WorldWideScience

Sample records for network decision aid

  1. FIESTA: An operational decision aid for space network fault isolation

    Science.gov (United States)

    Lowe, Dawn; Quillin, Bob; Matteson, Nadine; Wilkinson, Bill; Miksell, Steve

    1987-01-01

    The Fault Tolerance Expert System for Tracking and Data Relay Satellite System (TDRSS) Applications (FIESTA) is a fault detection and fault diagnosis expert system being developed as a decision aid to support operations in the Network Control Center (NCC) for NASA's Space Network. The operational objectives which influenced FIESTA development are presented and an overview of the architecture used to achieve these goals are provided. The approach to the knowledge engineering effort and the methodology employed are also presented and illustrated with examples drawn from the FIESTA domain.

  2. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    OpenAIRE

    João Raposo; Ana Rodrigues; Carlos Silva; Tomaz Dentinho

    2015-01-01

    This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city’s urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE’s characteristics other useful features, such as decision ...

  3. WeAidU-a decision support system for myocardial perfusion images using artificial neural networks.

    Science.gov (United States)

    Ohlsson, Mattias

    2004-01-01

    This paper presents a computer-based decision support system for automated interpretation of diagnostic heart images (called WeAidU), which is made available via the Internet. The system is based on image processing techniques, artificial neural networks (ANNs) and large well-validated medical databases. We present results using artificial neural networks, and compare with two other classification methods, on a retrospective data set containing 1320 images from the clinical routine. The performance of the artificial neural networks detecting infarction and ischemia in different parts of the heart, measured as areas under the receiver operating characteristic curves, is in the range 0.83-0.96. These results indicate a high potential for the tool as a clinical decision support system.

  4. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    Directory of Open Access Journals (Sweden)

    João Raposo

    2015-05-01

    Full Text Available This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city’s urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE’s characteristics other useful features, such as decision memory over time, versatility and adaptability. The case study, used here to present the dynamic-PROMETHEE, served as inspiration and base to create this new methodology. It can be used to model different problems and scenarios that may present similar requirement characteristics.

  5. A multi-criteria decision aid methodology to design electric vehicles public charging networks

    Science.gov (United States)

    Raposo, João; Rodrigues, Ana; Silva, Carlos; Dentinho, Tomaz

    2015-05-01

    This article presents a new multi-criteria decision aid methodology, dynamic-PROMETHEE, here used to design electric vehicle charging networks. In applying this methodology to a Portuguese city, results suggest that it is effective in designing electric vehicle charging networks, generating time and policy based scenarios, considering offer and demand and the city's urban structure. Dynamic-PROMETHE adds to the already known PROMETHEE's characteristics other useful features, such as decision memory over time, versatility and adaptability. The case study, used here to present the dynamic-PROMETHEE, served as inspiration and base to create this new methodology. It can be used to model different problems and scenarios that may present similar requirement characteristics.

  6. Computer aided decision making for heart disease detection using hybrid neural network-Genetic algorithm.

    Science.gov (United States)

    Arabasadi, Zeinab; Alizadehsani, Roohallah; Roshanzamir, Mohamad; Moosaei, Hossein; Yarifard, Ali Asghar

    2017-04-01

    Cardiovascular disease is one of the most rampant causes of death around the world and was deemed as a major illness in Middle and Old ages. Coronary artery disease, in particular, is a widespread cardiovascular malady entailing high mortality rates. Angiography is, more often than not, regarded as the best method for the diagnosis of coronary artery disease; on the other hand, it is associated with high costs and major side effects. Much research has, therefore, been conducted using machine learning and data mining so as to seek alternative modalities. Accordingly, we herein propose a highly accurate hybrid method for the diagnosis of coronary artery disease. As a matter of fact, the proposed method is able to increase the performance of neural network by approximately 10% through enhancing its initial weights using genetic algorithm which suggests better weights for neural network. Making use of such methodology, we achieved accuracy, sensitivity and specificity rates of 93.85%, 97% and 92% respectively, on Z-Alizadeh Sani dataset. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Multicriteria methodology for decision aiding

    CERN Document Server

    Roy, Bernard

    1996-01-01

    This is the first comprehensive book to present, in English, the multicriteria methodology for decision aiding In the foreword the distinctive features and main ideas of the European School of MCDA are outlined The twelve chapters are essentially expository in nature, but scholarly in treatment Some questions, which are too often neglected in the literature on decision theory, such as how is a decision made, who are the actors, what is a decision aiding model, how to define the set of alternatives, are discussed Examples are used throughout the book to illustrate the various concepts Ways to model the consequences of each alternative and building criteria taking into account the inevitable imprecisions, uncertainties and indeterminations are described and illustrated The three classical operational approaches of MCDA synthesis in one criterion (including MAUT), synthesis by outranking relations, interactive local judgements, are studied This methodology tries to be a theoretical or intellectual framework dire...

  8. Severe Weather Forecast Decision Aid

    Science.gov (United States)

    Bauman, William H., III; Wheeler, Mark M.; Short, David A.

    2005-01-01

    This report presents a 15-year climatological study of severe weather events and related severe weather atmospheric parameters. Data sources included local forecast rules, archived sounding data, Cloud-to-Ground Lightning Surveillance System (CGLSS) data, surface and upper air maps, and two severe weather event databases covering east-central Florida. The local forecast rules were used to set threat assessment thresholds for stability parameters that were derived from the sounding data. The severe weather events databases were used to identify days with reported severe weather and the CGLSS data was used to differentiate between lightning and non-lightning days. These data sets provided the foundation for analyzing the stability parameters and synoptic patterns that were used to develop an objective tool to aid in forecasting severe weather events. The period of record for the analysis was May - September, 1989 - 2003. The results indicate that there are certain synoptic patterns more prevalent on days with severe weather and some of the stability parameters are better predictors of severe weather days based on locally tuned threat values. The results also revealed the stability parameters that did not display any skill related to severe weather days. An interactive web-based Severe Weather Decision Aid was developed to assist the duty forecaster by providing a level of objective guidance based on the analysis of the stability parameters, CGLSS data, and synoptic-scale dynamics. The tool will be tested and evaluated during the 2005 warm season.

  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. AIDS: Administrative Decisions and Constitutional Rights.

    Science.gov (United States)

    Greenlaw, Paul S.; Kohl, John P.

    1993-01-01

    Review of case law in educational administration, hospitals, correctional institutions, and the military shows that, when risk of AIDS transmission is high, courts will support public sector administrators' decisions. Low risk means such decisions as mandatory blood testing will usually be struck down. (SK)

  11. Improving treatment decisions from radiographs: effect of a decision aid

    NARCIS (Netherlands)

    Mileman, P.A.; van den Hout, W.B.

    2009-01-01

    Purpose: To test whether dental students’ accuracy of treatment decision making for dentine caries using radiographs improved after using a decision aid (DA). Methods: Dental students (n = 227) assessed the need for treatment for proximal surfaces of a test set of radiographs for a scenario patient.

  12. Translating Evidence to Facilitate Shared Decision Making: Development and Usability of a Consult Decision Aid Prototype.

    Science.gov (United States)

    Stacey, Dawn; Légaré, France; Lyddiatt, Anne; Giguere, Anik M C; Yoganathan, Manosila; Saarimaki, Anton; Pardo, Jordi Pardo; Rader, Tamara; Tugwell, Peter

    2016-12-01

    The purpose of this study was to translate evidence from Cochrane Reviews into a format that can be used to facilitate shared decision making during the consultation, namely patient decision aids. A systematic development process (a) established a stakeholder committee; (b) developed a prototype according to the International Patient Decision Aid Standards; (c) applied the prototype to a Cochrane Review and used an interview-guided survey to evaluate acceptability/usability; (d) created 12 consult decision aids; and (e) used a Delphi process to reach consensus on considerations for creating a consult decision aid. The 1-page prototype includes (a) a title specifying the decision; (b) information on the health condition, options, benefits/harms with probabilities; (c) an explicit values clarification exercise; and (d) questions to screen for decisional conflict. Hyperlinks provide additional information on definitions, probabilities presented graphically, and references. Fourteen Cochrane Consumer Network members and Cochrane Editorial Unit staff participated. Thirteen reported that it would help patient/clinician discussions and were willing to use and/or recommend it. Seven indicated the right amount of information, six not enough, and one too much. Changes to the prototype were more links to definitions, more white space, and details on GRADE evidence ratings. Creating 12 consult decision aids took about 4 h each. We identified ten considerations when selecting Cochrane Reviews for creating consult decision aids. Using a systematic process, we developed a consult decision aid prototype to be populated with evidence from Cochrane Reviews. It was acceptable and easy to apply. Future studies will evaluate implementation of consult decision aids.

  13. Computer-aided decision making.

    Science.gov (United States)

    Keith M. Reynolds; Daniel L. Schmoldt

    2006-01-01

    Several major classes of software technologies have been used in decisionmaking for forest management applications over the past few decades. These computer-based technologies include mathematical programming, expert systems, network models, multi-criteria decisionmaking, and integrated systems. Each technology possesses unique advantages and disadvantages, and has...

  14. Decision aid reliance: modeling the effects of decision aid reliability and pressures to perform on reliance behavior

    NARCIS (Netherlands)

    Gomaa, M.I.; Hunton, J.E.; Vaassen, E.H.J.; Carree, M.A.

    2011-01-01

    We investigate the effects of decision aid reliability and pressure to perform on decision aid reliance. A total of 403 students took part in a four (pressures to perform: one through four) by five (decision aid reliability: 50%, 60%, 70%, 80% and 90%) between-participants experiment. We test two

  15. Adaptive Peircean decision aid project summary assessments.

    Energy Technology Data Exchange (ETDEWEB)

    Senglaub, Michael E.

    2007-01-01

    This efforts objective was to identify and hybridize a suite of technologies enabling the development of predictive decision aids for use principally in combat environments but also in any complex information terrain. The technologies required included formal concept analysis for knowledge representation and information operations, Peircean reasoning to support hypothesis generation, Mill's's canons to begin defining information operators that support the first two technologies and co-evolutionary game theory to provide the environment/domain to assess predictions from the reasoning engines. The intended application domain is the IED problem because of its inherent evolutionary nature. While a fully functioning integrated algorithm was not achieved the hybridization and demonstration of the technologies was accomplished and demonstration of utility provided for a number of ancillary queries.

  16. Factors affecting farmers networking decisions

    NARCIS (Netherlands)

    Pascucci, S.

    2011-01-01

    This paper analyses farmers' decisions to carry out transactions by using three different types of networks: input supply cooperatives, processing and/or marketing cooperatives, and producers associations. We use arguments from economic sociology and new institutional economics to define the main

  17. An Integrated Model for Optimization Oriented Decision Aiding and Rule Based Decision Making in Fuzzy Environment

    Directory of Open Access Journals (Sweden)

    A. Yousefli

    2014-01-01

    Full Text Available In this paper a fuzzy decision aid system is developed base on new concepts that presented in the field of fuzzy decision making in fuzzy environment (FDMFE. This framework aids decision makers to understand different circumstances of an uncertain problem that may occur in the future. Also, to keep decision maker from the optimization problem complexities, a decision support system, which can be replaced by optimization problem, is presented to make optimum or near optimum decisions without solving optimization problem directly. An application of the developed decision aid model and the decision support system is presented in the field of inventory models.

  18. Integrating Cognitive Mapping Analysis into Multi-Criteria Decision Aiding

    OpenAIRE

    Kpoumié, Amidou; Damart, Sébastien; Tsoukiàs, Alexis

    2017-01-01

    Multi-criteria decision aiding (MCDA) is a process implying two distinctive actors (the client and the analyst) which aims at providing transparent and coherent support for complex decision situations, taking into account values of decision makers involved in a specific decision context. The theoretical framework of MCDA traditionally addresses problems involving a single decision maker. However, MCDA ought to investigate the case where the decision maker is made up of groups of individuals w...

  19. Decision aids for patients facing health treatment or screening decisions: systematic review

    Science.gov (United States)

    O’Connor, Annette M; Rostom, Alaa; Fiset, Valerie; Tetroe, Jacqueline; Entwistle, Vikki; Llewellyn-Thomas, Hilary; Holmes-Rovner, Margaret; Barry, Michael; Jones, Jean

    1999-01-01

    Objective To conduct a systematic review of randomised trials of patient decision aids in improving decision making and outcomes. Design We included randomised trials of interventions providing structured, detailed, and specific information on treatment or screening options and outcomes to aid decision making. Two reviewers independently screened and extracted data on several evaluation criteria. Results were pooled by using weighted mean differences and relative risks. Results 17 studies met the inclusion criteria. Compared with the controls, decision aids produced higher knowledge scores (weighted mean difference=19/100, 95% confidence interval 14 to 25); lower decisional conflict scores (weighted mean difference=−0.3/5, −0.4 to −0.1); more active patient participation in decision making (relative risk = 2.27, 95% confidence interval 1.3 to 4); and no differences in anxiety, satisfaction with decisions (weighted mean difference=0.6/100, −3 to 4), or satisfaction with the decision making process (2/100,−3 to 7). Decision aids had a variable effect on decisions. When complex decision aids were compared with simpler versions, they were better at reducing decisional conflict, improved knowledge marginally, but did not affect satisfaction. Conclusions Decision aids improve knowledge, reduce decisional conflict, and stimulate patients to be more active in decision making without increasing their anxiety. Decision aids have little effect on satisfaction and a variable effect on decisions. The effects on outcomes of decisions (persistence with choice, quality of life) remain uncertain. PMID:10487995

  20. AIDS Clinical Trials Group Network

    Science.gov (United States)

    ... Bylaws, SOPs, and Guidelines Leadership and Operations Center Network Coordinating Center Statistical and Data Management Center Performance ... Accessibility Our Mission The mission of the ACTG Network is to cure HIV infection and reduce the ...

  1. Decision support for the definition of wind turbine systems adequacy to site specificities and weak electrical networks; Aide a la decision pour la definition d'un systeme eolien, adequation au site et a un reseau faible

    Energy Technology Data Exchange (ETDEWEB)

    Arbaoui, A

    2006-10-15

    A decision support system for the definition of wind turbine systems is developed by taking into account the wind and site characteristics, the wind turbine components and the electrical network properties close to the site. The approach is based on functional analysis, on the investigation of the functional fluxes and on the definition of a model suitable for supporting decision at the preliminary stages of wind turbine design. The complete set of solutions derived from the model is determined using a Constraint Satisfaction Problem solver. The intrinsic capability of the model to support decision is derived from the investigation of the model parsimony, precision, exactness and specialization. The model takes into account performance criteria resulting from knowledge of manufacturers, distributors and investors. These criteria are used to discriminate design alternatives. Design alternatives correspond to choices of site (wind, electric network) and wind turbine architectures (related to 7 design variables). Performance criteria are the cost of electric kWh, the amount of energy being produced and the discounted total cost of the project. Electric network connection to wind turbines is taken into account through slow variations of the voltage and Flickers phenomenon. First, the maximal rate of penetration of the wind turbine energy production is determined. Next, two design alternatives have been investigated to improve wind turbine system integration in electric distribution networks. These alternatives are a reactive power control system and an inertial energy storage system. Inertial storage systems seem to be more expensive than reactive power control systems for this type of application. The influence of site specificities on decision making process has been established through three different sites (a Mediterranean site and two sites located in northern Europe). Profits relative to the cost of kWh appear to be high for Mediterranean sites. Most of the

  2. Decision aids to help older people make health decisions : A systematic review and meta-analysis

    NARCIS (Netherlands)

    van Weert, J.C.M.; van Munster, B.C.; Sanders, R.; Spijker, R.; Hooft, L.; Jansen, J.

    2016-01-01

    Background Decision aids have been overall successful in improving the quality of health decision making. However, it is unclear whether the impact of the results of using decision aids also apply to older people (aged 65+). We sought to systematically review randomized controlled trials (RCTs) and

  3. Decision aids to help older people make health decisions : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Van Weert, Julia C M; Van Munster, Barbara C.; Sanders, Remco; Spijker, René; Hooft, Lotty; Jansen, Jesse

    2016-01-01

    Background: Decision aids have been overall successful in improving the quality of health decision making. However, it is unclear whether the impact of the results of using decision aids also apply to older people (aged 65+). We sought to systematically review randomized controlled trials (RCTs) and

  4. Decision aids to help older people make health decisions : a systematic review and meta-analysis

    NARCIS (Netherlands)

    van Weert, Julia C. M.; van Munster, Barbara C.; Sanders, Remco; Spijker, Rene; Hooft, Lotty; Jansen, Jesse

    2016-01-01

    Background: Decision aids have been overall successful in improving the quality of health decision making. However, it is unclear whether the impact of the results of using decision aids also apply to older people (aged 65+). We sought to systematically review randomized controlled trials (RCTs) and

  5. Decision aiding techniques for site remediation

    Energy Technology Data Exchange (ETDEWEB)

    Van de Walle, B.

    1996-09-18

    Decision making problems in the nuclear domain are known for their complexity since they usually involve a wide range of technical, social, and political considerations. Site restoration is a typical example of a complex nuclear decision problem, and more and more decision makers realize that they need new tools to assist in the decision making process. This paper reports on multi-criteria decision analysis, a powerful tool for handling complex decisions involving multiple criteria. The motivation to use multi-criteria decision analysis in the domain of site restoration is illustrated. New developments and challenges in this field are addressed.

  6. Geo-Spatial Tactical Decision Aid Systems: Fuzzy Logic for Supporting Decision Making

    National Research Council Canada - National Science Library

    Grasso, Raffaele; Giannecchini, Simone

    2006-01-01

    .... This paper describes a tactical decision aid system based on fuzzy logic reasoning for data fusion and on current Open Geospatial Consortium specifications for interoperability, data dissemination...

  7. A framework for explaining reliance on decision aids

    NARCIS (Netherlands)

    Dongen, C.J.G. van; Maanen, P.P. van

    2013-01-01

    This study presents a framework for understanding task and psychological factors affecting reliance on advice from decision aids. The framework describes how informational asymmetries in combination with rational, motivational and heuristic factors explain human reliance behavior. To test hypotheses

  8. JAVAMIX: A Tactical Decision Aid to Evaluate Minefield Clearance Plans

    National Research Council Canada - National Science Library

    Filho, Jose

    2001-01-01

    A Tactical Decision Aid (TDA) for mixed minefield clearance, JAVAMIX, was designed, developed and tested, The TDA uses a Monte Carlo Simulation and it is based on the Monte Carlo option of the TDA MIXER (Washburn, 1995...

  9. Decision Aids: the Effect of Labeling Options on Patient choices and Decision-Making

    Science.gov (United States)

    Dolan, James G.; Cherkasky, Olena A.; Chin, Nancy; Veazie, Peter J.

    2015-01-01

    Background Conscious and unconscious biases can influence how people interpret new information and make decisions. Current standards for creating decision aids, however, do not address this issue. Method Using a 2×2 factorial design we sent surveys to members of two Internet survey panels containing a decision scenario involving a choice between aspirin or a statin drug to lower risk of heart attack and a decision aid. Each aid presented identical information about reduction in heart attack risk and likelihood of a major side effect. They differed in whether the options were labeled and amount of decisional guidance: information only (a balance sheet) versus information plus values clarification (a multicriteria decision analysis). After using the decision aid, participants indicated their preferred medication. Those using a multicriteria decision aid also judged differences in the comparative outcome data provided for the two options and the relative importance of achieving benefits versus avoiding risks in making the decision. Results The study sample size is 536. Participants using decision aids with unlabeled options were more likely to choose a statin: 56% versus 25%, p < 0.001. The type of decision aid made no difference. This effect persists after adjusting for differences in survey company, age, gender, education level, health literacy, and numeracy. Participants using unlabeled decision aids were also more likely to interpret the data presented as favoring a statin with regard to both treatment benefits and risk of side effects (p ≤ 0.01). There were no significant differences in decision priorities (p=0.21). Conclusion Identifying the options in patient decision aids can influence patient preferences and change how they interpret comparative outcome data. PMID:26229084

  10. Decision Aids: The Effect of Labeling Options on Patient Choices and Decision Making.

    Science.gov (United States)

    Dolan, James G; Cherkasky, Olena A; Chin, Nancy; Veazie, Peter J

    2015-11-01

    Conscious and unconscious biases can influence how people interpret new information and make decisions. Current standards for creating decision aids, however, do not address this issue. Using a 2×2 factorial design, we developed surveys that contained a decision scenario (involving a choice between aspirin or a statin drug to lower risk of heart attack) and a decision aid. Each aid presented identical information about reduction in heart attack risk and likelihood of a major side effect. They differed in whether the options were labeled and the amount of decisional guidance: information only (a balance sheet) versus information plus values clarification (a multicriteria decision analysis). We sent the surveys to members of 2 Internet survey panels. After using the decision aid, participants indicated their preferred medication. Those using a multicriteria decision aid also judged differences in the comparative outcome data provided for the 2 options and the relative importance of achieving benefits versus avoiding risks in making the decision. The study sample size was 536. Participants using decision aids with unlabeled options were more likely to choose a statin: 56% versus 25% (P < 0.001). The type of decision aid made no difference. This effect persisted after adjustment for differences in survey company, age, gender, education level, health literacy, and numeracy. Participants using unlabeled decision aids were also more likely to interpret the data presented as favoring a statin with regard to both treatment benefits and risk of side effects (P ≤ 0.01). There were no significant differences in decision priorities (P = 0.21). Identifying the options in patient decision aids can influence patient preferences and change how they interpret comparative outcome data. © The Author(s) 2015.

  11. Text summarization as a decision support aid

    OpenAIRE

    Workman, T Elizabeth; Fiszman, Marcelo; Hurdle, John F

    2012-01-01

    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. Me...

  12. A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology.

    Science.gov (United States)

    Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T

    2017-06-01

    Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.

  13. Feasibility of web-based decision aids in neurological patients

    NARCIS (Netherlands)

    van Til, Janine Astrid; Drossaert, Constance H.C.; Renzenbrink, Gerbert J.; Snoek, Govert J.; Dijkstra, Evelien; Stiggelbout, Anne M.; IJzerman, Maarten Joost

    2010-01-01

    Decision aids (DAs) may be helpful in improving patients' participation in medical decision-making. We investigated the potential for web-based DAs in a rehabilitation population. Two self-administered DAs focused on the treatment of acquired ankle-foot impairment in stroke and the treatment of

  14. Practical Aspects of a Visual Aid to Decision Making

    Science.gov (United States)

    Fisher, Z.; Bailey, R.; Willner, P.

    2012-01-01

    Background: Previous research has demonstrated that people with mild intellectual disabilities (ID) have difficulty in "weighing up" information, defined as integrating disparate items of information in order to reach a decision. However, this problem could be overcome by the use of a visual aid to decision making. In an earlier study,…

  15. Multicriteria decision aid/analysis in finance

    NARCIS (Netherlands)

    J. Spronk (Jaap); R.E. Steuer; C. Zopounidis

    2005-01-01

    textabstractMULTIPLE CRITERIA DECISION ANALYSIS: State of the Art Surveys is the most comprehensive work available to survey the state of the art in MCDA to date. Its 25 chapters are organized in eight parts and are written by 52 international leading experts. Each of these parts covers one of the

  16. 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.

  17. Text summarization as a decision support aid.

    Science.gov (United States)

    Workman, T Elizabeth; Fiszman, Marcelo; Hurdle, John F

    2012-05-23

    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. 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. 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. 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.

  18. Collaborative Platforms Aid Emergency Decision Making

    Science.gov (United States)

    2013-01-01

    Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

  19. Decision aid for women considering breast cancer screening

    DEFF Research Database (Denmark)

    Pasternack, Iris; Saalasti-Koskinen, Ulla; Mäkelä, Marjukka

    2011-01-01

    relevant content and format for the decision aid for breast cancer screening. Feedback from women was sought for the draft documents. RESULTS: A decision aid attached to the invitation letter for screening was considered the best way to ensure access to information. In addition, tailored letter templates...... for all phases of the screening program, a poster, and a public website were developed. Initial feedback from users (women, professionals, and service providers), was mainly positive. Six months after publishing, the implementation of the decision aid was still incomplete. CONCLUSIONS: Providing balanced...... information for women invited to breast cancer screening is demanding and requires careful planning. Professionals and service providers need to be engaged in the HTA process to ensure proper dissemination and implementation of the information. End user participation is essential in the formulation...

  20. Decision Aids Using Heterogeneous Intelligence Analysis

    Science.gov (United States)

    2010-08-20

    would however give us dependence on the network. TAVI and TINDER are two sensor providers that stood out as being able to provide us with in- put on...ferent form-factor adopted that will provide additional viewing capability, especially in difficult lighting conditions. A side benefit of this is

  1. Integrating Decision Support and Social Networks

    Directory of Open Access Journals (Sweden)

    Francisco Antunes

    2012-01-01

    Full Text Available We elaborate on the shifting of decision support systems towards social networking, which is based on the concepts of Web 2.0 and Semantic Web technology. As the characteristics of the relevant components are different from traditional decision support systems, we present necessary adaptations when adopting social networks for decision support within an organization. We also present organizational obstacles when adopting/using such systems and clues to overcome them.

  2. Hierarchical outranking methods for multi-criteria decision aiding

    OpenAIRE

    Del Vasto Terrientes, Luis Miguel

    2015-01-01

    Multi-Criteria Decision Aiding (MCDA) methods support complex decision making involving multiple and conflictive criteria. MCDA distinguishes two main approaches to deal with this type of problems: utility-based and outranking methods, each with its own strengths and weaknesses. Outranking methods are based on social choice models combined with Artificial Intelligence techniques (such as the management of categorical data or uncertainty). They are recognized as providing tools for a realisti...

  3. The Use of Graphs as Decision Aids in Relation to Information Overload and Managerial Decision Quality.

    Science.gov (United States)

    Chan, Siu Y.

    2001-01-01

    Discussion of information overload focuses on a study of masters degree students at a Hong Kong university that investigated the effectiveness of graphs as decision aids to reduce adverse effects of information overload on decision quality. Results of a simulation of a business prediction task with a sample of business managers are presented.…

  4. Decision aiding in plastic surgery: a multicriteria analysis

    Directory of Open Access Journals (Sweden)

    Luiz Flávio Autran Monteiro Gomes

    2012-08-01

    Full Text Available The aim of this article is to present, through a real case, a practical way, based on Multicriteria Decision Aiding, to support decision making in Plastic Surgery. The case studied was a Caucasian woman of 36 years of age with mammarian hypertrophia with ptosis and abdominal lipodystrophy, making it necessary to select the most adequate techniques for the best aesthetic result. For this purpose, the multicriteria methods Even Swaps and PrOACT were used. Three plastic surgeons working in the city of Rio de Janeiro with equivalent professional experience were consulted as decision agents. In order to define the objectives to be achieved, the criteria relevant to the making of the decision and the alternatives which could be used were identified. Throughout this identification and in the later analysis the surgeons participated in the application of the methods, which contributed towards facilitating their acceptance of the multicriteria analysis in their decision making. It was confirmed, in this case study, that the use of Multicriteria Decision Aiding tends to make the medical decision more wide ranging and, above all, transparent. The plastic surgeons themselves validated the analysis, considering it fully consistent with their professional experience.

  5. Aiding Lay Decision Making Using a Cognitive Competencies Approach

    Science.gov (United States)

    Maule, A. J.; Maule, Simon

    2016-01-01

    Two prescriptive approaches have evolved to aid human decision making: just in time interventions that provide support as a decision is being made; and just in case interventions that educate people about future events that they may encounter so that they are better prepared to make an informed decision when these events occur. We review research on these two approaches developed in the context of supporting everyday decisions such as choosing an apartment, a financial product or a medical procedure. We argue that the lack of an underlying prescriptive theory has limited the development and evaluation of these interventions. We draw on recent descriptive research on the cognitive competencies that underpin human decision making to suggest new ways of interpreting how and why existing decision aids may be effective and suggest a different way of evaluating their effectiveness. We also briefly outline how our approach has the potential to develop new interventions to support everyday decision making and highlight the benefits of drawing on descriptive research when developing and evaluating interventions. PMID:26779052

  6. Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

    Science.gov (United States)

    Dhukaram, Anandhi Vivekanandan; Baber, Chris

    2015-06-01

    Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Regional Network on HIV/AIDS, Rural Livelihoods and Food ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Launched in 2001, the Regional Network on HIV/AIDS, Rural Livelihoods and Food Security (RENEWAL) is a growing network of networks made up of national food and nutrition organizations (public, private and nongovernmental) and partners in AIDS and public health. RENEWAL aims to understand and facilitate a ...

  8. What information is used in treatment decision aids? A systematic review of the types of evidence populating health decision aids.

    Science.gov (United States)

    Clifford, Amanda M; Ryan, Jean; Walsh, Cathal; McCurtin, Arlene

    2017-02-23

    Patient decision aids (DAs) are support tools designed to provide patients with relevant information to help them make informed decisions about their healthcare. While DAs can be effective in improving patient knowledge and decision quality, it is unknown what types of information and evidence are used to populate such decision tools. Systematic methods were used to identify and appraise the relevant literature and patient DAs published between 2006 and 2015. Six databases (Academic Search Complete, AMED, CINAHL, Biomedical Reference Collection, General Sciences and MEDLINE) and reference list searching were used. Articles evaluating the effectiveness of the DAs were appraised using the Cochrane Risk of Bias tool. The content, quality and sources of evidence in the decision aids were evaluated using the IPDASi-SF and a novel classification system. Findings were synthesised and a narrative analysis was performed on the results. Thirteen studies representing ten DAs met the inclusion criteria. The IPDASI-SF score ranged from 9 to 16 indicating many of the studies met the majority of quality criteria. Sources of evidence were described but reports were sometimes generic or missing important information. The majority of DAs incorporated high quality research evidence including systematic reviews and meta-analyses. Patient and practice evidence was less commonly employed, with only a third of included DAs using these to populate decision aid content. The quality of practice and patient evidence ranged from high to low. Contextual factors were addressed across all DAs to varying degrees and covered a range of factors. This is an initial study examining the information and evidence used to populate DAs. While research evidence and contextual factors are well represented in included DAs, consideration should be given to incorporating high quality information representing all four pillars of evidence based practice when developing DAs. Further, patient and expert practice

  9. An evaluation by teachers of a decision aid for viewing bitewing radiographs

    NARCIS (Netherlands)

    Mileman, P.A.; van den Hout, W.B.

    2008-01-01

    Objectives: To evaluate a new decision aid to improve restorative treatment decision making for proximal caries from bitewing radiographs. Methods: Dental teachers involved in patient treatment and clinical caries diagnosis (n = 31) viewed a computerized decision aid. Whilst using the aid, measures

  10. The Effect of a Decision Aid on the Quality of Colorectal Cancer Screening Decisions

    Science.gov (United States)

    2012-03-29

    of polyps associated with colon cancer are believed to originate as benign adenomatous polyps, which take 7 to 15 years to develop into life ...iii Abstract Title of Dissertation: The Effect of a Decision Aid on the Quality of Colon Cancer Screening Decisions Cecilia Lee, Doctor of...Administration Preventive Medicine and Biometrics Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States. CRC

  11. Video-based patient decision aids: A scoping review.

    Science.gov (United States)

    Winston, Karin; Grendarova, Petra; Rabi, Doreen

    2017-10-18

    This study reviews the published literature on the use of video-based decision aids (DA) for patients. The authors describe the areas of medicine in which video-based patient DA have been evaluated, the medical decisions targeted, their reported impact, in which countries studies are being conducted, and publication trends. The literature review was conducted systematically using Medline, Embase, CINAHL, PsychInfo, and Pubmed databases from inception to 2016. References of identified studies were reviewed, and hand-searches of relevant journals were conducted. 488 studies were included and organized based on predefined study characteristics. The most common decisions addressed were cancer screening, risk reduction, advance care planning, and adherence to provider recommendations. Most studies had sample sizes of fewer than 300, and most were performed in the United States. Outcomes were generally reported as positive. This field of study was relatively unknown before 1990s but the number of studies published annually continues to increase. Videos are largely positive interventions but there are significant remaining knowledge gaps including generalizability across populations. Clinicians should consider incorporating video-based DA in their patient interactions. Future research should focus on less studied areas and the mechanisms underlying effective patient decision aids. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid.

    NARCIS (Netherlands)

    Joseph-Williams, N.; Evans, R.; Edwards, A.; Newcombe, R.G.; Wright, P.; Grol, R.P.T.M.; Elwyn, G.

    2010-01-01

    BACKGROUND: Web-based decision aids are known to have an effect on knowledge, attitude, and behavior; important components of informed decision making. We know what decision aids achieve in randomized controlled trials (RCTs), but we still know very little about how they are used and how this

  13. Does the Use of a Decision Aid Improve Decision Making in Prosthetic Heart Valve Selection? A Multicenter Randomized Trial

    NARCIS (Netherlands)

    Korteland, Nelleke M.; Ahmed, Yunus; Koolbergen, David R.; Brouwer, Marjan; de Heer, Frederiek; Kluin, Jolanda; Bruggemans, Eline F.; Klautz, Robert J. M.; Stiggelbout, Anne M.; Bucx, Jeroen J. J.; Roos-Hesselink, Jolien W.; Polak, Peter; Markou, Thanasie; van den Broek, Inge; Ligthart, Rene; Bogers, Ad J. J. C.; Takkenberg, Johanna J. M.

    2017-01-01

    A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection. In

  14. Decision-making in irrigation networks: Selecting appropriate canal structures using multi-attribute decision analysis.

    Science.gov (United States)

    Hosseinzade, Zeinab; Pagsuyoin, Sheree A; Ponnambalam, Kumaraswamy; Monem, Mohammad J

    2017-12-01

    of the Neyrpic® gate are ease of operation and capacity to measure discharge flows. Overall, the application to the Qazvin irrigation network demonstrates the utility of the proposed DA framework in selecting appropriate structures for regulating water flows in irrigation canals. This framework systematically aids the decision process by capturing decisions made at various levels (individual farmers to high-level management). It can be applied to other cases where a new irrigation network is being designed, or where changes in irrigation structures need to be identified to improve flow control in existing networks. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Assessing Practitioners’ and Patients’ Needs Regarding Shared Decision-Making and Decision Aids

    Directory of Open Access Journals (Sweden)

    Michiel Hageman

    2016-04-01

    Full Text Available Background: As part of the process of developing a decision aid for carpal tunnel syndrome (CTS according to the Ottawa Decision Support Framework, we were interested in the level of ‘decisional conflict’ of hand surgeons and patients with CTS. This study addresses the null hypothesis that there is no difference between surgeon and patient decisional conflict with respect to test and treatment options for CTS. Secondary analyses assess the impact of patient and physician demographics and the strength of the patient-physician relationship on decisional conflict.   Methods: One-hundred-twenty-three observers of the Science of Variation Group (SOVG and 84 patients with carpal tunnel syndrome completed a survey regarding the Decisional Conflict Scale. Patients also filled out the Pain Self-efficacy Questionnaire (PSEQ and the Patient Doctor Relationship Questionnaire (PDRQ-9.   Results: On average, patients had significantly greater decision conflict and scored higher on most subscales of the decisional conflict scale than hand surgeons.Factors associated with greater decision conflict were specific hand surgeon, less self-efficacy (confidence that one can achieve one’s goals in spite of pain, and higher PDRQ (relationship between patient and doctor. Surgeons from Europe have--on average--significantly more decision conflict than surgeons in the United States of America.   Conclusions: Patients with CTS have more decision conflict than hand surgeons. Decision aids might help narrow this gap in decisional conflict.

  16. A qualitative study of physicians' perceptions of three decision aids.

    Science.gov (United States)

    Graham, Ian D; Logan, Jo; O'Connor, Annette; Weeks, Karen E; Aaron, Shawn; Cranney, Ann; Dales, Robert; Elmslie, Thomas; Hebert, Paul; Jolly, Elaine; Laupacis, Andreas; Mitchell, Susan; Tugwell, Peter

    2003-07-01

    The study objective was to investigate physicians' perceptions of three patient decision aids (DA). Semi-structured telephone interviews were conducted with 20 family physicians and 12 gynecologists about a DA for women considering long-term hormone replacement therapy; with 16 respirologists about a DA for the use of intubation and mechanical ventilation for patients with severe chronic obstructive pulmonary disease; and with 19 physicians (geriatricians, gastroenterologists, internists) about a DA for long-term placement of feeding tubes in the elderly. Participants were identified by a snowball sampling technique. The interviews were analyzed using standard qualitative methods. Most participants (81%) indicated some willingness to use the DAs. The characteristics of the DA viewed positively included it being: balanced, well organized, a useful tool, evidence-based, improves decision making process and multimedia. Some of the negative characteristics were stated as: too complex, the cost, the availability, only appropriate for certain groups of patients, and time consuming. The DAs were acceptable to most participants. Perceived positive and negative factors were similar for all DAs. Uptake of decision aids may be facilitated if physicians have an opportunity to examine and try them, and if they can have unfettered access to them for distribution purposes.

  17. Community Pharmacists' Perspectives of a Decision Aid for Managing Type 2 Diabetes in Ontario.

    Science.gov (United States)

    Verweel, Lee; Gionfriddo, Michael R; MacCallum, Lori; Dolovich, Lisa; Rosenberg-Yunger, Zahava R S

    2017-12-01

    Decision aids are tools designed to help patients make choices about their health care. We explored pharmacists' perceptions of an evidence-based diabetes decision aid developed by the Mayo Clinic, Diabetes Medication Choice (DMC). Using DMC as a reference, we aimed to explore pharmacists' perspectives on decision aids, their place in a community pharmacy setting and the implementing of a decision aid, such as DMC, in Ontario. We used semistructured interviews with a convenience sample of community pharmacists from Ontario. We applied a thematic analysis to the data. We conducted 16 interviews with pharmacists, of whom 9 were certified diabetes educators, and 10 were female. Three themes emerged from the data: pharmacists' knowledge and awareness of decision aids; pharmacists' perceptions of the DMC decision aids, and implementation of the DMC decision aids in Ontario pharmacies. Participants discussed their limited experience with and training in the use of decision aids. Although many participants agreed that the DMC decision aids may contribute to patient-centred care, all agreed that significant changes were needed to be made to implement this tool in practice. Pharmacists felt that the use of decision aids in community pharmacies in Ontario may improve patient-centred care. Modifications, however, are needed to improve the applicability to their context and fit into their workflow. Empirical data concerning the impact of decision aids in community pharmacy is needed. Copyright © 2017 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  18. ENERGY AWARE NETWORK: BAYESIAN BELIEF NETWORKS BASED DECISION MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Chaudhari

    2011-06-01

    Full Text Available A Network Management System (NMS plays a very important role in managing an ever-evolving telecommunication network. Generally an NMS monitors & maintains the health of network elements. The growing size of the network warrants extra functionalities from the NMS. An NMS provides all kinds of information about networks which can be used for other purposes apart from monitoring & maintaining networks like improving QoS & saving energy in the network. In this paper, we add another dimension to NMS services, namely, making an NMS energy aware. We propose a Decision Management System (DMS framework which uses a machine learning technique called Bayesian Belief Networks (BBN, to make the NMS energy aware. The DMS is capable of analysing and making control decisions based on network traffic. We factor in the cost of rerouting and power saving per port. Simulations are performed on standard network topologies, namely, ARPANet and IndiaNet. It is found that ~2.5-6.5% power can be saved.

  19. Separable explanations of neural network decisions

    DEFF Research Database (Denmark)

    Rieger, Laura

    2017-01-01

    Deep Taylor Decomposition is a method used to explain neural network decisions. When applying this method to non-dominant classifications, the resulting explanation does not reflect important features for the chosen classification. We propose that this is caused by the dense layers and propose...

  20. Can people find patient decision aids on the Internet?

    Science.gov (United States)

    Morris, Debra; Drake, Elizabeth; Saarimaki, Anton; Bennett, Carol; O'Connor, Annette

    2008-12-01

    To determine if people could find patient decision aids (PtDAs) on the Internet using the most popular general search engines. We chose five medical conditions for which English language PtDAs were available from at least three different developers. The search engines used were: Google (www.google.com), Yahoo! (www.yahoo.com), and MSN (www.msn.com). For each condition and search engine we ran six searches using a combination of search terms. We coded all non-sponsored Web pages that were linked from the first page of the search results. Most first page results linked to informational Web pages about the condition, only 16% linked to PtDAs. PtDAs were more readily found for the breast cancer surgery decision (our searches found seven of the nine developers). The searches using Yahoo and Google search engines were more likely to find PtDAs. The following combination of search terms: condition, treatment, decision (e.g. breast cancer surgery decision) was most successful across all search engines (29%). While some terms and search engines were more successful, few resulted in direct links to PtDAs. Finding PtDAs would be improved with use of standardized labelling, providing patients with specific Web site addresses or access to an independent PtDA clearinghouse.

  1. Decision Aids Can Support Cancer Clinical Trials Decisions: Results of a Randomized Trial.

    Science.gov (United States)

    Politi, Mary C; Kuzemchak, Marie D; Kaphingst, Kimberly A; Perkins, Hannah; Liu, Jingxia; Byrne, Margaret M

    2016-12-01

    Cancer patients often do not make informed decisions regarding clinical trial participation. This study evaluated whether a web-based decision aid (DA) could support trial decisions compared with our cancer center's website. Adults diagnosed with cancer in the past 6 months who had not previously participated in a cancer clinical trial were eligible. Participants were randomized to view the DA or our cancer center's website (enhanced usual care [UC]). Controlling for whether participants had heard of cancer clinical trials and educational attainment, multivariable linear regression examined group on knowledge, self-efficacy for finding trial information, decisional conflict (values clarity and uncertainty), intent to participate, decision readiness, and trial perceptions. Two hundred patients (86%) consented between May 2014 and April 2015. One hundred were randomized to each group. Surveys were completed by 87 in the DA group and 90 in the UC group. DA group participants reported clearer values regarding trial participation than UC group participants reported (least squares [LS] mean = 15.8 vs. 32, p trial participation among cancer patients facing this preference-sensitive choice. Although better informing patients before trial participation could improve retention, more work is needed to examine DA impact on enrollment and retention. This paper describes evidence regarding a decision tool to support patients' decisions about trial participation. By improving knowledge, helping patients clarify preferences for participation, and facilitating conversations about trials, decision aids could lead to decisions about participation that better match patients' preferences, promoting patient-centered care and the ethical conduct of clinical research. ©AlphaMed Press.

  2. Development and piloting of a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 breast cancer trial.

    Science.gov (United States)

    Juraskova, Ilona; Butow, Phyllis; Fisher, Alana; Bonner, Carissa; Anderson, Caroline; Bu, Stella; Scarlet, Jenni; Stockler, Martin R; Wetzig, Neil; Ung, Owen; Campbell, Ian

    2015-08-01

    This study aimed to (1) develop a decision aid for women considering participation in the Sentinel Node Biopsy versus Axillary Clearance 2 (SNAC-2) breast cancer surgical trial and (2) obtain evidence on its acceptability, feasibility, and potential efficacy in routine trial clinical practice via a two-stage pilot. The decision aid was developed according to International Patient Decision Aid Standards. Study 1: an initial pilot involved 25 members of the consumer advocacy group, Breast Cancer Network Australia. Study 2: the main pilot involved 20 women eligible to participate in the SNAC-2 trial in New Zealand. In both pilots, a questionnaire assessed: information and involvement preferences, decisional conflict, SNAC-2 trial-related understanding and attitudes, psychological distress, and general decision aid feedback. A follow-up telephone interview elicited more detailed feedback on the decision aid design and content. In both pilots, participants indicated good subjective and objective understanding of SNAC-2 trial and reported low decisional conflict and anxiety. The decision aid was found helpful when deciding about trial participation and provided additional, useful information to the standard trial information sheet. The development and two-stage piloting process for this decision aid resulted in a resource that women found very acceptable and helpful in assisting decision-making about SNAC-2 trial participation. The process and findings provide a guide for developing other trial decision aids. © The Author(s) 2015.

  3. HIV/AIDS, social capital, and online social networks.

    Science.gov (United States)

    Drushel, Bruce E

    2013-01-01

    The prospects for online social networks as sites of information-gathering and affiliation for persons with AIDS and others concerned about HIV/AIDS not only represent the latest development in a trend toward circumventing traditional media and official information sources, but also may offer hope for a revitalization of HIV/AIDS discourse in the public sphere. This article provides an overview of three decades of information-seeking on the pandemic and its social and personal implications, as well as case studies of three examples of social networking surrounding HIV/AIDS. It finds preliminary evidence of the formation of strong and weak ties as described in Social Network Theory and suggests that the online accumulation of social capital by opinion leaders could facilitate dissemination of messages on HIV/AIDS awareness and testing.

  4. Program Aids Simulation Of Neural Networks

    Science.gov (United States)

    Baffes, Paul T.

    1990-01-01

    Computer program NETS - Tool for Development and Evaluation of Neural Networks - provides simulation of neural-network algorithms plus software environment for development of such algorithms. Enables user to customize patterns of connections between layers of network, and provides features for saving weight values of network, providing for more precise control over learning process. Consists of translating problem into format using input/output pairs, designing network configuration for problem, and finally training network with input/output pairs until acceptable error reached. Written in C.

  5. Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions.

    Science.gov (United States)

    Ameling, Jessica M; Auguste, Priscilla; Ephraim, Patti L; Lewis-Boyer, LaPricia; DePasquale, Nicole; Greer, Raquel C; Crews, Deidra C; Powe, Neil R; Rabb, Hamid; Boulware, L Ebony

    2012-12-01

    Few educational resources have been developed to inform patients' renal replacement therapy (RRT) selection decisions. Patients progressing toward end stage renal disease (ESRD) must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients' treatment and support patients' decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in "stages." For the video, stages included (1) directed interviews with culturally appropriate patients and families and preliminary script development, (2) video production, and (3) screening the video with patients and their families. For the handbook, stages comprised (1) preliminary content design, (2) a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3) screening the handbook with patients and their families. The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals' testimonials regarding various considerations that might influence patients' and families' treatment selections. The handbook was comprised of written

  6. Development of a decision aid to inform patients’ and families’ renal replacement therapy selection decisions

    Directory of Open Access Journals (Sweden)

    Ameling Jessica M

    2012-12-01

    Full Text Available Abstract Background Few educational resources have been developed to inform patients’ renal replacement therapy (RRT selection decisions. Patients progressing toward end stage renal disease (ESRD must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients’ treatment and support patients’ decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. Methods We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in “stages.” For the video, stages included (1 directed interviews with culturally appropriate patients and families and preliminary script development, (2 video production, and (3 screening the video with patients and their families. For the handbook, stages comprised (1 preliminary content design, (2 a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3 screening the handbook with patients and their families. Results The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals’ testimonials regarding various considerations that might influence patients’ and families

  7. 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 OBJECTIVES: To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids. DESIGN: Scale development study, involving construct, item and scale development, validation and reliability testing. SETTING: 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. METHODS: Scale development study, involving construct, item and scale development, validation and reliability testing. PARTICIPANTS: 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. RESULTS: 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

  8. Information and Networks Working Paper: Aiding surveillance ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2014-12-01

    Dec 1, 2014 ... Information technology transfer is increasingly a key component of development and humanitarian aid initiatives. With social protection programs now incorporating digitized management information systems and electronic transfers, registration and electoral systems deploying biometric technologies, and ...

  9. Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations.

    NARCIS (Netherlands)

    Evans, R.; Edwards, A.; Brett, J.; Bradburn, M.; Watson, E.; Austoker, J.; Elwyn, G.

    2005-01-01

    A man's decision to have a prostate-specific antigen (PSA) test should be an informed one. We undertook a systematic review to identify and appraise PSA decision aids and evaluations. We searched 15 electronic databases and hand-searched key journals. We also contacted key authors and organisations.

  10. Data for decision making in networked health

    Directory of Open Access Journals (Sweden)

    Christian Bourret

    2006-06-01

    Full Text Available In developed countries, nowadays we live in a networked society: a society of information, knowledge and services (Castells, 1996, with strong specificities in the Health field (Bourret, 2003, Silber, 2003. The World Health Organization (WHO has outlined the importance of information for improving health for all. However, financial resources remain limited. Health costs represent 11% of GNP in France, Germany, Switzerland and Canada, 14% in the USA, and 7.5% in Spain and the United Kingdom. Governments, local powers, health or insurance organizations therefore face difficult choices in terms of opportunities and priorities, and for that they need specific and valuable data. Firstly, this paper provide a comprehensive overview of our networked society and the appointment of ICT (Information and Communication Technologies and Health (in other words e-Health in a perspective of needs and uses at the micro, meso, and macro levels. We point out the main challenges of development of Nationwide Health Information Network both in the US, UK and France. Then we analyze the main issues about data for Decision Making in Networked Health: coordination and evaluation. In the last sections, we use an Information System perspective to investigate the three interoperability layers (micro, meso and macro. We analyze the requirements and challenges to design an interoperability global architecture which supports different kinds of interactions; then we focus on the harmonization efforts provided at several levels. Finally, we identify common methodological and engineering issues.

  11. Computerized Aid Improves Safety Decision Process for Survivors of Intimate Partner Violence

    Science.gov (United States)

    Glass, Nancy; Eden, Karen B.; Bloom, Tina; Perrin, Nancy

    2010-01-01

    A computerized safety decision aid was developed and tested with Spanish or English-speaking abused women in shelters or domestic violence (DV) support groups (n = 90). The decision aid provides feedback about risk for lethal violence, options for safety, assistance with setting priorities for safety, and a safety plan personalized to the user.…

  12. arriba-lib: evaluation of an electronic library of decision aids in primary care physicians

    Directory of Open Access Journals (Sweden)

    Hirsch Oliver

    2012-06-01

    Full Text Available Abstract Background The successful implementation of decision aids in clinical practice initially depends on how clinicians perceive them. Relatively little is known about the acceptance of decision aids by physicians and factors influencing the implementation of decision aids from their point of view. Our electronic library of decision aids (arriba-lib is to be used within the encounter and has a modular structure containing evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. The aim of our study was to evaluate the acceptance of arriba-lib in primary care physicians. Methods We conducted an evaluation study in which 29 primary care physicians included 192 patients. The physician questionnaire contained information on which module was used, how extensive steps of the shared decision making process were discussed, who made the decision, and a subjective appraisal of consultation length. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Results Only a minority of consultations (8.9% was considered to be unacceptably extended. In 90.6% of consultations, physicians said that a decision could be made. A shared decision was perceived by physicians in 57.1% of consultations. Physicians said that a decision was more likely to be made when therapeutic options were discussed “detailed”. Prior experience with decision aids was not a critical variable for implementation within our sample of primary care physicians. Conclusions Our study showed that it might be feasible to apply our electronic library of decision aids (arriba-lib in the primary care context. Evidence-based decision aids offer support for physicians in the management of medical information. Future studies should monitor the long-term adoption of

  13. Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers.

    Science.gov (United States)

    Trevena, Lyndal J; Zikmund-Fisher, Brian J; Edwards, Adrian; Gaissmaier, Wolfgang; Galesic, Mirta; Han, Paul K J; King, John; Lawson, Margaret L; Linder, Suzanne K; Lipkus, Isaac; Ozanne, Elissa; Peters, Ellen; Timmermans, Danielle; Woloshin, Steven

    2013-01-01

    Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision making. This paper summarises current "best practices" in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a "state of the art" summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid "1 in x" formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. A substantial and rapidly expanding evidence base exists for risk

  14. The perspectives of Iranian physicians and patients towards patient decision aids: a qualitative study.

    Science.gov (United States)

    Rashidian, Hamideh; Nedjat, Saharnaz; Majdzadeh, Reza; Gholami, Jaleh; Haghjou, Leila; Abdollahi, Bahar Sadeghi; Davatchi, Fereydoun; Rashidian, Arash

    2013-09-25

    Patient preference is one of the main components of clinical decision making, therefore leading to the development of patient decision aids. The goal of this study was to describe physicians' and patients' viewpoints on the barriers and limitations of using patient decision aids in Iran, their proposed solutions, and, the benefits of using these tools. This qualitative study was conducted in 2011 in Iran by holding in-depth interviews with 14 physicians and 8 arthritis patient. Interviewees were selected through purposeful and maximum variation sampling. As an example, a patient decision aid on the treatment of knee arthritis was developed upon literature reviews and gathering expert opinion, and was presented at the time of interview. Thematic analysis was conducted to analyze the data by using the OpenCode software. The results were summarized into three categories and ten codes. The extracted categories were the perceived benefits of using the tools, as well as the patient-related and physician-related barriers in using decision aids. The following barriers in using patient decision aids were identified in this study: lack of patients and physicians' trainings in shared decision making, lack of specialist per capita, low treatment tariffs and lack of an exact evaluation system for patient participation in decision making. No doubt these barriers demand the health authorities' special attention. Hence, despite patients and physicians' inclination toward using patient decision aids, these problems have hindered the practical usage of these tools in Iran--as a developing country.

  15. AIDS communications through social networks: catalyst for ...

    African Journals Online (AJOL)

    Objective: To investigate distinctive communications through social networks which may be associated with population behaviour changes and HIV prevalence declines in Uganda compared to other countries. Methods: We undertook a comparative analysis of demographic and HIV behavioural data collected in ...

  16. Computer aided decision support system for cervical cancer classification

    Science.gov (United States)

    Rahmadwati, Rahmadwati; Naghdy, Golshah; Ros, Montserrat; Todd, Catherine

    2012-10-01

    Conventional analysis of a cervical histology image, such a pap smear or a biopsy sample, is performed by an expert pathologist manually. This involves inspecting the sample for cellular level abnormalities and determining the spread of the abnormalities. Cancer is graded based on the spread of the abnormal cells. This is a tedious, subjective and time-consuming process with considerable variations in diagnosis between the experts. This paper presents a computer aided decision support system (CADSS) tool to help the pathologists in their examination of the cervical cancer biopsies. The main aim of the proposed CADSS system is to identify abnormalities and quantify cancer grading in a systematic and repeatable manner. The paper proposes three different methods which presents and compares the results using 475 images of cervical biopsies which include normal, three stages of pre cancer, and malignant cases. This paper will explore various components of an effective CADSS; image acquisition, pre-processing, segmentation, feature extraction, classification, grading and disease identification. Cervical histological images are captured using a digital microscope. The images are captured in sufficient resolution to retain enough information for effective classification. Histology images of cervical biopsies consist of three major sections; background, stroma and squamous epithelium. Most diagnostic information are contained within the epithelium region. This paper will present two levels of segmentations; global (macro) and local (micro). At the global level the squamous epithelium is separated from the background and stroma. At the local or cellular level, the nuclei and cytoplasm are segmented for further analysis. Image features that influence the pathologists' decision during the analysis and classification of a cervical biopsy are the nuclei's shape and spread; the ratio of the areas of nuclei and cytoplasm as well as the texture and spread of the abnormalities

  17. A generic tool for development of decision aids based on clinical practice guidelines.

    NARCIS (Netherlands)

    Raats, C.J.; Veenendaal, H van; Versluijs, M.M.; Burgers, J.S.

    2008-01-01

    OBJECTIVE: Patient involvement in medical decision making has been suggested to contribute to patients' satisfaction and better patient outcomes. Decision aids are particularly useful for preference-sensitive decisions. Ideally, these should be based on up-to-date evidence-based guidelines. The

  18. Distributed training, testing, and decision aids within one solution

    Science.gov (United States)

    Strini, Robert A.; Strini, Keith

    2002-07-01

    Military air operations in the European theater require U.S. and NATO participants to send various mission experts to 10 Combined Air Operations Centers (CAOCs). Little or no training occurs prior to their arrival for tours of duty ranging between 90 days to 3 years. When training does occur, there is little assessment of its effectiveness in raising CAOC mission readiness. A comprehensive training management system has been developed that utilizes traditional and web based distance-learning methods for providing instruction and task practice as well as distributed simulation to provide mission rehearsal training opportunities on demand for the C2 warrior. This system incorporates new technologies, such as voice interaction and virtual tutors, and a Learning Management System (LMS) that tracks trainee progress from academic learning through procedural practice and mission training exercises. Supervisors can monitor their subordinate's progress through synchronous or asynchronous methods. Embedded within this system are virtual tutors, which provide automated performance measurement as well as tutoring. The training system offers a true time management savings for current instructors and training providers that today must perform On the Job Training (OJT) duties before, during and after each event. Many units do not have the resources to support OJT and are forced to maintain an overlap of several days to minimally maintain unit readiness. One CAOC Commander affected by this paradigm has advocated supporting a beta version of this system to test its ability to offer training on-demand and track the progress of its personnel and unit readiness. If successful, aircrew simulation devices can be connected through either Distributed Interactive Simulation or High Level Architecture methods to provide a DMT-C2 air operations training environment in Europe. This paper presents an approach to establishing a training, testing and decision aid capability and means to assess

  19. The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse

    DEFF Research Database (Denmark)

    Hulbæk, Mette; Primdahl, Jette; Nielsen, Jesper Bo

    The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse.......The Development of a Decision Aid with a Multi Criterial Analytic Approach for Women with Pelvic Organ Prolapse....

  20. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas.

    Science.gov (United States)

    Hoffman, Aubri S; Volk, Robert J; Saarimaki, Anton; Stirling, Christine; Li, Linda C; Härter, Martin; Kamath, Geetanjali R; Llewellyn-Thomas, Hilary

    2013-01-01

    In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension-the delivery of patient decision aids on the Internet-is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. As of 2012, the updated theoretical rationale and emerging evidence suggest potential benefits to delivering patient decision aids on the Internet. However, additional research is needed to identify best practices and quality metrics for Internet-based development, evaluation, and dissemination, particularly in the areas of interactivity, multimedia components, socially-generated information, and implementation strategies.

  1. Can patient decision aids help people make good decisions about participating in clinical trials? A study protocol

    Directory of Open Access Journals (Sweden)

    Fergusson Dean A

    2008-07-01

    Full Text Available Abstract Background Evidence shows that the standard process for obtaining informed consent in clinical trials can be inadequate, with study participants frequently not understanding even basic information fundamental to giving informed consent. Patient decision aids are effective decision support tools originally designed to help patients make difficult treatment or screening decisions. We propose that incorporating decision aids into the informed consent process will improve the extent to which participants make decisions that are informed and consistent with their preferences. A mixed methods study will test this proposal. Methods Phase one of this project will involve assessment of a stratified random sample of 50 consent documents from recently completed investigator-initiated clinical trials, according to existing standards for supporting good decision making. Phase two will involve interviews of a purposive sample of 50 trial participants (10 participants from each of five different clinical areas about their experience of the informed consent process, and how it could be improved. In phase three, we will convert consent forms for two completed clinical trials into decision aids and pilot test these new tools using a user-centered design approach, an iterative development process commonly employed in computer usability literature. In phase four, we will conduct a pilot observational study comparing the new tools to standard consent forms, with potential recruits to two hypothetical clinical trials. Outcomes will include knowledge of key aspects of the decision, knowledge of the probabilities of different outcomes, decisional conflict, the hypothetical participation decision, and qualitative impressions of the experience. Discussion This work will provide initial evidence about whether a patient decision aid can improve the informed consent process. The larger goal of this work is to examine whether study recruitment can be improved from

  2. Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid.

    Science.gov (United States)

    Joseph-Williams, Natalie; Evans, Rhodri; Edwards, Adrian; Newcombe, Robert G; Wright, Patricia; Grol, Richard; Elwyn, Glyn

    2010-05-26

    Web-based decision aids are known to have an effect on knowledge, attitude, and behavior; important components of informed decision making. We know what decision aids achieve in randomized controlled trials (RCTs), but we still know very little about how they are used and how this relates to the informed decision making outcome measures. To examine men's use of an online decision aid for prostate cancer screening using website transaction log files (web-logs), and to examine associations between usage and components of informed decision making. We conducted an observational web-log analysis of users of an online decision aid, Prosdex. Men between 50 and 75 years of age were recruited for an associated RCT from 26 general practices across South Wales, United Kingdom. Men allocated to one arm of the RCT were included in the current study. Time and usage data were derived from website log files. Components of informed decision making were measured by an online questionnaire. Available for analysis were 82 web-logs. Overall, there was large variation in the use of Prosdex. The mean total time spent on the site was 20 minutes. The mean number of pages accessed was 32 (SD 21) out of a possible 60 pages. Significant associations were found between increased usage and increased knowledge (Spearman rank correlation [rho] = 0.69, P limitation in mind. We recommend that web-log analysis should be an integral part of online decision aid development and analysis. ISRCTN48473735; http://www.controlled-trials.com/ISRCTN48473735 (Archived by WebCite at http://www.webcitation.org/5pqeF89tS).

  3. The impact of social networks on parents' vaccination decisions.

    Science.gov (United States)

    Brunson, Emily K

    2013-05-01

    Parents decide whether their children are vaccinated, but they rarely reach these decisions on their own. Instead parents are influenced by their social networks, broadly defined as the people and sources they go to for information, direction, and advice. This study used social network analysis to formally examine parents' social networks (people networks and source networks) related to their vaccination decision-making. In addition to providing descriptions of typical networks of parents who conform to the recommended vaccination schedule (conformers) and those who do not (nonconformers), this study also quantified the effect of network variables on parents' vaccination choices. This study took place in King County, Washington. Participation was limited to US-born, first-time parents with children aged ≤18 months. Data were collected via an online survey. Logistic regression was used to analyze the resulting data. One hundred twenty-six conformers and 70 nonconformers completed the survey. Although people networks were reported by 95% of parents in both groups, nonconformers were significantly more likely to report source networks (100% vs 80%, P network characteristics indicated that people network variables were better predictors of parents' vaccination choices than parents' own characteristics or the characteristics of their source networks. In fact, the variable most predictive of parents' vaccination decisions was the percent of parents' people networks recommending nonconformity. These results strongly suggest that social networks, and particularly parents' people networks, play an important role in parents' vaccination decision-making.

  4. A Generic Approach to the Development of Tactical Decision Aids

    NARCIS (Netherlands)

    Neef, R.M.; Brake, G. te

    2005-01-01

    Military tactics require efficient and effective decision making in unclear, complex and dynamic environments. Tactical decision-makers need to make the right choices based on large amounts of data from various sources with varying reliability and often under severe time-pressure. Therefore decision

  5. Sediment Analysis Network for Decision Support (SANDS)

    Science.gov (United States)

    Hardin, D. M.; Keiser, K.; Graves, S. J.; Conover, H.; Ebersole, S.

    2009-12-01

    Since the year 2000, Eastern Louisiana, coastal Mississippi, Alabama, and the western Florida panhandle have been affected by 28 tropical storms, seven of which were hurricanes. These tropical cyclones have significantly altered normal coastal processes and characteristics in the Gulf region through sediment disturbance. Although tides, seasonality, and agricultural development influence suspended sediment and sediment deposition over periods of time, tropical storm activity has the capability of moving the largest sediment loads in the shortest periods of time for coastal areas. The importance of sediments upon water quality, coastal erosion, habitats and nutrients has made their study and monitoring vital to decision makers in the region. Currently agencies such as United States Army Corps of Engineers (USACE), NASA, and Geological Survey of Alabama (GSA) are employing a variety of in-situ and airborne based measurements to assess and monitor sediment loading and deposition. These methods provide highly accurate information but are limited in geographic range, are not continuous over a region and, in the case of airborne LIDAR are expensive and do not recur on a regular basis. Multi-temporal and multi-spectral satellite imagery that shows tropical-storm-induced suspended sediment and storm-surge sediment deposits can provide decision makers with immediate and long-term information about the impacts of tropical storms and hurricanes. It can also be valuable for those conducting research and for projects related to coastal issues such as recovery, planning, management, and mitigation. The recently awarded Sediment Analysis Network for Decision Support will generate decision support products using NASA satellite observations from MODIS, Landsat and SeaWiFS instruments to support resource management, planning, and decision making activities in the Gulf of Mexico. Specifically, SANDS will generate decision support products that address the impacts of tropical storms

  6. Decision support aids with anthropomorphic characteristics influence trust and performance in younger and older adults.

    Science.gov (United States)

    Pak, Richard; Fink, Nicole; Price, Margaux; Bass, Brock; Sturre, Lindsay

    2012-01-01

    This study examined the use of deliberately anthropomorphic automation on younger and older adults' trust, dependence and performance on a diabetes decision-making task. Research with anthropomorphic interface agents has shown mixed effects in judgments of preferences but has rarely examined effects on performance. Meanwhile, research in automation has shown some forms of anthropomorphism (e.g. etiquette) have effects on trust and dependence on automation. Participants answered diabetes questions with no-aid, a non-anthropomorphic aid or an anthropomorphised aid. Trust and dependence in the aid was measured. A minimally anthropomorphic aide primarily affected younger adults' trust in the aid. Dependence, however, for both age groups was influenced by the anthropomorphic aid. Automation that deliberately embodies person-like characteristics can influence trust and dependence on reasonably reliable automation. However, further research is necessary to better understand the specific aspects of the aid that affect different age groups. Automation that embodies human-like characteristics may be useful in situations where there is under-utilisation of reasonably reliable aids by enhancing trust and dependence in that aid. Practitioner Summary: The design of decision-support aids on consumer devices (e.g. smartphones) may influence the level of trust that users place in that system and their amount of use. This study is the first step in articulating how the design of aids may influence user's trust and use of such systems.

  7. Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers

    Science.gov (United States)

    2013-01-01

    Background Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients’ risk perception and leads to better informed decision making. This paper summarises current “best practices” in communication of evidence-based numeric outcomes for developers of patient decision aids (PtDAs) and other health communication tools. Method An expert consensus group of fourteen researchers from North America, Europe, and Australasia identified eleven main issues in risk communication. Two experts for each issue wrote a “state of the art” summary of best evidence, drawing on the PtDA, health, psychological, and broader scientific literature. In addition, commonly used terms were defined and a set of guiding principles and key messages derived from the results. Results The eleven key components of risk communication were: 1) Presenting the chance an event will occur; 2) Presenting changes in numeric outcomes; 3) Outcome estimates for test and screening decisions; 4) Numeric estimates in context and with evaluative labels; 5) Conveying uncertainty; 6) Visual formats; 7) Tailoring estimates; 8) Formats for understanding outcomes over time; 9) Narrative methods for conveying the chance of an event; 10) Important skills for understanding numerical estimates; and 11) Interactive web-based formats. Guiding principles from the evidence summaries advise that risk communication formats should reflect the task required of the user, should always define a relevant reference class (i.e., denominator) over time, should aim to use a consistent format throughout documents, should avoid “1 in x” formats and variable denominators, consider the magnitude of numbers used and the possibility of format bias, and should take into account the numeracy and graph literacy of the audience. Conclusion A substantial and

  8. Patient decision aids in routine maternity care: Benefits, barriers, and new opportunities.

    Science.gov (United States)

    Stevens, Gabrielle; Thompson, Rachel; Watson, Bernadette; Miller, Yvette D

    2016-02-01

    Participation in decision-making, supported by comprehensive and quality information provision, is increasingly emphasised as a priority for women in maternity care. Patient decision aids are tools that can offer women greater access to information and guidance to participate in maternity care decision-making. Relative to their evaluation in controlled settings, the implementation of patient decision aids in routine maternity care has received little attention and our understanding of which approaches may be effective is limited. This paper critically discusses the application of patient decision aids in routine maternity care and explores viable solutions for promoting their successful uptake. A range of patient decision aids have been developed for use within maternity care, and controlled trials have highlighted their positive impact on the decision-making process for women. Nevertheless, evidence of successful patient decision aid implementation in real world health care settings is lacking due to practical and ideological barriers that exist. Patient-directed social marketing campaigns are a relatively novel approach to patient decision aid delivery that may facilitate their adoption in maternity care, at least in the short-term, by overcoming common implementation barriers. Social marketing may also be particularly well suited to maternity care, given the unique characteristics of this health context. The potential of social marketing campaigns to facilitate patient decision aid adoption in maternity care highlights the need for pragmatic trials to evaluate their effectiveness. Identifying which sub-groups of women are more or less likely to respond to these strategies will further direct implementation. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  9. A Framework For Design Of Operator Planning/Decision Aids: Expert Systems Approach

    Science.gov (United States)

    Yufik, Yan M.; Sheridan, Thomas B.

    1984-06-01

    This paper suggests an approach to modeling reactor control planning and decision-making which serves as a framework for the design of computer based decision aids. The suggested approach combines two distinct theoretical concepts. The first uses a probabilistic graph to characterize the operator's "internal model" of the system behavior; the second invokes the idea of implicit utility maximization as a generic computational heuristic operating on the graph. The model is used to derive some basic design principles of decision aids that might complement operator decision processes in planning control operations.

  10. Effectiveness of decision aids on smoking cessation in adult patients: a systematic review protocol.

    Science.gov (United States)

    Moyo, Fernea; Archibald, Ella; Slyer, Jason T

    2017-12-01

    The objective of this review is to determine the effectiveness of the use of decision aids in a shared decision-making encounter between any healthcare provider and adult patients who smoke, compared to standard education on smoking cessation, in any healthcare setting.Specifically, the review questions are: What is the effectiveness of the use of decision aids in a shared decision-making encounter in any healthcare setting between the healthcare provider and adult patients who smoke compared to standard education, based on the patient's.

  11. An architecture for integrating distributed and cooperating knowledge-based Air Force decision aids

    Science.gov (United States)

    Nugent, Richard O.; Tucker, Richard W.

    1988-01-01

    MITRE has been developing a Knowledge-Based Battle Management Testbed for evaluating the viability of integrating independently-developed knowledge-based decision aids in the Air Force tactical domain. The primary goal for the testbed architecture is to permit a new system to be added to a testbed with little change to the system's software. Each system that connects to the testbed network declares that it can provide a number of services to other systems. When a system wants to use another system's service, it does not address the server system by name, but instead transmits a request to the testbed network asking for a particular service to be performed. A key component of the testbed architecture is a common database which uses a relational database management system (RDBMS). The RDBMS provides a database update notification service to requesting systems. Normally, each system is expected to monitor data relations of interest to it. Alternatively, a system may broadcast an announcement message to inform other systems that an event of potential interest has occurred. Current research is aimed at dealing with issues resulting from integration efforts, such as dealing with potential mismatches of each system's assumptions about the common database, decentralizing network control, and coordinating multiple agents.

  12. Aid to Families with Dependent Children Quality Control Review Panel Decisions

    Data.gov (United States)

    U.S. Department of Health & Human Services — Decisions issued by the Aid to Families with Dependent Children (AFDC) Quality Control Review Panel of the Departmental Appeals Board concerning the AFDC program...

  13. Evaluation of Tactical Decision Aid Programs for Prediction of Field Performance of IR Sensors

    National Research Council Canada - National Science Library

    Goksin, Celalettin

    2000-01-01

    .... Army's ACQUIRE and the infrared module of the Navy/Air Force Tactical Decision Aid (TDA), WinEOTDA. Differences in the modeling of underlying physical principles, input parameters, and treatments are analyzed...

  14. CLIPS based decision support system for water distribution networks

    Directory of Open Access Journals (Sweden)

    K. Sandeep

    2011-10-01

    Full Text Available The difficulty in knowledge representation of a water distribution network (WDN problem has contributed to the limited use of artificial intelligence (AI based expert systems (ES in the management of these networks. This paper presents a design of a Decision Support System (DSS that facilitates "on-demand'' knowledge generation by utilizing results of simulation runs of a suitably calibrated and validated hydraulic model of an existing aged WDN corresponding to emergent or even hypothetical but likely scenarios. The DSS augments the capability of a conventional expert system by integrating together the hydraulic modelling features with heuristics based knowledge of experts under a common, rules based, expert shell named CLIPS (C Language Integrated Production System. In contrast to previous ES, the knowledge base of the DSS has been designed to be dynamic by superimposing CLIPS on Structured Query Language (SQL. The proposed ES has an inbuilt calibration module that enables calibration of an existing (aged WDN for the unknown, and unobservable, Hazen-Williams C-values. In addition, the daily run and simulation modules of the proposed ES further enable the CLIPS inference engine to evaluate the network performance for any emergent or suggested test scenarios. An additional feature of the proposed design is that the DSS integrates computational platforms such as MATLAB, open source Geographical Information System (GIS, and a relational database management system (RDBMS working under the umbrella of the Microsoft Visual Studio based common user interface. The paper also discusses implementation of the proposed framework on a case study and clearly demonstrates the utility of the application as an able aide for effective management of the study network.

  15. Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses.

    Science.gov (United States)

    Syrowatka, Ania; Krömker, Dörthe; Meguerditchian, Ari N; Tamblyn, Robyn

    2016-01-26

    Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however, some features performed better than

  16. Use of a patient decision aid for prenatal screening for Down syndrome: what do pregnant women say?

    NARCIS (Netherlands)

    Portocarrero, M.E.; Giguere, A.M.; Lepine, J.; Garvelink, M.M.; Robitaille, H.; Delanoe, A.; Levesque, I.; Wilson, B.J.; Rousseau, F.; Legare, F.

    2017-01-01

    BACKGROUND: Patient decision aids (PtDAs) help people make difficult, values-sensitive decisions. Prenatal screening for assessing the risk of genetic conditions in the fetus is one such decision and patient decision aids are rarely used in this clinical context. We sought to identify factors

  17. Personalised Multi-Criterial Online Decision Support for Siblings Considering Stem Cell Donation: An Interactive Aid.

    Science.gov (United States)

    Kaltoft, Mette Kjer; Salkeld, Glenn; Dowie, Jack

    2016-01-01

    Person-centred decision support combines the best available information on the considerations that matter to the individual, with the importance the person attaches to those considerations. Nurses and other health professionals can benefit from being able to draw on this support within a clinical conversation. A case study and storyline on four siblings facing a transplant coordinator's call to donate stem cells to their brother [1] is 'translated' and used to demonstrate how an interactive multi-criteria aid can be developed for each within a conversational mode. The personalized dialogue and decision aid are accessible online for interaction. Each sibling's decision exemplifies the communication including physical and psychosocial complexities within any decision cascade from call-to-test and to donate, if compatible. A shared template can embrace the informational and ethical aspects of a decision. By interactive decision support within a clinical conversation, each stakeholder can gain a personalised opinion, as well as increased generic health decision literacy [2].

  18. How does a German audience appraise an American decision aid on early stage breast cancer?

    Science.gov (United States)

    Albrecht, Karoline; Simon, Daniela; Buchholz, Angela; Reuter, Katrin; Frosch, Dominick; Seebauer, Laura; Härter, Martin

    2011-04-01

    To investigate how a German audience appraises an American video-based decision aid on early stage breast cancer for potential use in Germany. A German synchronized voice-over version was produced and subject to different focus groups with patients (n=9), health care providers (n=7) and German health care experts (n=15) using an individual questionnaire-based evaluation and a moderated group discussion. Research questions included a general appraisal of the decision aid and the exploration of adaptation needs for use in Germany. Descriptive statistics were calculated and the qualitative data were analyzed applying an inductive approach to categorize the statements. The general appraisal of the decision aid revealed positive results in all groups, especially with regard to comprehensible presentation of information and integration of patients' testimonials. However, cultural differences between the American decision aid and Germany were debated in all groups. Despite a high general interest and positive appraisal of the decision aid, the results of this study suggest that it cannot just be translated and used in another country. The decision aid needs further cultural adaptation and testing in an implementation study before it can be transferred to Germany. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Commander's Decision Aid for Predictive Battlespace Awareness (CDA4PBA)

    National Research Council Canada - National Science Library

    Calhoun, Christopher S; Fitzhugh, Elisabeth W; Klinger, David W

    2006-01-01

    ...), was to develop and demonstrate human-centered decision-making technologies to improve processes, performance, tools, and training to support a commander's predictive battlespace awareness ability...

  20. Enhanced Handover Decision Algorithm in Heterogeneous Wireless Network.

    Science.gov (United States)

    Abdullah, Radhwan Mohamed; Zukarnain, Zuriati Ahmad

    2017-07-14

    Transferring a huge amount of data between different network locations over the network links depends on the network's traffic capacity and data rate. Traditionally, a mobile device may be moved to achieve the operations of vertical handover, considering only one criterion, that is the Received Signal Strength (RSS). The use of a single criterion may cause service interruption, an unbalanced network load and an inefficient vertical handover. In this paper, we propose an enhanced vertical handover decision algorithm based on multiple criteria in the heterogeneous wireless network. The algorithm consists of three technology interfaces: Long-Term Evolution (LTE), Worldwide interoperability for Microwave Access (WiMAX) and Wireless Local Area Network (WLAN). It also employs three types of vertical handover decision algorithms: equal priority, mobile priority and network priority. The simulation results illustrate that the three types of decision algorithms outperform the traditional network decision algorithm in terms of handover number probability and the handover failure probability. In addition, it is noticed that the network priority handover decision algorithm produces better results compared to the equal priority and the mobile priority handover decision algorithm. Finally, the simulation results are validated by the analytical model.

  1. Do choosing wisely tools meet criteria for patient decision aids? A descriptive analysis of patient materials.

    Science.gov (United States)

    Légaré, France; Hébert, Jessica; Goh, Larissa; Lewis, Krystina B; Leiva Portocarrero, Maria Ester; Robitaille, Hubert; Stacey, Dawn

    2016-08-26

    Choosing Wisely is a remarkable physician-led campaign to reduce unnecessary or harmful health services. Some of the literature identifies Choosing Wisely as a shared decision-making approach. We evaluated the patient materials developed by Choosing Wisely Canada to determine whether they meet the criteria for shared decision-making tools known as patient decision aids. Descriptive analysis of all Choosing Wisely Canada patient materials. In May 2015, we selected all Choosing Wisely Canada patient materials from its official website. Four team members independently extracted characteristics of the English materials using the International Patient Decision Aid Standards (IPDAS) modified 16-item minimum criteria for qualifying and certifying patient decision aids. The research team discussed discrepancies between data extractors and reached a consensus. Descriptive analysis was conducted. Of the 24 patient materials assessed, 12 were about treatments, 11 were about screening and 1 was about prevention. The median score for patient materials using IPDAS criteria was 10/16 (range: 8-11) for screening topics and 6/12 (range: 6-9) for prevention and treatment topics. Commonly missed criteria were stating the decision (21/24 did not), providing balanced information on option benefits/harms (24/24 did not), citing evidence (24/24 did not) and updating policy (24/24 did not). Out of 24 patient materials, only 2 met the 6 IPDAS criteria to qualify as patient decision aids, and neither of these 2 met the 6 certifying criteria. Patient materials developed by Choosing Wisely Canada do not meet the IPDAS minimal qualifying or certifying criteria for patient decision aids. Modifications to the Choosing Wisely Canada patient materials would help to ensure that they qualify as patient decision aids and thus as more effective shared decision-making tools. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  2. Decision aids for respite service choices by carers of people with dementia: development and pilot RCT

    Science.gov (United States)

    2012-01-01

    Background Decision aids are often used to assist individuals confronted with a diagnosis of a serious illness to make decisions about treatment options. However, they are rarely utilised to help those with chronic or age related conditions to make decisions about care services. Decision aids should also be useful for carers of people with decreased decisional capacity. These carers' choices must balance health outcomes for themselves and for salient others with relational and value-based concerns, while relying on information from health professionals. This paper reports on a study that both developed and pilot tested a decision aid aimed at assisting carers to make evaluative judgements of community services, particularly respite care. Methods A mixed method sequential study, involving qualitative development and a pilot randomised controlled trial, was conducted in Tasmania, Australia. We undertook 13 semi-structured interviews and three focus groups to inform the development of the decision aid. For the randomised control trial we randomly assigned 31 carers of people with dementia to either receive the service decision aid at the start or end of the study. The primary outcome was measured by comparing the difference in carer burden between the two groups three months after the intervention group received the decision aid. Pilot data was collected from carers using interviewer-administered questionnaires at the commencement of the project, two weeks and 12 weeks later. Results The qualitative data strongly suggest that the intervention provides carers with needed decision support. Most carers felt that the decision aid was useful. The trial data demonstrated that, using the mean change between baseline and three month follow-up, the intervention group had less increase in burden, a decrease in decisional conflict and increased knowledge compared to control group participants. Conclusions While these results must be interpreted with caution due to the small

  3. Decision aids for respite service choices by carers of people with dementia: development and pilot RCT

    Directory of Open Access Journals (Sweden)

    Stirling Christine

    2012-03-01

    Full Text Available Abstract Background Decision aids are often used to assist individuals confronted with a diagnosis of a serious illness to make decisions about treatment options. However, they are rarely utilised to help those with chronic or age related conditions to make decisions about care services. Decision aids should also be useful for carers of people with decreased decisional capacity. These carers' choices must balance health outcomes for themselves and for salient others with relational and value-based concerns, while relying on information from health professionals. This paper reports on a study that both developed and pilot tested a decision aid aimed at assisting carers to make evaluative judgements of community services, particularly respite care. Methods A mixed method sequential study, involving qualitative development and a pilot randomised controlled trial, was conducted in Tasmania, Australia. We undertook 13 semi-structured interviews and three focus groups to inform the development of the decision aid. For the randomised control trial we randomly assigned 31 carers of people with dementia to either receive the service decision aid at the start or end of the study. The primary outcome was measured by comparing the difference in carer burden between the two groups three months after the intervention group received the decision aid. Pilot data was collected from carers using interviewer-administered questionnaires at the commencement of the project, two weeks and 12 weeks later. Results The qualitative data strongly suggest that the intervention provides carers with needed decision support. Most carers felt that the decision aid was useful. The trial data demonstrated that, using the mean change between baseline and three month follow-up, the intervention group had less increase in burden, a decrease in decisional conflict and increased knowledge compared to control group participants. Conclusions While these results must be interpreted with

  4. Development of a patient decision aid for the treatment of localised prostate cancer: a participatory design approach.

    Science.gov (United States)

    Al-Itejawi, Hoda H M; van Uden-Kraan, Cornelia F; Vis, André N; Nieuwenhuijzen, Jakko A; Hofstee, Myrna J A; van Moorselaar, Reindert Jeroen A; Verdonck-de Leeuw, Irma M

    2016-04-01

    To develop a patient decision aid and to prepare an overview of requirements for implementation. We developed a decision aid that fits the preferences of patients and health care professionals to ensure adequate uptake in clinical practice. A participatory design approach was used to acquire insight into preferences regarding the content and design of a decision aid and into barriers and aspects of the decision aid that facilitate implementation in clinical practice. Three focus group interviews with patients, their partners and health care professionals were conducted. A prototype of the decision aid was developed and presented to patients (n = 14) and health care professionals (n = 13) in semi-structured interviews. Patients (n = 5) participated in a usability study. Data were analysed by two independent coders. Health care professionals considered medical information on treatments and side effects as the most important aspect to be included in the decision aid. Patients also focused on nonmedical considerations, such as location. Both expected the decision aid to support patients in making a treatment choice. According to health care professionals, the oncology nurse was the most suitable to discuss the decision aid with patients, while some patients preferred to discuss the patient decision aid with the urologist. The main barrier to implementation of the decision aid was said to be the expectation that it is time and money consuming, while the incorporation of the decision aid into clinical guidelines and basing the content on these guidelines, would promote implementation. By using a participatory design approach a patient decision aid was designed to meet patients' and health care professionals' needs. Insight was also gained on requirements for implementation. Wide-scale implementation of decision aids is desirable. An overview is provided of requirements for implementation to successfully incorporate a decision aid into clinical practice. © 2016 John

  5. A Model of Submarine Emergency Decisionmaking and Decision Aiding

    Science.gov (United States)

    1986-10-01

    even in the absence of psychological effects. In particular, the question may be addressed: with how high an error rate may the aid operate and still...Rationality," Ajiiigm 0 Vl1, No.6, pp. 703-709. [9] Levis, A.H. arid K.L. Boettcher (1983j). "Decisionmaking Organizacions with Acyclical Informafion

  6. How does AIDS illness affect women's residential decisions ...

    African Journals Online (AJOL)

    Women attempt to balance their children's nurturing, in the short and long term, with care of the self. Their efforts do not always succeed and can incur high costs to their wellbeing and relationships with their children. Keywords: care, HIV/AIDS, households, kinship, motherhood, moving house, poverty, social anthropology, ...

  7. Understanding Decision Making through Complexity in Professional Networks

    Directory of Open Access Journals (Sweden)

    Kon Shing Kenneth Chung

    2014-01-01

    Full Text Available The attitudes of general practitioners (GP play an influential role in their decision making about patient treatment and care. Considering the GP-patient encounter as a complex system, the interactions between the GP and their personal network of peers give rise to “aggregate complexity,” which in turn influences the GP’s decisions about patient treatment. This study models aggregate complexity and its influence in decision making in primary care through the use of social network metrics. Professional network and attitudinal data on decision making responsibility from 107 rural GPs were analysed. Social network measures of “density” and “inclusiveness” were used for computing the “interrelatedness” of components within such a “complex system.” The “number of components” and “degree of interrelatedness” were used to determine the complexity profiles, which was then used to associate with responsibility in decision making for each GP. GPs in simple profiles (i.e., with low components and interactions in contrast to those in nonsimple profiles, indicate a higher responsibility for the decisions they make in medical care. This study suggests that social networks-based complexity profiles are useful for understanding decision making in primary care as it accounts for the role of influence through the professional networks of GPs.

  8. AID/APOBEC-network reconstruction identifies pathways associated with survival in ovarian cancer.

    Science.gov (United States)

    Svoboda, Martin; Meshcheryakova, Anastasia; Heinze, Georg; Jaritz, Markus; Pils, Dietmar; Castillo-Tong, Dan Cacsire; Hager, Gudrun; Thalhammer, Theresia; Jensen-Jarolim, Erika; Birner, Peter; Braicu, Ioana; Sehouli, Jalid; Lambrechts, Sandrina; Vergote, Ignace; Mahner, Sven; Zimmermann, Philip; Zeillinger, Robert; Mechtcheriakova, Diana

    2016-08-16

    Building up of pathway-/disease-relevant signatures provides a persuasive tool for understanding the functional relevance of gene alterations and gene network associations in multifactorial human diseases. Ovarian cancer is a highly complex heterogeneous malignancy in respect of tumor anatomy, tumor microenvironment including pro-/antitumor immunity and inflammation; still, it is generally treated as single disease. Thus, further approaches to investigate novel aspects of ovarian cancer pathogenesis aiming to provide a personalized strategy to clinical decision making are of high priority. Herein we assessed the contribution of the AID/APOBEC family and their associated genes given the remarkable ability of AID and APOBECs to edit DNA/RNA, and as such, providing tools for genetic and epigenetic alterations potentially leading to reprogramming of tumor cells, stroma and immune cells. We structured the study by three consecutive analytical modules, which include the multigene-based expression profiling in a cohort of patients with primary serous ovarian cancer using a self-created AID/APOBEC-associated gene signature, building up of multivariable survival models with high predictive accuracy and nomination of top-ranked candidate/target genes according to their prognostic impact, and systems biology-based reconstruction of the AID/APOBEC-driven disease-relevant mechanisms using transcriptomics data from ovarian cancer samples. We demonstrated that inclusion of the AID/APOBEC signature-based variables significantly improves the clinicopathological variables-based survival prognostication allowing significant patient stratification. Furthermore, several of the profiling-derived variables such as ID3, PTPRC/CD45, AID, APOBEC3G, and ID2 exceed the prognostic impact of some clinicopathological variables. We next extended the signature-/modeling-based knowledge by extracting top genes co-regulated with target molecules in ovarian cancer tissues and dissected potential

  9. A quantitative method for evaluating alternatives. [aid to decision making

    Science.gov (United States)

    Forthofer, M. J.

    1981-01-01

    When faced with choosing between alternatives, people tend to use a number of criteria (often subjective, rather than objective) to decide which is the best alternative for them given their unique situation. The subjectivity inherent in the decision-making process can be reduced by the definition and use of a quantitative method for evaluating alternatives. This type of method can help decision makers achieve degree of uniformity and completeness in the evaluation process, as well as an increased sensitivity to the factors involved. Additional side-effects are better documentation and visibility of the rationale behind the resulting decisions. General guidelines for defining a quantitative method are presented and a particular method (called 'hierarchical weighted average') is defined and applied to the evaluation of design alternatives for a hypothetical computer system capability.

  10. Improving decision making about clinical trial participation - a randomised controlled trial of a decision aid for women considering participation in the IBIS-II breast cancer prevention trial

    National Research Council Canada - National Science Library

    Juraskova, I; Butow, P; Bonner, C; Bell, M L; Smith, A B; Seccombe, M; Boyle, F; Reaby, L; Cuzick, J; Forbes, J F

    2014-01-01

    .... This study investigated whether decision aids (DAs) can reduce decisional difficulties among women considering participation in the International Breast Cancer Intervention Study-II (IBIS-II) trial...

  11. Enhanced Situational Awareness and Decision Support for Operators of Future Distributed Power Network Architectures

    DEFF Research Database (Denmark)

    Zaher, Ammar S. A. E.; Catterson, V. M.; Syed, M. H.

    2016-01-01

    . The control room visualisation and decision support functionality for aiding the operator in restoring the frequency to its target value will be considered. The analysis takes place within the Web-ofCells framework, adopted to deal with power system control through a web of subsystems, called cells, which......This paper describes scenarios proposed for a control room decision support system aimed at future power network operators. The purpose is to consider the requirements of the future control room from the perspective of the operator under the conditions of a significant frequency excursion incident...

  12. AN INTELLIGENT VERTICAL HANDOVER DECISION ALGORITHM FOR WIRELESS HETEROGENEOUS NETWORKS

    OpenAIRE

    V. Anantha Narayanan; Rajeswari, A; Sureshkumar, V.

    2014-01-01

    The Next Generation Wireless Networks (NGWN) should be compatible with other communication technologies to offer the best connectivity to the mobile terminal which can access any IP based services at any time from any network without the knowledge of its user. It requires an intelligent vertical handover decision making algorithm to migrate between technologies that enable seamless mobility, always best connection and minimal terminal power consumption. Currently existing decision engines are...

  13. Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas

    Science.gov (United States)

    2013-01-01

    Background In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension—the delivery of patient decision aids on the Internet—is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. Methods An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. Results The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and implementation theories support Internet-delivery for providing the right information (rapidly updated), to the right person (tailored), at the right time (the appropriate point in the decision making process). Additional efforts are needed to integrate the theoretical rationale and empirical evidence from health technology perspectives, such as consumer health informatics, user experience design, and human-computer interaction. Despite Internet usage ranging from 74% to 85% in developed countries and 80% of users searching for health information, it is unknown how many individuals specifically seek patient decision aids on the Internet. Among the 86 randomized controlled trials in the 2011 Cochrane Collaboration’s review of patient decision aids, only four studies focused on Internet-delivery. Given the limited number of published studies, this paper particularly focused on identifying gaps in the empirical evidence base and

  14. Effect of patient decision aid was influenced by presurgical evaluation among patients with osteoarthritis of the knee.

    Science.gov (United States)

    Boland, Laura; Taljaard, Monica; Dervin, Geoffrey; Trenaman, Logan; Tugwell, Peter; Pomey, Marie-Pascale; Stacey, Dawn

    2018-02-01

    Decision aids help patients make total joint arthroplasty decisions, but presurgical evaluation might influence the effects of a decision aid. We compared the effects of a decision aid among patients considering total knee arthroplasty at 2 surgical screening clinics with different evaluation processes. We performed a subgroup analysis of a randomized controlled trial. Patients were recruited from 2 surgical screening clinics: an academic clinic providing 20-minute physician consultations and a community clinic providing 45-minute physiotherapist/nurse consultations with education. We compared the effects of decision quality, decisional conflict and surgery rate using Cochran-Mantel-Haenszel χ2 tests and the Breslow-Day test. We evaluated 242 patients: 123 from the academic clinic (61 who used the decision aid and 62 controls) and 119 from the community clinic (59 who used the decision aid and 60 controls). Results suggested a between-site difference in the effect of the decision aid on the patients' decision quality (p = 0.09): at the academic site, patients who used the decision aid were more likely to make better-quality decisions than controls (54% v. 35%, p = 0.044), but not at the community site (47% v. 51%, p = 0.71). Fewer patients who used decision aids at the academic site than at the community site experienced decisional conflict (p = 0.007) (33% v. 52%, p = 0.05 at the academic site and 40% v. 24%, p = 0.08 at the community site). The effect of the decision aid on surgery rates did not differ between sites (p = 0.65). The decision aid had a greater effect at the academic site than at the community site, which provided longer consultations with more verbal education. Hence, decision aids might be of greater value when more extensive total knee arthroplasty presurgical assessment and counselling are either impractical or unavailable.

  15. Closed loop supply chain network design with fuzzy tactical decisions

    Science.gov (United States)

    Sherafati, Mahtab; Bashiri, Mahdi

    2016-01-01

    One of the most strategic and the most significant decisions in supply chain management is reconfiguration of the structure and design of the supply chain network. In this paper, a closed loop supply chain network design model is presented to select the best tactical and strategic decision levels simultaneously considering the appropriate transportation mode in activated links. The strategic decisions are made for a long term; thus, it is more satisfactory and more appropriate when the decision variables are considered uncertain and fuzzy, because it is more flexible and near to the real world. This paper is the first research which considers fuzzy decision variables in the supply chain network design model. Moreover, in this study a new fuzzy optimization approach is proposed to solve a supply chain network design problem with fuzzy tactical decision variables. Finally, the proposed approach and model are verified using several numerical examples. The comparison of the results with other existing approaches confirms efficiency of the proposed approach. Moreover the results confirms that by considering the vagueness of tactical decisions some properties of the supply chain network will be improved.

  16. Decision Support for Countering Terrorist Threats against Transportation Networks

    Directory of Open Access Journals (Sweden)

    Dr. Richard Adler

    2009-01-01

    Full Text Available This article presents a dynamic decision support methodology forcounter-terrorism decision support. The initial sections introduce basic objectives and challenges of terrorism risk analysis and risk management. The remainder of the paper describes TRANSEC, a decision support framework for defining, validating, and monitoring strategies focused on managing terrorism risks to international transportation networks. The methodology and software tools underlying TRANSEC are applicable to other homeland security problems, such as critical infrastructure and border protection.

  17. Complex Chemical Reaction Networks from Heuristics-Aided Quantum Chemistry.

    Science.gov (United States)

    Rappoport, Dmitrij; Galvin, Cooper J; Zubarev, Dmitry Yu; Aspuru-Guzik, Alán

    2014-03-11

    While structures and reactivities of many small molecules can be computed efficiently and accurately using quantum chemical methods, heuristic approaches remain essential for modeling complex structures and large-scale chemical systems. Here, we present a heuristics-aided quantum chemical methodology applicable to complex chemical reaction networks such as those arising in cell metabolism and prebiotic chemistry. Chemical heuristics offer an expedient way of traversing high-dimensional reactive potential energy surfaces and are combined here with quantum chemical structure optimizations, which yield the structures and energies of the reaction intermediates and products. Application of heuristics-aided quantum chemical methodology to the formose reaction reproduces the experimentally observed reaction products, major reaction pathways, and autocatalytic cycles.

  18. SOFTWARE PROCESS ASSESSMENT AND IMPROVEMENT USING MULTICRITERIA DECISION AIDING - CONSTRUCTIVIST

    Directory of Open Access Journals (Sweden)

    Leonardo Ensslin

    2012-12-01

    Full Text Available Software process improvement and software process assessment have received special attention since the 1980s. Some models have been created, but these models rest on a normative approach, where the decision-maker’s participation in a software organization is limited to understanding which process is more relevant to each organization. The proposal of this work is to present the MCDA-C as a constructivist methodology for software process improvement and assessment. The methodology makes it possible to visualize the criteria that must be taken into account according to the decision-makers’ values in the process improvement actions, making it possible to rank actions in the light of specific organizational needs. This process helped the manager of the company studied to focus on and prioritize process improvement actions. This paper offers an empirical understanding of the application of performance evaluation to software process improvement and identifies complementary tools to the normative models presented today.

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

    National Research Council Canada - National Science Library

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

    2015-01-01

    ...) 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...

  20. Social Networks and Decision Making for Clandestine Unsafe ...

    African Journals Online (AJOL)

    Little is known about the role of social networks in promoting clandestine abortions. This study investigated the role social networks play in decision making for and facilitation of clandestine abortions. It was a mixed method study in which 320 women treated for complications of unsafe abortions were interviewed in a cross ...

  1. A qualitative study of professional and client perspectives on information flows and decision aid use

    Science.gov (United States)

    2012-01-01

    Background This paper explores the meanings given by a diverse range of stakeholders to a decision aid aimed at helping carers of people in early to moderate stages of dementia (PWD) to select community based respite services. Decision aids aim to empower clients to share decision making with health professionals. However, the match between health professionals' perspectives on decision support needs and their clients' perspective is an important and often unstudied aspect of decision aid use. Methods A secondary analysis was undertaken of qualitative data collected as part of a larger study. The data included twelve interviews with carers of people with dementia, three interviews with expert advisors, and three focus groups with health professionals. A theoretical analysis was conducted, drawing on theories of 'positioning' and professional identity. Results Health professionals are seen to hold varying attitudes and beliefs about carers' decision support needs, and these appeared to be grounded in the professional identity of each group. These attitudes and beliefs shaped their attitudes towards decision aids, the information they believed should be offered to dementia carers, and the timing of its offering. Some groups understood carers as needing to be protected from realistic information and consequently saw a need to filter information to carer clients. Conclusion Health professionals' beliefs may cause them to restrict information flows, which can limit carers' ability to make decisions, and limit health services' ability to improve partnering and shared decision making. In an era where information is freely available to those with the resources to access it, we question whether health professionals should filter information. PMID:22458734

  2. Information processing by networks of quantum decision makers

    Science.gov (United States)

    Yukalov, V. I.; Yukalova, E. P.; Sornette, D.

    2018-02-01

    We suggest a model of a multi-agent society of decision makers taking decisions being based on two criteria, one is the utility of the prospects and the other is the attractiveness of the considered prospects. The model is the generalization of quantum decision theory, developed earlier for single decision makers realizing one-step decisions, in two principal aspects. First, several decision makers are considered simultaneously, who interact with each other through information exchange. Second, a multistep procedure is treated, when the agents exchange information many times. Several decision makers exchanging information and forming their judgment, using quantum rules, form a kind of a quantum information network, where collective decisions develop in time as a result of information exchange. In addition to characterizing collective decisions that arise in human societies, such networks can describe dynamical processes occurring in artificial quantum intelligence composed of several parts or in a cluster of quantum computers. The practical usage of the theory is illustrated on the dynamic disjunction effect for which three quantitative predictions are made: (i) the probabilistic behavior of decision makers at the initial stage of the process is described; (ii) the decrease of the difference between the initial prospect probabilities and the related utility factors is proved; (iii) the existence of a common consensus after multiple exchange of information is predicted. The predicted numerical values are in very good agreement with empirical data.

  3. Adaptive Decision-Making Scheme for Cognitive Radio Networks

    KAUST Repository

    Alqerm, Ismail

    2014-05-01

    Radio resource management becomes an important aspect of the current wireless networks because of spectrum scarcity and applications heterogeneity. Cognitive radio is a potential candidate for resource management because of its capability to satisfy the growing wireless demand and improve network efficiency. Decision-making is the main function of the radio resources management process as it determines the radio parameters that control the use of these resources. In this paper, we propose an adaptive decision-making scheme (ADMS) for radio resources management of different types of network applications including: power consuming, emergency, multimedia, and spectrum sharing. ADMS exploits genetic algorithm (GA) as an optimization tool for decision-making. It consists of the several objective functions for the decision-making process such as minimizing power consumption, packet error rate (PER), delay, and interference. On the other hand, maximizing throughput and spectral efficiency. Simulation results and test bed evaluation demonstrate ADMS functionality and efficiency.

  4. Decision trees and integrated features for computer aided mammographic screening

    Energy Technology Data Exchange (ETDEWEB)

    Kegelmeyer, W.P. Jr.; Groshong, B.; Allmen, M.; Woods, K.

    1997-02-01

    Breast cancer is a serious problem, which in the United States causes 43,000 deaths a year, eventually striking 1 in 9 women. Early detection is the only effective countermeasure, and mass mammography screening is the only reliable means for early detection. Mass screening has many shortcomings which could be addressed by a computer-aided mammographic screening system. Accordingly, we have applied the pattern recognition methods developed in earlier investigations of speculated lesions in mammograms to the detection of microcalcifications and circumscribed masses, generating new, more rigorous and uniform methods for the detection of both those signs. We have also improved the pattern recognition methods themselves, through the development of a new approach to combinations of multiple classifiers.

  5. A decision network account of reasoning about other people's choices

    Science.gov (United States)

    Jern, Alan; Kemp, Charles

    2015-01-01

    The ability to predict and reason about other people's choices is fundamental to social interaction. We propose that people reason about other people's choices using mental models that are similar to decision networks. Decision networks are extensions of Bayesian networks that incorporate the idea that choices are made in order to achieve goals. In our first experiment, we explore how people predict the choices of others. Our remaining three experiments explore how people infer the goals and knowledge of others by observing the choices that they make. We show that decision networks account for our data better than alternative computational accounts that do not incorporate the notion of goal-directed choice or that do not rely on probabilistic inference. PMID:26010559

  6. Supporting Shared Decision-making for Children's Complex Behavioral Problems: Development and User Testing of an Option Grid™ Decision Aid.

    Science.gov (United States)

    Barnett, Erin R; Boucher, Elizabeth A; Daviss, William B; Elwyn, Glyn

    2018-01-01

    There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence. Using semi-structured qualitative interviews (n = 18), we conducted user testing with four parents and four clinical prescribers and field testing with four parents, four clinical prescribers, and two clinic administrators. The researchers coded and synthesized the interview responses using mixed inductive and deductive methods. Parents, clinicians, and administrators felt the Option Grid had significant value, although they reported that additional training and other support would be required in order to successfully implement the Option Grid and achieve shared decision-making in clinical practice.

  7. User-centered design and the development of patient decision aids: protocol for a systematic review.

    Science.gov (United States)

    Witteman, Holly O; Dansokho, Selma Chipenda; Colquhoun, Heather; Coulter, Angela; Dugas, Michèle; Fagerlin, Angela; Giguere, Anik Mc; Glouberman, Sholom; Haslett, Lynne; Hoffman, Aubri; Ivers, Noah; Légaré, France; Légaré, Jean; Levin, Carrie; Lopez, Karli; Montori, Victor M; Provencher, Thierry; Renaud, Jean-Sébastien; Sparling, Kerri; Stacey, Dawn; Vaisson, Gratianne; Volk, Robert J; Witteman, William

    2015-01-26

    Providing patient-centered care requires that patients partner in their personal health-care decisions to the full extent desired. Patient decision aids facilitate processes of shared decision-making between patients and their clinicians by presenting relevant scientific information in balanced, understandable ways, helping clarify patients' goals, and guiding decision-making processes. Although international standards stipulate that patients and clinicians should be involved in decision aid development, little is known about how such involvement currently occurs, let alone best practices. This systematic review consisting of three interlinked subreviews seeks to describe current practices of user involvement in the development of patient decision aids, compare these to practices of user-centered design, and identify promising strategies. A research team that includes patient and clinician representatives, decision aid developers, and systematic review method experts will guide this review according to the Cochrane Handbook and PRISMA reporting guidelines. A medical librarian will hand search key references and use a peer-reviewed search strategy to search MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore, and Google Scholar. We will identify articles across all languages and years describing the development or evaluation of a patient decision aid, or the application of user-centered design or human-centered design to tools intended for patient use. Two independent reviewers will assess article eligibility and extract data into a matrix using a structured pilot-tested form based on a conceptual framework of user-centered design. We will synthesize evidence to describe how research teams have included users in their development process and compare these practices to user-centered design methods. If data permit, we will develop a measure of the user-centeredness of development processes and identify practices that are likely

  8. Medical decision-making, adherence and quality of life in people living with HIV/AIDS

    OpenAIRE

    Kremer, Heidemarie

    2004-01-01

    Introduction: The purpose of this study is to describe the decision about antiretroviral therapy (ART) from the perspective of people living with HIV/AIDS (PWHA) and to develop models to reduce decisional conflict and to optimize the quality of life in PWHA. Methods: 79 HIV+ people who had been offered ART by their physicians participated. In the qualitative part of this study, interviews on reasons and sources of information for decision-making and patient-physician relationship were eva...

  9. INTEGRATED TECHNOLOGY ROADMAPPING TOOL TO AID THE DECISION-MAKING OF R&D INVESTMENTS

    OpenAIRE

    HUSAM ARMAN; NABIL GINDY; MOHAMMAD KABLI; SHIRLEY CAVIN

    2014-01-01

    The technology planning activity that leads to an effective R&D portfolio must involve decisions that are taken under a considerable degree of uncertainty. In this paper, we describe an integrated technology planning approach with the focus on the use of technology roadmapping concept in a systematic process, using dedicated and customized software which utilizes integer linear programming (ILP) tools, to aid decision-makers in selecting the optimum portfolio of R&D projects in the manufactur...

  10. Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers

    NARCIS (Netherlands)

    Trevena, L.J.; Zikmund-Fisher, B.J.; Edwards, A.; Gaissmaier, W.; Galesic, M.; Han, P.K.J.; King, J.; Lawson, M.L.; Linder, S.K.; Lipkus, I.; Ozanne, E.; Peters, E.; Timmermans, D.R.M.; Woloshin, S.

    2013-01-01

    Background: Making evidence-based decisions often requires comparison of two or more options. Research-based evidence may exist which quantifies how likely the outcomes are for each option. Understanding these numeric estimates improves patients' risk perception and leads to better informed decision

  11. Which Cooperative Ownership Model Performs Better? A Financial-Decision Aid Approach

    NARCIS (Netherlands)

    Kalogeras, N.; Pennings, J.M.E.; Benos, T.; Doumpos, M.

    2013-01-01

    In this article the financial/ownership structures of agribusiness cooperatives are analyzed to examine whether new cooperative models perform better than the more traditional ones. The assessment procedure introduces a new financial decision-aid approach, which is based on data-analysis techniques

  12. A novel classification method for aid decision of traditional Chinese patent medicines for stroke treatment.

    Science.gov (United States)

    Zhao, Yufeng; Liu, Bo; He, Liyun; Bai, Wenjing; Yu, Xueyun; Cao, Xinyu; Luo, Lin; Rong, Peijing; Zhao, Yuxue; Li, Guozheng; Liu, Baoyan

    2017-09-01

    Traditional Chinese patent medicines are widely used to treat stroke because it has good efficacy in the clinical environment. However, because of the lack of knowledge on traditional Chinese patent medicines, many Western physicians, who are accountable for the majority of clinical prescriptions for such medicine, are confused with the use of traditional Chinese patent medicines. Therefore, the aid-decision method is critical and necessary to help Western physicians rationally use traditional Chinese patent medicines. In this paper, Manifold Ranking is employed to develop the aid-decision model of traditional Chinese patent medicines for stroke treatment. First, 115 stroke patients from three hospitals are recruited in the cross-sectional survey. Simultaneously, traditional Chinese physicians determine the traditional Chinese patent medicines appropriate for each patient. Second, particular indicators are explored to characterize the population feature of traditional Chinese patent medicines for stroke treatment. Moreover, these particular indicators can be easily obtained byWestern physicians and are feasible for widespread clinical application in the future. Third, the aid-decision model of traditional Chinese patent medicines for stroke treatment is constructed based on Manifold Ranking. Experimental results reveal that traditional Chinese patent medicines can be differentiated. Moreover, the proposed model can obtain high accuracy of aid decision.

  13. A study of a Dutch online decision aid for parents of children with ADHD

    NARCIS (Netherlands)

    Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.; Sorbi, Marjolijn J.; Seydel, E.R.

    2010-01-01

    During a three-month study period, visitors to an online decision aid (DA) for attention deficit hyperactivity disorder (ADHD) were invited to complete an online questionnaire before and after working through the DA. Some 75,000 unique visitors found their way to the page on DAs, although fewer than

  14. Decision-aid design factors in connection with HF communication and emitter location disciplines

    Science.gov (United States)

    Goodman, John M.

    1989-09-01

    The advance of microcomputer technology, the growing sophistication of specified propagation models, and the expanding ability to sense the medium and apply that knowledge in real time is leading to an improvement in the prediction of system performance for tactical users. The maturation of artificial intelligence disciplines should provide the user of advanced C3I decision aids an ability to manage the plethora of information more effectively. Critical aspects of the process of developing useful and cost-effective decision aids are identified with emphasis upon the HF medium which is strongly propagation-limited and controlled by variable and often unpredictable phenomena. A major factor in this field of activity is the evolution of self-adaptive system architecture incorporating imbedded Real Time Channel Evaluation (RTCE). In this context, the decision aid is a process which is operationally transparent to the the user but could be user-defined. A key to the development of an adaptive resource management capability is the integration of a set of tools or decision aids which direct the system to compensate for pathological effects by adjustment of system parameters. The approach is ultimately limited by the accuracy with which the ionosphere or the HF channel may be specified. The accepted specification accuracy will determine the design approaches to be followed.

  15. Biomedical Informatics for Computer-Aided Decision Support Systems: A Survey

    Science.gov (United States)

    Belle, Ashwin; Kon, Mark A.; Najarian, Kayvan

    2013-01-01

    The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest. PMID:23431259

  16. Clinical decision aids for chest pain in the emergency department: identifying low-risk patients

    Directory of Open Access Journals (Sweden)

    Alley W

    2015-11-01

    Full Text Available William Alley, Simon A Mahler Department of Emergency Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA Abstract: Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS. However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography. This review describes several of the chest pain decision aids developed and studied through the recent past, starting with the thrombolysis in myocardial infarction (TIMI risk score and Global Registry of Acute Coronary Events (GRACE scores, which were developed as prognostic aids for patients already diagnosed with ACS, then subsequently validated in the undifferentiated chest pain population. Asia-Pacific Evaluation of Chest Pain Trial (ASPECT; Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins (ADAPT; North American Chest Pain Rule (NACPR; and History, Electrocardiogram, Age, Risk factors, Troponin (HEART score have been developed exclusively for use in the undifferentiated chest pain population as well, with improved performance compared to their predecessors. This review describes the relative merits and limitations of these decision aids so that providers can determine which tool fits the needs of their clinical practice setting. Keywords: chest pain, decision aid, risk score, acute coronary syndrome

  17. Extracting rules from neural networks as decision diagrams.

    Science.gov (United States)

    Chorowski, Jan; Zurada, Jacek M

    2011-12-01

    Rule extraction from neural networks (NNs) solves two fundamental problems: it gives insight into the logic behind the network and in many cases, it improves the network's ability to generalize the acquired knowledge. This paper presents a novel eclectic approach to rule extraction from NNs, named LOcal Rule Extraction (LORE), suited for multilayer perceptron networks with discrete (logical or categorical) inputs. The extracted rules mimic network behavior on the training set and relax this condition on the remaining input space. First, a multilayer perceptron network is trained under standard regime. It is then transformed into an equivalent form, returning the same numerical result as the original network, yet being able to produce rules generalizing the network output for cases similar to a given input. The partial rules extracted for every training set sample are then merged to form a decision diagram (DD) from which logic rules can be extracted. A rule format explicitly separating subsets of inputs for which an answer is known from those with an undetermined answer is presented. A special data structure, the decision diagram, allowing efficient partial rule merging is introduced. With regard to rules' complexity and generalization abilities, LORE gives results comparable to those reported previously. An algorithm transforming DDs into interpretable boolean expressions is described. Experimental running times of rule extraction are proportional to the network's training time.

  18. Neural-network-based fuzzy logic decision systems

    Science.gov (United States)

    Kulkarni, Arun D.; Giridhar, G. B.; Coca, Praveen

    1994-10-01

    During the last few years there has been a large and energetic upswing in research efforts aimed at synthesizing fuzzy logic with neural networks. This combination of neural networks and fuzzy logic seems natural because the two approaches generally attack the design of `intelligent' system from quite different angles. Neural networks provide algorithms for learning, classification, and optimization whereas fuzzy logic often deals with issues such as reasoning in a high (semantic or linguistic) level. Consequently the two technologies complement each other. In this paper, we combine neural networks with fuzzy logic techniques. We propose an artificial neural network (ANN) model for a fuzzy logic decision system. The model consists of six layers. The first three layers map the input variables to fuzzy set membership functions. The last three layers implement the decision rules. The model learns the decision rules using a supervised gradient descent procedure. As an illustration we considered two examples. The first example deals with pixel classification in multispectral satellite images. In our second example we used the fuzzy decision system to analyze data from magnetic resonance imaging (MRI) scans for tissue classification.

  19. An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

    Science.gov (United States)

    Elgin, Peter D.; Thomas, Rickey P.

    2004-01-01

    The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

  20. Cultural targeting and tailoring of shared decision making technology: a theoretical framework for improving the effectiveness of patient decision aids in culturally diverse groups.

    Science.gov (United States)

    Alden, Dana L; Friend, John; Schapira, Marilyn; Stiggelbout, Anne

    2014-03-01

    Patient decision aids are known to positively impact outcomes critical to shared decision making (SDM), such as gist knowledge and decision preparedness. However, research on the potential improvement of these and other important outcomes through cultural targeting and tailoring of decision aids is very limited. This is the case despite extensive evidence supporting use of cultural targeting and tailoring to improve the effectiveness of health communications. Building on prominent psychological theory, we propose a two-stage framework incorporating cultural concepts into the design process for screening and treatment decision aids. The first phase recommends use of cultural constructs, such as collectivism and individualism, to differentially target patients whose cultures are known to vary on these dimensions. Decision aid targeting is operationalized through use of symbols and values that appeal to members of the given culture. Content dimensions within decision aids that appear particularly appropriate for targeting include surface level visual characteristics, language, beliefs, attitudes and values. The second phase of the framework is based on evidence that individuals vary in terms of how strongly cultural norms influence their approach to problem solving and decision making. In particular, the framework hypothesizes that differences in terms of access to cultural mindsets (e.g., access to interdependent versus independent self) can be measured up front and used to tailor decision aids. Thus, the second phase in the framework emphasizes the importance of not only targeting decision aid content, but also tailoring the information to the individual based on measurement of how strongly he/she is connected to dominant cultural mindsets. Overall, the framework provides a theory-based guide for researchers and practitioners who are interested in using cultural targeting and tailoring to develop and test decision aids that move beyond a "one-size fits all" approach

  1. Decision support systems and methods for complex networks

    Science.gov (United States)

    Huang, Zhenyu [Richland, WA; Wong, Pak Chung [Richland, WA; Ma, Jian [Richland, WA; Mackey, Patrick S [Richland, WA; Chen, Yousu [Richland, WA; Schneider, Kevin P [Seattle, WA

    2012-02-28

    Methods and systems for automated decision support in analyzing operation data from a complex network. Embodiments of the present invention utilize these algorithms and techniques not only to characterize the past and present condition of a complex network, but also to predict future conditions to help operators anticipate deteriorating and/or problem situations. In particular, embodiments of the present invention characterize network conditions from operation data using a state estimator. Contingency scenarios can then be generated based on those network conditions. For at least a portion of all of the contingency scenarios, risk indices are determined that describe the potential impact of each of those scenarios. Contingency scenarios with risk indices are presented visually as graphical representations in the context of a visual representation of the complex network. Analysis of the historical risk indices based on the graphical representations can then provide trends that allow for prediction of future network conditions.

  2. A coalitional graph game framework for network coding-aided D2D communication

    National Research Council Canada - National Science Library

    Zhao, Yulei; Li, Yong; Ding, Zhiguo; Ge, Ning; Poor, H Vincent

    2016-01-01

    .... In this paper, a coalitional graph game framework is proposed to jointly accomplish resource allocation and relay selection, two challenging problems in network coding-aided D2D communication networks...

  3. Application of artificial neural networks in computer-aided diagnosis.

    Science.gov (United States)

    Liu, Bei

    2015-01-01

    Computer-aided diagnosis is a diagnostic procedure in which a radiologist uses the outputs of computer analysis of medical images as a second opinion in the interpretation of medical images, either to help with lesion detection or to help determine if the lesion is benign or malignant. Artificial neural networks (ANNs) are usually employed to formulate the statistical models for computer analysis. Receiver operating characteristic curves are used to evaluate the performance of the ANN alone, as well as the diagnostic performance of radiologists who take into account the ANN output as a second opinion. In this chapter, we use mammograms to illustrate how an ANN model is trained, tested, and evaluated, and how a radiologist should use the ANN output as a second opinion in CAD.

  4. Cycling network projects: a decision-making aid approach

    OpenAIRE

    Martínez Plumed, Fernando; Ferri Ramírez, César; Contreras Ochando, Lidia

    2016-01-01

    Effcient and clean urban mobility is a key factor in quality of life and sustainability of towns and cities. Traditionally, cities have focused on cars and other fuel-based vehicles as transport means. However, several problems are directly linked to massive car use, particularly in terms of air pollution and traffc congestion. Several works reckon that vehicle emissions produce over 90% of air pollution. One way to reduce the use of fuel-based vehicles (and thus the emission of ...

  5. Equilibrium Decision Method for Earthquake First-Aid Medicine Allocation Based on Demand Information Updating

    Directory of Open Access Journals (Sweden)

    Yong Ye

    2017-01-01

    Full Text Available The allocation of rescue resources after an earthquake has become a popular research topic in the field of emergency management. The allocation of first-aid medicine for earthquake rescue has stronger time sensitivity than that of general rescue materials. This study focuses on the problem of first-aid medicine allocation in earthquake response. First, we consider the incompleteness and renewal of decision information in an emergency environment, as well as the balance between the risk of decision error and delay. Second, we propose an equilibrium decision method for the allocation of first-aid medicine in earthquake rescue based on information update. This method attempts to realize a fair allocation to all disaster places and minimize total transport time loss. Third, a simulation analysis is performed in which the proposed method is applied to the first-aid medicine allocation problem in the Wenchuan earthquake response. Results show that the method can be used to create a good allocation plan in an earthquake rescue situation.

  6. Show Me My Health Plans: Using a Decision Aid to Improve Decisions in the Federal Health Insurance Marketplace.

    Science.gov (United States)

    Politi, Mary C; Kuzemchak, Marie D; Liu, Jingxia; Barker, Abigail R; Peters, Ellen; Ubel, Peter A; Kaphingst, Kimberly A; McBride, Timothy; Kreuter, Matthew W; Shacham, Enbal; Philpott, Sydney E

    2016-07-01

    Since the Affordable Care Act was passed, more than 12 million individuals have enrolled in the health insurance marketplace. Without support, many struggle to make an informed plan choice that meets their health and financial needs. We designed and evaluated a decision aid, Show Me My Health Plans (SMHP), that provides education, preference assessment, and an annual out-of-pocket cost calculator with plan recommendations produced by a tailored, risk-adjusted algorithm incorporating age, gender, and health status. We evaluated whether SMHP compared to HealthCare.gov improved health insurance decision quality and the match between plan choice, needs, and preferences among 328 Missourians enrolling in the marketplace. Participants who used SMHP had higher health insurance knowledge (LS-Mean = 78 vs. 62; P < 0.001), decision self-efficacy (LS-Mean = 83 vs. 75; P < 0.002), confidence in their choice (LS-Mean = 3.5 vs. 2.9; P < 0.001), and improved health insurance literacy (odds ratio = 2.52, P <0.001) compared to participants using HealthCare.gov. Those using SMHP were 10.3 times more likely to select a silver- or gold-tier plan (P < 0.0001). SMHP can improve health insurance decision quality and the odds that consumers select an insurance plan with coverage likely needed to meet their health needs. This study represents a unique context through which to apply principles of decision support to improve health insurance choices.

  7. Visual Aids for Multimodal Treatment Options to Support Decision Making of Patients with Colorectal Cancer

    Directory of Open Access Journals (Sweden)

    Hofmann Sabine

    2012-10-01

    Full Text Available Abstract Background A variety of multimodal treatment options are available for colorectal cancer and many patients want to be involved in decisions about their therapies. However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons. The aim of the present study was to evaluate the treatment preferences of healthy persons and patients using visual aids depicting multimodal treatment options for colorectal cancer. Methods We designed visual aids for treatment scenarios based on four key studies concerning multimodal treatment of colorectal cancer. The visual aids were composed of diagrams depicting outcome parameters and side effects of two treatment options. They were presented to healthy persons (n = 265 and to patients with colorectal cancer (n = 102. Results Most patients and healthy persons could make immediate decisions after seeing the diagrams (range: 88% – 100%. Patients (79% chose the intensive-treatment option in the scenario with a clear survival benefit. In scenarios without survival benefit, all groups clearly preferred the milder treatment option (range: 78% - 90%. No preference was seen in the scenario depicting equally intense treatment options with different timing (neoadjuvant vs. adjuvant but without survival benefit. Conclusions Healthy persons’ and patients’ decisions using visual aids seem to be influenced by quality-of-life aspects rather than recurrence rates especially in situations without survival benefit. In the future visual aids may help to improve the management of patients with colorectal cancer.

  8. Evidence-based patient choice: a prostate cancer decision aid in plain language

    Directory of Open Access Journals (Sweden)

    Ohene-Frempong Janet

    2005-06-01

    Full Text Available Abstract Background Decision aids (DA to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer. Methods Document development steps included preparing an evidence-based DA in standard medical parlance, iteratively translating it to emphasize shared decision making and plain language in three formats (booklet, Internet, and audio-tape. Scientific review of medical content was integrated with expert health literacy review of document structure and design. Formative evaluation methods included focus groups (n = 4 and survey of a new sample of men newly diagnosed with prostate cancer (n = 60, compared with historical controls (n = 184. Results A transparent description of the development process and design elements is reported. Formative evaluation among newly diagnosed prostate cancer patients found the DA to be clear and useful in reaching a decision. Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy. Conclusion The plain language DA presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men.

  9. Quantum stochastic walks on networks for decision-making

    Science.gov (United States)

    Martínez-Martínez, Ismael; Sánchez-Burillo, Eduardo

    2016-03-01

    Recent experiments report violations of the classical law of total probability and incompatibility of certain mental representations when humans process and react to information. Evidence shows promise of a more general quantum theory providing a better explanation of the dynamics and structure of real decision-making processes than classical probability theory. Inspired by this, we show how the behavioral choice-probabilities can arise as the unique stationary distribution of quantum stochastic walkers on the classical network defined from Luce’s response probabilities. This work is relevant because (i) we provide a very general framework integrating the positive characteristics of both quantum and classical approaches previously in confrontation, and (ii) we define a cognitive network which can be used to bring other connectivist approaches to decision-making into the quantum stochastic realm. We model the decision-maker as an open system in contact with her surrounding environment, and the time-length of the decision-making process reveals to be also a measure of the process’ degree of interplay between the unitary and irreversible dynamics. Implementing quantum coherence on classical networks may be a door to better integrate human-like reasoning biases in stochastic models for decision-making.

  10. Reverse engineering cellular decisions for hybrid reconfigurable network modeling

    Science.gov (United States)

    Blair, Howard A.; Saranak, Jureepan; Foster, Kenneth W.

    2011-06-01

    Cells as microorganisms and within multicellular organisms make robust decisions. Knowing how these complex cells make decisions is essential to explain, predict or mimic their behavior. The discovery of multi-layer multiple feedback loops in the signaling pathways of these modular hybrid systems suggests their decision making is sophisticated. Hybrid systems coordinate and integrate signals of various kinds: discrete on/off signals, continuous sensory signals, and stochastic and continuous fluctuations to regulate chemical concentrations. Such signaling networks can form reconfigurable networks of attractors and repellors giving them an extra level of organization that has resilient decision making built in. Work on generic attractor and repellor networks and on the already identified feedback networks and dynamic reconfigurable regulatory topologies in biological cells suggests that biological systems probably exploit such dynamic capabilities. We present a simple behavior of the swimming unicellular alga Chlamydomonas that involves interdependent discrete and continuous signals in feedback loops. We show how to rigorously verify a hybrid dynamical model of a biological system with respect to a declarative description of a cell's behavior. The hybrid dynamical systems we use are based on a unification of discrete structures and continuous topologies developed in prior work on convergence spaces. They involve variables of discrete and continuous types, in the sense of type theory in mathematical logic. A unification such as afforded by convergence spaces is necessary if one wants to take account of the affect of the structural relationships within each type on the dynamics of the system.

  11. Adaptive spectrum decision framework for heterogeneous dynamic spectrum access networks

    CSIR Research Space (South Africa)

    Masonta, M

    2015-09-01

    Full Text Available Spectrum decision is the ability of a cognitive radio (CR) system to select the best available spectrum band to satisfy dynamic spectrum access network (DSAN) users¿ quality of service (QoS) requirements without causing harmful interference...

  12. Decision Aids for Multiple-Decision Disease Management as Affected by Weather Input Errors

    Science.gov (United States)

    Many disease management decision support systems (DSS) rely, exclusively or in part, on weather inputs to calculate an indicator for disease hazard. Error in the weather inputs, typically due to forecasting, interpolation or estimation from off-site sources, may affect model calculations and manage...

  13. Audio-video decision support for patients: the documentary genre as a basis for decision aids

    NARCIS (Netherlands)

    Volandes, A.E.; Barry, M.J.; Wood, F.; Elwyn, G.

    2013-01-01

    Objective Decision support tools are increasingly using audio-visual materials. However, disagreement exists about the use of audio-visual materials as they may be subjective and biased. Methods This is a literature review of the major texts for documentary film studies to extrapolate issues of

  14. Emergent decision-making in biological signal transduction networks

    Science.gov (United States)

    Helikar, Tomáš; Konvalina, John; Heidel, Jack; Rogers, Jim A.

    2008-01-01

    The complexity of biochemical intracellular signal transduction networks has led to speculation that the high degree of interconnectivity that exists in these networks transforms them into an information processing network. To test this hypothesis directly, a large scale model was created with the logical mechanism of each node described completely to allow simulation and dynamical analysis. Exposing the network to tens of thousands of random combinations of inputs and analyzing the combined dynamics of multiple outputs revealed a robust system capable of clustering widely varying input combinations into equivalence classes of biologically relevant cellular responses. This capability was nontrivial in that the network performed sharp, nonfuzzy classifications even in the face of added noise, a hallmark of real-world decision-making. PMID:18250321

  15. Coaching patients in the use of decision and communication aids: RE-AIM evaluation of a patient support program.

    Science.gov (United States)

    Belkora, Jeff; Volz, Shelley; Loth, Meredith; Teng, Alexandra; Zarin-Pass, Margot; Moore, Dan; Esserman, Laura

    2015-05-28

    Decision aids educate patients about treatment options and outcomes. Communication aids include question lists, consultation summaries, and audio-recordings. In efficacy studies, decision aids increased patient knowledge, while communication aids increased patient question-asking and information recall. Starting in 2004, we trained successive cohorts of post-baccalaureate, pre-medical interns to coach patients in the use of decision and communication aids at our university-based breast cancer clinic. From July 2005 through June 2012, we used the RE-AIM framework to measure Reach, Effectiveness, Adoption, Implementation and Maintenance of our interventions. 1. Reach: Over the study period, our program sent a total of 5,153 decision aids and directly administered 2,004 communication aids. In the most recent program year (2012), out of 1,524 eligible patient appointments, we successfully contacted 1,212 (80%); coached 1,110 (73%) in the self-administered use of decision and communication aids; sent 958 (63%) decision aids; and directly administered communication aids for 419 (27%) patients. In a 2010 survey, coached patients reported self-administering one or more communication aids in 81% of visits 2. Effectiveness: In our pre-post comparisons, decision aids were associated with increased patient knowledge and decreased decisional conflict. Communication aids were associated with increased self-efficacy and number of questions; and with high ratings of patient preparedness and satisfaction 3. Adoption: Among visitors sent decision aids, 82% of survey respondents reviewed some or all; among those administered communication aids, 86% reviewed one or more after the visit 4. Through continuous quality adaptations, we increased the proportion of available staff time used for patient support (i.e. exploitation of workforce capacity) from 29% in 2005 to 84% in 2012 5. Maintenance: The main barrier to sustainability was the cost of paid intern labor. We addressed this by

  16. Entertainment education for informed breast cancer treatment decisions in low-literate women: development and initial evaluation of a patient decision aid.

    Science.gov (United States)

    Jibaja-Weiss, Maria L; Volk, Robert J; Granch, Thomas S; Nefe, Nancy E; Spann, Stephen J; Aoki, Noriaki; Robinson, Emily K; Freidman, Lois C; Beck, J Robert

    2006-01-01

    We report on the development and initial evaluation of a novel computerized decision support system (CDSS) that utilizes concepts from entertainment education (edutainment) to assist low-literate, multiethnic women in making initial surgical treatment decisions. We randomly assigned 51 patients diagnosed with early stage breast cancer to use the decision aid. Patients who viewed the CDSS improved their knowledge of breast cancer treatment; found the application easy to use and understand, informative, and enjoyable; and were less worried about treatment. The system clearly reached its intended objectives to create a usable decision aid for low-literate, novice computer users.

  17. Consumer Decision Making in Online Shopping Environments: The Effects of Interactive Decision Aids

    OpenAIRE

    Gerald Häubl; Valerie Trifts

    2000-01-01

    Despite the explosive growth of electronic commerce and the rapidly increasing number of consumers who use interactive media (such as the World Wide Web) for prepurchase information search and online shopping, very little is known about how consumers make purchase decisions in such settings. A unique characteristic of online shopping environments is that they allow vendors to create retail interfaces with highly interactive features. One desirable form of interactivity from a consumer perspec...

  18. An exploration of decision aid effectiveness: the impact of promoting affective vs. deliberative processing on a health-related decision.

    Science.gov (United States)

    Davis, Esther L; McCaffery, Kirsten; Mullan, Barbara; Juraskova, Ilona

    2015-12-01

    Decision aids (DAs) are non-directive communication tools that help patients make value-consistent health-care decisions. However, most DAs have been developed without an explicit theoretical framework, resulting in a lack of understanding of how DAs achieve outcomes. To investigate the effect of promoting affective vs. deliberative processing on DA effectiveness based on dual-process theory. One hundred and forty-eight female university students participated in a randomized controlled experiment with three conditions: emotion-focused, information-focused and control. Preference-value consistency, knowledge, decisional conflict and satisfaction were compared across the conditions using planned contrast analyses. The intervention comprised two different DAs and instructional manipulations. The emotion-focused condition received a modified DA with affective content and instructions to induce an affective reaction. The information-focused and control conditions received the same DA without the affective content. The information-focused condition received additional instructions to induce deliberative processing. Controlling for the experiment-wise error rate at P affective processing may hinder value-consistent decision making, while deliberative processing may enhance decisional satisfaction. This investigation of the effect of affective and deliberative processes in DA-supported decision making has implications for the design and use of DAs. DA effectiveness may be enhanced by incorporating a simple instruction to focus on the details of the information. © 2014 John Wiley & Sons Ltd.

  19. AIDS vaccine for Asia Network (AVAN: expanding the regional role in developing HIV vaccines.

    Directory of Open Access Journals (Sweden)

    Stephen J Kent

    2010-09-01

    Full Text Available The HIV/AIDS pandemic continues to spread and an AIDS vaccine is urgently needed. Regional alliances and international collaborations can foster the development and evaluation of the next generation of AIDS vaccine candidates. The importance of coordinating and harmonizing efforts across regional alliances has become abundantly clear. We recently formed the AIDS Vaccine for Asia Network (AVAN to help facilitate the development of a regional AIDS vaccine strategy that accelerates research and development of an AIDS vaccine through government advocacy, improved coordination, and harmonization of research; develops clinical trial and manufacturing capacity; supports ethical and regulatory frameworks; and ensures community participation.

  20. Clinical decision aids for chest pain in the emergency department: identifying low-risk patients

    Science.gov (United States)

    Alley, William; Mahler, Simon A

    2015-01-01

    Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS). However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography. This review describes several of the chest pain decision aids developed and studied through the recent past, starting with the thrombolysis in myocardial infarction (TIMI) risk score and Global Registry of Acute Coronary Events (GRACE) scores, which were developed as prognostic aids for patients already diagnosed with ACS, then subsequently validated in the undifferentiated chest pain population. Asia-Pacific Evaluation of Chest Pain Trial (ASPECT); Accelerated Diagnostic Protocol to Assess Patients With Chest Pain Symptoms Using Contemporary Troponins (ADAPT); North American Chest Pain Rule (NACPR); and History, Electrocardiogram, Age, Risk factors, Troponin (HEART) score have been developed exclusively for use in the undifferentiated chest pain population as well, with improved performance compared to their predecessors. This review describes the relative merits and limitations of these decision aids so that providers can determine which tool fits the needs of their clinical practice setting. PMID:27147894

  1. Climatological Data Option in My Weather Impacts Decision Aid (MyWIDA) Overview

    Science.gov (United States)

    2017-07-18

    a rules-based tactical decision aid, provides weather effects on weapon systems by coupling weather forecast data with system-specific environmental...day o Global grids o Pressure level o 2.5 ° by 2.5 ° • Higher Fidelity Data with Weather Research and Forecasting (WRF) Model Run The WRF...TES Threshold Evaluation Service WSDL Web Services Description Language XML eXtensible Markup Language WRF Weather Research and Forecasting

  2. Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes

    Science.gov (United States)

    Clarinval, Caroline; Biller-Andorno, Nikola

    2014-01-01

    Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575

  3. Multi-criteria decision analysis for setting priorities on HIV/AIDS interventions in Thailand.

    Science.gov (United States)

    Youngkong, Sitaporn; Teerawattananon, Yot; Tantivess, Sripen; Baltussen, Rob

    2012-02-17

    A wide range of preventive, treatment, and care programs for HIV/AIDS are currently available and some of them have been implemented in Thailand. Policy makers are now facing challenges on how the scarce resources for HIV/AIDS control can be spent more wisely. Although effectiveness and cost-effectiveness information is useful for guiding policy decisions, empirical evidence indicates the importance of other criteria, such as equity and the characteristics of the target population, also play important roles in priority setting. This study aims to experiment with the use of multi-criteria decision analysis (MCDA) to prioritise interventions in HIV/AIDS control in Thailand. We used MCDA to rank 40 HIV/AIDS interventions on the basis of the priority setting criteria put forward by three groups of stakeholders including policy makers, people living with HIV/AIDs (PLWHA), and village health volunteers (VHVs). MCDA incorporated an explicit component of deliberation to let stakeholders reflect on the rank ordering, and adapt where necessary. Upon deliberation, policy makers expressed a preference for programs that target high risk groups such as men who have sex with men, injecting drug users, and female sex workers. The VHVs preferred interventions that target the youth or the general population, and gave lower priority to programs that target high risk groups. PLWHA gave all interventions the same priority. The rank order correlation between the priorities as expressed before and after deliberation was 37% among the policy makers and 46% among the VHVs. This study documented the feasibility of MCDA to prioritize HIV/AIDS interventions in Thailand, and has shown the usefulness of a deliberative process as an integrated component of MCDA. MCDA holds potential to contribute to a more transparent and accountable priority setting process, and further application of this approach in the prioritisation of health interventions is warranted.

  4. Decisional equipoise is not decisional conflict: avoiding the false clarity bias in the evaluation of decision aids and Shared Decision Making processes

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Salkeld, Glenn; Cunich, Michelle

    2014-01-01

    these criteria weights with the best available evidence on the performance of the two options (have or not have a PSA test) on each criterion, produced a personalised expected value score for each option on a 0 to 1 scale. The Absolute Difference (AD) between the two option scores for each individual......Purposes: To question the use of criteria related to decisional ‘sureness’ in evaluating decision aids and Shared Decision Making processes,- as occurs in the Decisional Conflict Scale (items 10-12) and its reduced form SURE (item 1) - on the ground that decisional equipoise is a legitimate outcome...... that should not affect an evaluation of decision quality or decision support. To investigate the empirical extent of equipoise in a decision aid trial and explore the relationship between degree of equipoise and decision quality as self-assessed by MyDecisionQuality, a dually-personalised instrument that does...

  5. Management in Networks On multi-actor decision making

    CERN Document Server

    de Bruijn, Hans

    2012-01-01

    Getting what you want - even if you are the boss - isn't always easy. Almost every organization, big or small, works among a network of competing interests. Whether it's governments pushing through policies, companies trying to increase profits, or even families deciding where to move house, rarely can decisions be made in isolation from competing interests both within the organization and outside it. In this accessible and straightforward account, Hans de Bruijn and Ernst ten Heuvelhof cast light on multi-stakeholder decision-making. Shunning simplistic model talk, they reveal the nuts and bo

  6. Development of cognitive and affective control networks and decision making.

    Science.gov (United States)

    Kar, Bhoomika R; Vijay, Nivita; Mishra, Shreyasi

    2013-01-01

    Cognitive control and decision making are two important research areas in the realm of higher-order cognition. Control processes such as interference control and monitoring in cognitive and affective contexts have been found to influence the process of decision making. Development of control processes follows a gradual growth pattern associated with the prolonged maturation of underlying neural circuits including the lateral prefrontal cortex, anterior cingulate, and the medial prefrontal cortex. These circuits are also involved in the control of processes that influences decision making, particularly with respect to choice behavior. Developmental studies on affective control have shown distinct patterns of brain activity with adolescents showing greater activation of amygdala whereas adults showing greater activity in ventral prefrontal cortex. Conflict detection, monitoring, and adaptation involve anticipation and subsequent performance adjustments which are also critical to complex decision making. We discuss the gradual developmental patterns observed in two of our studies on conflict monitoring and adaptation in affective and nonaffective contexts. Findings of these studies indicate the need to look at the differences in the effects of the development of cognitive and affective control on decision making in children and particularly adolescents. Neuroimaging studies have shown the involvement of separable neural networks for cognitive (medial prefrontal cortex and anterior cingulate) and affective control (amygdala, ventral medial prefrontal cortex) shows that one system can affect the other also at the neural level. Hence, an understanding of the interaction and balance between the cognitive and affective brain networks may be crucial for self-regulation and decision making during the developmental period, particularly late childhood and adolescence. The chapter highlights the need for empirical investigation on the interaction between the different aspects

  7. Spectrum handoff scheme with multiple attributes decision making for optimal network selection in cognitive radio networks

    Directory of Open Access Journals (Sweden)

    Krishan Kumar

    2017-08-01

    Full Text Available It is envisaged that in future Cognitive Radio (CR networks deployment, multiple radio access networks may coexist. The networks may have different characteristics in terms of multiple attributes. CRs will have choices of selecting the optimal network out of the available networks. Optimal network selection is a challenging task that can be performed by spectrum handoff with Multiple Attribute Decision Making (MADM. The spectrum handoff decision with MADM provides wider and optimal choice with quality of service. This motivates the devolopment of a spectrum handoff scheme with MADM methods such as simple additive weighting, a technique for order preference by similarity to the ideal solution, a grey relational analysis and a cost function based method, which is the objective of this study. The CR preferences are based on voice, video and data services, called triple play services. The numerical results show that all MADM methods are effective for selecting the optimal network for spectrum handoff with a reduced complexity for the spectrum handoff decision. The paper shows that the proposed spectrum handoff scheme can be effectively implemented to select the optimal network according to triple play services in CR networks.

  8. SEDIMENT ANALYSIS NETWORK FOR DECISION SUPPORT (SANDS) MODIS GULF SUBSETTED V1

    Data.gov (United States)

    National Aeronautics and Space Administration — Sediment Analysis Network for Decision Support (SANDS) MODIS Gulf Subsetted -- The Sediment Analysis Network for Decision Support (SANDS) analyzes GeoTIFF images to...

  9. Evolution of a vertebrate social decision-making network.

    Science.gov (United States)

    O'Connell, Lauren A; Hofmann, Hans A

    2012-06-01

    Animals evaluate and respond to their social environment with adaptive decisions. Revealing the neural mechanisms of such decisions is a major goal in biology. We analyzed expression profiles for 10 neurochemical genes across 12 brain regions important for decision-making in 88 species representing five vertebrate lineages. We found that behaviorally relevant brain regions are remarkably conserved over 450 million years of evolution. We also find evidence that different brain regions have experienced different selection pressures, because spatial distribution of neuroendocrine ligands are more flexible than their receptors across vertebrates. Our analysis suggests that the diversity of social behavior in vertebrates can be explained, in part, by variations on a theme of conserved neural and gene expression networks.

  10. ‘PICO-D Management’; a decision-aid for evidence-based chiropractic education and clinical practice

    National Research Council Canada - National Science Library

    Amorin-Woods, Lyndon G; Losco, Barrett E

    2016-01-01

    .... Results "PICO-D Man" (Patient-Intervention-Comparator-Outcome-Duration Management) is a decision-aid developed in an educational setting which field practitioners may also find useful for applying defensible evidence-based practice...

  11. Consumer Acceptance of Recommendations by Interactive Decision Aids: The Joint Role of Temporal Distance and Concrete vs. Abstract Communications

    NARCIS (Netherlands)

    C.F. Koehler (Clemens); E. Breugelmans (Els); B.G.C. Dellaert (Benedict)

    2010-01-01

    textabstractInteractive decision aids (IDAs) typically use concrete product feature-based approaches to interact with consumers. Recently however, interaction designs that focus on communicating abstract consumer needs have been suggested as a promising alternative. This article investigates how

  12. The analysis of HIV/AIDS drug-resistant on networks

    Science.gov (United States)

    Liu, Maoxing

    2014-01-01

    In this paper, we present an Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) drug-resistant model using an ordinary differential equation (ODE) model on scale-free networks. We derive the threshold for the epidemic to be zero in infinite scale-free network. We also prove the stability of disease-free equilibrium (DFE) and persistence of HIV/AIDS infection. The effects of two immunization schemes, including proportional scheme and targeted vaccination, are studied and compared. We find that targeted strategy compare favorably to a proportional condom using has prominent effect to control HIV/AIDS spread on scale-free networks.

  13. Feature extraction for deep neural networks based on decision boundaries

    Science.gov (United States)

    Woo, Seongyoun; Lee, Chulhee

    2017-05-01

    Feature extraction is a process used to reduce data dimensions using various transforms while preserving the discriminant characteristics of the original data. Feature extraction has been an important issue in pattern recognition since it can reduce the computational complexity and provide a simplified classifier. In particular, linear feature extraction has been widely used. This method applies a linear transform to the original data to reduce the data dimensions. The decision boundary feature extraction method (DBFE) retains only informative directions for discriminating among the classes. DBFE has been applied to various parametric and non-parametric classifiers, which include the Gaussian maximum likelihood classifier (GML), the k-nearest neighbor classifier, support vector machines (SVM) and neural networks. In this paper, we apply DBFE to deep neural networks. This algorithm is based on the nonparametric version of DBFE, which was developed for neural networks. Experimental results with the UCI database show improved classification accuracy with reduced dimensionality.

  14. Using Bayesian networks to support decision-focused information retrieval

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, P.; Elsaesser, C.; Seligman, L. [Mitre Corp., McLean, VA (United States)

    1996-12-31

    This paper has described an approach to controlling the process of pulling data/information from distributed data bases in a way that is specific to a persons specific decision making context. Our prototype implementation of this approach uses a knowledge-based planner to generate a plan, an automatically constructed Bayesian network to evaluate the plan, specialized processing of the network to derive key information items that would substantially impact the evaluation of the plan (e.g., determine that replanning is needed), automated construction of Standing Requests for Information (SRIs) which are automated functions that monitor changes and trends in distributed data base that are relevant to the key information items. This emphasis of this paper is on how Bayesian networks are used.

  15. A 'combined framework' approach to developing a patient decision aid: the PANDAs model.

    Science.gov (United States)

    Ng, Chirk Jenn; Mathers, Nigel; Bradley, Alastair; Colwell, Brigitte

    2014-10-24

    There is a lack of practical research frameworks to guide the development of patient decision aids [PtDAs]. This paper described how a PtDA was developed using the International Patient Decision Aids (IPDAS) guideline and UK Medical Research Council (UKMRC) frameworks to support patients when making treatment decisions in type 2 diabetes mellitus. This study used mixed methods to develop a PtDA for use in a UK general practice setting. A 10-member expert panel was convened to guide development and patients and clinicians were also interviewed individually using semi-structured interview guides to identify their decisional needs. Current literature was reviewed systematically to determine the best available evidence. The Ottawa Decision Support Framework was used to guide the presentation of the information and value clarification exercise. An iterative draft-review-revise process by the research team and review panel was conducted until the PtDA reached content and format 'saturation'. The PtDA was then pilot-tested by users in actual consultations to assess its acceptability and feasibility. The IPDAS and UKMRC frameworks were used throughout to inform the development process. The PANDAs PtDA was developed systematically and iteratively. Patients and clinicians highlighted the needs for information, decisional, emotional and social support, which were incorporated into the PtDA. The literature review identified gaps in high quality evidence and variations in patient outcome reporting. The PtDA comprised five components: background of the treatment options; pros and cons of each treatment option; value clarification exercise; support needs; and readiness to decide. This study has demonstrated the feasibility of combining the IPDAS and the UKMRC frameworks for the development and evaluation of a PtDA. Future studies should test this model for developing PtDAs across different decisions and healthcare contexts.

  16. Geriatric consultation can aid in complex treatment decisions for elderly cancer patients.

    Science.gov (United States)

    Schiphorst, A H W; Ten Bokkel Huinink, D; Breumelhof, R; Burgmans, J P J; Pronk, A; Hamaker, M E

    2016-05-01

    Treatment decisions for elderly cancer patients can be challenging. A geriatric assessment may identify unknown medical conditions, give insight on patients' ability to tolerate treatment and guide treatment decisions. Our aim was to study the value of a geriatric consultation in oncological decision-making. Data on cancer patients referred for geriatric consultation for clinical optimisation or due to uncertainty regarding their optimal treatment strategy were prospectively analysed. Outcome of geriatric evaluations, non-oncological interventions and suggested adaptations of oncological treatment proposals were evaluated. Seventy-two patients were referred for consultation, over half of which in a curative treatment setting. Prevalence of geriatric syndromes was 93%, previously undiagnosed conditions were identified in 49% of patients and non-oncological interventions were initiated in 56%. Time was spent discussing patients' priorities (53% of consultations), expectations on treatment (50%) and advance care planning (14%). For 82% of patients, suggestions were made regarding the optimal treatment decision: a more intensive treatment was recommended in 39%, a less intensive therapy for 42% and in 19% only supportive care was suggested. The results demonstrate that a geriatric consultation can aid in complex treatment decisions and may allow for a reduction in over- and undertreatment of elderly cancer patients. © 2015 John Wiley & Sons Ltd.

  17. The Legal Concept of Charity and its Expansion after the Aid/Watch Decision

    Directory of Open Access Journals (Sweden)

    Fiona Martin

    2011-11-01

    Full Text Available This paper provides the reader with an insight into the legal analysis of the concept of ‘charity’ and ‘charitable purpose’. This discussion is important in light of the 2010 High Court decision in Commissioner of Taxation v Aid/Watch Incorporated. It begins with an overview of the historical development of ‘charity’ as a legal concept. It then considers how this concept has been interpreted in the context of taxation law and in particular focuses on the arguments for and against a restriction of advocacy and political lobbying by charities. It concludes with an analysis of the Aid/Watch Case and how this may be applied in the future to other charitable entities.

  18. Patient-Centered Decision Support: Formative Usability Evaluation of Integrated Clinical Decision Support With a Patient Decision Aid for Minor Head Injury in the Emergency Department.

    Science.gov (United States)

    Melnick, Edward R; Hess, Erik P; Guo, George; Breslin, Maggie; Lopez, Kevin; Pavlo, Anthony J; Abujarad, Fuad; Powsner, Seth M; Post, Lori A

    2017-05-19

    The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions. Our objective is to formatively evaluate an electronic tool that not only helps clinicians at the bedside to determine the need for CT use based on the Canadian CT Head Rule but also promotes evidence-based conversations between patients and clinicians regarding patient-specific risk and patients' specific concerns. User-centered design with practice-based and participatory decision aid development was used to design, develop, and evaluate patient-centered decision support regarding CT use in minor head injury in the emergency department. User experience and user interface (UX/UI) development involved successive iterations with incremental refinement in 4 phases: (1) initial prototype development, (2) usability assessment, (3) field testing, and (4) beta testing. This qualitative approach involved input from patients, emergency care clinicians, health services researchers, designers, and clinical informaticists at every stage. The Concussion or Brain Bleed app is the product of 16 successive iterative revisions in accordance with UX/UI industry design standards. This useful and usable final product integrates clinical decision support with a patient decision aid. It promotes shared use by emergency clinicians and patients at the point of care within the emergency department context. This tablet computer app facilitates evidence-based conversations regarding CT in minor head injury. It is adaptable to individual clinician practice styles. The resultant tool

  19. Standards for UNiversal reporting of patient Decision Aid Evaluation studies: the development of SUNDAE Checklist.

    Science.gov (United States)

    Sepucha, Karen R; Abhyankar, Purva; Hoffman, Aubri S; Bekker, Hilary L; LeBlanc, Annie; Levin, Carrie A; Ropka, Mary; Shaffer, Victoria A; Sheridan, Stacey L; Stacey, Dawn; Stalmeier, Peep; Vo, Ha; Wills, Celia E; Thomson, Richard

    2017-12-21

    Patient decision aids (PDAs) are evidence-based tools designed to help patients make specific and deliberated choices among healthcare options. The International Patient Decision Aid Standards (IPDAS) Collaboration review papers and Cochrane systematic review of PDAs have found significant gaps in the reporting of evaluations of PDAs, including poor or limited reporting of PDA content, development methods and delivery. This study sought to develop and reach consensus on reporting guidelines to improve the quality of publications evaluating PDAs. An international workgroup, consisting of members from IPDAS Collaboration, followed established methods to develop reporting guidelines for PDA evaluation studies. This paper describes the results from three completed phases: (1) planning, (2) drafting and (3) consensus, which included a modified, two-stage, online international Delphi process. The work was conducted over 2 years with bimonthly conference calls and three in-person meetings. The workgroup used input from these phases to produce a final set of recommended items in the form of a checklist. The SUNDAE Checklist (Standards for UNiversal reporting of patient Decision Aid Evaluations) includes 26 items recommended for studies reporting evaluations of PDAs. In the two-stage Delphi process, 117/143 (82%) experts from 14 countries completed round 1 and 96/117 (82%) completed round 2. Respondents reached a high level of consensus on the importance of the items and indicated strong willingness to use the items when reporting PDA studies. The SUNDAE Checklist will help ensure that reports of PDA evaluation studies are understandable, transparent and of high quality. A separate Explanation and Elaboration publication provides additional details to support use of the checklist. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Decision aids for patients considering total joint replacement: a cost-effectiveness analysis alongside a randomised controlled trial.

    Science.gov (United States)

    Trenaman, L; Stacey, D; Bryan, S; Taljaard, M; Hawker, G; Dervin, G; Tugwell, P; Bansback, N

    2017-10-01

    Shared decision-making (SDM) is a key priority to improve patient-centred care, and can play an important role in helping patients decide whether to undergo total joint arthroplasty (TJA). Patient decision aids can support SDM; however, they may incur an upfront cost. We aimed to estimate the health and economic effects of patient decision aids for TJA. A cost-effectiveness analysis of a randomised controlled trial (RCT) with 2-year follow-up. 343 patients were recruited from two orthopedic screening clinics in Ottawa, Canada. Patients were randomized to either a patient decision aid plus surgeon preference report (decision aid) or usual care. Primary outcomes were costs (in 2014 CAD$), quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER). Costs were calculated by multiplying self-reported resource use by unit costs. QALYs were calculated by mapping the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to EuroQol 5-Dimension (EQ-5D) health utilities. Costs and QALYs were discounted at 5%. Multiple imputation was used to handle missing data, and bootstrapping was used to estimate uncertainty. The sample comprised 167 intervention and 167 control group patients. The decision aid arm had fewer surgeries over the 2-year period thereby incurring a negative incremental cost of -$560 (95% CI: -$1358 to $426) per patient while providing 0.05 (95% CI: -0.04 to 0.13) additional QALYs per patient. Consequently, the decision aid arm was dominant. The use of a patient decision aid was associated with fewer health care costs, while producing similar health outcomes. CT00911638 (clinicaltrials.gov). Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  1. Social networks, drug injectors' lives, and HIV/AIDS

    National Research Council Canada - National Science Library

    Friedman, Samuel R

    1999-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Individualistic Views of Risk Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . Social and Risk Networks Influence HIV Risk Behaviors and Infection...

  2. Predictors of the International HIV-AIDS INGO Network over Time

    Science.gov (United States)

    Shumate, Michelle; Fulk, Janet; Monge, Peter

    2005-01-01

    The HIV-AIDS epidemic is one of the most challenging and significant health crises facing the world today. In order to cope with its complexities, the United Nations and World Health Organization have increasingly relied upon the resources offered by networks of HIV-AIDS nongovernmental organizations (NGOs). The research reported here uses…

  3. Landslide Susceptibility Mapping of Tegucigalpa, Honduras Using Artificial Neural Network, Bayesian Network and Decision Trees

    Science.gov (United States)

    Garcia Urquia, E. L.; Braun, A.; Yamagishi, H.

    2016-12-01

    Tegucigalpa, the capital city of Honduras, experiences rainfall-induced landslides on a yearly basis. The high precipitation regime and the rugged topography the city has been built in couple with the lack of a proper urban expansion plan to contribute to the occurrence of landslides during the rainy season. Thousands of inhabitants live at risk of losing their belongings due to the construction of precarious shelters in landslide-prone areas on mountainous terrains and next to the riverbanks. Therefore, the city is in the need for landslide susceptibility and hazard maps to aid in the regulation of future development. Major challenges in the context of highly dynamic urbanizing areas are the overlap of natural and anthropogenic slope destabilizing factors, as well as the availability and accuracy of data. Data-driven multivariate techniques have proven to be powerful in discovering interrelations between factors, identifying important factors in large datasets, capturing non-linear problems and coping with noisy and incomplete data. This analysis focuses on the creation of a landslide susceptibility map using different methods from the field of data mining, Artificial Neural Networks (ANN), Bayesian Networks (BN) and Decision Trees (DT). The input dataset of the study contains geomorphological and hydrological factors derived from a digital elevation model with a 10 m resolution, lithological factors derived from a geological map, and anthropogenic factors, such as information on the development stage of the neighborhoods in Tegucigalpa and road density. Moreover, a landslide inventory map that was developed in 2014 through aerial photo interpretation was used as target variable in the analysis. The analysis covers an area of roughly 100 km2, while 8.95 km2 are occupied by landslides. In a first step, the dataset was explored by assessing and improving the data quality, identifying unimportant variables and finding interrelations. Then, based on a training

  4. Assessing the acceptability and feasibility of encounter decision aids for early stage breast cancer targeted at underserved patients

    NARCIS (Netherlands)

    Alam, S.; Elwyn, G.; Percac-Lima, S.; Grande, S.; Durand, M.A.

    2016-01-01

    BACKGROUND: Women of low socioeconomic status (SES) diagnosed with early stage breast cancer are less likely to be involved in treatment decisions. They tend to report higher decisional regret and poorer communication. Evidence suggests that well-designed encounter decision aids (DAs) could improve

  5. Childbearing Decision Making: A Qualitative Study of Women Living with HIV/AIDS in Southwest Nigeria

    Directory of Open Access Journals (Sweden)

    Y. A. Sofolahan

    2012-01-01

    Full Text Available Using the PEN-3 model, the purpose of this qualitative study was to understand the factors responsible for the childbearing decisions of women living with HIV/AIDS (WLHA in Lagos, Nigeria. Sixty WLHA who sought care at a teaching hospital in Lagos were recruited to participate in in-depth interviews. The average age of the participants was 30 years, and 48 participants were receiving antiretroviral therapy. Healthcare and spiritual practices, healthcare provider-patient communication about childbearing, and husband/partner support emerged as factors that contribute to the childbearing decisions of WLHA. The findings reveal the importance of discussing sexual reproductive health and childbearing issues with WLHA in the healthcare context prior to pregnancy.

  6. Artificial neural networks aided conceptual stage design of water harvesting structures

    Directory of Open Access Journals (Sweden)

    Vinay Chandwani

    2016-09-01

    Full Text Available The paper presents artificial neural networks (ANNs based methodology for ascertaining the structural parameters of water harvesting structures (WHS at the conceptual stage of design. The ANN is trained using exemplar patterns generated using an in-house MSExcel based design program, to draw a functional relationship between the five inputs design parameters namely, peak flood discharge, safe bearing capacity of strata, length of structure, height of structure and silt factor and four outputs namely, top width, bottom width, foundation depth and flood lift representing the structural parameters of WHS. The results of the study show that, the structural parameters of the WHS predicted using ANN model are in close agreement with the actual field parameters. The versatility of ANN to map complex or complex unknown relationships has been proven in the study. A parametric sensitivity study is also performed to assess the most significant design parameter. The study holistically presents a neural network based decision support tool that can be used to accurately estimate the major design parameters of the WHS at the conceptual stage of design in quick time, aiding the engineer-in-charge to conveniently forecast the budget requirements and minimize the labor involved during the subsequent phases of analysis and design.

  7. Quantum-Like Bayesian Networks for Modeling Decision Making

    Directory of Open Access Journals (Sweden)

    Catarina eMoreira

    2016-01-01

    Full Text Available In this work, we explore an alternative quantum structure to perform quantum probabilistic inferences to accommodate the paradoxical findings of the Sure Thing Principle. We propose a Quantum-Like Bayesian Network, which consists in replacing classical probabilities by quantum probability amplitudes. However, since this approach suffers from the problem of exponential growth of quantum parameters, we also propose a similarity heuristic that automatically fits quantum parameters through vector similarities. This makes the proposed model general and predictive in contrast to the current state of the art models, which cannot be generalized for more complex decision scenarios and that only provide an explanatory nature for the observed paradoxes. In the end, the model that we propose consists in a nonparametric method for estimating inference effects from a statistical point of view. It is a statistical model that is simpler than the previous quantum dynamic and quantum-like models proposed in the literature. We tested the proposed network with several empirical data from the literature, mainly from the Prisoner's Dilemma game and the Two Stage Gambling game. The results obtained show that the proposed quantum Bayesian Network is a general method that can accommodate violations of the laws of classical probability theory and make accurate predictions regarding human decision-making in these scenarios.

  8. An entertainment-education colorectal cancer screening decision aid for African American patients: A randomized controlled trial.

    Science.gov (United States)

    Hoffman, Aubri S; Lowenstein, Lisa M; Kamath, Geetanjali R; Housten, Ashley J; Leal, Viola B; Linder, Suzanne K; Jibaja-Weiss, Maria L; Raju, Gottumukkala S; Volk, Robert J

    2017-04-15

    Colorectal cancer screening rates for African American patients remain suboptimal. Patient decision aids designed with an entertainment-education approach have been shown to improve saliency and foster informed decision making. The purpose of this study was to assess whether an entertainment-education decision aid tailored for African American patients improved patients' decision making, attitudes, intentions, or colorectal cancer screening behavior. Eighty-nine participants were randomized to view 1) a patient decision aid video containing culturally tailored information about colorectal cancer screening options and theory-based support in decision making presented in an entertainment-education format or 2) an attention control video about hypertension that contained similarly detailed information. Participants met with their clinician and then completed follow-up questionnaires assessing their knowledge, decisional conflict, self-advocacy, attitudes, perceived social norms, and intentions. At 3 months, completion of screening was assessed by chart review. Viewing the culturally tailored decision aid significantly increased African American patients' knowledge of colorectal cancer screening recommendations and options. It also significantly reduced their decisional conflict and improved their self-advocacy. No significant differences were observed in participants' attitudes, norms, or intentions. At three months, 23% of all patients had completed a colonoscopy. Designing targeted, engaging patient decision aids for groups that receive suboptimal screening holds promise for improving patient decision making and self-advocacy. Additional research is warranted to investigate the effectiveness of such aids in clinical practices with suboptimal screening rates and on downstream behaviors (such as repeat testing). Cancer 2017;123:1401-1408. © 2016 American Cancer Society. © 2016 American Cancer Society.

  9. 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.

  10. CEO emotional bias and investment decision, Bayesian network method

    Directory of Open Access Journals (Sweden)

    Jarboui Anis

    2012-08-01

    Full Text Available This research examines the determinants of firms’ investment introducing a behavioral perspective that has received little attention in corporate finance literature. The following central hypothesis emerges from a set of recently developed theories: Investment decisions are influenced not only by their fundamentals but also depend on some other factors. One factor is the biasness of any CEO to their investment, biasness depends on the cognition and emotions, because some leaders use them as heuristic for the investment decision instead of fundamentals. This paper shows how CEO emotional bias (optimism, loss aversion and overconfidence affects the investment decisions. The proposed model of this paper uses Bayesian Network Method to examine this relationship. Emotional bias has been measured by means of a questionnaire comprising several items. As for the selected sample, it has been composed of some 100 Tunisian executives. Our results have revealed that the behavioral analysis of investment decision implies leader affected by behavioral biases (optimism, loss aversion, and overconfidence adjusts its investment choices based on their ability to assess alternatives (optimism and overconfidence and risk perception (loss aversion to create of shareholder value and ensure its place at the head of the management team.

  11. Bridging groundwater models and decision support with a Bayesian network

    Science.gov (United States)

    Fienen, Michael N.; Masterson, John P.; Plant, Nathaniel G.; Gutierrez, Benjamin T.; Thieler, E. Robert

    2013-01-01

    Resource managers need to make decisions to plan for future environmental conditions, particularly sea level rise, in the face of substantial uncertainty. Many interacting processes factor in to the decisions they face. Advances in process models and the quantification of uncertainty have made models a valuable tool for this purpose. Long-simulation runtimes and, often, numerical instability make linking process models impractical in many cases. A method for emulating the important connections between model input and forecasts, while propagating uncertainty, has the potential to provide a bridge between complicated numerical process models and the efficiency and stability needed for decision making. We explore this using a Bayesian network (BN) to emulate a groundwater flow model. We expand on previous approaches to validating a BN by calculating forecasting skill using cross validation of a groundwater model of Assateague Island in Virginia and Maryland, USA. This BN emulation was shown to capture the important groundwater-flow characteristics and uncertainty of the groundwater system because of its connection to island morphology and sea level. Forecast power metrics associated with the validation of multiple alternative BN designs guided the selection of an optimal level of BN complexity. Assateague island is an ideal test case for exploring a forecasting tool based on current conditions because the unique hydrogeomorphological variability of the island includes a range of settings indicative of past, current, and future conditions. The resulting BN is a valuable tool for exploring the response of groundwater conditions to sea level rise in decision support.

  12. International earth science information network for global change decision making

    Energy Technology Data Exchange (ETDEWEB)

    Autrey-Hunley, C.; Kuhn, W.R.; Kasischke, E.; Trichel, M.T.; Coppola, R.

    1991-01-01

    Effective environmental decision making depends upon the ability to predict physical changes in the environment, societal responses to these changes, and how both the physical changes and societal responses will be affected by changes in government regulations, public perceptions and the environment. Technological advances in remote sensing have provided a wealth of earth science data necessary to study global change problems; the Earth Observatory System will provide an unprecedented data source in the late 1990's. The Consortium for an International Earth Science Information Network (CIESIN) will combine earth science data (both satellite and ground-based) with data on the social sciences (e.g., economics, demographics, public health) to support informed policy decisions and to transfer knowledge on global change and its causes to the public.

  13. 'PICO-D Management'; a decision-aid for evidence-based chiropractic education and clinical practice.

    Science.gov (United States)

    Amorin-Woods, Lyndon G; Losco, Barrett E

    2016-01-01

    Various models and decision-making aids exist for chiropractic clinical practice. "PICO-D Man" (Patient-Intervention-Comparator-Outcome-Duration Management) is a decision-aid developed in an educational setting which field practitioners may also find useful for applying defensible evidence-based practice. Clinical decision-making involves understanding and evaluating both the proposed clinicalintervention(s) and the relevant and available management options with respect to describing the patient and their problem, clinical and cost effectiveness, safety, feasibility and time-frame. For people consulting chiropractors this decision-aid usually requires the practitioner to consider a comparison of usual chiropractic care, (clinical management including a combination of active care and passive manual interventions), to usual medical care usually including medications, or other allied healthmanagement options while being mindful of the natural history of the persons' condition.

  14. Cultural and Linguistic Adaptation of a Multimedia Colorectal Cancer Screening Decision Aid for Spanish Speaking Latinos

    Science.gov (United States)

    Ko, Linda K.; Reuland, Daniel; Jolles, Monica; Clay, Rebecca; Pignone, Michael

    2014-01-01

    As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse and most vulnerable populations. Latinos also have the lowest colorectal (CRC) screening rates of any ethnic group in the U.S. To address such disparities, health communication interventionists are often faced with the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. We describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish language version of an evidenced-based (English language) multimedia CRC screening decision aid. Our multi-step process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. We integrated these findings in the creation of the new adapted intervention. We describe how we used this process to identify and integrate socio-cultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish language decision aid. PMID:24328496

  15. "Provoking conversations": case studies of organizations where Option Grid™ decision aids have become 'normalized'.

    Science.gov (United States)

    Scalia, Peter; Elwyn, Glyn; Durand, Marie-Anne

    2017-08-18

    Implementing patient decision aids in clinic workflow has proven to be a challenge for healthcare organizations and physicians. Our aim was to determine the organizational strategies, motivations, and facilitating factors to the routine implementation of Option Grid™ encounter decision aids at two independent settings. Case studies conducted by semi-structured interview, using the Normalization Process Theory (NPT) as a framework for thematic analysis. Twenty three interviews with physicians, nurses, hospital staff and stakeholders were conducted at: 1) CapitalCare Medical Group in Albany, New York; 2) HealthPartners Clinics in Minneapolis, Minnesota. 'Coherent' motivations were guided by financial incentives at CapitalCare, and by a 'champion' physician at HealthPartners. Nurses worked 'collectively' at both settings and played an important role at sites where successful implementation occurred. Some physicians did not understand the perceived utility of Option Grid™, which led to varying degrees of implementation success across sites. The appraisal work (reflexive monitoring) identified benefits, particularly in terms of information provision. Physicians at both settings, however, were concerned with time pressures and the suitability of the tool for patients with low levels of health literacy. Although both practice settings illustrated the mechanisms of normalization postulated by the theory, the extent to which Option Grid™ was routinely embedded in clinic workflow varied between sites, and between clinicians. Implementation of new interventions will require attention to an identified rationale (coherence), and to the collective action, cognitive participation, and assessment of value by organizational members of the organization.

  16. Evolving neural networks for strategic decision-making problems.

    Science.gov (United States)

    Kohl, Nate; Miikkulainen, Risto

    2009-04-01

    Evolution of neural networks, or neuroevolution, has been a successful approach to many low-level control problems such as pole balancing, vehicle control, and collision warning. However, certain types of problems-such as those involving strategic decision-making-have remained difficult for neuroevolution to solve. This paper evaluates the hypothesis that such problems are difficult because they are fractured: The correct action varies discontinuously as the agent moves from state to state. A method for measuring fracture using the concept of function variation is proposed and, based on this concept, two methods for dealing with fracture are examined: neurons with local receptive fields, and refinement based on a cascaded network architecture. Experiments in several benchmark domains are performed to evaluate how different levels of fracture affect the performance of neuroevolution methods, demonstrating that these two modifications improve performance significantly. These results form a promising starting point for expanding neuroevolution to strategic tasks.

  17. The Interaction of Decision Aid Usage, Training Methodology, and Personality Construct on Decision Making Among Dyadic Air Crews in a Military Environment

    Science.gov (United States)

    2003-04-01

    difficult, as our beliefs, attitudes, and preferences are composed in given contexts which often elicit Primacy and Recency effects on of information...a/rf produced improvemente of more than 4.5-foId above less ttained counterparts who were not provided an aid. Although Ae effect of group...91 Discussion 95 Manipulation Effects 97 Training 97 Decision Aids 101 Scenario Type (risk factor) 106 Homogeneity 108 Contingency

  18. Effect of training algorithms on neural networks aided pavement ...

    African Journals Online (AJOL)

    user

    pavement modeling results for training the NN aided inverse analysis is .... Also, the Asphalt Institute's Thickness Design Manual MS-1 recommends ERi as ..... http://www.infrastructurereportcard.org/sites/default/files/RC2009_full_report.pdf ...

  19. Social Networks as Information Source for the Purchase Decision Process

    Directory of Open Access Journals (Sweden)

    Camila Leoni Nascimento

    2014-12-01

    Full Text Available The social networks have caused changes in the consumption habits and in the ways of relationship among companies and consumers, emerging a more demanding and informed consumer. In this paper it is aimed to assess the social networks as a source of information for the purchase of goods or services. In the study it was applied a research of exploratory nature through the survey method, conducted through personal interviews using a questionnaire with closed-ended questions. The sample of non-probabilistic type was comprised of 200 individuals from a higher education institution of São Paulo State hinterland. The survey data were analyzed descriptively. Overall, the results showed the use of social networks as a source of information search, in which the main motive is the practicality. The results corroborate the studies of Kotler and Keller (2006 when they state that the consumer seeks information on social networks to help him in the purchase, as Edelman and Hirshberg (2006 when approaching the user confidence in their friends’ opinion. For future works it is recommended to check what strategies and in what ways the companies could work in order to provide more detailed data to Internet users, aiming to support them in the decision

  20. The Longitudinal Impact of an Internet Safety Decision Aid for Abused Women.

    Science.gov (United States)

    Glass, Nancy E; Perrin, Nancy A; Hanson, Ginger C; Bloom, Tina L; Messing, Jill T; Clough, Amber S; Campbell, Jacquelyn C; Gielen, Andrea C; Case, James; Eden, Karen B

    2017-05-01

    Women experiencing intimate partner violence (IPV) navigate complex, dangerous decisions. Tailored safety information and safety planning, typically provided by domestic violence service providers, can prevent repeat IPV exposure and associated adverse health outcomes; however, few abused women access these services. The Internet represents a potentially innovative way to connect abused women with tailored safety planning resources and information. The purpose of this study was to compare safety and mental health outcomes at baseline, 6 months, and 12 months among abused women randomized to: (1) a tailored, Internet-based safety decision aid; or (2) control website (typical safety information available online). Multistate, community-based longitudinal RCT with one-to-one allocation ratio and blocked randomization. Data were collected March 2011-May 2013 and analyzed June-July 2015. Currently abused Spanish- or English-speaking women (N=720). A tailored Internet-based safety decision aid included priority-setting activities, risk assessment, and tailored feedback and safety plans. A control website offered typical safety information available online. Primary outcomes were decisional conflict, safety behaviors, and repeat IPV; secondary outcomes included depression and post-traumatic stress disorder. At 12 months, there were no significant group differences in IPV, depression, or post-traumatic stress disorder. Intervention women experienced significantly less decisional conflict after one use (β= -2.68, p=0.042) and greater increase in safety behaviors they rated as helpful from baseline to 12 months (12% vs 9%, p=0.033) and were more likely to have left the abuser (63% vs 53%, p=0.008). Women who left had higher baseline risk (14.9 vs 13.1, p=0.003) found more of the safety behaviors they tried helpful (61.1% vs 47.5%, pInternet-based safety planning represents a promising tool to reduce the public health impact of IPV. Copyright © 2017 American Journal of

  1. GT-MSOCC - A domain for research on human-computer interaction and decision aiding in supervisory control systems. [Georgia Tech - Multisatellite Operations Control Center

    Science.gov (United States)

    Mitchell, Christine M.

    1987-01-01

    The Georgia Tech-Multisatellite Operations Control Center (GT-MSOCC), a real-time interactive simulation of the operator interface to a NASA ground control system for unmanned earth-orbiting satellites, is described. The GT-MSOCC program for investigating a range of modeling, decision aiding, and workstation design issues related to the human-computer interaction is discussed. A GT-MSOCC operator function model is described in which operator actions, both cognitive and manual, are represented as the lowest level discrete control network nodes, and operator action nodes are linked to information needs or system reconfiguration commands.

  2. Impacts of subsidy policies on vaccination decisions in contact networks

    Science.gov (United States)

    Zhang, Hai-Feng; Wu, Zhi-Xi; Xu, Xiao-Ke; Small, Michael; Wang, Lin; Wang, Bing-Hong

    2013-07-01

    To motivate more people to participate in vaccination campaigns, various subsidy policies are often supplied by government and the health sectors. However, these external incentives may also alter the vaccination decisions of the broader public, and hence the choice of incentive needs to be carefully considered. Since human behavior and the networking-constrained interactions among individuals significantly impact the evolution of an epidemic, here we consider the voluntary vaccination on human contact networks. To this end, two categories of typical subsidy policies are considered: (1) under the free subsidy policy, the total amount of subsidy is distributed to a certain fraction of individual and who are vaccinated without personal cost, and (2) under the partial-offset subsidy policy, each vaccinated person is offset by a certain amount of subsidy. A vaccination decision model based on evolutionary game theory is established to study the effects of these different subsidy policies on disease control. Simulations suggest that, because the partial-offset subsidy policy encourages more people to take vaccination, its performance is significantly better than that of the free subsidy policy. However, an interesting phenomenon emerges in the partial-offset scenario: with limited amount of total subsidy, a moderate subsidy rate for each vaccinated individual can guarantee the group-optimal vaccination, leading to the maximal social benefits, while such an optimal phenomenon is not evident for the free subsidy scenario.

  3. Event-triggered Decision Propagation in Proximity Networks

    Directory of Open Access Journals (Sweden)

    Soumik eSarkar

    2014-12-01

    Full Text Available This paper proposes a novel event-triggered formulation as an extension of the recently develo-ped generalized gossip algorithm for decision/awareness propagation in mobile sensor networksmodeled as proximity networks. The key idea is to expend energy for communication (messagetransmission and reception only when there is any event of interest in the region of surveillance.The idea is implemented by using an agent’s belief about presence of a hotspot as feedback tochange its probability of (communication activity. In the original formulation, the evolution ofnetwork topology and the dynamics of decision propagation were completely decoupled whichis no longer the case as a consequence of this feedback policy. Analytical results and numeri-cal experiments are presented to show a significant gain in energy savings with no change inthe first moment characteristics of decision propagation. However, numerical experiments showthat the second moment characteristics may change and theoretical results are provided forupper and lower bounds for second moment characteristics. Effects of false alarms on networkformation and communication activity are also investigated.

  4. Artificial Neural Networks in Mammography Interpretation and Diagnostic Decision Making

    Directory of Open Access Journals (Sweden)

    Turgay Ayer

    2013-01-01

    Full Text Available Screening mammography is the most effective means for early detection of breast cancer. Although general rules for discriminating malignant and benign lesions exist, radiologists are unable to perfectly detect and classify all lesions as malignant and benign, for many reasons which include, but are not limited to, overlap of features that distinguish malignancy, difficulty in estimating disease risk, and variability in recommended management. When predictive variables are numerous and interact, ad hoc decision making strategies based on experience and memory may lead to systematic errors and variability in practice. The integration of computer models to help radiologists increase the accuracy of mammography examinations in diagnostic decision making has gained increasing attention in the last two decades. In this study, we provide an overview of one of the most commonly used models, artificial neural networks (ANNs, in mammography interpretation and diagnostic decision making and discuss important features in mammography interpretation. We conclude by discussing several common limitations of existing research on ANN-based detection and diagnostic models and provide possible future research directions.

  5. Artificial neural networks in mammography interpretation and diagnostic decision making.

    Science.gov (United States)

    Ayer, Turgay; Chen, Qiushi; Burnside, Elizabeth S

    2013-01-01

    Screening mammography is the most effective means for early detection of breast cancer. Although general rules for discriminating malignant and benign lesions exist, radiologists are unable to perfectly detect and classify all lesions as malignant and benign, for many reasons which include, but are not limited to, overlap of features that distinguish malignancy, difficulty in estimating disease risk, and variability in recommended management. When predictive variables are numerous and interact, ad hoc decision making strategies based on experience and memory may lead to systematic errors and variability in practice. The integration of computer models to help radiologists increase the accuracy of mammography examinations in diagnostic decision making has gained increasing attention in the last two decades. In this study, we provide an overview of one of the most commonly used models, artificial neural networks (ANNs), in mammography interpretation and diagnostic decision making and discuss important features in mammography interpretation. We conclude by discussing several common limitations of existing research on ANN-based detection and diagnostic models and provide possible future research directions.

  6. Portable Rule Extraction Method for Neural Network Decisions Reasoning

    Directory of Open Access Journals (Sweden)

    Darius PLIKYNAS

    2005-08-01

    Full Text Available Neural network (NN methods are sometimes useless in practical applications, because they are not properly tailored to the particular market's needs. We focus thereinafter specifically on financial market applications. NNs have not gained full acceptance here yet. One of the main reasons is the "Black Box" problem (lack of the NN decisions explanatory power. There are though some NN decisions rule extraction methods like decompositional, pedagogical or eclectic, but they suffer from low portability of the rule extraction technique across various neural net architectures, high level of granularity, algorithmic sophistication of the rule extraction technique etc. The authors propose to eliminate some known drawbacks using an innovative extension of the pedagogical approach. The idea is exposed by the use of a widespread MLP neural net (as a common tool in the financial problems' domain and SOM (input data space clusterization. The feedback of both nets' performance is related and targeted through the iteration cycle by achievement of the best matching between the decision space fragments and input data space clusters. Three sets of rules are generated algorithmically or by fuzzy membership functions. Empirical validation of the common financial benchmark problems is conducted with an appropriately prepared software solution.

  7. Towards the Significance of Decision Aid in Building Information Modeling (BIM Software Selection Process

    Directory of Open Access Journals (Sweden)

    Omar Mohd Faizal

    2014-01-01

    Full Text Available Building Information Modeling (BIM has been considered as a solution in construction industry to numerous problems such as delays, increased lead in times and increased costs. This is due to the concept and characteristic of BIM that will reshaped the way construction project teams work together to increase productivity and improve the final project outcomes (cost, time, quality, safety, functionality, maintainability, etc.. As a result, the construction industry has witnesses numerous of BIM software available in market. Each of this software has offers different function, features. Furthermore, the adoption of BIM required high investment on software, hardware and also training expenses. Thus, there is indentified that there is a need of decision aid for appropriated BIM software selection that fulfill the project needs. However, research indicates that there is limited study attempt to guide decision in BIM software selection problem. Thus, this paper highlight the importance of decision making and support for BIM software selection as it is vital to increase productivity, construction project throughout building lifecycle.

  8. Decisional outcomes following use of an interactive web-based decision aid for prostate cancer screening.

    Science.gov (United States)

    Tomko, Catherine; Davis, Kimberly; Ludin, Samantha; Kelly, Scott; Stern, Aaron; Luta, George; Taylor, Kathryn L

    2015-06-01

    Informed decision-making tools are recommended for men considering prostate cancer screening. We evaluated the extent to which use of an interactive, web-based decision aid was associated with decisional and screening outcomes. Participants (N = 253) were 57 (7.0) years old and completed telephone interviews at baseline, 1 month, and 13 months post-baseline. Tracking software captured minutes spent on the website (median = 33.9), sections viewed (median = 4.0/5.0), testimonials viewed (median = 4.0/6.0), and values clarification tool (VCT) use (77.3 %). In multivariable analyses, all four website use variables were positively associated with increased knowledge (p's < 0.05). Complete VCT use and number of informational sections were positively associated with greater decisional satisfaction (p's < 0.05). Decisional conflict and screening behavior were not associated with measures of website use. Increased use of informational content and interactive elements were related to improved knowledge and satisfaction. Methods to increase utilization of interactive website components may improve informed decision-making outcomes.

  9. Views of general practice staff about the use of a patient-oriented treatment decision aid in shared decision making for patients with type 2 diabetes : A mixed-methods study

    NARCIS (Netherlands)

    Wildeboer, Anita; du Pon, Esther; Schuling, Jan; Haaijer-Ruskamp, Flora M; Denig, Petra

    BACKGROUND: Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited. OBJECTIVES: To explore views of practice staff towards SDM and the DA. DESIGN:

  10. The loss of reason in patient decision aid research: do checklists damage the quality of informed choice interventions?

    Science.gov (United States)

    Bekker, Hilary L

    2010-03-01

    To discuss whether using the International Patient Decision Aids Standards (IPDAS) Collaboration checklist as a gold standard to judge interventions' quality is premature and potentially detrimental to the validity of resources designed to help patients make treatment choices. Conceptual review integrating the science behind individuals' decision making with the demands of designing complex, healthcare interventions. Patient decision aids are promoted as interventions to help professionals engage in shared and/or patient-centred care. The IPDAS domains were informed by experts' opinions of best practice. Decision scientists study how individuals make decisions, what biases their choices and how best to support decisions. There is debate from decision scientists about which component parts are the active ingredients that help people make decisions. Interventions to help patients make choices have different purposes, component parts and outcomes to those facilitating professional-patient communications. The IPDAS checklist will change to respond to new evidence from the decision sciences. Adhering uncritically to the IPDAS checklist may reduce service variation but is not sufficient to ensure interventions enable good patient decision making. Developers must be encouraged to reason about the IPDAS checklist to identify those component parts that do (not) meet their intervention's purpose. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Development of a decision aid for energy resource management for the Navajo Nation incorporating environmental cultural values

    Science.gov (United States)

    Necefer, Len Edward

    Decision-making surrounding pathways of future energy resource management are complexity and requires balancing tradeoffs of multiple environmental, social, economic, and technical outcomes. Technical decision aid can provide a framework for informed decision making, allowing individuals to better understand the tradeoff between resources, technology, energy services, and prices. While technical decision aid have made significant advances in evaluating these quantitative aspects of energy planning and performance, they have not been designed to incorporate human factors, such as preferences and behavior that are informed by cultural values. Incorporating cultural values into decision tools can provide not only an improved decision framework for the Navajo Nation, but also generate new insights on how these perspective can improve decision making on energy resources. Ensuring these aids are a cultural fit for each context has the potential to increase trust and promote understanding of the tradeoffs involved in energy resource management. In this dissertation I present the development of a technical tool that explicitly addresses cultural and spiritual values and experimentally assesses their influence on the preferences and decision making of Navajo citizens. Chapter 2 describes the results of a public elicitation effort to gather information about stakeholder views and concerns related to energy development in the Navajo Nation in order to develop a larger sample survey and a decision-support tool that links techno-economic energy models with sociocultural attributes. Chapter 3 details the methods of developing the energy decision aid and its underlying assumptions for alternative energy projects and their impacts. This tool also provides an alternative to economic valuation of cultural impacts based upon an ordinal index tied to environmental impacts. Chapter 4 details the the influence of various cultural, environmental, and economic outcome information provided

  12. A decision aid regarding long-term tube feeding targeting substitute decision makers for cognitively impaired older persons in Japan: a small-scale before-and-after study.

    Science.gov (United States)

    Kuraoka, Yumiko; Nakayama, Kazuhiro

    2014-02-05

    In Japan, there is no decision-making guide regarding long-term tube feeding that specifically targets individuals making decisions on behalf of cognitively impaired older persons (substitute decision makers). The objective of this study was to describe the development and evaluation of such a decision aid. In this before-and-after study, participants comprised substitute decision makers for 13 cognitively impaired inpatients aged 65 years and older who were being considered for placement of a percutaneous endoscopic gastrostomy tube in acute care hospitals and mixed-care hospitals in Japan. Questionnaires were used to compare substitute decision makers' knowledge, decisional conflict, and predisposition regarding feeding tube placement before and after exposure to a decision aid. The acceptability of the decision aid was also assessed. Paired t-tests were used to compare participants' knowledge and decisional conflict scores before and after using the decision aid. Substitute decision makers showed significantly increased knowledge (P substitute decision makers found the decision aid helpful and acceptable. The decision aid facilitated the decision-making process of substitute decision makers by decreasing decisional conflict and increasing knowledge.

  13. Tying up loose ends: a method for constructing and evaluating decision aids that meet blunt and sharp-end goals.

    Science.gov (United States)

    Keller, N; Czienskowski, U; Feufel, M A

    2014-01-01

    We present a methodological framework for constructing and evaluating decision aids--fast and frugal trees (FFTs)--ideally suited to the front line of an organisation. Their performance can be analysed in signal detection theory, allowing for transparent selection of FFTs given managerial-level trade-offs among type I and II errors. We extend FFTs from binary classification to selection from multiple actions (FFT multiple) as well as performance analysis to organisational goal states beyond type I and II error reduction. Concepts and framework are introduced and a tutorial-style example application (threat assessment at military checkpoints) is provided. Throughout, we discuss ways to deal with missing or incomplete data and show that the performance of decision aids may be overestimated if the effectiveness of actions is not heeded. The methodology can be used to construct and evaluate decision aids in any area characterised by dichotomised cues and a one-to-many mapping between categorisation outcomes and actions.

  14. Involving women in personalised decision-making on mode of delivery after caesarean section: the development and pilot testing of a patient decision aid

    NARCIS (Netherlands)

    Schoorel, E.N.; Vankan, E.; Scheepers, H.C.J.; Augustijn, B.C.; Dirksen, C.D.; Koning, M.; Kuijk, S.M. van; Kwee, A.; Melman, S.; Nijhuis, J.G.; Aardenburg, R.; Boer, K. de; Hasaart, T.H.M.; Mol, B.W.; Nieuwenhuijze, M.; Pampus, M.G. van; Roosmalen, J. van; Roumen, F.J.M.E.; Vries, R. de; Wouters, M.G.A.J.; Weijden, T.T. van der; Hermens, R.P.M.G.

    2014-01-01

    OBJECTIVE: To develop a patient decision aid (PtDA) for mode of delivery after caesarean section that integrates personalised prediction of vaginal birth after caesarean (VBAC) with the elicitation of patient preferences and evidence-based information. DESIGN: A PtDA was developed and pilot tested

  15. Development of a pediatric cardiac computer aided auscultation decision support system.

    Science.gov (United States)

    Pretorius, Eugene; Cronje, Matthys L; Strydom, Otto

    2010-01-01

    Developing countries have a large population of children living with undiagnosed heart murmurs. As a result of an accompanying skills shortage, most of these children will not get the necessary treatment. The objective of this paper was to develop a decision support system. This could enable health care providers in developing countries with tools to screen large amounts of children without the need for expensive equipment or specialist skills. For this purpose an algorithm was designed and tested to detect heart murmurs in digitally recorded signals. A specificity of 94% and a sensitivity of 91% were achieved using novel signal processing techniques and an ensemble of neural networks as classifier.

  16. Development of a patient decision aid for type 2 diabetes mellitus for patients not achieving glycemic control on metformin alone

    Directory of Open Access Journals (Sweden)

    Shillington AC

    2015-04-01

    Full Text Available Alicia C Shillington,1 Nananda Col,2 Robert A Bailey,3 Mark A Jewell11EPI-Q, Inc., Oak Brook, IL, USA; 2Shared Decision-making Resources, Georgetown, ME, USA; 3Janssen Scientific Affairs, LLC, Raritan, NJ, USAPurpose: To describe the process used to develop an evidence-based patient decision aid (PDA that facilitates shared decision-making for treatment intensification in inadequately controlled type 2 diabetes mellitus (T2DM consistent with International Patient Decision Aids Standards.Methods: A PDA was developed by a multidisciplinary steering committee of clinicians, patient advocate, nurse, certified diabetes educators, and decision scientist, using a systematic development process. The process included defining the PDA scope and purpose, outlining the framework, content creation, and designing for integration into clinical practice. This was accomplished through a review of the literature and publically available educational materials and input from practicing clinicians and patients during development and iteratively refining content based on input. Patients with poorly controlled T2DM on metformin considering additional medication assessed the PDA during a pilot.Results: Testing identified six preference-sensitive domains important for choosing T2DM treatment: degree of glycemic response, avoiding weight gain, hypoglycemia risk and other adverse events, avoiding injections, convenience of dose administration, blood glucose monitoring, and cost of therapy. Patient feedback guided content revision. Treatment options were offered after presenting medication class risk–benefit information and eliciting patient values, goals, and preferences. The PDA received the highest International Patient Decision Aids Standards global score to date, 88/100, with 100% of criteria fully met for the following dimensions: development process, disclosures, evaluation process, evidence quality, guidance for users, information quality, language

  17. Impact of state aid on business decisions and financial stability of family farms in Croatia

    Directory of Open Access Journals (Sweden)

    Mateja JEŽ ROGELJ

    2017-03-01

    Full Text Available The aim of this paper is to identify farmers' attitudes towards the impact of state aid on business decisions and financial stability of farms. It will also identify the share of agricultural support in the total income of farms and the reasons for certain agricultural branches having unequal economic dependence on the support. Furthermore, it will investigate which of the two pillars of the CAP farmers consider being more important for their business and which factors would mostly contribute to the increase of production on their farms. The research involved 184 holders of family farms from all Croatian counties and the City of Zagreb. The data were analyzed using the univariate (frequency and two-variate (chi-square test method. The main production on the farms has a statistically significant (P<0.05 effect on the share of state support in the total income of the farm as well as on the influence of the amount of state support to business decisions. Most of the respondents engaged in animal husbandry and farming declared that their farms would not be financially viable in the case of state support abolition, while the situation is different in fruit growing, vegetable growing and floriculture. The paper also demonstrates the extent to which selected motivators (satisfactory state aid, higher purchase prices, less bureaucracy, lower taxes, assured market, cheap loans and availability of agricultural land are important to farmers when deciding whether to increase the agricultural production on their farms. Overall, the two pillars of the CAP are equally important for the farmers but there is a statistically significant difference in the importance of each pillar of the CAP in regard to the prevailing production on the farm. The results of the study demonstrate both the importance of state support for the business of certain agricultural producers, especially herders, and the difference in sensitivity to possible changes in support policy.

  18. LG based decision aid for naval tactical action officer's (TAO) workstation

    Science.gov (United States)

    Stilman, Boris; Yakhnis, Vladimir; Umanskiy, Oleg; Boyd, Ron

    2005-05-01

    In the increasingly NetCentric battlespace of the 21st century, Stilman Advanced Strategies Linguistic Geometry software has the potential to revolutionize the way that the Navy fights in two key areas: as a Tactical Decision Aid and for creating a relevant Common Operating Picture. Incorporating STILMAN's software into a prototype Tactical Action Officers (TAO) workstation as a Tactical Decision Aid (TDA) will allow warfighters to manage their assets more intelligently and effectively. This prototype workstation will be developed using human-centered design principles and will be an open, component-based architecture for combat control systems for future small surface combatants. It will integrate both uninhabited vehicles and onboard sensors and weapon systems across a squadron of small surface combatants. In addition, the hypergame representation of complex operations provides a paradigm for the presentation of a common operating picture to operators and personnel throughout the command hierarchy. In the hypergame technology there are game levels that span the range from the tactical to the global strategy level, with each level informing the others. This same principle will be applied to presenting the relevant common operating picture to operators. Each operator will receive a common operating picture that is appropriate for their level in the command hierarchy. The area covered by this operating picture and the level of detail contained within it will be dependent upon the specific tasks the operator is performing (supervisory vice tactical control) and the level of the operator (or command personnel) within the command hierarchy. Each level will inform the others to keep the picture concurrent and up-to-date.

  19. [Application of the Bayesian network on the mutual relation of influencing factors and AIDS pathogenesis].

    Science.gov (United States)

    Zhang, Na; Wang, Guoyong; Zhu, Xiaoyan; Yang, Xingguang; Kang, Dianmin

    2014-04-01

    To explore the influencing factors of AIDS pathogenesis using the Bayesian network. Based on follow-up data of 2 431 cases of HIV/AIDS from 1992-2011 in Shandong province, this study constructed the network structure by NPC algorithm, and used the EM algorithm for parameter learning to construct the Bayesian network of influencing factors and AIDS pathogenesis, then did inference by the Bayesian network. A total of 49.77% (1 210/2 431) were AIDS. Get a Bayesian network with 7 nodes and 11 directed arcs and the related parameters by studying the follow-up data of 2 431 cases. The area under receiver operating curve(ROC) was 0.75. There was a direct causal association among sample resource, transmission route, CD4(+)T lymphocyte count of HIV-antibody confirmed positive, antiviral therapy, opportunistic infection therapy, follow-up intervention and AIDS pathogenesis. The incidence probability was 42.83% for those who received antiviral therapy and follow-up intervention, and it was 68.96% for those who received antiviral therapy without follow-up intervention. The probability to receive follow-up intervention was 68.96% for cases transmitted by homosexual behaviors, and it was 34.00%, 42.24%, 1.06% and 22.70% respectively to be reported by medical institutions, testing and counselling, supervision institutions and special surveys. The Bayesian network revealed the mutual relation and effect intension among multi-factors and multi-stages by network inference. It showed that the rate of AIDS pathogenesis was lower for those who received antiviral therapy and follow-up intervention.

  20. Block compressed sensing for feedback reduction in relay-aided multiuser full duplex networks

    KAUST Repository

    Elkhalil, Khalil

    2016-08-11

    Opportunistic user selection is a simple technique that exploits the spatial diversity in multiuser relay-aided networks. Nonetheless, channel state information (CSI) from all users (and cooperating relays) is generally required at a central node in order to make selection decisions. Practically, CSI acquisition generates a great deal of feedback overhead that could result in significant transmission delays. In addition to this, the presence of a full-duplex cooperating relay corrupts the fed back CSI by additive noise and the relay\\'s loop (or self) interference. This could lead to transmission outages if user selection is based on inaccurate feedback information. In this paper, we propose an opportunistic full-duplex feedback algorithm that tackles the above challenges. We cast the problem of joint user signal-to-noise ratio (SNR) and the relay loop interference estimation at the base-station as a block sparse signal recovery problem in compressive sensing (CS). Using existing CS block recovery algorithms, the identity of the strong users is obtained and their corresponding SNRs are estimated. Numerical results show that the proposed technique drastically reduces the feedback overhead and achieves a rate close to that obtained by techniques that require dedicated error-free feedback from all users. Numerical results also show that there is a trade-off between the feedback interference and load, and for short coherence intervals, full-duplex feedback achieves higher throughput when compared to interference-free (half-duplex) feedback. © 2016 IEEE.

  1. AIDS

    Science.gov (United States)

    ... smear to check for cancer of the anus Treatment HIV/AIDS is treated with medicines that stop the virus ... having a long-term illness. Outlook (Prognosis) With treatment, most people with HIV/AIDS can live a healthy and normal life. Current ...

  2. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

    Science.gov (United States)

    Pieterse, Arwen H; de Vries, Marieke

    2013-09-01

    Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

  3. Interpersonal Influence in Virtual Social Networks and Consumer Decisions

    Directory of Open Access Journals (Sweden)

    Eduardo Botti Abbade

    2014-04-01

    Full Text Available This study aimed to analyze the attitude of college students regarding to interpersonal influence in virtual social networks related to consume decisions. It was conducted a survey with 200 college students from an Institution of Higher Education located in Santa Maria/RS. The sample was obtained through voluntary adhesion and the data collection instrument was applied in a virtual environment. Scales were adapted to measure and evaluate the propensity of students to influence and be influenced by their virtual contacts. The results suggest that the scales adapted are satisfactory to measure what they intend to do. The study also found that men are more able to influence the opinions of their virtual social contacts. On the other hand, the time dedicated to access the Internet positively and significantly influences the propensity of users to be influenced by their virtual social contacts. The correlation between the ability to influence the propensity to be influenced is significant and positive.

  4. Understanding The Decision Context: DPSIR, Decision Landscape, And Social Network Analysis

    Science.gov (United States)

    Establishing the decision context for a management problem is the critical first step for effective decision analysis. Understanding the decision context allow stakeholders and decision-makers to integrate the societal, environmental, and economic considerations that must be con...

  5. Developing Evidence to Inform Decisions about Effectiveness (DeCIDE) Network

    Science.gov (United States)

    The Developing Evidence to Inform Decisions about Effectiveness Network is a network of research centers that the Agency for Healthcare Research and Quality created to conduct practical studies about health care items and services.

  6. Aid decision algorithms to estimate the risk in congenital heart surgery.

    Science.gov (United States)

    Ruiz-Fernández, Daniel; Monsalve Torra, Ana; Soriano-Payá, Antonio; Marín-Alonso, Oscar; Triana Palencia, Eddy

    2016-04-01

    In this paper, we have tested the suitability of using different artificial intelligence-based algorithms for decision support when classifying the risk of congenital heart surgery. In this sense, classification of those surgical risks provides enormous benefits as the a priori estimation of surgical outcomes depending on either the type of disease or the type of repair, and other elements that influence the final result. This preventive estimation may help to avoid future complications, or even death. We have evaluated four machine learning algorithms to achieve our objective: multilayer perceptron, self-organizing map, radial basis function networks and decision trees. The architectures implemented have the aim of classifying among three types of surgical risk: low complexity, medium complexity and high complexity. Accuracy outcomes achieved range between 80% and 99%, being the multilayer perceptron method the one that offered a higher hit ratio. According to the results, it is feasible to develop a clinical decision support system using the evaluated algorithms. Such system would help cardiology specialists, paediatricians and surgeons to forecast the level of risk related to a congenital heart disease surgery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. An exercise of stake holders involvement and multi-criteria decision aid for radioactively contaminated milk

    Energy Technology Data Exchange (ETDEWEB)

    Turcanu, C.O. [Universite Libre de Bruxelles (Belgium); Hardeman, F.; Carle, B. [Studiecentrum voor Kernenergie - Centre d' Etude de l' Energie Nucleaire, The Belgian Nuclear Research Centre Mol (Belgium)

    2006-07-01

    This paper focuses on a multi-criteria structuring process with stakeholders participation and illustrates its findings from a questionnaire conducted in the Belgian context. A multidisciplinary approach is adopted, which follows the practical problem in parallel with the methodological steps of multi-criteria decision aid. The chosen case study regards the countermeasures for the management of radioactively contaminated milk. This is motivated by the importance of milk in the food chain and the rapid transfer to milk of some radionuclides, such as{sup 131}I or {sup 137}Cs. The time framework addressed covers the early to intermediate phases of a radiological emergency. In case of milk, the limited storage facilities, as well as the constraints on the storage time of the fresh product (maximum 72 hours) lead to a certain time pressure on the decision process. The purpose of our analysis is twofold: on the one hand to provide support in case of a real crisis, but most importantly, to improve emergency preparedness and response and to facilitate exercises and training. The stakeholders interviewed range from real decision makers to representatives of the production and processing sectors. As expected, the points of view are sometimes divergent and therefore the results of the questionnaire are discussed and suggestions are formulated for conciliating the various points of view that come into play. The type of stakeholders process carried out is expected to ensure a higher degree of acceptability of the methodologies and tools employed. In the last section, provisional conclusions are drawn and directions for further development are envisaged. (N.C.)

  8. Randomized controlled trial of a patient decision-making aid for orthodontics.

    Science.gov (United States)

    Parker, Kate; Cunningham, Susan J; Petrie, Aviva; Ryan, Fiona S

    2017-08-01

    Patient decision-making aids (PDAs) are instruments that facilitate shared decision making and enable patients to reach informed, individual decisions regarding health care. The objective of this study was to assess the efficacy of a PDA compared with traditional information provision for adolescent patients considering fixed appliance orthodontic treatment. Before treatment, orthodontic patients were randomly allocated into 2 groups: the intervention group received the PDA and standard information regarding fixed appliances, and the control group received the standard information only. Decisional conflict was measured using the Decisional Conflict Scale, and the levels of decisional conflict were compared between the 2 groups. Seventy-two patients were recruited and randomized in a ratio of 1:1 to the PDA and control groups. Seventy-one patients completed the trial (control group, 36; PDA group, 35); this satisfied the sample size calculation. The median total Decisional Conflict Scale score in the PDA group was lower than in the control group (15.63 and 19.53, respectively). However, this difference was not statistically significant (difference between groups, 3.90; 95% confidence interval of the difference, -4.30 to 12.11). Sex, ethnicity, age, and the time point at which patients were recruited did not have significant effects on Decisional Conflict Scale scores. No harm was observed or reported for any participant in the study. The results of this study showed that the provision of a PDA to adolescents before they consented for fixed appliances did not significantly reduce decisional conflict. There may be a benefit in providing a PDA for some patients, but it is not yet possible to say how these patients could be identified. This trial was registered with the Harrow National Research Ethics Committee (reference 12/LO/0279). The protocol was not published before trial commencement. Copyright © 2017. Published by Elsevier Inc.

  9. Visual Aids for Patient, Family, and Physician Decision Making About Endovascular Thrombectomy for Acute Ischemic Stroke.

    Science.gov (United States)

    Tokunboh, Ivie; Vales Montero, Marta; Zopelaro Almeida, Matheus Fellipe; Sharma, Latisha; Starkman, Sidney; Szeder, Viktor; Jahan, Reza; Liebeskind, David; Gonzalez, Nestor; Demchuk, Andrew; Froehler, Michael T; Goyal, Mayank; Lansberg, Maarten G; Lutsep, Helmi; Schwamm, Lee; Saver, Jeffrey L

    2018-01-01

    Rapid decision making optimizes outcomes from endovascular thrombectomy for acute cerebral ischemia. Visual displays facilitate swift review of potential outcomes and can accelerate decision processes. From patient-level, pooled randomized trial data, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial and adverse effects of endovascular thrombectomy for patients with acute cerebral ischemia and large vessel occlusion using (1) automated (algorithmic) and (2) expert-guided joint outcome table specification. For the full 7-category modified Rankin Scale, thrombectomy added to IV tPA (intravenous tissue-type plasminogen activator) alone had number needed to treat to benefit 2.9 (95% confidence interval, 2.6-3.3) and number needed to harm 68.9 (95% confidence interval, 40-250); thrombectomy for patients ineligible for IV tPA had number needed to treat to benefit 2.3 (95% confidence interval, 2.1-2.5) and number needed to harm 100 (95% confidence interval, 62.5-250). Visual displays of treatment effects on 100 patients showed: with thrombectomy added to IV tPA alone, 34 patients have better disability outcome, including 14 more normal or near normal (modified Rankin Scale, 0-1); with thrombectomy for patients ineligible for IV tPA, 44 patients have a better disability outcome, including 16 more normal or nearly normal. Displays also showed that harm (increased modified Rankin Scale final disability) occurred in 1 of 100 patients in both populations, mediated by increased new territory infarcts. The person-icon figures integrated these outcomes, and early side-effects, in a single display. Visual decision aids are now available to rapidly educate healthcare providers, patients, and families about benefits and risks of endovascular thrombectomy, both when added to IV tPA in tPA-eligible patients and as the sole reperfusion treatment in tPA-ineligible patients. © 2017 American Heart Association, Inc.

  10. A randomized trial of a computer-tailored decision aid to improve prostate cancer screening decisions: results from the Take the Wheel trial.

    Science.gov (United States)

    Allen, Jennifer D; Othus, Megan K D; Hart, Alton; Tom, Laura; Li, Yi; Berry, Donna; Bowen, Deborah

    2010-09-01

    To evaluate a decision aid (DA) designed to promote informed decision making for prostate cancer screening. Twelve work sites were randomly assigned to an intervention or nonintervention comparison condition. Intervention sites received access to a computer-tailored DA at the workplace. Male employees age 45 years and above (n = 625) completed surveys at baseline and at 3-month follow-up, documenting aspects of informed decision making. Using an intention-to-treat analysis, men in the intervention group were significantly more likely to have made a screening decision and to have improved knowledge without increased decisional conflict, relative to men in the comparison group. These changes were observed despite the fact that only 30% of men in intervention sites used the DA. Among DA users, similar improvements were observed, although the magnitudes of changes were substantially greater, and significant improvements in decision self-efficacy were observed. A DA offered in the workplace promoted decision making, improved knowledge, and increased decision self-efficacy among users, without increasing decisional conflict. However, participation was suboptimal, suggesting that better methods for engaging men in workplace interventions are needed. IMPACT STATEMENT: This trial shows the efficacy of a computer-tailored DA in promoting informed decisions about prostate cancer screening. The DA was delivered through work sites, thereby providing access to resources required to participate in informed decision making without requiring a medical appointment. However, participation rates were suboptimal, and additional strategies for engaging men are needed. (c)2010 AACR.

  11. Examination of skin lesions for cancer : Which clinical decision aids and tools are available in general practice?

    NARCIS (Netherlands)

    Koelink, Cecile J. L.; Jonkman, Marcel F.; Van der Meer, Klaas; Van der Heide, Wouter K.

    2014-01-01

    Background While skin cancer incidence is rising throughout Europe, general practitioners (GP) feel unsure about their ability to diagnose skin malignancies. Objectives To evaluate whether the GP has sufficient validated clinical decision aids and tools for the examination of potentially malignant

  12. A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation

    DEFF Research Database (Denmark)

    LaHaye, Stephen Andrew; Gibbens, Sabra Lynn; Ball, David Gerald Andrew

    2012-01-01

    The availability of new antithrombotic agents, each with a unique efficacy and bleeding profile, has introduced a considerable amount of clinical uncertainty with physicians. We have developed a clinical decision aid in order to assist clinicians in determining an optimal antithrombotic regime...

  13. Effects of a web-based decision aid regarding diagnostic self-testing. A single-blind randomized controlled trial

    NARCIS (Netherlands)

    Ickenroth, M.H.; Grispen, J.E.; Vries, N.K. de; Dinant, G.J.; Ronda, G.; Weijden, T.T. van der

    2016-01-01

    Currently, there are many diagnostic self-tests on body materials available to consumers. The aim of this study was to assess the effect of an online decision aid on diagnostic self-testing for cholesterol and diabetes on knowledge among consumers with an intention to take these tests. A randomized

  14. Impact of computer-based pregnancy-induced hypertension and diabetes decision AIDS on empowering pregnant women

    NARCIS (Netherlands)

    Aslani, Azam; Tara, Fatemeh; Ghalighi, Lila; Pournik, Omid; Ensing, Sabine; Abu-Hanna, Ameen; Eslami, Saeid

    2014-01-01

    We designed a computer-based decision aid (CDA) for use by pregnant women at home to investigate and participate in solving their pregnancy problems related to pregnancy-induced hypertension (PIH) and gestational diabetes (GD). The system cannot and is not intended to replace visits to physicians;

  15. A Randomized Controlled Trial of a Mobile Clinical Decision Aid to Improve Access to Kidney Transplantation: iChoose Kidney

    Directory of Open Access Journals (Sweden)

    Rachel E. Patzer

    2016-05-01

    Discussion: Engaging patients in health care choices can increase patient empowerment and improve knowledge and understanding of treatment choices. If the effectiveness of iChoose Kidney has a greater impact on patients with low health literacy, lower socioeconomic status, and minority race, this decision aid could help reduce disparities in access to kidney transplantation.

  16. To notify or not to notify : Decision aid for policy makers on whether to make an infectious disease mandatorily notifiable

    NARCIS (Netherlands)

    Bijkerk, Paul; Fanoy, E. B.; Kardamanidis, K.; van der Plas, S. M.; te Wierik, M. J.; Kretzschmar, M. E.; Haringhuizen, G. B.; van Vliet, H. J.; van der Sande, M. A.

    2015-01-01

    Mandatory notification can be a useful tool to support infectious disease prevention and control. Guidelines are needed to help policymakers decide whether mandatory notification of an infectious disease is appropriate. We developed a decision aid, based on a range of criteria previously used in the

  17. Perceptions of Prostate Cancer Screening Controversy and Informed Decision Making: Implications for Development of a Targeted Decision Aid for Unaffected Male First-Degree Relatives.

    Science.gov (United States)

    Gwede, Clement K; Davis, Stacy N; Wilson, Shaenelle; Patel, Mitul; Vadaparampil, Susan T; Meade, Cathy D; Rivers, Brian M; Yu, Daohai; Torres-Roca, Javier; Heysek, Randy; Spiess, Philippe E; Pow-Sang, Julio; Jacobsen, Paul

    2015-01-01

    First-degree relatives (FDRs) of prostate cancer (PC) patients should consider multiple concurrent personal risk factors when engaging in informed decision making (IDM) about PC screening. This study assessed perceptions of IDM recommendations and risk-appropriate strategies for IDM among FDRs of varied race/ethnicity. A cross-sectional, qualitative study design was used. Study setting was a cancer center in southwest Florida. The study comprised 44 participants (24 PC patients and 20 unaffected FDRs). Focus groups and individual interviews were conducted and analyzed using content analysis and constant comparison methods. Patients and FDRs found the PC screening debate and IDM recommendations to be complex and counterintuitive. They overwhelmingly believed screening saves lives and does not have associated harms. There was a strongly expressed need to improve communication between patients and FDRs. A single decision aid that addresses the needs of all FDRs, rather than one separating by race/ethnicity, was recommended as sufficient by study participants. These perspectives guided the development of an innovative decision aid that deconstructs the screening controversy and IDM processes into simpler concepts and provides step-by-step strategies for FDRs to engage in IDM. Implementing IDM among FDRs is challenging because the IDM paradigm departs from historical messages promoting routine screening. These contradictions should be recognized and addressed for men to participate effectively in IDM. A randomized pilot study evaluating outcomes of the resulting decision aid is underway.

  18. The development of a web- and a print-based decision aid for prostate cancer screening

    Directory of Open Access Journals (Sweden)

    Schwartz Marc D

    2010-03-01

    Full Text Available Abstract Background Whether early detection and treatment of prostate cancer (PCa will reduce disease-related mortality remains uncertain. As a result, tools are needed to facilitate informed decision making. While there have been several decision aids (DAs developed and tested, very few have included an exercise to help men clarify their values and preferences about PCa screening. Further, only one DA has utilized an interactive web-based format, which allows for an expansion and customization of the material. We describe the development of two DAs, a booklet and an interactive website, each with a values clarification component and designed for use in diverse settings. Methods We conducted two feasibility studies to assess men's (45-70 years Internet access and their willingness to use a web- vs. a print-based tool. The booklet was adapted from two previous versions evaluated in randomized controlled trials (RCTs and the website was created to closely match the content of the revised booklet. Usability testing was conducted to obtain feedback regarding draft versions of the materials. The tools were also reviewed by a plain language expert and the interdisciplinary research team. Feedback on the content and presentation led to iterative modifications of the tools. Results The feasibility studies confirmed that the Internet was a viable medium, as the majority of men used a computer, had access to the Internet, and Internet use increased over time. Feedback from the usability testing on the length, presentation, and content of the materials was incorporated into the final versions of the booklet and website. Both the feasibility studies and the usability testing highlighted the need to address men's informed decision making regarding screening. Conclusions Informed decision making for PCa screening is crucial at present and may be important for some time, particularly if a definitive recommendation either for or against screening does not

  19. Development and application of culturally appropriate decision aids for smoking cessation in Korea: a pragmatic clustered randomization crossover trial

    Directory of Open Access Journals (Sweden)

    Lee JE

    2016-09-01

    Full Text Available Ji Eun Lee,1 Dong Wook Shin,1–3 Beomseok Suh,1 Sohyun Chun,4 You-Seon Nam,3 Belong Cho1,2 1Department of Family Medicine, Health Promotion Center, 2Laboratory of Health Promotion and Health Behavior, Biomedical Research Institute, Seoul National University Hospital, 3JW Lee Center for Global Medicine, Seoul National University College of Medicine, 4International Health Services, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea Introduction: In Asian countries, reluctance to seek pharmacological intervention is a major barrier for smoking cessation. Culturally appropriate decision aids are expected to help people in the decision making for the use of smoking cessation medication. Objective: The aim of this study was to develop a culturally tailored decision aid for smoking cessation and evaluate its effect on the use of smoking cessation medication. Patients and methods: A 7-minute video on smoking cessation information and options was developed. Physicians were randomized into intervention and control groups. The decision aid was provided to patients in the intervention group, and they watched it, while those in the control group were provided usual medical care for smoking cessation. The primary outcome was the proportion of smokers who were prescribed smoking cessation medication within 1 month after consultation. The secondary outcomes were abstinence rate and use of smoking cessation medication within 6 months. A logistic regression analysis was used to assess the effect of the decision aid on the outcomes. Results: In total, 414 current smokers (intervention group: 195; control group: 219 were enrolled. The mean age of the participants was 48.2 years, and 381 subjects (92% were males. In total, 11.8% of the participants in the intervention group and 10.5% in the control group were prescribed smoking cessation medications within 1 month. The odds ratio was 1.02 (95% CI: 0.40–2.63 after

  20. Impact of a decision aid on reducing uncertainty: pilot study of women in their 40s and screening mammography.

    Science.gov (United States)

    Scariati, Paula; Nelson, Lisa; Watson, Lindsey; Bedrick, Stephen; Eden, Karen B

    2015-11-10

    In 2009 the United States Preventive Services Task Force updated its breast cancer screening guidelines to recommend that average-risk women obtain a screening mammogram every two years starting at age 50 instead of annually starting at age 40. Inconsistencies in data regarding the benefit versus risk of routine screening for women less than 50-years-of-age led to a second recommendation - that women in their forties engage in a shared decision making process with their provider to make an individualized choice about screening mammography that was right for them. In response, a web-based interactive mammography screening decision aid was developed and evaluated. The decision aid was developed using an agile, iterative process. It was further honed based on feedback from clinical and technical subject matter experts. A convenience sample of 51 age- and risk-appropriate women was recruited to pilot the aid. Pre-post decisional conflict and screening choice was assessed. Women reported a significant reduction in overall decisional conflict after using the decision aid (Z = -5.3, p < 0.001). These participants also reported statistically significant reductions in each of the decisional conflict subscales: feeling uncertain (Z = -4.7, p < 0.001), feeling uninformed (Z = -5.2, p < 0.001), feeling unclear about values (Z = -5.0, p < 0.001), and feeling unsupported (Z = -4.0, p < 0.001). However, a woman's intention to obtain a screening mammogram in the next 1-2 years was not significantly changed (Wilcoxon signed-rank Z = -1.508, p = 0.132). This mammography screening decision aid brings value to patient care not by impacting what a woman chooses but by lending clarity to why or how she chooses it.

  1. Digital networks to aid research and education in Africa

    CERN Multimedia

    2005-01-01

    Around 120 participants were assembled over two days at CERN to discuss ways to bridge the digital divide with Africa. As part of efforts to implement the outcome of the first World Summit on the Information Society (WSIS), held in Geneva in 2003, CERN held the international workshop on Research and Education Networks in Africa, from 25 to 27 September. Organized by the United Nations University (UNU) in collaboration with the International Telecommunications Union (ITU) and CERN, this meeting was designed to promote scientific cooperation with and within Africa, through the development of networking infrastructure. Faster, reliable and more affordable Internet access is widely recognized as one of the key factors for enhancing research and education efforts in African academic and research institutions. For the first time, this workshop brought together representatives of all the key stakeholders: African academic and research institutions, international coordinators, funding agencies, grass-roots imple...

  2. Application of the Consumer Decision-Making Model to Hearing Aid Adoption in First-Time Users.

    Science.gov (United States)

    Amlani, Amyn M

    2016-05-01

    Since 1980, hearing aid adoption rates have remained essentially the same, increasing at a rate equal to the organic growth of the population. Researchers have used theoretical models from psychology and sociology to determine those factors or constructs that lead to the adoption of hearing aids by first-time impaired listeners entering the market. In this article, a theoretical model, the Consumer Decision-Making Model (CDM), premised on the neobehavioral approach that considers an individual's psychological and cognitive emphasis toward a product or service, is described. Three theoretical models (i.e., transtheoretical, social model of disability, Health Belief Model), and their relevant findings to the hearing aid market, are initially described. The CDM is then presented, along with supporting evidence of the model's various factors from the hearing aid literature. Future applications of the CDM to hearing health care also are discussed.

  3. Relay-aided multi-cell broadcasting with random network coding

    DEFF Research Database (Denmark)

    Lu, Lu; Sun, Fan; Xiao, Ming

    2010-01-01

    We investigate a relay-aided multi-cell broadcasting system using random network codes, where the focus is on devising efficient scheduling algorithms between relay and base stations. Two scheduling algorithms are proposed based on different feedback strategies; namely, a one-step scheduling...

  4. Potentialities and weaknesses in the care network of people with HIV/AIDS.

    Science.gov (United States)

    Tonnera, Liliam Cristiana Júlio; Meirelles, Betina Hörner Schlindwein

    2015-01-01

    to understand the strengths and weaknesses in the care network of people with HIV/AIDS in a referral center in the state of Santa Catarina-SC. participants were eight subjects and their care network, totaling 18 participants. Data were collected through interviews and examined by content analysis, theoretically supported by symbolic interaction. the analysis resulted in the following categories: The network offering care to people with acquired immunodeficiency syndrome, and Facing Barriers in care, which reflect the strengths and weaknesses in the care network. The fi rst depicts the provision of emotional and humanized care, and the second a restricted network formed by health professionals and a family member. the professional care network is important, despite the increased number of assistances in a physical structure and amount of professionals who no longer meet the growing demand.

  5. Consideration of Insulin Pumps or Continuous Glucose Monitors by Adolescents With Type 1 Diabetes and Their Parents: Stakeholder Engagement in the Design of Web-Based Decision Aids.

    Science.gov (United States)

    Wysocki, Tim; Hirschfeld, Fiona; Miller, Louis; Izenberg, Neil; Dowshen, Steven A; Taylor, Alex; Milkes, Amy; Shinseki, Michelle T; Bejarano, Carolina; Kozikowski, Chelsea; Kowal, Karen; Starr-Ashton, Penny; Ross, Judith L; Kummer, Mark; Carakushansky, Mauri; Lyness, D'Arcy; Brinkman, William; Pierce, Jessica; Fiks, Alexander; Christofferson, Jennifer; Rafalko, Jessica; Lawson, Margaret L

    2016-08-01

    This article describes the stakeholder-driven design, development, and testing of web-based, multimedia decision aids for youth with type 1 diabetes who are considering the insulin pump or continuous glucose monitoring and their parents. This is the initial phase of work designed to develop and evaluate the efficacy of these decision aids in promoting improved decision-making engagement with use of a selected device. Qualitative interviews of 36 parents and adolescents who had previously faced these decisions and 12 health care providers defined the content, format and structure of the decision aids. Experts in children's health media helped the research team to plan, create, and refine multimedia content and its presentation. A web development firm helped organize the content into a user-friendly interface and enabled tracking of decision aid utilization. Throughout, members of the research team, adolescents, parents, and 3 expert consultants offered perspectives about the website content, structure, and function until the design was complete. With the decision aid websites completed, the next phase of the project is a randomized controlled trial of usual clinical practice alone or augmented by use of the decision aid websites. Stakeholder-driven development of multimedia, web-based decision aids requires meticulous attention to detail but can yield exceptional resources for adolescents and parents contemplating major changes to their diabetes regimens. © 2016 The Author(s).

  6. Cognitive Works Aids for C2 Planning: Actionable Information to Support Operational Decision Making

    National Research Council Canada - National Science Library

    Wampler, Jeffrey; Whitaker, Randall; Roth, Emilie; Scott, Ronald; Stilson, Mona; Thomas-Meyers, Gina

    2005-01-01

    .... This paper describes a design for a global mission planning C2 work aid. The discussion describes a cognitive based design approach to developing work aids called Work Centered Support Systems (WCSS...

  7. Computer-Aided Diagnosis Based on Convolutional Neural Network System for Colorectal Polyp Classification: Preliminary Experience.

    Science.gov (United States)

    Komeda, Yoriaki; Handa, Hisashi; Watanabe, Tomohiro; Nomura, Takanobu; Kitahashi, Misaki; Sakurai, Toshiharu; Okamoto, Ayana; Minami, Tomohiro; Kono, Masashi; Arizumi, Tadaaki; Takenaka, Mamoru; Hagiwara, Satoru; Matsui, Shigenaga; Nishida, Naoshi; Kashida, Hiroshi; Kudo, Masatoshi

    2017-01-01

    Computer-aided diagnosis (CAD) is becoming a next-generation tool for the diagnosis of human disease. CAD for colon polyps has been suggested as a particularly useful tool for trainee colonoscopists, as the use of a CAD system avoids the complications associated with endoscopic resections. In addition to conventional CAD, a convolutional neural network (CNN) system utilizing artificial intelligence (AI) has been developing rapidly over the past 5 years. We attempted to generate a unique CNN-CAD system with an AI function that studied endoscopic images extracted from movies obtained with colonoscopes used in routine examinations. Here, we report our preliminary results of this novel CNN-CAD system for the diagnosis of colon polyps. A total of 1,200 images from cases of colonoscopy performed between January 2010 and December 2016 at Kindai University Hospital were used. These images were extracted from the video of actual endoscopic examinations. Additional video images from 10 cases of unlearned processes were retrospectively assessed in a pilot study. They were simply diagnosed as either an adenomatous or nonadenomatous polyp. The number of images used by AI to learn to distinguish adenomatous from nonadenomatous was 1,200:600. These images were extracted from the videos of actual endoscopic examinations. The size of each image was adjusted to 256 × 256 pixels. A 10-hold cross-validation was carried out. The accuracy of the 10-hold cross-validation is 0.751, where the accuracy is the ratio of the number of correct answers over the number of all the answers produced by the CNN. The decisions by the CNN were correct in 7 of 10 cases. A CNN-CAD system using routine colonoscopy might be useful for the rapid diagnosis of colorectal polyp classification. Further prospective studies in an in vivo setting are required to confirm the effectiveness of a CNN-CAD system in routine colonoscopy. © 2017 S. Karger AG, Basel.

  8. Characterizing Species at Risk II: Using Bayesian Belief Networks as Decision Support Tools to Determine Species Conservation Categories Under the Northwest Forest Plan

    Directory of Open Access Journals (Sweden)

    Bruce G. Marcot

    2006-12-01

    Full Text Available We developed a set of decision-aiding models as Bayesian belief networks (BBNs that represented a complex set of evaluation guidelines used to determine the appropriate conservation of hundreds of potentially rare species on federally-administered lands in the Pacific Northwest United States. The models were used in a structured assessment and paneling procedure as part of an adaptive management process that evaluated new scientific information under the Northwest Forest Plan. The models were not prescriptive but helped resource managers and specialists to evaluate complicated and at times conflicting conservation guidelines and to reduce bias and uncertainty in evaluating the scientific data. We concluded that applying the BBN modeling framework to complex and equivocal evaluation guidelines provided a set of clear, intuitive decision-aiding tools that greatly aided the species evaluation and conservation process.

  9. Serious Choices: A Protocol for an Environmental Scan of Patient Decision Aids for Seriously Ill People at Risk of Death Facing Choices about Life-Sustaining Treatments.

    Science.gov (United States)

    Saunders, Catherine H; Elwyn, Glyn; Kirkland, Kathryn; Durand, Marie-Anne

    2018-02-01

    Seriously ill people at high risk of death face difficult decisions, especially concerning the extent of medical intervention. Given the inherent difficulty and complexity of these decisions, the care they receive often does not align with their preferences. Patient decision aids that educate individuals about options and help them construct preferences about life-sustaining care may reduce the mismatch between the care people say they want and the care they receive. The quantity and quality of patient decision aids for those at high risk of death, however, are unknown. This protocol describes an approach for conducting an environmental scan of life-sustaining treatment patient decision aids for seriously ill patients, identified online and through informant analysis. We intend for the outcome to be an inventory of all life-sustaining treatment patient decision aids for seriously ill patients currently available (either publicly or proprietarily) along with information about their content, quality, and known use. We will identify patient decision aids in a three-step approach (1) mining previously published systematic reviews; (2) systematically searching online and in two popular app stores; and (3) undertaking a key informant survey. We will screen and assess the quality of each patient decision aid identified using the latest published draft of the U.S. National Quality Forum National Standards for the Certification of Patient Decision Aids. Additionally, we will evaluate readability via readable.io and content via inductive content analysis. We will also use natural language processing to assess the content of the decision aids. Researchers increasingly recognize the environmental scan as an optimal method for studying real-world interventions, such as patient decision aids. This study will advance our understanding of the availability, quality, and use of decision aids for life-sustaining interventions targeted at seriously ill patients. We also aim to provide

  10. 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.

  11. Networked Sensor - Aided Tracking of Walking Human in Robotic Space

    Directory of Open Access Journals (Sweden)

    Taeseok Jin

    2013-01-01

    Full Text Available The robots that will be needed in the near future are human-friendly robots that are able to coexist with humans and support humans effectively. To realize this, it is necessary for a robot to carry out human tracking as one of its human-affinitive movements. In this research, a predictable robotic space is introduced in order for a robot to follow a walking human by the shortest time trajectory. The mobile robot is controlled to follow the walking human using distributed networked sensors. The moving object is assumed to be a point-object and projected onto an image plane to form a geometrical constraint equation that provides position data of the object based on the kinematics of the robotic space. The computer simulation and experimental results on the mobile robot's success in estimating information and following a walking human are presented.

  12. Decision-support networks of women newly diagnosed with breast cancer.

    Science.gov (United States)

    Wallner, Lauren P; Li, Yun; McLeod, M Chandler; Hamilton, Ann S; Ward, Kevin C; Veenstra, Christine M; An, Lawrence C; Janz, Nancy K; Katz, Steven J; Hawley, Sarah T

    2017-10-15

    Little is known about the size and characteristics of the decision-support networks of women newly diagnosed with breast cancer and whether their involvement improves breast cancer treatment decisions. A population-based sample of patients newly diagnosed with breast cancer in 2014 and 2015, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries, were surveyed approximately 7 months after diagnosis (N = 2502; response rate, 68%). Network size was estimated by asking women to list up to 3 of the most important decision-support persons (DSPs) who helped them with locoregional therapy decisions. Decision deliberation was measured using 4 items assessing the degree to which patients thought through the decision, with higher scores reflecting more deliberative breast cancer treatment decisions. The size of the network (range, 0-3 or more) was compared across patient-level characteristics, and adjusted mean deliberation scores were estimated across levels of network size using multivariable linear regression. Of the 2502 women included in this analysis, 51% reported having 3 or more DSPs, 20% reported 2, 18% reported 1, and 11% reported not having any DSPs. Married/partnered women, those younger than 45 years, and black women all were more likely to report larger network sizes (all P support networks were associated with more deliberative surgical treatment decisions (P breast cancer should acknowledge and engage informal DSPs. Cancer 2017;123:3895-903. © 2017 American Cancer Society. © 2017 American Cancer Society.

  13. Values clarification in a decision aid about fertility preservation: does it add to information provision?

    Science.gov (United States)

    Garvelink, Mirjam M; ter Kuile, Moniek M; Stiggelbout, Anne M; de Vries, Marieke

    2014-08-09

    We aimed to evaluate the effect of a decision aid (DA) with information only compared to a DA with values clarification exercise (VCE), and to study the role of personality and information seeking style in DA-use, decisional conflict (DC) and knowledge. Two scenario-based experiments were conducted with two different groups of healthy female participants. Dependent measures were: DC, knowledge, and DA-use (time spent, pages viewed, VCE used). Respondents were randomized between a DA with information only (VCE-) and a DA with information plus a VCE(VCE+) (experiment 1), or between information only (VCE-), information plus VCE without referral to VCE(VCE+), and information plus a VCE with specific referral to the VCE, requesting participants to use the VCE(VCE++) (experiment 2). In experiment 2 we additionally measured personality (neuroticism/conscientiousness) and information seeking style (monitoring/blunting). Experiment 1. There were no differences in DC, knowledge or DA-use between VCE- (n=70) and VCE+ (n=70). Both DAs lead to a mean gain in knowledge from 39% at baseline to 73% after viewing the DA. Within VCE+, VCE-users (n=32, 46%) reported less DC compared to non-users. Since there was no difference in DC between VCE- and VCE+, this is likely an effect of VCE-use in a self-selected group, and not of the VCE per se. Experiment 2. There were no differences in DC or knowledge between VCE- (n=65), VCE+ (n=66), VCE++ (n=66). In all groups, knowledge increased on average from 42% at baseline to 72% after viewing the DA. Blunters viewed fewer DA-pages (R=0.38, pknowledge after viewing the DA (R=0.15, pknowledge in healthy populations making hypothetical decisions, and use of the VCE did not improve knowledge or DC. Personality characteristics were associated to some extent with DA-use, information seeking styles with aspects of DC. More research is needed to make clear recommendations regarding the need for tailoring of information provision to personality

  14. Decision Trajectories in Dementia Care Networks: Decisions and Related Key Events.

    Science.gov (United States)

    Groen-van de Ven, Leontine; Smits, Carolien; Oldewarris, Karen; Span, Marijke; Jukema, Jan; Eefsting, Jan; Vernooij-Dassen, Myrra

    2017-10-01

    This prospective multiperspective study provides insight into the decision trajectories of people with dementia by studying the decisions made and related key events. This study includes three waves of interviews, conducted between July 2010 and July 2012, with 113 purposefully selected respondents (people with beginning to advanced stages of dementia and their informal and professional caregivers) completed in 12 months (285 interviews). Our multilayered qualitative analysis consists of content analysis, timeline methods, and constant comparison. Four decision themes emerged-managing daily life, arranging support, community living, and preparing for the future. Eight key events delineate the decision trajectories of people with dementia. Decisions and key events differ between people with dementia living alone and living with a caregiver. Our study clarifies that decisions relate not only to the disease but to living with the dementia. Individual differences in decision content and sequence may effect shared decision-making and advance care planning.

  15. Exploring the requirements for a decision aid on familial breast cancer in the UK context: a qualitative study with patients referred to a cancer genetics service.

    NARCIS (Netherlands)

    Iredale, R.; Rapport, F.; Sivell, S.; Jones, W.; Edwards, A.; Gray, J.; Elwyn, G.

    2008-01-01

    RATIONALE: Patients concerned about a family history of breast cancer can face difficult decisions about screening, prophylactic surgery and genetic testing. Decision aids can facilitate patient decision making and currently include leaflets and computerized tools. These are largely aimed at the

  16. A Pilot Randomized Trial of a Video Patient Decision Aid to Facilitate Early Intervention Referrals From Primary Care.

    Science.gov (United States)

    Jimenez, Manuel E; DuRivage, Nathalie E; Bezpalko, Orysia; Suh, Andrew; Wade, Roy; Blum, Nathan J; Fiks, Alexander G

    2017-03-01

    Many young children identified with developmental concerns in pediatric settings do not receive early intervention (EI). We assessed the impact of a video decision aid and text message reminder on knowledge and attitudes regarding developmental delay and EI as well as referral completion. We conducted a pilot randomized controlled trial in an urban setting and enrolled 64 parent-child dyads referred to EI. Compared with controls, participants who received the intervention demonstrated increased knowledge regarding developmental delay and EI as well as more favorable attitudes in certain topics. Although we did not find a significant difference between arms in EI intake and evaluation, we found a pattern suggestive of increased intake and evaluation among participants with low health literacy in the intervention arm. Additional study is needed to identify strategies that improve the EI referral process for families and to understand the potential targeted role for decision aids and text messages.

  17. Diagnosis of Constant Faults in Read-Once Contact Networks over Finite Bases using Decision Trees

    KAUST Repository

    Busbait, Monther I.

    2014-05-01

    We study the depth of decision trees for diagnosis of constant faults in read-once contact networks over finite bases. This includes diagnosis of 0-1 faults, 0 faults and 1 faults. For any finite basis, we prove a linear upper bound on the minimum depth of decision tree for diagnosis of constant faults depending on the number of edges in a contact network over that basis. Also, we obtain asymptotic bounds on the depth of decision trees for diagnosis of each type of constant faults depending on the number of edges in contact networks in the worst case per basis. We study the set of indecomposable contact networks with up to 10 edges and obtain sharp coefficients for the linear upper bound for diagnosis of constant faults in contact networks over bases of these indecomposable contact networks. We use a set of algorithms, including one that we create, to obtain the sharp coefficients.

  18. Audio-video decision support for patients: the documentary genré as a basis for decision aids.

    Science.gov (United States)

    Volandes, Angelo E; Barry, Michael J; Wood, Fiona; Elwyn, Glyn

    2013-09-01

    Decision support tools are increasingly using audio-visual materials. However, disagreement exists about the use of audio-visual materials as they may be subjective and biased. This is a literature review of the major texts for documentary film studies to extrapolate issues of objectivity and bias from film to decision support tools. The key features of documentary films are that they attempt to portray real events and that the attempted reality is always filtered through the lens of the filmmaker. The same key features can be said of decision support tools that use audio-visual materials. Three concerns arising from documentary film studies as they apply to the use of audio-visual materials in decision support tools include whose perspective matters (stakeholder bias), how to choose among audio-visual materials (selection bias) and how to ensure objectivity (editorial bias). Decision science needs to start a debate about how audio-visual materials are to be used in decision support tools. Simply because audio-visual materials may be subjective and open to bias does not mean that we should not use them. Methods need to be found to ensure consensus around balance and editorial control, such that audio-visual materials can be used. © 2011 John Wiley & Sons Ltd.

  19. Proof-of-concept study of a Web-based methotrexate decision aid for patients with rheumatoid arthritis.

    Science.gov (United States)

    Li, Linda C; Adam, Paul M; Backman, Catherine L; Lineker, Sydney; Jones, C Allyson; Lacaille, Diane; Townsend, Anne F; Yacyshyn, Elaine; Yousefi, Charlene; Tugwell, Peter; Leese, Jenny; Stacey, Dawn

    2014-10-01

    To assess the extent to which an online patient decision aid reduced decisional conflict and improved self-management knowledge/skills in patients who were considering methotrexate for rheumatoid arthritis (RA). We used a mixed-methods pre-post study design. Eligible participants had a diagnosis of RA, had been prescribed methotrexate but were unsure about starting it, and had access to the internet. Outcome included the Decisional Conflict Scale, the Methotrexate in RA Knowledge Test, and the Effective Consumer Scale. Paired t-tests were used to assess changes before and after the intervention. Randomly selected participants were interviewed at the end of the study about their experiences with the decision aid. Of 30 participants, 23 were women. Mean ± SD age was 54.9 ± 14.9 years and the median disease duration was 1 year (interquartile range 0.3-5.0 years). Mean ± SD decisional conflict changed from 49.50 ± 23.17 preintervention to 21.83 ± 24.12 postintervention (change -27.67 [95% confidence interval -39.89, -15.44]; P consumer attributes (mean ± SD 68.24 ± 12.46 preintervention and 72.94 ± 12.74 postintervention; P = 0.15). Three themes emerged from interviews of 11 participants: seeking confirmation of one's own knowledge of methotrexate, amplifying reluctance when they encountered information contradicting their own experiences, and clarifying thoughts about the next step during the process. Patients' decisional conflict and knowledge improved after using the patient decision aid. Interview findings further highlighted the power of patients' prior knowledge and experiences with RA on how they approach the information presented in a decision aid. Copyright © 2014 by the American College of Rheumatology.

  20. Evaluation of the Ryegrass Stem Rust Model STEMRUST_G and Its Implementation as a Decision Aid.

    Science.gov (United States)

    Pfender, W F; Coop, L B; Seguin, S G; Mellbye, M E; Gingrich, G A; Silberstein, T B

    2015-01-01

    STEMRUST_G, a simulation model for epidemics of stem rust in perennial ryegrass grown to maturity as a seed crop, was validated for use as a heuristic tool and as a decision aid for disease management with fungicides. Multistage validation had been used in model creation by incorporating previously validated submodels for infection, latent period duration, sporulation, fungicide effects, and plant growth. Validation of the complete model was by comparison of model output with observed disease severities in 35 epidemics at nine location-years in the Pacific Northwest of the United States. We judge the model acceptable for its purposes, based on several tests. Graphs of modeled disease progress were generally congruent with plotted disease severity observations. There was negligible average bias in the 570 modeled-versus-observed comparisons across all data, although there was large variance in size of the deviances. Modeled severities were accurate in >80% of the comparisons, where accuracy is defined as the modeled value being within twice the 95% confidence interval of the observed value, within ±1 day of the observation date. An interactive website was created to produce disease estimates by running STEMRUST_G with user-supplied disease scouting information and automated daily weather data inputs from field sites. The model and decision aid supplement disease managers' information by estimating the level of latent (invisible) and expressed disease since the last scouting observation, given season-long weather conditions up to the present, and it estimates effects of fungicides on epidemic development. In additional large-plot experiments conducted in grower fields, the decision aid produced disease management outcomes (management cost and seed yield) as good as or better than the growers' standard practice. In future, STEMRUST_G could be modified to create similar models and decision aids for stem rust of wheat and barley, after additional experiments to

  1. Conception d'un outil d'aide a la decision de technologies de fabrication additive en milieu aeronautique

    Science.gov (United States)

    Buvat, Gael

    La fabrication additive offre une opportunite d'amelioration des methodes de productions de pieces. Cependant, les technologies de fabrication additive sont diverses, les fournisseurs de services sont multiples et peu de personnel est forme pour operer sur ces technologies. L'objectif de cette etude est d'emettre une suggestion de concepts d'outils d'aide a la decision de technologies, de materiaux et de post-traitements de fabrication additive en milieu aeronautique. Trois sous-objectifs sont employes. Premierement, la definition des criteres de decision de technologies, de materiaux et de post-traitements de fabrication additive. Ensuite, l'elaboration d'un cahier des charges de l'outil d'aide a la decision en accord avec les besoins industriels du secteur aeronautique. Et enfin, la suggestion de trois concepts d'outils d'aide a la decision et leur evaluation par comparaison au cahier des charges etabli. Les criteres captures aupres de 11 industriels concernent des criteres de couts, de qualite, de conception et de delai d'obtention. Ensuite, nous avons elabore un cahier des charges permettant de reunir les besoins des industriels du secteur aeronautique selon trois axes qui constituent la colonne vertebrale des outils d'aide a la decision : une suggestion d'interface utilisateur, une suggestion de bases de donnees et un moteur de selection des technologies, des materiaux et des post-traitements de fabrication additive. La convivialite de l'interface utilisateur, l'evaluation de la qualite souhaitee par l'utilisateur et la prise en compte des etudes de cas realisees par le moteur de selection sont exemples de besoins que nous avons identifie au sein de cette etude. Nous avons ensuite transcrit ces besoins en specifications techniques pour permettre une evaluation du niveau de satisfaction des industriels au travers d'un pointage des trois concepts suggeres. Ces trois concepts d'outils d'aide a la decision ont ete realises respectivement grâce a Microsoft Excel

  2. Parameter Identification by Bayes Decision and Neural Networks

    DEFF Research Database (Denmark)

    Kulczycki, P.; Schiøler, Henrik

    1994-01-01

    The problem of parameter identification by Bayes point estimation using neural networks is investigated.......The problem of parameter identification by Bayes point estimation using neural networks is investigated....

  3. Cognitive anchoring on self-generated decisions reduces operator reliance on automated diagnostic aids.

    Science.gov (United States)

    Madhavan, Poornima; Wiegmann, Douglas A

    2005-01-01

    Automation users often disagree with diagnostic aids that are imperfectly reliable. The extent to which users' agreements with an aid are anchored to their personal, self-generated diagnoses was explored. Participants (N = 75) performed 200 trials in which they diagnosed pump failures using an imperfectly reliable automated aid. One group (nonforced anchor, n = 50) provided diagnoses only after consulting the aid. Another group (forced anchor, n = 25) provided diagnoses both before and after receiving feedback from the aid. Within the nonforced anchor group, participants' self-reported tendency to prediagnose system failures significantly predicted their tendency to disagree with the aid, revealing a cognitive anchoring effect. Agreement rates of participants in the forced anchor group indicated that public commitment to a diagnosis did not strengthen this effect. Potential applications include the development of methods for reducing cognitive anchoring effects and improving automation utilization in high-risk domains.

  4. Improving self-care for heart failure for seniors: the impact of video and written education and decision aids.

    Science.gov (United States)

    Veroff, David R; Sullivan, Lisa A; Shoptaw, E J; Venator, Benjamin; Ochoa-Arvelo, Tamara; Baxter, Jonathan R; Manocchia, Michael; Wennberg, David

    2012-02-01

    Heart failure poses a substantial burden on health care expenditures and quality of life; therefore, strategies to improve health behaviors for heart failure are essential. Highly effective medical decision aids can enable health improvements for people with heart failure. In this randomized controlled study, individuals with heart failure in a private Medicare plan were randomized into either an intervention or control group. Participants in the intervention group received basic program information and a simple fact sheet about heart failure, plus a medical decision aid, Living with Heart Failure DVD and booklet; patients randomized to the control group received the basic written materials only. The study was powered to detect a 5% difference in the primary outcome measure (daily weight monitoring). Participants were surveyed 4 weeks after outreach materials were mailed. There were 480 survey respondents: 246 in the intervention group; 234 in the control group. Intervention group respondents were significantly more likely to weigh themselves daily (P=0.05) than control group respondents (44% versus 38%). The intervention group was more likely than the control group to monitor fluid intake (47% versus 44%) and follow a low-sodium diet (83% versus 77%). Other health behavior differences were not statistically significant. The DVD decision aid increased levels of daily weight monitoring and other important health behaviors. Broad application of inexpensive behavior change interventions, such as a DVD/booklet program, should help to facilitate important, routine self-care behaviors for individuals with heart failure.

  5. Back to the Bedside: Developing a Bedside Aid for Concussion and Brain Injury Decisions in the Emergency Department.

    Science.gov (United States)

    Melnick, Edward R; Lopez, Kevin; Hess, Erik P; Abujarad, Fuad; Brandt, Cynthia A; Shiffman, Richard N; Post, Lori A

    2015-01-01

    Current information-rich electronic health record (EHR) interfaces require large, high-resolution screens running on desktop computers. This interface compromises the provider's already limited time at the bedside by physically separating the patient from the doctor. The case study presented here describes a patient-centered clinical decision support (CDS) design process that aims to bring the physician back to the bedside by integrating a patient decision aid with CDS for shared use by the patient and provider on a touchscreen tablet computer for deciding whether or not to obtain a CT scan for minor head injury in the emergency department, a clinical scenario that could benefit from CDS but has failed previous implementation attempts. This case study follows the user-centered design (UCD) approach to build a bedside aid that is useful and usable, and that promotes shared decision-making between patients and their providers using a tablet computer at the bedside. The patient-centered decision support design process focuses on the prototype build using agile software development, but also describes the following: (1) the requirement gathering phase including triangulated qualitative research (focus groups and cognitive task analysis) to understand current challenges, (2) features for patient education, the physician, and shared decision-making, (3) system architecture and technical requirements, and (4) future plans for formative usability testing and field testing. We share specific lessons learned and general recommendations from critical insights gained in the patient-centered decision support design process about early stakeholder engagement, EHR integration, external expert feedback, challenges to two users on a single device, project management, and accessibility. Successful implementation of this tool will require seamless integration into the provider's workflow. This protocol can create an effective interface for shared decision-making and safe resource

  6. Coded-subcarrier-aided chromatic dispersion monitoring scheme for flexible optical OFDM networks.

    Science.gov (United States)

    Tse, Kam-Hon; Chan, Chun-Kit

    2014-08-11

    A simple coded-subcarrier aided scheme is proposed to perform chromatic dispersion monitoring in flexible optical OFDM networks. A pair of coded label subcarriers is added to both edges of the optical OFDM signal spectrum at the edge transmitter node. Upon reception at any intermediate or the receiver node, chromatic dispersion estimation is performed, via simple direct detection, followed by electronic correlation procedures with the designated code sequences. The feasibility and the performance of the proposed scheme have been experimentally characterized. It provides a cost-effective monitoring solution for the optical OFDM signals across intermediate nodes in flexible OFDM networks.

  7. SEDIMENT ANALYSIS NETWORK FOR DECISION SUPPORT (SANDS) LANDSAT GEOTIFF V1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Sediment Analysis Network for Decision Support (SANDS) analyzes Geotiff images for sediment redistribution after a hurricane on the Gulf coast and then creates a...

  8. Basic Principles of Industrial Electric Power Network Computer Aided Design and Engineering

    Directory of Open Access Journals (Sweden)

    M. I. Fursanov

    2012-01-01

    Full Text Available A conceptual model for a computer aided design and engineering system has been developed in the paper. The paper presents basic automation process principles including a graphical representation   network and calculation results, convenient user interface, automatic mode calculation, selection of transformer rated power and cross-section area of wires. The developed algorithm and program make it possible to save time and improve quality of project implementation.

  9. A decision aid to assist decisions on disclosure of mental health status to an employer: protocol for the CORAL exploratory randomised controlled trial.

    Science.gov (United States)

    Henderson, Claire; Brohan, Elaine; Clement, Sarah; Williams, Paul; Lassman, Francesca; Schauman, Oliver; Murray, Joanna; Murphy, Caroline; Slade, Mike; Thornicroft, Graham

    2012-08-31

    The UK Equality Act 2010 makes it unlawful for employers to ask health questions before making an offer of employment except in certain circumstances. While the majority of employers would prefer applicants to disclose a mental illness at the application stage, many people either wait until they have accepted the job and then disclose to an occupational health professional, or do not do so at all due to the anticipation of discrimination or a wish for privacy. However, non disclosure precludes the ability to request reasonable adjustments in the workplace or to make a claim of direct discrimination. Disclosure to employers is therefore a difficult decision. A recent pilot study by our group of the CORAL decision aid showed that it helped mental health service users clarify their needs and values regarding disclosure and led to reduction in decisional conflict. The present proof of concept trial aims to determine whether a full scale randomised controlled trial (RCT) is justifiable and feasible, and to optimise its design. In this single blind exploratory RCT in London, a total of 80 participants (inclusion criteria: age ≥ 18 years, on the caseload of a specialist employment adviser working with people with mental illness; referred to the adviser either from primary care via Improving Access to Psychological Therapies or secondary mental health service; currently seeking or interested in either paid or voluntary employment, and a Decisional Conflict Scale score of 37.5 or greater and stage of decision score 1-5) will be recruited from vocational advice services. After completing a baseline assessment, participants will be randomly assigned to one of two conditions (1) Use of the CORAL Decision Aid (DA) in addition to treatment as usual or (2) Treatment as usual. Those allocated to the DA condition will be given it to read and complete, and the researcher will be present to record the time taken and any content that causes confusion. Intervention participants may

  10. A decision aid to assist decisions on disclosure of mental health status to an employer: protocol for the CORAL exploratory randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Henderson Claire

    2012-08-01

    Full Text Available Abstract Background The UK Equality Act 2010 makes it unlawful for employers to ask health questions before making an offer of employment except in certain circumstances. While the majority of employers would prefer applicants to disclose a mental illness at the application stage, many people either wait until they have accepted the job and then disclose to an occupational health professional, or do not do so at all due to the anticipation of discrimination or a wish for privacy. However, non disclosure precludes the ability to request reasonable adjustments in the workplace or to make a claim of direct discrimination. Disclosure to employers is therefore a difficult decision. A recent pilot study by our group of the CORAL decision aid showed that it helped mental health service users clarify their needs and values regarding disclosure and led to reduction in decisional conflict. The present proof of concept trial aims to determine whether a full scale randomised controlled trial (RCT is justifiable and feasible, and to optimise its design. Methods In this single blind exploratory RCT in London, a total of 80 participants (inclusion criteria: age ≥18 years, on the caseload of a specialist employment adviser working with people with mental illness; referred to the adviser either from primary care via Improving Access to Psychological Therapies or secondary mental health service; currently seeking or interested in either paid or voluntary employment, and a Decisional Conflict Scale score of 37.5 or greater and stage of decision score 1–5 will be recruited from vocational advice services. After completing a baseline assessment, participants will be randomly assigned to one of two conditions (1 Use of the CORAL Decision Aid (DA in addition to treatment as usual or (2 Treatment as usual. Those allocated to the DA condition will be given it to read and complete, and the researcher will be present to record the time taken and any content that

  11. Wavelet Network Model Based on Multiple Criteria Decision Making for Forecasting Temperature Time Series

    OpenAIRE

    Zhang, Jian; Yang, Xiao-hua; Chen, Xiao-juan

    2015-01-01

    Due to nonlinear and multiscale characteristics of temperature time series, a new model called wavelet network model based on multiple criteria decision making (WNMCDM) has been proposed, which combines the advantage of wavelet analysis, multiple criteria decision making, and artificial neural network. One case for forecasting extreme monthly maximum temperature of Miyun Reservoir has been conducted to examine the performance of WNMCDM model. Compared with nearest neighbor bootstrapping regr...

  12. TANDEM: A Trust-Based Agent Framework for Networked Decision Making

    Science.gov (United States)

    2015-09-10

    TANDEM: a trust -based agent framework for networked decision making Sibel Adalı1 • Kevin Chan2 • Jin-Hee Cho2 Published online: 10 September 2015...nodes and links in the net- work can have differing capacity, modeled by agents’ ability to accomplish tasks and their trust for each other. The trust ...offs in team performance and interaction between different parameters. Keywords Agent based modeling Networks Decision making Trust 1

  13. Integrated Multimedia Based Intelligent Group Decision Support System for Electrical Power Network

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Saxena

    2002-05-01

    Full Text Available Electrical Power Network in recent time requires an intelligent, virtual environment based decision process for the coordination of all its individual elements and the interrelated tasks. Its ultimate goal is to achieve maximum productivity and efficiency through the efficient and effective application of generation, transmission, distribution, pricing and regulatory systems. However, the complexity of electrical power network and the presence of conflicting multiple goals and objectives postulated by various groups emphasized the need of an intelligent group decision support system approach in this field. In this paper, an Integrated Multimedia based Intelligent Group Decision Support System (IM1GDSS is presented, and its main components are analyzed and discussed. In particular attention is focused on the Data Base, Model Base, Central Black Board (CBB and Multicriteria Futuristic Decision Process (MFDP module. The model base interacts with Electrical Power Network Load Forecasting and Planning (EPNLFP Module; Resource Optimization, Modeling and Simulation (ROMAS Module; Electrical Power Network Control and Evaluation Process (EPNCAEP Module, and MFDP Module through CBB for strategic planning, management control, operational planning and transaction processing. The richness of multimedia channels adds a totally new dimension in a group decision making for Electrical Power Network. The proposed IMIGDSS is a user friendly, highly interactive group decision making system, based on efficient intelligent and multimedia communication support for group discussions, retrieval of content and multi criteria decision analysis.

  14. Synthetic tetracycline-inducible regulatory networks: computer-aided design of dynamic phenotypes

    Directory of Open Access Journals (Sweden)

    Kaznessis Yiannis N

    2007-01-01

    Full Text Available Abstract Background Tightly regulated gene networks, precisely controlling the expression of protein molecules, have received considerable interest by the biomedical community due to their promising applications. Among the most well studied inducible transcription systems are the tetracycline regulatory expression systems based on the tetracycline resistance operon of Escherichia coli, Tet-Off (tTA and Tet-On (rtTA. Despite their initial success and improved designs, limitations still persist, such as low inducer sensitivity. Instead of looking at these networks statically, and simply changing or mutating the promoter and operator regions with trial and error, a systematic investigation of the dynamic behavior of the network can result in rational design of regulatory gene expression systems. Sophisticated algorithms can accurately capture the dynamical behavior of gene networks. With computer aided design, we aim to improve the synthesis of regulatory networks and propose new designs that enable tighter control of expression. Results In this paper we engineer novel networks by recombining existing genes or part of genes. We synthesize four novel regulatory networks based on the Tet-Off and Tet-On systems. We model all the known individual biomolecular interactions involved in transcription, translation, regulation and induction. With multiple time-scale stochastic-discrete and stochastic-continuous models we accurately capture the transient and steady state dynamics of these networks. Important biomolecular interactions are identified and the strength of the interactions engineered to satisfy design criteria. A set of clear design rules is developed and appropriate mutants of regulatory proteins and operator sites are proposed. Conclusion The complexity of biomolecular interactions is accurately captured through computer simulations. Computer simulations allow us to look into the molecular level, portray the dynamic behavior of gene regulatory

  15. Designing optimal transportation networks: a knowledge-based computer-aided multicriteria approach

    Energy Technology Data Exchange (ETDEWEB)

    Tung, S.I.

    1986-01-01

    The dissertation investigates the applicability of using knowledge-based expert systems (KBES) approach to solve the single-mode (automobile), fixed-demand, discrete, multicriteria, equilibrium transportation-network-design problem. Previous works on this problem has found that mathematical programming method perform well on small networks with only one objective. Needed is a solution technique that can be used on large networks having multiple, conflicting criteria with different relative importance weights. The KBES approach developed in this dissertation represents a new way to solve network design problems. The development of an expert system involves three major tasks: knowledge acquisition, knowledge representation, and testing. For knowledge acquisition, a computer aided network design/evaluation model (UFOS) was developed to explore the design space. This study is limited to the problem of designing an optimal transportation network by adding and deleting capacity increments to/from any link in the network. Three weighted criteria were adopted for use in evaluating each design alternative: cost, average V/C ratio, and average travel time.

  16. Assessing the acceptability and feasibility of encounter decision aids for early stage breast cancer targeted at underserved patients.

    Science.gov (United States)

    Alam, Shama; Elwyn, Glyn; Percac-Lima, Sanja; Grande, Stuart; Durand, Marie-Anne

    2016-11-21

    Women of low socioeconomic status (SES) diagnosed with early stage breast cancer are less likely to be involved in treatment decisions. They tend to report higher decisional regret and poorer communication. Evidence suggests that well-designed encounter decision aids (DAs) could improve outcomes and potentially reduce healthcare disparities. Our goal was to evaluate the acceptability and feasibility of encounter decision aids (Option Grid, Comic Option Grid, and Picture Option Grid) adapted for a low-SES and low-literacy population. We used a multi-phase, mixed-methods approach. In phase 1, we conducted a focus group with rural community stakeholders. In phase 2, we developed and administered a web-based questionnaire with patients of low and high SES. In phase 3, we interviewed patients of low SES and relevant healthcare professionals. Data from phase 1 (n = 5) highlighted the importance of addressing treatment costs for patients. Data from phase 2 (n = 268) and phase 3 (n = 15) indicated that using both visual displays and numbers are helpful for understanding statistical information. Data from all three phases suggested that using plain language and simple images (Picture Option Grid) was most acceptable and feasible. The Comic Option Grid was deemed least acceptable. Option Grid and Picture Option Grid appeared acceptable and feasible in facilitating patient involvement and improving perceived understanding among patients of high and low SES. Picture Option Grid was considered most acceptable, accessible and feasible in the clinic visit. However, given the small sample sizes used, those findings need to be interpreted with caution. Further research is needed to determine the impact of pictorial and text-based encounter decision aids in underserved patients and across socioeconomic strata.

  17. Cognitive Systems Engineering Tool Survey - A Subtask in Support of Commander's Decision Aids for Predictive Battle-Space Awareness (CDA4PBA)

    National Research Council Canada - National Science Library

    Sanders, Mary; Fitzhugh, Elisabeth

    2005-01-01

    ...) DO 6, Commander's Decision Aids for Predictive Battle-Space Awareness, (CDA4PBA) is to identify system requirements necessary to capture the entire software and systems engineering process from concept...

  18. From Social Network (Centralized vs. Decentralized) to Collective Decision-Making (Unshared vs. Shared Consensus)

    Science.gov (United States)

    Sueur, Cédric; Deneubourg, Jean-Louis; Petit, Odile

    2012-01-01

    Relationships we have with our friends, family, or colleagues influence our personal decisions, as well as decisions we make together with others. As in human beings, despotism and egalitarian societies seem to also exist in animals. While studies have shown that social networks constrain many phenomena from amoebae to primates, we still do not know how consensus emerges from the properties of social networks in many biological systems. We created artificial social networks that represent the continuum from centralized to decentralized organization and used an agent-based model to make predictions about the patterns of consensus and collective movements we observed according to the social network. These theoretical results showed that different social networks and especially contrasted ones – star network vs. equal network - led to totally different patterns. Our model showed that, by moving from a centralized network to a decentralized one, the central individual seemed to lose its leadership in the collective movement's decisions. We, therefore, showed a link between the type of social network and the resulting consensus. By comparing our theoretical data with data on five groups of primates, we confirmed that this relationship between social network and consensus also appears to exist in animal societies. PMID:22393416

  19. Signaling networks: information flow, computation, and decision making.

    Science.gov (United States)

    Azeloglu, Evren U; Iyengar, Ravi

    2015-04-01

    Signaling pathways come together to form networks that connect receptors to many different cellular machines. Such networks not only receive and transmit signals but also process information. The complexity of these networks requires the use of computational models to understand how information is processed and how input-output relationships are determined. Two major computational approaches used to study signaling networks are graph theory and dynamical modeling. Both approaches are useful; network analysis (application of graph theory) helps us understand how the signaling network is organized and what its information-processing capabilities are, whereas dynamical modeling helps us determine how the system changes in time and space upon receiving stimuli. Computational models have helped us identify a number of emergent properties that signaling networks possess. Such properties include ultrasensitivity, bistability, robustness, and noise-filtering capabilities. These properties endow cell-signaling networks with the ability to ignore small or transient signals and/or amplify signals to drive cellular machines that spawn numerous physiological functions associated with different cell states. Copyright © 2015 Cold Spring Harbor Laboratory Press; all rights reserved.

  20. Application of a neural network as a potential aid in predicting NTF pump failure

    Science.gov (United States)

    Rogers, James L.; Hill, Jeffrey S.; Lamarsh, William J., II; Bradley, David E.

    1993-01-01

    The National Transonic Facility has three centrifugal multi-stage pumps to supply liquid nitrogen to the wind tunnel. Pump reliability is critical to facility operation and test capability. A highly desirable goal is to be able to detect a pump rotating component problem as early as possible during normal operation and avoid serious damage to other pump components. If a problem is detected before serious damage occurs, the repair cost and downtime could be reduced significantly. A neural network-based tool was developed for monitoring pump performance and aiding in predicting pump failure. Once trained, neural networks can rapidly process many combinations of input values other than those used for training to approximate previously unknown output values. This neural network was applied to establish relationships among the critical frequencies and aid in predicting failures. Training pairs were developed from frequency scans from typical tunnel operations. After training, various combinations of critical pump frequencies were propagated through the neural network. The approximated output was used to create a contour plot depicting the relationships of the input frequencies to the output pump frequency.

  1. Intersubjective decision-making for computer-aided forging technology design

    Science.gov (United States)

    Kanyukov, S. I.; Konovalov, A. V.; Muizemnek, O. Yu.

    2017-12-01

    We propose a concept of intersubjective decision-making for problems of open-die forging technology design. The intersubjective decisions are chosen from a set of feasible decisions using the fundamentals of the decision-making theory in fuzzy environment according to the Bellman-Zadeh scheme. We consider the formalization of subjective goals and the choice of membership functions for the decisions depending on subjective goals. We study the arrangement of these functions into an intersubjective membership function. The function is constructed for a resulting decision, which is chosen from a set of feasible decisions. The choice of the final intersubjective decision is discussed. All the issues are exemplified by a specific technological problem. The considered concept of solving technological problems under conditions of fuzzy goals allows one to choose the most efficient decisions from a set of feasible ones. These decisions correspond to the stated goals. The concept allows one to reduce human participation in automated design. This concept can be used to develop algorithms and design programs for forging numerous types of forged parts.

  2. Optimization of vertical handover decision processes for fourth generation heterogeneous wireless networks

    OpenAIRE

    Yan, Xiaohuan

    2017-01-01

    This thesis presents a vertical handover decision (VHD) scheme for optimizing the efficiency of vertical handover processes in the Fourth Generation (4G) heterogeneous wireless networks. The scheme consists of three closely integrated modules: Handover necessity estimation, handover target selection, and handover triggering condition estimation. Handover necessity estimation module determines whether a handover is necessary to an available network. Handover target selecti...

  3. Bayesian Networks as a Decision Tool for O&M of Offshore Wind Turbines

    DEFF Research Database (Denmark)

    Nielsen, Jannie Jessen; Sørensen, John Dalsgaard

    2010-01-01

    Costs to operation and maintenance (O&M) of offshore wind turbines are large. This paper presents how influence diagrams can be used to assist in rational decision making for O&M. An influence diagram is a graphical representation of a decision tree based on Bayesian Networks. Bayesian Networks...... offer efficient Bayesian updating of a damage model when imperfect information from inspections/monitoring is available. The extension to an influence diagram offers the calculation of expected utilities for decision alternatives, and can be used to find the optimal strategy among different alternatives...

  4. The effect of patient narratives on information search in a web-based breast cancer decision aid: an eye-tracking study.

    Science.gov (United States)

    Shaffer, Victoria A; Owens, Justin; Zikmund-Fisher, Brian J

    2013-12-17

    Previous research has examined the impact of patient narratives on treatment choices, but to our knowledge, no study has examined the effect of narratives on information search. Further, no research has considered the relative impact of their format (text vs video) on health care decisions in a single study. Our goal was to examine the impact of video and text-based narratives on information search in a Web-based patient decision aid for early stage breast cancer. Fifty-six women were asked to imagine that they had been diagnosed with early stage breast cancer and needed to choose between two surgical treatments (lumpectomy with radiation or mastectomy). Participants were randomly assigned to view one of four versions of a Web decision aid. Two versions of the decision aid included videos of interviews with patients and physicians or videos of interviews with physicians only. To distinguish between the effect of narratives and the effect of videos, we created two text versions of the Web decision aid by replacing the patient and physician interviews with text transcripts of the videos. Participants could freely browse the Web decision aid until they developed a treatment preference. We recorded participants' eye movements using the Tobii 1750 eye-tracking system equipped with Tobii Studio software. A priori, we defined 24 areas of interest (AOIs) in the Web decision aid. These AOIs were either separate pages of the Web decision aid or sections within a single page covering different content. We used multilevel modeling to examine the effect of narrative presence, narrative format, and their interaction on information search. There was a significant main effect of condition, P=.02; participants viewing decision aids with patient narratives spent more time searching for information than participants viewing the decision aids without narratives. The main effect of format was not significant, P=.10. However, there was a significant condition by format interaction on

  5. Alcohol Dependence and Altered Engagement of Neural Networks in Risky Decisions

    Directory of Open Access Journals (Sweden)

    Xi eZhu

    2016-03-01

    Full Text Available Alcohol dependence is associated with heightened risk tolerance and altered decision- making. This raises the question as to whether alcohol dependent patients (ADP are incapable of proper risk assessment. We investigated how healthy controls (HC and ADP engage neural networks to cope with the increased cognitive demands of risky decisions. We collected fMRI data while 34 HC and 16 ADP played a game that included safe and risky trials. In safe trials, participants accrued money at no risk of a penalty. In risky trials, reward and risk simultaneously increased as participants were instructed to decide when to stop a reward accrual period. If the participant failed to stop before an undisclosed time, the trial would bust and participants would not earn the money from that trial. Independent Component Analysis was used to identify networks engaged during the anticipation and the decision execution of risky compared with safe trials. Like HC, ADP demonstrated distinct network engagement for safe and risky trials at anticipation. However, at decision execution, ADP exhibited severely reduced discrimination in network engagement between safe and risky trials. Although ADP behaviorally responded to risk they failed to appropriately modify network engagement as the decision continued, leading ADP to assume similar network engagement regardless of risk prospects. This may reflect disorganized network switching and a facile response strategy uniformly adopted by ADP across risk conditions. We propose that aberrant salience network (SN engagement in ADP might contribute to ineffective network switching and that the role of the SN in risky decisions warrants further investigation.

  6. Alcohol Dependence and Altered Engagement of Brain Networks in Risky Decisions.

    Science.gov (United States)

    Zhu, Xi; Sundby, Kelsey; Bjork, James M; Momenan, Reza

    2016-01-01

    Alcohol dependence is associated with heightened risk tolerance and altered decision-making. This raises the question as to whether alcohol dependent patients (ADP) are incapable of proper risk assessment. We investigated how healthy controls (HC) and ADP engage neural networks to cope with the increased cognitive demands of risky decisions. We collected fMRI data while 34 HC and 16 ADP played a game that included "safe" and "risky" trials. In safe trials, participants accrued money at no risk of a penalty. In risky trials, reward and risk simultaneously increased as participants were instructed to decide when to stop a reward accrual period. If the participant failed to stop before an undisclosed time, the trial would "bust" and participants would not earn the money from that trial. Independent Component Analysis was used to identify networks engaged during the anticipation and the decision execution of risky compared with safe trials. Like HC, ADP demonstrated distinct network engagement for safe and risky trials at anticipation. However, at decision execution, ADP exhibited severely reduced discrimination in network engagement between safe and risky trials. Although ADP behaviorally responded to risk they failed to appropriately modify network engagement as the decision continued, leading ADP to assume similar network engagement regardless of risk prospects. This may reflect disorganized network switching and a facile response strategy uniformly adopted by ADP across risk conditions. We propose that aberrant salience network (SN) engagement in ADP might contribute to ineffective network switching and that the role of the SN in risky decisions warrants further investigation.

  7. Visual AIDS for multimodal treatment options to support decision making of patients with colorectal cancer

    National Research Council Canada - National Science Library

    Hofmann, Sabine; Vetter, Janina; Wachter, Christiane; Henne-Bruns, Doris; Porzsolt, Franz; Kornmann, Marko

    2012-01-01

    .... However, their desire for autonomy is limited by lack of disease-specific knowledge. Visual aids may be helpful tools to present complex data in an easy-to-understand, graphic form to lay persons...

  8. Improving transportation networks: Effects of population structure and decision making policies

    OpenAIRE

    Pablo-Mart?, Federico; S?nchez, Angel

    2017-01-01

    Transportation networks are one of the fundamental tools for human society to work, more so in our globalized world. The importance of a correct, efficient design of a transportation network for a given region or country cannot be overstated. We here study how network design is affected by the geography of the towns or nuclei to be connected, and also by the decision process necessary to choose which connections should be improved (in a generic sense) first. We begin by establishing that Dela...

  9. Decision dynamics in complex networks subject to mass media and social contact transmission mechanisms

    CERN Document Server

    Lucatero, Carlos Rodríguez; Jaquez, Roberto Bernal; Schaum, Alexander

    2012-01-01

    The dynamics of decisions in complex networks is studied within a Markov process framework using numerical simulations combined with mathematical insight into the process mechanisms. A mathematical discrete-time model is derived based on a set of basic assumptions on the convincing mechanisms associated to two opinions. The model is analyzed with respect to multiplicity of critical points, illustrating in this way the main behavior to be expected in the network. Particular interest is focussed on the effect of social network and exogenous mass media-based influences on the decision behavior. A set of numerical simulation results is provided illustrating how these mechanisms impact the final decision results. The analysis reveals (i) the presence of fixed-point multiplicity (with a maximum of four different fixed points), multistability, and sensitivity with respect to process parameters, and (ii) that mass media have a strong impact on the decision behavior.

  10. Assessing the conceptual clarity and evidence base of quality criteria/standards developed for evaluating decision aids

    Science.gov (United States)

    McDonald, Heather; Charles, Cathy; Gafni, Amiram

    2011-01-01

    Abstract Context  Promoting patient participation in treatment decision making is of increasing interest to researchers, clinicians and policy makers. Decision aids (DAs) are advocated as one way to help achieve this goal. Despite their proliferation, there has been little agreement on criteria or standards for evaluating these tools. To fill this gap, an international collaboration of researchers and others interested in the development, content and quality of DAs have worked over the past several years to develop a checklist and, based on this checklist, an instrument for determining whether any given DA meets a defined set of quality criteria. Objective/Methods  In this paper, we offer a framework for assessing the conceptual clarity and evidence base used to support the development of quality criteria/standards for evaluating DAs. We then apply this framework to assess the conceptual clarity and evidence base underlying the International Patient Decision Aids Standards (IPDAS) checklist criteria for one of the checklist domains: how best to present in DAs probability information to patients on treatment benefits and risks. Conclusion  We found that some of the central concepts underlying the presenting probabilities domain were not defined. We also found gaps in the empirical evidence and theoretical support for this domain and criteria within this domain. Finally, we offer suggestions for steps that should be undertaken for further development and refinement of quality standards for DAs in the future. PMID:22050440

  11. Task-dependent reorganization of functional connectivity networks during visual semantic decision making.

    Science.gov (United States)

    DeSalvo, Matthew N; Douw, Linda; Takaya, Shigetoshi; Liu, Hesheng; Stufflebeam, Steven M

    2014-01-01

    Functional MRI is widely used to study task-related changes in neuronal activity as well as resting-state functional connectivity. In this study, we explore task-related changes in functional connectivity networks using fMRI. Dynamic connectivity may represent a new measure of neural network robustness that would impact both clinical and research efforts. However, prior studies of task-related changes in functional connectivity have shown apparently conflicting results, leading to several competing hypotheses regarding the relationship between task-related and resting-state brain networks. We used a graph theory-based network approach to compare functional connectivity in healthy subjects between the resting state and when performing a clinically used semantic decision task. We analyzed fMRI data from 21 healthy, right-handed subjects. While three nonoverlapping, highly intraconnected functional modules were observed in the resting state, an additional language-related module emerged during the semantic decision task. Both overall and within-module connectivity were greater in default mode network (DMN) and classical language areas during semantic decision making compared to rest, while between-module connectivity was diffusely greater at rest, revealing a more widely distributed pattern of functional connectivity at rest. The results of this study suggest that there are differences in network topology between resting and task states. Specifically, semantic decision making is associated with a reduction in distributed connectivity through hub areas of the DMN as well as an increase in connectivity within both default and language networks.

  12. Computer Aided Learning of Multiple Criteria Decision Making: An Integrated System and Its Effectiveness.

    Science.gov (United States)

    Quaddus, M. A.

    1997-01-01

    This discussion of multiple criteria decision making (MCDM) focuses on an integrated system called MOLP/PC for learning MCDM tools for real world decision making. Results of an empirical test to measure the effectiveness of MOLP/PC are discussed, and the use of MOLP/PC for college courses in Singapore and Australia is described. (Author/LRW)

  13. A Methodology to Aid the Coast Guard in the Decision to Procure or Maintain Telecommunications Systems.

    Science.gov (United States)

    1986-06-20

    INTRODUCTION ------------------------------------ 11 A. BACKGROUND ---------------------------------- 11 B. AREA OF EMPHASIS...Matrix Multiplication---------131 A.6 Inconsistency Determination Matrix-------133 6% ’. ,’ .. 4 [4-, ,- I. INTRODUCTION A. BACKGROUND This thesis is...above spreadsheets into a multi-criteria decision making ( MCDM ) methodology. This will be done in order to give the decision-maker the ability to

  14. Patients' perceptions and attitudes on recurrent prostate cancer and hormone therapy: Qualitative comparison between decision-aid and control groups.

    Science.gov (United States)

    Gorawara-Bhat, Rita; O'Muircheartaigh, Siobhan; Mohile, Supriya; Dale, William

    2017-09-01

    To compare patients' attitudes towards recurrent prostate cancer (PCa) and starting hormone therapy (HT) treatment in two groups-Decision-Aid (DA) (intervention) and Standard-of-care (SoC) (Control). The present research was conducted at three academic clinics-two in the Midwest and one in the Northeast U.S. Patients with biochemical recurrence of PCa (n=26) and follow-up oncology visits meeting inclusion criteria were randomized to either the SoC or DA intervention group prior to their consultation. Analysts were blinded to group assignment. Semi-structured phone interviews with patients were conducted 1-week post consultation. Interviews were audio-taped and transcribed. Qualitative analytic techniques were used to extract salient themes and conduct a comparative analysis of the two groups. Four salient themes emerged-1) knowledge acquisition, 2) decision-making style, 3) decision-making about timing of HT, and 4) anxiety-coping mechanisms. A comparative analysis showed that patients receiving the DA intervention had a better comprehension of Prostate-specific antigen (PSA), an improved understanding of HT treatment implications, an external locus-of-control, participation in shared decision-making and, support-seeking for anxiety reduction. In contrast, SoC patients displayed worse comprehension of PSA testing and HT treatment implications, internal locus-of-control, unilateral involvement in knowledge-seeking and decision-making, and no support-seeking for anxiety-coping. The DA was more effective than the SoC group in helping PCa patients understand the full implications of PSA testing and treatment; motivating shared decision-making, and support-seeking for anxiety relief. DA DVD interventions can be a useful patient education tool for bringing higher quality decision-making to prostate cancer care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Going early, going late: the rationality of decisions about suicide in AIDS.

    Science.gov (United States)

    Battin, M P

    1994-12-01

    Where assistance in suicide is readily available to those dying of AIDS, as in the west coast gay communities of the United States and in the Netherlands, we must examine the different roles of physicians and friends (including lovers, spouses, family members, religious advisors, members of support groups, and intimate others) in helping a person with AIDS decide about and carry out suicide. This paper makes a central assumption: that where assistance in suicide is available, it is the moral obligation of others to protect and enhance as much as possible the rationality of that choice. Four components are identified in a rational choice about suicide in AIDS-whether it is a choice for or against suicide. Phrased as questions a person with AIDS might ask him- or herself, they are: (1) "Is suicide an option I want to consider?" (2) "Shall I hold out for the chance of a cure?" (3) "How shall I time my suicide?" (4) "What weight shall I give to the welfare and interests of others?" Although physicians often make assertions relevant to (1), they are appropriately involved only in (3); and although friends or intimate partners often provide the patient with anecdotal information relevant to (3), they should be involved primarily in (1). In short, both physicians and friends often intervene in the wrong parts of choices made by a person with AIDS about suicide.

  16. Spectrum decision in cognitive radio networks: a survey

    CSIR Research Space (South Africa)

    Masonta, MT

    2012-11-01

    Full Text Available Spectrum decision is the ability of a cognitive radio (CR) to select the best available spectrum band to satisfy secondary users’ (SUs’) quality of service (QoS) requirements, without causing harmful interference to licensed or primary users (PUs...

  17. How do Regional Headquarters Influence Corporate Decisions in Networked MNCs?

    DEFF Research Database (Denmark)

    Mahnke, Volker; Ambos, Björn; Nell, Phillip Christopher

    2012-01-01

    , and as a bridge between local subsidiaries and global corporate headquarters. This paper builds theory on the antecedents to regional headquarters' influence on corporate decisions (i.e., organizational, behavioral, and motivational). Based on a survey of regional headquarters in Europe and their relations...

  18. Social Network Analysis in Transnational Settings: The Case of Mexico City’s AIDS CBOs

    Directory of Open Access Journals (Sweden)

    Nielan Barnes

    2010-02-01

    Full Text Available Using a case study approach, I show how transnational civil society networks both help and hinder community-based HIV/AIDS organizations by providing opportunities for community-state partnerships that favor some local organizations over others, and (reproduce intra-organizational stratification at the local level. In the case of Mexico City, transnational ties encourage community-based AIDS organizations to develop formal organizational forms and strategies (negotiating fronts which often enhance organizational sustainability and draw organizations into a closer relationship with the state institutionalized sphere. However, such ties also create divisions (political fronts between outsider and insider organizations that compromise local inter-organizational collaboration and service delivery. As a result, transnational networks and resources solidify outsider-insider conflicts and balkanize service provision along political lines. The conclusions of this research are helpful to international health practitioners and social scientists seeking to understand how transnational networks and resources shape global civil society, and can both challenge and reproduce existing community-state power regimes and health inequities at local and transnational levels.

  19. SANDS: a service-oriented architecture for clinical decision support in a National Health Information Network.

    Science.gov (United States)

    Wright, Adam; Sittig, Dean F

    2008-12-01

    In this paper, we describe and evaluate a new distributed architecture for clinical decision support called SANDS (Service-oriented Architecture for NHIN Decision Support), which leverages current health information exchange efforts and is based on the principles of a service-oriented architecture. The architecture allows disparate clinical information systems and clinical decision support systems to be seamlessly integrated over a network according to a set of interfaces and protocols described in this paper. The architecture described is fully defined and developed, and six use cases have been developed and tested using a prototype electronic health record which links to one of the existing prototype National Health Information Networks (NHIN): drug interaction checking, syndromic surveillance, diagnostic decision support, inappropriate prescribing in older adults, information at the point of care and a simple personal health record. Some of these use cases utilize existing decision support systems, which are either commercially or freely available at present, and developed outside of the SANDS project, while other use cases are based on decision support systems developed specifically for the project. Open source code for many of these components is available, and an open source reference parser is also available for comparison and testing of other clinical information systems and clinical decision support systems that wish to implement the SANDS architecture. The SANDS architecture for decision support has several significant advantages over other architectures for clinical decision support. The most salient of these are:

  20. Informed decision making before prostate-specific antigen screening: Initial results using the American Cancer Society (ACS) Decision Aid (DA) among medically underserved men.

    Science.gov (United States)

    Gökce, Mehmet I; Wang, Xuemei; Frost, Jacqueline; Roberson, Pamela; Volk, Robert J; Brooks, Durado; Canfield, Steven E; Pettaway, Curtis A

    2017-02-15

    The American Cancer Society (ACS) recommends men have the opportunity to make an informed decision about screening for prostate cancer (PCa). The ACS developed a unique decision aid (ACS-DA) for this purpose. However, to date, studies evaluating the efficacy of the ACS-DA are lacking. The authors evaluated the ACS-DA among a cohort of medically underserved men (MUM). A multiethnic cohort of MUM (n = 285) was prospectively included between June 2010 and December 2014. The ACS-DA was presented in a group format. Levels of knowledge on PCa were evaluated before and after the presentation. Participants' decisional conflict and thoughts about the presentation also were evaluated. Logistic regression analyses were performed to determine factors associated with having an adequate level of knowledge. Before receiving the ACS-DA, 33.1% of participants had adequate knowledge on PCa, and this increased to 77% after the DA (P ACS-DA to others. Use of the ACS-DA was feasible among MUM and led to increased PCa knowledge. This also correlated with low levels of decisional conflict. The ACS-DA presented to groups of men may serve as a feasible tool for informed decision making in a MUM population. Cancer 2017;123:583-591. © 2016 American Cancer Society. © 2016 American Cancer Society.

  1. AIDS-related information exposure in the mass media and discussion within social networks among married women in Bombay, India.

    Science.gov (United States)

    Chatterjee, N

    1999-08-01

    Married women are at high risk of acquiring HIV infection in India and health education remains the most feasible preventive tool in their context. In a survey conducted among 350 married women in Bombay, it was found that a majority had acquired information about AIDS from the mass media, especially television. Although 87% of women who knew of AIDS had been exposed to AIDS-related information in the mass media in the past four weeks, only 57% had discussed it within their social networks. Those with more exposure to AIDS information in the mass media were significantly more likely to discuss AIDS within social networks. The women were most likely to discuss AIDS with their husbands as a general social issue, followed by friends and family members and least likely to talk to husbands about AIDS as a personal issue relating to their sexual relationship. Increased frequency and duration of AIDS messages on television will have a positive influence on AIDS knowledge in this group.

  2. Analysis of Greedy Decision Making for Geographic Routing for Networks of Randomly Moving Objects

    Directory of Open Access Journals (Sweden)

    Amber Israr

    2016-04-01

    Full Text Available Autonomous and self-organizing wireless ad-hoc communication networks for moving objects consist of nodes, which use no centralized network infrastructure. Examples of moving object networks are networks of flying objects, networks of vehicles, networks of moving people or robots. Moving object networks have to face many critical challenges in terms of routing because of dynamic topological changes and asymmetric networks links. A suitable and effective routing mechanism helps to extend the deployment of moving nodes. In this paper an attempt has been made to analyze the performance of the Greedy Decision method (position aware distance based algorithm for geographic routing for network nodes moving according to the random waypoint mobility model. The widely used GPSR (Greedy Packet Stateless Routing protocol utilizes geographic distance and position based data of nodes to transmit packets towards destination nodes. In this paper different scenarios have been tested to develop a concrete set of recommendations for optimum deployment of distance based Greedy Decision of Geographic Routing in randomly moving objects network

  3. CEO emotional bias and investment decision, Bayesian network method

    OpenAIRE

    Jarboui Anis; Mohamed Ali Azouzi

    2012-01-01

    This research examines the determinants of firms’ investment introducing a behavioral perspective that has received little attention in corporate finance literature. The following central hypothesis emerges from a set of recently developed theories: Investment decisions are influenced not only by their fundamentals but also depend on some other factors. One factor is the biasness of any CEO to their investment, biasness depends on the cognition and emotions, because some leaders use them as h...

  4. A randomised controlled trial of the effects of a web-based PSA decision aid, Prosdex. Protocol

    Directory of Open Access Journals (Sweden)

    Griffiths Jeff

    2007-10-01

    Full Text Available Abstract Background Informed decision making is the theoretical basis in the UK for men's decisions about Prostate Specific Antigen (PSA testing for prostate cancer testing. The aim of this study is to evaluate the effect of a web-based PSA decision-aid, Prosdex, on informed decision making in men. The objective is to assess the effect of Prosdex on six specific outcomes: (i knowledge of PSA and prostate cancer-related issues – the principal outcome of the study; (ii attitudes to testing; (iii decision conflict; (iv anxiety; (v intention to undergo PSA testing; (vi uptake of PSA testing. In addition, a mathematical simulation model of the effects of Prosdex will be developed. Methods A randomised controlled trial with four groups: two intervention groups, one viewing Prosdex and the other receiving a paper version of the site; two control groups, the second controlling for the potential Hawthorn effect of the questionnaire used with the first control group. Men between the ages of 50 and 75, who have not previously had a PSA test, will be recruited from General Practitioners (GPs in Wales, UK. The principal outcome, knowledge, and four other outcome measures – attitudes to testing, decision conflict, anxiety and intention to undergo testing – will be measured with an online questionnaire, used by men in three of the study groups. Six months later, PSA test uptake will be ascertained from GP records; the online questionnaire will then be repeated. These outcomes, and particularly PSA test uptake, will be used to develop a mathematical simulation model, specifically to consider the impact on health service resources. Trial registration Current Controlled Trial: ISRCTN48473735.

  5. A decision aid for considering indomethacin prophylaxis vs. symptomatic treatment of PDA for extreme low birth weight infants

    Directory of Open Access Journals (Sweden)

    AlKharfi Turki M

    2011-09-01

    Full Text Available Abstract Background Decision Aids (DA are well established in various fields of medicine. It can improve the quality of decision-making and reduce decisional conflict. In neonatal care, and due to scientific equipoise, neonatologists caring for extreme low birth weight (ELBW infants are in need to elicit parents' preferences with regard to the use of indomethacin therapy in ELBW infants. We aimed to develop a DA that elicits parents' preferences with regard to indomethacin therapy in ELBW infants. Methods We developed a DA for the use of the indomethacin therapy in ELBW infants according to the Ottawa Decision Support Framework. The development process involved parents, neonatologists, DA developers and decision making experts. A pilot testing with healthy volunteers was conducted through an evaluation questionnaire, a knowledge scale, and a validated decisional conflict scale. Results The DA is a computer-based interactive tool. In the first part, the DA provides information about patent ductus arteriosus (PDA as a disease, the different treatment options, and the benefits and downsides of using indomethacin therapy in preterm infants. In the second part, it coaches the parent in the decision making process through clarifying values and preferences. Volunteers rated 10 out of 13 items of the DA positively and showed significant improvement on both the knowledge scale (p = 0.008 and the decisional conflict scale (p = 0.008. Conclusion We have developed a computer based DA to assess parental preferences with regard to indomethacin therapy in preterm infants. Future research will involve measurement of parental preferences to guide and augment the clinical decisions in current neonatal practice.

  6. [Artificial neural networks for decision making in urologic oncology].

    Science.gov (United States)

    Remzi, M; Djavan, B

    2007-06-01

    This chapter presents a detailed introduction regarding Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. It includes a description of ANNs methodology and points out the differences between Artifical Intelligence and traditional statistic models in terms of usefulness for patients and clinicians, and its advantages over current statistical analysis.

  7. Factors Underlying Farmers’ Decisions to Participate in Networks

    Directory of Open Access Journals (Sweden)

    Bianka Kühne

    2013-11-01

    Full Text Available 800x600 The objective of this elicitation study is to provide insights into farmers’ beliefs which influence their participation in knowledge exchange and innovation networks to enable the enhancement of network participation. A set of facilitating and impeding factors was obtained. Participants identified (a 13 categories of behavioural beliefs (e.g. ‘You learn something’ and ‘Low perceived return on investment’, (b 4 groups of normative beliefs (influence of colleagues, spouses, network coordinators and chain partners and (c 11 control beliefs (facilitators or barriers related to, for example, ‘Network skills’, ‘No time’ and ‘Perceived restraint by farmers in communicating openly and honestly’. Normal 0 21 false false false DE X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table 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:0pt 5.4pt 0pt 5.4pt; mso-para-margin:0pt; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";}

  8. Multi-Criteria Decision Aid for Sustainable Energy Prioritization Using Fuzzy Axiomatic Design

    OpenAIRE

    Basar Oztaysi; Mine Isik; Secil Ercan

    2013-01-01

    Sustainability has gained tremendous importance and has been an important issue both for policy makers and practitioners. Realizing that the resources on the earth are limited, renewable energy alternatives have flourished and started to replace the conventional energy alternatives. Energy planning using different energy alternatives, for the long term becomes a vital decision. In this study, fuzzy multi criteria decision- making methodologies, axiomatic design (AD) and analytic hierarchy pro...

  9. Sexual discourse and decision-making by urban youth in AIDS ...

    African Journals Online (AJOL)

    This article begins by considering the ethics and practicalities of researching sensitive issues with older children and young adults in the context of HIV/AIDS. As part of qualitative fieldwork in the municipality of Mbabane, Swaziland, family caregivers and learners at two secondary schools explained how and where sexual ...

  10. Cultural and linguistic adaptation of a multimedia colorectal cancer screening decision aid for Spanish-speaking Latinos.

    Science.gov (United States)

    Ko, Linda K; Reuland, Daniel; Jolles, Monica; Clay, Rebecca; Pignone, Michael

    2014-01-01

    As the United States becomes more linguistically and culturally diverse, there is a need for effective health communication interventions that target diverse, vulnerable populations, including Latinos. To address such disparities, health communication interventionists often face the challenge to adapt existing interventions from English into Spanish in a way that retains essential elements of the original intervention while also addressing the linguistic needs and cultural perspectives of the target population. The authors describe the conceptual framework, context, rationale, methods, and findings of a formative research process used in creating a Spanish-language version of an evidence-based (English language) multimedia colorectal cancer screening decision aid. The multistep process included identification of essential elements of the existing intervention, literature review, assessment of the regional context and engagement of key stakeholders, and solicitation of direct input from target population. The authors integrated these findings in the creation of the new adapted intervention. They describe how they used this process to identify and integrate sociocultural themes such as personalism (personalismo), familism (familismo), fear (miedo), embarrassment (verguenza), power distance (respeto), machismo, and trust (confianza) into the Spanish-language decision aid.

  11. Feasibility of a patient decision aid regarding disclosure of personal health information: qualitative evaluation of the Health Care Information Directive

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-09-01

    Full Text Available Abstract Background Concerns regarding the privacy of health information are escalating owing both to the growing use of information technology to store and exchange data and to the increasing demand on the part of patients to control the use of their medical records. The objective of this study was to evaluate the Health Care Information Directive (HCID, a recently-developed patient decision aid that aims to delineate the level of health information an individual is willing to share. Methods We convened a series of four focus group meetings with several communities in a large Canadian city. A total of 28 men and women participated, representing health care consumer advocates, urban professionals, senior citizens, and immigrants who speak English as a second language. Data were analysed using qualitative methods. Results Participants lacked substantial knowledge regarding the fate and uses of personal health information. They expressed mistrust concerning how their information will be used and protected. Several suggestions were made towards customizing the use of data according to specific needs rather than broad and full access to their charts. Furthermore, despite concern regarding the implementation of a tool like the HCID, participants were hopeful that a refined instrument could contribute to the improved regulation of health information. Conclusion This study indicated poor knowledge concerning the uses of personal health information, distrust concerning security provisions, and cautious support for a patient decision aid such as the HCID to improve control over health data.

  12. Use of a computerised decision aid (DA) to inform the decision process on adjuvant chemotherapy in patients with stage II colorectal cancer: development and preliminary evaluation.

    Science.gov (United States)

    Miles, A; Chronakis, I; Fox, J; Mayer, A

    2017-03-24

    To develop a computerised decision aid (DA) to inform the decision process on adjuvant chemotherapy in patients with stage II colorectal cancer, and examine perceived usefulness, acceptability and areas for improvement of the DA. Mixed methods. Single outpatient oncology department in central London. Consecutive recruitment of 13 patients with stage II colorectal cancer, 12 of whom completed the study. Inclusion criteria were: age >18 years; complete resection for stage II adenocarcinoma of the colon or rectum; patients within 14-56 days after surgery; no contraindication to adjuvant chemotherapy; able to give written informed consent. Exclusion criterion: previous chemotherapy. Patient perceived usefulness (assessed by the PrepDM questionnaire) and acceptability of the DA. PrepDM scores, measuring the perceived usefulness of the DA in preparing the patient to communicate with their doctor and make a health decision, were above those reported in other patient groups. Patient acceptability scores were also high; however, interviews showed that there was evidence of a lack of understanding of key information among some patients, in particular their baseline risk of recurrence, the net benefit of combination chemotherapy and the rationale for having chemotherapy when cancer had apparently gone. Patients found the DA acceptable and useful in supporting their decision about whether or not to have adjuvant chemotherapy. Suggested improvements for the DA include: sequential presentation of treatment options (eg, no treatment vs 1 drug, 1 drug vs 2 drugs) to enhance patient understanding of the difference between combination and single therapy, diagrams to help patients understand the rationale for chemotherapy to prevent a recurrence and inbuilt checks on patient understanding of baseline risk of recurrence and net benefit of chemotherapy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Computer-Aided Cobb Measurement Based on Automatic Detection of Vertebral Slopes Using Deep Neural Network.

    Science.gov (United States)

    Zhang, Junhua; Li, Hongjian; Lv, Liang; Zhang, Yufeng

    2017-01-01

    To develop a computer-aided method that reduces the variability of Cobb angle measurement for scoliosis assessment. A deep neural network (DNN) was trained with vertebral patches extracted from spinal model radiographs. The Cobb angle of the spinal curve was calculated automatically from the vertebral slopes predicted by the DNN. Sixty-five in vivo radiographs and 40 model radiographs were analyzed. An experienced surgeon performed manual measurements on the aforementioned radiographs. Two examiners used both the proposed and the manual measurement methods to analyze the aforementioned radiographs. For model radiographs, the intraclass correlation coefficients were greater than 0.98, and the mean absolute differences were less than 3°. This indicates that the proposed system showed high repeatability for measurements of model radiographs. For the in vivo radiographs, the reliabilities were lower than those from the model radiographs, and the differences between the computer-aided measurement and the manual measurement by the surgeon were higher than 5°. The variability of Cobb angle measurements can be reduced if the DNN system is trained with enough vertebral patches. Training data of in vivo radiographs must be included to improve the performance of DNN. Vertebral slopes can be predicted by DNN. The computer-aided system can be used to perform automatic measurements of Cobb angle, which is used to make reliable and objective assessments of scoliosis.

  14. Neural network-aided variational Bayesian adaptive cubature Kalman filtering for nonlinear state estimation

    Science.gov (United States)

    Miao, Zhiyong; Shi, Hongyang; Zhang, Yi; Xu, Fan

    2017-10-01

    In this paper, a new variational Bayesian adaptive cubature Kalman filter (VBACKF) is proposed for nonlinear state estimation. Although the conventional VBACKF performs better than cubature Kalman filtering (CKF) in solving nonlinear systems with time-varying measurement noise, its performance may degrade due to the uncertainty of the system model. To overcome this drawback, a multilayer feed-forward neural network (MFNN) is used to aid the conventional VBACKF, generalizing it to attain higher estimation accuracy and robustness. In the proposed neural-network-aided variational Bayesian adaptive cubature Kalman filter (NN-VBACKF), the MFNN is used to turn the state estimation of the VBACKF adaptively, and it is used for both state estimation and in the online training paradigm simultaneously. To evaluate the performance of the proposed method, it is compared with CKF and VBACKF via target tracking problems. The simulation results demonstrate that the estimation accuracy and robustness of the proposed method are better than those of the CKF and VBACKF.

  15. RoCoMAR: Robots’ Controllable Mobility Aided Routing and Relay Architecture for Mobile Sensor Networks

    Directory of Open Access Journals (Sweden)

    Seokhoon Yoon

    2013-07-01

    Full Text Available In a practical deployment, mobile sensor network (MSN suffers from a low performance due to high node mobility, time-varying wireless channel properties, and obstacles between communicating nodes. In order to tackle the problem of low network performance and provide a desired end-to-end data transfer quality, in this paper we propose a novel ad hoc routing and relaying architecture, namely RoCoMAR (Robots’ Controllable Mobility Aided Routing that uses robotic nodes’ controllable mobility. RoCoMAR repeatedly performs link reinforcement process with the objective of maximizing the network throughput, in which the link with the lowest quality on the path is identified and replaced with high quality links by placing a robotic node as a relay at an optimal position. The robotic node resigns as a relay if the objective is achieved or no more gain can be obtained with a new relay. Once placed as a relay, the robotic node performs adaptive link maintenance by adjusting its position according to the movements of regular nodes. The simulation results show that RoCoMAR outperforms existing ad hoc routing protocols for MSN in terms of network throughput and end-to-end delay.

  16. Statistically derived factors of varied importance to audiologists when making a hearing aid brand preference decision.

    Science.gov (United States)

    Johnson, Earl E; Mueller, H Gustav; Ricketts, Todd A

    2009-01-01

    To determine the amount of importance audiologists place on various items related to their selection of a preferred hearing aid brand manufacturer. Three hundred forty-three hearing aid-dispensing audiologists rated a total of 32 randomized items by survey methodology. Principle component analysis identified seven orthogonal statistical factors of importance. In rank order, these factors were Aptitude of the Brand, Image, Cost, Sales and Speed of Delivery, Exposure, Colleague Recommendations, and Contracts and Incentives. While it was hypothesized that differences among audiologists in the importance ratings of these factors would dictate their preference for a given brand, that was not our finding. Specifically, mean ratings for the six most important factors did not differ among audiologists preferring different brands. A statistically significant difference among audiologists preferring different brands was present, however, for one factor: Contracts and Incentives. Its assigned importance, though, was always lower than that for the other six factors. Although most audiologists have a preferred hearing aid brand, differences in the perceived importance of common factors attributed to brands do not largely determine preference for a particular brand.

  17. Tourette syndrome: a disorder of the social decision-making network.

    Science.gov (United States)

    Albin, Roger L

    2017-08-22

    Tourette syndrome is a common neurodevelopmental disorder defined by characteristic involuntary movements, tics, with both motor and phonic components. Tourette syndrome is usually conceptualized as a basal ganglia disorder, with an emphasis on striatal dysfunction. While considerable evidence is consistent with these concepts, imaging data suggest diffuse functional and structural abnormalities in Tourette syndrome brain. Tourette syndrome exhibits features that are difficult to explain solely based on basal ganglia circuit dysfunctions. These features include the natural history of tic expression, with typical onset of tics around ages 5 to 7 years and exacerbation during the peri-pubertal years, marked sex disparity with higher male prevalence, and the characteristic distribution of tics. The latter are usually repetitive, somewhat stereotyped involuntary eye, facial and head movements, and phonations. A major functional role of eye, face, and head movements is social signalling. Prior work in social neuroscience identified a phylogenetically conserved network of sexually dimorphic subcortical nuclei, the Social Behaviour Network, mediating many social behaviours. Social behaviour network function is modulated developmentally by gonadal steroids and social behaviour network outputs are stereotyped sex and species specific behaviours. In 2011 O'Connell and Hofmann proposed that the social behaviour network interdigitates with the basal ganglia to form a greater network, the social decision-making network. The social decision-making network may have two functionally complementary limbs: the basal ganglia component responsible for evaluation of socially relevant stimuli and actions with the social behaviour network component responsible for the performance of social acts. Social decision-making network dysfunction can explain major features of the neurobiology of Tourette syndrome. Tourette syndrome may be a disorder of social communication resulting from

  18. Women and AIDS Support Network: mutual support to change community norms.

    Science.gov (United States)

    Ray, S

    1992-01-01

    A group of women formed the Women and AIDS Support Network (WASN) in Zimbabwe in June 1989 to improve women;s self-esteem and confidence and to bring about changes in attitudes and reactions toward AIDS-related problems. Both HIV-positive and HIV-negative women are WASN members. Women have limited control over sexual relationships. Women who know their partners are having intercourse with other women have few options, e.g., they may depend on their partners. A family council settles marital disagreements, but husbands do not always cooperate. Increased peer pressure could change societal acceptance of male infidelity to positive attitudes toward friendship and partnership in marriage. Therefore, WASN explores sexual relationships, especially control and power in them. These discussions should lead to affirmation of positive behavior. For example, men can promote condom use and monogamy to their male peers. They can also talk to their partners and their sons about HIV. Rural women should not blame urban women for their partner's HIV status. WASN also targets schoolgirls. Most early and some current messages of AIDS campaigns reinforces the dichotomy of good and bad women, supported by an earlier link between urban women and sexually transmitted diseases. Yet, they ignored men's role in HIV transmission. WASN speaks out against such negative images, e.g., dramas that depict the HIV-infected woman as evil and the innocent as good while the man worries about which woman infected him instead of feeling awful about infecting other women. WASN also addressee AIDS-related discrimination on the job and stigmatization issues. It now is conducting 2 research projects: information needs of urban and rural women and capacities of family support systems to assist HIV-positive women.

  19. Resource allocation within the National AIDS Control Program of Pakistan: a qualitative assessment of decision maker's opinions

    Directory of Open Access Journals (Sweden)

    Kadir Masood

    2007-01-01

    Full Text Available Abstract Background Limited resources, whether public or private, demand prioritisation among competing needs to maximise productivity. With a substantial increase in the number of reported HIV cases, little work has been done to understand how resources have been distributed and what factors may have influenced allocation within the newly introduced Enhanced National AIDS Control Program of Pakistan. The objective of this study was to identify perceptions of decision makers about the process of resource allocation within Pakistan's Enhanced National AIDS Control Program. Methods A qualitative study was undertaken and in-depth interviews of decision makers at provincial and federal levels responsible to allocate resources within the program were conducted. Results HIV was not considered a priority issue by all study participants and external funding for the program was thought to have been accepted because of poor foreign currency reserves and donor agency influence rather than local need. Political influences from the federal government and donor agencies were thought to manipulate distribution of funds within the program. These influences were thought to occur despite the existence of a well-laid out procedure to determine allocation of public resources. Lack of collaboration among departments involved in decision making, a pervasive lack of technical expertise, paucity of information and an atmosphere of ad hoc decision making were thought to reduce resistance to external pressures. Conclusion Development of a unified program vision through a consultative process and advocacy is necessary to understand goals to be achieved, to enhance program ownership and develop consensus about how money and effort should be directed. Enhancing public sector expertise in planning and budgeting is essential not just for the program, but also to reduce reliance on external agencies for technical support. Strengthening available databases for effective

  20. Tools to aid post-wildfire assessment and erosion-mitigation treatment decisions

    Science.gov (United States)

    Peter R. Robichaud; Louise E. Ashmun

    2013-01-01

    A considerable investment in post-fire research over the past decade has improved our understanding of wildfire effects on soil, hydrology, erosion and erosion-mitigation treatment effectiveness. Using this new knowledge, we have developed several tools to assist land managers with post-wildfire assessment and treatment decisions, such as prediction models, research...

  1. The Use of the Analytic Hierarchy Process to Aid Decision Making in Acquired Equinovarus Deformity

    NARCIS (Netherlands)

    van Til, Janine Astrid; Renzenbrink, G.J.; Dolan, J.G.; IJzerman, Maarten Joost

    2008-01-01

    Objective: To increase the transparency of decision making about treatment in patients with equinovarus deformity poststroke. - Design: The analytic hierarchy process (AHP) was used as a structured methodology to study the subjective rationale behind choice of treatment. - Setting: An 8-hour meeting

  2. Commander’s CBR-D Decision Training Aid (DECAID) Demonstration Model and Design Refinement

    Science.gov (United States)

    1989-07-12

    Event 9: &M EVENT 9: Piremain Pepl Firemnain Rupture P ocedurwpeislot1: Decision on whether and how to Detws resor Finemain. ~: Report of ruptured...require living cells for growth. Also, they are normally dependent on arthropod vectors for transmission, and are easily killed by heat, dehydration

  3. Computer-Aided Decisions in Human Services: Expert Systems and Multivariate Models.

    Science.gov (United States)

    Sicoly, Fiore

    1989-01-01

    This comparison of two approaches to the development of computerized supports for decision making--expert systems and multivariate models--focuses on computerized systems that assist professionals with tasks related to diagnosis or classification in human services. Validation of both expert systems and statistical models is emphasized. (39…

  4. Caries detection methods : Can they aid decision making for invasive sealant treatment?

    NARCIS (Netherlands)

    Pereira, AC; Verdonschot, EH; Huysmans, M

    2001-01-01

    The decision to place sealants is a difficult one, and it has been suggested that in a low risk population it may be efficient to wait until caries is detected in the fissure. An invasive sealant technique with fissure preparation may then be indicated. The diagnostic method used in the indication

  5. Computer-based clinical decision aids. A review of methods and assessment of systems

    NARCIS (Netherlands)

    Reisman, Y

    1996-01-01

    During the last three decades a great deal of research has been devoted to the development of integrated clinical decision support systems. This report aims to give a basic understanding of what is required for such a system. By means of a large literature study a survey is given of the major

  6. A Visual Aid to Decision-Making for People with Intellectual Disabilities

    Science.gov (United States)

    Bailey, Rebecca; Willner, Paul; Dymond, Simon

    2011-01-01

    Previous studies have shown that people with mild intellectual disabilities have difficulty in "weighing-up" information, defined as integrating information from two different sources for the purpose of reaching a decision. This was demonstrated in two very different procedures, temporal discounting and a scenario-based financial…

  7. Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards.

    Science.gov (United States)

    Montori, Victor M; LeBlanc, Annie; Buchholz, Angela; Stilwell, Diana L; Tsapas, Apostolos

    2013-01-01

    Patients and clinicians expect patient decision aids to be based on the best available research evidence. Since 2005, this expectation has translated into a quality dimension of the International Patient Decision Aid Standards. We reviewed the 2005 standards and the available literature on the evidence base of decision aids as well as searched for parallel activities in which evidence is brought to bear to inform clinical decisions. In conducting this work, we noted emerging and research issues that require attention and may inform this quality dimension in the future. This dimension requires patient decision aids to be based on research evidence about the relevant options and the nature and likelihood of their effect on outcomes that matter to patients. The synthesis of evidence should be comprehensive and up-to-date, and the evidence itself subject to critical appraisal. Ethical (informed patient choice), quality-of-care (patient-centered care), and scientific (evidence-based medicine) arguments justify this requirement. Empirical evidence suggests that over two thirds of available decision aids are based on high-quality evidence syntheses. Emerging issues identified include the duties of developers regarding the conduct of systematic reviews, the impact of comparative effectiveness research, their link with guidelines based on the same evidence, and how to present the developers' confidence in the estimates to the end-users. Systematic application of the GRADE system, common in contemporary practice guideline development, could enhance satisfaction of this dimension. While theoretical and practical issues remained to be addressed, high-quality patient decision aids should adhere to this dimension requiring they be based on comprehensive and up-to-date summaries of critically appraised evidence.

  8. Randomness in the network inhibits cooperation based on the bounded rational collective altruistic decision

    Science.gov (United States)

    Ohdaira, Tetsushi

    2014-07-01

    Previous studies discussing cooperation employ the best decision that every player knows all information regarding the payoff matrix and selects the strategy of the highest payoff. Therefore, they do not discuss cooperation based on the altruistic decision with limited information (bounded rational altruistic decision). In addition, they do not cover the case where every player can submit his/her strategy several times in a match of the game. This paper is based on Ohdaira's reconsideration of the bounded rational altruistic decision, and also employs the framework of the prisoner's dilemma game (PDG) with sequential strategy. The distinction between this study and the Ohdaira's reconsideration is that the former covers the model of multiple groups, but the latter deals with the model of only two groups. Ohdaira's reconsideration shows that the bounded rational altruistic decision facilitates much more cooperation in the PDG with sequential strategy than Ohdaira and Terano's bounded rational second-best decision does. However, the detail of cooperation of multiple groups based on the bounded rational altruistic decision has not been resolved yet. This study, therefore, shows how randomness in the network composed of multiple groups affects the increase of the average frequency of mutual cooperation (cooperation between groups) based on the bounded rational altruistic decision of multiple groups. We also discuss the results of the model in comparison with related studies which employ the best decision.

  9. Overview 2010 of ARL Program on Network Science for Human Decision Making.

    Science.gov (United States)

    West, Bruce J

    2011-01-01

    The Army Research Laboratory program on the Network Science of Human Decision Making brings together researchers from a variety of disciplines to work on a complex research problem that defies confinement within any single discipline. Consequently, new and rewarding solutions have been obtained for a problem of importance to society and the Army, that being, the human dimension of complex networks. This program investigates the basic research foundation of a science of networks supporting the linkage between the cognitive and social domains as they relate to human decision making. The research strategy extends recent methods of non-equilibrium statistical physics to non-stationary, renewal stochastic processes characteristic of the interactions among nodes in complex networks. The theoretical analyses of complex networks, although mathematically rigorous, often elude analytic solutions and require simulation and computation to analyze the underlying dynamic process. The information transfer between two complex networks is calculated using the principle of complexity management as well as direct numerical calculation of the decision making model developed within the project.

  10. OVERVIEW 2010 OF ARL PROGRAM ON NETWORK SCIENCE FOR HUMAN DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Bruce J West

    2011-11-01

    Full Text Available The Army Research Laboratory program on the Network Science of Human Decision Making brings together researchers from a variety of disciplines to work on a complex research problem that defies confinement within any single discipline. Consequently, new and rewarding solutions have been obtained for a problem of importance to society and the Army, that being, the human dimension of complex networks. This program investigates the basic research foundation of a science of networks supporting the linkage between the cognitive and social domains as they relate to human decision making. The research strategy extends recent methods of non-equilibrium statistical physics to non-stationary, renewal stochastic processes characteristic of the interactions among nodes in complex networks. The theoretical analyses of complex networks, although mathematically rigorous, often elude analytic solutions and require simulation and computation to analyze the underlying dynamic process. The information transfer between two complex networks is calculated using the Principle of Complexity Management (PCM as well as direct numerical calculation of the decision making model (DMM developed within the project.

  11. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases.

    Science.gov (United States)

    Hongoh, Valerie; Michel, Pascal; Gosselin, Pierre; Samoura, Karim; Ravel, André; Campagna, Céline; Cissé, Hassane Djibrilla; Waaub, Jean-Philippe

    2016-04-12

    The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA) approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration.

  12. Multi-Stakeholder Decision Aid for Improved Prioritization of the Public Health Impact of Climate Sensitive Infectious Diseases

    Directory of Open Access Journals (Sweden)

    Valerie Hongoh

    2016-04-01

    Full Text Available The effects of climate change on infectious diseases are an important global health concern and necessitate decisions for allocation of resources. Economic tools have been used previously; however, how prioritization results might differ when done using broader considerations identified by local stakeholders has yet to be assessed. A multicriteria decision analysis (MCDA approach was used to assess multi-stakeholder expressed concerns around disease prioritization via focus groups held in Quebec and Burkina Faso. Stakeholders weighted criteria and comparisons were made across study sites. A pilot disease prioritization was done to examine effects on disease rankings. A majority of identified criteria were common to both sites. The effect of context specific criteria and weights resulted in similar yet distinct prioritizations of diseases. The presence of consistent criteria between sites suggests that common concerns exist for prioritization; however, context-specific adjustments reveal much regarding resource availability, capacity and concerns that should be considered as this impacts disease ranking. Participatory decision aid approaches facilitate rich knowledge exchange and problem structuring. Furthermore, given multiple actors in low- and middle-income countries settings, multi-actor collaborations across non-governmental organizations, local government and community are important. Formal mechanisms such as MCDA provide means to foster consensus, shared awareness and collaboration.

  13. A GIS- and Fuzzy Set-Based Online Land Price Evaluation Approach Supported by Intelligence-Aided Decision-Making

    Directory of Open Access Journals (Sweden)

    Sheng Li

    2016-07-01

    Full Text Available In recent years, with the reforms to the land use system and the development of urbanization in China, land price evaluation has tended towards marketization. Prices are determined by the government, the land transaction market and the public. It is necessary to propose higher standards to be used in the evaluation process. This paper presents an online land price evaluation approach for convenience in evaluation. In a network environment, taking advantage of the data services provided by various departments, we propose two models to assist in decision-making: (1 a geographic information system (GIS- and fuzzy set-based location factor quantification model, which adopts dynamic data, rules and quantification measures (based on the road network to dynamically quantify location factors, thus transforming fuzzy sets into appropriate values; and (2 a neartude-based transaction sample push model, which quantifies the similarity between a given land and other samples, thus providing a basis for decision-making by an appraiser. This approach is applied in Shenzhen to evaluate its ability to simplify the work of appraisers and make their decisions more intuitive and objective in a real case.

  14. How and for whom are decision aids effective? Long-term psychological outcome of a randomized controlled trial in women with newly diagnosed breast cancer.

    Science.gov (United States)

    Vodermaier, Andrea; Caspari, Cornelia; Wang, Lisa; Koehm, Janna; Ditsch, Nina; Untch, Michael

    2011-01-01

    The current study evaluates the long-term psychological impact of a decision aid intervention for surgical and systemic treatment in women with newly diagnosed breast cancer from a previous reported randomized, controlled trial (Vodermaier et al., 2009). Patients (n = 111) were randomized into usual care, or a 20-min decision aid intervention plus an information brochure prior to consultation planning with the senior physician. The retention rate at 1 year was 88%. Linear mixed model analyses demonstrated that the intervention group experienced less decisional conflict (p = .047; d = .19), which was driven by perceptions of a more effective choice (p = .029; d = .20) over time. Subgroup analyses revealed that patients in the intervention group who participated in chemotherapy decision making showed better long-term body image outcomes (p = .009; d = .44), which were mediated by reduced depressive coping (p = .049). No effects emerged for anxiety and depressive symptoms, or for quality of life. Internal health locus of control moderated group effects on 'uncertainty with the decision' (p = .003). The study results provide novel evidence on the role of individual differences and the mechanisms behind decision aid effectiveness, and demonstrate the long-term impact of decision aid interventions on some indices of well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  15. The end of life decisions -- should physicians aid their patients in dying?

    Science.gov (United States)

    Sharma, B R

    2004-06-01

    Decisions pertaining to end of life whether legalized or otherwise, are made in many parts of the world but not reported on account of legal implications. The highly charged debate over voluntary euthanasia and physician assisted suicide was brought into the public arena again when two British doctors confessed to giving lethal doses of drugs to hasten the death of terminally ill patients. Lack of awareness regarding the distinction between different procedures on account of legal status granted to them in some countries is the other area of concern. Some equate withdrawal of life support measures to physician assisted suicide whereas physician assisted suicide is often misinterpreted as euthanasia. Debate among the medical practitioners, law makers and the public taking into consideration the cultural, social and religious ethos will lead to increased awareness, more safeguards and improvement of medical decisions concerning the end of life. International Human Rights Law can provide a consensual basis for such a debate on euthanasia.

  16. A Methodology for Physical Interconnection Decisions of Next Generation Transport Networks

    DEFF Research Database (Denmark)

    Gutierrez Lopez, Jose Manuel; Riaz, M. Tahir; Madsen, Ole Brun

    2011-01-01

    of possibilities when designing the physical network interconnection. This paper develops and presents a methodology in order to deal with aspects related to the interconnection problem of optical transport networks. This methodology is presented as independent puzzle pieces, covering diverse topics going from...... novel design criteria to well-known organized topologies. These can be used to investigate the influence of the physical interconnection of networks over their performance properties, and draw conclusions to improve the current decision support techniques related to this theme. In addition, several...

  17. Nonlinear phase noise tolerance for coherent optical systems using soft-decision-aided ML carrier phase estimation enhanced with constellation partitioning

    Science.gov (United States)

    Li, Yan; Wu, Mingwei; Du, Xinwei; Xu, Zhuoran; Gurusamy, Mohan; Yu, Changyuan; Kam, Pooi-Yuen

    2018-02-01

    A novel soft-decision-aided maximum likelihood (SDA-ML) carrier phase estimation method and its simplified version, the decision-aided and soft-decision-aided maximum likelihood (DA-SDA-ML) methods are tested in a nonlinear phase noise-dominant channel. The numerical performance results show that both the SDA-ML and DA-SDA-ML methods outperform the conventional DA-ML in systems with constant-amplitude modulation formats. In addition, modified algorithms based on constellation partitioning are proposed. With partitioning, the modified SDA-ML and DA-SDA-ML are shown to be useful for compensating the nonlinear phase noise in multi-level modulation systems.

  18. Actor-network-theory perspective on a forestry decision support system design

    NARCIS (Netherlands)

    Boerboom, L.G.J.; Ferritti, V.

    2014-01-01

    Use of decision support systems (DSS) has thus far been framed as a social process of adoption or technical process of usability. We analyze the development of a DSS as a process of institutionalization of new as well as drift of existing practices. We write an Actor-Network-Theory (ANT) account,

  19. Networks of conforming or nonconforming individuals tend to reach satisfactory decisions

    NARCIS (Netherlands)

    Ramazi, Pouria; Riehl, James Robert; Cao, Ming

    2016-01-01

    Binary decisions of agents coupled in networks can often be classified into two types: “coordination,” where an agent takes an action if enough neighbors are using that action, as in the spread of social norms, innovations, and viral epidemics, and “anticoordination,” where too many neighbors taking

  20. Applying Multi-Criteria Decision Aiding Techniques in the Process of Project Management within the Wedding Planning Business

    Directory of Open Access Journals (Sweden)

    Dorota Górecka

    2012-01-01

    Full Text Available Numerous problems that emerge in the process of project management can be presented as multi-criteria issues and solved with the help of appropriate methods. The contracting authority, selecting one tender out of many available tenders, assesses them, taking into account various criteria, e.g. price, expected execution time and the contractor's experience. The owner of a company intending to purchase the fixed assets requisite for the realization of the project behaves similarly, i.e. the most advantageous model of the device is chosen, taking into account not only its price but also production capacity, energy intensity, noise emission, service availability, etc. From among many concepts, the investor has to choose a solution which frequently constitutes a compromise between price, functional properties, durability and aesthetics of performance, as well as safety of the utilization and impact on the environment. The choice of an investment location depends not only on the market, financial and supply factors, but also on so called soft factors such as the perceived quality of institutions and the attitude of local communities. All such situations can be described in the same way: taking into account preferences of the decision maker, the best possible choice must be made out of a finite set of alternatives evaluated according to a finite set of criteria. There are many different methods that can be used to aid a decision maker in this choice, including, but not limited to, techniques based on the outranking relation, verbal decision analysis and the MACBETH method. In this article, they will be compared and their applicability to different types of decision making problems will be considered. Furthermore, the PROMETHEE II method with a veto threshold will be presented within the text. Because the application of project management in the wedding planning business has gained wide popularity, as an illustrative example an empirical study of

  1. COMPUTATIONAL ANALYSIS BASED ON ARTIFICIAL NEURAL NETWORKS FOR AIDING IN DIAGNOSING OSTEOARTHRITIS OF THE LUMBAR SPINE.

    Science.gov (United States)

    Veronezi, Carlos Cassiano Denipotti; de Azevedo Simões, Priscyla Waleska Targino; Dos Santos, Robson Luiz; da Rocha, Edroaldo Lummertz; Meláo, Suelen; de Mattos, Merisandra Côrtes; Cechinel, Cristian

    2011-01-01

    To ascertain the advantages of applying artificial neural networks to recognize patterns on lumbar spine radiographies in order to aid in the process of diagnosing primary osteoarthritis. This was a cross-sectional descriptive analytical study with a quantitative approach and an emphasis on diagnosis. The training set was composed of images collected between January and July 2009 from patients who had undergone lateral-view digital radiographies of the lumbar spine, which were provided by a radiology clinic located in the municipality of Criciúma (SC). Out of the total of 260 images gathered, those with distortions, those presenting pathological conditions that altered the architecture of the lumbar spine and those with patterns that were difficult to characterize were discarded, resulting in 206 images. The image data base (n = 206) was then subdivided, resulting in 68 radiographies for the training stage, 68 images for tests and 70 for validation. A hybrid neural network based on Kohonen self-organizing maps and on Multilayer Perceptron networks was used. After 90 cycles, the validation was carried out on the best results, achieving accuracy of 62.85%, sensitivity of 65.71% and specificity of 60%. Even though the effectiveness shown was moderate, this study is still innovative. The values show that the technique used has a promising future, pointing towards further studies on image and cycle processing methodology with a larger quantity of radiographies.

  2. Sensor-Aided Localized Capsule-Cooling Using Neural Networks for Energy-Efficient Refrigeration

    Directory of Open Access Journals (Sweden)

    N. Banerjee

    2014-06-01

    Full Text Available Sensor-aided localized capsule-cooling technique is a unique refrigeration process where sensors precisely capsulate the location of an item(s on a shelf of a fridge and hence direct the governing artificial intelligence to take suitable action. Here the sensors are used to locate the objects and the designed smart system (neural network activates the corresponding ductlines to cool the object. Here neural network system opens the gate(s and tilts the angle to allow the flow of cool air through the ductlines. Then the orifices, which fall in the virtual “Hot Region”, the domain that the active sensors had created almost immediately on sensing an obstruction, are opened. The orifices and sensors are arranged in a series on the lower wall of the ductlines to allow flow of air in the downward direction. These open orifices facilitate the direct hitting of cool air on the target-item and hence create a cold block within a fridge, instead of cooling the entire fridge uniformly, to keep the singular item refrigerated. This mode of operation offering selective cooling, rather than the conventional uniform one, is useful in saving energy, as the region then needed to be cooled is reduced significantly. A detail structural and theoretical explanations along with graphical analysis clearly elucidate the effective working of this mechanism under practical circumstances is given here. In this paper neural network is used for capsule cooling for energy efficient refrigeration

  3. AURP: an AUV-aided underwater routing protocol for underwater acoustic sensor networks.

    Science.gov (United States)

    Yoon, Seokhoon; Azad, Abul K; Oh, Hoon; Kim, Sunghwan

    2012-01-01

    Deploying a multi-hop underwater acoustic sensor network (UASN) in a large area brings about new challenges in reliable data transmissions and survivability of network due to the limited underwater communication range/bandwidth and the limited energy of underwater sensor nodes. In order to address those challenges and achieve the objectives of maximization of data delivery ratio and minimization of energy consumption of underwater sensor nodes, this paper proposes a new underwater routing scheme, namely AURP (AUV-aided underwater routing protocol), which uses not only heterogeneous acoustic communication channels but also controlled mobility of multiple autonomous underwater vehicles (AUVs). In AURP, the total data transmissions are minimized by using AUVs as relay nodes, which collect sensed data from gateway nodes and then forward to the sink. Moreover, controlled mobility of AUVs makes it possible to apply a short-range high data rate underwater channel for transmissions of a large amount of data. To the best to our knowledge, this work is the first attempt to employ multiple AUVs as relay nodes in a multi-hop UASN to improve the network performance in terms of data delivery ratio and energy consumption. Simulations, which are incorporated with a realistic underwater acoustic communication channel model, are carried out to evaluate the performance of the proposed scheme, and the results indicate that a high delivery ratio and low energy consumption can be achieved.

  4. AURP: An AUV-Aided Underwater Routing Protocol for Underwater Acoustic Sensor Networks

    Directory of Open Access Journals (Sweden)

    Sunghwan Kim

    2012-02-01

    Full Text Available Deploying a multi-hop underwater acoustic sensor network (UASN in a large area brings about new challenges in reliable data transmissions and survivability of network due to the limited underwater communication range/bandwidth and the limited energy of underwater sensor nodes. In order to address those challenges and achieve the objectives of maximization of data delivery ratio and minimization of energy consumption of underwater sensor nodes, this paper proposes a new underwater routing scheme, namely AURP (AUV-aided underwater routing protocol, which uses not only heterogeneous acoustic communication channels but also controlled mobility of multiple autonomous underwater vehicles (AUVs. In AURP, the total data transmissions are minimized by using AUVs as relay nodes, which collect sensed data from gateway nodes and then forward to the sink. Moreover, controlled mobility of AUVs makes it possible to apply a short-range high data rate underwater channel for transmissions of a large amount of data. To the best to our knowledge, this work is the first attempt to employ multiple AUVs as relay nodes in a multi-hop UASN to improve the network performance in terms of data delivery ratio and energy consumption. Simulations, which are incorporated with a realistic underwater acoustic communication channel model, are carried out to evaluate the performance of the proposed scheme, and the results indicate that a high delivery ratio and low energy consumption can be achieved.

  5. A neural network application to search and rescue satellite aided tracking (SARSAT)

    Science.gov (United States)

    Taylor, Ivan W.; Vigneault, Michel O.

    1992-04-01

    The Search and Rescue Satellite Aided Tracking (SARSAT) system uses polar orbiting satellites to monitor the earth's surface for emergency locator transmitters (ELT's). A detected ELT signal is retransmitted to ground facilities for processing. The ELT location is determined by fitting a Doppler curve to the signal, and this location estimate is then sent for transmission to a rescue unit for action. The heuristic based approach to predict the location accuracy category of SARSAT hits based on the parameters of the Doppler curve fit work reasonably well but are far from ideal. They consistently have difficulty identifying very good solutions when they occur and very poor solutions when they occur. Normal data fitting techniques based on multiple linear regression do not work well because SARSAT data are inherently nonlinear. Neural networks were thus applied to SARSAT data as a nonlinear data fitting technique. A neural network program was trained on a sample of 173 observations and tested on a sample of 172 observations. Results are compared to the current method. Although the results so far have been promising, they are still far from ideal. Other artificial intelligence technologies such as fuzzy logic, expert systems, and inductive learning are being investigated to enhance the neural network approach.

  6. Development and pilot testing of a decision aid for men considering genetic testing for breast and/or ovarian cancer-related mutations (BRCA1/2).

    Science.gov (United States)

    Juan, Anne S; Wakefield, Claire E; Kasparian, Nadine A; Kirk, Judy; Tyler, Janet; Tucker, Kathy

    2008-12-01

    Despite the fact that both men and women can carry a breast/ovarian cancer-related mutation, the main emphasis in genetic counseling for breast/ovarian cancer-related risk remains on females. This study aimed to develop and pilot a decision aid specifically designed for men with a strong family history of breast and/or ovarian cancer who are considering genetic testing. The decision aid was developed by a multidisciplinary team of experts and a consumer representative. It was then reviewed by 27 men who had previously undergone genetic testing to identify a mutation in a BRCA1 or BRCA2 gene. All men who reviewed the decision aid indicated that they would recommend the booklet to other men in the same situation, and 96% of the sample (n = 26) reported being "very satisfied" or "satisfied" with the information contained in the decision aid. The decision aid was perceived by all participants as "very relevant" or "quite relevant" for men considering genetic testing. Ninety-three percent of men felt that it was easy to weigh the pros and cons of genetic testing with the help of the decision aid. The perceived impact on participants' emotions and understanding of the genetic testing process was also assessed. Several factors may hinder men from effectively weighing up the potential benefits and risks of genetic testing. A greater understanding of these issues may help health professionals to encourage men with a strong family history of breast and/or ovarian cancer to learn about cancer risk and the appropriate management strategies for themselves and their female relatives.

  7. Modeling Land-Use Decision Behavior with Bayesian Belief Networks

    Directory of Open Access Journals (Sweden)

    Inge Aalders

    2008-06-01

    Full Text Available The ability to incorporate and manage the different drivers of land-use change in a modeling process is one of the key challenges because they are complex and are both quantitative and qualitative in nature. This paper uses Bayesian belief networks (BBN to incorporate characteristics of land managers in the modeling process and to enhance our understanding of land-use change based on the limited and disparate sources of information. One of the two models based on spatial data represented land managers in the form of a quantitative variable, the area of individual holdings, whereas the other model included qualitative data from a survey of land managers. Random samples from the spatial data provided evidence of the relationship between the different variables, which I used to develop the BBN structure. The model was tested for four different posterior probability distributions, and results showed that the trained and learned models are better at predicting land use than the uniform and random models. The inference from the model demonstrated the constraints that biophysical characteristics impose on land managers; for older land managers without heirs, there is a higher probability of the land use being arable agriculture. The results show the benefits of incorporating a more complex notion of land managers in land-use models, and of using different empirical data sources in the modeling process. Future research should focus on incorporating more complex social processes into the modeling structure, as well as incorporating spatio-temporal dynamics in a BBN.

  8. Constructing a clinical decision-making framework for image-guided radiotherapy using a Bayesian Network

    Science.gov (United States)

    Hargrave, C.; Moores, M.; Deegan, T.; Gibbs, A.; Poulsen, M.; Harden, F.; Mengersen, K.

    2014-03-01

    A decision-making framework for image-guided radiotherapy (IGRT) is being developed using a Bayesian Network (BN) to graphically describe, and probabilistically quantify, the many interacting factors that are involved in this complex clinical process. Outputs of the BN will provide decision-support for radiation therapists to assist them to make correct inferences relating to the likelihood of treatment delivery accuracy for a given image-guided set-up correction. The framework is being developed as a dynamic object-oriented BN, allowing for complex modelling with specific subregions, as well as representation of the sequential decision-making and belief updating associated with IGRT. A prototype graphic structure for the BN was developed by analysing IGRT practices at a local radiotherapy department and incorporating results obtained from a literature review. Clinical stakeholders reviewed the BN to validate its structure. The BN consists of a sub-network for evaluating the accuracy of IGRT practices and technology. The directed acyclic graph (DAG) contains nodes and directional arcs representing the causal relationship between the many interacting factors such as tumour site and its associated critical organs, technology and technique, and inter-user variability. The BN was extended to support on-line and off-line decision-making with respect to treatment plan compliance. Following conceptualisation of the framework, the BN will be quantified. It is anticipated that the finalised decision-making framework will provide a foundation to develop better decision-support strategies and automated correction algorithms for IGRT.

  9. An Energy-Efficient Game-Theory-Based Spectrum Decision Scheme for Cognitive Radio Sensor Networks.

    Science.gov (United States)

    Salim, Shelly; Moh, Sangman

    2016-06-30

    A cognitive radio sensor network (CRSN) is a wireless sensor network in which sensor nodes are equipped with cognitive radio. In this paper, we propose an energy-efficient game-theory-based spectrum decision (EGSD) scheme for CRSNs to prolong the network lifetime. Note that energy efficiency is the most important design consideration in CRSNs because it determines the network lifetime. The central part of the EGSD scheme consists of two spectrum selection algorithms: random selection and game-theory-based selection. The EGSD scheme also includes a clustering algorithm, spectrum characterization with a Markov chain, and cluster member coordination. Our performance study shows that EGSD outperforms the existing popular framework in terms of network lifetime and coordination overhead.

  10. An Energy-Efficient Game-Theory-Based Spectrum Decision Scheme for Cognitive Radio Sensor Networks

    Directory of Open Access Journals (Sweden)

    Shelly Salim

    2016-06-01

    Full Text Available A cognitive radio sensor network (CRSN is a wireless sensor network in which sensor nodes are equipped with cognitive radio. In this paper, we propose an energy-efficient game-theory-based spectrum decision (EGSD scheme for CRSNs to prolong the network lifetime. Note that energy efficiency is the most important design consideration in CRSNs because it determines the network lifetime. The central part of the EGSD scheme consists of two spectrum selection algorithms: random selection and game-theory-based selection. The EGSD scheme also includes a clustering algorithm, spectrum characterization with a Markov chain, and cluster member coordination. Our performance study shows that EGSD outperforms the existing popular framework in terms of network lifetime and coordination overhead.

  11. Social network and decision-making in primates: a report on Franco-Japanese research collaborations.

    Science.gov (United States)

    Sueur, Cédric; Pelé, Marie

    2016-07-01

    Sociality is suggested to evolve as a strategy for animals to cope with challenges in their environment. Within a population, each individual can be seen as part of a network of social interactions that vary in strength, type and dynamics (Sueur et al. 2011a). The structure of this social network can strongly impact upon not only on the fitness of individuals and their decision-making, but also on the ecology of populations and the evolution of a species. Our Franco-Japanese collaboration allowed us to study social networks in several species (Japanese macaques, chimpanzees, colobines, etc.) and on different topics (social epidemiology, social evolution, information transmission). Individual attributes such as stress, rank or age can affect how individuals take decisions and the structure of the social network. This heterogeneity is linked to the assortativity of individuals and to the efficiency of the flow within a network. It is important, therefore, that this heterogeneity is integrated in the process or pattern under study in order to provide a better resolution of investigation and, ultimately, a better understanding of behavioural strategies, social dynamics and social evolution. How social information affects decision-making could be important to understand how social groups make collective decisions and how information may spread throughout the social group. In human beings, road-crossing behaviours in the presence of other individuals is a good way to study the influence of social information on individual behaviour and decision-making, for instance. Culture directly affects which information - personal vs social - individuals prefer to follow. Our collaboration contributed to the understanding of the relative influence of different factors, cultural and ecological, on primate, including human, sociality.

  12. Cost effectiveness of a web-based decision aid for parents deciding about MMR vaccination: a three-arm cluster randomised controlled trial in primary care

    Science.gov (United States)

    Tubeuf, Sandy; Edlin, Richard; Shourie, Swati; Cheater, Francine M; Bekker, Hilary; Jackson, Cath

    2014-01-01

    Background Levels of measles in England and Wales are at their highest for 18 years, and strategies targeting the different groups of parents who do not vaccinate their children continue to be needed. Decision aids for decisions regarding childhood immunisation appear to be effective in achieving an increase in vaccine uptake but their cost effectiveness is unknown. Aim To assess the cost effectiveness of a web-based decision aid to increase uptake of the MMR vaccine. Design and setting Economic evaluation conducted alongside a cluster randomised controlled trial using urban GP practices in the north of England. Method Fifty GP practices in the north of England were randomised to one of three trial arms: decision aid, leaflet, usual practice. A total of 220 first-time parents (child aged 3–12 months) were recruited. Parents self-reported their contacts with the NHS and other previous/expected resource utilisation; associated costs were calculated. Vaccine-uptake data were collected from GP practices. A cost-effectiveness analysis was undertaken and provided the incremental cost per first-vaccine uptake. Multiple imputation was used to account for missing data and findings were adjusted for baseline differences in parents’ levels of decisional conflict regarding MMR vaccination. Results Of the 220 first-time parents recruited to the study, 179 completed the baseline and post-intervention questionnaires. MMR uptake was highest for those receiving the decision aid (42 out of 42, 100%) versus usual practice (61 out of 62, 98%) and leaflet arm (69 out of 75, 92%), and was associated with lower cost (–£9.20 versus usual practice and –£7.17 versus leaflet). Conclusion The decision aid has a high chance of being cost effective, regardless of the value placed on obtaining additional vaccinations. It also appears to offer an efficient means of decision support for parents. PMID:25071062

  13. Development and validation of a personalized, web-based decision aid for lung cancer screening using mixed methods: a study protocol.

    Science.gov (United States)

    Lau, Yan Kwan; Caverly, Tanner J; Cherng, Sarah T; Cao, Pianpian; West, Mindy; Arenberg, Douglas; Meza, Rafael

    2014-12-19

    The National Lung Screening Trial demonstrated that low-dose computed tomography (LDCT) screening could be an effective way to reduce lung cancer mortality. Informed decision-making in the context of lung cancer screening requires that potential screening subjects accurately recognize their own lung cancer risk, as well as the harms and benefits associated with screening, while taking into account their personal values and preferences. Our objective is to develop a Web-based decision aid in accordance with the qualifying and certification criteria in the International Patient Decision Aid Standards instrument version 4.0 that will assist patients in making informed decisions with regard to lung cancer screening. In "alpha" testing, a prototype of the decision aid was tested for usability with 10 potential screening participants in focus groups. Feedback was also sought from public health and health risk communication experts external to the study. Following that, improvements to the prototype were made accordingly, and "beta" testing was done in the form of a quasi-experimental design-a before-after study-with a group of 60 participants. Outcomes tested were knowledge, risk perception of lung cancer and lung cancer screening, decisional conflict, and acceptability of the decision aid as determined by means of a self-administered electronic survey. Focus groups of a subsample of survey participants will be conducted to gain further insight into usability issues. Alpha testing is completed. Beta testing is currently being carried out. As of 2014 December 7, 60 participants had completed the before-after study. We expect to have results by 2015 January 31. Qualitative data collection and analysis are expected to be completed by 2015 May 31. We hypothesize that this Web-based, interactive decision aid containing personalized, graphical, and contextual information on the benefits and harms of LDCT screening will increase knowledge, reduce decisional conflict, and

  14. Patient-Centered Robot-Aided Passive Neurorehabilitation Exercise Based on Safety-Motion Decision-Making Mechanism

    Directory of Open Access Journals (Sweden)

    Lizheng Pan

    2017-01-01

    Full Text Available Safety is one of the crucial issues for robot-aided neurorehabilitation exercise. When it comes to the passive rehabilitation training for stroke patients, the existing control strategies are usually just based on position control to carry out the training, and the patient is out of the controller. However, to some extent, the patient should be taken as a “cooperator” of the training activity, and the movement speed and range of the training movement should be dynamically regulated according to the internal or external state of the subject, just as what the therapist does in clinical therapy. This research presents a novel motion control strategy for patient-centered robot-aided passive neurorehabilitation exercise from the point of the safety. The safety-motion decision-making mechanism is developed to online observe and assess the physical state of training impaired-limb and motion performances and regulate the training parameters (motion speed and training rage, ensuring the safety of the supplied rehabilitation exercise. Meanwhile, position-based impedance control is employed to realize the trajectory tracking motion with interactive compliance. Functional experiments and clinical experiments are investigated with a healthy adult and four recruited stroke patients, respectively. The two types of experimental results demonstrate that the suggested control strategy not only serves with safety-motion training but also presents rehabilitation efficacy.

  15. Patient-Centered Robot-Aided Passive Neurorehabilitation Exercise Based on Safety-Motion Decision-Making Mechanism.

    Science.gov (United States)

    Pan, Lizheng; Song, Aiguo; Duan, Suolin; Yu, Zhuqing

    2017-01-01

    Safety is one of the crucial issues for robot-aided neurorehabilitation exercise. When it comes to the passive rehabilitation training for stroke patients, the existing control strategies are usually just based on position control to carry out the training, and the patient is out of the controller. However, to some extent, the patient should be taken as a "cooperator" of the training activity, and the movement speed and range of the training movement should be dynamically regulated according to the internal or external state of the subject, just as what the therapist does in clinical therapy. This research presents a novel motion control strategy for patient-centered robot-aided passive neurorehabilitation exercise from the point of the safety. The safety-motion decision-making mechanism is developed to online observe and assess the physical state of training impaired-limb and motion performances and regulate the training parameters (motion speed and training rage), ensuring the safety of the supplied rehabilitation exercise. Meanwhile, position-based impedance control is employed to realize the trajectory tracking motion with interactive compliance. Functional experiments and clinical experiments are investigated with a healthy adult and four recruited stroke patients, respectively. The two types of experimental results demonstrate that the suggested control strategy not only serves with safety-motion training but also presents rehabilitation efficacy.

  16. Real-time decision aiding - Aircraft guidance for wind shear avoidance

    Science.gov (United States)

    Stratton, D. A.; Stengel, Robert F.

    1992-01-01

    Modern control theory and artificial intelligence technology are applied to the Wind Shear Safety Advisor, a conceptual airborne advisory system to help flight crews avoid or survive encounter with hazardous low-altitude wind shear. Numerical and symbolic processes of the system fuse diverse, time-varying data from ground-based and airborne measurements. Simulated wind-shear-encounter scenarios illustrate the need to consider a variety of factors for optimal decision reliability. The wind-shear-encounter simulations show the Wind Shear Safety Advisor's potential for effectively integrating the available information, highlighting the benefits of the computational techniques employed.

  17. Utilization of extended bayesian networks in decision making under uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Van Eeckhout, Edward M [Los Alamos National Laboratory; Leishman, Deborah A [Los Alamos National Laboratory; Gibson, William L [Los Alamos National Laboratory

    2009-01-01

    Bayesian network tool (called IKE for Integrated Knowledge Engine) has been developed to assess the probability of undesirable events. The tool allows indications and observables from sensors and/or intelligence to feed directly into hypotheses of interest, thus allowing one to quantify the probability and uncertainty of these events resulting from very disparate evidence. For example, the probability that a facility is processing nuclear fuel or assembling a weapon can be assessed by examining the processes required, establishing the observables that should be present, then assembling information from intelligence, sensors and other information sources related to the observables. IKE also has the capability to determine tasking plans, that is, prioritize which observable should be collected next to most quickly ascertain the 'true' state and drive the probability toward 'zero' or 'one.' This optimization capability is called 'evidence marshaling.' One example to be discussed is a denied facility monitoring situation; there is concern that certain process(es) are being executed at the site (due to some intelligence or other data). We will show how additional pieces of evidence will then ascertain with some degree of certainty the likelihood of this process(es) as each piece of evidence is obtained. This example shows how both intelligence and sensor data can be incorporated into the analysis. A second example involves real-time perimeter security. For this demonstration we used seismic, acoustic, and optical sensors linked back to IKE. We show how these sensors identified and assessed the likelihood of 'intruder' versus friendly vehicles.

  18. ANALYZING SOCIAL NETWORKS FROM THE PERSPECTIVE OF MARKETING DECISIONS

    Directory of Open Access Journals (Sweden)

    Logica BANICA

    2015-12-01

    Full Text Available Nowadays, the Web became more than a space for product presentation, but also a capitalization market (e-commerce and an efficient way to know the customer preferences and to meet their requirements. Large companies have the financial potential to use various marketing strategies and, in particular, digital-marketing. Instead, small businesses are looking for lower cost or no cost methods (also called guerrilla marketing. A small company can compete with a large company by approaching a particular range of products that excel in quality, and also by inventiveness in the marketing strategy. During 2010-2015 the potential of Information Technology and Communications (IT&C sector was proved for the companies which aimed towards modernization of technologies and introduced new strategies in order to commercialize new products. An important challenge for companies was to be aware of the changes in customer behaviour, using social networks software. Finally, research centers have set up new IT&C services and improved marketing and communications following the crisis. More and more companies invest in analytic tools to monitor their marketing strategies and Big Data becomes extremely useful for this purpose, using information like customer demographics and spending habits, oscillation between simplicity, comfort and glamour. There are various tools that can transform in a very short time, massive amounts of data into real business value in a very short time, helping companies and retailers to understand, at any point in the product lifecycle, which trends are gaining and which are losing ground. These insights give them the possibility to reduce the risk of not selling their products by making adjustments to the design, production or promotional strategies, before putting the goods on the market. In this paper we aim to present the advantages of exploring customer requirements from social media for marketing strategy of an enterprise, by using SNA

  19. Secret-Key-Aided Scheme for Securing Untrusted DF Relaying Networks

    KAUST Repository

    Shafie, Ahmed El

    2017-06-12

    This paper proposes a new scheme to secure the transmissions in an untrusted decode-and-forward (DF) relaying network. A legitimate source node, Alice, sends her data to a legitimate destination node, Bob, with the aid of an untrusted DF relay node, Charlie. To secure the transmissions from Charlie during relaying time slots, each data codeword is secured using a secret-key codeword that has been previously shared between Alice and Bob during the perfectly secured time slots (i.e., when the channel secrecy rate is positive). The secret-key bits exchanged between Alice and Bob are stored in a finite-length buffer and are used to secure data transmission whenever needed. We model the secret-key buffer as a queueing system and analyze its Markov chain. Our numerical results show the gains of our proposed scheme relative to benchmarks. Moreover, the proposed scheme achieves an upper bound on the secure throughput.

  20. Medical decision-making system of ultrasound carotid artery intima-media thickness using neural networks.

    Science.gov (United States)

    Santhiyakumari, N; Rajendran, P; Madheswaran, M

    2011-12-01

    The objective of this work is to develop and implement a medical decision-making system for an automated diagnosis and classification of ultrasound carotid artery images. The proposed method categorizes the subjects into normal, cerebrovascular, and cardiovascular diseases. Two contours are extracted for each and every preprocessed ultrasound carotid artery image. Two types of contour extraction techniques and multilayer back propagation network (MBPN) system have been developed for classifying carotid artery categories. The results obtained show that MBPN system provides higher classification efficiency, with minimum training and testing time. The outputs of decision support system are validated with medical expert to measure the actual efficiency. MBPN system with contour extraction algorithms and preprocessing scheme helps in developing medical decision-making system for ultrasound carotid artery images. It can be used as secondary observer in clinical decision making.

  1. Information Technology for Agriculture: Using it tools to aid decision-making process in small properties

    Directory of Open Access Journals (Sweden)

    Caroline de Oliveira Ferraz

    2017-07-01

    Full Text Available With the current scenario of agricultural competitiveness, the use of Information and Communication Technology (ICT tools has become increasingly common in the rural community, making life easier for farmers. The information obtained through Agroinformatics (Information Technology applied to agribusiness, serves as a basis for both decision-making, planning, and application of the best techniques and production processes. In Brazil, companies such as EMPRAPA (The Brazilian Agricultural Research Corporation work in the research and development of new technological tools, which seek to boost the agricultural production of small rural producers, reducing their costs and improving their results. But for this, it is necessary that the producers understand the concept of the importance in carrying out information collection in a correct way, because the information will be processed according to what is inserted in the systems. In this sense, this article aims to demonstrate through an explanatory research of qualitative nature and bibliographical character the importance of the use of ICT to support decision-making in the Brazilian rural sector. Also highlighting the benefits originated by the use of ICT in all stages of agricultural production and its accounting management, through examples of tools.

  2. Watchful waiting or induction of labour--a matter of informed choice: identification, analysis and critical appraisal of decision aids and patient information regarding care options for women with uncomplicated singleton late and post term pregnancies: a review.

    Science.gov (United States)

    Berger, Bettina; Schwarz, Christiane; Heusser, Peter

    2015-05-07

    Decision-making during pregnancy regarding different options of care can be difficult, particularly when risks of intervention versus no intervention for mother and baby are unclear. Unbiased information and support for decision making may be beneficial in these situations. The management of normal pregnancies at and beyond term is an example of such a situation. In order to determine the need to develop an evidence-based decision aid this paper searches, analyses and appraises patient decision aids and patient information leaflets regarding care options in cases of late term and post-term pregnancies, including complementary and alternative medicine (CAM). A literature search was carried out in a variety of lay and medical databases. written information related to uncomplicated singleton pregnancies and targeted at lay people. Analysis and appraisal of included material by means of quality criteria was set up based on the International Patient Decision Aid Standards accounting for evidence-basing of CAM options. Inclusion of two decision aids and eleven leaflets from four decision aids and sixteen leaflets. One decision aid met the quality criteria almost completely, the other one only insufficiently despite providing some helpful information. Only one leaflet is of good quality, but cannot substitute a decision aid. There is an urgent need for the design of an evidence-based decision aid of good quality for late-term or post-term pregnancy, particularly in German language.

  3. An AIDS-denialist online community on a Russian social networking service: patterns of interactions with newcomers and rhetorical strategies of persuasion.

    Science.gov (United States)

    Meylakhs, Peter; Rykov, Yuri; Koltsova, Olessia; Koltsov, Sergey

    2014-11-17

    The rise of social media proved to be a fertile ground for the expansion of the acquired immune deficiency syndrome (AIDS)-denialist movement (in the form of online communities). While there is substantial literature devoted to disproving AIDS-denialist views, there is a lack of studies exploring AIDS-denialists online communities that interact with an external environment. We explored three research areas: (1) reasons for newcomers to come to an AIDS-denialist community, (2) the patterns of interactions of the community with the newcomers, and (3) rhetorical strategies that denialists use for persuasion in the veracity of their views. We studied the largest AIDS-denialist community on one of the most popular social networking services in Russia. We used netnography as a method for collecting data for qualitative analysis and observed the community for 9 months (at least 2-3 times a week). While doing netnography, we periodically downloaded community discussions. In total, we downloaded 4821 posts and comments for analysis. Grounded theory approach was used for data analysis. Most users came to the community for the following reasons: their stories did not fit the unitary picture of AIDS disease progression translated by popular medical discourse, health problems, concern about HIV-positive tests, and desire to dissuade community members from false AIDS beliefs. On the basis of strength in AIDS-denialist beliefs, we constructed a typology of the newcomers consisting of three ideal-typical groups: (1) convinced: those who already had become denialists before coming to the group, (2) doubters: those who were undecided about the truth of either human immunodeficiency virus (HIV) science theory or AIDS-denialist theory, and (3) orthodox: those who openly held HIV science views. Reception of a newcomer mainly depended on the newcomer's belief status. Reception was very warm for the convinced, cold or slightly hostile for the doubters, and extremely hostile or derisive

  4. Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

    Science.gov (United States)

    Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

    2014-10-01

    Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder

  5. Combining Multicriteria Decision Aid and System Dynamics for the Control of Socio-economic Processes. An Iterative Real-time Procedure

    OpenAIRE

    Brans, J. P.; Chevalier, A.; Kunsch, P. L.; Macharis, C.; Schwaninger, Markus

    1998-01-01

    The paper presents the elements of a new methodology to control complex and hypercomplex socio-economic structures. The control process is iterative, combining the principles of System Dynamics, Control theory and the PROMETHEE Multicriteria Decision Aid (MCDA) methodology. It consists of three main stages: setting up and calibration of a quantitative model, definition of long-term strategies and short-term control. The purpose is to define within a panel of decision makers appropriate strate...

  6. Architecture of a corporate system to aid the scheduling of a oil derivatives transport in a pipeline network; Arquitetura de um sistema corporativo para auxilio a programacao do transporte de derivados de petroleo em redes dutoviarias

    Energy Technology Data Exchange (ETDEWEB)

    Lara, Guilherme R.; Polli, Helton L.; Esser, Eduardo M.; Lueders, Ricardo; Neves Junior, Flavio; Magatao, Leandro; Stebel, Sergio L. [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Ribas, Paulo C. [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil). Centro de Pesquisas (CENPES)

    2008-07-01

    This paper addresses the development and the architecture of a corporative package to aid the operational decision-making of the scheduling activities in a real-world pipeline network for oil derivatives. The system was developed based on a service-oriented architecture, allowing the development of Web applications to define the network scheduling, as well as graphic display of the movements. The solution of the scheduling is generated by an optimization block as a service of this application. However, this paper emphasizes the description of the architecture and its functionalities, which was defined with the help of experienced programmers. (author)

  7. NASA Water-Cycle Solutions Networks and Community of Practice Approaches to enhance Decision-making

    Science.gov (United States)

    Pozzi, W.; Ward, J.; Cox, E. L.; Lawford, R. G.; Matthews, D.; Houser, P.; Doherty, M.

    2009-12-01

    The Japanese Aerospace Exploration Agency (JAXA) has created the Asian Water Cycle Initiative regional network for South Asia and NASA has launched two networks to enhance the rapid transitioning of scientific achievements and NASA technology into operational use. All three networks meet a new type of scientific challenge by providing strong linkage among the scientific communities, the space agencies, and decision makers. We focus here on the two NASA-sponsored networks that carry out complementary approaches: WaterNet focused on large-scale national/international collaborations; North Olympic Peninsula Solution Network developed a local proof of concept project first, then began integration and collaboration at progressively larger scales, culminating with a national-level discourse via the National Association of Resource, Conservation and Development councils (NARC&DC). The ultimate goals of both groups were to bring NASA Science and Technology products to organizations/groups to improve decision making and to create collaborations and networks that would extend beyond the parent groups and expand and continue to be sustainable, after the original projects were completed. This paper provides a summary of lessons learned. The primary objective of the NOPSN is to bring NASA science and technology tools to watershed managers to improve the scientific basis of decision making in NASA national application areas of water management, agricultural efficiency, and ecological forecasting. To achieve this objective, the NOPSN team first developed and implemented a local proof-of-concept project for the Dungeness River, Washington, to improve water forecasting. The team then developed local and regional collaborations with water resource managers, stakeholder groups, and local, state, and federal agencies to identify environmental issues, challenges, and needs that could be addressed with NASA technology. Finally,through its partnership with NARC&D, it provided the NOPSN

  8. Common gene-network signature of different neurological disorders and their potential implications to neuroAIDS.

    Directory of Open Access Journals (Sweden)

    Vidya Sagar

    Full Text Available The neurological complications of AIDS (neuroAIDS during the infection of human immunodeficiency virus (HIV are symptomized by non-specific, multifaceted neurological conditions and therefore, defining a specific diagnosis/treatment mechanism(s for this neuro-complexity at the molecular level remains elusive. Using an in silico based integrated gene network analysis we discovered that HIV infection shares convergent gene networks with each of twelve neurological disorders selected in this study. Importantly, a common gene network was identified among HIV infection, Alzheimer's disease, Parkinson's disease, multiple sclerosis, and age macular degeneration. An mRNA microarray analysis in HIV-infected monocytes showed significant changes in the expression of several genes of this in silico derived common pathway which suggests the possible physiological relevance of this gene-circuit in driving neuroAIDS condition. Further, this unique gene network was compared with another in silico derived novel, convergent gene network which is shared by seven major neurological disorders (Alzheimer's disease, Parkinson's disease, Multiple Sclerosis, Age Macular Degeneration, Amyotrophic Lateral Sclerosis, Vascular Dementia, and Restless Leg Syndrome. These networks differed in their gene circuits; however, in large, they involved innate immunity signaling pathways, which suggests commonalities in the immunological basis of different neuropathogenesis. The common gene circuits reported here can provide a prospective platform to understand how gene-circuits belonging to other neuro-disorders may be convoluted during real-time neuroAIDS condition and it may elucidate the underlying-and so far unknown-genetic overlap between HIV infection and neuroAIDS risk. Also, it may lead to a new paradigm in understanding disease progression, identifying biomarkers, and developing therapies.

  9. Decision-making guide for management of agriculture in the case of a nuclear accident; Guide d'aide a la decision pour la gestion du milieu agricole en cas d'accident nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Reales, N. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92 - Clamart (France); Fourrie, L. [Association De Coordination Technique Agricole, 75 - Paris (France); Quinio, C.; Grastilleur, Ch. [Ministere de l' Agriculture et de la Peche, 75 - Paris (France). Direction Generale de l' Alimentation

    2008-07-15

    For several years, agricultural and nuclear professionals in France have been working on how to manage the agricultural situation in the event of a nuclear accident. This work resulted in measures at both the national (Aube nuclear safety exercises in 2003, INEX3 in 2005) and international levels (EURATOM Programmes). Following on from the European FARMING (FP5) and EURANOS (FP6) works, ACTA', IRSN and six agricultural technical institutes which are specialized in agricultural production and processing network (arable crop [especially cereals, maize, pulses, potatoes and forage crops], fruits and vegetables, vine and wine, livestock farming [cattle, sheep, goats, pigs, poultry]), created a resource adapted to the French context: the Decision-aiding Tool for the Management of Agriculture in case of a Nuclear Accident. Devised for the Ministry of Agriculture services supporting state officials in a radiation emergency, this manual focuses on the early phase following the accident when the state of emergency would make discussion on countermeasures with a large stakeholder panel impossible. Supported by the Ministry of Agriculture and Fisheries and the French Nuclear Safety Authority, this project increased knowledge of post-accident management strategies and made an important contribution to the national think tank set up within the framework of the French Steering Committee for managing the post-event phase of a nuclear accident (CODIRPA). This article describes how the manual evolved throughout the project and the development of new resources. (authors)

  10. Physics of the Mind:. Opinion Dynamics and Decision Making Processes Based on a Binary Network Model

    Science.gov (United States)

    Kusmartsev, F. V.; Kürten, Karl E.

    2009-12-01

    We propose a new theory of the human mind. The formation of human mind is considered as a collective process of the mutual interaction of people via exchange of opinions and formation of collective decisions. We investigate the associated dynamical processes of the decision making when people are put in different conditions including risk situations in natural catastrophes when the decision must be made very fast or at national elections. We also investigate conditions at which the fast formation of opinion is arising as a result of open discussions or public vote. Under a risk condition the system is very close to chaos and therefore the opinion formation is related to the order disorder transition. We study dramatic changes which may happen with societies which in physical terms may be considered as phase transitions from ordered to chaotic behavior. Our results are applicable to changes which are arising in various social networks as well as in opinion formation arising as a result of open discussions. One focus of this study is the determination of critical parameters, which influence a formation of stable mind, public opinion and where the society is placed "at the edge of chaos". We show that social networks have both, the necessary stability and the potential for evolutionary improvements or self-destruction. We also show that the time needed for a discussion to take a proper decision depends crucially on the nature of the interactions between the entities as well as on the topology of the social networks.

  11. Paradoxes and asymmetries of transnational networks: a comparative case study of Mexico's community-based AIDS organizations.

    Science.gov (United States)

    Barnes, Nielan

    2008-02-01

    This article examines whether transnational networks reconfigure state-civil society relationships in ways that lead to civil society empowerment and increased organizational capacity to address the HIV/AIDS epidemic in Mexico. Using a comparative case study, I identify the types of transnational networks and exchanges that both help and hinder community-based HIV/AIDS organizations (CBOs) that provide AIDS prevention and treatment services in Tijuana and Mexico City. Data derive from over 50 formal interviews, organizational documents and archival records, and observation. I argue that the form and function of transnational networks is shaped by the geo-political context of local organizational fields and that, in turn, transnational networks provide innovative opportunities for civil society-state partnerships that favor some local organizations over others. Ultimately, I take apart the prevailing assumption that transnational networks are inherently good, and show how they can (re)produce inter-organizational stratification at the local level. The conclusions of this research are helpful to international health practitioners and social scientists seeking to understand how civil society's participation in transnational networks can both challenge and reproduce existing community-state power regimes and health inequities.

  12. The user testing toolset: a decision support system to aid the evaluation of assistive technology products.

    Science.gov (United States)

    Woodcock, Andree; Fielden, Simon; Bartlett, Richard

    2012-01-01

    Developers of assistive technology products need to ensure that their offerings meet the requirements of end users, and that usability issues have been discovered prior to manufacture. This may be difficult for SMEs (Small Medium Enterprises) who may lack the necessary skills and resources required to plan and conduct an evaluation. To assist SMEs in the assistive technology market, a stand alone, decision support system was developed to assist in the planning and evaluation of their products, taking into account the resources available, nature of the product being developed and stage of the design process. The responses given by the designer to 40 multiple choice questions are matched against a database of 42 research methods. The methods achieving the highest score in relation to all questions are displayed as the final output. The paper describes the development of the User Testing Toolset (UTT), including the additional functionality provided to ensure that the evaluation methods were correctly matched and weighted to the responses.

  13. [An expert system of aiding decision making in breast pathology connected to a clinical data base].

    Science.gov (United States)

    Brunet, M; Durrleman, S; Ferber, J; Ganascia, J G; Hacene, K; Hirt, F; Jouniaux, F; Meeus, L

    1987-01-01

    The René Huguenin Cancer Center holds a medical file for each patient which is intended to store and process medical data. Since 1970, we introduced computerization: a development plan was elaborated and simultaneously a statistical software (Clotilde--GSI/CFRO) was selected. Thus, we now have access to a large database, structured according to medical rationale, and utilizable with methods of artificial intelligence towards three objectives: improved data acquisition, decision making and exploitation. The first application was to breast pathology, which represents one of the Center's primary activities. The structure of the data concerning patients is by all criteria part of the medical knowledge. This information needs to be presented as well as processed with a suitable language. To this end, we chose a language-oriented object, Mering II, usable with Apple and IBM 4 micro-computers. This project has already allowed to work out an operational model.

  14. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jennifer [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); D' Alimonte, Laura [Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Angus, Jan [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Paszat, Larry [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Metcalfe, Kelly [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Whelan, Tim [Department of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario (Canada); Llewellyn-Thomas, Hilary [Department of Community and Family Medicine, The Center of Informed Choice, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH (Lebanon); Warner, Eiran [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Franssen, Edmee [Consultant Statistician, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Szumacher, Ewa, E-mail: Ewa.Szumacher@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be

  15. Developmental changes of neuronal networks associated with strategic social decision-making.

    Science.gov (United States)

    Steinmann, Elisabeth; Schmalor, Antonia; Prehn-Kristensen, Alexander; Wolff, Stephan; Galka, Andreas; Möhring, Jan; Gerber, Wolf-Dieter; Petermann, Franz; Stephani, Ulrich; Siniatchkin, Michael

    2014-04-01

    One of the important prerequisites for successful social interaction is the willingness of each individual to cooperate socially. Using the ultimatum game, several studies have demonstrated that the process of decision-making to cooperate or to defeat in interaction with a partner is associated with activation of the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), anterior insula (AI), and inferior frontal cortex (IFC). This study investigates developmental changes in this neuronal network. 15 healthy children (8-12 years), 15 adolescents (13-18 years) and 15 young adults (19-28 years) were investigated using the ultimatum game. Neuronal networks representing decision-making based on strategic thinking were characterized using functional MRI. In all age groups, the process of decision-making in reaction to unfair offers was associated with hemodynamic changes in similar regions. Compared with children, however, healthy adults and adolescents revealed greater activation in the IFC and the fusiform gyrus, as well as the nucleus accumbens. In contrast, healthy children displayed more activation in the AI, the dorsal part of the ACC, and the DLPFC. There were no differences in brain activations between adults and adolescents. The neuronal mechanisms underlying strategic social decision making are already developed by the age of eight. Decision-making based on strategic thinking is associated with age-dependent involvement of different brain regions. Neuronal networks underlying theory of mind and reward anticipation are more activated in adults and adolescents with regard to the increasing perspective taking with age. In relation to emotional reactivity and respective compensatory coping in younger ages, children have higher activations in a neuronal network associated with emotional processing and executive control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Cost-Based Vertical Handover Decision Algorithm for WWAN/WLAN Integrated Networks

    Directory of Open Access Journals (Sweden)

    Kim LaeYoung

    2009-01-01

    Full Text Available Abstract Next generation wireless communications are expected to rely on integrated networks consisting of multiple wireless technologies. Heterogeneous networks based on Wireless Local Area Networks (WLANs and Wireless Wide Area Networks (WWANs can combine their respective advantages on coverage and data rates, offering a high Quality of Service (QoS to mobile users. In such environment, multi-interface terminals should seamlessly switch from one network to another in order to obtain improved performance or at least to maintain a continuous wireless connection. Therefore, network selection algorithm is important in providing better performance to the multi-interface terminals in the integrated networks. In this paper, we propose a cost-based vertical handover decision algorithm that triggers the Vertical Handover (VHO based on a cost function for WWAN/WLAN integrated networks. For the cost function, we focus on developing an analytical model of the expected cost of WLAN for the mobile users that enter the double-coverage area while having a connection in the WWAN. Our simulation results show that the proposed scheme achieves better performance in terms of power consumption and throughput than typical approach where WLANs are always preferred whenever the WLAN access is available.

  17. Cost-Based Vertical Handover Decision Algorithm for WWAN/WLAN Integrated Networks

    Directory of Open Access Journals (Sweden)

    KunHo Hong

    2009-01-01

    Full Text Available Next generation wireless communications are expected to rely on integrated networks consisting of multiple wireless technologies. Heterogeneous networks based on Wireless Local Area Networks (WLANs and Wireless Wide Area Networks (WWANs can combine their respective advantages on coverage and data rates, offering a high Quality of Service (QoS to mobile users. In such environment, multi-interface terminals should seamlessly switch from one network to another in order to obtain improved performance or at least to maintain a continuous wireless connection. Therefore, network selection algorithm is important in providing better performance to the multi-interface terminals in the integrated networks. In this paper, we propose a cost-based vertical handover decision algorithm that triggers the Vertical Handover (VHO based on a cost function for WWAN/WLAN integrated networks. For the cost function, we focus on developing an analytical model of the expected cost of WLAN for the mobile users that enter the double-coverage area while having a connection in the WWAN. Our simulation results show that the proposed scheme achieves better performance in terms of power consumption and throughput than typical approach where WLANs are always preferred whenever the WLAN access is available.

  18. Improving transportation networks: Effects of population structure and decision making policies.

    Science.gov (United States)

    Pablo-Martí, Federico; Sánchez, Angel

    2017-07-03

    Transportation networks are one of the fundamental tools for human society to work, more so in our globalized world. The importance of a correct, efficient design of a transportation network for a given region or country cannot be overstated. We here study how network design is affected by the geography of the towns or nuclei to be connected, and also by the decision process necessary to choose which connections should be improved (in a generic sense) first. We begin by establishing that Delaunay networks provide an efficient starting point for the network design and at the same time allow us to introduce a computationally amenable model. Subsequent improvements lead to decentralized designs in geographies where towns are more or less homogeneously distributed, whereas radial designs arise when there is a core-periphery distribution of nodes. We also show that optimization of Delaunay networks outperforms that of complete networks at a lower cost, by allowing for a proper selection of the links to improve. In closing, we draw conclusions relevant to policy making applied to designing transportation networks and point our how our study can be useful to identify mechanisms relevant to the historical development of a region.

  19. Throughput Maximization for Sensor-Aided Cognitive Radio Networks with Continuous Energy Arrivals.

    Science.gov (United States)

    Nguyen, Thanh-Tung; Koo, Insoo

    2015-11-27

    We consider a Sensor-Aided Cognitive Radio Network (SACRN) in which sensors capable of harvesting energy are distributed throughout the network to support secondary transmitters for sensing licensed channels in order to improve both energy and spectral efficiency. Harvesting ambient energy is one of the most promising solutions to mitigate energy deficiency, prolong device lifetime, and partly reduce the battery size of devices. So far, many works related to SACRN have considered single secondary users capable of harvesting energy in whole slot as well as short-term throughput. In the paper, we consider two types of energy harvesting sensor nodes (EHSN): Type-I sensor nodes will harvest ambient energy in whole slot duration, whereas type-II sensor nodes will only harvest energy after carrying out spectrum sensing. In the paper, we also investigate long-term throughput in the scheduling window, and formulate the throughput maximization problem by considering energy-neutral operation conditions of type-I and -II sensors and the target detection probability. Through simulations, it is shown that the sensing energy consumption of all sensor nodes can be efficiently managed with the proposed scheme to achieve optimal long-term throughput in the window.

  20. The effect of a patient-oriented treatment decision aid for risk factor management in patients with diabetes (PORTDA-diab: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Denig Petra

    2012-11-01

    Full Text Available Abstract Background To improve risk factor management in diabetes, we need to support effective interactions between patients and healthcare providers. Our aim is to develop and evaluate a treatment decision aid that offers personalised information on treatment options and outcomes, and is intended to empower patients in taking a proactive role in their disease management. Important features are: (1 involving patients in setting goals together with their provider; (2 encourage them to prioritise on treatments that maximise relevant outcomes; and (3 integration of the decision aid in the practice setting and workflow. As secondary aim, we want to evaluate the impact of different presentation formats, and learn more from the experiences of the healthcare providers and patients with the decision aid. Methods and design We will conduct a randomised trial comparing four formats of the decision aid in a 2×2 factorial design with a control group. Patients with type 2 diabetes managed in 18 to 20 primary care practices in The Netherlands will be recruited. Excluded are patients with a recent myocardial infarction, stroke, heart failure, angina pectoris, terminal illness, cognitive deficits, >65 years at diagnosis, or not able to read Dutch. The decision aid is offered to the patients immediately before their quarterly practice consultation. The same decision information will be available to the healthcare provider for use during consultation. In addition, the providers receive a set of treatment cards, which they can use to discuss the benefits and risks of different options. Patients in the control group will receive care as usual. We will measure the effect of the intervention on patient empowerment, satisfaction with care, beliefs about medication, negative emotions, health status, prescribed medication, and predicted cardiovascular risk. Data will be collected with questionnaires and automated extraction from medical records in 6 months before and

  1. Prediction Approach of Critical Node Based on Multiple Attribute Decision Making for Opportunistic Sensor Networks

    Directory of Open Access Journals (Sweden)

    Qifan Chen

    2016-01-01

    Full Text Available Predicting critical nodes of Opportunistic Sensor Network (OSN can help us not only to improve network performance but also to decrease the cost in network maintenance. However, existing ways of predicting critical nodes in static network are not suitable for OSN. In this paper, the conceptions of critical nodes, region contribution, and cut-vertex in multiregion OSN are defined. We propose an approach to predict critical node for OSN, which is based on multiple attribute decision making (MADM. It takes RC to present the dependence of regions on Ferry nodes. TOPSIS algorithm is employed to find out Ferry node with maximum comprehensive contribution, which is a critical node. The experimental results show that, in different scenarios, this approach can predict the critical nodes of OSN better.

  2. Recurrent neural networks in computer-based clinical decision support for laryngopathies: an experimental study.

    Science.gov (United States)

    Szkoła, Jarosław; Pancerz, Krzysztof; Warchoł, Jan

    2011-01-01

    The main goal of this paper is to give the basis for creating a computer-based clinical decision support (CDS) system for laryngopathies. One of approaches which can be used in the proposed CDS is based on the speech signal analysis using recurrent neural networks (RNNs). RNNs can be used for pattern recognition in time series data due to their ability of memorizing some information from the past. The Elman networks (ENs) are a classical representative of RNNs. To improve learning ability of ENs, we may modify and combine them with another kind of RNNs, namely, with the Jordan networks. The modified Elman-Jordan networks (EJNs) manifest a faster and more exact achievement of the target pattern. Validation experiments were carried out on speech signals of patients from the control group and with two kinds of laryngopathies.

  3. Effect of network topology on the evolutionary ultimatum game based on the net-profit decision

    Science.gov (United States)

    Ye, Shun-Qiang; Wang, Lu; Jones, Michael C.; Ye, Ye; Wang, Meng; Xie, Neng-Gang

    2016-04-01

    The ubiquity of altruist behavior amongst humans has long been a significant puzzle in the social sciences. Ultimatum game has proved to be a useful tool for explaining altruistic behavior among selfish individuals. In an ultimatum game where alternating roles exist, we suppose that players make their decisions based on the net profit of their own. In this paper, we specify a player's strategy with two parameters: offer level α ∈ [ 0,1) and net profit acceptance level β ∈ [ - 1,1). By Monte Carlo simulation, we analyze separately the effect of the size of the neighborhood, the small-world property and the heterogeneity of the degree distributions of the networks. Results show that compared with results observed for homogeneous networks, heterogeneous networks lead to more rational outcomes. Moreover, network structure has no effect on the evolution of kindness level, so moderate kindness is adaptable to any social groups and organizations.

  4. Comparing social factors affecting recommender decisions in online and educational social network

    Science.gov (United States)

    MartÍn, Estefanía; Hernán-Losada, Isidoro; Haya, Pablo A.

    2016-01-01

    In the educational context, there is an increasing interest in learning networks. Recommender systems (RSs) can play an important role in achieving educational objectives. Although we can find many papers focused on recommendation techniques and algorithms, in general, less attention has been dedicated to social factors that influence the recommendation process. This process could be improved if we had a deeper understanding of the social factors that influence the quality or validity of a suggestion made by the RS. This work elucidates and analyses the social factors that influence the design and decision-making process of RSs. We conducted a survey in which 126 undergraduate students were asked to extract which are the main factors for improving suggestions when they are interacting with an Online Social Network (OSN) or in an Educational Social Network (ESN). The results show that different factors have to be considered depending on the type of network.

  5. Auditory decision aiding in supervisory control of multiple unmanned aerial vehicles.

    Science.gov (United States)

    Donmez, Birsen; Cummings, M L; Graham, Hudson D

    2009-10-01

    This article is an investigation of the effectiveness of sonifications, which are continuous auditory alerts mapped to the state of a monitored task, in supporting unmanned aerial vehicle (UAV) supervisory control. UAV supervisory control requires monitoring a UAV across multiple tasks (e.g., course maintenance) via a predominantly visual display, which currently is supported with discrete auditory alerts. Sonification has been shown to enhance monitoring performance in domains such as anesthesiology by allowing an operator to immediately determine an entity's (e.g., patient) current and projected states, and is a promising alternative to discrete alerts in UAV control. However, minimal research compares sonification to discrete alerts, and no research assesses the effectiveness of sonification for monitoring multiple entities (e.g., multiple UAVs). The authors conducted an experiment with 39 military personnel, using a simulated setup. Participants controlled single and multiple UAVs and received sonifications or discrete alerts based on UAV course deviations and late target arrivals. Regardless of the number of UAVs supervised, the course deviation sonification resulted in reactions to course deviations that were 1.9 s faster, a 19% enhancement, compared with discrete alerts. However, course deviation sonifications interfered with the effectiveness of discrete late arrival alerts in general and with operator responses to late arrivals when supervising multiple vehicles. Sonifications can outperform discrete alerts when designed to aid operators to predict future states of monitored tasks. However, sonifications may mask other auditory alerts and interfere with other monitoring tasks that require divided attention. This research has implications for supervisory control display design.

  6. Put listening to the test: An aid to decision making in language placement

    Directory of Open Access Journals (Sweden)

    Marais, Fiona

    2010-12-01

    Full Text Available Universities and other higher education establishments throughout the world, including South Africa, have become concerned about the academic literacy levels of the students they enrol. The problem at most South African tertiary education institutions, which is in line with global trends, is certainly considerable, with almost a third of the students identified as being at risk. A lack of ability in academic discourse is seen as a major cause of students' failure to complete their courses within the given period. In 2006, as part of a nationwide attempt to remedy the academic literacy crisis, Stellenbosch University, along with other academic establishments, officially decided to implement a test of academic literacy in both English and Afrikaans. At Stellenbosch University, the English version of this test is known as TALL (Test of Academic Literacy Levels. It was developed to assess reading and writing abilities in an academic context. The results are used to ‘stream’ students into programmes which assist them in acquiring the various skills deemed necessary for their academic success. Students are sorted according to their TALL results into 'high risk' and 'low to no risk' categories, however, a need has been identified for further screening of the borderline students whose performance in the test falls between these two groups. Administrative and logistical limitations have, thus far, prevented listening skills from being included in the construct of TALL, but there is general consensus that listening is an important skill, particularly at university level. The focus of the research project, reported on in this article, was to design, and put into practice, an academic listening test (ALT to assist in decision making regarding the placement of first-year students in approved language courses at Stellenbosch University. The qualitative and quantitative results obtained from the various administrations of ALT were analysed to determine the

  7. Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, R.E.D.; Cuypers, M.; Garvelink, M.M.; Vries, M. de; Bosch, J.L.H.R.; Kil, P.J.M.

    2016-01-01

    Objective: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Methods: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2:

  8. Development of a decision aid for the treatment of benign prostatic hyperplasia: A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, R.E.; Cuypers, M.; Garvelink, M.M.; Vries, M. de; Bosch, J.L.; Kil, P.J.

    2016-01-01

    OBJECTIVE: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). METHODS: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2:

  9. Development of a decision aid for the treatment of benign prostatic hyperplasia : A four stage method using a Delphi consensus study

    NARCIS (Netherlands)

    Lamers, Romy E D; Cuypers, Maarten; Garvelink, Mirjam M.; Bosch, J. L H Ruud|info:eu-repo/dai/nl/088914364; Kil, Paul J M

    2016-01-01

    Objective: To develop a web-based decision aid (DA) for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (LUTS/BPH). Methods: From February-September 2014 we performed a four-stage development method: 1: Two-round Delphi consensus method among urologists, 2:

  10. The Cat and the Pigeons: Some General Comments on (TP) Tax Rulings and State Aid After the Starbucks and Fiat Decisions

    NARCIS (Netherlands)

    Wattel, P.J.; Richelle, I.; Schön, W.; Traversa, E.

    2016-01-01

    The Commission State aid decisions on individual tax rulings have created legal uncertainty, which may have been one of their goals. This article comments on their political and policy merits and effects, it wonders whether EU law requires member States to have—and apply in a certain manner—specific

  11. The effect of a patient-oriented treatment decision aid for risk factor management in patients with diabetes (PORTDA-diab) : study protocol for a randomised controlled trial

    NARCIS (Netherlands)

    Denig, Petra; Dun, Mathijs; Schuling, Jan; Haaijer-Ruskamp, Flora M.; Voorham, Jaco

    2012-01-01

    Background: To improve risk factor management in diabetes, we need to support effective interactions between patients and healthcare providers. Our aim is to develop and evaluate a treatment decision aid that offers personalised information on treatment options and outcomes, and is intended to

  12. Standards as a tool aiding the decision processes in market economy

    Directory of Open Access Journals (Sweden)

    A. Tabor

    2010-07-01

    Full Text Available The long–lasting process of adaptation of the Polish standardisation system to the conditions of the European Community has not beencompleted yet. Its logical consequence is the need to shape the mentality of the entrepreneurs and make them understand the importance of standards and their value in a competitive market. It is the intention of the authors of this study to disclose the main aspects of standardisation at both Polish and European level, explain the model of standardisation system currently functioning in Poland, and against this background highlight the priorities in the standardisation policy adopted by the European Union, especially as regards some specific subjects, including – among others – problems related with environmental protection and occupational safety. In standardisation system, the problems of occupational safety and environmental protection are dealt with by a large group of standards harmonised with the New Approach Directive, which touches on the safety–related issues. Our knowledge of standards speaking the language of business is the challenge of modern times that should not be rejected, as in many cases it determines our competitiveness in the common market. The synthetic knowledge comprised in standards creates conditions for good decisions supporting the process of company development, strengthening its position in the European market, and creating the image of a successful modern enterprise ready to start cooperation with other enterprises, making – moreover – an important contribution to the economic management of products manufactured by various technological processes.

  13. Standards as a tool aiding the decision processes in market economy

    Directory of Open Access Journals (Sweden)

    A. Tabor

    2010-04-01

    Full Text Available The long–lasting process of adaptation of the Polish standardisation system to the conditions of the European Community has not beencompleted yet. Its logical consequence is the need to shape the mentality of the entrepreneurs and make them understand the importance of standards and their value in a competitive market. It is the intention of the authors of this study to disclose the main aspects of standardisation at both Polish and European level, explain the model of standardisation system currently functioning in Poland, and against this background highlight the priorities in the standardisation policy adopted by the European Union, especially as regards some specific subjects, including – among others – problems related with environmental protection and occupational safety. In standardisation system, the problems of occupational safety and environmental protection are dealt with by a large group of standards harmonised with the New Approach Directive, which touches on the safety–related issues. Our knowledge of standards speaking the language of business is the challenge of modern times that should not be rejected, as in many cases it determines our competitiveness in the common market. The synthetic knowledge comprised in standards creates conditions for good decisions supporting the process of company development, strengthening its position in the European market, and creating the image of a successful modern enterprise ready to start cooperation with other enterprises, making – moreover – an important contribution to the economic management of products manufactured by varioustechnological processes.

  14. Technologies and decision support systems to aid solid-waste management: a systematic review.

    Science.gov (United States)

    Vitorino de Souza Melaré, Angelina; Montenegro González, Sahudy; Faceli, Katti; Casadei, Vitor

    2017-01-01

    Population growth associated with population migration to urban areas and industrial development have led to a consumption relation that results in environmental, social, and economic problems. With respect to the environment, a critical concern is the lack of control and the inadequate management of the solid waste generated in urban centers. Among the challenges are proper waste-collection management, treatment, and disposal, with an emphasis on sustainable management. This paper presents a systematic review on scientific publications concerning decision support systems applied to Solid Waste Management (SWM) using ICTs and OR in the period of 2010-2013. A statistical analysis of the eighty-seven most relevant publications is presented, encompassing the ICTs and OR methods adopted in SWM, the processes of solid-waste management where they were adopted, and which countries are investigating solutions for the management of solid waste. A detailed discussion on how the ICTs and OR methods have been combined in the solutions was also presented. The analysis and discussion provided aims to help researchers and managers to gather insights on technologies/methods suitable the SWM challenges they have at hand, and on gaps that can be explored regarding technologies/methods that could be useful as well as the processes in SWM that currently do not benefit from using ICTs and OR methods. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. How important is Overdiagnosis to members of the public offered the chance to include it in an online multi-criteria decision aid for prostate cancer screening?

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    Objectives To establish the proportion of men who chose to include Overdiagnosis as a criterion in an online multi-criteria decision aid for the prostate cancer screening decision; and to determine the relative importance assigned to Overdiagnosis by those who included it in their personalised aid....... Methods The data are from the 'Pick Your Own' arm of an Australian community panel-based trial involving men aged 40-69 years without diagnosed prostate cancer. The 720 participants were asked to choose between 1 and 10 criteria for inclusion in their aid. With only Overdiagnosis spelled out here......, the criteria, all preceded by ‘Avoiding’, were: LOSS OF LIFETIME; LOSS OF HEALTH; NEEDLESS BIOPSY; OVERDIAGNOSIS (and needless treatment) as a result of a PSA test detecting a cancer that would not have affected your life or health; URINARY PROBLEMS; BOWEL PROBLEMS; SEXUAL PROBLEMS; BURDEN of TREATMENT; BURDEN...

  16. Patient understanding of the revised USPSTF screening mammogram guidelines: need for development of patient decision aids

    Directory of Open Access Journals (Sweden)

    Allen Summer V

    2012-10-01

    Full Text Available Abstract Background The purpose of the study was to examine patients’ understanding of the revised screening mammogram guidelines released by the United States Preventive Services Task Force (USPSTF in 2009 addressing age at initiation and frequency of screening mammography. Methods Patients from the Departments of Family Medicine, Internal Medicine, and Obstetrics and Gynecology (n = 150 at a tertiary care medical center in the United States completed a survey regarding their understanding of the revised USPSTF guidelines following their release, within four to six months of their scheduled mammogram (March 2010 to May 2010. Results Of the patients surveyed, 97/147 (67% indicated increased confusion regarding the age and frequency of screening mammography, 61/148 (41% reported increased anxiety about mammograms, and 58/146 (40% reported anxiety about their own health status following the release of the revised screening guidelines. Most of the patients surveyed, 111/148 (75%, did not expect to change their timing or frequency of screening mammograms in the future. Conclusion Results from this survey suggested increased confusion and possibly an increase in patients’ anxiety related to screening mammography and their own health status following the release of the revised USPSTF screening mammogram guidelines to the public and subsequent media portrayal of the revised guidelines. Although the study did not specifically address causality for these findings, the results highlight the need for improvements in the communication of guidelines to patients and the public. Development of shared decision-making tools and outcomes should be considered to address the communication challenge.

  17. International Exchange of Emergency Phase Information and Assessment: An Aid to Inter/National Decision Makers

    Energy Technology Data Exchange (ETDEWEB)

    Sullivan, T J; Chino, M; Ehrhardt, J; Shershakov, V

    2003-09-01

    This paper discusses a collaborative project whose purpose is (1) to demonstrate the technical feasibility and mutual benefit of a system seeking early review or preview, in a ''quasi peer review'' mode, of nuclear accident plume and dose assessment predictions by four major international nuclear accident emergency response systems before release of their calculations to their respective national authorities followed by (2) sharing these results with responsible international authorities. The extreme sensitivity of the general public to any nuclear accident information has been a strong motivation to seek peer review prior to public release. Another intended objective of this work is (3) the development of an affordable/accessible system for distribution of prediction results to countries having no prediction capabilities and (4) utilization of the link for exercises and collaboration studies. The project exploits the Internet as a ubiquitous communications medium, browser technology as a simple, user friendly interface, and low-cost PC level hardware. The participants are developing a web based dedicated node with ID and password access control, where the four systems can deposit a minimal set of XML-based data and graphics files, which are then displayed in a common identical map format. Side-by-side viewing and televideo conferencing will permit rapid evaluation, correction or elaboration of data, recalculation (if necessary) and should produce a strong level of consensus to assist international decision makers. Successful completion of this work could lead to easy utilization by national and international organizations, such as the IAEA and WHO, as well as by non-nuclear states at risk of a trans-boundary incursion on their territory.

  18. Decision-aids for enhancing intergovernmental interactions: The Pre-notification Analysis Support System (PASS)

    Energy Technology Data Exchange (ETDEWEB)

    Lester, M.; Liebow, E. [Battelle Human Affairs Research Center, Seattle, WA (United States); Holm, J. [USDOE Assistant Secretary for Environmental Management, Washington, DC (United States). Office of Special Programs

    1994-05-01

    The Department of Energy (DOE) plans to honor its commitment to government-to-government interactions by providing advance notice of DOE spent fuel and high-level waste shipments to Indian tribes whose jurisdictions are crossed by or adjacent to transportation routes. The tribes are important contributors to a regional response network, and providing tribes with advance notice of DOE shipping plans marks the start -- not the end -- of direct, government-to-government interactions with DOE. The Tribal Prenotification Analysis Support System (PASS) is being developed for the Office of Special Programs within the Department`s Office of Environmental Restoration and Waste Management. PASS will help DOE-Headquarters to coordinate field office activities and provide technical and institutional support to the DOE field offices. PASS is designed to be used by anyone with minimum computer literacy and having contemporary computer hardware and software. It uses on-screen maps to choose and display a shipment route, and to display the tribal jurisdictions. With forms that are easy to understand, it provides information about each jurisdiction and points of contact. PASS records all contacts, commitments made, and actions taken.

  19. Research on Evaluation Method Based on Modified Buckley Decision Making and Bayesian Network

    Directory of Open Access Journals (Sweden)

    Neng-pu Yang

    2015-01-01

    Full Text Available This work presents a novel evaluation method, which can be applied in the field of risk assessment, project management, cause analysis, and so forth. Two core technologies are used in the method, namely, modified Buckley Decision Making and Bayesian Network. Based on the modified Buckley Decision Making, the fuzzy probabilities of element factors are calibrated. By the forward and backward calculation of Bayesian Network, the structure importance, probability importance, and criticality importance of each factor are calculated and discussed. A numerical example of risk evaluation for dangerous goods transport process is given to verify the method. The results indicate that the method can efficiently identify the weakest element factor. In addition, the method can improve the reliability and objectivity for evaluation.

  20. Usability evaluation and adaptation of the e-health Personal Patient Profile-Prostate decision aid for Spanish-speaking Latino men.

    Science.gov (United States)

    Berry, Donna L; Halpenny, Barbara; Bosco, Jaclyn L F; Bruyere, John; Sanda, Martin G

    2015-07-24

    The Personal Patient Profile-Prostate (P3P), a web-based decision aid, was demonstrated to reduce decisional conflict in English-speaking men with localized prostate cancer early after initial diagnosis. The purpose of this study was to explore and enhance usability and cultural appropriateness of a Spanish P3P by Latino men with a diagnosis of prostate cancer. P3P was translated to Spanish and back-translated by three native Spanish-speaking translators working independently. Spanish-speaking Latino men with a diagnosis of localized prostate cancer, who had made treatment decisions in the past 24 months, were recruited from two urban clinical care sites. Individual cognitive interviews were conducted by two bilingual research assistants as each participant used the Spanish P3P. Notes of user behavior, feedback, and answers to direct questions about comprehension, usability and perceived usefulness were analyzed and categorized. Seven participants with a range of education levels identified 25 unique usability issues in navigation, content comprehension and completeness, sociocultural appropriateness, and methodology. Revisions were prioritized to refine the usability and cultural and linguistic appropriateness of the decision aid. Usability issues were discovered that are potential barriers to effective decision support. Successful use of decision aids requires adaptation and testing beyond translation. Our findings led to revisions further refining the usability and linguistic and cultural appropriateness of Spanish P3P.

  1. Social Network, Surgeon, and Media Influence on the Decision to Undergo Contralateral Prophylactic Mastectomy.

    Science.gov (United States)

    Venetis, Maria K; MacGeorge, Erina L; Baptiste, Dadrie F; Mouton, Ashton; Friley, Lorin B; Pastor, Rebekah; Hatten, Kristen; Lagoo, Janaka; Bowling, Monet W; Clare, Susan E

    2016-07-26

    The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013. Questions addressed the involvement and influence of the social network (family, friends, and nonsurgeon health professionals), surgeon, and media on the CPM decision. Spouses, children, family, friends, and health professionals were reported as exerting a meaningful degree of influence on patients' decisions, largely in ways that were positive or neutral toward CPM. Most surgeons were regarded as providing options rather than encouraging or discouraging CPM. Media influence was present, but limited. Patients who choose CPM do so with influence and support from members of their social networks. Reversing the increasing choice of CPM will require educating these influential others, which can be accomplished by encouraging patients to include them in clinical consultations, and by providing patients with educational materials that can be shared with their social networks. Surgeons need to be perceived as having an opinion, specifically that CPM should be reserved for those patients for whom it is medically indicated.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/.

  2. Dissociating Parieto-Frontal Networks for Phonological and Semantic Word Decisions

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Weigel, Anni; Schuschan, Paul

    2016-01-01

    Left posterior inferior frontal gyrus (pIFG) and supramarginal gyrus (SMG) are key regions for phonological decisions, whereas angular gyrus (ANG) and anterior IFG (aIFG) are associated with semantics. However, it is less clear whether the functional contribution of one area changes in the presence...... of a dysfunctional area within the network. Using repetitive transcranial magnetic stimulation (rTMS), we first tested whether perturbing one area would disrupt behavior. Second, we applied a condition-and-perturb approach, combining parietal offline rTMS with frontal online rTMS to investigate how the functional...... contribution of a frontal region changes in the presence of a dysfunctional parietal region. We found that rTMS over SMG or pIFG delayed phonological decisions, but this was not enhanced by combining supramarginal rTMS with pIFG rTMS. In contrast, semantic decisions were only impaired when angular r...

  3. DECISION WITH ARTIFICIAL NEURAL NETWORKS IN DISCRETE EVENT SIMULATION MODELS ON A TRAFFIC SYSTEM

    Directory of Open Access Journals (Sweden)

    Marília Gonçalves Dutra da Silva

    2016-04-01

    Full Text Available ABSTRACT This work aims to demonstrate the use of a mechanism to be applied in the development of the discrete-event simulation models that perform decision operations through the implementation of an artificial neural network. Actions that involve complex operations performed by a human agent in a process, for example, are often modeled in simplified form with the usual mechanisms of simulation software. Therefore, it was chosen a traffic system controlled by a traffic officer with a flow of vehicles and pedestrians to demonstrate the proposed solution. From a module built in simulation software itself, it was possible to connect the algorithm for intelligent decision to the simulation model. The results showed that the model elaborated responded as expected when it was submitted to actions, which required different decisions to maintain the operation of the system with changes in the flow of people and vehicles.

  4. Decision Fusion with Channel Errors in Distributed Decode-Then-Fuse Sensor Networks.

    Science.gov (United States)

    Yan, Yongsheng; Wang, Haiyan; Shen, Xiaohong; Zhong, Xionghu

    2015-08-05

    Decision fusion for distributed detection in sensor networks under non-ideal channels is investigated in this paper. Usually, the local decisions are transmitted to the fusion center (FC) and decoded, and a fusion rule is then applied to achieve a global decision. We propose an optimal likelihood ratio test (LRT)-based fusion rule to take the uncertainty of the decoded binary data due to modulation, reception mode and communication channel into account. The average bit error rate (BER) is employed to characterize such an uncertainty. Further, the detection performance is analyzed under both non-identical and identical local detection performance indices. In addition, the performance of the proposed method is compared with the existing optimal and suboptimal LRT fusion rules. The results show that the proposed fusion rule is more robust compared to these existing ones.

  5. Neuron Networks and Trees of Decision-making for Prediction of Eficiency in Studies

    Directory of Open Access Journals (Sweden)

    Marijana Zekić-Sušac

    2009-12-01

    Full Text Available The paper is dealing with models for prediction of students eficiency with the help of neuron networks and decision-making classifcation trees and then with the analysis of factors that infuence the efciency of students. A created model, based on demographic data of students as well as their behaviour and attitudes toward learning, tries to classify student in one of the two efciency categories. Te efciency is measured by the average of marks during studies. Various architectures of neuron networks have been trained and tested and the best model is obtained with the help of stratifed perceptron network. Te trees of decisi- on-making ofered a signifcantly better accuracy than neuron networks and we suggest their using due to their being a more precise method for the set of observed data. A sensitivity analysis of output variables on the input ones carried out with neuron networks refers to the fact that preliminary exams, attendance of exercises, importance of marks to students, and scholarships are among the most signifcant factors for the efciency of students. Te trees of decision-making separated the most signifcant variables: the time spent in learning, attendance of exercises and the sorts of materials from which students learn. Future researches, with the increased number of input variables and enlargement of the pattern and methodological expansion of other artifcial intelligence techniques and statistical methods, would make possible to create more succe- ssful model to be the basis for building the support system of decision-making in university level education.

  6. The Attitude of Physicians toward the Use of Patient Decision Aids in Iran as a Developing Country.

    Science.gov (United States)

    Rashidian, Hamideh; Nedjat, Saharnaz; Mounesan, Leila; Haghjou, Leila; Majdzadeh, Reza

    2015-01-01

    The patient decision aids (PDAs), which can facilitate the decision-making process when choosing the optimal method of treatment, are a challenge to patients. This study tried to determine the attitude of physicians on the barriers of using PDAs in the way of prioritizing and proposing solutions to them. This study was a cross-sectional research carried out on 150 clinical faculty members of research centers and scientific associations affiliated with Tehran University of Medical Sciences. The participants were chosen using the convenience sampling method. The attitude of physicians toward the application of PDAs was interviewed using a self-made questionnaire composed of 23 questions. The association between physicians' attitude to the use of PDAs and their characteristics was examined using the t-test, analysis of variance, and correlation test. The mean score of physicians' attitude was 76.2 (standard deviation =11.9) and the range was 33-107. There was a significant and direct association between the attitude toward the use of PDA and the respondents' age (r = 0.237, P = 0.007), years of experience (r = 0.205, P = 0.02), being male (P = 0.04), and working in the private sector (P = 0.009). The attitude score of instructors was significantly lower than that of professors (P = 0.02). The general attitude of physicians toward the use of PDAs was positive. However, apparently as a result of problems mentioned in this study for the developing countries such as Iran, it is much easier to employ these tools in centers run by the private sector. Usage of such tools in public centers necessitates systemic infrastructure as well as credits and budgets required for the training of patients and physicians.

  7. Effects of computer-aided clinical decision support systems in improving antibiotic prescribing by primary care providers: a systematic review.

    Science.gov (United States)

    Holstiege, Jakob; Mathes, Tim; Pieper, Dawid

    2015-01-01

    To assess the effectiveness of computer-aided clinical decision support systems (CDSS) in improving antibiotic prescribing in primary care. A literature search utilizing Medline (via PubMed) and Embase (via Embase) was conducted up to November 2013. Randomized controlled trials (RCTs) and cluster randomized trials (CRTs) that evaluated the effects of CDSS aiming at improving antibiotic prescribing practice in an ambulatory primary care setting were included for review. Two investigators independently extracted data about study design and quality, participant characteristics, interventions, and outcomes. Seven studies (4 CRTs, 3 RCTs) met our inclusion criteria. All studies were performed in the USA. Proportions of eligible patient visits that triggered CDSS use varied substantially between intervention arms of studies (range 2.8-62.8%). Five out of seven trials showed marginal to moderate statistically significant effects of CDSS in improving antibiotic prescribing behavior. CDSS that automatically provided decision support were more likely to improve prescribing practice in contrast to systems that had to be actively initiated by healthcare providers. CDSS show promising effectiveness in improving antibiotic prescribing behavior in primary care. Magnitude of effects compared to no intervention, appeared to be similar to other moderately effective single interventions directed at primary care providers. Additional research is warranted to determine CDSS characteristics crucial to triggering high adoption by providers as a perquisite of clinically relevant improvement of antibiotic prescribing. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.

  8. The impact of a decision aid about heart disease prevention on patients' discussions with their doctor and their plans for prevention: a pilot randomized trial

    Directory of Open Access Journals (Sweden)

    Simpson Ross J

    2006-09-01

    Full Text Available Abstract Background Low utilization of effective coronary heart disease (CHD prevention strategies may be due to many factors, but chief among them is the lack of patient involvement in prevention decisions. We undertook this study to test the effectiveness of an individually-tailored, computerized decision aid about CHD on patients' discussions with their doctor and their plans for CHD prevention. Methods We conducted a pilot randomized trial in a convenience sample of adults with no previous history of cardiovascular disease to test the effectiveness of an individually-tailored, computerized decision aid about CHD prevention against a risk factor list that patients could present to their doctor. Results We enrolled 75 adults. Mean age was 53. 59% were female, 73% white, and 23% African-American. 66% had some college education. 43% had a 10-year CHD risk of 0–5%, 25% a risk of 6–10%, 24% a risk of 11–20%, and 5% a risk of > 20%. 78% had at least one option to reduce their CHD risk, but only 45% accurately identified the strategies best supported by evidence. 41 patients received the decision aid, 34 received usual care. In unadjusted analysis, the decision aid increased the proportion of patients who discussed CHD risk reduction with their doctor from 24% to 40% (absolute difference 16%; 95% CI -4% to +37% and increased the proportion who had a specific plan to reduce their risk from 24% to 37% (absolute difference 13%; 95% CI -7% to +34%. In pre-post testing, the decision aid also appeared to increase the proportion of patients with plans to intervene on their CHD risk (absolute increase ranging from 21% to 47% for planned medication use and 5% to 16% for planned behavioral interventions. Conclusion Our study confirms patients' limited knowledge about their CHD risk and effective risk reduction options and provides preliminary evidence that an individually-tailored decision aid about CHD prevention might be expected to increase patients

  9. The role of social networking web sites in influencing residency decisions.

    Science.gov (United States)

    Schweitzer, Justin; Hannan, Alexander; Coren, Joshua

    2012-10-01

    Social networking Web sites such as Facebook have grown rapidly in popularity. It is unknown how such sites affect the ways in which medical trainees investigate and interact with graduate medical education (GME) programs. To evaluate the use of social networking Web sites as a means for osteopathic medical students, interns, residents, and fellows to interact with GME programs and report the degree to which that interaction impacts a medical trainee's choice of GME program. An anonymous, 10-item electronic survey on social networking Web sites was e-mailed to osteopathic medical student, intern, resident, and fellow members of the American College of Osteopathic Family Physicians. The weighted least squares test and the Fisher exact test were used for data analysis. A total of 9606 surveys were distributed, and 992 (10%) were completed. Nine hundred twenty-eight (93%) of the respondents used social networking Web sites, with the most popular services being Facebook (891 [90%]; P=.03), the Student Doctor Network (278 [28%]), and LinkedIn (89 [9%]; P=.03). Three hundred fifty-three respondents (36%; P=.52) were connected with a professional organization and 673 (68%; P=.73) used social networking Web sites for job searching related to GME programs or postresidency employment. Within the population of 497 third-, fourth-, and fifth-year osteopathic medical students, 136 (27%) reported gleaning information about programs through social networking Web sites (P=.01). Within the total population, 100 of 992 (10%) reported that this information influenced their decisions (P=.07). Of note, 144 (14%) of the total 992 respondents reported that the programs they applied to did not have any presence on social networking Web sites (P=.05). Our results indicate that social networking Web sites have a present and growing influence on how osteopathic medical students, interns, residents, and fellows learn about and select a GME program.

  10. Decision Support for Route Search and Optimum Finding in Transport Networks under Uncertainty

    Directory of Open Access Journals (Sweden)

    G. Szücs

    2015-02-01

    Full Text Available The aim of this paper is to find solution for route planning in road network for a user, and to find the equilibrium in the path optimization problem, where the roads have uncertain attributes. The concept is based on the Dempster-Shafer theory and Dijkstra's algorithm, which help to model the uncertainty and to find the best route, respectively. Based on uncertain influencing factors an interval of travel time (so called cost interval of each road can be calculated. An algorithm has been outlined for determining the best route comparing the intervals and using decision rules depending on the user's attitude. Priorities can be defined among the rules, and the constructed rule based mechanism for users’ demands is great contribution of this paper. The first task is discussed in more general in this paper, i.e. instead of travel time a general cost is investigated for any kind of network. At the solution of the second task, where the goal is to find equilibrium in transport network at case of uncertain situation, the result of the first task is used. Simulation tool has been used to find the equilibrium, which gives only approximate solution, but this is sufficient and appropriate solution for large networks. Furthermore this is built in a decision support system, which is another contribution of this work. At the end of the paper the implementation of the theoretical concept is presented with a test bed of a town presenting effects of different uncertain influencing factors for the roads.

  11. Deep Convolutional Neural Networks for Computer-Aided Detection: CNN Architectures, Dataset Characteristics and Transfer Learning

    Science.gov (United States)

    Hoo-Chang, Shin; Roth, Holger R.; Gao, Mingchen; Lu, Le; Xu, Ziyue; Nogues, Isabella; Yao, Jianhua; Mollura, Daniel

    2016-01-01

    Remarkable progress has been made in image recognition, primarily due to the availability of large-scale annotated datasets (i.e. ImageNet) and the revival of deep convolutional neural networks (CNN). CNNs enable learning data-driven, highly representative, layered hierarchical image features from sufficient training data. However, obtaining datasets as comprehensively annotated as ImageNet in the medical imaging domain remains a challenge. There are currently three major techniques that successfully employ CNNs to medical image classification: training the CNN from scratch, using off-the-shelf pre-trained CNN features, and conducting unsupervised CNN pre-training with supervised fine-tuning. Another effective method is transfer learning, i.e., fine-tuning CNN models (supervised) pre-trained from natural image dataset to medical image tasks (although domain transfer between two medical image datasets is also possible). In this paper, we exploit three important, but previously understudied factors of employing deep convolutional neural networks to computer-aided detection problems. We first explore and evaluate different CNN architectures. The studied models contain 5 thousand to 160 million parameters, and vary in numbers of layers. We then evaluate the influence of dataset scale and spatial image context on performance. Finally, we examine when and why transfer learning from pre-trained ImageNet (via fine-tuning) can be useful. We study two specific computeraided detection (CADe) problems, namely thoraco-abdominal lymph node (LN) detection and interstitial lung disease (ILD) classification. We achieve the state-of-the-art performance on the mediastinal LN detection, with 85% sensitivity at 3 false positive per patient, and report the first five-fold cross-validation classification results on predicting axial CT slices with ILD categories. Our extensive empirical evaluation, CNN model analysis and valuable insights can be extended to the design of high performance

  12. The use of artificial neural networks in decision support in cancer: a systematic review.

    Science.gov (United States)

    Lisboa, Paulo J; Taktak, Azzam F G

    2006-05-01

    Artificial neural networks have featured in a wide range of medical journals, often with promising results. This paper reports on a systematic review that was conducted to assess the benefit of artificial neural networks (ANNs) as decision making tools in the field of cancer. The number of clinical trials (CTs) and randomised controlled trials (RCTs) involving the use of ANNs in diagnosis and prognosis increased from 1 to 38 in the last decade. However, out of 396 studies involving the use of ANNs in cancer, only 27 were either CTs or RCTs. Out of these trials, 21 showed an increase in benefit to healthcare provision and 6 did not. None of these studies however showed a decrease in benefit. This paper reviews the clinical fields where neural network methods figure most prominently, the main algorithms featured, methodologies for model selection and the need for rigorous evaluation of results.

  13. High-accuracy Decision of Call-triage by Using Bayesian Network

    Science.gov (United States)

    Yunoki, Shota; Hamagami, Tomoki; Oshige, Kenji; Kawakami, Chihiro; Suzuki, Noriyuki

    A new call-triage system, a key part of emergency support system with stochastic network model is examined. The call-triage is an operation allowing the efficient decision of service grade and dispatching of suitable rescue team service from phone call information. Nowadays, the call-triage is being trialed on a few cities and is achieving an effect. However, there is the issue that if under-triage in which the condition of sick person is estimated more lightly is eliminated, the efficiency is degraded (over-triage). In this report, in order to overcome the issue, the Bayesian network scheme is examined to the call-triage system. The experiments with real call-triage data set results show the Bayesian network achieves precision enhancement.

  14. Joining forces for food security - Linking earth observation and crowd-sourcing for improved decision-support to aid organizations

    Science.gov (United States)

    Enenkel, M.; Dorigo, W.; See, L. M.; Vinck, P.; Pham, P.

    2013-12-01

    Droughts statistically exceed all other natural disasters in spatio-temporal extent, number of people affected or financial loss. Triggered by crop failure, food insecurity is a major manifestation of agricultural drought and water scarcity. However, other socio-economic precursors, such as chronically low levels of disaster preparedness, hampered access to food security or a lack of social safety nets are equally important factors. Consequently, this study is focused on two complementary developments - a new satellite-derived agricultural drought index and a mobile phone application. The Combined Drought Index (CDI) is enhanced by replacing field measurements of temperature and rainfall modelled/assimilated data. The vegetation component is replaced by a smoothed NDVI dataset. A soil moisture component is introduced to close the gap between rainfall deficiencies and the first visible impacts of atmospheric anomalies on vegetation. The mobile phone application enables the validation of drought index outputs and gives aid organizations an opportunity to increase the speed of socio-economic vulnerability assessments. Supported by Doctors without Borders (MSF) this approach aims at decreasing uncertainties in decision-making via a more holistic risk framework.

  15. A flexible decision-aided maximum likelihood phase estimation in hybrid QPSK/OOK coherent optical WDM systems

    Science.gov (United States)

    Zhang, Yong; Wang, Yulong

    2016-04-01

    Although decision-aided (DA) maximum likelihood (ML) phase estimation (PE) algorithm has been investigated intensively, block length effect impacts system performance and leads to the increasing of hardware complexity. In this paper, a flexible DA-ML algorithm is proposed in hybrid QPSK/OOK coherent optical wavelength division multiplexed (WDM) systems. We present a general cross phase modulation (XPM) model based on Volterra series transfer function (VSTF) method to describe XPM effects induced by OOK channels at the end of dispersion management (DM) fiber links. Based on our model, the weighted factors obtained from maximum likelihood method are introduced to eliminate the block length effect. We derive the analytical expression of phase error variance for the performance prediction of coherent receiver with the flexible DA-ML algorithm. Bit error ratio (BER) performance is evaluated and compared through both theoretical derivation and Monte Carlo (MC) simulation. The results show that our flexible DA-ML algorithm has significant improvement in performance compared with the conventional DA-ML algorithm as block length is a fixed value. Compared with the conventional DA-ML with optimum block length, our flexible DA-ML can obtain better system performance. It means our flexible DA-ML algorithm is more effective for mitigating phase noise than conventional DA-ML algorithm.

  16. Mathematical prediction of core body temperature from environment, activity, and clothing: The heat strain decision aid (HSDA).

    Science.gov (United States)

    Potter, Adam W; Blanchard, Laurie A; Friedl, Karl E; Cadarette, Bruce S; Hoyt, Reed W

    2017-02-01

    Physiological models provide useful summaries of complex interrelated regulatory functions. These can often be reduced to simple input requirements and simple predictions for pragmatic applications. This paper demonstrates this modeling efficiency by tracing the development of one such simple model, the Heat Strain Decision Aid (HSDA), originally developed to address Army needs. The HSDA, which derives from the Givoni-Goldman equilibrium body core temperature prediction model, uses 16 inputs from four elements: individual characteristics, physical activity, clothing biophysics, and environmental conditions. These inputs are used to mathematically predict core temperature (Tc) rise over time and can estimate water turnover from sweat loss. Based on a history of military applications such as derivation of training and mission planning tools, we conclude that the HSDA model is a robust integration of physiological rules that can guide a variety of useful predictions. The HSDA model is limited to generalized predictions of thermal strain and does not provide individualized predictions that could be obtained from physiological sensor data-driven predictive models. This fully transparent physiological model should be improved and extended with new findings and new challenging scenarios. Published by Elsevier Ltd.

  17. A Study on the Application of Defect Data Mining in the Aid Decision Making of Dispatching and Control Integration

    Directory of Open Access Journals (Sweden)

    Guo Hongzuo

    2015-01-01

    Full Text Available The purpose of the research project is to design an aid decision-making system of dispatching and control integration that cooperates with expert judgments based on the data mining of equipment defects so as to improve the risk pre-warning and pre-control ability of unattended centralized monitoring, enhance the level of centralized monitoring operation and guarantee the safety and stability of power system in the dispatching and control integration system. Defect analysis and condition based maintenance are deeply integrated in this research project. Condition data of equipment defects is firstly obtained and then classified, aggregated and analyzed. Through the model training of SVM, the law of the big data when equipment defects occur is obtained and the operation curve of equipment and the current status information are matched so that the risk of defects can be confirmed and the accuracy of risk anticipation can be effectively improved. In this research project, familial defects of equipment and the expert system are incorporated into the system design range and the practicability of the system is enhanced.

  18. Developing a computer touch-screen interactive colorectal screening decision aid for a low-literacy African American population: lessons learned.

    Science.gov (United States)

    Bass, Sarah Bauerle; Gordon, Thomas F; Ruzek, Sheryl Burt; Wolak, Caitlin; Ruggieri, Dominique; Mora, Gabriella; Rovito, Michael J; Britto, Johnson; Parameswaran, Lalitha; Abedin, Zainab; Ward, Stephanie; Paranjape, Anuradha; Lin, Karen; Meyer, Brian; Pitts, Khaliah

    2013-07-01

    African Americans have higher colorectal cancer (CRC) mortality than White Americans and yet have lower rates of CRC screening. Increased screening aids in early detection and higher survival rates. Coupled with low literacy rates, the burden of CRC morbidity and mortality is exacerbated in this population, making it important to develop culturally and literacy appropriate aids to help low-literacy African Americans make informed decisions about CRC screening. This article outlines the development of a low-literacy computer touch-screen colonoscopy decision aid using an innovative marketing method called perceptual mapping and message vector modeling. This method was used to mathematically model key messages for the decision aid, which were then used to modify an existing CRC screening tutorial with different messages. The final tutorial was delivered through computer touch-screen technology to increase access and ease of use for participants. Testing showed users were not only more comfortable with the touch-screen technology but were also significantly more willing to have a colonoscopy compared with a "usual care group." Results confirm the importance of including participants in planning and that the use of these innovative mapping and message design methods can lead to significant CRC screening attitude change.

  19. Joint Transmit Power Allocation and Splitting for SWIPT Aided OFDM-IDMA in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Shanshan Li

    2017-07-01

    Full Text Available In this paper, we propose to combine Orthogonal Frequency Division Multiplexing-Interleave Division Multiple Access (OFDM-IDMA with Simultaneous Wireless Information and Power Transfer (SWIPT, resulting in SWIPT aided OFDM-IDMA scheme for power-limited sensor networks. In the proposed system, the Receive Node (RN applies Power Splitting (PS to coordinate the Energy Harvesting (EH and Information Decoding (ID process, where the harvested energy is utilized to guarantee the iterative Multi-User Detection (MUD of IDMA to work under sufficient number of iterations. Our objective is to minimize the total transmit power of Source Node (SN, while satisfying the requirements of both minimum harvested energy and Bit Error Rate (BER performance from individual receive nodes. We formulate such a problem as a joint power allocation and splitting one, where the iteration number of MUD is also taken into consideration as the key parameter to affect both EH and ID constraints. To solve it, a sub-optimal algorithm is proposed to determine the power profile, PS ratio and iteration number of MUD in an iterative manner. Simulation results verify that the proposed algorithm can provide significant performance improvement.

  20. Joint Transmit Power Allocation and Splitting for SWIPT Aided OFDM-IDMA in Wireless Sensor Networks.

    Science.gov (United States)

    Li, Shanshan; Zhou, Xiaotian; Wang, Cheng-Xiang; Yuan, Dongfeng; Zhang, Wensheng

    2017-07-04

    In this paper, we propose to combine Orthogonal Frequency Division Multiplexing-Interleave Division Multiple Access (OFDM-IDMA) with Simultaneous Wireless Information and Power Transfer (SWIPT), resulting in SWIPT aided OFDM-IDMA scheme for power-limited sensor networks. In the proposed system, the Receive Node (RN) applies Power Splitting (PS) to coordinate the Energy Harvesting (EH) and Information Decoding (ID) process, where the harvested energy is utilized to guarantee the iterative Multi-User Detection (MUD) of IDMA to work under sufficient number of iterations. Our objective is to minimize the total transmit power of Source Node (SN), while satisfying the requirements of both minimum harvested energy and Bit Error Rate (BER) performance from individual receive nodes. We formulate such a problem as a joint power allocation and splitting one, where the iteration number of MUD is also taken into consideration as the key parameter to affect both EH and ID constraints. To solve it, a sub-optimal algorithm is proposed to determine the power profile, PS ratio and iteration number of MUD in an iterative manner. Simulation results verify that the proposed algorithm can provide significant performance improvement.

  1. Joint Transmit Power Allocation and Splitting for SWIPT Aided OFDM-IDMA in Wireless Sensor Networks

    Science.gov (United States)

    Li, Shanshan; Zhou, Xiaotian; Wang, Cheng-Xiang; Yuan, Dongfeng; Zhang, Wensheng

    2017-01-01

    In this paper, we propose to combine Orthogonal Frequency Division Multiplexing-Interleave Division Multiple Access (OFDM-IDMA) with Simultaneous Wireless Information and Power Transfer (SWIPT), resulting in SWIPT aided OFDM-IDMA scheme for power-limited sensor networks. In the proposed system, the Receive Node (RN) applies Power Splitting (PS) to coordinate the Energy Harvesting (EH) and Information Decoding (ID) process, where the harvested energy is utilized to guarantee the iterative Multi-User Detection (MUD) of IDMA to work under sufficient number of iterations. Our objective is to minimize the total transmit power of Source Node (SN), while satisfying the requirements of both minimum harvested energy and Bit Error Rate (BER) performance from individual receive nodes. We formulate such a problem as a joint power allocation and splitting one, where the iteration number of MUD is also taken into consideration as the key parameter to affect both EH and ID constraints. To solve it, a sub-optimal algorithm is proposed to determine the power profile, PS ratio and iteration number of MUD in an iterative manner. Simulation results verify that the proposed algorithm can provide significant performance improvement. PMID:28677636

  2. Development of a decision aid for cardiopulmonary resuscitation and invasive mechanical ventilation in the intensive care unit employing user-centered design and a wiki platform for rapid prototyping.

    Science.gov (United States)

    Plaisance, Ariane; Witteman, Holly O; LeBlanc, Annie; Kryworuchko, Jennifer; Heyland, Daren Keith; Ebell, Mark H; Blair, Louisa; Tapp, Diane; Dupuis, Audrey; Lavoie-Bérard, Carole-Anne; McGinn, Carrie Anna; Légaré, France; Archambault, Patrick Michel

    2018-01-01

    Upon admission to an intensive care unit (ICU), all patients should discuss their goals of care and express their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. To adapt an existing decision aid about CPR to create a wiki-based decision aid individually adapted to each patient's risk factors; and to document the use of a wiki platform for this purpose. We conducted three weeks of ethnographic observation in our ICU to observe intensivists and patients discussing goals of care and to identify their needs regarding decision making. We interviewed intensivists individually. Then we conducted three rounds of rapid prototyping involving 15 patients and 11 health professionals. We recorded and analyzed all discussions, interviews and comments, and collected sociodemographic data. Using a wiki, a website that allows multiple users to contribute or edit content, we adapted the decision aid accordingly and added the Good Outcome Following Attempted Resuscitation (GO-FAR) prediction rule calculator. We added discussion of invasive mechanical ventilation. The final decision aid comprises values clarification, risks and benefits of CPR and invasive mechanical ventilation, statistics about CPR, and a synthesis section. We added the GO-FAR prediction calculator as an online adjunct to the decision aid. Although three rounds of rapid prototyping simplified the information in the decision aid, 60% (n = 3/5) of the patients involved in the last cycle still did not understand its purpose. Wikis and user-centered design can be used to adapt decision aids to users' needs and local contexts. Our wiki platform allows other centers to adapt our tools, reducing duplication and accelerating scale-up. Physicians need training in shared decision making skills about goals of care and in using the

  3. [The adaptation and validation to Spanish of the questionnaire Aid to Capacity Evaluation (ACE), for the assessment of the ability of patients in medical decision-making].

    Science.gov (United States)

    Moraleda Barba, Sandra; Ballesta Rodríguez, M Isabel; Delgado Quero, Antonio Luis; Lietor Villajos, Norberto; Moreno Corredor, Andrés; Delgado Rodríguez, Miguel

    2015-03-01

    To adapt and validate the Spanish version of the Aid to Capacity Evaluation scale, designed to assess the capacity of the adult in medical decision-making, both in diagnosis and treatment processes. Observational study of prospective validation. Primary and hospital care of the basic health area of Jaen. One hundred twenty-nine patients. Questionnaire which included sociodemographic variables, concerning the decision (scope, type of decision, the need for written informed consent), assessment of the capacity to the Aid to Capacity Evaluation scale and other related comorbidity (hearing loss, alcoholism, cognitive level variables with the Mini-Mental State Examination and depression by Goldberg or Yesavage test). The tool is considered viable. The conclusions of the expert panel were favorable. The result of the criteria' validity, comparing the results with the assessment of the experts (forensic and psychiatrist) was very satisfying (P<.001). The intra-observer reliability was low (kappa=0,135). Interobserver reliability remained high (kappa=0.74). The internal consistency was awarded an alpha of Cronbach's 0,645 for the reduced model of 6 items. The Aid to Capacity Evaluation scale was adapted to Spanish, demonstrating adequate internal consistency and construct validity. Its use in clinical practice could contribute to the identification of patients unable to make a particular medical decision and/or to give an informed consent. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  4. Integrative modelling of the influence of MAPK network on cancer cell fate decision.

    Directory of Open Access Journals (Sweden)

    Luca Grieco

    2013-10-01

    Full Text Available The Mitogen-Activated Protein Kinase (MAPK network consists of tightly interconnected signalling pathways involved in diverse cellular processes, such as cell cycle, survival, apoptosis and differentiation. Although several studies reported the involvement of these signalling cascades in cancer deregulations, the precise mechanisms underlying their influence on the balance between cell proliferation and cell death (cell fate decision in pathological circumstances remain elusive. Based on an extensive analysis of published data, we have built a comprehensive and generic reaction map for the MAPK signalling network, using CellDesigner software. In order to explore the MAPK responses to different stimuli and better understand their contributions to cell fate decision, we have considered the most crucial components and interactions and encoded them into a logical model, using the software GINsim. Our logical model analysis particularly focuses on urinary bladder cancer, where MAPK network deregulations have often been associated with specific phenotypes. To cope with the combinatorial explosion of the number of states, we have applied novel algorithms for model reduction and for the compression of state transition graphs, both implemented into the software GINsim. The results of systematic simulations for different signal combinations and network perturbations were found globally coherent with published data. In silico experiments further enabled us to delineate the roles of specific components, cross-talks and regulatory feedbacks in cell fate decision. Finally, tentative proliferative or anti-proliferative mechanisms can be connected with established bladder cancer deregulations, namely Epidermal Growth Factor Receptor (EGFR over-expression and Fibroblast Growth Factor Receptor 3 (FGFR3 activating mutations.

  5. Providing Quantitative Information and a Nudge to Undergo Stool Testing in a Colorectal Cancer Screening Decision Aid: A Randomized Clinical Trial.

    Science.gov (United States)

    Schwartz, Peter H; Perkins, Susan M; Schmidt, Karen K; Muriello, Paul F; Althouse, Sandra; Rawl, Susan M

    2017-08-01

    Guidelines recommend that patient decision aids should provide quantitative information about probabilities of potential outcomes, but the impact of this information is unknown. Behavioral economics suggests that patients confused by quantitative information could benefit from a "nudge" towards one option. We conducted a pilot randomized trial to estimate the effect sizes of presenting quantitative information and a nudge. Primary care patients (n = 213) eligible for colorectal cancer screening viewed basic screening information and were randomized to view (a) quantitative information (quantitative module), (b) a nudge towards stool testing with the fecal immunochemical test (FIT) (nudge module), (c) neither a nor b, or (d) both a and b. Outcome measures were perceived colorectal cancer risk, screening intent, preferred test, and decision conflict, measured before and after viewing the decision aid, and screening behavior at 6 months. Patients viewing the quantitative module were more likely to be screened than those who did not ( P = 0.012). Patients viewing the nudge module had a greater increase in perceived colorectal cancer risk than those who did not ( P = 0.041). Those viewing the quantitative module had a smaller increase in perceived risk than those who did not ( P = 0.046), and the effect was moderated by numeracy. Among patients with high numeracy who did not view the nudge module, those who viewed the quantitative module had a greater increase in intent to undergo FIT ( P = 0.028) than did those who did not. The limitations of this study were the limited sample size and single healthcare system. Adding quantitative information to a decision aid increased uptake of colorectal cancer screening, while adding a nudge to undergo FIT did not increase uptake. Further research on quantitative information in decision aids is warranted.

  6. A Decision Support System For Equipment Allocation In A Telemedicine Referral Network

    Directory of Open Access Journals (Sweden)

    Treurnicht, Maria J.

    2014-05-01

    Full Text Available Telemedicine applications have had much success in strengthening health systems worldwide. Unfortunately, many systems are implemented without decisions based on proper needs assessments. In South Africa, this technology push approach has led to a large amount of equipment standing dormant. It is proposed that the potential of telemedicine be measured prior to implementation, thus pulling the technology towards a clinical need. A decision support system is developed that uses health informatics and computational intelligence to determine the need for telemedicine and to allocate equipment in a network of facilities to achieve the best cost benefit. The system facilitates the collection and storage of electronic health record (EHR data in a data warehouse. A linear programming model is used with a genetic algorithm. The system was developed and tested for the South African public health sector, using data from 27 hospitals in the Western Cape Province. Results have shown that if telemedicine workstations with specific peripheral equipment, as determined by the algorithm, were implemented in the given period, an estimated R8.7 million in referral costs could have been saved for the 27 hospitals. Thus the case study provided evidence for the benefits of implementation in the chosen network of hospitals. This new application of health informatics could provide telemedicine management with a useful tool for making implementation decisions based on evidence. Future work would include the development of similar systems for other markets.

  7. Influence of Acoustic Feedback on the Learning Strategies of Neural Network-Based Sound Classifiers in Digital Hearing Aids

    Directory of Open Access Journals (Sweden)

    Lorena Álvarez

    2009-01-01

    Full Text Available Sound classifiers embedded in digital hearing aids are usually designed by using sound databases that do not include the distortions associated to the feedback that often occurs when these devices have to work at high gain and low gain margin to oscillation. The consequence is that the classifier learns inappropriate sound patterns. In this paper we explore the feasibility of using different sound databases (generated according to 18 configurations of real patients, and a variety of learning strategies for neural networks in the effort of reducing the probability of erroneous classification. The experimental work basically points out that the proposed methods assist the neural network-based classifier in reducing its error probability in more than 18%. This helps enhance the elderly user's comfort: the hearing aid automatically selects, with higher success probability, the program that is best adapted to the changing acoustic environment the user is facing.

  8. Fuzzy bi-criteria decision making approach for supplier selection and distribution network planning in supply chain management

    DEFF Research Database (Denmark)

    Gandhi, Kanika; Govindan, Kannan; Jha, P. C.

    2016-01-01

    selection process is carried out on the bases of multi factors therefore it is considered as a multi criteria decision problem. The model presented in the paper is using the analytic network process (ANP), a multi criteria decision making technique for supplier selection. To obtain the best coordination...

  9. Optimization of Network Topology in Computer-Aided Detection Schemes Using Phased Searching with NEAT in a Time-Scaled Framework.

    Science.gov (United States)

    Tan, Maxine; Pu, Jiantao; Zheng, Bin

    2014-01-01

    In the field of computer-aided mammographic mass detection, many different features and classifiers have been tested. Frequently, the relevant features and optimal topology for the artificial neural network (ANN)-based approaches at the classification stage are unknown, and thus determined by trial-and-error experiments. In this study, we analyzed a classifier that evolves ANNs using genetic algorithms (GAs), which combines feature selection with the learning task. The classifier named "Phased Searching with NEAT in a Time-Scaled Framework" was analyzed using a dataset with 800 malignant and 800 normal tissue regions in a 10-fold cross-validation framework. The classification performance measured by the area under a receiver operating characteristic (ROC) curve was 0.856 ± 0.029. The result was also compared with four other well-established classifiers that include fixed-topology ANNs, support vector machines (SVMs), linear discriminant analysis (LDA), and bagged decision trees. The results show that Phased Searching outperformed the LDA and bagged decision tree classifiers, and was only significantly outperformed by SVM. Furthermore, the Phased Searching method required fewer features and discarded superfluous structure or topology, thus incurring a lower feature computational and training and validation time requirement. Analyses performed on the network complexities evolved by Phased Searching indicate that it can evolve optimal network topologies based on its complexification and simplification parameter selection process. From the results, the study also concluded that the three classifiers - SVM, fixed-topology ANN, and Phased Searching with NeuroEvolution of Augmenting Topologies (NEAT) in a Time-Scaled Framework - are performing comparably well in our mammographic mass detection scheme.

  10. Overview of Aro Program on Network Science for Human Decision Making

    Science.gov (United States)

    West, Bruce J.

    This program brings together researchers from disparate disciplines to work on a complex research problem that defies confinement within any single discipline. Consequently, not only are new and rewarding solutions sought and obtained for a problem of importance to society and the Army, that is, the human dimension of complex networks, but, in addition, collaborations are established that would not otherwise have formed given the traditional disciplinary compartmentalization of research. This program develops the basic research foundation of a science of networks supporting the linkage between the physical and human (cognitive and social) domains as they relate to human decision making. The strategy is to extend the recent methods of non-equilibrium statistical physics to non-stationary, renewal stochastic processes that appear to be characteristic of the interactions among nodes in complex networks. We also pursue understanding of the phenomenon of synchronization, whose mathematical formulation has recently provided insight into how complex networks reach accommodation and cooperation. The theoretical analyses of complex networks, although mathematically rigorous, often elude analytic solutions and require computer simulation and computation to analyze the underlying dynamic process.

  11. Using Neural Networks in Decision Making for a Reconfigurable Electro Mechanical Actuator (EMA)

    Science.gov (United States)

    Latino, Carl D.

    2001-01-01

    The objectives of this project were to demonstrate applicability and advantages of a neural network approach for evaluating the performance of an electro-mechanical actuator (EMA). The EMA in question was intended for the X-37 Advanced Technology Vehicle. It will have redundant components for safety and reliability. The neural networks for this application are to monitor the operation of the redundant electronics that control the actuator in real time and decide on the operating configuration. The system we proposed consists of the actuator, sensors, control circuitry and dedicated (embedded) processors. The main purpose of the study was to develop suitable hardware and neural network capable of allowing real time reconfiguration decisions to be made. This approach was to be compared to other methods such as fuzzy logic and knowledge based systems considered for the same application. Over the course of the project a more general objective was the identification of the other neural network applications and the education of interested NASA personnel on the topic of Neural Networks.

  12. Bandwidth variable transceivers with artificial neural network-aided provisioning and capacity improvement capabilities in meshed optical networks with cascaded ROADM filtering

    Science.gov (United States)

    Zhou, Xingyu; Zhuge, Qunbi; Qiu, Meng; Xiang, Meng; Zhang, Fangyuan; Wu, Baojian; Qiu, Kun; Plant, David V.

    2018-02-01

    We investigate the capacity improvement achieved by bandwidth variable transceivers (BVT) in meshed optical networks with cascaded ROADM filtering at fixed channel spacing, and then propose an artificial neural network (ANN)-aided provisioning scheme to select optimal symbol rate and modulation format for the BVTs in this scenario. Compared with a fixed symbol rate transceiver with standard QAMs, it is shown by both experiments and simulations that BVTs can increase the average capacity by more than 17%. The ANN-aided BVT provisioning method uses parameters monitored from a coherent receiver and then employs a trained ANN to transform these parameters into the desired configuration. It is verified by simulation that the BVT with the proposed provisioning method can approach the upper limit of the system capacity obtained by brute-force search under various degrees of flexibilities.

  13. Using Social Network Analysis to Evaluate Health-Related Adaptation Decision-Making in Cambodia

    Directory of Open Access Journals (Sweden)

    Kathryn J. Bowen

    2014-01-01

    Full Text Available Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or ‘shadow networks’ in the context of climate change adaptation policy and activities. The health governance ‘map’ in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes.

  14. Computing by Robust Transience: How the Fronto-Parietal Network Performs Sequential, Category-Based Decisions.

    Science.gov (United States)

    Chaisangmongkon, Warasinee; Swaminathan, Sruthi K; Freedman, David J; Wang, Xiao-Jing

    2017-03-22

    Decision making involves dynamic interplay between internal judgements and external perception, which has been investigated in delayed match-to-category (DMC) experiments. Our analysis of neural recordings shows that, during DMC tasks, LIP and PFC neurons demonstrate mixed, time-varying, and heterogeneous selectivity, but previous theoretical work has not established the link between these neural characteristics and population-level computations. We trained a recurrent network model to perform DMC tasks and found that the model can remarkably reproduce key features of neuronal selectivity at the single-neuron and population levels. Analysis of the trained networks elucidates that robust transient trajectories of the neural population are the key driver of sequential categorical decisions. The directions of trajectories are governed by network self-organized connectivity, defining a "neural landscape" consisting of a task-tailored arrangement of slow states and dynamical tunnels. With this model, we can identify functionally relevant circuit motifs and generalize the framework to solve other categorization tasks. Published by Elsevier Inc.

  15. Using Social Network Analysis to Evaluate Health-Related Adaptation Decision-Making in Cambodia

    Science.gov (United States)

    Bowen, Kathryn J.; Alexander, Damon; Miller, Fiona; Dany, Va

    2014-01-01

    Climate change adaptation in the health sector requires decisions across sectors, levels of government, and organisations. The networks that link these different institutions, and the relationships among people within these networks, are therefore critical influences on the nature of adaptive responses to climate change in the health sector. This study uses social network research to identify key organisational players engaged in developing health-related adaptation activities in Cambodia. It finds that strong partnerships are reported as developing across sectors and different types of organisations in relation to the health risks from climate change. Government ministries are influential organisations, whereas donors, development banks and non-government organisations do not appear to be as influential in the development of adaptation policy in the health sector. Finally, the study highlights the importance of informal partnerships (or ‘shadow networks’) in the context of climate change adaptation policy and activities. The health governance ‘map’ in relation to health and climate change adaptation that is developed in this paper is a novel way of identifying organisations that are perceived as key agents in the decision-making process, and it holds substantial benefits for both understanding and intervening in a broad range of climate change-related policy problems where collaboration is paramount for successful outcomes. PMID:24487452

  16. Transcalar networks for policy transfer and implementation: the case of global health policies for malaria and HIV/AIDS in Cameroon.

    Science.gov (United States)

    Ngoasong, Michael Zisuh

    2011-01-01

    This paper explores the nature and type of policy transfer promoted by global health partnerships to facilitate access to medication in Cameroon and the associated implementation challenges. Using concepts from policy transfer, multi-level governance and the politics of scale, the paper conceptualizes the social spaces (global-national-local linkages) through which global health policies are negotiated as transcalar networks. The framework is used to analyse policy documents, technical and media reports and journal articles focusing on two global health partnerships (GHPs)-Roll Back Malaria and the Accelerating Access Initiative-in Cameroon. Both GHPs helped to create the national Malaria and HIV/AIDS programmes in Cameroon, respectively. Global policies are negotiated through dialogue processes involving global, national and local partners who constitute the national HIV/AIDS and malaria committees. Successful policy transfer is evident from the consensual nature of decision-making. Analysis of policy implementation reveals that GHPs offer a 'technical fix' based on specific medical intervention programmes with a relatively limited focus on disease prevention. The GHP approach imposes new governance challenges due to policy resistance strategies (strategic interests of international agencies and country-specific challenges). Evidence of this is seen in the existence of several overlapping programmes and initiatives that distort accountability and governance mechanisms defined by the national committees. Finally, the implications of these challenges for achieving access to medication are discussed.

  17. Reducing Spectrum Handoffs and Energy Switching Consumption of MADM-Based Decisions in Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    Rafael Aguilar-Gonzalez

    2016-01-01

    Full Text Available In a cognitive radio network (CRN, the number of spectrum handoffs increases energy consumption of cognitive (or secondary users due to the channel switching process. This might limit the operation of the CRN, especially in scenarios where secondary users terminals are battery-powered. Thus, reducing the number of times a cognitive user involved in a transmission switch to different spectrum holes is required to increase battery life-time. In this regard, available spectrum holes possess different attributes (e.g., bandwidth that can be exploited to satisfy specific secondary users requirements (i.e., connection profile for data transmission while saving energy. Here, three multiple attribute decision-making (MADM algorithms for the spectrum decision functionality are evaluated using real spectrum measurements of TV bands. This is performed by proposing six decision parameters, which are extracted from the spectrum data to characterize its suitability. Then, these are used as inputs of the MADM algorithms to select the most suitable spectrum hole for a cognitive user. Thus, an enhanced MADM-based decision process is proposed to reduce the number of handoffs considering energy consumption due to channel switching (ECCS. Results quantify savings from 30% to 90% in ECCS and spectrum handoffs reductions from 47% to 90%.

  18. Combining data and meta-analysis to build Bayesian networks for clinical decision support.

    Science.gov (United States)

    Yet, Barbaros; Perkins, Zane B; Rasmussen, Todd E; Tai, Nigel R M; Marsh, D William R

    2014-12-01

    Complex clinical decisions require the decision maker to evaluate multiple factors that may interact with each other. Many clinical studies, however, report 'univariate' relations between a single factor and outcome. Such univariate statistics are often insufficient to provide useful support for complex clinical decisions even when they are pooled using meta-analysis. More useful decision support could be provided by evidence-based models that take the interaction between factors into account. In this paper, we propose a method of integrating the univariate results of a meta-analysis with a clinical dataset and expert knowledge to construct multivariate Bayesian network (BN) models. The technique reduces the size of the dataset needed to learn the parameters of a model of a given complexity. Supplementing the data with the meta-analysis results avoids the need to either simplify the model - ignoring some complexities of the problem - or to gather more data. The method is illustrated by a clinical case study into the prediction of the viability of severely injured lower extremities. The case study illustrates the advantages of integrating combined evidence into BN development: the BN developed using our method outperformed four different data-driven structure learning methods, and a well-known scoring model (MESS) in this domain. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. A cortical network model of cognitive and emotional influences in human decision making.

    Science.gov (United States)

    Nazir, Azadeh Hassannejad; Liljenström, Hans

    2015-10-01

    Decision making (DM)(2) is a complex process that appears to involve several brain structures. In particular, amygdala, orbitofrontal cortex (OFC) and lateral prefrontal cortex (LPFC) seem to be essential in human decision making, where both emotional and cognitive aspects are taken into account. In this paper, we present a computational network model representing the neural information processing of DM, from perception to behavior. We model the population dynamics of the three neural structures (amygdala, OFC and LPFC), as well as their interaction. In our model, the neurodynamic activity of amygdala and OFC represents the neural correlates of secondary emotion, while the activity of certain neural populations in OFC alone represents the outcome expectancy of different options. The cognitive/rational aspect of DM is associated with LPFC. Our model is intended to give insights on the emotional and cognitive processes involved in DM under various internal and external contexts. Different options for actions are represented by the oscillatory activity of cell assemblies, which may change due to experience and learning. Knowledge and experience of the outcome of our decisions and actions can eventually result in changes in our neural structures, attitudes and behaviors. Simulation results may have implications for how we make decisions for our individual actions, as well as for societal choices, where we take examples from transport and its impact on CO2 emissions and climate change. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. High-frequency oscillations in distributed neural networks reveal the dynamics of human decision making

    Directory of Open Access Journals (Sweden)

    Adrian G Guggisberg

    2008-03-01

    Full Text Available We examine the relative timing of numerous brain regions involved in human decisions that are based on external criteria, learned information, personal preferences, or unconstrained internal considerations. Using magnetoencephalography (MEG and advanced signal analysis techniques, we were able to non-invasively reconstruct oscillations of distributed neural networks in the high-gamma frequency band (60–150 Hz. The time course of the observed neural activity suggested that two-alternative forced choice tasks are processed in four overlapping stages: processing of sensory input, option evaluation, intention formation, and action execution. Visual areas are activated fi rst, and show recurring activations throughout the entire decision process. The temporo-occipital junction and the intraparietal sulcus are active during evaluation of external values of the options, 250–500 ms after stimulus presentation. Simultaneously, personal preference is mediated by cortical midline structures. Subsequently, the posterior parietal and superior occipital cortices appear to encode intention, with different subregions being responsible for different types of choice. The cerebellum and inferior parietal cortex are recruited for internal generation of decisions and actions, when all options have the same value. Action execution was accompanied by activation peaks in the contralateral motor cortex. These results suggest that high-gamma oscillations as recorded by MEG allow a reliable reconstruction of decision processes with excellent spatiotemporal resolution.

  1. An Evaluation of Feral Cat Management Options Using a Decision Analysis Network

    Directory of Open Access Journals (Sweden)

    Kerrie Anne T. Loyd

    2010-12-01

    Full Text Available The feral domestic cat (Felis catus is a predatory invasive species with documented negative effects on native wildlife. The issue of appropriate and acceptable feral cat management is a matter of contentious debate in cities and states across the United States due to concerns for wildlife conservation, cat welfare, and public health. Common management strategies include: Trap-Neuter-Release, Trap-Neuter-Release with removal of kittens for adoption and Trap-Euthanize. Very little empirical evidence exists relevant to the efficacy of alternative options and a model-based approach is needed to predict population response and extend calculations to impact on wildlife. We have created a structured decision support model representing multiple stakeholder groups to facilitate the coordinated management of feral cats. We used a probabilistic graphical model (a Bayesian Belief Network to evaluate and rank alternative management decisions according to efficacy, societal preferences, and cost. Our model predicts that Trap-Neuter-Release strategies would be optimal management decisions for small local populations of less than fifty cats while Trap-Euthanize would be the optimal management decision for populations greater than 50 cats. Removal is predicted to reduce feral cat populations quickly and prevent cats from taking a large number of wildlife prey.

  2. Sharing clinical decisions for multimorbidity case management using social network and open-source tools.

    Science.gov (United States)

    Martínez-García, Alicia; Moreno-Conde, Alberto; Jódar-Sánchez, Francisco; Leal, Sandra; Parra, Carlos

    2013-12-01

    Social networks applied through Web 2.0 tools have gained importance in health domain, because they produce improvements on the communication and coordination capabilities among health professionals. This is highly relevant for multimorbidity patients care because there is a large number of health professionals in charge of patient care, and this requires to obtain clinical consensus in their decisions. Our objective is to develop a tool for collaborative work among health professionals for multimorbidity patient care. We describe the architecture to incorporate decision support functionalities in a social network tool to enable the adoption of shared decisions among health professionals from different care levels. As part of the first stage of the project, this paper describes the results obtained in a pilot study about acceptance and use of the social network component in our healthcare setting. At Virgen del Rocío University Hospital we have designed and developed the Shared Care Platform (SCP) to provide support in the continuity of care for multimorbidity patients. The SCP has two consecutively developed components: social network component, called Clinical Wall, and Clinical Decision Support (CDS) system. The Clinical Wall contains a record where health professionals are able to debate and define shared decisions. We conducted a pilot study to assess the use and acceptance of the SCP by healthcare professionals through questionnaire based on the theory of the Technology Acceptance Model. In March 2012 we released and deployed the SCP, but only with the social network component. The pilot project lasted 6 months in the hospital and 2 primary care centers. From March to September 2012 we created 16 records in the Clinical Wall, all with a high priority. A total of 10 professionals took part in the exchange of messages: 3 internists and 7 general practitioners generated 33 messages. 12 of the 16 record (75%) were answered by the destination health professionals

  3. A Wireless Sensor Network-Based Approach with Decision Support for Monitoring Lake Water Quality

    Directory of Open Access Journals (Sweden)

    Xiaoci Huang

    2015-11-01

    Full Text Available Online monitoring and water quality analysis of lakes are urgently needed. A feasible and effective approach is to use a Wireless Sensor Network (WSN. Lake water environments, like other real world environments, present many changing and unpredictable situations. To ensure flexibility in such an environment, the WSN node has to be prepared to deal with varying situations. This paper presents a WSN self-configuration approach for lake water quality monitoring. The approach is based on the integration of a semantic framework, where a reasoner can make decisions on the configuration of WSN services. We present a WSN ontology and the relevant water quality monitoring context information, which considers its suitability in a pervasive computing environment. We also propose a rule-based reasoning engine that is used to conduct decision support through reasoning techniques and context-awareness. To evaluate the approach, we conduct usability experiments and performance benchmarks.

  4. A Wireless Sensor Network-Based Approach with Decision Support for Monitoring Lake Water Quality.

    Science.gov (United States)

    Huang, Xiaoci; Yi, Jianjun; Chen, Shaoli; Zhu, Xiaomin

    2015-11-19

    Online monitoring and water quality analysis of lakes are urgently needed. A feasible and effective approach is to use a Wireless Sensor Network (WSN). Lake water environments, like other real world environments, present many changing and unpredictable situations. To ensure flexibility in such an environment, the WSN node has to be prepared to deal with varying situations. This paper presents a WSN self-configuration approach for lake water quality monitoring. The approach is based on the integration of a semantic framework, where a reasoner can make decisions on the configuration of WSN services. We present a WSN ontology and the relevant water quality monitoring context information, which considers its suitability in a pervasive computing environment. We also propose a rule-based reasoning engine that is used to conduct decision support through reasoning techniques and context-awareness. To evaluate the approach, we conduct usability experiments and performance benchmarks.

  5. Optimization of Management Decision by Network Method used for Chipboards Manufacturing

    Directory of Open Access Journals (Sweden)

    Ivan Cismaru

    2008-03-01

    Full Text Available The paper presents a method of an economic analyses through which the bases of the management decision may be set in order to optimize the chipboards manufacturing activity. The method is focused on the national and efficient capitalization of raw materials, as network rate assortments, and depending on the stocks situation within the store, to establish momently the optimal recipe to be implemented according to the manufacturing expenses and the profit implicitely, this recipe being variable in time depending on the supply possibilities.

  6. Pancreas Segmentation in MRI using Graph-Based Decision Fusion on Convolutional Neural Networks.

    Science.gov (United States)

    Cai, Jinzheng; Lu, Le; Zhang, Zizhao; Xing, Fuyong; Yang, Lin; Yin, Qian

    2016-10-01

    Automated pancreas segmentation in medical images is a prerequisite for many clinical applications, such as diabetes inspection, pancreatic cancer diagnosis, and surgical planing. In this paper, we formulate pancreas segmentation in magnetic resonance imaging (MRI) scans as a graph based decision fusion process combined with deep convolutional neural networks (CNN). Our approach conducts pancreatic detection and boundary segmentation with two types of CNN models respectively: 1) the tissue detection step to differentiate pancreas and non-pancreas tissue with spatial intensity context; 2) the boundary detection step to allocate the semantic boundaries of pancreas. Both detection results of the two networks are fused together as the initialization of a conditional random field (CRF) framework to obtain the final segmentation output. Our approach achieves the mean dice similarity coefficient (DSC) 76.1% with the standard deviation of 8.7% in a dataset containing 78 abdominal MRI scans. The proposed algorithm achieves the best results compared with other state of the arts.

  7. Study on Network Error Analysis and Locating based on Integrated Information Decision System

    Science.gov (United States)

    Yang, F.; Dong, Z. H.

    2017-10-01

    Integrated information decision system (IIDS) integrates multiple sub-system developed by many facilities, including almost hundred kinds of software, which provides with various services, such as email, short messages, drawing and sharing. Because the under-layer protocols are different, user standards are not unified, many errors are occurred during the stages of setup, configuration, and operation, which seriously affect the usage. Because the errors are various, which may be happened in different operation phases, stages, TCP/IP communication protocol layers, sub-system software, it is necessary to design a network error analysis and locating tool for IIDS to solve the above problems. This paper studies on network error analysis and locating based on IIDS, which provides strong theory and technology supports for the running and communicating of IIDS.

  8. Big Multidimensional Datasets Visualization Using Neural Networks – Efficient Decision Support

    Directory of Open Access Journals (Sweden)

    Gintautas Dzemyda

    2016-04-01

    Full Text Available Nowadays business information systems are thought of as decision-oriented systems supported by different types of subsystems. Multidimensional data visualization is an essential part of such systems. As datasets tend to be increasingly large, more effective ways are required to display, analyze and interpret information they contain. Most of the classical visualization methods are unsuitable for large datasets. This paper focuses on the artificial neural networks-based methods for visualization of big multidimensional datasets; namely,  on the approaches for the faster obtaining of visual results. The new strategy, which is identified by the decreased number of cycles of data reviews (passes of training data up to the only one, when training neural networks, is proposed. To test this strategy, the results of experiments, using two unsupervised learning methods on benchmark data, are briefly presented.

  9. Reversal of Alcohol-Induced Dysregulation in Dopamine Network Dynamics May Rescue Maladaptive Decision-making.

    Science.gov (United States)

    Schindler, Abigail G; Soden, Marta E; Zweifel, Larry S; Clark, Jeremy J

    2016-03-30

    Alcohol is the most commonly abused substance among adolescents, promoting the development of substance use disorders and compromised decision-making in adulthood. We have previously demonstrated, with a preclinical model in rodents, that adolescent alcohol use results in adult risk-taking behavior that positively correlates with phasic dopamine transmission in response to risky options, but the underlying mechanisms remain unknown. Here, we show that adolescent alcohol use may produce maladaptive decision-making through a disruption in dopamine network dynamics via increased GABAergic transmission within the ventral tegmental area (VTA). Indeed, we find that increased phasic dopamine signaling after adolescent alcohol use is attributable to a midbrain circuit, including the input from the pedunculopontine tegmentum to the VTA. Moreover, we demonstrate that VTA dopamine neurons from adult rats exhibit enhanced IPSCs after adolescent alcohol exposure corresponding to decreased basal dopamine levels in adulthood that negatively correlate with risk-taking. Building on these findings, we develop a model where increased inhibitory tone on dopamine neurons leads to a persistent decrease in tonic dopamine levels and results in a potentiation of stimulus-evoked phasic dopamine release that may drive risky choice behavior. Based on this model, we take a pharmacological approach to the reversal of risk-taking behavior through normalization of this pattern in dopamine transmission. These results isolate the underlying circuitry involved in alcohol-induced maladaptive decision-making and identify a novel therapeutic target. One of the primary problems resulting from chronic alcohol use is persistent, maladaptive decision-making that is associated with ongoing addiction vulnerability and relapse. Indeed, studies with the Iowa Gambling Task, a standard measure of risk-based decision-making, have reliably shown that alcohol-dependent individuals make riskier, more maladaptive

  10. Patient Acceptability of the Yorkshire Dialysis Decision Aid (YoDDA) Booklet: A Prospective Non-Randomized Comparison Study Across 6 Predialysis Services.

    Science.gov (United States)

    Winterbottom, Anna E; Gavaruzzi, Teresa; Mooney, Andrew; Wilkie, Martin; Davies, Simon J; Crane, Dennis; Tupling, Ken; Baxter, Paul D; Meads, David M; Mathers, Nigel; Bekker, Hilary L

    2016-01-01

    ♦ Patients are satisfied with their kidney care but want more support in making dialysis choices. Predialysis leaflets vary across services, with few being sufficient to enable patients' informed decision making. We describe the acceptability of a patient decision aid and feasibility of evaluating its effectiveness within usual predialysis practice. ♦ Prospective non-randomized comparison design, Usual Care or Usual Care Plus Yorkshire Dialysis Decision Aid Booklet (+YoDDA), in 6 referral centers (Yorkshire-Humber, UK) for patients with sustained deterioration of kidney function. Consenting (C) patients completed questionnaires after predialysis consultation (T1), and 6 weeks later (T2). Measures assessed YoDDA's utility to support patients' decisions and integration within usual care. ♦ Usual Care (n = 105) and +YoDDA (n = 84) participant characteristics were similar: male (62%), white (94%), age (mean = 62.6; standard deviation [SD] 14.4), kidney disease severity (glomerular filtration rate [eGFR] mean = 14.7; SD 3.7); decisional conflict was < 25; choice-preference for home versus hospital dialysis approximately 50:50. Patients valued receiving YoDDA, reading it on their own (96%), and sharing it with family (72%). The +YoDDA participants had higher scores for understanding kidney disease, reasoning about options, feeling in control, sharing their decision with family. Study engagement varied by center (estimated range 14 - 49%; mean 45%); participants varied in completion of decision quality measures. ♦ Receiving YoDDA as part of predialysis education was valued and useful to patients with worsening kidney disease. Integrating YoDDA actively within predialysis programs will meet clinical guidelines and patient need to support dialysis decision making in the context of patients' lifestyle. Copyright © 2016 International Society for Peritoneal Dialysis.

  11. Comparing the effect of a decision aid plus patient navigation with usual care on colorectal cancer screening completion in vulnerable populations: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Brenner, Alison T; Getrich, Christina M; Pignone, Michael; Rhyne, Robert L; Hoffman, Richard M; McWilliams, Andrew; de Hernandez, Brisa Urquieta; Weaver, Mark A; Tapp, Hazel; Harbi, Khalil; Reuland, Daniel

    2014-07-08

    Screening can reduce colorectal cancer (CRC) incidence and mortality. However, screening is underutilized in vulnerable patient populations, particularly among Latinos. Patient-directed decision aids can increase CRC screening knowledge, self-efficacy, and intent; however, their effect on actual screening test completion tends to be modest. This is probably because decision aids do not address some of the patient-specific barriers that prevent successful completion of CRC screening in these populations. These individual barriers might be addressed though patient navigation interventions. This study will test a combined decision aid and patient navigator intervention on screening completion in diverse populations of vulnerable primary care patients. We will conduct a multisite, randomized controlled trial with patient-level randomization. Planned enrollment is 300 patients aged 50 to 75 years at average CRC risk presenting for appointments at two primary clinics in North Carolina and New Mexico. Intervention participants will view a video decision aid immediately before the clinic visit. The 14 to 16 minute video presents information about fecal occult blood tests and colonoscopy and will be viewed on a portable computer tablet in English or Spanish. Clinic-based patient navigators are bilingual and bicultural and will provide both face-to-face and telephone-based navigation. Control participants will view an unrelated food safety video and receive usual care. The primary outcome is completion of a CRC screening test at six months. Planned subgroup analyses include examining intervention effectiveness in Latinos, who will be oversampled. Secondarily, the trial will evaluate the intervention effects on knowledge of CRC screening, self-efficacy, intent, and patient-provider communication. The study will also examine whether patient ethnicity, acculturation, language preference, or health insurance status moderate the intervention effect on CRC screening. This

  12. Design and implementation of wireless dose logger network for radiological emergency decision support system

    Energy Technology Data Exchange (ETDEWEB)

    Gopalakrishnan, V.; Baskaran, R.; Venkatraman, B. [Radiation Impact Assessment Section, Radiological Safety Division, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam 603102 (India)

    2016-08-15

    A decision support system (DSS) is implemented in Radiological Safety Division, Indira Gandhi Centre for Atomic Research for providing guidance for emergency decision making in case of an inadvertent nuclear accident. Real time gamma dose rate measurement around the stack is used for estimating the radioactive release rate (source term) by using inverse calculation. Wireless gamma dose logging network is designed, implemented, and installed around the Madras Atomic Power Station reactor stack to continuously acquire the environmental gamma dose rate and the details are presented in the paper. The network uses XBee–Pro wireless modules and PSoC controller for wireless interfacing, and the data are logged at the base station. A LabView based program is developed to receive the data, display it on the Google Map, plot the data over the time scale, and register the data in a file to share with DSS software. The DSS at the base station evaluates the real time source term to assess radiation impact.

  13. Octopamine neuromodulatory effects on a social behavior decision-making network in Drosophila males.

    Directory of Open Access Journals (Sweden)

    Sarah J Certel

    2010-10-01

    Full Text Available Situations requiring rapid decision-making in response to dynamic environmental demands occur repeatedly in natural environments. Neuromodulation can offer important flexibility to the output of neural networks in coping with changing conditions, but the contribution of individual neuromodulatory neurons in social behavior networks remains relatively unknown. Here we manipulate the Drosophila octopaminergic system and assay changes in adult male decision-making in courtship and aggression paradigms. When the functional state of OA neural circuits is enhanced, males exhibit elevated courtship behavior towards other males in both behavioral contexts. Eliminating the expression of the male form of the neural sex determination factor, Fruitless (Fru(M, in three OA suboesophageal ganglia (SOG neurons also leads to increased male-male courtship behavior in these same contexts. We analyzed the fine anatomical structure through confocal examination of labeled single neurons to determine the arborization patterns of each of the three Fru(M-positive OA SOG neurons. These neurons send processes that display mirror symmetric, widely distributed arbors of endings within brain regions including the ventrolateral protocerebra, the SOG and the peri-esophageal complex. The results suggest that a small subset of OA neurons have the potential to provide male selective modulation of behavior at a single neuron level.

  14. Strategic rehabilitation planning of piped water networks using multi-criteria decision analysis.

    Science.gov (United States)

    Scholten, Lisa; Scheidegger, Andreas; Reichert, Peter; Maurer, Max; Mauer, Max; Lienert, Judit

    2014-02-01

    To overcome the difficulties of strategic asset management of water distribution networks, a pipe failure and a rehabilitation model are combined to predict the long-term performance of rehabilitation strategies. Bayesian parameter estimation is performed to calibrate the failure and replacement model based on a prior distribution inferred from three large water utilities in Switzerland. Multi-criteria decision analysis (MCDA) and scenario planning build the framework for evaluating 18 strategic rehabilitation alternatives under future uncertainty. Outcomes for three fundamental objectives (low costs, high reliability, and high intergenerational equity) are assessed. Exploitation of stochastic dominance concepts helps to identify twelve non-dominated alternatives and local sensitivity analysis of stakeholder preferences is used to rank them under four scenarios. Strategies with annual replacement of 1.5-2% of the network perform reasonably well under all scenarios. In contrast, the commonly used reactive replacement is not recommendable unless cost is the only relevant objective. Exemplified for a small Swiss water utility, this approach can readily be adapted to support strategic asset management for any utility size and based on objectives and preferences that matter to the respective decision makers. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Recognition of Protozoa and Metazoa using image analysis tools, discriminant analysis, neural networks and decision trees.

    Science.gov (United States)

    Ginoris, Y P; Amaral, A L; Nicolau, A; Coelho, M A Z; Ferreira, E C

    2007-07-09

    Protozoa and metazoa are considered good indicators of the treatment quality in activated sludge systems due to the fact that these organisms are fairly sensitive to physical, chemical and operational processes. Therefore, it is possible to establish close relationships between the predominance of certain species or groups of species and several operational parameters of the plant, such as the biotic indices, namely the Sludge Biotic Index (SBI). This procedure requires the identification, classification and enumeration of the different species, which is usually achieved manually implying both time and expertise availability. Digital image analysis combined with multivariate statistical techniques has proved to be a useful tool to classify and quantify organisms in an automatic and not subjective way. This work presents a semi-automatic image analysis procedure for protozoa and metazoa recognition developed in Matlab language. The obtained morphological descriptors were analyzed using discriminant analysis, neural network and decision trees multivariable statistical techniques to identify and classify each protozoan or metazoan. The obtained procedure was quite adequate for distinguishing between the non-sessile protozoa classes and also for the metazoa classes, with high values for the overall species recognition with the exception of sessile protozoa. In terms of the wastewater conditions assessment the obtained results were found to be suitable for the prediction of these conditions. Finally, the discriminant analysis and neural networks results were found to be quite similar whereas the decision trees technique was less appropriate.

  16. Gene expression profiles and protein–protein interaction network analysis in AIDS patients with HIV-associated encephalitis and dementia

    Directory of Open Access Journals (Sweden)

    Shityakov S

    2015-11-01

    Full Text Available Sergey Shityakov,1 Thomas Dandekar,2 Carola Förster1 1Department of Anesthesia and Critical Care, 2Department of Bioinformatics, University of Würzburg, Würzburg, Germany Abstract: Central nervous system dysfunction is an important cause of morbidity and mortality in patients with human immunodeficiency virus type 1 (HIV-1 infection and acquired immunodeficiency virus syndrome (AIDS. Patients with AIDS are usually affected by HIV-associated encephalitis (HIVE with viral replication limited to cells of monocyte origin. To examine the molecular mechanisms underlying HIVE-induced dementia, the GSE4755 Affymetrix data were obtained from the Gene Expression Omnibus database and the differentially expressed genes (DEGs between the samples from AIDS patients with and without apparent features of HIVE-induced dementia were identified. In addition, protein–protein interaction networks were constructed by mapping DEGs into protein–protein interaction data to identify the pathways that these DEGs are involved in. The results revealed that the expression of 1,528 DEGs is mainly involved in the immune response, regulation of cell proliferation, cellular response to inflammation, signal transduction, and viral replication cycle. Heat-shock protein alpha, class A member 1 (HSP90AA1, and fibronectin 1 were detected as hub nodes with degree values >130. In conclusion, the results indicate that HSP90A and fibronectin 1 play important roles in HIVE pathogenesis.Keywords: microarray, human immunodeficiency virus, differentially expressed genes, protein–protein interaction network, gene ontology, encephalitis, dementia

  17. An extreme events laboratory to provide network centric collaborative situation assessment and decision making

    Science.gov (United States)

    Panulla, Brian J.; More, Loretta D.; Shumaker, Wade R.; Jones, Michael D.; Hooper, Robert; Vernon, Jeffrey M.; Aungst, Stanley G.

    2009-05-01

    Rapid improvements in communications infrastructure and sophistication of commercial hand-held devices provide a major new source of information for assessing extreme situations such as environmental crises. In particular, ad hoc collections of humans can act as "soft sensors" to augment data collected by traditional sensors in a net-centric environment (in effect, "crowd-sourcing" observational data). A need exists to understand how to task such soft sensors, characterize their performance and fuse the data with traditional data sources. In order to quantitatively study such situations, as well as study distributed decision-making, we have developed an Extreme Events Laboratory (EEL) at The Pennsylvania State University. This facility provides a network-centric, collaborative situation assessment and decision-making capability by supporting experiments involving human observers, distributed decision making and cognition, and crisis management. The EEL spans the information chain from energy detection via sensors, human observations, signal and image processing, pattern recognition, statistical estimation, multi-sensor data fusion, visualization and analytics, and modeling and simulation. The EEL command center combines COTS and custom collaboration tools in innovative ways, providing capabilities such as geo-spatial visualization and dynamic mash-ups of multiple data sources. This paper describes the EEL and several on-going human-in-the-loop experiments aimed at understanding the new collective observation and analysis landscape.

  18. Orthogonal DF Cooperative Relay Networks with Multiple-SNR Thresholds and Multiple Hard-Decision Detections

    Directory of Open Access Journals (Sweden)

    Dian-Wu Yue

    2010-01-01

    Full Text Available This paper investigates a wireless cooperative relay network with multiple relays communicating with the destination over orthogonal channels. Proposed is a cooperative transmission scheme that employs two signal-to-noise ratio (SNR thresholds and multiple hard-decision detections (HDD at the destination. One SNR threshold is used to select transmitting relays, and the other threshold is used at the destination for detection. Then the destination simply combines all the hard-decision results and makes the final binary decision based on majority voting. Focusing on the decode-and-forward (DF relaying protocol, the average bit error probability is derived and diversity analysis is carried out. It is shown that the full diversity order can be achieved by setting appropriate thresholds even when the destination does not know the exact or average SNRs of the source-relay links. The performance analysis is further extended to multi-hop cooperation and/or with the presence of a direct link where multiple thresholds are needed. By combining the multiple-SNR threshold method with a selection of the best relaying link, a high spectral-efficiency cooperative transmission scheme is further presented. Simulation results verify the theoretical analysis and demonstrate performance advantage of our proposed schemes over the existing ones.

  19. The manual of strategic economic decision making using Bayesian belief networks to solve complex problems

    CERN Document Server

    Grover, Jeff

    2016-01-01

    This book is an extension of the author’s first book and serves as a guide and manual on how to specify and compute 2-, 3-, & 4-Event Bayesian Belief Networks (BBN). It walks the learner through the steps of fitting and solving fifty BBN numerically, using mathematical proof. The author wrote this book primarily for naïve learners and professionals, with a proof-based academic rigor. The author's first book on this topic, a primer introducing learners to the basic complexities and nuances associated with learning Bayes’ theory and inverse probability for the first time, was meant for non-statisticians unfamiliar with the theorem - as is this book. This new book expands upon that approach and is meant to be a prescriptive guide for building BBN and executive decision-making for students and professionals; intended so that decision-makers can invest their time and start using this inductive reasoning principle in their decision-making processes. It highlights the utility of an algorithm that served as ...

  20. Evaluating research and impact: a bibliometric analysis of research by the NIH/NIAID HIV/AIDS clinical trials networks.

    Directory of Open Access Journals (Sweden)

    Scott R Rosas

    2011-03-01

    Full Text Available Evaluative bibliometrics uses advanced techniques to assess the impact of scholarly work in the context of other scientific work and usually compares the relative scientific contributions of research groups or institutions. Using publications from the National Institute of Allergy and Infectious Diseases (NIAID HIV/AIDS extramural clinical trials networks, we assessed the presence, performance, and impact of papers published in 2006-2008. Through this approach, we sought to expand traditional bibliometric analyses beyond citation counts to include normative comparisons across journals and fields, visualization of co-authorship across the networks, and assess the inclusion of publications in reviews and syntheses. Specifically, we examined the research output of the networks in terms of the a presence of papers in the scientific journal hierarchy ranked on the basis of journal influence measures, b performance of publications on traditional bibliometric measures, and c impact of publications in comparisons with similar publications worldwide, adjusted for journals and fields. We also examined collaboration and interdisciplinarity across the initiative, through network analysis and modeling of co-authorship patterns. Finally, we explored the uptake of network produced publications in research reviews and syntheses. Overall, the results suggest the networks are producing highly recognized work, engaging in extensive interdisciplinary collaborations, and having an impact across several areas of HIV-related science. The strengths and limitations of the approach for evaluation and monitoring research initiatives are discussed.

  1. Evaluating Research and Impact: A Bibliometric Analysis of Research by the NIH/NIAID HIV/AIDS Clinical Trials Networks

    Science.gov (United States)

    Rosas, Scott R.; Kagan, Jonathan M.; Schouten, Jeffrey T.; Slack, Perry A.; Trochim, William M. K.

    2011-01-01

    Evaluative bibliometrics uses advanced techniques to assess the impact of scholarly work in the context of other scientific work and usually compares the relative scientific contributions of research groups or institutions. Using publications from the National Institute of Allergy and Infectious Diseases (NIAID) HIV/AIDS extramural clinical trials networks, we assessed the presence, performance, and impact of papers published in 2006–2008. Through this approach, we sought to expand traditional bibliometric analyses beyond citation counts to include normative comparisons across journals and fields, visualization of co-authorship across the networks, and assess the inclusion of publications in reviews and syntheses. Specifically, we examined the research output of the networks in terms of the a) presence of papers in the scientific journal hierarchy ranked on the basis of journal influence measures, b) performance of publications on traditional bibliometric measures, and c) impact of publications in comparisons with similar publications worldwide, adjusted for journals and fields. We also examined collaboration and interdisciplinarity across the initiative, through network analysis and modeling of co-authorship patterns. Finally, we explored the uptake of network produced publications in research reviews and syntheses. Overall, the results suggest the networks are producing highly recognized work, engaging in extensive interdisciplinary collaborations, and having an impact across several areas of HIV-related science. The strengths and limitations of the approach for evaluation and monitoring research initiatives are discussed. PMID:21394198

  2. Application of Bayesian Decision Networks for sustainable groundwater resources management in semi-arid regions

    Science.gov (United States)

    Mohajerani, Hadis; Casper, Markus; Kholghi, Majid; Mosaedi, Abolfazl; Farmani, Raziyeh; Saadoddin, Amir; Meftah Halaghi, Mehdi

    2017-04-01

    This paper presents management of groundwater resource using a Bayesian Decision Network (BDN). The Kordkooy region in North East of Iran has been selected as study area. The region has been divided to three parts based on Transmissivity (T) and Electrical Conductivity (EC) values. The BDN parameters (prior probabilities and Conditional Probability Tables (CPTs) have been identified for each of the three zones. Three groups of management scenarios have been developed based on the two decision variables including "Crop pattern" and "Domestic water demand" across the three zones of the study area: 1) status quo management for all three zones representing current conditions. 2) the effect of change in cropping pattern on management endpoints and 3) the effect of increasing domestic water demand on management endpoints in the future. The outcomes arising from implementing each scenario have been predicted using the BDN for each of the zones. Results reveal that probability of drawdown in groundwater levels of southern areas is relatively high compared with other zones. Groundwater withdrawal from northern and northwestern areas of the study area should be limited due to the groundwater quality problems associated with shallow groundwater of these two zones. The ability of the Bayesian Decision Network to take into account key uncertainties in natural resources and performing a meaningful analysis in cases where there is not vast amount of information and observed data available -even based partly on expert opinion- emphasizes the advantage of this approach in groundwater resources management process, as limited data availability was a serious problem faced by groundwater resources of the study area.

  3. Language differences in the brain network for reading in naturalistic story reading and lexical decision.

    Science.gov (United States)

    Wang, Xiaojuan; Yang, Jianfeng; Yang, Jie; Mencl, W Einar; Shu, Hua; Zevin, Jason David

    2015-01-01

    Differences in how writing systems represent language raise important questions about whether there could be a universal functional architecture for reading across languages. In order to study potential language differences in the neural networks that support reading skill, we collected fMRI data from readers of alphabetic (English) and morpho-syllabic (Chinese) writing systems during two reading tasks. In one, participants read short stories under conditions that approximate natural reading, and in the other, participants decided whether individual stimuli were real words or not. Prior work comparing these two writing systems has overwhelmingly used meta-linguistic tasks, generally supporting the conclusion that the reading system is organized differently for skilled readers of Chinese and English. We observed that language differences in the reading network were greatly dependent on task. In lexical decision, a pattern consistent with prior research was observed in which the Middle Frontal Gyrus (MFG) and right Fusiform Gyrus (rFFG) were more active for Chinese than for English, whereas the posterior temporal sulcus was more active for English than for Chinese. We found a very different pattern of language effects in a naturalistic reading paradigm, during which significant differences were only observed in visual regions not typically considered specific to the reading network, and the middle temporal gyrus, which is thought to be important for direct mapping of orthography to semantics. Indeed, in areas that are often discussed as supporting distinct cognitive or linguistic functions between the two languages, we observed interaction. Specifically, language differences were most pronounced in MFG and rFFG during the lexical decision task, whereas no language differences were observed in these areas during silent reading of text for comprehension.

  4. The role of the social network in contraceptive decision-making among young, African American and Latina women.

    Science.gov (United States)

    Yee, Lynn; Simon, Melissa

    2010-10-01

    Understanding reasons for contraception decisions is critical to improving our ability to reduce rates of unintended pregnancies. We used an in-depth qualitative approach to examine the contraceptive decision-making process, with special attention to the role of the social network, among a group of young, postpartum urban minority women. Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women. In-person one-on-one interviews were then reviewed for themes using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. In this cohort of African American (63%) and Hispanic (37%) women (median age, 26), 73% had unplanned pregnancies. The social network, including friends, mothers, and partners, were key sources of contraception myths, misconceptions, and vicarious experiences. Women also utilized media, including the internet, as an additional source of information. Information relayed by the social network had a direct influence on contraceptive decisions for many women. The experiences and opinions of the social network influence contraceptive decisions in this population of young, minority women. The social network, including friends, family members, and media sources, is a key source of contraceptive information for many women. Comprehensive contraception counseling should explore the experiences and opinions of the patient's social network to the extent possible. Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. Optimal Channel Selection Based on Online Decision and Offline Learning in Multichannel Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Mu Qiao

    2017-01-01

    Full Text Available We propose a channel selection strategy with hybrid architecture, which combines the centralized method and the distributed method to alleviate the overhead of access point and at the same time provide more flexibility in network deployment. By this architecture, we make use of game theory and reinforcement learning to fulfill the optimal channel selection under different communication scenarios. Particularly, when the network can satisfy the requirements of energy and computational costs, the online decision algorithm based on noncooperative game can help each individual sensor node immediately select the optimal channel. Alternatively, when the network cannot satisfy the requirements of energy and computational costs, the offline learning algorithm based on reinforcement learning can help each individual sensor node to learn from its experience and iteratively adjust its behavior toward the expected target. Extensive simulation results validate the effectiveness of our proposal and also prove that higher system throughput can be achieved by our channel selection strategy over the conventional off-policy channel selection approaches.

  6. Research and Collaboration Overview of Institut Pasteur International Network: A Bibliometric Approach toward Research Funding Decisions

    Directory of Open Access Journals (Sweden)

    Ehsan Mostafavi

    2014-01-01

    Full Text Available Background Institut Pasteur International Network (IPIN, which includes 32 research institutes around the world, is a network of research and expertise to fight against infectious diseases. A scientometric approach was applied to describe research and collaboration activities of IPIN. Methods Publications were identified using a manual search of IPIN member addresses in Science Citation Index Expanded (SCIE between 2006 and 2011. Total publications were then subcategorized by geographic regions. Several scientometric indicators and the H-index were employed to estimate the scientific production of each IPIN member. Subject and geographical overlay maps were also applied to visualize the network activities of the IPIN members. Results A total number of 12667 publications originated from IPIN members. Each author produced an average number of 2.18 papers and each publication received an average of 13.40 citations. European Pasteur Institutes had the largest amount of publications, authored papers, and H-index values. Biochemistry and molecular biology, microbiology, immunology and infectious diseases were the most important research topics, respectively. Geographic mapping of IPIN publications showed wide international collaboration among IPIN members around the world. Conclusion IPIN has strong ties with national and international authorities and organizations to investigate the current and future health issues. It is recommended to use scientometric and collaboration indicators as measures of research performance in IPIN future policies and investment decisions.

  7. Personal Networks and Migration Decision: The Case of Jamaican Brain Drain

    Directory of Open Access Journals (Sweden)

    Rosalyn NEGRÓN

    2012-05-01

    Full Text Available Brain drain is the phenomena where the most educated citizens of a country migrate to countries with better opportunities. This typically affects developing countries more negatively than developed countries. Given the close proximity to the US and the high standard of education of its citizens, Jamaica tends to be particularly hard hit by this brain drain. In this paper I examine intentions to migrate among skilled and educated Jamaicans. Specifically, I explore to what extent the composition of their personal network affects their decision to migrate. The data set consists of 62 university students, roughly half of who intended to migrate. Data were collected on 40 people that they knew, including information about social support provided by their social networks. The socioeconomic data about respondents did not predict intentions to migrate. However, students at Campion College, a prestigious high school linked to upper middle class status, were significantly more likely to express an interest in migration than students from other schools. Frequency of travel abroad was negatively related to intention to migrate for those that had traveled at least once. The proportion of network members that provided informational and career advice was significantly higher for those that intended to migrate. Implications of these findings for immigration policy in Jamaica and receiving countries are discussed.

  8. From complex questionnaire and interviewing data to intelligent Bayesian network models for medical decision support.

    Science.gov (United States)

    Constantinou, Anthony Costa; Fenton, Norman; Marsh, William; Radlinski, Lukasz

    2016-02-01

    (1) To develop a rigorous and repeatable method for building effective Bayesian network (BN) models for medical decision support from complex, unstructured and incomplete patient questionnaires and interviews that inevitably contain examples of repetitive, redundant and contradictory responses; (2) To exploit expert knowledge in the BN development since further data acquisition is usually not possible; (3) To ensure the BN model can be used for interventional analysis; (4) To demonstrate why using data alone to learn the model structure and parameters is often unsatisfactory even when extensive data is available. The method is based on applying a range of recent BN developments targeted at helping experts build BNs given limited data. While most of the components of the method are based on established work, its novelty is that it provides a rigorous consolidated and generalised framework that addresses the whole life-cycle of BN model development. The method is based on two original and recent validated BN models in forensic psychiatry, known as DSVM-MSS and DSVM-P. When employed with the same datasets, the DSVM-MSS demonstrated competitive to superior predictive performance (AUC scores 0.708 and 0.797) against the state-of-the-art (AUC scores ranging from 0.527 to 0.705), and the DSVM-P demonstrated superior predictive performance (cross-validated AUC score of 0.78) against the state-of-the-art (AUC scores ranging from 0.665 to 0.717). More importantly, the resulting models go beyond improving predictive accuracy and into usefulness for risk management purposes through intervention, and enhanced decision support in terms of answering complex clinical questions that are based on unobserved evidence. This development process is applicable to any application domain which involves large-scale decision analysis based on such complex information, rather than based on data with hard facts, and in conjunction with the incorporation of expert knowledge for decision support

  9. The Salience Network and Its Functional Architecture in a Perceptual Decision: An Effective Connectivity Study.

    Science.gov (United States)

    Lamichhane, Bidhan; Dhamala, Mukesh

    2015-08-01

    The anterior insulae (INSs) are involved in accumulating sensory evidence in perceptual decision-making independent of the motor response, whereas the dorsal anterior cingulate cortex (dACC) is known to play a role in choosing appropriate behavioral responses. Recent evidence suggests that INSs and dACC are part of the salience network (SN), a key network known to be involved in decision-making and thought to be important for the coordination of behavioral responses. However, how these nodes in the SN contribute to the decision-making process from segregation of stimuli to the generation of an appropriate behavioral response remains unknown. In this study, the authors scanned 33 participants in functional magnetic resonance imaging and asked them to decide whether the presented pairs of audio (a beep of sound) and visual (a flash of light) stimuli were synchronous or asynchronous. Participants reported their perception with a button press. Stimuli were presented in block of eight pairs with a temporal lag (ΔT) between the first (audio) and the second (visual) stimulus in each pair. They used dynamic causal modeling (DCM) and the Bayesian model evidence technique to elucidate the functional architecture between the nodes of SN. Both the synchrony and the asynchrony perception resulted in strong activation in the SN. Most importantly, the DCM analyses demonstrated that the INSs were integrating as well as driving hubs in the SN. The INSs were found to a play an important role in the integration of sensory information; input to the SN is most likely through INSs. Furthermore, significant INSs to dACC intrinsic connectivity established by these task conditions help us conclude that INSs drive the dACC to guide the behavior of choosing the appropriate response. The authors therefore argue that the dACC and INS are part of a system involved in the decision-making process from perception to planning of a motor response, and that this observed functional mechanism might

  10. Recognition of handwritten similar Chinese characters by self-growing probabilistic decision-based neural network.

    Science.gov (United States)

    Fu, H C; Xu, Y Y; Chang, H Y

    1999-12-01

    Recognition of similar (confusion) characters is a difficult problem in optical character recognition (OCR). In this paper, we introduce a neural network solution that is capable of modeling minor differences among similar characters, and is robust to various personal handwriting styles. The Self-growing Probabilistic Decision-based Neural Network (SPDNN) is a probabilistic type neural network, which adopts a hierarchical network structure with nonlinear basis functions and a competitive credit-assignment scheme. Based on the SPDNN model, we have constructed a three-stage recognition system. First, a coarse classifier determines a character to be input to one of the pre-defined subclasses partitioned from a large character set, such as Chinese mixed with alphanumerics. Then a character recognizer determines the input image which best matches the reference character in the subclass. Lastly, the third module is a similar character recognizer, which can further enhance the recognition accuracy among similar or confusing characters. The prototype system has demonstrated a successful application of SPDNN to similar handwritten Chinese recognition for the public database CCL/HCCR1 (5401 characters x200 samples). Regarding performance, experiments on the CCL/HCCR1 database produced 90.12% recognition accuracy with no rejection, and 94.11% accuracy with 6.7% rejection, respectively. This recognition accuracy represents about 4% improvement on the previously announced performance. As to processing speed, processing before recognition (including image preprocessing, segmentation, and feature extraction) requires about one second for an A4 size character image, and recognition consumes approximately 0.27 second per character on a Pentium-100 based personal computer, without use of any hardware accelerator or co-processor.

  11. A hybrid model using decision tree and neural network for credit scoring problem

    Directory of Open Access Journals (Sweden)

    Amir Arzy Soltan

    2012-08-01

    Full Text Available Nowadays credit scoring is an important issue for financial and monetary organizations that has substantial impact on reduction of customer attraction risks. Identification of high risk customer can reduce finished cost. An accurate classification of customer and low type 1 and type 2 errors have been investigated in many studies. The primary objective of this paper is to develop a new method, which chooses the best neural network architecture based on one column hidden layer MLP, multiple columns hidden layers MLP, RBFN and decision trees and ensembling them with voting methods. The proposed method of this paper is run on an Australian credit data and a private bank in Iran called Export Development Bank of Iran and the results are used for making solution in low customer attraction risks.

  12. Evaluation of Vertical Handoff Decision Algorightms Based on MADM Methods for Heterogeneous Wireless Networks

    Directory of Open Access Journals (Sweden)

    E. Stevens-Navarro

    2012-08-01

    Full Text Available In the forthcoming heterogeneous wireless environment, the mobility management of users roaming between differentwireless access technologies is a challenging and important technical issue. New mobile devices such as netbooks,smartphones and tablets allow users to perform vertical handoffs among different wireless networks. The multipleattribute decision making (MADM methods are suitable tools to model and study the vertical handoff process. Hence,recently several MADM methods such as SAW, MEW, TOPSIS, GRA, ELECTRE, VIKOR and WMC have beenproposed for vertical handoff. In this paper, we present an extensive performance evaluation and comparative study ofthe seven MAMD methods by means of numerical simulations in MATLAB. We evaluate the performance of eachvertical handoff method under different applications such as voice, data, and cost-constrained connections. We alsoperform a sensitivity analysis and evaluate the computational complexity of each method in terms of number offloating point operations.

  13. A speech recognition system based on hybrid wavelet network including a fuzzy decision support system

    Science.gov (United States)

    Jemai, Olfa; Ejbali, Ridha; Zaied, Mourad; Ben Amar, Chokri

    2015-02-01

    This paper aims at developing a novel approach for speech recognition based on wavelet network learnt by fast wavelet transform (FWN) including a fuzzy decision support system (FDSS). Our contributions reside in, first, proposing a novel learning algorithm for speech recognition based on the fast wavelet transform (FWT) which has many advantages compared to other algorithms and in which major problems of the previous works to compute connection weights were solved. They were determined by a direct solution which requires computing matrix inversion, which may be intensive. However, the new algorithm was realized by the iterative application of FWT to compute connection weights. Second, proposing a new classification way for this speech recognition system. It operated a human reasoning mode employing a FDSS to compute similarity degrees between test and training signals. Extensive empirical experiments were conducted to compare the proposed approach with other approaches. Obtained results show that the new speech recognition system has a better performance than previously established ones.

  14. Expert Systems, Job Aids, and the Future of Instructional Technology; and Decision Tables, the Poor Person's Answer to "Expert Systems."

    Science.gov (United States)

    Harmon, Paul; Pipe, Peter

    1986-01-01

    Describes design and presents examples of industrial use of small expert systems and guidelines for choosing problems which lend themselves to small tool solutions. Use of microcomputer facilitated decision tables to diagnose and categorize people, things, and issues is suggested, and development of three decision table formats is described. (MBR)

  15. A multiattribute utility analysis of sites nominated for characterization for the first radioactive-waste repository: A decision-aiding methodology

    Energy Technology Data Exchange (ETDEWEB)

    none,

    1986-05-01

    In December 1984, the Department of Energy (DOE) published draft environmental assessments (EAs) to support the proposed nomination of five sites and the recommendation of three sites for characterization for the first radioactive-waste repository. A chapter common to all the draft EAs (Chapter 7) presented rankings of the five sites against the postclosure and the preclosure technical siting guidelines. To determine which three sites appeared most favorable for recommendation for characterization, three simple quantitative methods were used to aggregate the rankings assigned to each site for the various technical guidelines. In response to numerous comments on the methods, the DOE has undertaken a formal application of one of them (hereafter referred to as the decision-aiding methodology) for the purpose of obtaining a more rigorous evaluation of the nominated sites. The application of the revised methodology is described in this report. The method of analysis is known as multiattribute utility analysis; it is a tool for providing insights as to which sites are preferable and why. The decision-aiding methodology accounts for all the fundamental considerations specified by the siting guidelines and uses as source information the data and evaluations reported or referenced in the EAs. It explicitly addresses the uncertainties and value judgments that are part of all siting problems. Furthermore, all scientific and value judgments are made explicit for the reviewer. An independent review of the application of the decision-aiding methodology has been conducted by the Board on Radioactive Waste Management of the National Academy of Sciences; the comments of the Board are included as an appendix to this report.

  16. Combining Bayesian Networks and Agent Based Modeling to develop a decision-support model in Vietnam

    Science.gov (United States)

    Nong, Bao Anh; Ertsen, Maurits; Schoups, Gerrit

    2016-04-01

    Complexity and uncertainty in natural resources management have been focus themes in recent years. Within these debates, with the aim to define an approach feasible for water management practice, we are developing an integrated conceptual modeling framework for simulating decision-making processes of citizens, in our case in the Day river area, Vietnam. The model combines Bayesian Networks (BNs) and Agent-Based Modeling (ABM). BNs are able to combine both qualitative data from consultants / experts / stakeholders, and quantitative data from observations on different phenomena or outcomes from other models. Further strengths of BNs are that the relationship between variables in the system is presented in a graphical interface, and that components of uncertainty are explicitly related to their probabilistic dependencies. A disadvantage is that BNs cannot easily identify the feedback of agents in the system once changes appear. Hence, ABM was adopted to represent the reaction among stakeholders under changes. The modeling framework is developed as an attempt to gain better understanding about citizen's behavior and factors influencing their decisions in order to reduce uncertainty in the implementation of water management policy.

  17. An Optimal Hierarchical Decision Model for a Regional Logistics Network with Environmental Impact Consideration

    Science.gov (United States)

    Zhang, Dezhi; Li, Shuangyan

    2014-01-01

    This paper proposes a new model of simultaneous optimization of three-level logistics decisions, for logistics authorities, logistics operators, and logistics users, for regional logistics network with environmental impact consideration. The proposed model addresses the interaction among the three logistics players in a complete competitive logistics service market with CO2 emission charges. We also explicitly incorporate the impacts of the scale economics of the logistics park and the logistics users' demand elasticity into the model. The logistics authorities aim to maximize the total social welfare of the system, considering the demand of green logistics development by two different methods: optimal location of logistics nodes and charging a CO2 emission tax. Logistics operators are assumed to compete with logistics service fare and frequency, while logistics users minimize their own perceived logistics disutility given logistics operators' service fare and frequency. A heuristic algorithm based on the multinomial logit model is presented for the three-level decision model, and a numerical example is given to illustrate the above optimal model and its algorithm. The proposed model provides a useful tool for modeling competitive logistics services and evaluating logistics policies at the strategic level. PMID:24977209

  18. Livelihood Networks and Decision-making Among Congolese Young People in Formal and Informal Refugee Contexts in Uganda

    OpenAIRE

    Christina Clark

    2006-01-01

    Refugee young people who are without their biological parents are often assumed to be among the most disempowered members of displaced populations. This paper interrogates this assumption by exploring Congolese young people’s access to decision-making in a variety of household contexts in Kampala and Kyaka II refugee settlement, western Uganda. Using a network approach to household and family, research findings reveal shrinking networks, increasing delinkage between household and family, and ...

  19. Achieving Congestion Mitigation Using Distributed Power Control for Spectrum Sensor Nodes in Sensor Network-Aided Cognitive Radio Ad Hoc Networks.

    Science.gov (United States)

    Zhang, Long; Xu, Haitao; Zhuo, Fan; Duan, Hucai

    2017-09-15

    The data sequence of spectrum sensing results injected from dedicated spectrum sensor nodes (SSNs) and the data traffic from upstream secondary users (SUs) lead to unpredictable data loads in a sensor network-aided cognitive radio ad hoc network (SN-CRN). As a result, network congestion may occur at a SU acting as fusion center when the offered data load exceeds its available capacity, which degrades network performance. In this paper, we present an effective approach to mitigate congestion of bottlenecked SUs via a proposed distributed power control framework for SSNs over a rectangular grid based SN-CRN, aiming to balance resource load and avoid excessive congestion. To achieve this goal, a distributed power control framework for SSNs from interior tier (IT) and middle tier (MT) is proposed to achieve the tradeoff between channel capacity and energy consumption. In particular, we firstly devise two pricing factors by considering stability of local spectrum sensing and spectrum sensing quality for SSNs. By the aid of pricing factors, the utility function of this power control problem is formulated by jointly taking into account the revenue of power reduction and the cost of energy consumption for IT or MT SSN. By bearing in mind the utility function maximization and linear differential equation constraint of energy consumption, we further formulate the power control problem as a differential game model under a cooperation or noncooperation scenario, and rigorously obtain the optimal solutions to this game model by employing dynamic programming. Then the congestion mitigation for bottlenecked SUs is derived by alleviating the buffer load over their internal buffers. Simulation results are presented to show the effectiveness of the proposed approach under the rectangular grid based SN-CRN scenario.

  20. Achieving Congestion Mitigation Using Distributed Power Control for Spectrum Sensor Nodes in Sensor Network-Aided Cognitive Radio Ad Hoc Networks

    Science.gov (United States)

    Zhuo, Fan; Duan, Hucai

    2017-01-01

    The data sequence of spectrum sensing results injected from dedicated spectrum sensor nodes (SSNs) and the data traffic from upstream secondary users (SUs) lead to unpredictable data loads in a sensor network-aided cognitive radio ad hoc network (SN-CRN). As a result, network congestion may occur at a SU acting as fusion center when the offered data load exceeds its available capacity, which degrades network performance. In this paper, we present an effective approach to mitigate congestion of bottlenecked SUs via a proposed distributed power control framework for SSNs over a rectangular grid based SN-CRN, aiming to balance resource load and avoid excessive congestion. To achieve this goal, a distributed power control framework for SSNs from interior tier (IT) and middle tier (MT) is proposed to achieve the tradeoff between channel capacity and energy consumption. In particular, we firstly devise two pricing factors by considering stability of local spectrum sensing and spectrum sensing quality for SSNs. By the aid of pricing factors, the utility function of this power control problem is formulated by jointly taking into account the revenue of power reduction and the cost of energy consumption for IT or MT SSN. By bearing in mind the utility function maximization and linear differential equation constraint of energy consumption, we further formulate the power control problem as a differential game model under a cooperation or noncooperation scenario, and rigorously obtain the optimal solutions to this game model by employing dynamic programming. Then the congestion mitigation for bottlenecked SUs is derived by alleviating the buffer load over their internal buffers. Simulation results are presented to show the effectiveness of the proposed approach under the rectangular grid based SN-CRN scenario. PMID:28914803

  1. Usability evaluation and adaptation of the e-health Personal Patient Profile-Prostate decision aid for Spanish-speaking Latino men

    OpenAIRE

    Berry, Donna L.; Halpenny, Barbara; Bosco, Jaclyn L. F.; Bruyere, John; Sanda, Martin G.

    2015-01-01

    Background The Personal Patient Profile-Prostate (P3P), a web-based decision aid, was demonstrated to reduce decisional conflict in English-speaking men with localized prostate cancer early after initial diagnosis. The purpose of this study was to explore and enhance usability and cultural appropriateness of a Spanish P3P by Latino men with a diagnosis of prostate cancer. Methods P3P was translated to Spanish and back-translated by three native Spanish-speaking translators working independent...

  2. Using the Networked Fire Chief for ego-depletion research: measuring dynamic decision-making effort and performance.

    Science.gov (United States)

    Barber, Larissa K; Smit, Brandon W

    2014-01-01

    This study replicated ego-depletion predictions from the self-control literature in a computer simulation task that requires ongoing decision-making in relation to constantly changing environmental information: the Network Fire Chief (NFC). Ego-depletion led to decreased self-regulatory effort, but not performance, on the NFC task. These effects were also buffered by task enjoyment so