literature on aspects sustainable computing such as energy efficiency and natural resources conservation that emphasizes the role of ICT (information and communications technology) in achieving system design and operation objectives. The energy impact/design of more efficient IT infrastructures is a key challenge in realizing new computing paradigms. The book explores the uses of computational intelligence (CI) techniques for intelligent decision support that can be explo...

  16. A Clinical Decision Support System for Breast Cancer Patients

    Science.gov (United States)

    Fernandes, Ana S.; Alves, Pedro; Jarman, Ian H.; Etchells, Terence A.; Fonseca, José M.; Lisboa, Paulo J. G.

    This paper proposes a Web clinical decision support system for clinical oncologists and for breast cancer patients making prognostic assessments, using the particular characteristics of the individual patient. This system comprises three different prognostic modelling methodologies: the clinically widely used Nottingham prognostic index (NPI); the Cox regression modelling and a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). All three models yield a different prognostic index that can be analysed together in order to obtain a more accurate prognostic assessment of the patient. Missing data is incorporated in the mentioned models, a common issue in medical data that was overcome using multiple imputation techniques. Risk group assignments are also provided through a methodology based on regression trees, where Boolean rules can be obtained expressed with patient characteristics.

  17. Decision support system for outage management and automated crew dispatch

    Science.gov (United States)

    Kang, Ning; Mousavi, Mirrasoul

    2018-01-23

    A decision support system is provided for utility operations to assist with crew dispatch and restoration activities following the occurrence of a disturbance in a multiphase power distribution network, by providing a real-time visualization of possible location(s). The system covers faults that occur on fuse-protected laterals. The system uses real-time data from intelligent electronics devices coupled with other data sources such as static feeder maps to provide a complete picture of the disturbance event, guiding the utility crew to the most probable location(s). This information is provided in real-time, reducing restoration time and avoiding more costly and laborious fault location finding practices.

  18. Fundamental research of decision support systems: Final report

    International Nuclear Information System (INIS)

    Kurstedt, H.A. Jr.

    1986-01-01

    Through an iterative application of Decision Support Systems (DSS) apparatus and evolution of DSS concepts, we redefined DSS from a systems perspective. By focusing on successful DSS and the definition of success for the newly-defined DSS, we generated a paradigm for understanding, applying, and improving DSS. The significance of the research is that we now: (1) understand the various roles management tools play within the new DSS concept; (2) recognize the need for characterizing the domain of responsibility of a manager to obtain a successful DSS; and (3) have learned special characteristics of government agencies like Nuclear Materials (NM) to identify what features of the new DSS concept can be expected to improve performance

  19. Facilitating knowledge transfer: decision support tools in environment and health.

    Science.gov (United States)

    Liu, Hai-Ying; Bartonova, Alena; Neofytou, Panagiotis; Yang, Aileen; Kobernus, Michael J; Negrenti, Emanuele; Housiadas, Christos

    2012-06-28

    The HENVINET Health and Environment Network aimed to enhance the use of scientific knowledge in environmental health for policy making. One of the goals was to identify and evaluate Decision Support Tools (DST) in current use. Special attention was paid to four "priority" health issues: asthma and allergies, cancer, neurodevelopment disorders, and endocrine disruptors.We identified a variety of tools that are used for decision making at various levels and by various stakeholders. We developed a common framework for information acquisition about DSTs, translated this to a database structure and collected the information in an online Metadata Base (MDB).The primary product is an open access web-based MDB currently filled with 67 DSTs, accessible through the HENVINET networking portal http://www.henvinet.eu and http://henvinet.nilu.no. Quality assurance and control of the entries and evaluation of requirements to use the DSTs were also a focus of the work. The HENVINET DST MDB is an open product that enables the public to get basic information about the DSTs, and to search the DSTs using pre-designed attributes or free text. Registered users are able to 1) review and comment on existing DSTs; 2) evaluate each DST's functionalities, and 3) add new DSTs, or change the entry for their own DSTs. Assessment of the available 67 DSTs showed: 1) more than 25% of the DSTs address only one pollution source; 2) 25% of the DSTs address only one environmental stressor; 3) almost 50% of the DSTs are only applied to one disease; 4) 41% of the DSTs can only be applied to one decision making area; 5) 60% of the DSTs' results are used only by national authority and/or municipality/urban level administration; 6) almost half of the DSTs are used only by environmental professionals and researchers. This indicates that there is a need to develop DSTs covering an increasing number of pollution sources, environmental stressors and health end points, and considering links to other 'Driving

  20. Observations to support adaptation: Principles, scales and decision-making

    Science.gov (United States)

    Pulwarty, R. S.

    2012-12-01

    As has been long noted, a comprehensive, coordinated observing system is the backbone of any Earth information system. Demands are increasingly placed on earth observation and prediction systems and attendant services to address the needs of economically and environmentally vulnerable sectors and investments, including energy, water, human health, transportation, agriculture, fisheries, tourism, biodiversity, and national security. Climate services include building capacity to interpret information and recognize standards and limitations of data in the promotion of social and economic development in a changing climate. This includes improving the understanding of climate in the context of a variety of temporal and spatial scales (including the influence of decadal scale forcings and land surface feedbacks on seasonal forecast reliability). Climate data and information are central for developing decision options that are sensitive to climate-related uncertainties and the design of flexible adaptation pathways. Ideally monitoring should be action oriented to support climate risk assessment and adaptation including informing robust decision making to multiple risks over the long term. Based on the experience of global observations programs and empirical research we outline- Challenges in developing effective monitoring and climate information systems to support adaptation. The types of observations of critical importance needed for sector planning to enhance food, water and energy security, and to improve early warning for disaster risk reduction Observations needed for ecosystem-based adaptation including the identification of thresholds, maintenance of biological diversity and land degradation The benefits and limits of linking regional model output to local observations including analogs and verification for adaptation planning To support these goals a robust systems of integrated observations are needed to characterize the uncertainty surrounding emergent risks

  1. Improving life cycle assessment methodology for the application of decision support

    DEFF Research Database (Denmark)

    Herrmann, Ivan Tengbjerg

    for the application of decision support and evaluation of uncertainty in LCA. From a decision maker’s (DM’s) point of view there are at least three main “illness” factors influencing the quality of the information that the DM uses for making decisions. The factors are not independent of each other, but it seems......) refrain from making a decision based on an LCA and thus support a decision on other parameters than the LCA environmental parameters. Conversely, it may in some decision support contexts be acceptable to base a decision on highly uncertain information. This all depends on the specific decision support...... the different steps. A deterioration of the quality in each step is likely to accumulate through the statistical value chain in terms of increased uncertainty and bias. Ultimately this can make final decision support problematic. The "Law of large numbers" (LLN) is the methodological tool/probability theory...

  2. Improvements in agricultural water decision support using remote sensing

    Science.gov (United States)

    Marshall, M. T.

    2012-12-01

    Population driven water scarcity, aggravated by climate-driven evaporative demand in dry regions of the world, has the potential of transforming ecological and social systems to the point of armed conflict. Water shortages will be most severe in agricultural areas, as the priority shifts to urban and industrial use. In order to design, evaluate, and monitor appropriate mitigation strategies, predictive models must be developed that quantify exposure to water shortage. Remote sensing data has been used for more than three decades now to parametrize these models, because field measurements are costly and difficult in remote regions of the world. In the past decade, decision-makers for the first time can make accurate and near real-time evaluations of field conditions with the advent of hyper- spatial and spectral and coarse resolution continuous remote sensing data. Here, we summarize two projects representing diverse applications of remote sensing to improve agricultural water decision support. The first project employs MODIS (coarse resolution continuous data) to drive an evapotranspiration index, which is combined with the Standardized Precipitation Index driven by meteorological satellite data to improve famine early warning in Africa. The combined index is evaluated using district-level crop yield data from Kenya and Malawi and national-level crop yield data from the United Nations Food and Agriculture Organization. The second project utilizes hyper- spatial (GeoEye 1, Quickbird, IKONOS, and RapidEye) and spectral (Hyperion/ALI), as well as multi-spectral (Landsat ETM+, SPOT, and MODIS) data to develop biomass estimates for key crops (alfalfa, corn, cotton, and rice) in the Central Valley of California. Crop biomass is an important indicator of crop water productivity. The remote sensing data is combined using various data fusion techniques and evaluated with field data collected in the summer of 2012. We conclude with a brief discussion on implementation of

  3. WEB-GIS Decision Support System for CO2 storage

    Science.gov (United States)

    Gaitanaru, Dragos; Leonard, Anghel; Radu Gogu, Constantin; Le Guen, Yvi; Scradeanu, Daniel; Pagnejer, Mihaela

    2013-04-01

    Environmental decision support systems (DSS) paradigm evolves and changes as more knowledge and technology become available to the environmental community. Geographic Information Systems (GIS) can be used to extract, assess and disseminate some types of information, which are otherwise difficult to access by traditional methods. In the same time, with the help of the Internet and accompanying tools, creating and publishing online interactive maps has become easier and rich with options. The Decision Support System (MDSS) developed for the MUSTANG (A MUltiple Space and Time scale Approach for the quaNtification of deep saline formations for CO2 storaGe) project is a user friendly web based application that uses the GIS capabilities. MDSS can be exploited by the experts for CO2 injection and storage in deep saline aquifers. The main objective of the MDSS is to help the experts to take decisions based large structured types of data and information. In order to achieve this objective the MDSS has a geospatial objected-orientated database structure for a wide variety of data and information. The entire application is based on several principles leading to a series of capabilities and specific characteristics: (i) Open-Source - the entire platform (MDSS) is based on open-source technologies - (1) database engine, (2) application server, (3) geospatial server, (4) user interfaces, (5) add-ons, etc. (ii) Multiple database connections - MDSS is capable to connect to different databases that are located on different server machines. (iii)Desktop user experience - MDSS architecture and design follows the structure of a desktop software. (iv)Communication - the server side and the desktop are bound together by series functions that allows the user to upload, use, modify and download data within the application. The architecture of the system involves one database and a modular application composed by: (1) a visualization module, (2) an analysis module, (3) a guidelines module

  4. Using Google Earth in Marine Research and Operational Decision Support

    Science.gov (United States)

    Blower, J. D.; Bretherton, D.; Haines, K.; Liu, C.; Rawlings, C.; Santokhee, A.; Smith, I.

    2006-12-01

    A key advantage of Virtual Globes ("geobrowsers") such as Google Earth is that they can display many different geospatial data types at a huge range of spatial scales. In this demonstration and poster display we shall show how marine data from disparate sources can be brought together in a geobrowser in order to support both scientific research and operational search and rescue activities. We have developed the Godiva2 interactive website for browsing and exploring marine data, mainly output from supercomputer analyses and predictions of ocean circulation. The user chooses a number of parameters (e.g. sea temperature at 100m depth on 1st July 2006) and can load an image of the resulting data in Google Earth. Through the use of an automatically-refreshing NetworkLink the user can explore the whole globe at a very large range of spatial scales: the displayed data will automatically be refreshed to show data at increasingly fine resolution as the user zooms in. This is a valuable research tool for exploring these terabyte- scale datasets. Many coastguard organizations around the world use SARIS, a software application produced by BMT Cordah Ltd., to predict the drift pattern of objects in the sea in order to support search and rescue operations. Different drifting objects have different trajectories depending on factors such as their buoyancy and windage and so a computer model, supported by meteorological and oceanographic data, is needed to help rescuers locate their targets. We shall demonstrate how Google Earth is used to display output from the SARIS model (including the search target location and associated error polygon) alongside meteorological data (wind vectors) and oceanographic data (sea temperature, surface currents) from Godiva2 in order to support decision-making. We shall also discuss the limitations of using Google Earth in this context: these include the difficulties of working with time- dependent data and the need to access data securely. essc

  5. Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts

    NARCIS (Netherlands)

    Zaal, R.J.; Jansen, M.; Duisenberg-van Essenberg, M.; C.C., Tijssen; Roukema, J.A.; van den Bemt, P.M.

    2013-01-01

    Background Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective study.

  6. Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts

    NARCIS (Netherlands)

    R.J. Zaal (Rianne); M.M.P.M. Jansen (Mark M. P.); M. Duisenberg-Van Essenberg (Marjolijn); C.C. Tijssen (Cees); J.A. Roukema; P.M.L.A. van den Bemt (Patricia)

    2013-01-01

    textabstractBackground Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective

  7. Object-oriented design and programming in medical decision support.

    Science.gov (United States)

    Heathfield, H; Armstrong, J; Kirkham, N

    1991-12-01

    The concept of object-oriented design and programming has recently received a great deal of attention from the software engineering community. This paper highlights the realisable benefits of using the object-oriented approach in the design and development of clinical decision support systems. These systems seek to build a computational model of some problem domain and therefore tend to be exploratory in nature. Conventional procedural design techniques do not support either the process of model building or rapid prototyping. The central concepts of the object-oriented paradigm are introduced, namely encapsulation, inheritance and polymorphism, and their use illustrated in a case study, taken from the domain of breast histopathology. In particular, the dual roles of inheritance in object-oriented programming are examined, i.e., inheritance as a conceptual modelling tool and inheritance as a code reuse mechanism. It is argued that the use of the former is not entirely intuitive and may be difficult to incorporate into the design process. However, inheritance as a means of optimising code reuse offers substantial technical benefits.

  8. Eliminating Health Care Disparities With Mandatory Clinical Decision Support: The Venous Thromboembolism (VTE) Example.

    Science.gov (United States)

    Lau, Brandyn D; Haider, Adil H; Streiff, Michael B; Lehmann, Christoph U; Kraus, Peggy S; Hobson, Deborah B; Kraenzlin, Franca S; Zeidan, Amer M; Pronovost, Peter J; Haut, Elliott R

    2015-01-01

    All hospitalized patients should be assessed for venous thromboembolism (VTE) risk factors and prescribed appropriate prophylaxis. To improve best-practice VTE prophylaxis prescription for all hospitalized patients, we implemented a mandatory computerized clinical decision support (CCDS) tool. The tool requires completion of checklists to evaluate VTE risk factors and contraindications to pharmacological prophylaxis, and then recommends the risk-appropriate VTE prophylaxis regimen. The objective of the study was to examine the effect of a quality improvement intervention on race-based and sex-based health care disparities across 2 distinct clinical services. This was a retrospective cohort study of a quality improvement intervention. The study included 1942 hospitalized medical patients and 1599 hospitalized adult trauma patients. In this study, the proportion of patients prescribed risk-appropriate, best-practice VTE prophylaxis was evaluated. Racial disparities existed in prescription of best-practice VTE prophylaxis in the preimplementation period between black and white patients on both the trauma (70.1% vs. 56.6%, P=0.025) and medicine (69.5% vs. 61.7%, P=0.015) services. After implementation of the CCDS tool, compliance improved for all patients, and disparities in best-practice prophylaxis prescription between black and white patients were eliminated on both services: trauma (84.5% vs. 85.5%, P=0.99) and medicine (91.8% vs. 88.0%, P=0.082). Similar findings were noted for sex disparities in the trauma cohort. Despite the fact that risk-appropriate prophylaxis should be prescribed equally to all hospitalized patients regardless of race and sex, practice varied widely before our quality improvement intervention. Our CCDS tool eliminated racial disparities in VTE prophylaxis prescription across 2 distinct clinical services. Health information technology approaches to care standardization are effective to eliminate health care disparities.

  9. Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

    Science.gov (United States)

    Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

    2009-04-01

    Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

  10. Documentation of a decision framework to support enhanced sludge washing

    International Nuclear Information System (INIS)

    Brothers, A.J.

    1995-01-01

    This document describes a proposed decision model that, if developed to its fullest, can provide a wide range of analysis options and insights to pretreatment/sludge washing alternatives. A recent decision has been made to terminate this work

  11. Decision Support Tool for Prioritization of Surveillance and Maintenance Investment

    International Nuclear Information System (INIS)

    Velez, L.Y.; Conley, T.B.

    2009-01-01

    The Department of Energy (DOE) currently faces a difficult task in the disposition of the numerous excess or to-be excessed facilities owned by the Department. Many of these facilities are in various physical conditions and contain potentially hazardous nuclear, chemical, radiological or industrial materials left behind as a byproduct of nuclear weapons production, nuclear powered naval vessels and commercial nuclear energy production. During the last period of a facility's life cycle, it is important that surveillance and maintenance (S and M) be adequate to maintain the facility within an appropriate safety envelope. Inadequate investment in maintenance can cause facilities to deteriorate to the point they are unsafe for human entry. Too often this can mean tremendous increases to cost during deactivation and decommissioning (D and D). However, experiences often show that once buildings have been declared excess and enter the transition phase (as defined in DOE G 430.1-5 Transition Implementation Guide), maintenance budgets are drastically reduced. This is justified by the desire to not spend money 'on a building that is being torn down'. The objective of this study was to provide the U.S. Department of Energy (DOE) Environmental Management (EM) federal project directors and their contractors with a decision support tool to aid in prioritizing S and M investment across a site's excess facilities so that the limited budget available can be used most effectively. The analytical hierarchy process (AHP), a multi-criteria decision making method developed by Dr. Thomas Saaty in the 1970's, was used to derive the weight of importance of a defined list of risk-based criteria and typical S and M activities. A total of 10 facilities at the Oak Ridge National Laboratory (ORNL) varying in perceived hazards and conditions were chosen to test the tool by evaluating them with respect to each risk criterion and combining these results with the weight of importance of the S and M

  12. Envisioning a Future Decision Support System for Requirements Engineering : A Holistic and Human-centred Perspective

    OpenAIRE

    Alenljung, Beatrice

    2008-01-01

    Complex decision-making is a prominent aspect of requirements engineering (RE) and the need for improved decision support for RE decision-makers has been identified by a number of authors in the research literature. The fundamental viewpoint that permeates this thesis is that RE decision-making can be substantially improved by RE decision support systems (REDSS) based on the actual needs of RE decision-makers as well as the actual generic human decision-making activities that take place in th...

  13. Guideline Formalization and Knowledge Representation for Clinical Decision Support

    Directory of Open Access Journals (Sweden)

    Tiago OLIVEIRA

    2012-09-01

    Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} The prevalence of situations of medical error and defensive medicine in healthcare institutions is a great concern of the medical community. Clinical Practice Guidelines are regarded by most researchers as a way to mitigate theseoccurrences; however, there is a need to make them interactive, easier to update and to deploy. This paper provides a model for Computer-Interpretable Guidelines based on the generic tasks of the clinical process, devised to be included in the framework of a Clinical Decision Support System. Aiming to represent medical recommendations in a simple and intuitive way. Hence, this work proposes a knowledge representation formalism that uses an Extension to Logic Programming to handle incomplete information. This model is used to represent different cases of missing, conflicting and inexact information with the aid of a method to quantify its quality. The integration of the guideline model with the knowledge representation formalism yields a clinical decision model that relies on the development of multiple information scenarios and the exploration of different clinical hypotheses.

  14. Guideline Formalization and Knowledge Representation for Clinical Decision Support

    Directory of Open Access Journals (Sweden)

    Paulo NOVAIS

    2013-07-01

    Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} The prevalence of situations of medical error and defensive medicine in healthcare institutions is a great concern of the medical community. Clinical Practice Guidelines are regarded by most researchers as a way to mitigate these occurrences; however, there is a need to make them interactive, easier to update and to deploy. This paper provides a model for Computer-Interpretable Guidelines based on the generic tasks of the clinical process, devised to be included in the framework of a Clinical Decision Support System. Aiming to represent medical recommendations in a simple and intuitive way. Hence, this work proposes a knowledge representation formalism that uses an Extension to Logic Programming to handle incomplete information. This model is used to represent different cases of missing, conflicting and inexact information with the aid of a method to quantify its quality. The integration of the guideline model with the knowledge representation formalism yields a clinical decision model that relies on the development of multiple information scenarios and the exploration of different clinical hypotheses.

  15. Decision support system for breast cancer detection using mammograms.

    Science.gov (United States)

    Ganesan, Karthikeyan; Acharya, Rajendra U; Chua, Chua K; Min, Lim C; Mathew, Betty; Thomas, Abraham K

    2013-07-01

    Mammograms are by far one of the most preferred methods of screening for breast cancer. Early detection of breast cancer can improve survival rates to a greater extent. Although the analysis and diagnosis of breast cancer are done by experienced radiologists, there is always the possibility of human error. Interobserver and intraobserver errors occur frequently in the analysis of medical images, given the high variability between every patient. Also, the sensitivity of mammographic screening varies with image quality and expertise of the radiologist. So, there is no golden standard for the screening process. To offset this variability and to standardize the diagnostic procedures, efforts are being made to develop automated techniques for diagnosis and grading of breast cancer images. This article presents a classification pipeline to improve the accuracy of differentiation between normal, benign, and malignant mammograms. Several features based on higher-order spectra, local binary pattern, Laws' texture energy, and discrete wavelet transform were extracted from mammograms. Feature selection techniques based on sequential forward, backward, plus-l-takeaway-r, individual, and branch-and-bound selections using the Mahalanobis distance criterion were used to rank the features and find classification accuracies for combination of several features based on the ranking. Six classifiers were used, namely, decision tree classifier, fisher classifier, linear discriminant classifier, nearest mean classifier, Parzen classifier, and support vector machine classifier. We evaluated our proposed methodology with 300 mammograms obtained from the Digital Database for Screening Mammography and 300 mammograms from the Singapore Anti-Tuberculosis Association CommHealth database. Sensitivity, specificity, and accuracy values were used to compare the performances of the classifiers. Our results show that the decision tree classifier demonstrated an excellent performance compared to

  16. Integrated models to support multiobjective ecological restoration decisions.

    Science.gov (United States)

    Fraser, Hannah; Rumpff, Libby; Yen, Jian D L; Robinson, Doug; Wintle, Brendan A

    2017-12-01

    Many objectives motivate ecological restoration, including improving vegetation condition, increasing the range and abundance of threatened species, and improving species richness and diversity. Although models have been used to examine the outcomes of ecological restoration, few researchers have attempted to develop models to account for multiple, potentially competing objectives. We developed a combined state-and-transition, species-distribution model to predict the effects of restoration actions on vegetation condition and extent, bird diversity, and the distribution of several bird species in southeastern Australian woodlands. The actions reflected several management objectives. We then validated the models against an independent data set and investigated how the best management decision might change when objectives were valued differently. We also used model results to identify effective restoration options for vegetation and bird species under a constrained budget. In the examples we evaluated, no one action (improving vegetation condition and extent, increasing bird diversity, or increasing the probability of occurrence for threatened species) provided the best outcome across all objectives. In agricultural lands, the optimal management actions for promoting the occurrence of the Brown Treecreeper (Climacteris picumnus), an iconic threatened species, resulted in little improvement in the extent of the vegetation and a high probability of decreased vegetation condition. This result highlights that the best management action in any situation depends on how much the different objectives are valued. In our example scenario, no management or weed control were most likely to be the best management options to satisfy multiple restoration objectives. Our approach to exploring trade-offs in management outcomes through integrated modeling and structured decision-support approaches has wide application for situations in which trade-offs exist between competing

  17. Flight Deck Weather Avoidance Decision Support: Implementation and Evaluation

    Science.gov (United States)

    Wu, Shu-Chieh; Luna, Rocio; Johnson, Walter W.

    2013-01-01

    Weather related disruptions account for seventy percent of the delays in the National Airspace System (NAS). A key component in the weather plan of the Next Generation of Air Transportation System (NextGen) is to assimilate observed weather information and probabilistic forecasts into the decision process of flight crews and air traffic controllers. In this research we explore supporting flight crew weather decision making through the development of a flight deck predicted weather display system that utilizes weather predictions generated by ground-based radar. This system integrates and presents this weather information, together with in-flight trajectory modification tools, within a cockpit display of traffic information (CDTI) prototype. that the CDTI features 2D and perspective 3D visualization models of weather. The weather forecast products that we implemented were the Corridor Integrated Weather System (CIWS) and the Convective Weather Avoidance Model (CWAM), both developed by MIT Lincoln Lab. We evaluated the use of CIWS and CWAM for flight deck weather avoidance in two part-task experiments. Experiment 1 compared pilots' en route weather avoidance performance in four weather information conditions that differed in the type and amount of predicted forecast (CIWS current weather only, CIWS current and historical weather, CIWS current and forecast weather, CIWS current and forecast weather and CWAM predictions). Experiment 2 compared the use of perspective 3D and 21/2D presentations of weather for flight deck weather avoidance. Results showed that pilots could take advantage of longer range predicted weather forecasts in performing en route weather avoidance but more research will be needed to determine what combinations of information are optimal and how best to present them.

  18. A Gaussian model of expert opinions for supporting design decisions

    NARCIS (Netherlands)

    Rajabali Nejad, Mohammadreza; Spitas, C.; Dorian, Marjanovic; Mario, Storga; Neven, Pavkovic; Nenad, Bojcetic

    2012-01-01

    The focus of this paper is on development of a novel method for decision making process. Decisions play a major role at all stages of the design process. Here we propose to use a new decision making tool for the design process. This method helps designers

  19. Information Systems to Support a Decision Process at Stanford.

    Science.gov (United States)

    Chaffee, Ellen Earle

    1982-01-01

    When a rational decision process is desired, information specialists can contribute information and also contribute to the process in which that information is used, thereby promoting rational decision-making. The contribution of Stanford's information specialists to rational decision-making is described. (MLW)

  20. How Decision Support Systems Can Benefit from a Theory of Change Approach

    Science.gov (United States)

    Allen, Will; Cruz, Jennyffer; Warburton, Bruce

    2017-06-01

    Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

  1. How Decision Support Systems Can Benefit from a Theory of Change Approach.

    Science.gov (United States)

    Allen, Will; Cruz, Jennyffer; Warburton, Bruce

    2017-06-01

    Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

  2. Distributed Hydrologic Modeling Apps for Decision Support in the Cloud

    Science.gov (United States)

    Swain, N. R.; Latu, K.; Christiensen, S.; Jones, N.; Nelson, J.

    2013-12-01

    Advances in computation resources and greater availability of water resources data represent an untapped resource for addressing hydrologic uncertainties in water resources decision-making. The current practice of water authorities relies on empirical, lumped hydrologic models to estimate watershed response. These models are not capable of taking advantage of many of the spatial datasets that are now available. Physically-based, distributed hydrologic models are capable of using these data resources and providing better predictions through stochastic analysis. However, there exists a digital divide that discourages many science-minded decision makers from using distributed models. This divide can be spanned using a combination of existing web technologies. The purpose of this presentation is to present a cloud-based environment that will offer hydrologic modeling tools or 'apps' for decision support and the web technologies that have been selected to aid in its implementation. Compared to the more commonly used lumped-parameter models, distributed models, while being more intuitive, are still data intensive, computationally expensive, and difficult to modify for scenario exploration. However, web technologies such as web GIS, web services, and cloud computing have made the data more accessible, provided an inexpensive means of high-performance computing, and created an environment for developing user-friendly apps for distributed modeling. Since many water authorities are primarily interested in the scenario exploration exercises with hydrologic models, we are creating a toolkit that facilitates the development of a series of apps for manipulating existing distributed models. There are a number of hurdles that cloud-based hydrologic modeling developers face. One of these is how to work with the geospatial data inherent with this class of models in a web environment. Supporting geospatial data in a website is beyond the capabilities of standard web frameworks and it

  3. Research of Simple Multi-Attribute Rating Technique for Decision Support

    Science.gov (United States)

    Siregar, Dodi; Arisandi, Diki; Usman, Ari; Irwan, Dedy; Rahim, Robbi

    2017-12-01

    One of the roles of decision support system is that it can assist the decision maker in obtaining the appropriate alternative with the desired criteria, one of the methods that could apply for the decision maker is SMART method with multicriteria decision making. This multi-criteria decision-making theory has meaning where every alternative has criteria and has value and weight, and the author uses this approach to facilitate decision making with a compelling case. The problems discussed in this paper are classified into problems of a variety Multiobjective (multiple goals to be accomplished) and multicriteria (many of the decisive criteria in reaching such decisions).

  4. Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform.

    Science.gov (United States)

    Hoffman, Aubri S; Llewellyn-Thomas, Hilary A; Tosteson, Anna N A; O'Connor, Annette M; Volk, Robert J; Tomek, Ivan M; Andrews, Steven B; Bartels, Stephen J

    2014-12-12

    Over 100 trials show that patient decision aids effectively improve patients' information comprehension and values-based decision making. However, gaps remain in our understanding of several fundamental and applied questions, particularly related to the design of interactive, personalized decision aids. This paper describes an interdisciplinary development process for, and early field testing of, a web-based patient decision support research platform, or virtual decision lab, to address these questions. An interdisciplinary stakeholder panel designed the web-based research platform with three components: a) an introduction to shared decision making, b) a web-based patient decision aid, and c) interactive data collection items. Iterative focus groups provided feedback on paper drafts and online prototypes. A field test assessed a) feasibility for using the research platform, in terms of recruitment, usage, and acceptability; and b) feasibility of using the web-based decision aid component, compared to performance of a videobooklet decision aid in clinical care. This interdisciplinary, theory-based, patient-centered design approach produced a prototype for field-testing in six months. Participants (n = 126) reported that: the decision aid component was easy to use (98%), information was clear (90%), the length was appropriate (100%), it was appropriately detailed (90%), and it held their interest (97%). They spent a mean of 36 minutes using the decision aid and 100% preferred using their home/library computer. Participants scored a mean of 75% correct on the Decision Quality, Knowledge Subscale, and 74 out of 100 on the Preparation for Decision Making Scale. Completing the web-based decision aid reduced mean Decisional Conflict scores from 31.1 to 19.5 (p development of a web-based patient decision support research platform that was feasible for use in research studies in terms of recruitment, acceptability, and usage. Within this platform, the web

  5. Supported Decision Making: A Synthesis of the Literature across Intellectual Disability, Mental Health, and Aging

    Science.gov (United States)

    Shogren, Karrie A.; Wehmeyer, Michael L.; Lassmann, Heather; Forber-Pratt, Anjali J.

    2017-01-01

    Supported decision making (SDM) has begun to receive significant attention as means to enable people to exercise autonomy and self-determination over decisions about their life. Practice frameworks that can be used to promote the provision of supports for decision making are needed. This paper integrates the literature across intellectual and…

  6. Is there a need for hydrological modelling in decision support systems for nuclear emergencies

    International Nuclear Information System (INIS)

    Raskob, W.; Heling, R.; Zheleznyak, M.

    2004-01-01

    This paper discusses the role of hydrological modelling in decision support systems for nuclear emergencies. In particular, most recent developments such as, the radionuclide transport models integrated in to the decision support system RODOS will be explored. Recent progress in the implementation of physically-based distributed hydrological models for operational forecasting in national and supranational centres, may support a closer cooperation between national hydrological services and therefore, strengthen the use of hydrological and radiological models implemented in decision support systems. (authors)

  7. Multi-criteria decision analysis using hydrological indicators for decision support - a conceptual framework.

    Science.gov (United States)

    Butchart-Kuhlmann, Daniel; Kralisch, Sven; Meinhardt, Markus; Fleischer, Melanie

    2017-04-01

    Assessing the quantity and quality of water available in water stressed environments under various potential climate and land-use changes is necessary for good water and environmental resources management and governance. Within the region covered by the Southern African Science Service Centre for Climate Change and Adaptive Land Management (SASSCAL) project, such areas are common. One goal of the SASSCAL project is to develop and provide an integrated decision support system (DSS) with which decision makers (DMs) within a given catchment can obtain objective information regarding potential changes in water flow quantity and timing. The SASSCAL DSS builds upon existing data storage and distribution capability, through the SASSCAL Information System (IS), as well as the J2000 hydrological model. Using output from validated J2000 models, the SASSCAL DSS incorporates the calculation of a range of hydrological indicators based upon Indicators of Hydrological Alteration/Environmental Flow Components (IHA/EFC) calculated for a historic time series (pre-impact) and a set of model simulations based upon a selection of possible climate and land-use change scenarios (post-impact). These indicators, obtained using the IHA software package, are then used as input for a multi-criteria decision analysis (MCDA) undertaken using the open source diviz software package. The results of these analyses will provide DMs with an indication as to how various hydrological indicators within a catchment may be altered under different future scenarios, as well providing a ranking of how each scenario is preferred according to different DM preferences. Scenarios are represented through a combination of model input data and parameter settings in J2000, and preferences are represented through criteria weighting in the MCDA. Here, the methodology is presented and applied to the J2000 Luanginga model results using a set of hypothetical decision maker preference values as input for an MCDA based on

  8. Effectively marketing prepaid medical care with decision support systems.

    Science.gov (United States)

    Forgionne, G A

    1991-01-01

    The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.

  9. Walkability and Urban Capabilities: evaluation and Planning Decision Support

    Directory of Open Access Journals (Sweden)

    Ivan Blečić

    2015-06-01

    Full Text Available We propose a methodology for the evaluation of urban walkability, and the related software tool for decision and planning support. In the introduction, we discuss the relevance of the concept of walkability for urban quality of life, and attempt to place it within the framework of the capability approach. The central part of the article is dedicated to the presentation of the spatial multi-criteria evaluation model for walkability. Our construction of the walkability in the model proposes a certain change of perspective with regard to the methods suggested thus far: rather than evaluating how a place is walkable in itself, the walkability score we calculate reflects how and where to one can walk from that place, in other words, what is the walkability the place is endowed with. Therefore, the walkability score combines three components: (1 the number of available destinations (urban “opportunities” reachable by foot; (2 their distances; and (3 the quality of pedestrian routes towards those destinations. The quality of pedestrian routes is evaluated on different attributes relevant for walkability, related to the characteristics of the streets and their surrounding environment which contribute to render the route pleasant, secure and attractive. By way of example, in the third part we present an example application on the city of Alghero (Italy.

  10. Decision support program for congestion management using demand side flexibility

    DEFF Research Database (Denmark)

    Esmat, Ayman; Pinson, Pierre; Usaola, Julio

    2017-01-01

    In the past decades, Distribution System Operators (DSOs) have been mitigating distribution networks (DNs) contingencies by opting to grid reinforcements. However, this approach is not always cost and time efficient. Demand Side Flexibility (DSF) is one of the recent alternatives used in DNs cong...... effect is taken into consideration as well as the uncertain behavior of customers. Finally, the distribution grid of the Danish Bornholm Island is used to illustrate the merits of the DSP. The total cost incurred by the DSO is calculated and presented.......In the past decades, Distribution System Operators (DSOs) have been mitigating distribution networks (DNs) contingencies by opting to grid reinforcements. However, this approach is not always cost and time efficient. Demand Side Flexibility (DSF) is one of the recent alternatives used in DNs...... congestion management. Consequently, new market players such as aggregators are needed to handle DSF transaction between customers and DSOs. This paper proposes and models a decision support program (DSP) to optimize the total cost charged by the DSO for using DSF services. Moreover, the energy rebound...

  11. Why decision support systems are important for medical education.

    Science.gov (United States)

    Konstantinidis, Stathis Th; Bamidis, Panagiotis D

    2016-03-01

    During the last decades, the inclusion of digital tools in health education has rapidly lead to a continuously enlarging digital era. All the online interactions between learners and tutors, the description, creation, reuse and sharing of educational digital resources and the interlinkage between them in conjunction with cheap storage technology has led to an enormous amount of educational data. Medical education is a unique type of education due to accuracy of information needed, continuous changing competences required and alternative methods of education used. Nowadays medical education standards provide the ground for organising the educational data and the paradata. Analysis of such education data through education data mining techniques is in its infancy, but decision support systems (DSSs) for medical education need further research. To the best of our knowledge, there is a gap and a clear need for identifying the challenges for DSSs in medical education in the era of medical education standards. Thus, in this Letter the role and the attributes of such a DSS for medical education are delineated and the challenges and vision for future actions are identified.

  12. A Semantic Sensor Web for Environmental Decision Support Applications

    Science.gov (United States)

    Gray, Alasdair J. G.; Sadler, Jason; Kit, Oles; Kyzirakos, Kostis; Karpathiotakis, Manos; Calbimonte, Jean-Paul; Page, Kevin; García-Castro, Raúl; Frazer, Alex; Galpin, Ixent; Fernandes, Alvaro A. A.; Paton, Norman W.; Corcho, Oscar; Koubarakis, Manolis; De Roure, David; Martinez, Kirk; Gómez-Pérez, Asunción

    2011-01-01

    Sensing devices are increasingly being deployed to monitor the physical world around us. One class of application for which sensor data is pertinent is environmental decision support systems, e.g., flood emergency response. For these applications, the sensor readings need to be put in context by integrating them with other sources of data about the surrounding environment. Traditional systems for predicting and detecting floods rely on methods that need significant human resources. In this paper we describe a semantic sensor web architecture for integrating multiple heterogeneous datasets, including live and historic sensor data, databases, and map layers. The architecture provides mechanisms for discovering datasets, defining integrated views over them, continuously receiving data in real-time, and visualising on screen and interacting with the data. Our approach makes extensive use of web service standards for querying and accessing data, and semantic technologies to discover and integrate datasets. We demonstrate the use of our semantic sensor web architecture in the context of a flood response planning web application that uses data from sensor networks monitoring the sea-state around the coast of England. PMID:22164110

  13. Probabilistic source term predictions for use with decision support systems

    International Nuclear Information System (INIS)

    Grindon, E.; Kinniburgh, C.G.

    2003-01-01

    Full text: Decision Support Systems for use in off-site emergency management, following an incident at a Nuclear Power Plant (NPP) within Europe, are becoming accepted as a useful and appropriate tool to aid decision makers. An area which is not so well developed is the 'upstream' prediction of the source term released into the environment. Rapid prediction of this source term is crucial to the appropriate early management of a nuclear emergency. The initial source term prediction would today be typically based on simple tabulations taking little, or no, account of plant status. It is the interface between the inward looking plant control room team and the outward looking off-site emergency management team that needs to be addressed. This is not an easy proposition as these two distinct disciplines have little common basis from which to communicate their immediate findings and concerns. Within the Euratom Fifth Framework Programme (FP5), complementary approaches are being developed to the pre-release stage; each based on software tools to help bridge this gap. Traditionally source terms (or releases into the environment) provided for use with Decision Support Systems are estimated on a deterministic basis. These approaches use a single, deterministic assumption about plant status. The associated source term represents the 'best estimate' based an available information. No information is provided an the potential for uncertainty in the source term estimate. Using probabilistic methods the outcome is typically a number of possible plant states each with an associated source term and probability. These represent both the best estimate and the spread of the likely source term. However, this is a novel approach and the usefulness of such source term prediction tools is yet to be tested on a wide scale. The benefits of probabilistic source term estimation are presented here; using, as an example, the SPRINT tool developed within the FP5 STERPS project. System for the

  14. Decision Support System for Reservoir Management and Operation in Africa

    Science.gov (United States)

    Navar, D. A.

    2016-12-01

    Africa is currently experiencing a surge in dam construction for flood control, water supply and hydropower production, but ineffective reservoir management has caused problems in the region, such as water shortages, flooding and loss of potential hydropower generation. Our research aims to remedy ineffective reservoir management by developing a novel Decision Support System(DSS) to equip water managers with a technical planning tool based on the state of the art in hydrological sciences. The DSS incorporates a climate forecast model, a hydraulic model of the watershed, and an optimization model to effectively plan for the operation of a system of cascade large-scale reservoirs for hydropower production, while treating water supply and flood control as constraints. Our team will use the newly constructed hydropower plants in the Omo Gibe basin of Ethiopia as the test case. Using the basic HIDROTERM software developed in Brazil, the General Algebraic Modeling System (GAMS) utilizes a combination of linear programing (LP) and non-linear programming (NLP) in conjunction with real time hydrologic and energy demand data to optimize the monthly and daily operations of the reservoir system. We compare the DSS model results with the current reservoir operating policy used by the water managers of that region. We also hope the DSS will eliminate the current dangers associated with the mismanagement of large scale water resources projects in Africa.

  15. Development and commissioning of decision support tools for sewerage management.

    Science.gov (United States)

    Manic, G; Printemps, C; Zug, M; Lemoine, C

    2006-01-01

    Managing sewerage systems is a highly complex task due to the dynamic nature of the facilities. Their performance strongly depends on the know-how applied by the operators. In order to define optimal operational settings, two decision support tools based on mathematical models have been developed. Moreover, easy-to-use interfaces have been created as well, aiding operators who presumably do not have the necessary skills to use modelling software. The two developed programs simulate the behaviour of both wastewater treatment plants (WWTP) and sewer network systems, respectively. They have essentially the same structure, including raw data management and statistical analysis, a simulation layer using the application programming interface of the applied software and a layer responsible for the representation of the obtained results. Four user modes are provided in the two software including the simulation of historical data using the applied and novel operational settings, as well as modes concerning prediction of possible operation periods and updates. Concerning the WWTP software, it was successfully installed in Nantes (France) in June 2004. Moreover, the one managing sewer networks has been deployed in Saint-Malo (France) in January 2005. This paper presents the structure of the developed software and the first results obtained during the commissioning phase.

  16. Computerized provider order entry systems.

    Science.gov (United States)

    2001-01-01

    Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use.

  17. A Decision Support System for the Location of Naval Surface Reserve Units

    National Research Council Canada - National Science Library

    Venable, Laura

    1998-01-01

    .... The research suggests the feasibility of a PC based Decision Support System to assist Commander, Naval Surface Reserve Force improve the effectiveness and efficiency of the unit location decision...

  18. Adjudication Decision Support (ADS) System Automated Approval Estimates for NACLC Investigations

    National Research Council Canada - National Science Library

    Lang, Eric L; Youpa, Daniel G; Berman, Sandi; Leggitt, John S

    2007-01-01

    The present research is the second in a series of studies to test preliminary decision rules and provide automated approval estimates for a Department of Defense Adjudication Decision Support (ADS) system...

  19. Reliability of decision-support systems for nuclear emergency management

    Energy Technology Data Exchange (ETDEWEB)

    Ionescu, Tudor B.

    2013-08-15

    Decision support systems for nuclear emergency management (DSNE) are currently used worldwide to assist decision makers in taking emergency response countermeasures in case of accidental releases of radioactive materials from nuclear facilities. The present work has been motivated by the fact that, up until now, DSNE systems have not been regarded as safetycritical software systems, such as embedded software currently being used in vehicles and aircraft. The core of any DSNE system is represented by the different simulation codes linked together to form the dispersion simulation workflow. These codes require input emission and meteorological data to produce forecasts of the atmospheric dispersion of radioactive pollutants and other substances. However, the reliability of the system not only depends on the trustworthiness of the measured (or generated) input data but also on the reliability of the simulation codes used. The main goal of this work is to improve the reliability of DSNE systems by adapting current state of the art methods from the domain of software reliability engineering to the case of atmospheric dispersion simulation codes. The current approach is based on the design by diversity principle for improving the reliability of codes and the trustworthiness of results as well as on a flexible fault-tolerant workflow scheduling algorithm for ensuring the maximum availability of the system. The author's contribution is represented by (i) an acceptance test for dispersion simulation results, (ii) an adjudication algorithm (voter) based on comparing taxonomies of dispersion simulation results, and (iii) a feedback-control based fault-tolerant workflow scheduling algorithm. These tools provide means for the continuous verification of dispersion simulation codes while tolerating timing faults caused by disturbances in the underlying computational environment and will thus help increase the reliability and trustworthiness of DSNE systems in missioncritical

  20. Reliability of decision-support systems for nuclear emergency management

    International Nuclear Information System (INIS)

    Ionescu, Tudor B.

    2013-08-01

    Decision support systems for nuclear emergency management (DSNE) are currently used worldwide to assist decision makers in taking emergency response countermeasures in case of accidental releases of radioactive materials from nuclear facilities. The present work has been motivated by the fact that, up until now, DSNE systems have not been regarded as safetycritical software systems, such as embedded software currently being used in vehicles and aircraft. The core of any DSNE system is represented by the different simulation codes linked together to form the dispersion simulation workflow. These codes require input emission and meteorological data to produce forecasts of the atmospheric dispersion of radioactive pollutants and other substances. However, the reliability of the system not only depends on the trustworthiness of the measured (or generated) input data but also on the reliability of the simulation codes used. The main goal of this work is to improve the reliability of DSNE systems by adapting current state of the art methods from the domain of software reliability engineering to the case of atmospheric dispersion simulation codes. The current approach is based on the design by diversity principle for improving the reliability of codes and the trustworthiness of results as well as on a flexible fault-tolerant workflow scheduling algorithm for ensuring the maximum availability of the system. The author's contribution is represented by (i) an acceptance test for dispersion simulation results, (ii) an adjudication algorithm (voter) based on comparing taxonomies of dispersion simulation results, and (iii) a feedback-control based fault-tolerant workflow scheduling algorithm. These tools provide means for the continuous verification of dispersion simulation codes while tolerating timing faults caused by disturbances in the underlying computational environment and will thus help increase the reliability and trustworthiness of DSNE systems in missioncritical