WorldWideScience

Sample records for network decision aid

  1. 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.

  2. 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.

  3. Computerized operator decision aids

    International Nuclear Information System (INIS)

    Long, A.B.

    1984-01-01

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

  4. Towards Aiding Decision-Making in Social Networks by Using Sentiment and Stress Combined Analysis

    OpenAIRE

    Guillem Aguado; Vicente Julian; Ana Garcia-Fornes

    2018-01-01

    The present work is a study of the detection of negative emotional states that people have using social network sites (SNSs), and the effect that this negative state has on the repercussions of posted messages. We aim to discover in which grade a user having an affective state considered negative by an Analyzer can affect other users and generate bad repercussions. Those Analyzers that we propose are a Sentiment Analyzer, a Stress Analyzer and a novel combined Analyzer. We also want to discov...

  5. Towards Aiding Decision-Making in Social Networks by Using Sentiment and Stress Combined Analysis

    Directory of Open Access Journals (Sweden)

    Guillem Aguado

    2018-05-01

    Full Text Available The present work is a study of the detection of negative emotional states that people have using social network sites (SNSs, and the effect that this negative state has on the repercussions of posted messages. We aim to discover in which grade a user having an affective state considered negative by an Analyzer can affect other users and generate bad repercussions. Those Analyzers that we propose are a Sentiment Analyzer, a Stress Analyzer and a novel combined Analyzer. We also want to discover what Analyzer is more suitable to predict a bad future situation, and in what context. We designed a Multi-Agent System (MAS that uses different Analyzers to protect or advise users. This MAS uses the trained and tested Analyzers to predict future bad situations in social media, which could be triggered by the actions of a user that has an emotional state considered negative. We conducted an experimentation with different datasets of text messages from Twitter.com to examine the ability of the system to predict bad repercussions, by comparing the polarity, stress level or combined value classification of the messages that are replies to the ones of the messages that originated them.

  6. 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...

  7. Probability of Survival Decision Aid (PSDA)

    National Research Council Canada - National Science Library

    Xu, Xiaojiang; Amin, Mitesh; Santee, William R

    2008-01-01

    A Probability of Survival Decision Aid (PSDA) is developed to predict survival time for hypothermia and dehydration during prolonged exposure at sea in both air and water for a wide range of environmental conditions...

  8. Decision aids for people facing health treatment or screening decisions.

    Science.gov (United States)

    Stacey, Dawn; Légaré, France; Col, Nananda F; Bennett, Carol L; Barry, Michael J; Eden, Karen B; Holmes-Rovner, Margaret; Llewellyn-Thomas, Hilary; Lyddiatt, Anne; Thomson, Richard; Trevena, Lyndal; Wu, Julie H C

    2014-01-28

    Decision aids are intended to help people participate in decisions that involve weighing the benefits and harms of treatment options often with scientific uncertainty. To assess the effects of decision aids for people facing treatment or screening decisions. For this update, we searched from 2009 to June 2012 in MEDLINE; CENTRAL; EMBASE; PsycINFO; and grey literature. Cumulatively, we have searched each database since its start date including CINAHL (to September 2008). We included published randomized controlled trials of decision aids, which are interventions designed to support patients' decision making by making explicit the decision, providing information about treatment or screening options and their associated outcomes, compared to usual care and/or alternative interventions. We excluded studies of participants making hypothetical decisions. Two review authors independently screened citations for inclusion, extracted data, and assessed risk of bias. The primary outcomes, based on the International Patient Decision Aid Standards (IPDAS), were:A) 'choice made' attributes;B) 'decision-making process' attributes.Secondary outcomes were behavioral, health, and health-system effects. We pooled results using mean differences (MD) and relative risks (RR), applying a random-effects model. This update includes 33 new studies for a total of 115 studies involving 34,444 participants. For risk of bias, selective outcome reporting and blinding of participants and personnel were mostly rated as unclear due to inadequate reporting. Based on 7 items, 8 of 115 studies had high risk of bias for 1 or 2 items each.Of 115 included studies, 88 (76.5%) used at least one of the IPDAS effectiveness criteria: A) 'choice made' attributes criteria: knowledge scores (76 studies); accurate risk perceptions (25 studies); and informed value-based choice (20 studies); and B) 'decision-making process' attributes criteria: feeling informed (34 studies) and feeling clear about values (29

  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. 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...

  12. The University of Michigan's Computer-Aided Engineering Network.

    Science.gov (United States)

    Atkins, D. E.; Olsen, Leslie A.

    1986-01-01

    Presents an overview of the Computer-Aided Engineering Network (CAEN) of the University of Michigan. Describes its arrangement of workstations, communication networks, and servers. Outlines the factors considered in hardware and software decision making. Reviews the program's impact on students. (ML)

  13. Physicians' intentions and use of three patient decision aids

    Directory of Open Access Journals (Sweden)

    Mitchell Susan L

    2007-07-01

    Full Text Available Abstract Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270 returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80% also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians ( Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids.

  14. Physicians' intentions and use of three patient decision aids

    Science.gov (United States)

    Graham, Ian D; Logan, Jo; Bennett, Carol L; Presseau, Justin; O'Connor, Annette M; Mitchell, Susan L; Tetroe, Jacqueline M; Cranney, Ann; Hebert, Paul; Aaron, Shawn D

    2007-01-01

    Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270) returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80%) also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians (<60%) felt the decision aid would improve the quality of patient visits or be easily implemented into practice and very few (27%) felt that the decision aid would save time. Physicians' intentions to use the decision aid were related to their comfort with offering it to patients, the decision aid topic, and the perceived ease of implementing it into practice. While 54% of the surveyed physicians indicated they would use the decision aid, less than a third followed through with this

  15. A decision-aiding system: DACFOOD

    International Nuclear Information System (INIS)

    Despres, A.; Heymes, P.

    1994-01-01

    The DACFOOD (Decision Aiding for Contaminated FOODstuffs) system provides decision makers with necessary data for the implementation of optimized protection measures in case of radioactive contamination of foodstuffs. The system evaluates the dose impact due to ingestion of these products, calculates the dose reduction after implementation of specific actions and, by combining these actions, assesses several strategies by using their cost-effectiveness ratios. Such evaluations need the description of contamination as radionuclide activities in each foodstuff, and the description of consumers' groups according to their dietary habits. Then it is possible to define areas in which the doses received are reasonably homogeneous in different age classes. If deposition occurs at a period of the year without harvest, the system applies dynamic transfer models to calculate the concentration in future productions. (authors). 2 refs

  16. Studies and Analyses of Vulnerabilities in Aided Adversarial Decision Making

    National Research Council Canada - National Science Library

    Llinas, James

    1998-01-01

    .... The aid" in the analysis (i.e., an automated decision aid) focuses upon a generic data fusion processor that estimates situation and threat states based on multisensor/multisource-based data assessments...

  17. 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.

  18. 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 ...

  19. Addressing health literacy in patient decision aids

    Science.gov (United States)

    2013-01-01

    Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-making outcomes, and 2. the extent to which existing PtDAs a) account for health literacy, and b) are tested in lower health literacy populations. Methods We reviewed literature for evidence relevant to these two aims. When high-quality systematic reviews existed, we summarized their evidence. When reviews were unavailable, we conducted our own systematic reviews. Results Aim 1: In an existing systematic review of PtDA trials, lower health literacy was associated with lower patient health knowledge (14 of 16 eligible studies). Fourteen studies reported practical design strategies to improve knowledge for lower health literacy patients. In our own systematic review, no studies reported on values clarity per se, but in 2 lower health literacy was related to higher decisional uncertainty and regret. Lower health literacy was associated with less desire for involvement in 3 studies, less question-asking in 2, and less patient-centered communication in 4 studies; its effects on other measures of patient involvement were mixed. Only one study assessed the effects of a health literacy intervention on outcomes; it showed that using video to improve the salience of health states reduced decisional uncertainty. Aim 2: In our review of 97 trials, only 3 PtDAs overtly addressed the needs of lower health literacy users. In 90% of trials, user health literacy and readability of the PtDA were not reported. However, increases in knowledge and informed choice were reported in those studies

  20. Tactical Decision Aids High Bandwidth Links Using Autonomous Vehicles

    Science.gov (United States)

    2004-01-01

    1 Tactical Decision Aids (High Bandwidth Links Using Autonomous Vehicles ) A. J. Healey, D. P. Horner, Center for Autonomous Underwater Vehicle...SUBTITLE Tactical Decision Aids (High Bandwidth Links Using Autonomous Vehicles ) 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  1. Refining a brief decision aid in stable CAD: cognitive interviews

    OpenAIRE

    Kelly-Blake, Karen; Clark, Stacie; Dontje, Katherine; Olomu, Adesuwa; Henry, Rebecca C; Rovner, David R; Rothert, Marilyn L; Holmes-Rovner, Margaret

    2014-01-01

    Background We describe the results of cognitive interviews to refine the “Making Choices©” Decision Aid (DA) for shared decision-making (SDM) about stress testing in patients with stable coronary artery disease (CAD). Methods We conducted a systematic development process to design a DA consistent with International Patient Decision Aid Standards (IPDAS) focused on Alpha testing criteria. Cognitive interviews were conducted with ten stable CAD patients using the “think aloud” interview techniq...

  2. 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

  3. 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

  4. Decision Aid for Cigarette Smokers Scheduled for Elective Surgery.

    Science.gov (United States)

    Warner, David O; LeBlanc, Annie; Kadimpati, Sandeep; Vickers, Kristin S; Shi, Yu; Montori, Victor M

    2015-07-01

    Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. In formative work, a decision aid was designed to facilitate patient-clinician discussion regarding three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good. A randomized, two-group pilot study was then conducted in smokers evaluated in preparation for elective surgery in a preoperative clinic to test the hypothesis that the decision aid would improve measures of decisional quality compared with usual care. The final decision aid consisted of three laminated cards. The front of each card included a colorful graphic describing each choice; the reverse including two to three pros and cons for each decision, a simple graphic illustrating the effects of smoking on the body, and a motivational phrase. In the randomized trial of 130 patients, the decision aid significantly (P < 0.05) improved measures of decisional quality and patient involvement in decision making (Cohen's d effect sizes of 0.76 and 1.20 for the Decisional Conflict Scale and Observing PatienT involvement In decisiON-making scale, respectively). However, the decision aid did not affect any aspect of perioperative smoking behavior, including the distribution of or adherence to choices. Although the use of a decision aid to facilitate clinician-patient discussions regarding tobacco use around the time of surgery substantially improved measures of decisional quality, it alone did not change perioperative tobacco use behavior.

  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. Decision aiding techniques for site remediation

    International Nuclear Information System (INIS)

    Van de Walle, B.

    1996-01-01

    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

  7. Systematic Review of Decision Aids for Newly Diagnosed Patients with Prostate Cancer Making Treatment Decisions.

    Science.gov (United States)

    Adsul, Prajakta; Wray, Ricardo; Spradling, Kyle; Darwish, Oussama; Weaver, Nancy; Siddiqui, Sameer

    2015-11-01

    Despite established evidence for using patient decision aids, use with newly diagnosed patients with prostate cancer remains limited partly due to variability in aid characteristics. We systematically reviewed decision aids for newly diagnosed patients with prostate cancer. Published peer reviewed journal articles, unpublished literature on the Internet and the Ottawa decision aids web repository were searched to identify decision aids designed for patients with prostate cancer facing treatment decisions. A total of 14 aids were included in study. Supplementary materials on aid development and published studies evaluating the aids were also included. We studied aids designed to help patients make specific choices among options and outcomes relevant to health status that were specific to prostate cancer treatment and in English only. Aids were reviewed for IPDAS (International Patient Decision Aid Standards) and additional standards deemed relevant to prostate cancer treatment decisions. They were also reviewed for novel criteria on the potential for implementation. Acceptable interrater reliability was achieved at Krippendorff α = 0.82. Eight of the 14 decision aids (57.1%) were developed in the United States, 6 (42.8%) were print based, 5 (35.7%) were web or print based and only 4 (28.5%) had been updated since 2013. Ten aids (71.4%) were targeted to prostate cancer stage. All discussed radiation and surgery, 10 (71.4%) discussed active surveillance and/or watchful waiting and 8 (57.1%) discussed hormonal therapy. Of the aids 64.2% presented balanced perspectives on treatment benefits and risks, and/or outcome probabilities associated with each option. Ten aids (71.4%) presented value clarification prompts for patients and steps to make treatment decisions. No aid was tested with physicians and only 4 (28.6%) were tested with patients. Nine aids (64.2%) provided details on data appraisal and 4 (28.6%) commented on the quality of evidence used. Seven of the 8

  8. Nurse aide decision making in nursing homes: factors affecting empowerment.

    Science.gov (United States)

    Chaudhuri, Tanni; Yeatts, Dale E; Cready, Cynthia M

    2013-09-01

    To evaluate factors affecting structural empowerment among nurse aides in nursing homes. Structural empowerment can be defined as the actual rather than perceived ability to make autonomous decisions within an organisation. Given the paucity of research on the subject, this study helps to close the gap by identifying factors that affect nurse aide empowerment, that is, decision-making among nurse aides. The data for the study come from self-administered questionnaires distributed to direct-care workers (nurse aides) in 11 nursing homes in a southern state in the USA. Ordinary least square regression models were estimated to analyse the effects of demographic predictors, personal factors (competency, emotional exhaustion and positive attitude) and structural characteristics (coworker and supervisor support, information availability and shared governance) on nurse aide decision-making. Findings suggest race among demographic predictors, emotional exhaustion among personal characteristics, and supervisor support, and shared governance among structural factors, significantly affect nurse aide decision-making. It is important to explore race as one of the central determinants of structural empowerment among nurse aides. In addition, the nature and type of emotional exhaustion that propels decision-making needs to be further examined. The study shows the importance of shared governance and supervisor support for fostering nurse aide empowerment. © 2013 Blackwell Publishing Ltd.

  9. 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...

  10. Rade-aid: an operational tool for decision-makers

    International Nuclear Information System (INIS)

    Wagenaar, G.; van den Bosch, C.J.H.; Ehrhardt, J.; Steinhauer, C.; Morrey, M.; Robinson, C.A.

    1991-01-01

    If an accidental release of radionuclides occurs, decisions on countermeasures are required. Since the making of a decision involves many competing factors (for instance, the health risk versus the costs relating to a countermeasure), the decision-maker faces a problem. The aim of the RADE-AID (Radiological Accident DEcision AIDing) project is the development of a computer decision support system which can be used in the formulation of decisions. The theoretical background of the decision technique and its methods are outlined, together with the practical application of the technique in the form of the software package developed. Both the benefits of formal techniques and computerized tools in this field are discussed. In order to explore the appropriateness of the decision technique for the management of radiological emergencies, illustrative, but stylized, applications were carried out. Conclusions from these applications are discussed

  11. Aiding Lay Decision Making Using a Cognitive Competencies Approach

    OpenAIRE

    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 pr...

  12. Rough set and rule-based multicriteria decision aiding

    Directory of Open Access Journals (Sweden)

    Roman Slowinski

    2012-08-01

    Full Text Available The aim of multicriteria decision aiding is to give the decision maker a recommendation concerning a set of objects evaluated from multiple points of view called criteria. Since a rational decision maker acts with respect to his/her value system, in order to recommend the most-preferred decision, one must identify decision maker's preferences. In this paper, we focus on preference discovery from data concerning some past decisions of the decision maker. We consider the preference model in the form of a set of "if..., then..." decision rules discovered from the data by inductive learning. To structure the data prior to induction of rules, we use the Dominance-based Rough Set Approach (DRSA. DRSA is a methodology for reasoning about data, which handles ordinal evaluations of objects on considered criteria and monotonic relationships between these evaluations and the decision. We review applications of DRSA to a large variety of multicriteria decision problems.

  13. Decision aids for patients facing a surgical treatment decision: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Knops, Anouk M.; Legemate, Dink A.; Goossens, Astrid; Bossuyt, Patrick M. M.; Ubbink, Dirk T.

    2013-01-01

    To summarize the evidence available on the effects of decision aids in surgery. When consenting to treatment, few patients adequately understand their treatment options. To help patients make deliberate treatment choices, decision aids provide evidence-based information on the disease, treatment

  14. Analytical evaluation of computer-based decision aids

    International Nuclear Information System (INIS)

    Kisner, R.A.

    1985-01-01

    This paper introduces a method for evaluating decision aids for nuclear power plant operators. The method involves a two-stage process of classification and analytical evaluation of display form and content. The classification scheme relates each specific aid to one or more general decision-making tasks. Evaluation then proceeds using a normative top-down design process based on the classification scheme by determining or deducing how various design issues associated with this process were resolved by the designer. The result is an assessment of the ''understandability'' of the aid as well as identification of the training and display features necessary to ensure understandability. 7 refs., 4 figs., 1 tab

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

    Science.gov (United States)

    Staszewska, Anna; Zaki, Pearl; Lee, Joon

    2017-10-06

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

  16. Decision aids for people considering taking part in clinical trials.

    Science.gov (United States)

    Gillies, Katie; Cotton, Seonaidh C; Brehaut, Jamie C; Politi, Mary C; Skea, Zoe

    2015-11-27

    Several interventions have been developed to promote informed consent for participants in clinical trials. However, many of these interventions focus on the content and structure of information (e.g. enhanced information or changes to the presentation format) rather than the process of decision making. Patient decision aids support a decision making process about medical options. Decision aids support the decision process by providing information about available options and their associated outcomes, alongside information that enables patients to consider what value they place on particular outcomes, and provide structured guidance on steps of decision making. They have been shown to be effective for treatment and screening decisions but evidence on their effectiveness in the context of informed consent for clinical trials has not been synthesised. To assess the effectiveness of decision aids for clinical trial informed consent compared to no intervention, standard information (i.e. usual practice) or an alternative intervention on the decision making process. We searched the following databases and to March 2015: Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Library; MEDLINE (OvidSP) (from 1950); EMBASE (OvidSP) (from 1980); PsycINFO (OvidSP) (from 1806); ASSIA (ProQuest) (from 1987); WHO International Clinical Trials Registry Platform (ICTRP) (http://apps.who.int/trialsearch/); ClinicalTrials.gov; ISRCTN Register (http://www.controlled-trials.com/isrctn/). We also searched reference lists of included studies and relevant reviews. We contacted study authors and other experts. There were no language restrictions. We included randomised and quasi-randomised controlled trials comparing decision aids in the informed consent process for clinical trials alone, or in conjunction with standard information (such as written or verbal) or alongside alternative interventions (e.g. paper-based versus web-based decision aids). Included trials involved

  17. 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

  18. Perceptions of shared decision making and decision aids among rural primary care clinicians.

    Science.gov (United States)

    King, Valerie J; Davis, Melinda M; Gorman, Paul N; Rugge, J Bruin; Fagnan, L J

    2012-01-01

    Shared decision making (SDM) and decision aids (DAs) increase patients' involvement in health care decisions and enhance satisfaction with their choices. Studies of SDM and DAs have primarily occurred in academic centers and large health systems, but most primary care is delivered in smaller practices, and over 20% of Americans live in rural areas, where poverty, disease prevalence, and limited access to care may increase the need for SDM and DAs. To explore perceptions and practices of rural primary care clinicians regarding SDM and DAs. Cross-sectional survey. Setting and Participants Primary care clinicians affiliated with the Oregon Rural Practice-based Research Network. Surveys were returned by 181 of 231 eligible participants (78%); 174 could be analyzed. Two-thirds of participants were physicians, 84% practiced family medicine, and 55% were male. Sixty-five percent of respondents were unfamiliar with the term shared decision making, but following definition, 97% reported that they found the approach useful for conditions with multiple treatment options. Over 90% of clinicians perceived helping patients make decisions regarding chronic pain and health behavior change as moderate/hard in difficulty. Although 69% of respondents preferred that patients play an equal role in making decisions, they estimate that this happens only 35% of the time. Time was reported as the largest barrier to engaging in SDM (63%). Respondents were receptive to using DAs to facilitate SDM in print- (95%) or web-based formats (72%), and topic preference varied by clinician specialty and decision difficulty. Rural clinicians recognized the value of SDM and were receptive to using DAs in multiple formats. Integration of DAs to facilitate SDM in routine patient care may require addressing practice operation and reimbursement.

  19. Empirical Evaluation of a Decision-Analytic Aid.

    Science.gov (United States)

    1980-05-01

    Morris, Smallwood , Lansford, and Gibbons (1980) state: "In the traditional paradigm, the decision-maker must decide to accept or reject the model. If he... Smallwood , R. D., Langford, R. K., & Gibbons, R. S. Analytic Procedures for Evaluating Decision Aids. Applied Decision Analysis, Inc. (Menlo Park, CA...Menlo Park, CA 94025 Department of Psychology University of Oklahoma Dr. Jesse Orlansky 455 West Lindsey Institute for Defense Analyses Norman , OK 73069

  20. MINDS - Medical Information Network Decision Support System

    National Research Council Canada - National Science Library

    Armenian, H. K

    2008-01-01

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

  1. 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.

  2. Decision aid for women considering breast cancer screening

    DEFF Research Database (Denmark)

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

    2011-01-01

    OBJECTIVES: The aim of this study was to describe the process and challenges of developing a decision aid for the national public breast cancer screening program in Finland. METHODS: An expert team with stakeholder representation used European guidelines and other literature as basis for selecting...... 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...... 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...

  3. 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."

  4. Heuristic Decision Making in Network Linking

    NARCIS (Netherlands)

    M.J.W. Harmsen - Van Hout (Marjolein); B.G.C. Dellaert (Benedict); P.J.J. Herings (Jean-Jacques)

    2015-01-01

    textabstractNetwork formation among individuals constitutes an important part of many OR processes, but relatively little is known about how individuals make their linking decisions in networks. This article provides an investigation of heuristic effects in individual linking decisions for

  5. Comparison of safety measures with a multicriteria decision aiding technique

    International Nuclear Information System (INIS)

    Lombard, J.

    1985-01-01

    Attributes such as political, social and psychological factors have to be taken into account for the decision-making process. Multiattribute decision-aiding techniques are used to cope with this multidimensionality of the risk management process. A simple example will be given to illustrate how such method can be helpful for the selection of proper safety measures in a rational way. (orig./HP) [de

  6. 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 ...

  7. Amsterdam wrist rules: A clinical decision aid

    Directory of Open Access Journals (Sweden)

    Bentohami Abdelali

    2011-10-01

    Full Text Available Abstract Background Acute trauma of the wrist is one of the most frequent reasons for visiting the Emergency Department. These patients are routinely referred for radiological examination. Most X-rays however, do not reveal any fractures. A clinical decision rule determining the need for X-rays in patients with acute wrist trauma may help to percolate and select patients with fractures. Methods/Design This study will be a multi-center observational diagnostic study in which the data will be collected cross-sectionally. The study population will consist of all consecutive adult patients (≥18 years presenting with acute wrist trauma at the Emergency Department in the participating hospitals. This research comprises two components: one study will be conducted to determine which clinical parameters are predictive for the presence of a distal radius fracture in adult patients presenting to the Emergency Department following acute wrist trauma. These clinical parameters are defined by trauma-mechanism, physical examination, and functional testing. This data will be collected in two of the three participating hospitals and will be assessed by using logistic regression modelling to estimate the regression coefficients after which a reduced model will be created by means of a log likelihood ratio test. The accuracy of the model will be estimated by a goodness of fit test and an ROC curve. The final model will be validated internally through bootstrapping and by shrinking it, an adjusted model will be generated. In the second component of this study, the developed prediction model will be validated in a new dataset consisting of a population of patients from the third hospital. If necessary, the model will be calibrated using the data from the validation study. Discussion Wrist trauma is frequently encountered at the Emergency Department. However, to this date, no decision rule regarding this type of trauma has been created. Ideally, radiographs are

  8. Decision aids for improved accuracy and standardization of mammographic diagnosis

    International Nuclear Information System (INIS)

    D'Orsi, C.J.; Getty, D.J.; Swets, J.A.; Pickett, R.M.; Seltzer, S.E.; McNeil, B.J.

    1990-01-01

    This paper examines the gains in the accuracy of mammographic diagnosis of breast cancer achievable from a pair of decision aids. Twenty-three potentially relevant perceptual features of mammograms were identified through interviews, psychometric tests, and consensus meetings with mammography specialists. Statistical analyses determined the 12 independent features that were most information diagnostically and assigned a weight to each according to its importance. Two decision aids were developed: a checklist that solicits a scale value from the radiologist for each feature and a computer program that merges those values optimally in an advisory estimate of the probability of malignancy. Six radiologists read a set of 150 cases, first in their usual way and later with the aids

  9. Refining a brief decision aid in stable CAD: cognitive interviews.

    Science.gov (United States)

    Kelly-Blake, Karen; Clark, Stacie; Dontje, Katherine; Olomu, Adesuwa; Henry, Rebecca C; Rovner, David R; Rothert, Marilyn L; Holmes-Rovner, Margaret

    2014-02-13

    We describe the results of cognitive interviews to refine the "Making Choices©" Decision Aid (DA) for shared decision-making (SDM) about stress testing in patients with stable coronary artery disease (CAD). We conducted a systematic development process to design a DA consistent with International Patient Decision Aid Standards (IPDAS) focused on Alpha testing criteria. Cognitive interviews were conducted with ten stable CAD patients using the "think aloud" interview technique to assess the clarity, usefulness, and design of each page of the DA. Participants identified three main messages: 1) patients have multiple options based on stress tests and they should be discussed with a physician, 2) take care of yourself, 3) the stress test is the gold standard for determining the severity of your heart disease. Revisions corrected the inaccurate assumption of item number three. Cognitive interviews proved critical for engaging patients in the development process and highlighted the necessity of clear message development and use of design principles that make decision materials easy to read and easy to use. Cognitive interviews appear to contribute critical information from the patient perspective to the overall systematic development process for designing decision aids.

  10. Aiding Lay Decision Making Using a Cognitive Competencies Approach.

    Science.gov (United States)

    Maule, A J; Maule, Simon

    2015-01-01

    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.

  11. Vehicle-network defensive aids suite

    Science.gov (United States)

    Rapanotti, John

    2005-05-01

    Defensive Aids Suites (DAS) developed for vehicles can be extended to the vehicle network level. The vehicle network, typically comprising four platoon vehicles, will benefit from improved communications and automation based on low latency response to threats from a flexible, dynamic, self-healing network environment. Improved DAS performance and reliability relies on four complementary sensor technologies including: acoustics, visible and infrared optics, laser detection and radar. Long-range passive threat detection and avoidance is based on dual-purpose optics, primarily designed for manoeuvring, targeting and surveillance, combined with dazzling, obscuration and countermanoeuvres. Short-range active armour is based on search and track radar and intercepting grenades to defeat the threat. Acoustic threat detection increases the overall robustness of the DAS and extends the detection range to include small calibers. Finally, detection of active targeting systems is carried out with laser and radar warning receivers. Synthetic scene generation will provide the integrated environment needed to investigate, develop and validate these new capabilities. Computer generated imagery, based on validated models and an acceptable set of benchmark vignettes, can be used to investigate and develop fieldable sensors driven by real-time algorithms and countermeasure strategies. The synthetic scene environment will be suitable for sensor and countermeasure development in hardware-in-the-loop simulation. The research effort focuses on two key technical areas: a) computing aspects of the synthetic scene generation and b) and development of adapted models and databases. OneSAF is being developed for research and development, in addition to the original requirement of Simulation and Modelling for Acquisition, Rehearsal, Requirements and Training (SMARRT), and is becoming useful as a means for transferring technology to other users, researchers and contractors. This procedure

  12. Intelligent decision aids for abnormal events in nuclear power plants

    International Nuclear Information System (INIS)

    Kafka, P.; Polke, H.

    1988-01-01

    German nuclear power plants are characterized by a high degree of automation, not only for normal operation but also for abnormal events. Therefore the role of the operating personnel is mainly a supervisory function. Nevertheless, for a spectrum of unexpected events the operating personnel have to react with manual recovery actions. In order to minimize human error in such recovery actions, different kinds of intelligent decision aid support the operators today. In this paper such aids are discussed and one of them is described in more detail. (author)

  13. 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.

  14. An Introduction to Neural Networks for Hearing Aid Noise Recognition.

    Science.gov (United States)

    Kim, Jun W.; Tyler, Richard S.

    1995-01-01

    This article introduces the use of multilayered artificial neural networks in hearing aid noise recognition. It reviews basic principles of neural networks, and offers an example of an application in which a neural network is used to identify the presence or absence of noise in speech. The ability of neural networks to "learn" the…

  15. Value assessment aid to complex decision making. Final report

    International Nuclear Information System (INIS)

    Humphress, G.; Lewis, E.

    1982-07-01

    Value assessment (VA) is a new decision aid that can improve the performance of decisionmakers confronted with multiple attributes and conflicting objectives. Managers who are not supported by formal decision aids turn to various ''satisficing'' or effort-reducing biases that can lead to serious errors in the decisionmaking process. Value assessment, on the other hand, is an optimizing approach to problem-solving behavior. VA helps decisionmakers overcome the tendency to turn to effort-reducing biases by reducing the complexity of making tradeoffs and weighing all available information. Many of the issues which confront modern electric utility managements are complex, multiple attribute problems which must be viewed from engineering, financial and socio-political perspectives simultaneously. Added to this are the complications contributed by factors like uncertainty, risk, incomplete information and conflicting objectives among the public it serves. This is the complex decisionmaking arena which VA is intended to support

  16. Operation and validation of the decision aid system 'CAIRE' in complex terrain

    International Nuclear Information System (INIS)

    De Witt, H.; Nuesser, A.; Brenk, H.D.

    1998-01-01

    In cases of nuclear emergencies it is the primary task of emergency response forces and decision making authorities to act properly. Based on telemetric surveillance networks, an advanced automatic on-line decision support system named CAIRE (Computer Aided Response to Emergencies) has been developed and is in operation now at 4 sites as a real time emergency response tool. This tool is designed to provide decision makers with precise radiation exposure data for the population at risk. Depending on the individual layout of the connected telemetric networks, CAIRE is able to satisfy the following main requirements: automatic identification of the source location and of the source term, automatic diagnosis of the actual radiological situation and identification of the endangered area, projection of the radiological situation, delivery of all this information in the form computer graphics. (R.P.)

  17. Decision aid prototype development for parents considering adenotonsillectomy for their children with sleep disordered breathing

    OpenAIRE

    Maguire, Erin; Hong, Paul; Ritchie, Krista; Meier, Jeremy; Archibald, Karen; Chorney, Jill

    2016-01-01

    Background To describe the process involved in developing a decision aid prototype for parents considering adenotonsillectomy for their children with sleep disordered breathing. Methods A paper-based decision aid prototype was developed using the framework proposed by the International Patient Decision Aids Standards Collaborative. The decision aid focused on two main treatment options: watchful waiting and adenotonsillectomy. Usability was assessed with parents of pediatric patients and prov...

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

    Science.gov (United States)

    Siminoff, L A; Sandberg, D E

    2015-05-01

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

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

    Science.gov (United States)

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

    2015-09-24

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

  20. Are patient decision aids the best way to improve clinical decision making? Report of the IPDAS Symposium.

    Science.gov (United States)

    Holmes-Rovner, Margaret; Nelson, Wendy L; Pignone, Michael; Elwyn, Glyn; Rovner, David R; O'Connor, Annette M; Coulter, Angela; Correa-de-Araujo, Rosaly

    2007-01-01

    This article reports on the International Patient Decision Aid Standards Symposium held in 2006 at the annual meeting of the Society for Medical Decision Making in Cambridge, Massachusetts. The symposium featured a debate regarding the proposition that "decision aids are the best way to improve clinical decision making.'' The formal debate addressed the theoretical problem of the appropriate gold standard for an improved decision, efficacy of decision aids, and prospects for implementation. Audience comments and questions focused on both theory and practice: the often unacknowledged roots of decision aids in expected utility theory and the practical problems of limited patient decision aid implementation in health care. The participants' vote on the proposition was approximately half for and half against.

  1. Regional Climate Change and Development of Public Health Decision Aids

    Science.gov (United States)

    Hegedus, A. M.; Darmenova, K.; Grant, F.; Kiley, H.; Higgins, G. J.; Apling, D.

    2011-12-01

    According to the World Heath Organization (WHO) climate change is a significant and emerging threat to public health, and changes the way we must look at protecting vulnerable populations. Worldwide, the occurrence of some diseases and other threats to human health depend predominantly on local climate patterns. Rising average temperatures, in combination with changing rainfall patterns and humidity levels, alter the lifecycle and regional distribution of certain disease-carrying vectors, such as mosquitoes, ticks and rodents. In addition, higher surface temperatures will bring heat waves and heat stress to urban regions worldwide and will likely increase heat-related health risks. A growing body of scientific evidence also suggests an increase in extreme weather events such as floods, droughts and hurricanes that can be destructive to human health and well-being. Therefore, climate adaptation and health decision aids are urgently needed by city planners and health officials to determine high risk areas, evaluate vulnerable populations and develop public health infrastructure and surveillance systems. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. WRF model is initialized with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model simulations forced with the Special Report on Emissions (SRES) A1B emissions scenario. Our methodology involves development of climatological indices of extreme weather, quantifying the risk of occurrence of water/rodent/vector-borne diseases as well as developing various heat stress related decision aids. Our results indicate that the downscale simulations provide the necessary

  2. 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

  3. A study on spatial decision support systems for HIV/AIDS prevention based on COM GIS technology

    Science.gov (United States)

    Yang, Kun; Luo, Huasong; Peng, Shungyun; Xu, Quanli

    2007-06-01

    Based on the deeply analysis of the current status and the existing problems of GIS technology applications in Epidemiology, this paper has proposed the method and process for establishing the spatial decision support systems of AIDS epidemic prevention by integrating the COM GIS, Spatial Database, GPS, Remote Sensing, and Communication technologies, as well as ASP and ActiveX software development technologies. One of the most important issues for constructing the spatial decision support systems of AIDS epidemic prevention is how to integrate the AIDS spreading models with GIS. The capabilities of GIS applications in the AIDS epidemic prevention have been described here in this paper firstly. Then some mature epidemic spreading models have also been discussed for extracting the computation parameters. Furthermore, a technical schema has been proposed for integrating the AIDS spreading models with GIS and relevant geospatial technologies, in which the GIS and model running platforms share a common spatial database and the computing results can be spatially visualized on Desktop or Web GIS clients. Finally, a complete solution for establishing the decision support systems of AIDS epidemic prevention has been offered in this paper based on the model integrating methods and ESRI COM GIS software packages. The general decision support systems are composed of data acquisition sub-systems, network communication sub-systems, model integrating sub-systems, AIDS epidemic information spatial database sub-systems, AIDS epidemic information querying and statistical analysis sub-systems, AIDS epidemic dynamic surveillance sub-systems, AIDS epidemic information spatial analysis and decision support sub-systems, as well as AIDS epidemic information publishing sub-systems based on Web GIS.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. A Framework for Evaluating the Cost-Effectiveness of Patient Decision Aids: A Case Study Using Colorectal Cancer Screening

    Science.gov (United States)

    Cantor, Scott B.; Rajan, Tanya; Linder, Suzanne K.; Volk, Robert J.

    2017-01-01

    Objective Patient decision aids are important tools for facilitating balanced, evidence-based decision making. However, the potential of decision aids to lower health care utilization and costs is uncertain; few studies have investigated the cost-effectiveness of decision aids that change patient behavior. Using an example of a decision aid for colorectal cancer screening, we provide a framework for analyzing the cost-effectiveness of decision aids. Methods A decision-analytic model with two strategies (decision aid or no decision aid) was used to calculate expected costs in U.S. dollars and benefits measured in life-years saved (LYS). Data from a systematic review of ten studies about decision aid effectiveness was used to calculate the percentage increase in the number of people choosing screening instead of no screening. We then calculated the incremental cost per LYS with the use of the decision aid. Results The no decision aid strategy had an expected cost of $3,023 and yielded 18.19 LYS. The decision aid strategy cost $3,249 and yielded 18.20 LYS. The incremental cost-effectiveness ratio for the decision aid strategy was $36,126 per LYS. Results were sensitive to the cost of the decision aid and the percentage change in behavior caused by the decision aid. Conclusions This study provides proof-of-concept evidence for future studies examining the cost-effectiveness of decision aids. The results suggest that decision aids can be beneficial and cost-effective. PMID:25979678

  10. Shared decision making and patient decision aids: knowledge, attitudes, and practices among Hawai'i physicians.

    Science.gov (United States)

    Alden, Dana L; Friend, John; Chun, Maria B J

    2013-11-01

    As the health care field moves toward patient-centered care (PCC), increasing emphasis has been placed on the benefits of patient decision aids for promoting shared decision making (SDM). This study provides a baseline measure of knowledge, attitudes, and practices (KAP) among Hawai'i's physicians with respect to patient decision aids (DAs). Physicians throughout the State of Hawai'i were invited to complete a survey assessing their knowledge, attitudes, and practices with respect to the clinical use of DAs. One hundred and seventy four valid surveys were analyzed. Reported awareness and use of DAs were low, but recognition of the benefits of SDM and openness to the use of DAs were very high. The leading perceived barriers to the implementation of DAs were lack of awareness, lack of resources, and limited physician time to learn about DA technology. However, a significant majority of the respondents reported that DAs could empower patients by improving knowledge (88%), increasing satisfaction with the consultation process (81%), and increasing compliance (74%). Among physicians currently employing DAs, use of brochures or options matrix sheets was the most common aid tool. However, leading recommended DA formats were paper-based brochures for clinic use (75%) and interactive online website programs for outside clinic use (73.5%). Given growing emphasis on the PCC model and the recognized desire of many patients to participate in the medical decision making process, positive responses toward SDM and the use of DAs by Hawai'i physicians are promising.

  11. 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...

  12. 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 ...

  13. Measuring the Extent of European State Aid Control : An Econometric Analysis of the European Commission Decisions

    NARCIS (Netherlands)

    Brouwer, E.; Ozbugday, F.C.

    2011-01-01

    This paper provides an analysis of the European Commission (EC) decisions on state aid control using data on 550 state aid cases approved by the EC between 1998 and 2009. More specifically, we measure the determinants of the duration of state aid, total budget of state aid and daily budget of state

  14. Measuring the Extent of European State Aid Control : An Econometric Analysis of the European Commission Decisions

    NARCIS (Netherlands)

    Brouwer, E.; Ozbugday, F.C.

    2010-01-01

    This paper provides an analysis of the European Commission (EC) decisions on state aid control using data on 550 state aid cases approved by the EC between 1998 and 2009. More specifically, we measure the determinants of the duration of state aid, total budget of state aid and daily budget of state

  15. The neglected topic: presentation of cost information in patient decision AIDS.

    Science.gov (United States)

    Blumenthal-Barby, J S; Robinson, Emily; Cantor, Scott B; Naik, Aanand D; Russell, Heidi Voelker; Volk, Robert J

    2015-05-01

    Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. © The Author(s) 2015.

  16. Studies and Analyses of Aided Adversarial Decision Making. Phase 2: Research on Human Trust in Automation

    National Research Council Canada - National Science Library

    Llinas, James

    1998-01-01

    .... Given that offensive IW operations may interfere with automated, data-fusion based decision aids, it is necessary to understand how personnel may rely on or trust these aids when appropriate (e.g...

  17. Decision aids for multiple-decision disease management as affected by weather input errors.

    Science.gov (United States)

    Pfender, W F; Gent, D H; Mahaffee, W F; Coop, L B; Fox, A D

    2011-06-01

    Many disease management decision support systems (DSSs) 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 management decision recommendations. The extent to which errors in weather inputs affect the quality of the final management outcome depends on a number of aspects of the disease management context, including whether management consists of a single dichotomous decision, or of a multi-decision process extending over the cropping season(s). Decision aids for multi-decision disease management typically are based on simple or complex algorithms of weather data which may be accumulated over several days or weeks. It is difficult to quantify accuracy of multi-decision DSSs due to temporally overlapping disease events, existence of more than one solution to optimizing the outcome, opportunities to take later recourse to modify earlier decisions, and the ongoing, complex decision process in which the DSS is only one component. One approach to assessing importance of weather input errors is to conduct an error analysis in which the DSS outcome from high-quality weather data is compared with that from weather data with various levels of bias and/or variance from the original data. We illustrate this analytical approach for two types of DSS, an infection risk index for hop powdery mildew and a simulation model for grass stem rust. Further exploration of analysis methods is needed to address problems associated with assessing uncertainty in multi-decision DSSs.

  18. Justification, optimization and decision-aiding in existing exposure situations

    International Nuclear Information System (INIS)

    Hedemann-Jensen, Per

    2004-01-01

    The existing ICRP system of radiological protection from 1990 (ICRP Publication 60) can be seen as a binary or dual-line system dealing with protection in exposure situations categorized as either practices or interventions. The distinction between practices and interventions is summarized in the paper with focus on some of the problems experienced in making such a distinction. The protection principles within the existing system of protection are presented with emphasis on the application to de facto or existing exposure situations. Decision on countermeasures to mitigate the consequences of existing exposure situations such as nuclear or radiological accidents and naturally occurring exposure situations include factors or attributes describing benefits from the countermeasure and those describing harm. Some of these attributes are discussed and the general process of justification of intervention and optimization of protection arriving at generic reference levels for implementing protective measures is presented. In addition, the role of radiological protection professionals and other stakeholders in the decision-making process is discussed. Special attention is given to the question whether radiological protection should form only one of many decision-aiding inputs to a broader societal decision-making process or whether societal aspects should be fully integrated into the radiological protection framework. The concepts of practices and interventions, however logical they are, have created some confusion when applied to protection of the public following a nuclear or radiological accident. These problems may be solved in a new set of general ICRP recommendations on radiological protection, which are anticipated to supersede Publication 60 in 2005. The evolution of the basic ICRP principles for radiological protection in existing exposure situations into a new set of ICRP recommendations is briefly discussed based upon the various material that has been presented

  19. Negative Affect, Decision Making, and Attentional Networks.

    Science.gov (United States)

    Ortega, Ana Raquel; Ramírez, Encarnación; Colmenero, José María; García-Viedma, Ma Del Rosario

    2017-02-01

    This study focuses on whether risk avoidance in decision making depends on negative affect or it is specific to anxious individuals. The Balloon Analogue Risk Task was used to obtain an objective measure in a risk situation with anxious, depressive, and control individuals. The role of attentional networks was also studied using the Attentional Network Test-Interaction (ANT-I) task with neutral stimuli. A significant difference was observed between anxious and depressive individuals in assumed risk in decision making. We found no differences between anxious and normal individuals in the alert, orientation, and congruency effects obtained in the ANT-I task. The results showed that there was no significant relationship between the risk avoidance and the indexes of alertness, orienting, and control. Future research shall determine whether emotionally relevant stimulation leads to attentional control deficit or whether differences between anxious and no anxious individuals are due to the type of strategy followed in choice tasks.

  20. Review of Multi-Criteria Decision Aid for Integrated Sustainability Assessment of Urban Water Systems - MCEARD

    Science.gov (United States)

    Integrated sustainability assessment is part of a new paradigm for urban water decision making. Multi-criteria decision aid (MCDA) is an integrative framework used in urban water sustainability assessment, which has a particular focus on utilising stakeholder participation. Here ...

  1. Decision aids for familial breast cancer: exploring women's views using focus groups.

    NARCIS (Netherlands)

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

    2006-01-01

    BACKGROUND: There is increasing need for accessible information about familial breast cancer for those facing complex decisions around genetic testing, screening and treatment. Information currently includes leaflets and computerized decision aids, offering interactive interfaces to clarify complex

  2. Decision aids for second-line palliative chemotherapy: a randomised phase II multicentre trial

    NARCIS (Netherlands)

    Oostendorp, L.J.M.; Ottevanger, P.B.; Donders, A.R.T.; Wouw, A.J. van de; Schoenaker, I.J.; Smilde, T.J.; Graaf, W.T.A. van der; Stalmeier, P.F.M.

    2017-01-01

    BACKGROUND: There is increasing recognition of the delicate balance between the modest benefits of palliative chemotherapy and the burden of treatment. Decision aids (DAs) can potentially help patients with advanced cancer with these difficult treatment decisions, but providing detailed information

  3. Explanation and elaboration of the Standards for UNiversal reporting of patient Decision Aid Evaluations (SUNDAE) guidelines: examples of reporting SUNDAE items from patient decision aid evaluation literature

    Science.gov (United States)

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

    2018-01-01

    This Explanation and Elaboration (E&E) article expands on the 26 items in the Standards for UNiversal reporting of Decision Aid Evaluations guidelines. The E&E provides a rationale for each item and includes examples for how each item has been reported in published papers evaluating patient decision aids. The E&E focuses on items key to reporting studies evaluating patient decision aids and is intended to be illustrative rather than restrictive. Authors and reviewers may wish to use the E&E broadly to inform structuring of patient decision aid evaluation reports, or use it as a reference to obtain details about how to report individual checklist items. PMID:29467235

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

    Directory of Open Access Journals (Sweden)

    Glyn Elwyn

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

  5. Development of a decision aid for children faced with the decision to undergo dental treatment with sedation or general anaesthesia.

    Science.gov (United States)

    Hulin, Joe; Baker, Sarah R; Marshman, Zoe; Albadri, Sondos; Rodd, Helen D

    2017-09-01

    Decision aids are tools used to help individuals faced with difficult healthcare decisions. They help patients further understand the treatment options available and encourage the sharing of information between patients and clinicians. To develop a decision aid for young patients faced with the decision to undergo dental treatment with inhalation sedation, intravenous sedation, or general anaesthesia (GA). Qualitative interviews with dental patients (aged 10-16 years), and their parents/guardians were used to inform the content of a draft decision aid. Following further revisions, a pilot evaluation of the decision aid was conducted. Patients referred for dental treatment with sedation or GA were recruited from a UK dental hospital. Patients (n = 15) and parents/guardians (n = 13) assigned to the intervention group received the decision aid and routine clinical counselling, whereas patients (n = 17) and parents/guardians (n = 13) in the control group only received routine clinical counselling. Participants completed measures of knowledge, decisional conflict, and dental anxiety. Knowledge scores were significantly higher for participants who received the decision aid when compared to standard care. There were no other significant differences between groups. A decision aid was successfully developed, and initial findings suggest such tools could be beneficial to dental sedation or GA patients and their parents/guardians. Further research is required on the use of such tools in primary care settings, with particular attention to the impact of the decision aid on attendance and completion rates of treatment. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. 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.

  7. Offering online recommendations with minimum customer input through conjoint-based decision aids

    NARCIS (Netherlands)

    De Bruyn, Arnaud; Liechty, John C.; Huizingh, Eelko K. R. E.; Lilien, Gary L.

    2008-01-01

    In their purchase decisions, online customers seek to improve decision quality while limiting search efforts. In practice, many merchants have understood the importance of helping customers in the decision-making process and provide online decision aids to their visitors. In this paper, we show how

  8. 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 ...

  9. Trustworthy patient decision aids: a qualitative analysis addressing the risk of competing interests

    NARCIS (Netherlands)

    Elwyn, G.; Dannenberg, M.; Blaine, A.; Poddar, U.; Durand, M.A.

    2016-01-01

    OBJECTIVE: Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. DESIGN: Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing

  10. 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

  11. 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.

  12. Acceptance of shared decision making with reference to an electronic library of decision aids (arriba-lib) and its association to decision making in patients: an evaluation study.

    Science.gov (United States)

    Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

    2011-07-07

    Decision aids based on the philosophy of shared decision making are designed to help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes. A patient decision aid can be regarded as a complex intervention because it consists of several presumably relevant components. Decision aids have rarely been field tested to assess patients' and physicians' attitudes towards them. It is also unclear what effect decision aids have on the adherence to chosen options. The electronic library of decision aids (arriba-lib) to be used within the clinical encounter has a modular structure and contains 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. We conducted an evaluation study in which 29 primary care physicians included 192 patients. After the consultation, patients filled in questionnaires and were interviewed via telephone two months later. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Patients were highly satisfied with arriba-lib and the process of shared decision making. Two-thirds of patients reached in the telephone interview wanted to be counselled again with arriba-lib. There was a high congruence between preferred and perceived decision making. Of those patients reached in the telephone interview, 80.7% said that they implemented the decision, independent of gender and education. Elderly patients were more likely to say that they implemented the decision. Shared decision making with our multi-modular electronic library of decision aids (arriba-lib) was accepted by a high number of patients. It has positive associations to general aspects of decision making in patients. It can be used for patient groups with a wide range of individual

  13. Promoting the dissemination of decision aids: an odyssey in a dysfunctional health care financing system.

    Science.gov (United States)

    Billings, John

    2004-01-01

    The usefulness of patient decision aids (PtDAs) is well documented, yet they are not in widespread use. Barriers include assuring balance and fairness (auspices matter), the cost of producing and maintaining them, and getting them into the hands of patients at the right time. The Foundation for Informed Medical Decision Making and its for-profit partner, Health Dialog, have developed a creative business model that helps overcome these barriers and has greatly expanded the reach of decision aids.

  14. Network approaches for expert decisions in sports.

    Science.gov (United States)

    Glöckner, Andreas; Heinen, Thomas; Johnson, Joseph G; Raab, Markus

    2012-04-01

    This paper focuses on a model comparison to explain choices based on gaze behavior via simulation procedures. We tested two classes of models, a parallel constraint satisfaction (PCS) artificial neuronal network model and an accumulator model in a handball decision-making task from a lab experiment. Both models predict action in an option-generation task in which options can be chosen from the perspective of a playmaker in handball (i.e., passing to another player or shooting at the goal). Model simulations are based on a dataset of generated options together with gaze behavior measurements from 74 expert handball players for 22 pieces of video footage. We implemented both classes of models as deterministic vs. probabilistic models including and excluding fitted parameters. Results indicated that both classes of models can fit and predict participants' initially generated options based on gaze behavior data, and that overall, the classes of models performed about equally well. Early fixations were thereby particularly predictive for choices. We conclude that the analyses of complex environments via network approaches can be successfully applied to the field of experts' decision making in sports and provide perspectives for further theoretical developments. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation

    Science.gov (United States)

    Cox, Christopher E.; Lewis, Carmen L.; Hanson, Laura C.; Hough, Catherine L.; Kahn, Jeremy M.; White, Douglas B.; Song, Mi-Kyung; Tulsky, James A.; Carson, Shannon S.

    2013-01-01

    Objective Shared decision making is inadequate in intensive care units (ICUs). Decision aids can improve decision making quality, though their role in an ICU setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation. Setting ICUs at three medical centers. Subjects 53 surrogate decision makers and 58 physicians. Design and interventions We developed the decision aid using defined methodological guidelines. After an iterative revision process, formative cognitive testing was performed among surrogate-physician dyads. Next, we compared the decision aid to usual care control in a prospective, before/after design study. Measurements and main results Primary outcomes were physician-surrogate discordance for expected patient survival, comprehension of relevant medical information, and the quality of communication. Compared to control, the intervention group had lower surrogate-physician discordance (7 [10] vs 43 [21]), greater comprehension (11.4 [0.7] vs 6.1 [3.7]), and improved quality of communication (8.7 [1.3] vs 8.4 [1.3]) (all ppost-intervention. Hospital costs were lower in the intervention group ($110,609 vs $178,618; p=0.044); mortality did not differ by group (38% vs 50%, p=0.95). 94% of surrogates and 100% of physicians reported that the decision aid was useful in decision making. Conclusion We developed a prolonged mechanical ventilation decision aid that is feasible, acceptable, and associated with both improved decision making quality and less resource utilization. Further evaluation using a randomized controlled trial design is needed to evaluate the decision aid's effect on long-term patient and surrogate outcomes. PMID:22635048

  16. 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

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

    OpenAIRE

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

    2015-01-01

    Background 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 br...

  18. Teaching advance care planning to medical students with a computer-based decision aid.

    Science.gov (United States)

    Green, Michael J; Levi, Benjamin H

    2011-03-01

    Discussing end-of-life decisions with cancer patients is a crucial skill for physicians. This article reports findings from a pilot study evaluating the effectiveness of a computer-based decision aid for teaching medical students about advance care planning. Second-year medical students at a single medical school were randomized to use a standard advance directive or a computer-based decision aid to help patients with advance care planning. Students' knowledge, skills, and satisfaction were measured by self-report; their performance was rated by patients. 121/133 (91%) of students participated. The Decision-Aid Group (n = 60) outperformed the Standard Group (n = 61) in terms of students' knowledge (p satisfaction with their learning experience (p student performance. Use of a computer-based decision aid may be an effective way to teach medical students how to discuss advance care planning with cancer patients.

  19. Rade-aid a decision support system to evaluate countermeasures after a radiological accident

    International Nuclear Information System (INIS)

    Wagenaar, G.; Van Den Bosch, C.J.H.; Weger, D. de.

    1990-01-01

    After Chernobyl the authorities in many countries were overwhelmed by the enormous amount of information that was being generated by measuring and monitoring programs. In making decisions, this information had to be combined with the results of specific countermeasures, in order to determine the optimal strategy with respect to a large number of consequences. The development of RADE-AID, the Radiological Accident Decision AIDing system, is aimed at providing a powerful tool in the decision-making process. RADE-AID is developed by TNO (The Netherlands) in a joint contract with KfK (FRG) and NRPB (UK). In the first phase a demonstration system will be built, called RADE-AID/D. RADE-AID/D will be used as a decision support system in the intermediate and late phase after a radiological accident. RADE-AID/D will consider countermeasures with respect to external exposure and internal exposure by food ingestion. Countermeasures are evaluated considering reduction in doses and in numbers of health effects, costs, and social effects. The paper covers the structure of the program, presentation of data and results, and the decision analysis technique that is being used. This decision analysis part is an important feature of the system; an advanced decision analysis technique is used, that is able to compare data of varying nature. Furthermore the place of RADE-AID in the decision-making process will be treated. RADE-AID/D is an interactive computer program, that offers the user the possibility to enter relevant data and to have data and results displayed in a variety of ways. Furthermore the system contains an advanced decision analysis technique, that is able to compare data of varying nature. Input data for the decision analysis calculations are provided by models from UFOMOD and MARC-codes

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

    African Journals Online (AJOL)

    AJRH Managing Editor

    networks play in decision making for and facilitation of clandestine abortions. It was a mixed ... Keywords: abortion decisions, social influence, health seeking behavior. Résumé ..... Special attention is given to young women who depend more ...

  1. Right choice, right time: Evaluation of an online decision aid for youth depression.

    Science.gov (United States)

    Simmons, Magenta B; Elmes, Aurora; McKenzie, Joanne E; Trevena, Lyndal; Hetrick, Sarah E

    2017-08-01

    Appropriate treatment for youth depression is an important public health priority. Shared decision making has been recommended, yet no decision aids exist to facilitate this. The main objective of this study was to evaluate an online decision aid for youth depression. An uncontrolled cohort study with pre-decision, immediately post-decision and follow-up measurements. Young people (n=66) aged 12-25 years with mild, mild-moderate or moderate-severe depression were recruited from two enhanced primary care services. Online decision aid with evidence communication, preference elicitation and decision support components. The main outcome measures were ability to make a decision; whether the decision was in line with clinical practice guidelines, personal preferences and values; decisional conflict; perceived involvement; satisfaction with decision; adherence; and depression scores at follow-up. After using the decision aid, clients were more likely to make a decision in line with guideline recommendations (93% vs 70%; P=.004), were more able to make a decision (97% vs 79%; P=.022), had significantly reduced decisional conflict (17.8 points lower (95% CI: 13.3-22.9 points lower) on the Decisional Conflict Scale (range 0-100)) and felt involved and satisfied with their decision. At follow-up, clients had significantly reduced depression symptoms (2.7 points lower (95% CI: 1.3-4.0 points lower) on the Patient Health Questionnaire nine-item scale (range 0-27)) and were adherent to 88% (95% CI: 82%-94%) of treatment courses. A decision aid for youth depression can help ensure evidence-based, client-centred care, promoting collaboration in this often difficult to engage population. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  2. 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.

  3. Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making.

    Science.gov (United States)

    Schroy, Paul C; Mylvaganam, Shamini; Davidson, Peter

    2014-02-01

    Decision aids for colorectal cancer (CRC) screening have been shown to enable patients to identify a preferred screening option, but the extent to which such tools facilitate shared decision making (SDM) from the perspective of the provider is less well established. Our goal was to elicit provider feedback regarding the impact of a CRC screening decision aid on SDM in the primary care setting. Cross-sectional survey. Primary care providers participating in a clinical trial evaluating the impact of a novel CRC screening decision aid on SDM and adherence. Perceptions of the impact of the tool on decision-making and implementation issues. Twenty-nine of 42 (71%) eligible providers responded, including 27 internists and two nurse practitioners. The majority (>60%) felt that use of the tool complimented their usual approach, increased patient knowledge, helped patients identify a preferred screening option, improved the quality of decision making, saved time and increased patients' desire to get screened. Respondents were more neutral is their assessment of whether the tool improved the overall quality of the patient visit or patient satisfaction. Fewer than 50% felt that the tool would be easy to implement into their practices or that it would be widely used by their colleagues. Decision aids for CRC screening can improve the quality and efficiency of SDM from the provider perspective but future use is likely to depend on the extent to which barriers to implementation can be addressed. © 2011 John Wiley & Sons Ltd.

  4. Review of decision aids for nuclear-plant operators

    International Nuclear Information System (INIS)

    Kisner, R.A.

    1983-01-01

    Responses to various computer-based operational aids varied widely in detail, thus forcing distillation of the salient features of many operational aids from information sources other than the initial questionnaire. These sources included technical and management presentations, technical papers and reports, personal discussions, taped responses, sales brochures, system specifications and schematics, and other documents. The data base is dynamic, not static, owing to the nature of current trends in operational aid development. The information contained in it is subject to review and revision by the developing organizations. More systems are pending review and entry into the data base; hence the list is incomplete

  5. Nearest unlike neighbor (NUN): an aid to decision confidence estimation

    Science.gov (United States)

    Dasarathy, Belur V.

    1995-09-01

    The concept of nearest unlike neighbor (NUN), proposed and explored previously in the design of nearest neighbor (NN) based decision systems, is further exploited in this study to develop a measure of confidence in the decisions made by NN-based decision systems. This measure of confidence, on the basis of comparison with a user-defined threshold, may be used to determine the acceptability of the decision provided by the NN-based decision system. The concepts, associated methodology, and some illustrative numerical examples using the now classical Iris data to bring out the ease of implementation and effectiveness of the proposed innovations are presented.

  6. 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.

  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. 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...

  9. 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

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

    Science.gov (United States)

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

    2016-01-01

    Background 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. Objective 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. Methods 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. Results 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

  11. Making fair decisions about financing care for persons with AIDS.

    Science.gov (United States)

    Roper, W L; Winkenwerder, W

    1988-01-01

    An estimated 40 percent of the nation's 55,000 persons with acquired immunodeficiency syndrome (AIDS) have received care under the Medicaid Program, which is administered by the Health Care Financing Administration (HCFA) and funded jointly by the Federal Government and the States. In fiscal year 1988, Medicaid will spend between $700 and $750 million for AIDS care and treatment. Medicaid spending on AIDS is likely to reach $2.4 billion by fiscal year 1992, an estimate that does not include costs of treatment with zidovudine (AZT). Four policy principles are proposed for meeting this new cost burden in a way that is fair, responsive, efficient, and in harmony with our current joint public-private system of health care financing. The four guidelines are to (a) treat AIDS as any other serious disease, without the creation of a disease-specific entitlement program; (b) bring AIDS treatment financing into the mainstream of the health care financing system, making it a shared responsibility and promoting initiatives such as high-risk insurance pools: (c) give States the flexibility to meet local needs, including Medicaid home care and community-based care services waivers; (d) encourage health care professionals to meet their obligation to care for AIDS patients. PMID:3131823

  12. 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

  13. Analytic Procedures For Designing and Evaluating Decision Aids.

    Science.gov (United States)

    1980-04-01

    the taxonomy of decision charateristics . Chapter 5 applies the taxonomies to the information processing functions needed for AAW decisions, and...rationality emphasizes the extent to which organizations and other social institutions consist of individuals who pursue individual objectives by means of...adaptive rationality is always wrong or naive; most of us know persons that seem to be naturally good decision-makers. There is no logic that guarantees

  14. Combining morphological analysis and Bayesian networks for strategic decision support

    Directory of Open Access Journals (Sweden)

    A de Waal

    2007-12-01

    Full Text Available Morphological analysis (MA and Bayesian networks (BN are two closely related modelling methods, each of which has its advantages and disadvantages for strategic decision support modelling. MA is a method for defining, linking and evaluating problem spaces. BNs are graphical models which consist of a qualitative and quantitative part. The qualitative part is a cause-and-effect, or causal graph. The quantitative part depicts the strength of the causal relationships between variables. Combining MA and BN, as two phases in a modelling process, allows us to gain the benefits of both of these methods. The strength of MA lies in defining, linking and internally evaluating the parameters of problem spaces and BN modelling allows for the definition and quantification of causal relationships between variables. Short summaries of MA and BN are provided in this paper, followed by discussions how these two computer aided methods may be combined to better facilitate modelling procedures. A simple example is presented, concerning a recent application in the field of environmental decision support.

  15. Tactical and strategic decision-making aids for nuclear power plant emergency response

    International Nuclear Information System (INIS)

    Cain, D.G.

    1987-01-01

    This paper examines the prospective role of computer-based decision aids for nuclear power plant emergency response. The role of these systems is subordinate to human activities, but in a complementary manner these systems process decision logic more accurately and foster a more thorough understanding of emergency situations than might other wise be possible. Within this context two decision support systems being developed are discussed. Both of these systems utilize technology derived from artificial intelligence, focussing on two different facets of emergency response. An automated emergency operating procedures (EOP) tracking expert system is described as a tactical aid for control room operator response. A reactor emergency action level monitor (REALM) expert system is proposed as a strategic decision aid for site emergency response. The discrimination between tactical and strategic decision-making is an intrinsic part of this examination

  16. 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.

  17. The Pathways fertility preservation decision aid website for women with cancer: development and field testing.

    Science.gov (United States)

    Woodard, Terri L; Hoffman, Aubri S; Covarrubias, Laura A; Holman, Deborah; Schover, Leslie; Bradford, Andrea; Hoffman, Derek B; Mathur, Aakrati; Thomas, Jerah; Volk, Robert J

    2018-02-01

    To improve survivors' awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©. Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14). Field-testing (n = 20 survivors) assessed post-decision aid scores on the Fertility Preservation Knowledge Scale, feasibility of assessing women's decision-making values while using the website, and website usability/acceptability ratings. Iterative stakeholder engagement optimized the Pathways decision aid website to meet survivors' and providers' needs, including providing patient-friendly information and novel features such as interactive value clarification exercises, testimonials that model shared decision making, financial/referral resources, and a printable personal summary. Survivors scored an average of 8.2 out of 13 (SD 1.6) on the Fertility Preservation Knowledge Scale. They rated genetic screening and having a biological child as strong factors in their decision-making, and 71% indicated a preference for egg freezing. Most women (> 85%) rated Pathways favorably, and all women (100%) said they would recommend it to other women. The Pathways decision aid is a usable and acceptable tool to help women learn about fertility preservation. The Pathways decision aid may help women make well-informed values-based decisions and prevent future infertility-related distress.

  18. 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

  19. Evidence-based surgery: Dissemination, communication, decision aids

    NARCIS (Netherlands)

    Knops, A.M.

    2013-01-01

    Surgeons are expected to make treatment decisions that are based on the best available evidence. Moreover, they are called to recognise that important decisions should also be shared with patients. While dissemination of evidence-based surgery and communication of evidence to patients have been

  20. Do personal stories make patient decision aids more effective? A critical review of theory and evidence

    Science.gov (United States)

    2013-01-01

    Background Patient decision aids support people to make informed decisions between healthcare options. Personal stories provide illustrative examples of others’ experiences and are seen as a useful way to communicate information about health and illness. Evidence indicates that providing information within personal stories affects the judgments and values people have, and the choices they make, differentially from facts presented in non-narrative prose. It is unclear if including narrative communications within patient decision aids enhances their effectiveness to support people to make informed decisions. Methods A survey of primary empirical research employing a systematic review method investigated the effect of patient decision aids with or without a personal story on people’s healthcare judgements and decisions. Searches were carried out between 2005-2012 of electronic databases (Medline, PsycINFO), and reference lists of identified articles, review articles, and key authors. A narrative analysis described and synthesised findings. Results Of 734 citations identified, 11 were included describing 13 studies. All studies found participants’ judgments and/or decisions differed depending on whether or not their decision aid included a patient story. Knowledge was equally facilitated when the decision aids with and without stories had similar information content. Story-enhanced aids may help people recall information over time and/or their motivation to engage with health information. Personal stories affected both “system 1” (e.g., less counterfactual reasoning, more emotional reactions and perceptions) and “system 2” (e.g., more perceived deliberative decision making, more stable evaluations over time) decision-making strategies. Findings exploring associations with narrative communications, decision quality measures, and different levels of literacy and numeracy were mixed. The pattern of findings was similar for both experimental and real

  1. Veterans Like Me: Formative evaluation of a patient decision aid design.

    Science.gov (United States)

    Gibson, Bryan; Butler, Jorie; Doyon, Katherine; Ellington, Lee; Bray, Bruce E; Zeng, Qing

    2017-07-01

    Patient decision aids are tools intended to facilitate shared decision-making. Currently development of a patient decision aid is resource intensive: it requires a decision-specific review of the scientific literature by experts to ascertain the potential outcomes under different treatments. The goal of this project was to conduct a formative evaluation of a generalizable, scalable decision aid component we call Veterans Like Me (VLme). VLme mines EHR data to present the outcomes of individuals "like you" on different treatments to the user. These outcome are presented through a combination of an icon array and simulated narratives. Twenty-six patients participated in semi-structured interviews intended to elicit feedback on the tool's functional and interface design. The interview focused on the filters users desired with which to make cases similar to them, the kinds of outcomes they wanted presented, and their envisioned use of the tool. The interview also elicited participants information needs and salient factors related to the therapeutic decision. The interview transcripts were analyzed using an iteratively refined coding schema and content analysis. . Participants generally expressed enthusiasm for the tool's design and functionality. Our analysis identified desired filters for users to view patients like themselves, outcome types that should be included in future iterations of the tool (e.g. patient reported outcomes), and information needs that need to be addressed for patients to effectively participate in shared decision making. Implications for the integration of our findings into the design of patient decision aids are discussed. Published by Elsevier Inc.

  2. Constructing a relevant decision aid for parents of children with bronchopulmonary dysplasia.

    Science.gov (United States)

    Skibo, M; Guillen, U; Zhang, H; Munson, D; Mackley, A; Nilan, K; Kirpalani, H

    2017-12-01

    To develop and test a decision aid for counseling parents of children with bronchopulmonary dysplasia (BPD).Local problem:Parental education about complex conditions is not standardized and communication and understanding may not be adequate. Semi-structured interviews were conducted with 33 neonatal clinicians and 12 parents of children with BPD using a qualitative research design. The interviews were used to identify education topics that were felt to be important in BPD education. These topics were then used to create a visual decision aid to be used in counseling sessions with parents. The decision aid was then used in mock counseling sessions with 15 'experienced' participants and 7 'naïve' participants to assess its efficacy. The participants completed a pre and post test to assess change in knowledge as well as an 11-question Likert style acceptability survey. Implementation of a decision aid while educating parents about BPD. Topics identified during the interviews were used to create eight educational cards which included pictures, pictographs and statistics. Overall, participants thought the decision aid contained an appropriate amount of information, were easy to understand and improved their knowledge about BPD. Testing demonstrated a significant increase in knowledge in both the 'experienced' (Pdecision aid for parents of children with BPD may improve understanding of the condition and help facilitate communication between parents and doctors.

  3. 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.

  4. onlineDeCISion.org: a web-based decision aid for DCIS treatment.

    Science.gov (United States)

    Ozanne, Elissa M; Schneider, Katharine H; Soeteman, Djøra; Stout, Natasha; Schrag, Deborah; Fordis, Michael; Punglia, Rinaa S

    2015-11-01

    Women diagnosed with DCIS face complex treatment decisions and often do so with inaccurate and incomplete understanding of the risks and benefits involved. Our objective was to create a tool to guide these decisions for both providers and patients. We developed a web-based decision aid designed to provide clinicians with tailored information about a patient’s recurrence risks and survival outcomes following different treatment strategies for DCIS. A theoretical framework, microsimulation model (Soeteman et al., J Natl Cancer 105:774–781, 2013) and best practices for web-based decision tools guided the development of the decision aid. The development process used semi-structured interviews and usability testing with key stakeholders, including a diverse group of multidisciplinary clinicians and a patient advocate. We developed onlineDeCISion.​org to include the following features that were rated as important by the stakeholders: (1) descriptions of each of the standard treatment options available; (2) visual projections of the likelihood of time-specific (10-year and lifetime) breast-preservation, recurrence, and survival outcomes; and (3) side-by-side comparisons of down-stream effects of each treatment choice. All clinicians reviewing the decision aid in usability testing were interested in using it in their clinical practice. The decision aid is available in a web-based format and is planned to be publicly available. To improve treatment decision making in patients with DCIS, we have developed a web-based decision aid onlineDeCISion.​org that conforms to best practices and that clinicians are interested in using in their clinics with patients to better inform treatment decisions.

  5. Using linguistic descriptions with multi-criteria decision aid approaches in urban energy systems

    OpenAIRE

    Afsordegan, Arayeh; Sánchez Soler, Monica; Agell Jané, Núria; Gamboa Jimenez, Gonzalo; Cremades Oliver, Lázaro Vicente

    2015-01-01

    Multi-Criteria Decision Aid (MCDA) methods include various collections of mathematical techniques related to decision support systems in non-deterministic environments to support such applications as facility management, disaster management and urban planning. This paper applies MCDA approaches based on qualitative reasoning techniques with linguistic labels assessment. The aim of this method is ranking multi-attribute alternatives in group decision-making with qualitative labels. Finally ...

  6. Latest developments for a computer aided thermohydraulic network

    International Nuclear Information System (INIS)

    Alemberti, A.; Graziosi, G.; Mini, G.; Susco, M.

    1999-01-01

    Thermohydraulic networks are I-D systems characterized by a small number of basic components (pumps, valves, heat exchangers, etc) connected by pipes and limited spatially by a defined number of boundary conditions (tanks, atmosphere, etc). The network system is simulated by the well known computer program RELAPS/mod3. Information concerning the network geometry component behaviour, initial and boundary conditions are usually supplied to the RELAPS code using an ASCII input file by means of 'input cards'. CATNET (Computer Aided Thermalhydraulic NETwork) is a graphically user interface that, under specific user guidelines which completely define its range of applicability, permits a very high level of standardization and simplification of the RELAPS/mod3 input deck development process as well as of the output processing. The characteristics of the components (pipes, valves, pumps etc), defining the network system can be entered through CATNET. The CATNET interface is provided by special functions to compute form losses in the most typical bending and branching configurations. When the input of all system components is ready, CATNET is able to generate the RELAPS/mod3 input file. Finally, by means of CATNET, the RELAPS/mod3 code can be run and its output results can be transformed to an intuitive display form. The paper presents an example of application of the CATNET interface as well as the latest developments which greatly simplified the work of the users and allowed to reduce the possibility of input errors. (authors)

  7. Development and testing of a decision aid on goals of care for advanced dementia.

    Science.gov (United States)

    Einterz, Seth F; Gilliam, Robin; Lin, Feng Chang; McBride, J Marvin; Hanson, Laura C

    2014-04-01

    Decision aids are effective to improve decision-making, yet they are rarely tested in nursing homes (NHs). Study objectives were to (1) examine the feasibility of a goals of care (GOC) decision aid for surrogate decision-makers (SDMs) of persons with dementia; and (2) to test its effect on quality of communication and decision-making. Pre-post intervention to test a GOC decision aid intervention for SDMs for persons with dementia in NHs. Investigators collected data from reviews of resident health records and interviews with SDMs at baseline and 3-month follow-up. Two NHs in North Carolina. Eighteen residents who were over 65 years of age, had moderate to severe dementia on the global deterioration scale (5, 6, or 7), and an English-speaking surrogate decision-maker. (1) GOC decision aid video viewed by the SDM and (2) a structured care plan meeting between the SDM and interdisciplinary NH team. Surrogate knowledge, quality of communication with health care providers, surrogate-provider concordance on goals of care, and palliative care domains addressed in the care plan. Eighty-nine percent of the SDMs thought the decision aid was relevant to their needs. After viewing the video decision aid, SDMs increased the number of correct responses on knowledge-based questions (12.5 vs 14.2; P communication scores (6.1 vs 6.8; P = .01) and improved concordance on primary goal of care with NH team (50% vs 78%; P = .003). The number of palliative care domains addressed in the care plan increased (1.8 vs 4.3; P decision-support intervention piloted in this study was feasible and relevant for surrogate decision-makers of persons with advanced dementia in NHs, and it improved quality of communication between SDM and NH providers. A larger randomized clinical trial is underway to provide further evidence of the effects of this decision aid intervention. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  8. Online, Interactive Option Grid Patient Decision Aids and their Effect on User Preferences.

    Science.gov (United States)

    Scalia, Peter; Durand, Marie-Anne; Kremer, Jan; Faber, Marjan; Elwyn, Glyn

    2018-01-01

    Randomized trials have shown that patient decision aids can modify users' preferred healthcare options, but research has yet to identify the attributes embedded in these tools that cause preferences to shift. The aim of this study was to investigate people's preferences as they used decision aids for 5 health decisions and, for each of the following: 1) determine if using the interactive Option Grid led to a pre-post shift in preferences; 2) determine which frequently asked questions (FAQs) led to preference shifts; 3) determine the FAQs that were rated as the most important as users compared options. Interactive Option Grid decision aids enable users to view attributes of available treatment or screening options, rate their importance, and specify their preferred options before and after decision aid use. The McNemar-Bowker paired test was used to compare stated pre-post preferences. Multinomial logistic regressions were conducted to investigate possible associations between covariates and preference shifts. Overall, 626 users completed the 5 most-used tools: 1) Amniocentesis test: yes or no? ( n = 73); 2) Angina: treatment options ( n = 88); 3) Breast cancer: surgical options ( n = 265); 4) Prostate Specific Antigen (PSA) test: yes or no? ( n = 82); 5) Statins for heart disease risk: yes or no? ( n = 118). The breast cancer, PSA, and statins Option Grid decision aids generated significant preference shifts. Generally, users shifted their preference when presented with the description of the available treatment options, and the risk associated with each option. The use of decision aids for some, but not all health decisions, was accompanied by a shift in user preferences. Users typically valued information associated with risks, and chose more risk averse options after completing the interactive tool.

  9. Network stigma towards people living with HIV/AIDS and their caregivers: An egocentric network study.

    Science.gov (United States)

    Wu, Fei; He, Xin; Guida, Jennifer; Xu, Yongfang; Liu, Hongjie

    2015-10-01

    HIV stigma occurs among peers in social networks. However, the features of social networks that drive HIV stigma are not well understood. The objective of this study is to investigate anticipated HIV stigma within the social networks of people living with HIV/AIDS (PLWHA) (N = 147) and the social networks of PLWHA's caregivers (N = 148). The egocentric social network data were collected in Guangxi, China. More than half of PLWHA (58%) and their caregivers (53%) anticipated HIV stigma from their network peers. Both PLWHA and their caregivers anticipated that spouses or other family members were less likely to stigmatise them, compared to friend peers or other relationships. Married network peers were believed to stigmatise caregivers more than unmarried peers. The association between frequent contacts and anticipated stigma was negative among caregivers. Being in a close relationship with PLWHA or caregivers (e.g., a spouse or other family member) was associated with less anticipated stigma. Lower network density was associated with higher anticipated stigma among PLWHA's alters, but not among caregivers' alters. Findings may shed light on innovative stigma reduction interventions at the social network level and therefore improve HIV/AIDS treatment utilisation.

  10. Flexible Decision Support in Dynamic Interorganizational Networks

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Annie LeBlanc

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

  12. 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.

  13. 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 χ 2 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.

  14. A Model of Submarine Emergency Decisionmaking and Decision Aiding

    Science.gov (United States)

    1986-10-01

    Rationality," Ajiiigm 0 Vl1, No.6, pp. 703-709. [9] Levis, A.H. arid K.L. Boettcher (1983j). "Decisionmaking Organizacions with Acyclical Informafion...and Decision Systems, MIT, Cambridge, MA.4 [18] Labak, SJ. (1985-86). Private Communication. [19] Anonymous, SSN 688 Class Ship Systems Manual , Vol. 7

  15. Tuition and Student Aid: Their Relation to College Enrollment Decisions.

    Science.gov (United States)

    Corwin, Thomas M., Ed.; Kent, Laura, Ed.

    Presentations and critiques include these topics: determinants of college decisions; supply and demand in postsecondary education; shortcomings of models and data bases; effects of price and nonprice characteristics; and some methodoligical considerations. Discussion questions include: Is there a middle-income squeeze?; How can nonapplicants be…

  16. Factors influencing implementation of a patient decision aid in a developing country: an exploratory study.

    Science.gov (United States)

    Tong, Wen Ting; Lee, Yew Kong; Ng, Chirk Jenn; Lee, Ping Yein

    2017-03-21

    Most studies on barriers and facilitators to implementation of patient decision aids (PDAs) are conducted in the west; hence, the findings may not be transferable to developing countries. This study aims to use a locally developed insulin PDA as an exemplar to explore the barriers and facilitators to implementing PDAs in Malaysia, an upper middle-income country in Asia. Qualitative methodology was adopted. Nine in-depth interviews (IDIs) and three focus group discussions (FGDs) were conducted with policymakers (n = 6), medical officers (n = 13), diabetes educators (n = 5) and a nurse, who were involved in insulin initiation management at an academic primary care clinic. The interviews were conducted with the aid of a semi-structured interview guide based on the Theoretical Domains Framework. The interviews were audio-recorded, transcribed verbatim and analyzed using a thematic approach. Five themes emerged, and they were lack of shared decision-making (SDM) culture, role boundary, lack of continuity of care, impact on consultation time and reminder network. Healthcare providers' (HCPs) paternalistic attitude, patients' passivity and patient trust in physicians rendered SDM challenging which affected the implementation of the PDA. Clear role boundaries between the doctors and nurses made collaborative implementation of the PDA challenging, as nurses may not view the use of insulin PDA to be part of their job scope. The lack of continuity of care might cause difficulties for doctors to follow up on insulin PDA use with their patient. While time was the most commonly cited barrier for PDA implementation, use of the PDA might reduce consultation time. A reminder network was suggested to address the issue of forgetfulness as well as to trigger interest in using the PDA. The suggested reminders were peer reminders (i.e. HCPs reminding one another to use the PDA) and system reminders (e.g. incorporating electronic medical record prompts, displaying posters

  17. 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

    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....... 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...

  18. Decision aid systems for evaluating sustainability: a critical survey

    International Nuclear Information System (INIS)

    Brunner, Norbert; Starkl, Markus

    2004-01-01

    Assessing sustainability in compliance with the EU water framework directive is affected by numerous conflicting interests. As they can no longer be resolved by means of intuitive reasoning, some authors propose the integration of the major fragmented indicators into one common indicator of the overall sustainability by means of a codified multi-criteria decision support methodology (DSM). Practitioners in urban water management, however, usually object to the use of a codified DSM, as in the legal context (negotiations between the stakeholders, tendering procedure) it might jeopardize the feasibility of the decision making process (DMP). Here we show that a feasible implementation of a DSM into the DMP is possible. To this end, we design a cooperative approach, which by means of an axiomatic evaluation helps to select an appropriate DSM. We illustrate it by a hypothetical dialogue between the relevant authority and the developer. It will expose the inherent limitations of the DSM, which are due to their underlying mathematical features

  19. 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.

  20. Airland Battlefield Environment (ALBE) Tactical Decision Aid (TDA) Demonstration Program,

    Science.gov (United States)

    1987-11-12

    Management System (DBMS) software, GKS graphics libraries, and user interface software. These components of the ATB system software architecture will be... knowlede base ano auqent the decision mak:n• process by providing infocr-mation useful in the formulation and execution of battlefield strategies...Topographic Laboratories as an Engineer. Ms. Capps is managing the software development of the AirLand Battlefield Environment (ALBE) geographic

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

    CSIR Research Space (South Africa)

    De Waal, AJ

    2007-12-01

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

  2. 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.

  3. Underwater Inherent Optical Properties Estimation Using a Depth Aided Deep Neural Network

    Directory of Open Access Journals (Sweden)

    Zhibin Yu

    2017-01-01

    Full Text Available Underwater inherent optical properties (IOPs are the fundamental clues to many research fields such as marine optics, marine biology, and underwater vision. Currently, beam transmissometers and optical sensors are considered as the ideal IOPs measuring methods. But these methods are inflexible and expensive to be deployed. To overcome this problem, we aim to develop a novel measuring method using only a single underwater image with the help of deep artificial neural network. The power of artificial neural network has been proved in image processing and computer vision fields with deep learning technology. However, image-based IOPs estimation is a quite different and challenging task. Unlike the traditional applications such as image classification or localization, IOP estimation looks at the transparency of the water between the camera and the target objects to estimate multiple optical properties simultaneously. In this paper, we propose a novel Depth Aided (DA deep neural network structure for IOPs estimation based on a single RGB image that is even noisy. The imaging depth information is considered as an aided input to help our model make better decision.

  4. Underwater Inherent Optical Properties Estimation Using a Depth Aided Deep Neural Network.

    Science.gov (United States)

    Yu, Zhibin; Wang, Yubo; Zheng, Bing; Zheng, Haiyong; Wang, Nan; Gu, Zhaorui

    2017-01-01

    Underwater inherent optical properties (IOPs) are the fundamental clues to many research fields such as marine optics, marine biology, and underwater vision. Currently, beam transmissometers and optical sensors are considered as the ideal IOPs measuring methods. But these methods are inflexible and expensive to be deployed. To overcome this problem, we aim to develop a novel measuring method using only a single underwater image with the help of deep artificial neural network. The power of artificial neural network has been proved in image processing and computer vision fields with deep learning technology. However, image-based IOPs estimation is a quite different and challenging task. Unlike the traditional applications such as image classification or localization, IOP estimation looks at the transparency of the water between the camera and the target objects to estimate multiple optical properties simultaneously. In this paper, we propose a novel Depth Aided (DA) deep neural network structure for IOPs estimation based on a single RGB image that is even noisy. The imaging depth information is considered as an aided input to help our model make better decision.

  5. Exploring the use of Option Grid™ patient decision aids in a sample of clinics in Poland.

    Science.gov (United States)

    Scalia, Peter; Elwyn, Glyn; Barr, Paul; Song, Julia; Zisman-Ilani, Yaara; Lesniak, Monika; Mullin, Sarah; Kurek, Krzysztof; Bushell, Matt; Durand, Marie-Anne

    2018-05-29

    Research on the implementation of patient decision aids to facilitate shared decision making in clinical settings has steadily increased across Western countries. A study which implements decision aids and measures their impact on shared decision making has yet to be conducted in the Eastern part of Europe. To study the use of Option Grid TM patient decision aids in a sample of Grupa LUX MED clinics in Warsaw, Poland, and measure their impact on shared decision making. We conducted a pre-post interventional study. Following a three-month period of usual care, clinicians from three Grupa LUX MED clinics received a one-hour training session on how to use three Option Grid TM decision aids and were provided with copies for use for four months. Throughout the study, all eligible patients were asked to complete the three-item CollaboRATE patient-reported measure of shared decision making after their clinical encounter. CollaboRATE enables patients to assess the efforts clinicians make to: (i) inform them about their health issues; (ii) listen to 'what matters most'; (iii) integrate their treatment preference in future plans. A Hierarchical Logistic Regression model was performed to understand which variables had an effect on CollaboRATE. 2,048 patients participated in the baseline phase; 1,889 patients participated in the intervention phase. Five of the thirteen study clinicians had a statistically significant increase in their CollaboRATE scores (pOption Grid TM helped some clinicians practice shared decision making as reflected in CollaboRATE scores, but most clinicians did not have a significant increase in their scores. Our study indicates that the effect of these interventions may be dependent on clinic contexts and clinician engagement. Copyright © 2018. Published by Elsevier GmbH.

  6. Bayesian Networks for Modeling Dredging Decisions

    Science.gov (United States)

    2011-10-01

    years, that algorithms have been developed to solve these problems efficiently. Most modern Bayesian network software uses junction tree (a.k.a. join... software was used to develop the network . This is by no means an exhaustive list of Bayesian network applications, but it is representative of recent...characteristic node (SCN), state- defining node ( SDN ), effect node (EFN), or value node. The five types of nodes can be described as follows: ERDC/EL TR-11

  7. Location-Aided Reliable Routing for Opportunistic Networks

    Institute of Scientific and Technical Information of China (English)

    Yong Yang; Zhi Ren; Jibi Li

    2012-01-01

    In our study, we investigate the problem of location-based routing in opportunistic networks. Due to the uncertainty of end-to-end paths between sources and destinations, the classical location-based ad hoc routing protocols cannot adapt to the environment of opportunistic networks, which leads to the decrease of the delivery rate of data. To address it, we propose in this paper a novel location-aided routing protocol which is suitable for opportunistic networks. In our protocol, a node can send location information on demand by using prediction mechanism, and when sending a data packet, the node chooses multiple neighbors which are closer to the destination as next hops. If the candidate neighbors do not exist, the node carries the data till it meets a proper neighbor or the destination. Theoretical analysis and simulation results show that our proposed protocol outperforms DREAM (Distance Routing Effect Protocol Mobility) and one of its improved versions, BFDREAM (Boundary Forwarding DREAM), in terms of the delivery rate and overhead.

  8. Selecting a risk-based tool to aid in decision making

    Energy Technology Data Exchange (ETDEWEB)

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  9. Balancing emotion and cognition: a case for decision aiding in conservation efforts.

    Science.gov (United States)

    Wilson, Robyn S

    2008-12-01

    Despite advances in the quality of participatory decision making for conservation, many current efforts still suffer from an inability to bridge the gap between science and policy. Judgment and decision-making research suggests this gap may result from a person's reliance on affect-based shortcuts in complex decision contexts. I examined the results from 3 experiments that demonstrate how affect (i.e., the instantaneous reaction one has to a stimulus) influences individual judgments in these contexts and identified techniques from the decision-aiding literature that help encourage a balance between affect-based emotion and cognition in complex decision processes. In the first study, subjects displayed a lack of focus on their stated conservation objectives and made decisions that reflected their initial affective impressions. Value-focused approaches may help individuals incorporate all the decision-relevant objectives by making the technical and value-based objectives more salient. In the second study, subjects displayed a lack of focus on statistical risk and again made affect-based decisions. Trade-off techniques may help individuals incorporate relevant technical data, even when it conflicts with their initial affective impressions or other value-based objectives. In the third study, subjects displayed a lack of trust in decision-making authorities when the decision involved a negatively affect-rich outcome (i.e., a loss). Identifying shared salient values and increasing procedural fairness may help build social trust in both decision-making authorities and the decision process.

  10. 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

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

    NARCIS (Netherlands)

    Pieterse, A.H.; de Vries, M.

    2013-01-01

    Background  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

  12. Theoretical concepts aiding in decision making and practical aspects

    International Nuclear Information System (INIS)

    Schenker-Wicki, Andrea; Rauber, Dominique

    1997-01-01

    Emergency-simulating drillings are current preoccupations of the national organizations in charge with emergency interventions. Generally, the attention is focused on the initial phases of the operations to the detriment of the later stages that concern the agricultural and agro-alimentary problems. In order to test its theoretical concepts and its coordinating role, the National Centre for Emergency Operations launched the drilling BACCHUS, addressed to the personnel of different authorities. For the first time in Switzerland executive bodies in the agricultural and agro-alimentary fields were integrated in the decision-making process involved in final phases. These final phases aim at simulating the means of reducing the ingestion doses after an accidental release of radioactivity. The principal conclusion was that the contamination criteria used by radiation protection and agro-alimentary industry experts could be very different if healthy foodstuffs are available

  13. The Value of Information in Distributed Decision Networks

    Science.gov (United States)

    2016-03-04

    formulation, and then we describe the various results at- tained. 1 Mathematical description of Distributed Decision Network un- der Information...Constraints We now define a mathematical framework for networks. Let G = (V,E) be an undirected random network (graph) drawn from a known distribution pG, 1...to any linear, combinatorial problem like shortest path optimization, and, further, so long as the original combinatorial problem can be solved in

  14. Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet

    Directory of Open Access Journals (Sweden)

    Torvaldsen Siranda

    2010-04-01

    Full Text Available Abstract Background Most women use some method of pain relief during labour. There is extensive research evidence available of pharmacological pain relief during labour; however this evidence is not readily available to pregnant women. Decision aids are tools that present evidence based information and allow preference elicitation. Methods We developed a labour analgesia decision aid. Using a RCT design women either received a decision aid or a pamphlet. Eligible women were primiparous, ≥ 37 weeks, planning a vaginal birth of a single infant and had sufficient English to complete the trial materials. We used a combination of affective (anxiety, satisfaction and participation in decision-making and behavioural outcomes (intention and analgesia use to assess the impact of the decision aid, which were assessed before labour. Results 596 women were randomised (395 decision aid group, 201 pamphlet group. There were significant differences in knowledge scores between the decision aid group and the pamphlet group (mean difference 8.6, 95% CI 3.70, 13.40. There were no differences between decisional conflict scores (mean difference -0.99 (95% CI -3.07, 1.07, or anxiety (mean difference 0.3, 95% CI -2.15, 1.50. The decision aid group were significantly more likely to consider their care providers opinion (RR 1.28 95%CI 0.64, 0.95. There were no differences in analgesia use and poor follow through between antenatal analgesia intentions and use. Conclusions This decision aid improves women's labour analgesia knowledge without increasing anxiety. Significantly, the decision aid group were more informed of labour analgesia options, and considered the opinion of their care providers more often when making their analgesia decisions, thus improving informed decision making. Trial Registration Trial registration no: ISRCTN52287533

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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

  20. 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.

  1. The computer-aided design of a servo system as a multiple-criteria decision problem

    NARCIS (Netherlands)

    Udink ten Cate, A.J.

    1986-01-01

    This paper treats the selection of controller gains of a servo system as a multiple-criteria decision problem. In contrast to the usual optimization-based approaches to computer-aided design, inequality constraints are included in the problem as unconstrained objectives. This considerably simplifies

  2. Use of Video Decision Aids to Promote Advance Care Planning in Hilo, Hawai'i.

    Science.gov (United States)

    Volandes, Angelo E; Paasche-Orlow, Michael K; Davis, Aretha Delight; Eubanks, Robert; El-Jawahri, Areej; Seitz, Rae

    2016-09-01

    Advance care planning (ACP) seeks to promote care delivery that is concordant with patients' informed wishes. Scalability and cost may be barriers to widespread ACP, and video decision aids may help address such barriers. Our primary hypothesis was that ACP documentation would increase in Hilo after ACP video implementation. Secondary hypotheses included increased use of hospice, fewer deaths in the hospital, and decreased costs in the last month of life. The city of Hilo in Hawai'i (population 43,263), which is served by one 276-bed hospital (Hilo Medical Center), one hospice (the Hospice of Hilo), and 30 primary care physicians. The intervention consisted of a single, 1- to 4-h training and access to a suite of ACP video decision aids. Prior to implementation, the rate of ACP documentation for hospitalized patients with late-stage disease was 3.2 % (11/346). After the intervention, ACP documentation was 39.9 % (1,107/2,773) (P Hilo patients was $3,458 (95 % CI $3,051 to 3,865) lower per patient after the intervention when compared to the control region. Implementing ACP video decision aids was associated with improved ACP documentation, greater use of hospice, and decreased costs. Decision aids that promote ACP offer a scalable and cost-efficient medium to place patients at the center of their care.

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

    NARCIS (Netherlands)

    Gerven, M.A.J. van

    2007-01-01

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

  4. 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

  5. Decision aiding in public policy generation and implementation: a multicriteria approach to evaluate territorial resilience

    Directory of Open Access Journals (Sweden)

    Maria Franca Norese

    2016-12-01

    Full Text Available A decision aid process should be the result of an interaction between analysts, decision makers and stakeholders. Decision aiding is sometimes required when the problem situation is new and a formal decision system does not exist. Its role becomes that of facilitating the Intelligence phase of a decision process. In other situations, a criticism of certain policy making processes and their use of data, which may be available in institutional databases or are required as indicators for the decision process, motivates an intervention oriented towards structure knowledge and improvements of these processes. A preliminary study, which includes modelling and application of multi-criteria methods, can clarify a complex and new situation, propose a consistent approach for the later phases of a decision process or propose a different and more effective use of the data. A case study is proposed here to describe this methodological approach in relation to the disaster resilience of municipalities near the mbrone River, in Tuscany (Italy.

  6. The need for decision and communication aids: a survey of breast cancer survivors.

    Science.gov (United States)

    Belkora, Jeffrey K; Miller, Melissa F; Dougherty, Kasey; Gayer, Christopher; Golant, Mitch; Buzaglo, Joanne S

    2015-03-01

    Qualitative studies have identified barriers to communication and informed decision making among breast cancer survivors making treatment decisions. The prevalence of these barriers is unknown. To quantify the need for decision support among breast cancer survivors. We surveyed 2,521 breast cancer survivors participating in an online registry hosted by the Cancer Support Community to find out what proportion of breast cancer patients: made decisions during their first visit with a specialist; received satisfactory information before that visit; asked questions and received responses; and endorsed expanded use of decision support. We received 1,017 (41%) responses and analyzed 917 surveys from women who lived in the United States. Most of the respondents recalled making treatment decisions during their first visit (52%). A minority (14%) received information before the first specialist visit. At least 25% of respondents rated their satisfaction below 7 on a scale of 10 for decision-making, information, and questions asked and answered. Respondents endorsed the need for assistance with obtaining information, listing questions, taking notes, and making audio-recordings of visits. The respondent sample skewed younger and had higher-stage cancer compared with all breast cancer survivors. Responses were subject to recall bias. Cancer survivors expressed gaps in their care with respect to reviewing information, asking questions, obtaining answers, and making decisions. Implementing decision and communication aids immediately upon diagnosis, when treatment decisions are being made, would address these gaps. ©2015 Frontline Medical Communications.

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

    African Journals Online (AJOL)

    ... low-risk behaviour and left some adolescents feeling marginalised and lonely. Ways of approaching these issues at the community level are suggested. Keywords: Africa, elderly caregivers, global childhoods, peer pressure, researching with children, social networks. African Journal of AIDS Research 2006, 5(2): 145–157 ...

  8. A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting

    NARCIS (Netherlands)

    Cuypers, M.; Lamers, R.E.D.; Kil, P.J.M.; The, R.; Karssen, K.; van de Poll-Franse, L.V.; de Vries, M.

    2018-01-01

    Many new decision aids are developed while aspects of existing decision aids could also be useful, leading to a sub-optimal use of resources. To support treatment decision-making in prostate cancer patients, a pre-existing evidence-based Canadian decision aid was adjusted to Dutch clinical setting.

  9. Brain network response underlying decisions about abstract reinforcers.

    Science.gov (United States)

    Mills-Finnerty, Colleen; Hanson, Catherine; Hanson, Stephen Jose

    2014-12-01

    Decision making studies typically use tasks that involve concrete action-outcome contingencies, in which subjects do something and get something. No studies have addressed decision making involving abstract reinforcers, where there are no action-outcome contingencies and choices are entirely hypothetical. The present study examines these kinds of choices, as well as whether the same biases that exist for concrete reinforcer decisions, specifically framing effects, also apply during abstract reinforcer decisions. We use both General Linear Model as well as Bayes network connectivity analysis using the Independent Multi-sample Greedy Equivalence Search (IMaGES) algorithm to examine network response underlying choices for abstract reinforcers under positive and negative framing. We find for the first time that abstract reinforcer decisions activate the same network of brain regions as concrete reinforcer decisions, including the striatum, insula, anterior cingulate, and VMPFC, results that are further supported via comparison to a meta-analysis of decision making studies. Positive and negative framing activated different parts of this network, with stronger activation in VMPFC during negative framing and in DLPFC during positive, suggesting different decision making pathways depending on frame. These results were further clarified using connectivity analysis, which revealed stronger connections between anterior cingulate, insula, and accumbens during negative framing compared to positive. Taken together, these results suggest that not only do abstract reinforcer decisions rely on the same brain substrates as concrete reinforcers, but that the response underlying framing effects on abstract reinforcers also resemble those for concrete reinforcers, specifically increased limbic system connectivity during negative frames. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. 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

  11. 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.

  12. Ecological rationality: a framework for understanding and aiding the aging decision maker.

    Science.gov (United States)

    Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

    2012-01-01

    The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people's decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker.

  13. Decision aids: when 'nudging' patients to make a particular choice is more ethical than balanced, nondirective content.

    Science.gov (United States)

    Blumenthal-Barby, J S; Cantor, Scott B; Russell, Heidi Voelker; Naik, Aanand D; Volk, Robert J

    2013-02-01

    Patient decision aids, such as instructional leaflets describing treatment options for prostate cancer, are designed to help educate patients so that they can share in decisions about their care. Developers of these decision aids strive for balance, aiming to be as neutral, unbiased, and nondirective as possible. We argue that balance should not always be a goal, and we identify three situations where it should not be. For example, men diagnosed with early-stage prostate cancer frequently are not advised by their physicians that active surveillance is a reasonable alternative to immediate surgery or radiation. It may be desirable to design decision aids that promote active surveillance as an option. We recognize that the arguments put forth in this article are controversial. But they are also justified. We challenge medical decision makers and decision aid developers to determine if and when patients should be "nudged" toward one option or another.

  14. Object-Oriented Bayesian Networks for a Decision Support System

    OpenAIRE

    Julia Mortera; Paola Vicard; Cecilia Vergari

    2012-01-01

    We study an economic decision problem where the actors are two rms and the Antitrust Authority whose main task is to monitor and prevent rms potential anti-competitive behaviour. The Antitrust Au- thority's decision process is modelled using a Bayesian network whose relational structure and parameters are estimated from data provided by the Authority itself. Several economic variables in uencing this de- cision process are included in the model. We analyse how monitoring by the Antitrust Auth...

  15. Intra-annual wave resource characterization for energy exploitation: A new decision-aid tool

    International Nuclear Information System (INIS)

    Carballo, R.; Sánchez, M.; Ramos, V.; Fraguela, J.A.; Iglesias, G.

    2015-01-01

    Highlights: • A decision-aid tool is developed for computing the monthly performance of WECs. • It allows the generation of high-resolution monthly characterization matrices. • The decision-aid tool is implemented to the Death Coast (N Spain). • The monthly matrices can be obtained at any coastal location within the Death Coast. • The tool is applied to a coastal location of a proposed wave farm. - Abstract: The wave energy resource is usually characterized by a significant variability throughout the year. In estimating the power performance of a Wave Energy Converter (WEC) it is fundamental to take into account this variability; indeed, an estimate based on mean annual values may well result in a wrong decision making. In this work, a novel decision-aid tool, iWEDGE (intra-annual Wave Energy Diagram GEnerator) is developed and implemented to a coastal region of interest, the Death Coast (Spain), one of the regions in Europe with the largest wave resource. Following a comprehensive procedure, and based on deep water wave data and high-resolution numerical modelling, this tool provides the monthly high-resolution characterization matrices (or energy diagrams) for any location of interest. In other words, the information required for the accurate computation of the intra-annual performance of any WEC at any location within the region covered is made available. Finally, an application of iWEDGE to the site of a proposed wave farm is presented. The results obtained highlight the importance of the decision-aid tool herein provided for wave energy exploitation

  16. Weather Avoidance Using Route Optimization as a Decision Aid: An AWIN Topical Study. Phase 1

    Science.gov (United States)

    1998-01-01

    The aviation community is faced with reducing the fatal aircraft accident rate by 80 percent within 10 years. This must be achieved even with ever increasing, traffic and a changing National Airspace System. This is not just an altruistic goal, but a real necessity, if our growing level of commerce is to continue. Honeywell Technology Center's topical study, "Weather Avoidance Using Route Optimization as a Decision Aid", addresses these pressing needs. The goal of this program is to use route optimization and user interface technologies to develop a prototype decision aid for dispatchers and pilots. This decision aid will suggest possible diversions through single or multiple weather hazards and present weather information with a human-centered design. At the conclusion of the program, we will have a laptop prototype decision aid that will be used to demonstrate concepts to industry for integration into commercialized products for dispatchers and/or pilots. With weather a factor in 30% of aircraft accidents, our program will prevent accidents by strategically avoiding weather hazards in flight. By supplying more relevant weather information in a human-centered format along with the tools to generate flight plans around weather, aircraft exposure to weather hazards can be reduced. Our program directly addresses the NASA's five year investment areas of Strategic Weather Information and Weather Operations (simulation/hazard characterization and crew/dispatch/ATChazard monitoring, display, and decision support) (NASA Aeronautics Safety Investment Strategy: Weather Investment Recommendations, April 15, 1997). This program is comprised of two phases, Phase I concluded December 31, 1998. This first phase defined weather data requirements, lateral routing algorithms, an conceptual displays for a user-centered design. Phase II runs from January 1999 through September 1999. The second phase integrates vertical routing into the lateral optimizer and combines the user

  17. Development of a patient decision aid for prevention of myocardial infarction in type 2 diabetes - rationale, design and pilot testing.

    Science.gov (United States)

    Lenz, Matthias; Kasper, Jürgen; Mühlhauser, Ingrid

    2009-10-19

    Development and testing of a decision aid about prevention of myocardial infarction for persons with type 2 diabetes. Development and testing were guided by the UK Medical Research Council's guidance for the development and evaluation of complex interventions. This comprised a systematic literature review, a focus group of 9 potential providers, modelling a prototype, interviews to qualitatively explore understanding and additional information needs, and revision of the decision aid. The decision aid includes evidence-based information, a tool for individual risk-assessment, worksheets, and an action plan. Five diabetes educators and 15 patients underwent two 60-minutes face-to-face interviews, firstly browsing the decision aid for the first time and then after using it. Both groups differed in their ratings. Overall, the decision aid was rated to present essential information in a complex but understandable and unbiased manner. Difficulties involved understanding of terminology and risk interpretation. "Social status as a risk factor" was the most challenged content by educators but considered as highly important by patients. The risk assessment tool was used inadequately. 5 patients allocated themselves into false risk categories. After revision of the tool, all 12 patients who were recruited for reassessment used the tool correctly. The decision aid was evaluated with diabetes educators and patients. Qualitative data analysis revealed aspects for revision. The decision aid is planned to be part of a shared decision making programme, comprising a strategy for patient counselling and educational modules addressed to providers. Quantitative evaluation is required to assess its effectiveness.

  18. Design and development of a decision aid to enhance shared decision making by patients with an asymptomatic abdominal aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Dirk T Ubbink

    2008-11-01

    Full Text Available Dirk T Ubbink1,2, Anouk M Knops1, Sjaak Molenaar1, Astrid Goossens11Department of Quality Assurance and Process Innovation and 2Department of Surgery, Academic Medical Center, Amsterdam, The NetherlandsObjective: To design, develop, and evaluate an evidence-based decision aid (DA for patients with an asymptomatic abdominal aortic aneurysm (AAA to inform them about the pros and cons of their treatment options (ie, surgery or watchful observation and to help them make a shared decision.Methods: A multidisciplinary team defined criteria for the desired DA as to design, medical content and functionality, particularly for elderly users. Development was according to the international standard (IPDAS. Fifteen patients with an AAA, who were either treated or not yet treated, evaluated the tool.Results: A DA was developed to offer information about the disease, the risks and benefits of surgical treatment and watchful observation, and the individual possibilities and threats based on the patient’s aneurysm diameter and risk profile. The DA was improved and judged favorably by physicians and patients.Conclusion: This evidence-based DA for AAA patients, developed according to IPDAS criteria, is likely to be a simple, user-friendly tool to offer patients evidence-based information about the pros and cons of treatment options for AAA, to improve patients’ understanding of the disease and treatment options, and may support decision making based on individual values.Keywords: decision support techniques, research design, program development, abdominal aortic aneurysm, decision making

  19. Minimal Representation and Decision Making for Networked Autonomous Agents

    Science.gov (United States)

    2015-08-27

    University of Illinois at Urbana Champaign 1308 W Main, Urbana , IL 61801 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S...Laboratory University of Illinois at Urbana Champaign 1308 W Main, Urbana , IL 61801 tel: 217-333-1368, fax: 217-244-1653 email: voulgari@illinois.edu...a mobile sensor network (MSN) when some of the nodes in the network fail. We posed the problem as a multi-stage decision process, and used forward

  20. Balancing the presentation of information and options in patient decision aids: an updated review.

    Science.gov (United States)

    Abhyankar, Purva; Volk, Robert J; Blumenthal-Barby, Jennifer; Bravo, Paulina; Buchholz, Angela; Ozanne, Elissa; Vidal, Dale Colins; Col, Nananda; Stalmeier, Peep

    2013-01-01

    Standards for patient decision aids require that information and options be presented in a balanced manner; this requirement is based on the argument that balanced presentation is essential to foster informed decision making. If information is presented in an incomplete/non-neutral manner, it can stimulate cognitive biases that can unduly affect individuals' knowledge, perceptions of risks and benefits, and, ultimately, preferences. However, there is little clarity about what constitutes balance, and how it can be determined and enhanced. We conducted a literature review to examine the theoretical and empirical evidence related to balancing the presentation of information and options. A literature search related to patient decision aids and balance was conducted on Medline, using MeSH terms and PubMed; this search supplemented the 2011 Cochrane Collaboration's review of patient decision aids trials. Only English language articles relevant to patient decision making and addressing the balance of information and options were included. All members of the team independently screened clusters of articles; uncertainties were resolved by seeking review by another member. The team then worked in sub-groups to extract and synthesise data on theory, definitions, and evidence reported in these studies. A total of 40 articles met the inclusion criteria. Of these, six explained the rationale for balancing the presentation of information and options. Twelve defined "balance"; the definition of "balance" that emerged is as follows: "The complete and unbiased presentation of the relevant options and the information about those options-in content and in format-in a way that enables individuals to process this information without bias". Ten of the 40 articles reported assessing the balance of the relevant decision aid. All 10 did so exclusively from the users' or patients' perspective, using a five-point Likert-type scale. Presenting information in a side-by-side display form was

  1. A comparison of web-based versus print-based decision AIDS for prostate cancer screening: participants' evaluation and utilization.

    Science.gov (United States)

    Tomko, Catherine; Davis, Kimberly M; Luta, George; Krist, Alexander H; Woolf, Steven H; Taylor, Kathryn L

    2015-01-01

    Patient decision aids facilitate informed decision making for medical tests and procedures that have uncertain benefits. To describe participants' evaluation and utilization of print-based and web-based prostate cancer screening decision aids that were found to improve decisional outcomes in a prior randomized controlled trial. Men completed brief telephone interviews at baseline, one month, and 13 months post-randomization. Participants were primary care patients, 45-70 years old, who received the print-based (N = 628) or web-based decision aid (N = 625) and completed the follow-up assessments. We assessed men's baseline preference for web-based or print-based materials, time spent using the decision aids, comprehension of the overall message, and ratings of the content. Decision aid use was self-reported by 64.3 % (web) and 81.8 % (print) of participants. Significant predictors of decision aid use were race (white vs. non-white, OR = 2.43, 95 % CI: 1.77, 3.35), higher education (OR = 1.68, 95 % CI: 1.06, 2.70) and trial arm (print vs. web, OR = 2.78, 95 % CI: 2.03, 3.83). Multivariable analyses indicated that web-arm participants were more likely to use the website when they preferred web-based materials (OR: 1.91, CI: 1.17, 3.12), whereas use of the print materials was not significantly impacted by a preference for print-based materials (OR: 0.69, CI: 0.38, 1.25). Comprehension of the decision aid message (i.e., screening is an individual decision) did not significantly differ between arms in adjusted analyses (print: 61.9 % and web: 68.2 %, p = 0.42). Decision aid use was independently influenced by race, education, and the decision aid medium, findings consistent with the 'digital divide.' These results suggest that when it is not possible to provide this age cohort with their preferred decision aid medium, print materials will be more highly used than web-based materials. Although there are many advantages to web-based decision aids, providing an option for

  2. Ecological Rationality: A Framework for Understanding and Aiding the Aging Decision Maker

    Directory of Open Access Journals (Sweden)

    Rui eMata

    2012-02-01

    Full Text Available Ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. The concept of ecological rationality focuses the study of cognition on two key questions: First, what are the environmental regularities to which people’s decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environments? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into diminished decision performance. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision ecology in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker.

  3. 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...

  4. 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

  5. Clinical use of patient decision-making aids for stone patients.

    Science.gov (United States)

    Lim, Amy H; Streeper, Necole M; Best, Sara L; Penniston, Kristina L; Nakada, Stephen Y

    2017-08-01

    Patient decision-making aids (PDMAs) help patients make informed healthcare decisions and improve patient satisfaction. The utility of PDMAs for patients considering treatments for urolithiasis has not yet been published. We report our experience using PDMAs developed at our institution in the outpatient clinical setting in patients considering a variety of treatment options for stones. Patients with radiographically confirmed urolithiasis were given PDMAs regarding treatment options for their stone(s) based on their clinical profile. We assessed patients' satisfaction, involvedness, and feeling of making a more informed decision with utilization of the PDMAs using a Likert Scale Questionnaire. Information was also collected regarding previous stone passage, history and type of surgical intervention for urolithiasis, and level of education. Patients (n = 43; 18 males, 23 females and two unknown) 53 +/- 14years old were included. Patients reported that they understood the advantages and disadvantages outlined in the PDMAs (97%), that the PDMAs helped them make a more informed decision (83%) and felt more involved in the decision making process (88%). Patients reported that the aids were presented in a balanced manner and used up-to-date scientific information (100%, 84% respectively). Finally, a majority of the patients prefer an expert's opinion when making a treatment decision (98%) with 73% of patients preferring to form their own opinion based on available information. Previous stone surgery was associated with patients feeling more involved with the decision making process (p = 0.0465). PDMAs have a promising role in shared decision-making in the setting of treatment options for nephrolithiasis.

  6. Breast cancer anxiety's associations with responses to a chemoprevention decision aid.

    Science.gov (United States)

    Dillard, Amanda J; Scherer, Laura; Ubel, Peter A; Smith, Dylan M; Zikmund-Fisher, Brian J; McClure, Jennifer B; Greene, Sarah; Stark, Azadeh; Fagerlin, Angela

    2013-01-01

    Few studies have examined how specific emotions may affect decision-making processes. Anxiety may be especially relevant in health decisions such as those related to cancer in which thoughts of illness or death may be abundant. We examined associations between women's anxiety about developing breast cancer and variables related to their decision to take a medication that could reduce their chances of the disease. Six-hundred and thirty-two American women, who had an increased risk of breast cancer, reviewed a web-based decision aid about tamoxifen. We examined associations between their baseline, self-reported anxiety about developing the disease and post decision aid measures including knowledge about tamoxifen, attitude toward the medication, and behavioral intentions to look for more information and take the medication. Results showed that anxiety was not associated with knowledge about tamoxifen, but it was associated with attitude toward the medication such that women who were more anxious about developing breast cancer were more likely to think the benefits were worth the risks. Greater anxiety was also associated with greater behavioral intentions to look for additional information and take the medication in the next few months. Secondary analyses showed that behavioral intentions were related to knowledge of tamoxifen and attitude toward the medication only for women who were reporting low levels of anxiety. Overall, the findings suggest that anxiety about breast cancer may motivate interest in tamoxifen and not necessarily through affecting knowledge or attitudes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. 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.

  8. The Wind Atlas for South Africa (WASA): A tool to aid developers and decision makers

    CSIR Research Space (South Africa)

    Mabille, E

    2015-10-01

    Full Text Available ): A tool to aid developers and decision makers Eugene Mabille The WASA Project Team SANEDI South African National Energy Development Institute • executing agency – contracting the implementing partners • coordination and dissemination UCT... to produce wind atlas for generalised surface conditions (uniform terrain and roughness). Files compatible with WAsP software.  Used for the first WASA published in 2012.  KAMM/WAsP method, numerically very cheap, gives good results  underestimation...

  9. Use of Video Decision Aids to Promote Advance Care Planning in Hilo, Hawai?i

    OpenAIRE

    Volandes, Angelo E.; Paasche-Orlow, Michael K.; Davis, Aretha Delight; Eubanks, Robert; El-Jawahri, Areej; Seitz, Rae

    2016-01-01

    Introduction: Advance care planning (ACP) seeks to promote care delivery that is concordant with patients’ informed wishes. Scalability and cost may be barriers to widespread ACP, and video decision aids may help address such barriers. Aim Our primary hypothesis was that ACP documentation would increase in Hilo after ACP video implementation. Secondary hypotheses included increased use of hospice, fewer deaths in the hospital, and decreased costs in the last month of life. Setting: The city o...

  10. 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...

  11. Spectrum decision in cognitive radio networks: a survey

    CSIR Research Space (South Africa)

    Masonta, MT

    2012-11-01

    Full Text Available provides an up-to-date survey of spectrum decision in CR networks (CRNs) and addresses issues of spectrum characterization (including PU activity modelling), spectrum selection and CR reconfiguration. For each of these issues, we highlight key open research...

  12. 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.

  13. Quantum stochastic walks on networks for decision-making.

    Science.gov (United States)

    Martínez-Martínez, Ismael; Sánchez-Burillo, Eduardo

    2016-03-31

    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.

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

    National Research Council Canada - National Science Library

    Schipani, Salvatore

    2003-01-01

    ..., processing, and acting upon information is often inadequate. The current research examined two levels of training, decision aiding, and homogeneity on group performance, using a personality concept classified "action orientation...

  15. 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 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.

  16. Decision optimization of case-based computer-aided decision systems using genetic algorithms with application to mammography

    International Nuclear Information System (INIS)

    Mazurowski, Maciej A; Habas, Piotr A; Zurada, Jacek M; Tourassi, Georgia D

    2008-01-01

    This paper presents an optimization framework for improving case-based computer-aided decision (CB-CAD) systems. The underlying hypothesis of the study is that each example in the knowledge database of a medical decision support system has different importance in the decision making process. A new decision algorithm incorporating an importance weight for each example is proposed to account for these differences. The search for the best set of importance weights is defined as an optimization problem and a genetic algorithm is employed to solve it. The optimization process is tailored to maximize the system's performance according to clinically relevant evaluation criteria. The study was performed using a CAD system developed for the classification of regions of interests (ROIs) in mammograms as depicting masses or normal tissue. The system was constructed and evaluated using a dataset of ROIs extracted from the Digital Database for Screening Mammography (DDSM). Experimental results show that, according to receiver operator characteristic (ROC) analysis, the proposed method significantly improves the overall performance of the CAD system as well as its average specificity for high breast mass detection rates

  17. Development and testing of a decision aid for women considering delayed breast reconstruction.

    Science.gov (United States)

    Metcalfe, Kelly; Zhong, Toni; O'Neill, Anne C; McCready, David; Chan, Linda; Butler, Kate; Brennenstuhl, Sarah; Hofer, Stefan O P

    2018-03-01

    The decision to have post-mastectomy breast reconstruction (PMBR) is highly complex and many women feel ill equipped to make this decision. Decision aids have been advocated to promote patient involvement in decision-making by streamlining and standardizing communication between the patient and the health care professional. In this study, we report on the development and testing of a decision aid (DA) for breast cancer survivors considering delayed PMBR. The DA was developed and evaluated in three phases. The first phase included the development of the DA with input and review by practitioners and key stakeholders. The second phase involved pilot testing of the feasibility and acceptability of the DA with a convenience sample of women with delayed PMBR. The third phase involved a pretest/post-test evaluation of the DA for women who were making decisions about their PMBR options. The DA was developed using the Ottawa Decision Support Framework. In the second phase of the study, 21 women completed the acceptability survey, of whom 100% reported that they would recommend the DA to other women. In the third phase, decisional conflict decreased significantly (p < 0.001) and knowledge increased significantly (p < 0.001) from prior to using the DA to 1-2 weeks after using the DA. The DA is feasible and acceptable to women considering delayed PMBR. Furthermore, the DA is effective at reducing decisional conflict and increasing knowledge about delayed PMBR. The DA is an appropriate tool to be used in addition with standard care in women considering PMBR. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Shamshad Lakho

    2017-12-01

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

  19. A Multimetric Approach for Handoff Decision in Heterogeneous Wireless Networks

    Science.gov (United States)

    Kustiawan, I.; Purnama, W.

    2018-02-01

    Seamless mobility and service continuity anywhere at any time are an important issue in the wireless Internet. This research proposes a scheme to make handoff decisions effectively in heterogeneous wireless networks using a fuzzy system. Our design lies in an inference engine which takes RSS (received signal strength), data rate, network latency, and user preference as strategic determinants. The logic of our engine is realized on a UE (user equipment) side in faster reaction to network dynamics while roaming across different radio access technologies. The fuzzy system handles four metrics jointly to deduce a moderate decision about when to initiate handoff. The performance of our design is evaluated by simulating move-out mobility scenarios. Simulation results show that our scheme outperforms other approaches in terms of reducing unnecessary handoff.

  20. Networking CD-ROMs: The Decision Maker's Guide to Local Area Network Solutions.

    Science.gov (United States)

    Elshami, Ahmed M.

    In an era when patrons want access to CD-ROM resources but few libraries can afford to buy multiple copies, CD-ROM local area networks (LANs) are emerging as a cost-effective way to provide shared access. To help librarians make informed decisions, this manual offers information on: (1) the basics of LANs, a "local area network primer";…

  1. Development of an integrated decision support system to aid cognitive activities of operators

    International Nuclear Information System (INIS)

    Lee, Seung Jun; Seong, Poong Hyun

    2007-01-01

    As digital and computer technologies have grown, Human-Machine Interfaces (HMIs) have evolved. In safety-critical systems, especially in Nuclear Power Plants (NPPs), HMIs are important for reducing operational costs, the number of necessary operators, and the probability of accident occurrence. Efforts have been made to improve Main Control Room (MCR) interface design and to develop automated or decision support systems to ensure convenient operation and maintenance. In this paper, an integrated decision support system to aid operator cognitive processes is proposed for advanced MCRs of future NPPs. This work suggests the design concept of a decision support system which accounts for an operator's cognitive processes. The proposed system supports not only a particular task, but also the entire operation process based on a human cognitive process model. In this paper, the operator's operation processes are analyzed according to a human cognitive process model and appropriate support systems that support each cognitive process activity are suggested

  2. Patient Decision Aids Improve Decision Quality and Patient Experience and Reduce Surgical Rates in Routine Orthopaedic Care: A Prospective Cohort Study.

    Science.gov (United States)

    Sepucha, Karen; Atlas, Steven J; Chang, Yuchiao; Dorrwachter, Janet; Freiberg, Andrew; Mangla, Mahima; Rubash, Harry E; Simmons, Leigh H; Cha, Thomas

    2017-08-02

    Patient decision aids are effective in randomized controlled trials, yet little is known about their impact in routine care. The purpose of this study was to examine whether decision aids increase shared decision-making when used in routine care. A prospective study was designed to evaluate the impact of a quality improvement project to increase the use of decision aids for patients with hip or knee osteoarthritis, lumbar disc herniation, or lumbar spinal stenosis. A usual care cohort was enrolled before the quality improvement project and an intervention cohort was enrolled after the project. Participants were surveyed 1 week after a specialist visit, and surgical status was collected at 6 months. Regression analyses adjusted for clustering of patients within clinicians and examined the impact on knowledge, patient reports of shared decision-making in the visit, and surgical rates. With 550 surveys, the study had 80% to 90% power to detect a difference in these key outcomes. The response rates to the 1-week survey were 70.6% (324 of 459) for the usual care cohort and 70.2% (328 of 467) for the intervention cohort. There was no significant difference (p > 0.05) in any patient characteristic between the 2 cohorts. More patients received decision aids in the intervention cohort at 63.6% compared with the usual care cohort at 27.3% (p = 0.007). Decision aid use was associated with higher knowledge scores, with a mean difference of 18.7 points (95% confidence interval [CI], 11.4 to 26.1 points; p < 0.001) for the usual care cohort and 15.3 points (95% CI, 7.5 to 23.0 points; p = 0.002) for the intervention cohort. Patients reported more shared decision-making (p = 0.009) in the visit with their surgeon in the intervention cohort, with a mean Shared Decision-Making Process score (and standard deviation) of 66.9 ± 27.5 points, compared with the usual care cohort at 62.5 ± 28.6 points. The majority of patients received their preferred treatment, and this did not differ

  3. AIDS

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000594.htm HIV/AIDS To use the sharing features on this page, ... immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the ...

  4. The image recognition based on neural network and Bayesian decision

    Science.gov (United States)

    Wang, Chugege

    2018-04-01

    The artificial neural network began in 1940, which is an important part of artificial intelligence. At present, it has become a hot topic in the fields of neuroscience, computer science, brain science, mathematics, and psychology. Thomas Bayes firstly reported the Bayesian theory in 1763. After the development in the twentieth century, it has been widespread in all areas of statistics. In recent years, due to the solution of the problem of high-dimensional integral calculation, Bayesian Statistics has been improved theoretically, which solved many problems that cannot be solved by classical statistics and is also applied to the interdisciplinary fields. In this paper, the related concepts and principles of the artificial neural network are introduced. It also summarizes the basic content and principle of Bayesian Statistics, and combines the artificial neural network technology and Bayesian decision theory and implement them in all aspects of image recognition, such as enhanced face detection method based on neural network and Bayesian decision, as well as the image classification based on the Bayesian decision. It can be seen that the combination of artificial intelligence and statistical algorithms has always been the hot research topic.

  5. 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.

  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. Semiorders, Intervals Orders and Pseudo Orders Preference Structures in Multiple Criteria Decision Aid Methods

    Directory of Open Access Journals (Sweden)

    Fernández Barberis, Gabriela

    2013-06-01

    Full Text Available During the last decades, an important number of Multicriteria Decision Aid Methods (MCDA has been proposed to help the decision maker to select the best compromise alternative. Meanwhile, the PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluations family of outranking method and their applications has attracted much attention from academics and practitioners. In this paper, an extension of these methods is presented, consisting of analyze its functioning under New Preference Structures (NPS. The preference structures taken into account are, namely: semiorders, intervals orders and pseudo orders. These structures outstandingly improve the modelization as they give more flexibility, amplitude and certainty at the preferences formulation, since they tend to abandon the Complete Transitive Comparability Axiom of Preferences in order to substitute it by the Partial Comparability Axiom of Preferences. It must be remarked the introduction of Incomparability relations to the analysis and the consideration of preference structures that accept the Indifference intransitivity. The NPS incorporation is carried out in three phases that the PROMETHEE Methodology takes in: preference structure enrichment, dominance relation enrichment and outranking relation exploitation for decision aid, in order to finally arrive at solving the alternatives ranking problem through the PROMETHEE I or the PROMETHEE II utilization, according to whether a partial ranking or a complete one, is respectively required under the NPS

  8. A risk-based decision-aiding tool for waste disposal

    International Nuclear Information System (INIS)

    Weiner, R.F.; Reiser, A.S.; Elcock, C.G.; Nevins, S.

    1997-01-01

    N-CART (the National Spent Nuclear Fuel Program Cost Analysis and Risk Tool) is being developed to aid in low-risk, cost-effective, timely management of radioactive waste and spent nuclear fuel, and can therefore be used in management of mixed waste. N-CART provides evaluation of multiple alternatives and presents the consequences of proposed waste management activities in a clear and concise format. N-CART's decision-aiding analyses include comparisons and sensitivity analyses of multiple alternatives and allows the user to perform quick turn-around open-quotes what ifclose quotes studies to investigate various scenarios. Uncertainties in data (such as cost and schedule of various activities) are represented as distributions. N-CART centralizes documentation of the bases of program alternatives and program decisions, thereby supporting responses to stakeholders concerns. The initial N-CART design considers regulatory requirements, costs, and schedules for alternative courses of action. The final design will include risks (public health, occupational, economic, scheduling), economic benefits, and the impacts of secondary waste generation. An optimization tool is being incorporated that allows the user to specify the relative importance of cost, time risks, and other bases for decisions. The N-CART prototype can be used to compare the costs and schedules of disposal alternatives for mixed low-level radioactive waste (MLLW) and greater-than-Class-C (GTCC) waste, as well as spent nuclear fuel (SNF) and related scrap material

  9. Evaluation of a Patient Decision Aid for Unicompartmental or Total Knee Arthroplasty for Medial Knee Osteoarthritis.

    Science.gov (United States)

    de Jesus, Christopher; Stacey, Dawn; Dervin, Geoffrey F

    2017-11-01

    Many patients with isolated medial compartment osteoarthritis are candidates for either unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). A novel patient decision aid (PDA) was developed to educate patients on both interventions and prepare them for making the decision with their surgeon. The study objective was to evaluate the acceptability and usefulness of a PDA for informing and helping patients reach a surgical preference without increasing decisional conflict. A PDA was developed in accordance with the criteria listed by Ottawa Decision Support Framework and prospectively tested in UKA and TKA patients, who were mailed the PDAs to complete at home along with outcome measures before surgeon consultation. Of 50 patients who consented to participate, 45 patients (26 men, 19 women) used the PDA. Quantitative analysis of acceptability, decisional conflict, knowledge, and preferred surgical option was then performed. Mean patient age was 64.6 years (range, 50-80 years). Patients rated the PDA as acceptable: 84.4% indicated balanced presentation of information and 77.8% asserted that PDA helped them to make decisions between UKA and TKA. Mean knowledge score was 86.6% and total decisional conflict was 19.7 out of 100. Of 45, 33 stated a preferred option (24 UKA; 9 TKA; 12 unsure). Patients understood the majority of the benefits and risks for each surgical option without increasing decisional conflict. The decision aid for advanced medial compartment osteoarthritis is shown to be acceptable and useful for choosing between UKA and TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Arriba-lib: association of an evidence-based electronic library of decision aids with communication and decision-making in patients and primary care physicians.

    Science.gov (United States)

    Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

    2012-03-01

    In shared decision-making, patients are empowered to actively ask questions and participate in decisions about their healthcare based on their preferences and values. Decision aids should help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes; however, they have rarely been field tested, especially in the primary care context. We therefore evaluated associations between the use of an interactive, transactional and evidence-based library of decision aids (arriba-lib) and communication and decision-making in patients and physicians in the primary care context. Our electronic library of decision aids ('arriba-lib') includes evidence-based modules for cardiovascular prevention, diabetes, coronary heart disease, atrial fibrillation and depression. Twenty-nine primary care physicians recruited 192 patients. We used questionnaires to ask patients and physicians about their experiences with and attitudes towards the programme. Patients were interviewed via telephone 2 months after the consultation. Data were analysed by general estimation equations, cross tab analyses and by using effect sizes. Only a minority (8.9%) of the consultations were felt to be too long because physicians said consultations were unacceptably extended by arriba-lib. We found a negative association between the detailedness of the discussion of the clinical problem's definition and the age of the patients. Physicians discuss therapeutic options in less detail with patients who have a formal education of less than 8 years. Patients who were counselled by a physician with no experience in using a decision aid more often reported that they do not remember being counselled with the help of a decision aid or do not wish to be counselled again with a decision aid. Arriba-lib has positive associations to the decision-making process in patients and physicians. It can also be used with older age groups and patients with less

  11. A theory-based decision aid for patients with cancer: results of feasibility and acceptability testing of DecisionKEYS for cancer.

    Science.gov (United States)

    Hollen, Patricia J; Gralla, Richard J; Jones, Randy A; Thomas, Christopher Y; Brenin, David R; Weiss, Geoffrey R; Schroen, Anneke T; Petroni, Gina R

    2013-03-01

    Appropriate utilization of treatment is a goal for all patients undergoing cancer treatment. Proper treatment maximizes benefit and limits exposure to unnecessary measures. This report describes findings of the feasibility and acceptability of implementing a short, clinic-based decision aid and presents an in-depth clinical profile of the participants. This descriptive study used a prospective, quantitative approach to obtain the feasibility and acceptability of a decision aid (DecisionKEYS for Balancing Choices) for use in clinical settings. It combined results of trials of patients with three different common malignancies. All groups used the same decision aid series. Participants included 80 patients with solid tumors (22 with newly diagnosed breast cancer, 19 with advanced prostate cancer, and 39 with advanced lung cancer) and their 80 supporters as well as their physicians and nurses, for a total of 160 participants and 10 health professionals. The decision aid was highly acceptable to patient and supporter participants in all diagnostic groups. It was feasible for use in clinic settings; the overall value was rated highly. Of six physicians, all found the interactive format with the help of the nurse as feasible and acceptable. Nurses also rated the decision aid favorably. This intervention provides the opportunity to enhance decision making about cancer treatment and warrants further study including larger and more diverse groups. Strengths of the study included a theoretical grounding, feasibility testing of a practical clinic-based intervention, and summative evaluation of acceptability of the intervention by patient and supporter pairs. Further research also is needed to test the effectiveness of the decision aid in diverse clinical settings and to determine if this intervention can decrease overall costs.

  12. Data acquisition in modeling using neural networks and decision trees

    Directory of Open Access Journals (Sweden)

    R. Sika

    2011-04-01

    Full Text Available The paper presents a comparison of selected models from area of artificial neural networks and decision trees in relation with actualconditions of foundry processes. The work contains short descriptions of used algorithms, their destination and method of data preparation,which is a domain of work of Data Mining systems. First part concerns data acquisition realized in selected iron foundry, indicating problems to solve in aspect of casting process modeling. Second part is a comparison of selected algorithms: a decision tree and artificial neural network, that is CART (Classification And Regression Trees and BP (Backpropagation in MLP (Multilayer Perceptron networks algorithms.Aim of the paper is to show an aspect of selecting data for modeling, cleaning it and reducing, for example due to too strong correlationbetween some of recorded process parameters. Also, it has been shown what results can be obtained using two different approaches:first when modeling using available commercial software, for example Statistica, second when modeling step by step using Excel spreadsheetbasing on the same algorithm, like BP-MLP. Discrepancy of results obtained from these two approaches originates from a priorimade assumptions. Mentioned earlier Statistica universal software package, when used without awareness of relations of technologicalparameters, i.e. without user having experience in foundry and without scheduling ranks of particular parameters basing on acquisition, can not give credible basis to predict the quality of the castings. Also, a decisive influence of data acquisition method has been clearly indicated, the acquisition should be conducted according to repetitive measurement and control procedures. This paper is based on about 250 records of actual data, for one assortment for 6 month period, where only 12 data sets were complete (including two that were used for validation of neural network and useful for creating a model. It is definitely too

  13. Protocol for the Osteoporosis Choice trial. A pilot randomized trial of a decision aid in primary care practice

    Directory of Open Access Journals (Sweden)

    Tulledge-Scheitel Sidna M

    2009-12-01

    Full Text Available Abstract Background Bisphosphonates can reduce fracture risk in patients with osteoporosis, but many at-risk patients do not start or adhere to these medications. The aims of this study are to: (1 preliminarily evaluate the effect of an individualized 10-year osteoporotic fracture risk calculator and decision aid (OSTEOPOROSIS CHOICE for postmenopausal women at risk for osteoporotic fractures; and (2 assess the feasibility and validity (i.e., absence of contamination of patient-level randomization (vs. cluster randomization in pilot trials of decision aid efficacy. Methods/Design This is a protocol for a parallel, 2-arm, randomized trial to compare an intervention group receiving OSTEOPOROSIS CHOICE to a control group receiving usual primary care. Postmenopausal women with bone mineral density T-scores of STEOPOROSIS CHOICE on five outcomes: (a patient knowledge regarding osteoporosis risk factors and treatment; (b quality of the decision-making process for both the patient and clinician; (c patient and clinician acceptability and satisfaction with the decision aid; (d rate of bisphosphonate use and adherence, and (e trial processes (e.g., ability to recruit participants, collect patient outcomes. To capture these outcomes, we will use patient and clinician surveys following each visit and video recordings of the clinical encounters. These video recordings will also allow us to determine the extent to which clinicians previously exposed to the decision aid were able to recreate elements of the decision aid with control patients (i.e., contamination. Pharmacy prescription profiles and follow-up phone interviews will assess medication start and adherence at 6 months. Discussion This pilot trial will provide evidence of feasibility, validity of patient randomization, and preliminary efficacy of a novel approach -- decision aids -- to improving medication adherence for postmenopausal women at risk of osteoporotic fractures. The results will inform

  14. The NIAID Division of AIDS enterprise information system: integrated decision support for global clinical research programs

    Science.gov (United States)

    Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-01-01

    The National Institute of Allergy and Infectious Diseases (NIAID) Division of AIDS (DAIDS) Enterprise Information System (DAIDS-ES) is a web-based system that supports NIAID in the scientific, strategic, and tactical management of its global clinical research programs for HIV/AIDS vaccines, prevention, and therapeutics. Different from most commercial clinical trials information systems, which are typically protocol-driven, the DAIDS-ES was built to exchange information with those types of systems and integrate it in ways that help scientific program directors lead the research effort and keep pace with the complex and ever-changing global HIV/AIDS pandemic. Whereas commercially available clinical trials support systems are not usually disease-focused, DAIDS-ES was specifically designed to capture and incorporate unique scientific, demographic, and logistical aspects of HIV/AIDS treatment, prevention, and vaccine research in order to provide a rich source of information to guide informed decision-making. Sharing data across its internal components and with external systems, using defined vocabularies, open standards and flexible interfaces, the DAIDS-ES enables NIAID, its global collaborators and stakeholders, access to timely, quality information about NIAID-supported clinical trials which is utilized to: (1) analyze the research portfolio, assess capacity, identify opportunities, and avoid redundancies; (2) help support study safety, quality, ethics, and regulatory compliance; (3) conduct evidence-based policy analysis and business process re-engineering for improved efficiency. This report summarizes how the DAIDS-ES was conceptualized, how it differs from typical clinical trial support systems, the rationale for key design choices, and examples of how it is being used to advance the efficiency and effectiveness of NIAID's HIV/AIDS clinical research programs. PMID:21816958

  15. A hierarchical decision aid in a debate on national energy policy

    International Nuclear Information System (INIS)

    Haemaelaeinen, R.P.; Seppaelaeinen, T.; Oehladt, K.; Ruusunen, J.

    1985-12-01

    A wide public depate on the future energy policy of Finland has been going on for the past few years, and at the moment the discussion is centered around the question whether a new nuclear power plant should be built or not. To clarify the differences between anti-nuclear and pro-nuclear opinions, a decision analysis of the issue was conducted with a microcomputer-based decision aid which utilizes the Analytic Hierarchy Process. The participants representing the opposite opinions were the Minister of Finance and a chief industrial executive. This paper presents the preference profiles of the participants and sensitivity analyses of the results, and discusses the implications of the results for the depate. Essential sources of opinion differences are pointed out and a deeper understanding of the issue is gained. This enables focusing the depate on the critical questions and elimination of less important criteria, which otherwise might receive disproportonate attention

  16. Use of a decision aid for prenatal testing of fetal abnormalities to improve women's informed decision making: a cluster randomised controlled trial [ISRCTN22532458].

    Science.gov (United States)

    Nagle, C; Gunn, J; Bell, R; Lewis, S; Meiser, B; Metcalfe, S; Ukoumunne, O C; Halliday, J

    2008-02-01

    To evaluate the effectiveness of a decision aid for prenatal testing of fetal abnormalities compared with a pamphlet in supporting women's decision making. A cluster randomised controlled trial. Primary health care. Women in early pregnancy consulting a GP. GPs were randomised to provide women with either a decision aid or a pamphlet. The decision aid was a 24-page booklet designed using the Ottowa Decision Framework. The pamphlet was an existing resource available in the trial setting. Validated scales were used to measure the primary outcomes, informed choice and decisional conflict, and the secondary outcomes, anxiety, depression, attitudes to the pregnancy/fetus and acceptability of the resource. Outcomes were measured at 14 weeks of gestation from questionnaires that women completed and returned by post. Women in the intervention group were more likely to make an informed decision 76% (126/165) than those in the control group 65% (107/165) (adjusted OR 2.08; 95% CI 1.14-3.81). A greater proportion of women in the intervention group 88% (147/167) had a 'good' level of knowledge than those in the control group 72% (123/171) (adjusted OR 3.43; 95% CI 1.79-6.58). Mean (SD) decisional conflict scores were low in both groups, decision aid 1.71 (0.49), pamphlet 1.65 (0.55) (adjusted mean difference 0.10; 95% CI -0.02 to 0.22). There was no strong evidence of differences between the trial arms in the measures of psychological or acceptability outcomes. A tailored prenatal testing decision aid plays an important role in improving women's knowledge of first and second trimester screening tests and assisting them to make decisions about screening and diagnostic tests that are consistent with their values.

  17. 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.

  18. 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.

  19. Protocol for the evaluation of a decision aid for women with a breech-presenting baby [ISRCTN14570598

    Directory of Open Access Journals (Sweden)

    Peat Brian

    2004-12-01

    Full Text Available Abstract Background There is now good evidence about the management options for pregnant women with a breech presentation (buttocks or feet rather than head-first at term; external cephalic version (ECV – the turning of a breech baby to a head-down position and/or planned caesarean section (CS. Each of these options has benefits and risks and the relative importance of these vary for each woman, subject to her personal values and preferences, a situation where a decision aid may be helpful. Decision aids are designed to assist patients and their doctors in making informed decisions using information that is unbiased and based on high quality research evidence. Decision aids are non-directive in the sense that they do not aim to steer the user towards any one option, but rather to support decision making which is informed and consistent with personal values. The ECV decision aid was developed using the Ottawa Decision Support Framework, including a systematic review of the evidence about the benefits and risks of the options for breech pregnancy. It comprises an audiotape with a supplementary booklet and worksheet, a format that can be taken home and discussed with a partner. This project aims to evaluate the ECV decision aid for women with a breech presenting baby in late pregnancy. Study design We aim to evaluate the effectiveness of the decision aid compared with usual care in a randomised controlled trial in maternity hospitals that offer ECV. The study group will receive the decision aid in addition to usual care and the control group will receive standard information on management options for breech presentation from their usual pregnancy care provider. Approximately 184 women with a single breech-presenting baby at greater than 34 weeks gestation and who are clinically eligible for ECV will be recruited for the trial. The primary outcomes of the study are knowledge, decisional conflict, anxiety and satisfaction with decision-making that

  20. Protocol for the evaluation of a decision aid for women with a breech-presenting baby [ISRCTN14570598

    Science.gov (United States)

    Roberts, Christine L; Nassar, Natasha; Barratt, Alexandra; Raynes-Greenow, Camille H; Peat, Brian; Henderson-Smart, David

    2004-01-01

    Background There is now good evidence about the management options for pregnant women with a breech presentation (buttocks or feet rather than head-first) at term; external cephalic version (ECV) – the turning of a breech baby to a head-down position and/or planned caesarean section (CS). Each of these options has benefits and risks and the relative importance of these vary for each woman, subject to her personal values and preferences, a situation where a decision aid may be helpful. Decision aids are designed to assist patients and their doctors in making informed decisions using information that is unbiased and based on high quality research evidence. Decision aids are non-directive in the sense that they do not aim to steer the user towards any one option, but rather to support decision making which is informed and consistent with personal values. The ECV decision aid was developed using the Ottawa Decision Support Framework, including a systematic review of the evidence about the benefits and risks of the options for breech pregnancy. It comprises an audiotape with a supplementary booklet and worksheet, a format that can be taken home and discussed with a partner. This project aims to evaluate the ECV decision aid for women with a breech presenting baby in late pregnancy. Study design We aim to evaluate the effectiveness of the decision aid compared with usual care in a randomised controlled trial in maternity hospitals that offer ECV. The study group will receive the decision aid in addition to usual care and the control group will receive standard information on management options for breech presentation from their usual pregnancy care provider. Approximately 184 women with a single breech-presenting baby at greater than 34 weeks gestation and who are clinically eligible for ECV will be recruited for the trial. The primary outcomes of the study are knowledge, decisional conflict, anxiety and satisfaction with decision-making that will be assessed using

  1. 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

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

    African Journals Online (AJOL)

    Especially, the use of Finite Element (FE) based pavement modeling results for training the NN aided inverse analysis is considered to be accurate in realistically characterizing the non-linear stress-sensitive response of underlying pavement layers in real-time. Efficient NN learning algorithms have been developed and ...

  3. 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

  4. "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.

  5. Cognitive radio-aided wireless sensor networks for emergency response

    International Nuclear Information System (INIS)

    Arkoulis, Stamatios; Spanos, Dimitrios-Emmanuel; Barbounakis, Socrates; Zafeiropoulos, Anastasios; Mitrou, Nikolas

    2010-01-01

    A lot of research effort has been put into wireless sensor networks (WSNs) and several methods have been proposed to minimize the energy consumption and maximize the network's lifetime. However, little work has been carried out regarding WSNs deployed for emergency situations. We argue that such WSNs should function under a flexible channel allocation scheme when needed and be able to operate and adapt in dynamic, ever-changing environments coexisting with other interfering networks (IEEE 802.11b/g, 802.15.4, 802.15.1). In this paper, a simple and efficient method for the detection of a single operational frequency channel that guarantees satisfactory communication among all network nodes is proposed. Experimental measurements carried out in a real environment reveal the coexistence problem among networks in close proximity that operate in the same frequency band and prove the validity and efficiency of our approach

  6. 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.

  7. Decision aid use during post-biopsy consultations for localized prostate cancer.

    Science.gov (United States)

    Holmes-Rovner, Margaret; Srikanth, Akshay; Henry, Stephen G; Langford, Aisha; Rovner, David R; Fagerlin, Angela

    2018-02-01

    Decision Aids (DAs) effectively translate medical evidence for patients but are not routinely used in clinical practice. Little is known about how DAs are used during patient-clinician encounters. To characterize the content and communicative function of high-quality DAs during diagnostic clinic visits for prostate cancer. 252 men newly diagnosed with localized prostate cancer who had received a DA, 45 treating physicians at 4 US Veterans Administration urology clinics. Qualitative analysis of transcribed audio recordings was used to inductively develop categories capturing content and function of all direct references to DAs (booklet talk). The presence or absence of any booklet talk per transcript was also calculated. Booklet talk occurred in 55% of transcripts. Content focused on surgical procedures (36%); treatment choice (22%); and clarifying risk classification (17%). The most common function of booklet talk was patient corroboration of physicians' explanations (42%), followed by either physician or patient acknowledgement that the patient had the booklet. Codes reflected the absence of DA use for shared decision-making. In regression analysis, predictors of booklet talk were fewer years of patient education (P = .027) and more time in the encounter (P = .027). Patient race, DA type, time reading the DA, physician informing quality and physician age did not predict booklet talk. Results show that good decision aids, systematically provided to patients, appeared to function not to open up deliberations about how to balance benefits and harms of competing treatments, but rather to allow patients to ask narrow technical questions about recommended treatments. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  8. 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.

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

    KAUST Repository

    Elkhalil, Khalil; Eltayeb, Mohammed; Kammoun, Abla; Al-Naffouri, Tareq Y.; Bahrami, Hamid Reza

    2016-01-01

    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.

  10. The International Decision Support Initiative Reference Case for Economic Evaluation: An Aid to Thought.

    Science.gov (United States)

    Wilkinson, Thomas; Sculpher, Mark J; Claxton, Karl; Revill, Paul; Briggs, Andrew; Cairns, John A; Teerawattananon, Yot; Asfaw, Elias; Lopert, Ruth; Culyer, Anthony J; Walker, Damian G

    2016-12-01

    Policymakers in high-, low-, and middle-income countries alike face challenging choices about resource allocation in health. Economic evaluation can be useful in providing decision makers with the best evidence of the anticipated benefits of new investments, as well as their expected opportunity costs-the benefits forgone of the options not chosen. To guide the decisions of health systems effectively, it is important that the methods of economic evaluation are founded on clear principles, are applied systematically, and are appropriate to the decision problems they seek to inform. The Bill and Melinda Gates Foundation, a major funder of economic evaluations of health technologies in low- and middle-income countries (LMICs), commissioned a "reference case" through the International Decision Support Initiative (iDSI) to guide future evaluations, and improve both the consistency and usefulness to decision makers. The iDSI Reference Case draws on previous insights from the World Health Organization, the US Panel on Cost-Effectiveness in Health Care, and the UK National Institute for Health and Care Excellence. Comprising 11 key principles, each accompanied by methodological specifications and reporting standards, the iDSI Reference Case also serves as a means of identifying priorities for methods research, and can be used as a framework for capacity building and technical assistance in LMICs. The iDSI Reference Case is an aid to thought, not a substitute for it, and should not be followed slavishly without regard to context, culture, or history. This article presents the iDSI Reference Case and discusses the rationale, approach, components, and application in LMICs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Mapping of multiple criteria for priority setting of health interventions: an aid for decision makers

    Directory of Open Access Journals (Sweden)

    Tromp Noor

    2012-12-01

    Full Text Available Abstract Background In rationing decisions in health, many criteria like costs, effectiveness, equity and feasibility concerns play a role. These criteria stem from different disciplines that all aim to inform health care rationing decisions, but a single underlying concept that incorporates all criteria does not yet exist. Therefore, we aim to develop a conceptual mapping of criteria, based on the World Health Organization’s Health Systems Performance and Health Systems Building Blocks frameworks. This map can be an aid to decision makers to identify the relevant criteria for priority setting in their specific context. Methods We made an inventory of all possible criteria for priority setting on the basis of literature review. We categorized the criteria according to both health system frameworks that spell out a country’s health system goals and input. We reason that the criteria that decision makers use in priority setting exercises are a direct manifestation of this. Results Our map includes thirty-one criteria that are distributed among five categories that reflect the goals of a health system (i.e. to improve level of health, fair distribution of health, responsiveness, social & financial risk protection and efficiency and leadership/governance one category that reflects feasibiliy based on the health system building blocks (i.e. service delivery, health care workforce , information, medical products, vaccines & technologies, financing and. Conclusions This conceptual mapping of criteria, based on well-established health system frameworks, will further develop the field of priority setting by assisting decision makers in the identification of multiple criteria for selection of health interventions.

  12. 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.

  13. 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.

  14. [Evaluation of the decision aid "Entscheidungshilfe Prostatakrebs" from the patients' view : Results from the first three months].

    Science.gov (United States)

    Groeben, C; Ihrig, A; Hölscher, T; Krones, T; Kessler, E; Kliesch, S; Wülfing, C; Koch, R; Wirth, M P; Huber, J

    2016-12-01

    The decision aid "Entscheidungshilfe Prostatakrebs" is available online free of charge since June 2016. It is designed to support patients with their treatment decision-making and to lighten the burden on their treating urologists. This study evaluates usage data from the first 3 months. The ICHOM standard set was applied to allow a personalised presentation and to collect relevant data for subsequent counselling. Additionally, personal preferences and psychological burden were assessed amongst others. We collected anonymous data. A multivariate model evaluated predictors for high user satisfaction. From June through August 2016 a total of 319 patients used the decision aid, showing a continuous monthly increase in the number of users. There were n = 219 (68.7%) complete questionnaires. Median age was 66.1 ± 8.0 years. The oncological risk was low in 30.3%, intermediate in 43.6% and high in 26.1%. A majority of 57.5% used the decision aid together with their partner, 35.1% alone and 5.5% with their children. In all, 54.8% were "very satisfied" and 32.0% were "satisfied" with the decision aid for a total satisfaction rate of about 87%. The only predictors of total satisfaction were the usage mode and reported distress level. As shown by the continuously increasing number of users this decision aid is becoming well established in German urology. Patients' overall ratings are very positive. The majority of patients use the decision aid with their partner. This represents a significant advantage of a multimedia approach compared to print media.

  15. Deep learning aided decision support for pulmonary nodules diagnosing: a review.

    Science.gov (United States)

    Yang, Yixin; Feng, Xiaoyi; Chi, Wenhao; Li, Zhengyang; Duan, Wenzhe; Liu, Haiping; Liang, Wenhua; Wang, Wei; Chen, Ping; He, Jianxing; Liu, Bo

    2018-04-01

    Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades. The recent remarkable and significant progress in deep learning for pulmonary nodules achieved in both academia and the industry has demonstrated that deep learning techniques seem to be promising alternative decision support schemes to effectively tackle the central issues in pulmonary nodules diagnosing, including feature extraction, nodule detection, false-positive reduction, and benign-malignant classification for the huge volume of chest scan data. The main goal of this investigation is to provide a comprehensive state-of-the-art review of the deep learning aided decision support for pulmonary nodules diagnosing. As far as the authors know, this is the first time that a review is devoted exclusively to deep learning techniques for pulmonary nodules diagnosing.

  16. Point-of-views representation for hypothetical reasoning: application to decision-aid

    International Nuclear Information System (INIS)

    Diaz, Antoine

    1992-01-01

    Most of the knowledge based Decision Support Systems must deal with two difficulties in problem solving representation: reasoning with incomplete knowledge and managing contradictory reasoning. We propose a method which answers the question of reasoning revision when a contradiction occurs, while preserving the functionalities of the De Kleer's ATMS System for simulating hypothetical reasoning. As a matter of fact, these functionalities are particularly suitable for decision aiding problems. In order to formalize the ATMS, we use a resolution method called Cat-resolution (Cayrol and Tayrac). This method allows the computation of ATMS functions relating to a set of propositional clauses by saturating this set. Owing to this choice, we can use the same principles as ATMS on the saturation trace. Each clause in the saturated set can be linked to the sets of initial clauses justifying its derivation by Cat-resolution. The reasoning inconsistency is now managed. First the user can identify the source of the inconsistency thanks to the empty clause explanation. Then he can try to restore the reasoning consistency by relaxing at least one of the initial clauses justifying the empty clause. The computation of 'partial' ATMS, representing a point of view in the decision-making problem, is more effective owing to the justifications of the derived clauses. (author) [fr

  17. 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.

  18. 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.

  19. Evaluation of a decision aid for women with breech presentation at term: a randomised controlled trial [ISRCTN14570598

    Science.gov (United States)

    Nassar, N; Roberts, CL; Raynes-Greenow, CH; Barratt, A; Peat, B

    2007-01-01

    Objectives To evaluate the effectiveness of a decision aid for women with a breech presentation compared with usual care. Design Randomised controlled trial. Setting Tertiary obstetric hospitals offering external cephalic version (ECV). Population Women with a singleton pregnancy were diagnosed antenatally with a breech presentation at term, and were clinically eligible for ECV. Methods Women were randomised to either receive a decision aid about the management options for breech presentation in addition to usual care or to receive usual care only with standard counselling from their usual pregnancy care provider. The decision aid comprised a 24-page booklet supplemented by a 30-minute audio-CD and worksheet that was designed for women to take home and review with a partner. Main outcome measures Decisional conflict (uncertainty), knowledge, anxiety and satisfaction with decision making, and were assessed using self-administered questionnaires. Results Compared with usual care, women reviewing the decision aid experienced significantly lower decisional conflict (mean difference −8.92; 95% CI −13.18, −4.66) and increased knowledge (mean difference 8.40; 95% CI 3.10, 13.71), were more likely to feel that they had enough information to make a decision (RR 1.30; 95% CI 1.14, 1.47), had no increase in anxiety and reported greater satisfaction with decision making and overall experience of pregnancy and childbirth. In contrast, 19% of women in the usual care group reported they would have made a different decision about their care. Conclusions A decision aid is an effective and acceptable tool for pregnant women that provides an important adjunct to standard counselling for the management of breech presentation. Please cite this paper as: Nassar N, Roberts C, Raynes-Greenow C, Barratt A, Peat B, on behalf of the Decision Aid for Breech Presentation Trial Collaborators. Evaluation of a decision aid for women with breech presentation at term: a randomised controlled

  20. 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

  1. Computer-aided diagnosis of prostate cancer using a deep convolutional neural network from multiparametric MRI.

    Science.gov (United States)

    Song, Yang; Zhang, Yu-Dong; Yan, Xu; Liu, Hui; Zhou, Minxiong; Hu, Bingwen; Yang, Guang

    2018-04-16

    Deep learning is the most promising methodology for automatic computer-aided diagnosis of prostate cancer (PCa) with multiparametric MRI (mp-MRI). To develop an automatic approach based on deep convolutional neural network (DCNN) to classify PCa and noncancerous tissues (NC) with mp-MRI. Retrospective. In all, 195 patients with localized PCa were collected from a PROSTATEx database. In total, 159/17/19 patients with 444/48/55 observations (215/23/23 PCas and 229/25/32 NCs) were randomly selected for training/validation/testing, respectively. T 2 -weighted, diffusion-weighted, and apparent diffusion coefficient images. A radiologist manually labeled the regions of interest of PCas and NCs and estimated the Prostate Imaging Reporting and Data System (PI-RADS) scores for each region. Inspired by VGG-Net, we designed a patch-based DCNN model to distinguish between PCa and NCs based on a combination of mp-MRI data. Additionally, an enhanced prediction method was used to improve the prediction accuracy. The performance of DCNN prediction was tested using a receiver operating characteristic (ROC) curve, and the area under the ROC curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Moreover, the predicted result was compared with the PI-RADS score to evaluate its clinical value using decision curve analysis. Two-sided Wilcoxon signed-rank test with statistical significance set at 0.05. The DCNN produced excellent diagnostic performance in distinguishing between PCa and NC for testing datasets with an AUC of 0.944 (95% confidence interval: 0.876-0.994), sensitivity of 87.0%, specificity of 90.6%, PPV of 87.0%, and NPV of 90.6%. The decision curve analysis revealed that the joint model of PI-RADS and DCNN provided additional net benefits compared with the DCNN model and the PI-RADS scheme. The proposed DCNN-based model with enhanced prediction yielded high performance in statistical analysis, suggesting

  2. A global, incremental development method for a web-based prostate cancer treatment decision aid and usability testing in a Dutch clinical setting.

    Science.gov (United States)

    Cuypers, Maarten; Lamers, Romy Ed; Kil, Paul Jm; The, Regina; Karssen, Klemens; van de Poll-Franse, Lonneke V; de Vries, Marieke

    2017-07-01

    Many new decision aids are developed while aspects of existing decision aids could also be useful, leading to a sub-optimal use of resources. To support treatment decision-making in prostate cancer patients, a pre-existing evidence-based Canadian decision aid was adjusted to Dutch clinical setting. After analyses of the original decision aid and routines in Dutch prostate cancer care, adjustments to the decision aid structure and content were made. Subsequent usability testing (N = 11) resulted in 212 comments. Care providers mainly provided feedback on medical content, and patients commented most on usability and summary layout. All participants reported that the decision aid was comprehensible and well-structured and would recommend decision aid use. After usability testing, final adjustments to the decision aid were made. The presented methods could be useful for cultural adaptation of pre-existing tools into other languages and settings, ensuring optimal usage of previous scientific and practical efforts and allowing for a global, incremental decision aid development process.

  3. Psychosocial Factors of Health Professionals' Intention to Use a Decision Aid for Down Syndrome Screening: Cross-Sectional Quantitative Study.

    Science.gov (United States)

    Abbasgholizadeh Rahimi, Samira; Lépine, Johanie; Croteau, Jordie; Robitaille, Hubert; Giguere, Anik Mc; Wilson, Brenda J; Rousseau, François; Lévesque, Isabelle; Légaré, France

    2018-04-25

    Decisions about prenatal screening for Down syndrome are difficult for women, as they entail risk, potential loss, and regret. Shared decision making increases women's knowledge of their choices and better aligns decisions with their values. Patient decision aids foster shared decision making but are rarely used in this context. One of the most promising strategies for implementing shared decision making is distribution of decision aids by health professionals. We aimed to identify factors influencing their intention to use a DA during prenatal visit for decisions about Down syndrome screening. We conducted a cross-sectional quantitative study. Using a Web panel, we conducted a theory-based survey of health professionals in Quebec province (Canada). Eligibility criteria were as follows: (1) family physicians, midwives, obstetrician-gynecologists, or trainees in these professions; (2) involved in prenatal care; and (3) working in Quebec province. Participants watched a video depicting a health professional using a decision aid during a prenatal consultation with a woman and her partner, and then answered a questionnaire based on an extended version of the theory of planned behavior, including some of the constructs of the theoretical domains framework. The questionnaire assessed 8 psychosocial constructs (attitude, anticipated regret, subjective norm, self-identity, moral norm, descriptive norm, self-efficacy, and perceived control), 7 related sets of behavioral beliefs (advantages, disadvantages, emotions, sources of encouragement or discouragement, incentives, facilitators, and barriers), and sociodemographic data. We performed descriptive, bivariate, and multiple linear regression analyses to identify factors influencing health professionals' intention to use a decision aid. Among 330 health professionals who completed the survey, 310 met the inclusion criteria: family physicians, 55.2% (171/310); obstetrician-gynecologists, 33.8% (105/310); and midwives, 11

  4. 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

  5. Design of the decision aiding system for the control of the research nuclear reactor

    International Nuclear Information System (INIS)

    Adda, F.; Allek, M.; Larbes, C.

    2003-01-01

    Intelligent and decision aiding systems as support to operators are becoming increasingly a necessity in nuclear installations and in nuclear reactors in particular, specially after the Tree Mile Island. Development of new technologies based on linguistic approaches such as fuzzy logic has given rise to much interest during the last years. Fuzzy logic controller (FLC) has many advantage compared to conventional controllers using classical techniques. The aim of the present work is to use a fuzzy logic controller in parallel to actual semi-automatic controller in order to supervise in real time the operation of the research nuclear reactor. The principal of this controller is based on rules which are established previous from experiment using the semi-automatic controller and from the knowledge of the operators. (authors)

  6. Microprocessor-based, on-line decision aid for resolving conflicting nuclear reactor instrumentation

    International Nuclear Information System (INIS)

    Alesso, H.P.

    1981-01-01

    We describe one design for a microprocessor-based, on-line decision aid for identifying and resolving false, conflicting, or misleading instrument indications resulting from certain systems interactions for a pressurized water reactor. The system processes sensor signals from groups of instruments that track together under nominal transient and certain accident conditions, and alarms when they do not track together. We examine multiple-casualty systems interaction and formulate a trial grouping of variables that track together under specified conditions. A two-of-three type redundancy check of key variables provides alarm and indication of conflicting information when one signal suddenly tracks in opposition due to multiple casualty, instrument failure, and/or locally abnormal conditions. Since a vote count of two of three variables in conflict as inconclusive evidence, the system is not designed to provide tripping or corrective action, but improves the operator/instrument interface by providing additional and partially digested information

  7. The development and use of decision aiding techniques for establishing intervention levels

    International Nuclear Information System (INIS)

    Kelly, G.N.; Sinnaeve, J.

    1989-01-01

    Following the Chernobyl accident there has been considerable international discussion on the principles underlying the choice of intervention levels and their practical application. While there is broad agreement on the underlying principles - that is to put potentially exposed individuals into a better position in the sense that lower overall risks are achieved at reasonable cost in financial and social terms - the determination of what constitutes the most appropriate type and level of intervention in any particular circumstances is more complex. Within the CEC Radiation Protection Research Programme techniques are being developed to aid well founded and more transparent decisions on the choice of intervention levels. The techniques are described and areas identified where they might usefully be applied

  8. Artificial neural networks for decision-making in urologic oncology.

    Science.gov (United States)

    Anagnostou, Theodore; Remzi, Mesut; Lykourinas, Michael; Djavan, Bob

    2003-06-01

    The authors are presenting a thorough introduction in Artificial Neural Networks (ANNs) and their contribution to modern Urologic Oncology. The article covers a description of Artificial Neural Network methodology and points out the differences of Artificial Intelligence to traditional statistic models in terms of serving patients and clinicians, in a different way than current statistical analysis. Since Artificial Intelligence is not yet fully understood by many practicing clinicians, the authors have reviewed a careful selection of articles in order to explore the clinical benefit of Artificial Intelligence applications in modern Urology questions and decision-making. The data are from real patients and reflect attempts to achieve more accurate diagnosis and prognosis, especially in prostate cancer that stands as a good example of difficult decision-making in everyday practice. Experience from current use of Artificial Intelligence is also being discussed, and the authors address future developments as well as potential problems such as medical record quality, precautions in using ANNs or resistance to system use, in an attempt to point out future demands and the need for common standards. The authors conclude that both methods should continue to be used in a complementary manner. ANNs still do not prove always better as to replace standard statistical analysis as the method of choice in interpreting medical data.

  9. 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.

  10. Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

    Science.gov (United States)

    Wong, Charlene A; Kulhari, Sajal; McGeoch, Ellen J; Jones, Arthur T; Weiner, Janet; Polsky, Daniel; Baker, Tom

    2018-05-29

    The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices. To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison. In November-December 2016, we examined the public and private online health insurance exchanges. We navigated each site for "real-shopping" (personal information required) and "window-shopping" (no required personal information). Public (n = 13; 12 state-based marketplaces and HealthCare.gov ) and private (n = 23) online health insurance exchanges. Features included consumer decision aids (e.g., total cost estimators, provider lookups) and plan display (e.g., order of plans). We examined private health insurance exchanges for notable features (i.e., those not found on public exchanges) and compared the total cost estimates on public versus private exchanges for a standardized consumer. Nearly all studied consumer decision aids saw increased deployment in the public marketplaces in OEP4 compared to OEP3. Over half of the public exchanges (n = 7 of 13) had total cost estimators (versus 5 of 14 in OEP3) in window-shopping and integrated provider lookups (window-shopping: 7; real-shopping: 8). The most common default plan orders were by premium or total cost estimate. Notable features on private health insurance exchanges were unique data presentation (e.g., infographics) and further personalized shopping (e.g., recommended plan flags). Health plan total cost estimates varied substantially between the public and private exchanges (average difference $1526). The ACA's public health insurance exchanges offered more tools in OEP4 to help consumers select a plan. While private health insurance exchanges presented notable features, the total cost estimates for a standardized consumer varied widely on public

  11. 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.

  12. 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.

  13. 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.

  14. Evolutionary Artificial Neural Network Weight Tuning to Optimize Decision Making for an Abstract Game

    Science.gov (United States)

    2010-03-01

    EVOLUTIONARY ARTIFICIAL NEURAL NETWORK WEIGHT TUNING TO OPTIMIZE DECISION MAKING FOR AN ABSTRACT...AFIT/GCS/ENG/10-06 EVOLUTIONARY ARTIFICIAL NEURAL NETWORK WEIGHT TUNING TO OPTIMIZE DECISION MAKING FOR AN ABSTRACT GAME THESIS Presented...35 14: Diagram of pLoGANN’s Artificial Neural Network and

  15. What factors influence health professionals to use decision aids for Down syndrome prenatal screening?

    Science.gov (United States)

    Lépine, Johanie; Leiva Portocarrero, Maria Esther; Delanoë, Agathe; Robitaille, Hubert; Lévesque, Isabelle; Rousseau, François; Wilson, Brenda J; Giguère, Anik M C; Légaré, France

    2016-09-05

    Health professionals are expected to engage pregnant women in shared decision making to help them make informed values-based decisions about prenatal screening. Patient decision aids (PtDAs) foster shared decision-making, but are rarely used in this context. Our objective was to identify factors that could influence health professionals to use a PtDA for decisions about prenatal screening for Down syndrome during a clinical pregnancy follow-up. We planned to recruit a purposive sample of 45 health professionals (obstetrician-gynecologists, family physicians and midwives) involved in the care of pregnant women in three clinical sites (15 per site). Participating health professionals first watched a video showing two simulated consecutive prenatal follow-up consultations during which a pregnant woman, her partner and a health professional used a PtDA about Down syndrome prenatal screening. Participants were then interviewed about factors that would influence their use of the PtDA. Questions were based on the Theoretical Domains Framework. We performed content analyses of transcribed verbatim interviews. Out of 42 eligible health professionals approached, 36 agreed to be interviewed (86 % response rate). Of these, 27 were female (75 %), nine were obstetrician-gynecologists (25 %), 15 were family physicians (42 %), and 12 were midwives (33 %), with a mean age of 42.1 ± 11.6 years old. We identified 35 distinct factors reported by 20 % or more participants that were mapped onto 10 of the 12 of the Theoretical Domains Framework domains. The six most frequently mentioned factors influencing use of the PtDA were: 1) a positive appraisal (n = 29, 81 %, beliefs about consequences domain); 2) its availability in the office (n = 27, 75 %, environmental context and resources domain); 3) colleagues' approval (n = 27, 75 %, social influences domain); 4) time constraints (n = 26, 72 %, environmental context and resources domain); 5) finding it a

  16. Decision-Aiding and Optimization for Vertical Navigation of Long-Haul Aircraft

    Science.gov (United States)

    Patrick, Nicholas J. M.; Sheridan, Thomas B.

    1996-01-01

    different airspace design and air traffic management policies. A decision aid is proposed which would combine the pilot's notion of optimality with the GA-based optimization, provide the pilot with a number of alternative pareto-optimal trajectories, and allow him to consider unmodelled attributes and constraints in choosing among them. A solution to the problem of displaying alternatives in a multi-attribute decision space is also presented.

  17. 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...

  18. Bayesian networks for clinical decision support in lung cancer care.

    Directory of Open Access Journals (Sweden)

    M Berkan Sesen

    Full Text Available Survival prediction and treatment selection in lung cancer care are characterised by high levels of uncertainty. Bayesian Networks (BNs, which naturally reason with uncertain domain knowledge, can be applied to aid lung cancer experts by providing personalised survival estimates and treatment selection recommendations. Based on the English Lung Cancer Database (LUCADA, we evaluate the feasibility of BNs for these two tasks, while comparing the performances of various causal discovery approaches to uncover the most feasible network structure from expert knowledge and data. We show first that the BN structure elicited from clinicians achieves a disappointing area under the ROC curve of 0.75 (± 0.03, whereas a structure learned by the CAMML hybrid causal discovery algorithm, which adheres with the temporal restrictions, achieves 0.81 (± 0.03. Second, our causal intervention results reveal that BN treatment recommendations, based on prescribing the treatment plan that maximises survival, can only predict the recorded treatment plan 29% of the time. However, this percentage rises to 76% when partial matches are included.

  19. Medical communication and technology: a video-based process study of the use of decision aids in primary care consultations

    Directory of Open Access Journals (Sweden)

    Graham Ruth

    2007-01-01

    Full Text Available Abstract Background Much of the research on decision-making in health care has focused on consultation outcomes. Less is known about the process by which clinicians and patients come to a treatment decision. This study aimed to quantitatively describe the behaviour shown by doctors and patients during primary care consultations when three types of decision aids were used to promote treatment decision-making in a randomised controlled trial. Methods A video-based study set in an efficacy trial which compared the use of paper-based guidelines (control with two forms of computer-based decision aids (implicit and explicit versions of DARTS II. Treatment decision concerned warfarin anti-coagulation to reduce the risk of stroke in older patients with atrial fibrillation. Twenty nine consultations were video-recorded. A ten-minute 'slice' of the consultation was sampled for detailed content analysis using existing interaction analysis protocols for verbal behaviour and ethological techniques for non-verbal behaviour. Results Median consultation times (quartiles differed significantly depending on the technology used. Paper-based guidelines took 21 (19–26 minutes to work through compared to 31 (16–41 minutes for the implicit tool; and 44 (39–55 minutes for the explicit tool. In the ten minutes immediately preceding the decision point, GPs dominated the conversation, accounting for 64% (58–66% of all utterances and this trend was similar across all three arms of the trial. Information-giving was the most frequent activity for both GPs and patients, although GPs did this at twice the rate compared to patients and at higher rates in consultations involving computerised decision aids. GPs' language was highly technically focused and just 7% of their conversation was socio-emotional in content; this was half the socio-emotional content shown by patients (15%. However, frequent head nodding and a close mirroring in the direction of eye-gaze suggested

  20. 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.

  1. 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...

  2. An Examination of the Social Networks and Social Isolation in Older and Younger Adults Living with HIV/AIDS

    Science.gov (United States)

    Emlet, Charles A.

    2006-01-01

    This study examined social networks and social isolation in older (50 years or more) and younger (ages 20 to 39) adults with HIV/AIDS. The author conducted interviews with 88 individuals living with HIV/AIDS in the Pacific Northwest. Both groups' social networks had similar patterns; however, older adults were more likely to live alone. More than…

  3. Usability testing of ANSWER: a web-based methotrexate decision aid for patients with rheumatoid arthritis.

    Science.gov (United States)

    Li, Linda C; Adam, Paul M; Townsend, Anne F; Lacaille, Diane; Yousefi, Charlene; Stacey, Dawn; Gromala, Diane; Shaw, Chris D; Tugwell, Peter; Backman, Catherine L

    2013-12-01

    Decision aids are evidence-based tools designed to inform people of the potential benefit and harm of treatment options, clarify their preferences and provide a shared decision-making structure for discussion at a clinic visit. For patients with rheumatoid arthritis (RA) who are considering methotrexate, we have developed a web-based patient decision aid called the ANSWER (Animated, Self-serve, Web-based Research Tool). This study aimed to: 1) assess the usability of the ANSWER prototype; 2) identify strengths and limitations of the ANSWER from the patient's perspective. The ANSWER prototype consisted of: 1) six animated patient stories and narrated information on the evidence of methotrexate for RA; 2) interactive questionnaires to clarify patients' treatment preferences. Eligible participants for the usability test were patients with RA who had been prescribed methotrexate. They were asked to verbalize their thoughts (i.e., think aloud) while using the ANSWER, and to complete the System Usability Scale (SUS) to assess overall usability (range = 0-100; higher = more user friendly). Participants were audiotaped and observed, and field notes were taken. The testing continued until no new modifiable issues were found. We used descriptive statistics to summarize participant characteristics and the SUS scores. Content analysis was used to identified usability issues and navigation problems. 15 patients participated in the usability testing. The majority were aged 50 or over and were university/college graduates (n = 8, 53.4%). On average they took 56 minutes (SD = 34.8) to complete the tool. The mean SUS score was 81.2 (SD = 13.5). Content analysis of audiotapes and field notes revealed four categories of modifiable usability issues: 1) information delivery (i.e., clarity of the information and presentation style); 2) navigation control (i.e., difficulties in recognizing and using the navigation control buttons); 3) layout (i.e., position of the

  4. 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.

  5. 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.)

  6. A Decision Aid to Promote Appropriate Colorectal Cancer Screening among Older Adults: A Randomized Controlled Trial.

    Science.gov (United States)

    Lewis, Carmen L; Kistler, Christine E; Dalton, Alexandra F; Morris, Carolyn; Ferrari, Renée; Barclay, Colleen; Brewer, Noel T; Dolor, Rowena; Harris, Russell; Vu, Maihan; Golin, Carol E

    2018-07-01

    Concerns have been raised about both over- and underutilization of colorectal cancer (CRC) screening in older patients and the need to align screening behavior with likelihood of net benefit. The purpose of this study was to test a novel use of a patient decision aid (PtDA) to promote appropriate CRC screening in older adults. A total of 424 patients ages 70 to 84 y who were not up to date with CRC screening participated in a double-blinded randomized controlled trial of a PtDA targeted to older adults making decisions about whether to undergo CRC screening from March 2012 to February 2015. Patients were randomized to a targeted PtDA or an attention control. The PtDA was designed to facilitate individualized decision making-helping patients understand the potential risks, benefits, and uncertainties of CRC screening given advanced age, health state, preferences, and values. Two composite outcomes, appropriate CRC screening behavior 6 mo after the index visit and appropriate screening intent immediately after the visit, were defined as completed screening or intent for patients in good health, discussion about screening with their provider for patients in intermediate health, and no screening or intent for patients in poor health. Health state was determined by age and Charlson Comorbidity Index. Four hundred twelve (97%) and 421 (99%) patients were analyzed for the primary and secondary outcomes, respectively. Appropriate screening behavior at 6 mo was higher in the intervention group (55% v. 45%, P = 0.023) as was appropriate screening intent following the provider visit (61% v. 47%, P = 0.003). The study took place in a single geographic region. The appropriate CRC screening classification system used in this study has not been formally validated. A PtDA for older adults promoted appropriate CRC screening behavior and intent. Clinicaltrials.gov, registration number NCT01575990. https://clinicaltrials.gov/ct2/show/NCT01575990?term=epic-d&rank=1.

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

    International Nuclear Information System (INIS)

    Turcanu, C.O.; Hardeman, F.; Carle, B.

    2006-01-01

    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 131 I or 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. Development and evaluation of a patient decision aid for young people and parents considering fixed orthodontic appliances.

    Science.gov (United States)

    Marshman, Zoe; Eddaiki, Abdussalam; Bekker, Hilary L; Benson, Philip E

    2016-12-01

    To develop and evaluate a child-centred patient decision aid for young people, and their parents, supporting shared decision making about fixed orthodontic appliance treatment with dental health professionals, namely the Fixed Appliance Decision Aid (FADA). The studies were undertaken in a UK teaching dental hospital orthodontic department in 2013-2014. The development phase involved an interview study with: (a) 10 patients (12-16 years old), and their parents, receiving orthodontic care to investigate treatment decision making and inform the content of the FADA and (b) 23 stakeholders critiquing the draft decision aid's content, structure and utility. The evaluation phase employed a pre-/post-test study design, with 30 patients (12-16 years old) and 30 parents. Outcomes included the Decisional Conflict Scale; measures of orthodontic treatment expectations and knowledge. Qualitative analysis identified two informational needs: effectiveness of treatment on orthodontic outcomes and treatment consequences for patients' lives. Quantitative analysis found decisional conflict reduced in both patients (mean difference -12.3, SD 15.3, 95% CI 6.6-17.9; p orthodontic treatment increased; expectations about care were unchanged. Using the FADA may enable dental professionals to support patients and their parents, decisions about fixed appliance treatments more effectively, ensuring young people's preferences are integrated into care planning.

  9. Women's role in reproductive health decision making and vulnerability to STD and HIV/AIDS in Ekiti, Nigeria.

    Science.gov (United States)

    Orubuloye, I O; Oguntimehin, F; Sadiq, T

    1997-01-01

    An exploratory study of women's role in reproductive decision making in Ekiti shows that women in the state are increasingly taking active decisions on matters affecting their daily lives. More women than ever before believed that they could take decisions on family size, when to have a baby and choice of spacing period. The cultural barrier against short postpartum abstinence appeared to have diminished and sex during lactation was not considered a major cultural and religious taboo. Knowledge of contraception has become universal in recent years, and the majority of women take decisions on the method and timing of family planning. All women who used family planning considered their decision in this regard very important. The ability of women to take decisions on these issues may not only enhance their bargaining power but also reduce their vulnerability to STDs including AIDS from diseased or high-risk partners.

  10. 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.

  11. Influence of Mobility Models in Precision Spray Aided by Wireless Sensor Networks

    International Nuclear Information System (INIS)

    Gonçalves, L B L; Neves, L A; Zafalon, G F D; Costa, F G; Ueyama, J; Montez, C; Pinto, A S R

    2015-01-01

    Precision Spray is a technique to increase performance of Precision Agriculture. This spray technique may be aided by a Wireless Sensor Network, however, for such approach, the communication between the agricultural input applicator vehicle and network is critical due to its proper functioning. Thus, this work analyzes how the number of nodes in a wireless sensor network, its type of distribution and different areas of scenario affects the performance of communication. We performed simulations to observe system's behavior changing to find the most fitted non-controlled mobility model to the system

  12. 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.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    In networked MNCs where knowledge and power are distributed, corporate strategy processes benefit from input arising from many different levels of the organization. Recently, the regional (i.e., supra-national) level has been emphasized as an important additional source of knowledge and input......, 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...... with MNC headquarters, we provide empirical evidence that a regional headquarters' autonomy and signaling behavior have significant effects on its influence on corporate strategy. Furthermore, we find support for our hypothesis that the regional headquarters' charter moderates such bottom–up influence....

  14. 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...

  15. 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

  16. 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.

  17. 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

  18. Neural Network Aided Glitch-Burst Discrimination and Glitch Classification

    Science.gov (United States)

    Rampone, Salvatore; Pierro, Vincenzo; Troiano, Luigi; Pinto, Innocenzo M.

    2013-11-01

    We investigate the potential of neural-network based classifiers for discriminating gravitational wave bursts (GWBs) of a given canonical family (e.g. core-collapse supernova waveforms) from typical transient instrumental artifacts (glitches), in the data of a single detector. The further classification of glitches into typical sets is explored. In order to provide a proof of concept, we use the core-collapse supernova waveform catalog produced by H. Dimmelmeier and co-Workers, and the data base of glitches observed in laser interferometer gravitational wave observatory (LIGO) data maintained by P. Saulson and co-Workers to construct datasets of (windowed) transient waveforms (glitches and bursts) in additive (Gaussian and compound-Gaussian) noise with different signal-to-noise ratios (SNR). Principal component analysis (PCA) is next implemented for reducing data dimensionality, yielding results consistent with, and extending those in the literature. Then, a multilayer perceptron is trained by a backpropagation algorithm (MLP-BP) on a data subset, and used to classify the transients as glitch or burst. A Self-Organizing Map (SOM) architecture is finally used to classify the glitches. The glitch/burst discrimination and glitch classification abilities are gauged in terms of the related truth tables. Preliminary results suggest that the approach is effective and robust throughout the SNR range of practical interest. Perspective applications pertain both to distributed (network, multisensor) detection of GWBs, where some intelligence at the single node level can be introduced, and instrument diagnostics/optimization, where spurious transients can be identified, classified and hopefully traced back to their entry points.

  19. 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.

  20. Computer-aided detection as a decision assistant in chest radiography

    Science.gov (United States)

    Samulski, Maurice R. M.; Snoeren, Peter R.; Platel, Bram; van Ginneken, Bram; Hogeweg, Laurens; Schaefer-Prokop, Cornelia; Karssemeijer, Nico

    2011-03-01

    Background. Contrary to what may be expected, finding abnormalities in complex images like pulmonary nodules in chest radiographs is not dominated by time-consuming search strategies but by an almost immediate global interpretation. This was already known in the nineteen-seventies from experiments with briefly flashed chest radiographs. Later on, experiments with eye-trackers showed that abnormalities attracted the attention quite fast but often without further reader actions. Prolonging one's search seldom leads to newly found abnormalities and may even increase the chance of errors. The problem of reading chest radiographs is therefore not dominated by finding the abnormalities, but by interpreting them. Hypothesis. This suggests that readers could benefit from computer-aided detection (CAD) systems not so much by their ability to prompt potential abnormalities, but more from their ability to 'interpret' the potential abnormalities. In this paper, this hypothesis was investigated by an observer experiment. Experiment. In one condition, the traditional CAD condition, the most suspicious CAD locations were shown to the subjects, without telling them the levels of suspiciousness according to CAD. In the other condition, interactive CAD condition, levels of suspiciousness were given, but only when readers requested them at specified locations. These two conditions focus on decreasing search errors and decision errors, respectively. Results of reading without CAD were also recorded. Six subjects, all non-radiologists, read 223 chest radiographs in both conditions. CAD results were obtained from the OnGuard 5.0 system developed by Riverain Medical (Miamisburg, Ohio). Results. The observer data were analyzed by Location Response Operating Characteristic analysis (LROC). It was found that: 1) With the aid of CAD, the performance is significantly better than without CAD; 2) The performance with interactive CAD is significantly better than with traditional CAD at low false

  1. Visual Aids for Improving Patient Decision Making in Severe Symptomatic Carotid Stenosis.

    Science.gov (United States)

    Fridman, Sebastian; Saposnik, Gustavo; Sposato, Luciano A

    2017-12-01

    Because of the large amount of information to process and the limited time of a clinical consult, choosing between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS) can be confusing for patients with severe symptomatic internal carotid stenosis (ICA). We aim to develop a visual aid tool to help clinicians and patients in the decision-making process of selecting between CEA and CAS. Based on pooled analysis from randomized controlled trials including patients with symptomatic and severe ICA (SSICA), we generated visual plots comparing CEA with CAS for 3 prespecified postprocedural time points: (1) any stroke or death at 4 months, and (2) any stroke or death in the first 30 days and ipsilateral stroke thereafter at 5 years and (3) at 10 years. A total of 4574 participants (2393 assigned to CAS, and 2361 to CEA) were included in the analyses. For every 100 patients with SSICA, 6 would develop any stroke or death in the CEA group compared with 9 undergoing CAS at 4 months (hazard ratio [HR] 1.53; 95%CI 1.20-1.95). At 5 years, 7 patients in the CEA group would develop any periprocedural stroke or death and ipsilateral stroke thereafter versus 12 undergoing CAS (HR 1.72; 95%CI 1.24-2.39), compared with 10 patients in the CEA and 13 in the CAS groups at 10 years (HR 1.17; 95%CI 0.82-1.66). Visual aids presented in this study could potentially help patients with severe symptomatic internal carotid stenosis to better weigh the risks and benefits of CEA versus CAS as a function of time, allowing for the prioritization of personal preferences, and should be prospectively assessed. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  2. 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

  3. 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.

  4. 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).

  5. A decision aid for men with early stage prostate cancer: theoretical basis and a test by surrogate patients

    Science.gov (United States)

    Feldman‐Stewart, Deb; Brundage, Michael D.; Van Manen, Lori

    2008-01-01

    Background We developed a decision aid for patients with curable prostate cancer based on Svenson’s DiffCon Theory of Decision Making. This study was designed to determine if surrogate patients using the aid could understand the information presented, complete all tasks, show evidence of differentiation, and arrive at a preferred treatment choice. Methods Men, at least 50 years old and never diagnosed with prostate cancer, were recruited through local advertisements. Participants were asked to imagine that they were a case‐scenario patient. Then they completed the decision aid interview, which included three components: (i) information presentation, with comprehension questions, (ii) exercises to help identify attributes important to the decision, and (iii) value‐clarification exercises. Results Sixty‐nine men volunteered. They had a mean age of 61.2 (range 50–83) years, 37% had no formal education beyond high school, and 87% were living with a partner. All participants completed all aspects of the interview. They answered an average of 10 comprehension questions each, with a mean of 94.7% correct without a prompt. Each attribute in the information presented was identified by at least one participant as important to his decision. Participants identified a median of five attributes as important (ranges 1–14) at each of three points during the interview; 75% changed at least one important attribute during the interview. Forty‐nine per cent of participants also identified attributes as important that were not included in the presented information. Participants showed a wide range of values in each of seven trade‐off exercises. Eighty‐eight per cent of participants showed evidence of differentiation; 75% had a clear treatment preference by the end of the interview. Conclusions Our decision aid appears to meet its goals for surrogate patients and illustrates the strengths of the DiffCon theory. The ability of the aid to accommodate wide

  6. An Interactive Risk Detection Tool to Aid Decision-Making in Global Mangrove Restoration

    Science.gov (United States)

    Goldberg, L.; Lagomasino, D.

    2017-12-01

    Mangrove ecosystems hold high ecological and economic value in coastal communities worldwide; detecting potential regions of mangrove stress is therefore critical to strategic planning of forest and coastal resources. In order to address the need for a unified risk management system for mangrove loss, a Risk Evaluation for MAngroves Portal (REMaP) was developed to identify the locations and causes of mangrove degradation worldwide, as well as project future areas of stress or loss. Long-term Earth observations from LANDSAT, MODIS, and TRMM were used in identifying regions with low, medium, and high vulnerability. Regions were categorized by vulnerability level based upon disturbance metrics in NDVI, land surface temperature, and precipitation using designated thresholds. Natural risks such as erosion and degradation were also evaluated through an analysis of NDVI time series trends from calendar year 1984 to 2017. Future trends in ecosystem vulnerability and resiliency were modeled using IPCC climate scenarios. Risk maps for anthropogenic-based disturbances such as urbanization and the expansion of agriculture and aquaculture through rice, rubber, shrimp, and oil palm farming were also included. The natural and anthropogenic risk factors evaluated were then aggregated to generate a cumulative estimate for total mangrove vulnerability in each region. This interactive modeling tool can aid decision-making on the regional, national, and international levels on an ongoing basis to continuously identify areas best suited for mangrove restoration measures, assisting governments and local communities in addressing a wide range of Sustainable Development Goals for coastal areas.

  7. A decision aid tool for equity issues analysis in emission permit allocations

    International Nuclear Information System (INIS)

    Vaillancourt, K.; Waaub, J.P.

    2004-01-01

    The general intention of global climate agreements is to stabilize greenhouse gases (GHG) concentrations in the atmosphere which contribute to climate change. Climate models indicate that the global average temperature will increase by about 1.4 to 5.8 degrees C by 2100 compared to the 1990 level. This study assumed the participation of all countries, including developing countries, to achieve a global GHG stabilization target. It examined international cooperation mechanisms such as permit trading to achieve global economic efficiency. The study proposed a decision aid tool that provides relevant information on various equitable permit allocation schemes. A dynamic multicriterion model was presented to share the global quantity of permits among 15 regions. Multiple definitions of equity were considered. A realistic simulation of the World-MARKAL energy model was conducted to demonstrate the potential application of the scheme in international negotiations. The goal was to propose a range of permit allocations for each country in order to restrict the number of possibilities and guide negotiations. A model of the global reduction scenario makes it possible to determine cost effective solutions and to calculate reduction costs. Equity issues related to permit allocations were also addressed along with permit allocations and net reduction costs for each region. 45 refs., 5 tabs., 2 figs., 1 appendix

  8. A decision support system for pre-earthquake planning of lifeline networks

    Energy Technology Data Exchange (ETDEWEB)

    Liang, J.W. [Tianjin Univ. (China). Dept. of Civil Engineering

    1996-12-01

    This paper describes the frame of a decision support system for pre-earthquake planning of gas and water networks. The system is mainly based on the earthquake experiences and lessons from the 1976 Tangshan earthquake. The objective of the system is to offer countermeasures and help make decisions for seismic strengthening, remaking, and upgrading of gas and water networks.

  9. Identifying design considerations for a shared decision aid for use at the point of outpatient clinical care: An ethnographic study at an inner city clinic.

    Science.gov (United States)

    Hajizadeh, Negin; Perez Figueroa, Rafael E; Uhler, Lauren M; Chiou, Erin; Perchonok, Jennifer E; Montague, Enid

    2013-03-06

    Computerized decision aids could facilitate shared decision-making at the point of outpatient clinical care. The objective of this study was to investigate whether a computerized shared decision aid would be feasible to implement in an inner-city clinic by evaluating the current practices in shared decision-making, clinicians' use of computers, patient and clinicians' attitudes and beliefs toward computerized decision aids, and the influence of time on shared decision-making. Qualitative data analysis of observations and semi-structured interviews with patients and clinicians at an inner-city outpatient clinic. The findings provided an exploratory look at the prevalence of shared decision-making and attitudes about health information technology and decision aids. A prominent barrier to clinicians engaging in shared decision-making was a lack of perceived patient understanding of medical information. Some patients preferred their clinicians make recommendations for them rather than engage in formal shared decision-making. Health information technology was an integral part of the clinic visit and welcomed by most clinicians and patients. Some patients expressed the desire to engage with health information technology such as viewing their medical information on the computer screen with their clinicians. All participants were receptive to the idea of a decision aid integrated within the clinic visit although some clinicians were concerned about the accuracy of prognostic estimates for complex medical problems. We identified several important considerations for the design and implementation of a computerized decision aid including opportunities to: bridge clinician-patient communication about medical information while taking into account individual patients' decision-making preferences, complement expert clinician judgment with prognostic estimates, take advantage of patient waiting times, and make tasks involved during the clinic visit more efficient. These findings

  10. Impact of a web-based prostate cancer treatment decision aid on patient-reported decision process parameters: results from the Prostate Cancer Patient Centered Care trial.

    Science.gov (United States)

    Cuypers, Maarten; Lamers, Romy E D; Kil, Paul J M; van de Poll-Franse, Lonneke V; de Vries, Marieke

    2018-05-12

    To compare patients' evaluation of the treatment decision-making process in localized prostate cancer between counseling that included an online decision aid (DA) and standard counseling. Eighteen Dutch hospitals were randomized to DA counseling (n = 235) or the control group with standard counseling (n = 101) in a pragmatic, cluster randomized controlled trial. The DA was provided to patients at, or soon after diagnosis. Decisional conflict, involvement, knowledge, and satisfaction with information were assessed with a questionnaire after treatment decision-making. Anxiety and depression served as covariates. The levels of decision involvement and conflict were comparable between patients in both groups. Patients with a DA felt more knowledgeable but scored equally well on a knowledge test as patients without a DA. Small significant negative effects were found on satisfaction with information and preparation for decision-making. A preference for print over online and depression and anxiety symptoms was negatively associated with satisfaction and conflict scores in the DA group. The DA aimed to support shared decision-making, while outcomes for a majority of DA users were comparable to patients who received standard counseling. Patients, who are less comfortable with the online DA format or experience anxiety or depression symptoms, could require more guidance toward shared decision-making. To evaluate long-term DA effects, follow-up evaluation on treatment satisfaction and decisional regret will be done.

  11. 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.

  12. Long-term health outcomes of a decision aid: data from a randomized trial of adjuvant! In women with localized breast cancer.

    Science.gov (United States)

    Vickers, Andrew J; Elkin, Elena B; Peele, Pamela B; Dickler, Maura; Siminoff, Laura A

    2009-01-01

    Women with localized breast cancer face difficult decisions about adjuvant therapy. Several decision aids are available to help women choose between treatment options. Decision aids are known to affect treatment choices and may therefore affect patient survival. The authors aimed to model the effects of the Adjuvant! decision aid on expected survival in women with early stage breast cancer. Data were obtained from a randomized trial of Adjuvant! (n = 395). To calculate the effects of the decision aid on survival, the authors used the Adjuvant! survival predictions as a surrogate endpoint. Data from each arm were entered separately into statistical models to estimate change in survival associated with receiving the Adjuvant! decision aid. Most women (approximately 85%) chose a treatment option that maximized predicted survival. The effects of the decision aid on outcome could not be modeled because a small number of women (n = 12, 3%) chose treatment options associated with a large (5%-14%) loss in survival. These women-most typically estrogen receptor positive but refusing hormonal therapy-were equally divided between Adjuvant! and control groups and were not distinguished by medical or demographic factors. Expected benefit from treatment is a key variable in understanding patient behavior. A small number of women refuse adjuvant treatment associated with large increases in predicted survival, even when they are explicitly informed about the degree of benefit they would forgo. Investigation of the effects of decision aids on cancer survival is unlikely to be fruitful due to power considerations.

  13. 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.

  14. The development of an online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making: a usability and pilot study.

    Science.gov (United States)

    Reumkens, Kelly; Tummers, Marly H E; Gietel-Habets, Joyce J G; van Kuijk, Sander M J; Aalfs, Cora M; van Asperen, Christi J; Ausems, Margreet G E M; Collée, Margriet; Dommering, Charlotte J; Kets, C Marleen; van der Kolk, Lizet E; Oosterwijk, Jan C; Tjan-Heijnen, Vivianne C G; van der Weijden, Trudy; de Die-Smulders, Christine E M; van Osch, Liesbeth A D M

    2018-05-30

    An online decision aid to support persons having a genetic predisposition to cancer and their partners during reproductive decision-making was developed. A two-phase usability test was conducted among 12 couples (N = 22; 2 persons participated without their partner) at risk for hereditary cancer and 15 health care providers. Couples and health care providers expressed similar suggestions for improvements, and evaluated the modified decision aid as acceptable, easy to use, and comprehensible. The final decision aid was pilot tested (N = 16) with paired sample t tests comparing main outcomes (decisional conflict, knowledge, realistic expectations regarding the reproductive options and decision self-efficacy) before (T0), immediately (T1) and 2 weeks after (T2) use of the decision aid. Pilot testing indicated decreased decisional conflict scores, increased knowledge, and improved realistic expectations regarding the reproductive options, at T1 and T2. No effect was found for couples' decision self-efficacy. The positive findings during usability testing were thus reflected in the pilot study. The decision aid will be further evaluated in a nationwide pretest-posttest study to facilitate implementation in the onco-genetic counselling setting. Ultimately, it is expected that the decision aid will enable end-users to make an informed decision.

  15. Computer-aided diagnosis workstation and network system for chest diagnosis based on multislice CT images

    Science.gov (United States)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru

    2008-03-01

    Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The function to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and Success in login" effective. As a result, patients' private information is protected. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and security improvement of medical information.

  16. 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.

  17. Large-scale network dynamics of beta-band oscillations underlie auditory perceptual decision-making

    Directory of Open Access Journals (Sweden)

    Mohsen Alavash

    2017-06-01

    Full Text Available Perceptual decisions vary in the speed at which we make them. Evidence suggests that translating sensory information into perceptual decisions relies on distributed interacting neural populations, with decision speed hinging on power modulations of the neural oscillations. Yet the dependence of perceptual decisions on the large-scale network organization of coupled neural oscillations has remained elusive. We measured magnetoencephalographic signals in human listeners who judged acoustic stimuli composed of carefully titrated clouds of tone sweeps. These stimuli were used in two task contexts, in which the participants judged the overall pitch or direction of the tone sweeps. We traced the large-scale network dynamics of the source-projected neural oscillations on a trial-by-trial basis using power-envelope correlations and graph-theoretical network discovery. In both tasks, faster decisions were predicted by higher segregation and lower integration of coupled beta-band (∼16–28 Hz oscillations. We also uncovered the brain network states that promoted faster decisions in either lower-order auditory or higher-order control brain areas. Specifically, decision speed in judging the tone sweep direction critically relied on the nodal network configurations of anterior temporal, cingulate, and middle frontal cortices. Our findings suggest that global network communication during perceptual decision-making is implemented in the human brain by large-scale couplings between beta-band neural oscillations. The speed at which we make perceptual decisions varies. This translation of sensory information into perceptual decisions hinges on dynamic changes in neural oscillatory activity. However, the large-scale neural-network embodiment supporting perceptual decision-making is unclear. We addressed this question by experimenting two auditory perceptual decision-making situations. Using graph-theoretical network discovery, we traced the large-scale network

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

    OpenAIRE

    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...

  19. 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

  20. Patient‐focussed decision‐making in early‐stage prostate cancer: insights from a cognitively based decision aid

    Science.gov (United States)

    Feldman‐Stewart, Deb; Brundage, Michael D; Manen, Lori Van; Svenson, Ola

    2004-01-01

    Abstract Purpose  To study the cognitive processes of early‐stage prostate cancer patients as they determined which treatment they preferred, using our cognitively based decision aid. Method  The aid was a one‐to‐one interview that included the structured presentation of information, listing exercises in which the patient identified attributes important to his decision, and trade‐off exercises to help him weigh and integrate those attributes together. At various points of the interview, patients identified the attributes they felt were important to their decision, rated their treatment options and completed standardized assessments relating to their decision. In addition, patients participated in a follow‐up interview at the time they made their actual treatment decision and again 3 months later. Results  Sixty of 70 (86%) of the invited patients participated in the study. Participating patients identified a median of four important attributes (range 1–10); 36 different attributes were identified at some point in the interview by the group. During the interview, 78% of patients changed which attributes they considered important, and 72% changed their treatment ratings. Stability of treatment choice after the interview and lack of regret after the decision were each positively associated with increasing differentiation between treatment options over time. Conclusions  The decision process appears to be dynamic for the patients with great variability across patients in what is important to the decision. Increasing stability of choice and lack of regret appear to be related positively to increasing difference over time in how attractive the preferred option is over its closest competitor, rather than to the size of the difference at any one point in time. PMID:15117387

  1. Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer.

    Science.gov (United States)

    Reichlin, Lindsey; Mani, Nithya; McArthur, Kara; Harris, Amy M; Rajan, Nithin; Dacso, Clifford C

    2011-01-12

    Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men's awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient's health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Serious games are a promising approach to health education and decision support for older men. Participants

  2. Decision aiding model for the evaluation of agricultural countermeasures after an accidental release of radionuclides to the environment

    International Nuclear Information System (INIS)

    Turcanu, C.

    2009-01-01

    Implementation of remedial actions after a radiological contamination of the environment has to take into account, alongside with radiological and feasibility criteria, also the acceptability of the countermeasures, ethical and environmental considerations, as well as the spatial variation and the needs of people in urban, rural and industrial environments. This highlights multi-criteria analysis as a suitable tool, since it is able to structure discussions and to facilitate a common understanding of the decision problem, with the values and priorities of the actors involved. The related theoretical framework, multi-criteria decision aid (MCDA), has emerged from the operational research field as an answer given to a couple of important questions encountered in complex decision problems. Firstly, the aim is not to replace the decision maker with a mathematical model, but to support him to construct his solution by describing and evaluating his options. Secondly, instead of using a unique criterion capturing all aspects of the problem, in MCDA one seeks to build multiple criteria, representing several points of view. The methods belonging to MCDA can be classified as multi-attribute utility/value methods, outranking methods and interactive methods. Past attempts to apply multi-criteria analysis in the context of nuclear emergency management have highlighted however the need to better integrate the operational and socio-political context of the decision-making process into the tools and models developed for decision-support. This PhD project had two main objectives: 1) to develop a multi-criteria decision aid model for the decision problem on countermeasures for contaminated milk, that better accommodates the nuclear crisis management context in Belgium and 2) to build prototype tools implementing and demonstrating the methodology developed

  3. A Novel Decision Aid to Support Informed Decision-Making Process in Patients with a Symptomatic Nonlower Pole Renal Stone <20 mm in Diameter.

    Science.gov (United States)

    Gökce, Mehmet İlker; Esen, Barış; Sancı, Adem; Akpınar, Cağrı; Süer, Evren; Gülpınar, Ömer

    2017-07-01

    Stone disease is an important health problem, and patients have different treatment choices. Shared decision making is recommended for deciding the treatment type, but patient education is necessary. Decision aids (DAs) are used for this aim, and herein, we developed a novel DA for patients with symptomatic nonlower pole renal stones group assessment resulted in a total score of 50/54. Patient evaluation of the DA resulted in favorable outcomes, and patients generally recommended its use by other patients. This novel DA for patients with a symptomatic nonlower pole renal stone <20 mm showed promising results and was well accepted by the patients. We believe that this DA will have a positive impact on patients' level of knowledge. Increased level of knowledge will also improve the patients' contribution to the shared decision-making process. A further prospective randomized trial to compare with the standard patient informing process is also planned.

  4. Selection of examples in case-based computer-aided decision systems

    International Nuclear Information System (INIS)

    Mazurowski, Maciej A; Zurada, Jacek M; Tourassi, Georgia D

    2008-01-01

    Case-based computer-aided decision (CB-CAD) systems rely on a database of previously stored, known examples when classifying new, incoming queries. Such systems can be particularly useful since they do not need retraining every time a new example is deposited in the case base. The adaptive nature of case-based systems is well suited to the current trend of continuously expanding digital databases in the medical domain. To maintain efficiency, however, such systems need sophisticated strategies to effectively manage the available evidence database. In this paper, we discuss the general problem of building an evidence database by selecting the most useful examples to store while satisfying existing storage requirements. We evaluate three intelligent techniques for this purpose: genetic algorithm-based selection, greedy selection and random mutation hill climbing. These techniques are compared to a random selection strategy used as the baseline. The study is performed with a previously presented CB-CAD system applied for false positive reduction in screening mammograms. The experimental evaluation shows that when the development goal is to maximize the system's diagnostic performance, the intelligent techniques are able to reduce the size of the evidence database to 37% of the original database by eliminating superfluous and/or detrimental examples while at the same time significantly improving the CAD system's performance. Furthermore, if the case-base size is a main concern, the total number of examples stored in the system can be reduced to only 2-4% of the original database without a decrease in the diagnostic performance. Comparison of the techniques shows that random mutation hill climbing provides the best balance between the diagnostic performance and computational efficiency when building the evidence database of the CB-CAD system.

  5. The effect of offering different numbers of colorectal cancer screening test options in a decision aid: a pilot randomized trial

    Directory of Open Access Journals (Sweden)

    Brenner Alison RT

    2008-01-01

    Full Text Available Abstract Background Decision aids can improve decision making processes, but the amount and type of information that they should attempt to communicate is controversial. We sought to compare, in a pilot randomized trial, two colorectal cancer (CRC screening decision aids that differed in the number of screening options presented. Methods Adults ages 48–75 not currently up to date with screening were recruited from the community and randomized to view one of two versions of our previously tested CRC screening decision aid. The first version included five screening options: fecal occult blood test (FOBT, sigmoidoscopy, a combination of FOBT and sigmoidoscopy, colonoscopy, and barium enema. The second discussed only the two most frequently selected screening options, FOBT and colonoscopy. Main outcomes were differences in screening interest and test preferences between groups after decision aid viewing. Patient test preference was elicited first without any associated out-of-pocket costs (OPC, and then with the following costs: FOBT-$10, sigmoidoscopy-$50, barium enema-$50, and colonoscopy-$200. Results 62 adults participated: 25 viewed the 5-option decision aid, and 37 viewed the 2-option version. Mean age was 54 (range 48–72, 58% were women, 71% were White, 24% African-American; 58% had completed at least a 4-year college degree. Comparing participants that viewed the 5-option version with participants who viewed the 2-option version, there were no differences in screening interest after viewing (1.8 vs. 1.9, t-test p = 0.76. Those viewing the 2-option version were somewhat more likely to choose colonoscopy than those viewing the 5-option version when no out of pocket costs were assumed (68% vs. 46%, p = 0.11, but not when such costs were imposed (41% vs. 42%, p = 1.00. Conclusion The number of screening options available does not appear to have a large effect on interest in colorectal cancer screening. The effect of offering differing

  6. 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

  7. CONTEXT-CAPTURE MULTI-VALUED DECISION FUSION WITH FAULT TOLERANT CAPABILITY FOR WIRELESS SENSOR NETWORKS

    OpenAIRE

    Jun Wu; Shigeru Shimamoto

    2011-01-01

    Wireless sensor networks (WSNs) are usually utilized to perform decision fusion of event detection. Current decision fusion schemes are based on binary valued decision and do not consider bursty contextcapture. However, bursty context and multi-valued data are important characteristics of WSNs. One on hand, the local decisions from sensors usually have bursty and contextual characteristics. Fusion center must capture the bursty context information from the sensors. On the other hand, in pract...

  8. 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.

  9. How do patients between the age of 65 and 75 use a web-based decision aid for treatment choice in localized prostate cancer?

    Science.gov (United States)

    Schrijvers, Jessie; Vanderhaegen, Joke; Van Poppel, Hendrik; Haustermans, Karin; Van Audenhove, Chantal

    2013-08-01

    This study was designed to evaluate the use of a web-based decision aid by a 65plus patient group in their decision-making process for treatment of localized prostate cancer. Of particular interest was the use of technology features such as patients' statements, comparative tables, and a values clarification tool. One hundred men from the University Hospital of Leuven campus, Gasthuisberg, were invited to use the web-based decision aid in their decision-making process. Twenty-six men were excluded based on non- or limited use of the decision aid. Of the remaining 74 men, user specifications, decision aid surfing characteristics by means of web-log data, and especially the use of technology features were analyzed. Men spent on average 30 minutes on the web-based decision aid. Most time was spent on the pages with information on treatment options. These pages were also most frequently accessed. The use of the feature 'comparative tables' was the highest, followed by the 'values clarification tool'. According to age (70 years) differences were observed for the time spent on the decision aid, the pages accessed, and the use of the technology features. Despite concerns about the usability of a web-based decision aid for elderly patients, these results indicated that the majority of 65plus persons with good internet skills use a web-based decision aid as well as its incorporated technology features. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  10. Does Patient Preference Measurement in Decision Aids Improve Decisional Conflict? A Randomized Trial in Men with Prostate Cancer.

    Science.gov (United States)

    Shirk, Joseph D; Crespi, Catherine M; Saucedo, Josemanuel D; Lambrechts, Sylvia; Dahan, Ely; Kaplan, Robert; Saigal, Christopher

    2017-12-01

    Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement. We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting. Men with incident localized prostate cancer (n = 122) were recruited from the Greater Los Angeles Veterans Affairs (VA) Medical Center urology clinic, Olive View UCLA Medical Center, and Harbor UCLA Medical Center from January 2011 to May 2015 and randomized to education with a brochure about prostate cancer treatment or software-based preference assessment in addition to the brochure. Men undergoing preference assessment received a report detailing the relative strength of their preferences for treatment outcomes used in review with their doctor. Participants completed instruments measuring decisional conflict, knowledge, SDM, and patient satisfaction with care before and/or after their cancer consultation. Baseline knowledge scores were low (mean 62%). The baseline mean total score on the Decisional Conflict Scale was 2.3 (±0.9), signifying moderate decisional conflict. Men undergoing preference assessment had a significantly larger decrease in decisional conflict total score (p = 0.023) and the Perceived Effective Decision Making subscale (p = 0.003) post consult compared with those receiving education only. Improvements in satisfaction with care, SDM, and knowledge were similar between groups. Individual-level preference assessment is feasible in the clinic setting. Patients with prostate cancer who undergo preference assessment are more certain about their treatment decisions and report decreased levels of decisional conflict when making these decisions.

  11. 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.

  12. The pros and cons of funnel plots as an aid to risk communication and patient decision making.

    Science.gov (United States)

    Rakow, Tim; Wright, Rebecca J; Spiegelhalter, David J; Bull, Catherine

    2015-05-01

    Funnel plots, which simultaneously display a sample statistic and the corresponding sample size for multiple cases, have a range of applications. In medicine, they are used to display treatment outcome rates and caseload volume by institution, which can inform strategic decisions about health care delivery. We investigated lay people's understanding of such plots and explored their suitability as an aid to individual treatment decisions. In two studies, 172 participants answered objective questions about funnel plots representing the surgical outcomes (survival or mortality rates) of institutions varying in caseload, and indicated their preferred institutions. Accuracy for extracting objective information was high, unless question phrasing was inconsistent with the plot's survival/mortality framing, or participants had low numeracy levels. Participants integrated caseload-volume and outcome-rate data when forming preferences, but were influenced by reference lines on the plot to make inappropriate discriminations between institutions with similar outcome rates. With careful choice of accompanying language, funnel plots can be readily understood and are therefore a useful tool for communicating risk. However, they are less effective as a decision aid for individual patient's treatment decisions, and we recommend refinements to the standard presentation of the plots if they are to be used for that purpose. © 2014 The British Psychological Society.

  13. 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....

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

    Science.gov (United States)

    Portocarrero, Maria Esther Leiva; Giguère, Anik M C; Lépine, Johanie; Garvelink, Mirjam M; Robitaille, Hubert; Delanoë, Agathe; Lévesque, Isabelle; Wilson, Brenda J; Rousseau, François; Légaré, France

    2017-03-20

    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 influencing pregnant women's use of a patient decision aid for deciding about prenatal screening for Down syndrome (DS). This qualitative study was embedded in a sequential mixed-methods research program whose main aim is to implement shared decision-making (SDM) in the context of prenatal screening for DS in the province of Quebec, Canada. We planned to recruit a purposive sample of 45 pregnant women with low-risk pregnancy consulting for prenatal care at three clinical sites. Participating women watched a video depicting a prenatal care follow-up during which a pregnant woman, her partner and a health professional used a PtDA to decide about prenatal screening for DS. The women were then interviewed about factors that would influence the use of this PtDA using questions based on the Theoretical Domains Framework (TDF). We performed content analysis of transcribed verbatim interviews. Out of 216 eligible women, 100 agreed to participate (46% response rate) and 46 were interviewed. Regarding the type of health professional responsible for their prenatal care, 19 participants (41%) reported having made a decision about prenatal screening for DS with an obstetrician-gynecologist, 13 (28%) with a midwife, 12 (26%) with a family physician, and two (4%) decided on their own. We identified 54 factors that were mapped onto nine of the 12 TDF domains. The three most frequently-mentioned were: opinion of the pregnant woman's partner (n = 33, 72%), presentation of the PtDA by health professional and a discussion (n = 27, 72%), and not having encountered a PtDA (n = 26, 57%). This study allowed us to identify factors influencing pregnant women's use of a PtDA for prenatal screening for

  15. 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

  16. 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.

  17. The Design of an IEP Decision Aid: A Tool for Diverse Parents of Children with Autism

    Science.gov (United States)

    Schuttler, Jessica Oeth

    2012-01-01

    Decision-making is a universal process that occurs constantly in life. Parent participation in educational decision-making is recognized as important by special education law, by special education and school psychology literature (Christenson & Sheridan, 2001; IDEIA, 2004;). Partnership in decision-making is especially important for parents of…

  18. 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...

  19. Development and Pilot Testing of a Decision Aid for Genomic Research Participants Notified of Clinically Actionable Research Findings for Cancer Risk.

    Science.gov (United States)

    Willis, Amanda M; Smith, Sian K; Meiser, Bettina; Ballinger, Mandy L; Thomas, David M; Tattersall, Martin; Young, Mary-Anne

    2018-02-17

    Germline genomic testing is increasingly used in research to identify genetic causes of disease, including cancer. However, there is evidence that individuals who are notified of clinically actionable research findings have difficulty making informed decisions regarding uptake of genetic counseling for these findings. This study aimed to produce and pilot test a decision aid to assist participants in genomic research studies who are notified of clinically actionable research findings to make informed choices regarding uptake of genetic counseling. Development was guided by published literature, the International Patient Decision Aid Standards, and the expertise of a steering committee of clinicians, researchers, and consumers. Decision aid acceptability was assessed by self-report questionnaire. All 19 participants stated that the decision aid was easy to read, clearly presented, increased their understanding of the implications of taking up research findings, and would be helpful in decision-making. While low to moderate levels of distress/worry were reported after reading the booklet, a majority of participants also reported feeling reassured. All participants would recommend the booklet to others considering uptake of clinically actionable research findings. Results indicate the decision aid is acceptable to the target audience, with potential as a useful decision support tool for genomic research participants.

  20. SEDIMENT ANALYSIS NETWORK FOR DECISION SUPPORT (SANDS) LANDSAT GEOLOGICAL SURVEY OF AL (GSA) ANALYSIS V1

    Data.gov (United States)

    National Aeronautics and Space Administration — The Sediment Analysis Network for Decision Support (SANDS) Landsat Geological Survey of AL (GSA) Analysis dataset analyzed changes in the coastal shoreline and...

  1. Comparison of the use of binary decision trees and neural networks in top-quark detection

    International Nuclear Information System (INIS)

    Bowser-Chao, D.; Dzialo, D.L.

    1993-01-01

    The use of neural networks for signal versus background discrimination in high-energy physics experiments has been investigated and has compared favorably with the efficiency of traditional kinematic cuts. Recent work in top-quark identification produced a neural network that, for a given top-quark mass, yielded a higher signal-to-background ratio in Monte Carlo simulation than a corresponding set of conventional cuts. In this article we discuss another pattern-recognition algorithm, the binary decision tree. We apply a binary decision tree to top-quark identification at the Fermilab Tevatron and find it to be comparable in performance to the neural network. Furthermore, reservations about the ''black box'' nature of neural network discriminators do not appy to binary decision trees; a binary decision tree may be reduced to a set of kinematic cuts subject to conventional error analysis

  2. A Belief Network Decision Support Method Applied to Aerospace Surveillance and Battle Management Projects

    National Research Council Canada - National Science Library

    Staker, R

    2003-01-01

    This report demonstrates the application of a Bayesian Belief Network decision support method for Force Level Systems Engineering to a collection of projects related to Aerospace Surveillance and Battle Management...

  3. 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

    not include such ‘sureness’ criteria. Methods: In the fixed criteria arm of an Australian trial of decision aids relating to PSA testing for prostate cancer 727 respondents supplied their importance weights for 5 criteria (loss of lifetime, needless biopsy, and bowel, urinary and sexual problems). Combining...... 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...... was calculated and those whose AD was .01 or less were defined as being in effective equipoise. These ADs were then correlated with respondent’s scores on the self-weighted and self-rated instrument, MyDecisionQuality, which contains 8 items (Options, Effects, Importance, Chances, Trust, Support, Control...

  4. Similarity, Self-Esteem and Reactions to Aid in a Simulated Decision Making Task.

    Science.gov (United States)

    esteem - low self esteem recipients were the three experimental factors. The effect of these experimental variables on the recipients self -perceptions...The study explored the effects of the overall similarity between donor and recipient of resistance and the recipient’s level of self - esteem on his...reactions to being helped. A 2 x 2 x 2 factorial between subjects design was employed in which aid-no aid, similar donor-dissimilar donor and high self

  5. Vacation portfolio decisions: analysis using a Bayesian belief network

    NARCIS (Netherlands)

    Grigolon, A.B.; Kemperman, A.D.A.M.; Timmermans, H.J.P.

    2011-01-01

    The aim of this study is to analyse the extent to which vacation portfolio decisions are influenced by socio-demographic characteristics. A vacation portfolio involves interdependent decisions related to the facets that make the vacation trip, including transport mode, accommodation, destination,

  6. Morally responsible decision making in networked military operations

    NARCIS (Netherlands)

    Boshuijzen-Van Burken, C.G.; Van Bezooijen, B.

    2015-01-01

    Introducing responsible innovations on the battlefield requires a rethinking of social and psychological aspects of moral decision making on the battlefield, and in particular, including how these aspects are influenced by technology. In this chapter, the social aspects of moral decision making are

  7. Development and initial testing of a computer-based patient decision aid to promote colorectal cancer screening for primary care practice

    Directory of Open Access Journals (Sweden)

    Fowler Beth

    2005-11-01

    Full Text Available Abstract Background Although colorectal cancer screening is recommended by major policy-making organizations, rates of screening remain low. Our aim was to develop a patient-directed, computer-based decision aid about colorectal cancer screening and investigate whether it could increase patient interest in screening. Methods We used content from evidence-based literature reviews and our previous decision aid research to develop a prototype. We performed two rounds of usability testing with representative patients to revise the content and format. The final decision aid consisted of an introductory segment, four test-specific segments, and information to allow comparison of the tests across several key parameters. We then conducted a before-after uncontrolled trial of 80 patients 50–75 years old recruited from an academic internal medicine practice. Results Mean viewing time was 19 minutes. The decision aid improved patients' intent to ask providers for screening from a mean score of 2.8 (1 = not at all likely to ask, 4 = very likely to ask before viewing the decision aid to 3.2 afterwards (difference, 0.4; p Conclusion We conclude that a computer-based decision aid can increase patient intent to be screened and increase interest in screening. Practice Implications: This decision aid can be viewed by patients prior to provider appointments to increase motivation to be screened and to help them decide about which modality to use for screening. Further work is required to integrate the decision aid with other practice change strategies to raise screening rates to target levels.

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

    Science.gov (United States)

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

    2014-01-01

    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. A PtDA was developed and pilot tested using the International Patients Decision Aid Standards (IPDAS) criteria. Obstetric health care in the Netherlands. A multidisciplinary steering group, an expert panel, and 25 future users of the PtDA, i.e. women with a previous caesarean section. The development consisted of a construction phase (definition of scope and purpose, and selection of content, framework, and format) and a pilot testing phase by interview. The process was supervised by a multidisciplinary steering group. Usability, clarity, and relevance. The construction phase resulted in a booklet including unbiased balanced information on mode of birth after caesarean section, a preference elicitation exercise, and tailored risk information, including a prediction model for successful VBAC. During pilot testing, visualisation of risks and clarity formed the main basis for revisions. Pilot testing showed the availability of tailored structured information to be the main factor involving women in decision-making. The PtDA meets 39 out of 50 IPDAS criteria (78%): 23 out of 23 criteria for content (100%) and 16 out of 20 criteria for the development process (80%). Criteria for effectiveness (n = 7) were not evaluated. An evidence-based PtDA was developed, with the probability of successful VBAC and the availability of structured information as key items. It is likely that the PtDA enhances the quality of decision-making on mode of birth after caesarean section. © 2013 Royal College of Obstetricians and Gynaecologists.

  9. 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.

  10. Influence of social networks on the purchase decisions of university students

    OpenAIRE

    Gutiérrez Flórez, Lorena Estefania; Correa Escobar, Maria Isabel; Henao Restrepo, Andrés; Arango Botero, Diana; Valencia Arias, Alejandro

    2017-01-01

    [EN] The emergence of social networks has not just had a great impact in the way companies promote their products and services, but also in the decision-making process of consumers regarding their purchases. Using the application and extension of the models proposed by Okazaki et al. (2012), the present study tries to understand the factors that motivate the use of social networks in the purchase decisions of young university students, for this a self-administered questionnaires were applied ...

  11. Development and quantitative effect estimation of an integrated decision support system to aid operator's cognitive activities for NPP advanced main control rooms

    International Nuclear Information System (INIS)

    Lee, Seung Jun

    2007-02-01

    As digital and computer technologies have grown, human-machine interfaces (HMIs) have evolved. In safety critical systems, especially in nuclear power plants (NPPs), HMIs are important for reducing operational costs, for reducing the number of necessary operators, and for reducing the probability of accident occurrence. Efforts have been made to improve main control room (MCR) interface design and to develop automation or support systems to ensure convenient operation and maintenance. In this paper, an integrated decision support system to aid the cognitive activities of operators is proposed for advanced MCRs in future NPPs. The proposed system supports not merely a particular task, but also the entire operation process based on a human cognitive process model. It supports the operator's entire cognitive process by integrating decision support systems that support each cognitive activity. In this paper, the operator's operation processes are analyzed based on a human cognitive process model and appropriate support systems that support each activity of the human cognitive process are suggested. Two decision support systems were developed in this paper. The first one is the fault diagnosis advisory system (FDAS) which detects faults and diagnoses them. The FDAS provides a list of possible faults and expected causes to operators. It was implemented using two kinds of neural networks for more reliable diagnosis results. The second system is the multifunctional operator support system for operation guidance, which includes the FDAS and the operation guidance system. The operation guidance system is to prevent operator's commission errors and omission errors. Furthermore, the effect of the proposed system was estimated because to evaluate decision support systems in order to validate their efficiency is as important as to design highly reliable decision support systems. The effect estimations were performed theoretically and experimentally. The Bayesian

  12. 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.

  13. Artificial neural network decision support systems for new product development project selection

    NARCIS (Netherlands)

    Thieme, R.J.; Song, Michael; Calantone, R.J.

    2000-01-01

    The authors extend and develop an artificial neural network decision support system and demonstrate how it can guide managers when they make complex new product development decisions. The authors use data from 612 projects to compare this new method with traditional methods for predicting various

  14. From social network (centralized vs. decentralized to collective decision-making (unshared vs. shared consensus.

    Directory of Open Access Journals (Sweden)

    Cédric Sueur

    Full Text Available 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.

  15. 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.

  16. 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

  17. Mismatch between health-care professionals' and patients' views on a diabetes patient decision aid: a qualitative study.

    Science.gov (United States)

    Lee, Ping Yein; Khoo, Ee Ming; Low, Wah Yun; Lee, Yew Kong; Abdullah, Khatijah Lim; Azmi, Syahidatul Akmal; Ng, Chirk Jenn

    2016-04-01

    Malaysia is an Asian country with population of diverse culture and health perceptions. Patient decision aid (PDA) is a new tool in Malaysia. Patients' and health-care professionals' (HCPs) expectation of a PDA is unknown. We aimed to explore patients' and health-care professionals'(HCPs) views on the information needed in a patient decision aid (PDA) on insulin initiation developed for patients with type 2 diabetes mellitus (T2DM). We used a qualitative design and thematic approach. Three main primary health-care settings in Malaysia: public university-based primary care clinics, public health-care clinics and private general practices. We conducted focus groups and one-to-one interviews with a purposive sample of health professionals and patients with type 2 diabetes. We interviewed 18 patients and 13 HCPs. Patients viewed the content of the PDA as simple and clear. However, HCPs felt the PDA might be difficult for patients with low literacy to understand. HCPs thought the PDA was too lengthy. Nevertheless, patients would prefer more information. HCPs tended to focus on benefits of insulin, while patients wanted to know the impact of insulin on their quality of life and practical issues regarding insulin and its side-effects. Patients preferred numbers to weigh the risks and benefits of treatment options. HCPs' views that presenting numbers in a PDA would be too complex for patients to understand. It is important to consider including issues related to psycho-social impact of treatment to patients when developing a patient decision aid. © 2015 John Wiley & Sons Ltd.

  18. Interplay Between Hiv/aids Epidemics and Demographic Structures Based on Sexual Contact Networks

    Science.gov (United States)

    Bai, Wen-Jie; Zhou, Tao; Wang, Bing-Hong

    In this article, we propose a network spreading model for HIV epidemics, wherein each individual is represented by a node of the transmission network and the edges are the connections between individuals along which the infection may spread. The sexual activity of each individual, measured by its degree, is not homogeneous but obeys a power-law distribution. Due to the heterogeneity of activity, the infection can persistently exist at a very low prevalence, which has been observed in the real data but cannot be illuminated by previous models with homogeneous mixing hypothesis. The model displays a clear picture of hierarchical spread: In the early stage the infection is adhered to these high-risk persons, and then, diffuses toward low-risk population. Furthermore, we find that to reduce the risky behaviors is much more effective in the fight against HIV/AIDS rather than the antiretroviral drug therapies. The prediction results show that the development of epidemics can be roughly categorized into three patterns for different countries, and the pattern of a given country is mainly determined by the average sex-activity and transmission probability per sexual partner. In most cases, the effect of HIV epidemics on demographic structure is very small. However, for some extremely countries, like Botswana, the number of sex-active people can be depressed to nearly a half by AIDS.

  19. Requirements for advanced decision support tools in future distribution network planning

    NARCIS (Netherlands)

    Grond, M.O.W.; Morren, J.; Slootweg, J.G.

    2013-01-01

    This paper describes the need and requirements for advanced decision support tools in future network planning from a distribution network operator perspective. The existing tools will no longer be satisfactory for future application due to present developments in the electricity sector that increase

  20. Hypothesis Management Framework: a exible design pattern for belief networks in decision support systems

    NARCIS (Netherlands)

    Gosliga, S.P. van; Voorde, I. van de

    2008-01-01

    This article discusses a design pattern for building belief networks for application domains in which causal models are hard to construct. In this approach we pursue a modular belief network structure that is easily extended by the users themselves, while remaining reliable for decision support. The

  1. Tragic Choices in Humanitarian Aid : A Framework of Organizational Determinants of NGO Decision Making

    NARCIS (Netherlands)

    Heyse, Liesbet

    Humanitarian NGOs face difficult choices about whom to help and whom not on a daily basis. The research question in this article is how humanitarian NGOs make these difficult decisions and why in a particular way. March's study on consequential and appropriate decision-making processes is used to

  2. A Socioecological Model of Rape Survivors' Decisions to Aid in Case Prosecution

    Science.gov (United States)

    Anders, Mary C.; Christopher, F. Scott

    2011-01-01

    The purpose of our study was to identify factors underlying rape survivors' post-assault prosecution decisions by testing a decision model that included the complex relations between the multiple social ecological systems within which rape survivors are embedded. We coded 440 police rape cases for characteristics of the assault and characteristics…

  3. Using Consumer Behavior and Decision Models to Aid Students in Choosing a Major.

    Science.gov (United States)

    Kaynama, Shohreh A.; Smith, Louise W.

    1996-01-01

    A study found that using consumer behavior and decision models to guide students to a major can be useful and enjoyable for students. Students consider many of the basic parameters through multi-attribute and decision-analysis models, so time with professors, who were found to be the most influential group, can be used for more individual and…

  4. Energy Technology Investments: Maximizing Efficiency Through a Maritime Energy Portfolio Interface and Decision Aid

    Science.gov (United States)

    2012-02-09

    Investment (ROI) and Break Even Point ( BEP ). These metrics are essential for determining whether an initiative would be worth pursuing. Balanced...is Unlimited Energy Decision Framework Identify Inefficiencies 2. Perform Analyses 3. Examine Technology Candidates 1. Improve Energy...Unlimited Energy Decision Framework Identify Inefficiencies 2. Perform Analyses 3. Examine Technology Candidates 1. Improve Energy Efficiency 4

  5. 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.

  6. RoCoMAR: Robots' Controllable Mobility Aided Routing and Relay Architecture for Mobile Sensor Networks

    Science.gov (United States)

    Van Le, Duc; Oh, Hoon; Yoon, Seokhoon

    2013-01-01

    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. PMID:23881134

  7. 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.

  8. 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.

  9. 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...

  10. 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.

  11. Evaluating the utility of a patient decision aid for potential participants of a prostate cancer trial (RAVES-TROG 08.03)

    International Nuclear Information System (INIS)

    Sundaresan, Puma; Turner, Sandra; Kneebone, Andrew; Pearse, Maria; Butow, Phyllis

    2011-01-01

    Randomised controlled trials (RCTs) can be hampered by poor patient accrual and retention. Decision aids (DAs) containing simple, evidence-based information, may assist patients with decision-making regarding trial participation. The current DA was of use for 95% of participants. Further evaluation of the DA in a RCT is currently underway.

  12. Adaptive Decision-Making Scheme for Cognitive Radio Networks

    KAUST Repository

    Alqerm, Ismail; Shihada, Basem

    2014-01-01

    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

  13. Evaluating the content and development of decision aid tools for the management of menopause: A scoping review.

    Science.gov (United States)

    Siyam, Tasneem; Sultani, Humirah; Ross, Sue; Chatterley, Trish; Yuksel, Nese

    2017-12-01

    Decision-making during menopause (especially surgical menopause) can be complex given the variability in risk-benefit perceptions of menopausal treatments. Decision aid tools (DATs) help women participate in decision-making about options. Our objective is to identify and evaluate the content and development of DATs for managing menopause, with a special focus on surgical menopause. We systematically searched electronic databases, including MEDLINE and EMBASE, from inception to March 2017 for relevant records. The principal inclusion criterion was that papers reported studies on DATs for managing menopause. Search terms were derived from two concepts: menopause and DATs. Data extracted were presented in written evidence tables and narrative summaries. Our search yielded 18,801 records. Of these, 26 records met our inclusion criteria, which gave rise to 12 DATs from peer-reviewed literature and 6 from grey literature. Seventeen DATs were focused on natural menopause and two targeted surgical menopause, both identified from grey literature. More than half were published before the Women's Health Initiative (WHI) publication and 70% before the release of the International Patient Decision Aid Standards (IPDAS). Very few studies reported the full development of the DAT involved, and less than half of DATs were informed by a needs assessment to identify the decisional needs of their target population. Most DATs focused on hormone therapy as a treatment option and did not provide a comprehensive overview of other options. None of the DATs reported the steps involved in finding, appraising and summarizing scientific content of the tool. This review highlights several limitations in the content and development of DATs for managing menopause. No peer-reviewed DATs were identified for surgical menopause. A need for a complete, evidence-based DAT in the context of surgical menopause is identified. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer.

    Science.gov (United States)

    Song, Lixin; Tyler, Christina; Clayton, Margaret F; Rodgiriguez-Rassi, Eleanor; Hill, Latorya; Bai, Jinbing; Pruthi, Raj; Bailey, Donald E

    2017-02-01

    To analyze the effects of a decision aid on improving patients' and family members' information giving and question asking during consultations for prostate cancer treatment decision-making. This study is a secondary analysis of archived audio-recorded real-time consultation visits with participants from a randomized clinical trial. Participants were randomly assigned into three groups: TD-intervention targeted patient-only; TS-intervention targeted patients and family members; and control-a handout on staying healthy during treatment. We conducted content analysis using a researcher-developed communication coding system. Using SAS 9.3, we conducted Chi-square/Fisher's exact test to examine whether information giving and question asking among patients and family members varied by groups when discussing different content/topics. Compared with those in the TS and control groups, significantly higher percentages of participants in the TD group demonstrated information giving in discussing topics about diagnosis, treatment options, risks and benefits, and preferences; and engaged in question asking when discussing diagnosis, watchful waiting/active surveillance, risks and benefits, and preferences for treatment impacts. Information support and communication skills training for patients were effective in improving communication during treatment decision-making consultations. Providing information about prostate cancer and communication skills training empower patients and their family members. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group

    Science.gov (United States)

    Bourmaud, Aurelie; Soler-Michel, Patricia; Oriol, Mathieu; Regnier, Véronique; Tinquaut, Fabien; Nourissat, Alice; Bremond, Alain; Moumjid, Nora; Chauvin, Franck

    2016-01-01

    Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated. PMID:26883201

  16. Water distribution network segmentation based on group multi-criteria decision approach

    Directory of Open Access Journals (Sweden)

    Marcele Elisa Fontana

    Full Text Available Abstract A correct Network Segmentation (NS is necessary to perform proper maintenance activities in water distribution networks (WDN. For this, usually, isolation valves are allocating near the ends of pipes, blocking the flow of water. However, the allocation of valves increases costs substantially for the water supply companies. Additionally, other criteria should be taking account to analyze the benefits of the valves allocation. Thus, the problem is to define an alternative of NS which shows a good compromise in these different criteria. Moreover, usually, in this type of decision, there is more than one decision-maker involved, who can have different viewpoints. Therefore, this paper presents a model to support group decision-making, based on a multi-criteria method, in order to support the decision making procedure in the NS problem. As result, the model is able to find a solution that shows the best compromise regarding the benefits, costs, and the decision makers' preferences.

  17. Ecological rationality: a framework for understanding and aiding the aging decision maker

    OpenAIRE

    Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

    2012-01-01

    The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people’s decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities...

  18. Evaluating Adaptation of a Cancer Clinical Trial Decision Aid for Rural Cancer Patients: A Mixed-Methods Approach.

    Science.gov (United States)

    Pathak, Swati; George, Nerissa; Monti, Denise; Robinson, Kathy; Politi, Mary C

    2018-06-03

    Rural-residing cancer patients often do not participate in clinical trials. Many patients misunderstand cancer clinical trials and their rights as participant. The purpose of this study is to modify a previously developed cancer clinical trials decision aid (DA), incorporating the unique needs of rural populations, and test its impact on knowledge and decision outcomes. The study was conducted in two phases. Phase I recruited 15 rural-residing cancer survivors in a qualitative usability study. Participants navigated the original DA and provided feedback regarding usability and implementation in rural settings. Phase II recruited 31 newly diagnosed rural-residing cancer patients. Patients completed a survey before and after using the revised DA, R-CHOICES. Primary outcomes included decisional conflict, decision self-efficacy, knowledge, communication self-efficacy, and attitudes towards and willingness to consider joining a trial. In phase I, the DA was viewed positively by rural-residing cancer survivors. Participants provided important feedback about factors rural-residing patients consider when thinking about trial participation. In phase II, after using R-CHOICES, participants had higher certainty about their choice (mean post-test = 3.10 vs. pre-test = 2.67; P = 0.025) and higher trial knowledge (mean percentage correct at post-test = 73.58 vs. pre-test = 57.77; P decision self-efficacy, communication self-efficacy, and attitudes towards or willingness to join trials. The R-CHOICES improved rural-residing patients' knowledge of cancer clinical trials and reduced conflict about making a trial decision. More research is needed on ways to further support decisions about trial participation among this population.

  19. 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.

  20. 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

    2015-01-01

    Objective: 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. Methods: 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. Results: 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%. Conclusions: 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. PMID:27027010

  1. 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:

  2. Empirical Demonstration of Isoperformance Methodology Preparatory of an Interactive Expert Computerized Decision Aid

    Science.gov (United States)

    1988-11-01

    after modest amounts of 7 practi.ce. Moreover, the advant.ages of display aiding (e.g., Smith & Kennedy, 1976) or artificial intelligence may be largely...team performance in tanks is largely a function of the intelligence of the tank commmander (Wallace, 1932). In summary, individual differences such as...versus small CRT screen), and training on a videogame task which simulated a remotely piloted vehicle. This study was successful as an isoperformance

  3. A multi-criteria decision analysis approach for importance identification and ranking of network components

    International Nuclear Information System (INIS)

    Almoghathawi, Yasser; Barker, Kash; Rocco, Claudio M.; Nicholson, Charles D.

    2017-01-01

    Analyzing network vulnerability is a key element of network planning in order to be prepared for any disruptive event that might impact the performance of the network. Hence, many importance measures have been proposed to identify the important components in a network with respect to vulnerability and rank them accordingly based on individual importance measure. However, in this paper, we propose a new approach to identify the most important network components based on multiple importance measures using a multi criteria decision making (MCDM) method, namely the technique for order performance by similarity to ideal solution (TOPSIS), able to take into account the preferences of decision-makers. We consider multiple edge-specific flow-based importance measures provided as the multiple criteria of a network where the alternatives are the edges. Accordingly, TOPSIS is used to rank the edges of the network based on their importance considering multiple different importance measures. The proposed approach is illustrated through different networks with different densities along with the effects of weighs. - Highlights: • We integrate several perspectives on network vulnerability to generate a component importance ranking. • We apply these measures to determine the importance of edges after disruptions. • Networks of varying size and density are explored.

  4. 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

  5. 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.

  6. Men’s Migration, Women’s Personal Networks, and Responses to HIV/AIDS in Mozambique

    Directory of Open Access Journals (Sweden)

    Victor Agadjanian

    2013-03-01

    Full Text Available This study brings together the literature on social network approaches to social capital and health and on migration and HIV risks to examine how non-migrating wives of labor migrants use their personal networks to cope with perceived risks of HIV infection in rural southern Mozambique. Using data from a 2006 survey of 1,680 women and their dyadic interactions, we compare the composition of personal networks, HIV/AIDS communication, and preventive behavior of women married to migrants and those married to non-migrants. Results show that migrants’ wives were more likely than non-migrants’ wives to have other migrants’ wives as personal network members, to engage in HIV/AIDS communication, and to discuss HIV prevention. However, they were no more likely to talk about HIV/AIDS with migrants’ wives than with non-migrants’ wives. They were also no more likely to talk about AIDS and its prevention than non-migrants’ wives who express worry about HIV infection from their spouses. Finally, we detect that network members’ prevention behavior was similar to respondents’, although this did not depend on migration. We contextualize these findings within the literature and discuss their policy implications.

  7. Perceived Need for a Parental Decision Aid for the HPV Vaccine: Content and Format Preferences

    Science.gov (United States)

    Lechuga, Julia; Swain, Geoffrey; Weinhardt, Lance S.

    2014-01-01

    The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process. PMID:21444922

  8. Perceived need of a parental decision aid for the HPV vaccine: content and format preferences.

    Science.gov (United States)

    Lechuga, Julia; Swain, Geoffrey; Weinhardt, Lance S

    2012-03-01

    The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process.

  9. Ethical Decision-Making: The Role of Self-Monitoring, Future Orientation, and Social Networks

    Directory of Open Access Journals (Sweden)

    Ana Carla Bon

    2017-02-01

    Full Text Available This study examines the influence of individual factors (self monitoring, temporal orientation on social networking, and their relationship with unethical decision-making. The study used surveys to measure the unethical intentions and social network data of 129 professionals. Data were analyzed using confirmatory factor analysis and structural equation modeling. The findings provided evidence that individual factors influence the development of social networks and, along with self-monitoring, the likelihood of unethical decision-making. In particular, being in positions of lower network centrality increased individuals’ risk of unethical intention. One explanation stems from the need for high situation control to reduce risk and ensure the success of an event, which only a closed network can provide. However, ethical low self-monitor women were also found to have low centrality, so social networks alone do not explain ethical decision-making. This research represents a step forward in our understanding of ethical decision-making through the adoption of multiple and simultaneous factors, proposing an integrated theory of individual and situational factors influencing unethical options.

  10. Expanding the Reach of Participatory Risk Management: Testing an Online Decision-Aiding Framework for Informing Internally Consistent Choices.

    Science.gov (United States)

    Bessette, Douglas L; Campbell-Arvai, Victoria; Arvai, Joseph

    2016-05-01

    This article presents research aimed at developing and testing an online, multistakeholder decision-aiding framework for informing multiattribute risk management choices associated with energy development and climate change. The framework was designed to provide necessary background information and facilitate internally consistent choices, or choices that are in line with users' prioritized objectives. In order to test different components of the decision-aiding framework, a six-part, 2 × 2 × 2 factorial experiment was conducted, yielding eight treatment scenarios. The three factors included: (1) whether or not users could construct their own alternatives; (2) the level of detail regarding the composition of alternatives users would evaluate; and (3) the way in which a final choice between users' own constructed (or highest-ranked) portfolio and an internally consistent portfolio was presented. Participants' self-reports revealed the framework was easy to use and providing an opportunity to develop one's own risk-management alternatives (Factor 1) led to the highest knowledge gains. Empirical measures showed the internal consistency of users' decisions across all treatments to be lower than expected and confirmed that providing information about alternatives' composition (Factor 2) resulted in the least internally consistent choices. At the same time, those users who did not develop their own alternatives and were not shown detailed information about the composition of alternatives believed their choices to be the most internally consistent. These results raise concerns about how the amount of information provided and the ability to construct alternatives may inversely affect users' real and perceived internal consistency. © 2015 Society for Risk Analysis.

  11. 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.

  12. Secret-Key-Aided Scheme for Securing Untrusted DF Relaying Networks

    KAUST Repository

    Shafie, Ahmed El; Salem, Ahmed Sultan; Mabrouk, Asma; Tourki, Kamel; Al-Dhahir, Naofal

    2017-01-01

    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.

  13. [Computer aided diagnosis model for lung tumor based on ensemble convolutional neural network].

    Science.gov (United States)

    Wang, Yuanyuan; Zhou, Tao; Lu, Huiling; Wu, Cuiying; Yang, Pengfei

    2017-08-01

    The convolutional neural network (CNN) could be used on computer-aided diagnosis of lung tumor with positron emission tomography (PET)/computed tomography (CT), which can provide accurate quantitative analysis to compensate for visual inertia and defects in gray-scale sensitivity, and help doctors diagnose accurately. Firstly, parameter migration method is used to build three CNNs (CT-CNN, PET-CNN, and PET/CT-CNN) for lung tumor recognition in CT, PET, and PET/CT image, respectively. Then, we aimed at CT-CNN to obtain the appropriate model parameters for CNN training through analysis the influence of model parameters such as epochs, batchsize and image scale on recognition rate and training time. Finally, three single CNNs are used to construct ensemble CNN, and then lung tumor PET/CT recognition was completed through relative majority vote method and the performance between ensemble CNN and single CNN was compared. The experiment results show that the ensemble CNN is better than single CNN on computer-aided diagnosis of lung tumor.

  14. Management of complex knowledge in planning for sustainable development: The use of multi-criteria decision aids

    International Nuclear Information System (INIS)

    Kain, Jaan-Henrik; Soederberg, Henriette

    2008-01-01

    The vision of sustainable development entails new and complex planning situations, confronting local policy makers with changing political conditions, different content in decision making and planning and new working methods. Moreover, the call for sustainable development has been a major driving force towards an increasingly multi-stakeholder planning system. This situation requires competence in working in, and managing, groups of actors, including not only experts and project owners but also other categories of stakeholders. Among other qualities, such competence requires a working strategy aimed at integrating various, and sometimes incommensurable, forms of knowledge to construct a relevant and valid knowledge base prior to decision making. Consequently, there lies great potential in methods that facilitate the evaluation of strategies for infrastructural development across multiple knowledge areas, so-called multi-criteria decision aids (MCDAs). In the present article, observations from six case studies are discussed, where the common denominators are infrastructural planning, multi-stakeholder participation and the use of MCDAs as interactive decision support. Three MCDAs are discussed - NAIADE, SCA and STRAD - with an emphasis on how they function in their procedural context. Accordingly, this is not an analysis of MCDA algorithms, of software programming aspects or of MCDAs as context-independent 'decision machines'-the focus is on MCDAs as actor systems, not as expert systems. The analysis is carried out across four main themes: (a) symmetrical management of different forms of knowledge; (b) management of heterogeneity, pluralism and conflict; (c) functionality and ease of use; and (d) transparency and trust. It shows that STRAD, by far, seems to be the most useful MCDA in interactive settings. NAIADE and SCA are roughly equivalent but have their strengths and weaknesses in different areas. Moreover, it was found that some MCDA issues require further

  15. 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

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

    Science.gov (United States)

    Husain, Sara; Kadir, Masood; Fatmi, Zafar

    2007-01-23

    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. 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. 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. 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 decision making is required to make financial allocations based on real

  17. The role of decision-making ability in HIV/AIDS: impact on prospective memory.

    Science.gov (United States)

    Coulehan, Kelly; Byrd, Desiree; Arentoft, Alyssa; Monzones, Jennifer; Fuentes, Armando; Fraser, Felicia; Rosario, Ana; Morgello, Susan; Mindt, Monica Rivera

    2014-01-01

    Prospective memory (ProM), a form of episodic memory related to execution of future intentions, is important for everyday functioning. Among persons living with HIV (PLWH), executive dysfunction is implicated in ProM impairments. However, specific subcomponents of executive functioning involved in ProM deficits remain poorly understood. Unlike more "traditional" neurocognitive (NC) measures of executive functioning associated with dorsolateral prefrontal cortex (i.e., conceptual reasoning, abstraction), those associated with medial orbitofrontal/ventromedial prefrontal (mOF/vmP) cortex (i.e., decision making, inhibitory control, goal-oriented behavior) have yet to be examined in ProM. This study characterized ProM ability in a sample of 89 HIV-seropositive adults and examined the unique role of decision-making ability in ProM. Participants completed a standard NC battery, the Iowa Gambling Task (IGT; a decision-making measure), and the Memory for Intentions Screening Test (MIST; a ProM measure). Correlational analyses revealed that both traditional executive functioning measures and the IGT were associated with ProM. Regression analyses revealed that the IGT significantly predicted ProM, even after accounting for NC measures. Among all NC measures, only executive functioning significantly contributed to ProM. Further examination of mOF/vmP-sensitive executive dysfunction within this population is needed as PLWH may require more tailored treatment recommendations due to specific decision-making difficulties that can impact medication management.

  18. 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

  19. 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

  20. An Ensemble of Neural Networks for Stock Trading Decision Making

    Science.gov (United States)

    Chang, Pei-Chann; Liu, Chen-Hao; Fan, Chin-Yuan; Lin, Jun-Lin; Lai, Chih-Ming

    Stock turning signals detection are very interesting subject arising in numerous financial and economic planning problems. In this paper, Ensemble Neural Network system with Intelligent Piecewise Linear Representation for stock turning points detection is presented. The Intelligent piecewise linear representation method is able to generate numerous stocks turning signals from the historic data base, then Ensemble Neural Network system will be applied to train the pattern and retrieve similar stock price patterns from historic data for training. These turning signals represent short-term and long-term trading signals for selling or buying stocks from the market which are applied to forecast the future turning points from the set of test data. Experimental results demonstrate that the hybrid system can make a significant and constant amount of profit when compared with other approaches using stock data available in the market.

  1. 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.

  2. The development of the CoRE-Values framework as an aid to ethical decision-making.

    Science.gov (United States)

    Manson, Helen M

    2012-01-01

    Ethical analysis frameworks can help to identify the ethical dimensions to clinical care and provide a method for justifying clinical decisions. Published frameworks, however, have some limitations to easy, practical use. The aim was to identify a comprehensive yet easy-to-use framework that clarifies ethical decision-making, suitable for use by medical learners and clinical educators. A literature search identified published frameworks that define the components of ethical clinical decision-making. On this basis, a new framework, the 'CoRE-Values Compass and Grid' was constructed. This was formally evaluated during a medical school interprofessional teaching session. For 88% of 228 medical and nursing students, the new framework was easy to understand; 85% reported it as easy to use. The framework improved awareness of the ethical dimensions to a clinical scenario for 97% of students and the ability to systematically identify ethical aspects for 83%. Students and instructors reported that the framework helped to link ethics theory with clinical practice. The framework was described as a useful educational tool by 85% of students and 95% of instructors. The 'CoRE-Values Compass and Grid' is a new framework, shown to aid the systematic identification and consideration of ethical aspects to clinical cases.

  3. 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.

  4. Biogas plants site selection integrating Multicriteria Decision Aid methods and GIS techniques: A case study in a Portuguese region

    International Nuclear Information System (INIS)

    Silva, Sandra; Alçada-Almeida, Luís; Dias, Luís C.

    2014-01-01

    This work addresses the problem of determining the most suitable sites for locating biogas plants using dairy manure as feedstock, specifically in the Entre-Douro-e-Minho Region in Portugal. A Multicriteria Spatial Decision Support System is developed to tackle this complex multicriteria decision-making problem, involving constraints and many environmental, economic, safety, and social factors. The approach followed combines the use of a Geographic Information System (GIS) to manage and process spatial information with the flexibility of Multicriteria Decision Aid (MCDA) to assess factual information (e.g. soil type, slope, infrastructures) with more subjective information (e.g. expert opinion). The MCDA method used is ELECTRE TRI, an outranking-type method that yields a classification of the possible alternatives. The results of the performed analysis show that the use of ELECTRE TRI is suitable to address real-world problems of land suitability, leading towards a flexible and integrated assessment. - Highlights: • We present a spatial multi-criteria methodology to decide biogas plants siting. • Methodology combines ELECTRE TRI with GIS for spatial analysis. • Constraints and environmental, economic and social factors have been identified. • The methodology is illustrated with application to a case study in the EDM Region. • A suitability map was generated, identifying the most suitable biogas plant locations

  5. Primary Care Provider Views About Usefulness and Dissemination of a Web-Based Depression Treatment Information Decision Aid.

    Science.gov (United States)

    Beaulac, Julie; Westmacott, Robin; Walker, John R; Vardanyan, Gohar

    2016-06-08

    Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences. The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings. Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff. The study design was a qualitative framework analytic approach of 5 focus groups. Focus groups were conducted during regular staff meetings, were digitally recorded, and transcripts created. Analysis involved a content and theme analysis. Seven key themes emerged including the key role of the primary care provider, common questions about treatments, treatment barriers, sources of patient information, concern about quality and quantity of available information, positive opinions about the IDA, and disseminating the IDA. The most common questions mentioned were about medication and side effects and alternatives to medication. Patients have limited access to alternative treatment options owing to cost and availability. Practitioners evaluated the IDA positively. The resources were described as useful, supportive of providers' messages, and accessible for patients. There was unanimous consensus that information needs to be available electronically through the Internet.

  6. 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

  7. 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.

  8. A randomised controlled trial evaluating the utility of a patient Decision Aid to improve clinical trial (RAVES 08.03) related decision-making.

    Science.gov (United States)

    Sundaresan, Puma; Ager, Brittany; Turner, Sandra; Costa, Dan; Kneebone, Andrew; Pearse, Maria; Woo, Henry; Tesson, Stephanie; Juraskova, Ilona; Butow, Phyllis

    2017-10-01

    Randomised controlled trials (RCTs) are considered the 'gold-standard' for evaluating medical treatments. However, patients and clinicians report difficulties with informed consent and recruitment. We evaluated the utility of a Decision Aid (DA) in reducing RCT-related decisional conflict, and improving RCT knowledge and recruitment. Potential participants for a radiotherapy RCT were invited to participate in the current study. Participants were randomised to receive the RCT's participant information sheet with or without a DA. Questionnaires were administered at baseline, one and six months. The primary outcome measure was decisional conflict. Secondary outcome measures included knowledge regarding and recruitment to the RCT. 129 men were randomised to the DA (63) and control (66) arms. Decisional conflict was significantly lower over 6-months (p=0.048) in the DA arm. Knowledge regarding the RCT was significantly higher at 6months (p=0.033) in the DA arm. 20.6% of the DA arm (13 of 63) and 9% of the control arm (6 of 66) entered the RCT. This study demonstrates the utility of a DA in reducing decisional conflict and improving trial knowledge in men with cancer who are making decisions regarding RCT participation. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  9. Cortical Network Dynamics of Perceptual Decision-Making in the Human Brain

    Directory of Open Access Journals (Sweden)

    Markus eSiegel

    2011-02-01

    Full Text Available Goal-directed behavior requires the flexible transformation of sensory evidence about our environment into motor actions. Studies of perceptual decision-making have shown that this transformation is distributed across several widely separated brain regions. Yet, little is known about how decision-making emerges from the dynamic interactions among these regions. Here, we review a series of studies, in which we characterized the cortical network interactions underlying a perceptual decision process in the human brain. We used magnetoencephalography (MEG to measure the large-scale cortical population dynamics underlying each of the sub-processes involved in this decision: the encoding of sensory evidence and action plan, the mapping between the two, and the attentional selection of task-relevant evidence. We found that these sub-processes are mediated by neuronal oscillations within specific frequency ranges. Localized gamma-band oscillations in sensory and motor cortices reflect the encoding of the sensory evidence and motor plan. Large-scale oscillations across widespread cortical networks mediate the integrative processes connecting these local networks: Gamma- and beta-band oscillations across frontal, parietal and sensory cortices serve the selection of relevant sensory evidence and its flexible mapping onto action plans. In sum, our results suggest that perceptual decisions are mediated by oscillatory interactions within overlapping local and large-scale cortical networks.

  10. Commander’s Decision Aid for Predictive Battlespace Awareness (CDA4PBA)

    Science.gov (United States)

    2006-12-01

    plans include enhancing Natural Language Processing (NLP) capabilities, improved knowledge acquisition techniques, and meta - rule formation to capture...Reality to Understand Complex Metabolic Networks. Atlantic Symposium on Computational Biology, Genomic Information Systems & Technology, September...Based on the availability of airborne and ground-based weapon systems, data link architectures, and tactical C2 relationships, the primary outputs

  11. Identification of radon anomalies in soil gas using decision trees and neural networks

    International Nuclear Information System (INIS)

    Zmazek, B.; Dzeroski, S.; Torkar, D.; Vaupotic, J.; Kobal, I.

    2010-01-01

    The time series of radon ( 222 Rn) concentration in soil gas at a fault, together with the environmental parameters, have been analysed applying two machine learning techniques: (I) decision trees and (II) neural networks, with the aim at identifying radon anomalies caused by seismic events and not simply ascribed to the effect of the environmental parameters. By applying neural networks, 10 radon anomalies were observed for 12 earthquakes, while with decision trees, the anomaly was found for every earthquake, but, undesirably, some anomalies appeared also during periods without earthquakes. (authors)

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

    Science.gov (United States)

    Albin, Roger L

    2018-02-01

    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

  13. 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.

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

    Science.gov (United States)

    Ramazi, Pouria; Riehl, James; Cao, Ming

    2016-11-15

    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 a particular action causes an agent to take the opposite action, as in traffic congestion, crowd dispersion, and division of labor. Both of these cases can be modeled using linear-threshold-based dynamics, and a fundamental question is whether the individuals in such networks are likely to reach decisions with which they are satisfied. We show that, in the coordination case, and perhaps more surprisingly, also in the anticoordination case, the agents will indeed always tend to reach satisfactory decisions, that is, the network will almost surely reach an equilibrium state. This holds for every network topology and every distribution of thresholds, for both asynchronous and partially synchronous decision-making updates. These results reveal that irregular network topology, population heterogeneity, and partial synchrony are not sufficient to cause cycles or nonconvergence in linear-threshold dynamics; rather, other factors such as imitation or the coexistence of coordinating and anticoordinating agents must play a role.

  15. Application of artificial neural network for medical image recognition and diagnostic decision making

    International Nuclear Information System (INIS)

    Asada, N.; Eiho, S.; Doi, K.; MacMahon, H.; Montner, S.M.; Giger, M.L.

    1989-01-01

    An artificial neural network has been applied for pattern recognition and used as a tool in an expert system. The purpose of this study is to examine the potential usefulness of the neural network approach in medical applications for image recognition and decision making. The authors designed multilayer feedforward neural networks with a back-propagation algorithm for our study. Using first-pass radionuclide ventriculograms, we attempted to identify the right and left ventricles of the heart and the lungs by training the neural network from patterns of time-activity curves. In a preliminary study, the neural network enabled identification of the lungs and heart chambers once the network was trained sufficiently by means of repeated entries of data from the same case

  16. Three decision-making aids: brainstorming, nominal group, and Delphi technique.

    Science.gov (United States)

    McMurray, A R

    1994-01-01

    The methods of brainstorming, Nominal Group Technique, and the Delphi technique can be important resources for nursing staff development educators who wish to expand their decision-making skills. Staff development educators may find opportunities to use these methods for such tasks as developing courses, setting departmental goals, and forecasting trends for planning purposes. Brainstorming, Nominal Group Technique, and the Delphi technique provide a structured format that helps increase the quantity and quality of participant responses.

  17. Behavioral Economics and Marketing in Aid of Decision Making Among the Poor

    OpenAIRE

    Bertrand, Marianne; Shafir, Eldar; Mullainathan, Sendhil

    2006-01-01

    This article considers several aspects of the economic decision making of the poor from the perspective of behavioral economics, and it focuses on potential contributions from marketing. Among other things, the authors consider some relevant facets of the social and institutional environments in which the poor interact, and they review some behavioral patterns that are likely to arise in these contexts. A behaviorally more informed perspective can help make sense of what might otherwise be co...

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

    OpenAIRE

    Ajay Kumar Saxena; S. 0. Bhatnagar; P. K Saxena

    2002-01-01

    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 p...

  19. Women’s Social Networks and Birth Attendant Decisions: Application of the Network-Episode Model

    OpenAIRE

    Edmonds, Joyce K.; Hruschka, Daniel; Bernard, H. Russell; Sibley, Lynn

    2011-01-01

    This paper examines the association of women's social networks with the use of skilled birth attendants in uncomplicated pregnancy and childbirth in Matlab, Bangladesh. The Network-Episode Model was applied to determine if network structure variables (density / kinship homogeneity / strength of ties) together with network content (endorsement for or against a particular type of birth attendant) explain the type of birth attendant used by women above and beyond the variance explained by women'...

  20. A Brief Discussion on the Decision Aiding Techniques Applied to a Laboratory of Radioactive Decontamination: A General Case

    International Nuclear Information System (INIS)

    Kodma, Y.; Sordi, G. M. A. A.; Rodrigues, D. L.

    2004-01-01

    In the Laboratory of Radioactive Decontamination ( RDL ) at the Instituto de Pesquisas Energeticas e Nucleares IPEN it has been received objects and equipments from the various installations, each one processing different kinds of radioisotopes. These radioactive materials can range from nuclear fuel fabrication and processing, research reactor utilization or radiopharmaceuticals production. This means many different physical and chemical properties of the contaminants and composition of the contaminated surface. It is difficult to decide whether to decontaminate or not the objects and equipment that were used on the processing of these radioactive materials. Most of the radioactive contamination are transferable ones but some are fixed that would imply in more effort to reduce the contamination levels. Depending on the reuse or on the repairing need, for instance, of equipments, tools or objects, the permissible levels of remaining contamination varies and for so the decontamination process shall be more severe. Several parameters must be considered to make a decision, not only their cost to buy new ones compared to the cost of the materials and personnel those will execute the decontamination, but also the installation budget to buy new equipments, collective dose of the workers, readiness for reuse and so on. In this work we discuss how the parameters influence on the decision about decontaminate or not and if so, up to where to proceed. We also compare the decision aiding techniques applied to a general case considering some parameters those are fundamental and others that are not so important all the time but can affect in a significant way the decontamination choice and the way they can affect the decision maker to choose the best option. (Author) 8 refs

  1. 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

  2. Evaluation of a Decision Aid for Women with Epilepsy Who Are Considering Pregnancy: A Randomized Controlled Trial.

    Science.gov (United States)

    McGrath, Amanda; Sharpe, Louise; Lah, Suncica; Parratt, Kaitlyn

    2017-07-01

    For many women with epilepsy (WWE), decision making about pregnancy is complicated by considerations such as the potential teratogenicity of antiepileptic drugs, offspring risk of epilepsy, seizure occurrence during pregnancy, and the challenges of parenting amidst poorly controlled seizures. This proof-of-concept, randomized controlled trial aimed to evaluate a decision aid (DA) developed to help WWE decide if they should start or enlarge their families. Seventy-nine WWE of childbearing age were recruited from Epilepsy Action Australia between October and November 2013 and randomized to receive the intervention (the DA) or not, and to complete a set of questionnaires pre- and post- intervention. The DA, delivered as a PDF booklet, provided balanced evidence-based information about options, risks and benefits, including probabilities; as well as steps for clarifying values and considering options within one's personal situation. Compared with the control group, the DA group had statistically significant improvements in knowledge about pregnancy and epilepsy (Cohen's d = 1.24; 95%CI = 0.77 to 1.83) and reduced decisional conflict (Cohen's d = 0.59; 95%CI = 0.21 to 0.99). Changes in decision self-efficacy, certainty of choice, patient-practitioner communication abilities and value congruence with choice were comparable between the DA and control group. Importantly, women's decisions about motherhood were not biased towards either direction, and there were no adverse effects on depression or anxiety. All women who received the DA indicated they would recommend it to other WWE. The DA has the potential to serve as a useful support tool for WWE who are considering motherhood. Future research is needed to test the DA in clinical settings with guidance from a health professional. The trial was registered with the Australian New Zealand Clinical Trials Registry (ID ACTRN12613001082796).

  3. 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)

  4. Common planning of operations of and extensions to a nuclear park and a high-voltage network of a service area with the aid of a modified optimization method of dynamic programming

    International Nuclear Information System (INIS)

    Bieselt, R.

    1974-01-01

    While making extensive use of the possibilities dynamic programming as an optimization method has to offer, a planning method for the common operation and the extension of a nuclear park and a high-voltage network for a service area of a large size is worked out in a system-analytical manner in this thesis. With the aid of the computer programmes developed, those decisions concerning construction and operation of power plant and network are looked for which result within appr. 10 years of planning in a minimum of overall generating and transmission costs. (orig./LN) [de

  5. Situation-assessment and decision-aid production-rule analysis system for nuclear plant monitoring and emergency preparedness

    International Nuclear Information System (INIS)

    Gvillo, D.; Ragheb, M.; Parker, M.; Swartz, S.

    1987-01-01

    A Production-Rule Analysis System is developed for Nuclear Plant Monitoring. The signals generated by the Zion-1 Plant are considered. A Situation-Assessment and Decision-Aid capability is provided for monitoring the integrity of the Plant Radiation, the Reactor Coolant, the Fuel Clad, and the Containment Systems. A total of 41 signals are currently fed as facts to an Inference Engine functioning in the backward-chaining mode and built along the same structure as the E-Mycin system. The Goal-Tree constituting the Knowledge Base was generated using a representation in the form of Fault Trees deduced from plant procedures information. The system is constructed in support of the Data Analysis and Emergency Preparedness tasks at the Illinois Radiological Emergency Assessment Center (REAC)

  6. Situation-Assessment And Decision-Aid Production-Rule Analysis System For Nuclear Plant Monitoring And Emergency Preparedness

    Science.gov (United States)

    Gvillo, D.; Ragheb, M.; Parker, M.; Swartz, S.

    1987-05-01

    A Production-Rule Analysis System is developed for Nuclear Plant Monitoring. The signals generated by the Zion-1 Plant are considered. A Situation-Assessment and Decision-Aid capability is provided for monitoring the integrity of the Plant Radiation, the Reactor Coolant, the Fuel Clad, and the Containment Systems. A total of 41 signals are currently fed as facts to an Inference Engine functioning in the backward-chaining mode and built along the same structure as the E-Mycin system. The Goal-Tree constituting the Knowledge Base was generated using a representation in the form of Fault Trees deduced from plant procedures information. The system is constructed in support of the Data Analysis and Emergency Preparedness tasks at the Illinois Radiological Emergency Assessment Center (REAC).

  7. Decision-making aids for the rational use of energy in office buildings

    Energy Technology Data Exchange (ETDEWEB)

    Daniels, K [HL-Technik G.m.b.H., Muenchen (Germany, F.R.)

    1979-11-01

    The rational use of energy in office buildings can be assured by intensifying cooperation between owner, architect, structural designer, and installer with a view to the employment of technical aids and the interdependence of design concept and structural configuration. As can be seen from a comparison of different types of buildings, there are considerable differences in the anticipated energy consumption and the potential use of energy. It is important to note that continued serviceability of an office building must be assured at times of crisis when only a minimum of energy is available and that modern office buildings are so supplied with utilities that energy is only used if this is required for comfort and office work.

  8. Optimization of matrix tablets controlled drug release using Elman dynamic neural networks and decision trees.

    Science.gov (United States)

    Petrović, Jelena; Ibrić, Svetlana; Betz, Gabriele; Đurić, Zorica

    2012-05-30

    The main objective of the study was to develop artificial intelligence methods for optimization of drug release from matrix tablets regardless of the matrix type. Static and dynamic artificial neural networks of the same topology were developed to model dissolution profiles of different matrix tablets types (hydrophilic/lipid) using formulation composition, compression force used for tableting and tablets porosity and tensile strength as input data. Potential application of decision trees in discovering knowledge from experimental data was also investigated. Polyethylene oxide polymer and glyceryl palmitostearate were used as matrix forming materials for hydrophilic and lipid matrix tablets, respectively whereas selected model drugs were diclofenac sodium and caffeine. Matrix tablets were prepared by direct compression method and tested for in vitro dissolution profiles. Optimization of static and dynamic neural networks used for modeling of drug release was performed using Monte Carlo simulations or genetic algorithms optimizer. Decision trees were constructed following discretization of data. Calculated difference (f(1)) and similarity (f(2)) factors for predicted and experimentally obtained dissolution profiles of test matrix tablets formulations indicate that Elman dynamic neural networks as well as decision trees are capable of accurate predictions of both hydrophilic and lipid matrix tablets dissolution profiles. Elman neural networks were compared to most frequently used static network, Multi-layered perceptron, and superiority of Elman networks have been demonstrated. Developed methods allow simple, yet very precise way of drug release predictions for both hydrophilic and lipid matrix tablets having controlled drug release. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Operator decision aid for breached fuel operation in liquid metal cooled nuclear reactors

    International Nuclear Information System (INIS)

    Gross, K.C.; Hawkins, R.E.; Nickless, W.K.

    1991-01-01

    The purpose of this paper is to report the development of an expert system that provides continuous assessment of the safety significance and technical specification conformance of Delayed Neutron (DN) signals during breached fuel operation. The completed expert system has been parallelized on an innovative distributed-memory network-computing system that enables the computationally intensive kernel of the expert system to run in parallel on a group of low-cost Unix workstations. 1 ref

  10. 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.

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

    International Nuclear Information System (INIS)

    Ohdaira, Tetsushi

    2014-01-01

    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. (paper)

  12. 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.

  13. International exchange of emergency phase information and assessments: an aid to inter/national decision makers

    International Nuclear Information System (INIS)

    Sullivan, T.J.

    2003-01-01

    Full text: Nuclear accidents/incidents cause significant fear in citizens perceived to be (potentially) impacted. Such events challenge national governments and international agencies to quickly and confidently provide assurance and protection advice. Based on the experience of several radiological accidents, e.g., Three Mile Island, Chernobyl, Algeciras, etc., it is evident that large areas, frequently transboundary, and numbers of citizens have the potential to be impacted. Additionally, as a consequence of current 'globalization', i.e. governmental, business, education and leisure travel, most nations now daily host numerous international visitors whose national government embassies have a responsibility to advise and project them from hazards. This mixture of large area, transboundary and international mobility presents a significant challenge to the decision maker community in order to deliver the best consistent advice to all those potentially impacted by a nuclear accident (and assure those not impacted). Post-Chernobyl there has been definitive progress and agreement in the determination of dose protection thresholds. In the same time period there has been a proliferation of dispersion models and assessment systems (from the local to the international scale) to support decision makers at all levels of government. Unfortunately, due to the varying parameters of scale, resolution, input data, and physics assumptions, the consequent assessment results can vary substantially enough [Atmes] to potentially cause confusion and even contradiction when presented to decision makers. Such a circumstance potentially leads to wrong decisions, undercuts confidence and negates all the work and benefits of good assessment calculations. From 1996 to 1999 Japan (JAERI) and the USA (LLNL) investigated, developed and tested an initial capability to share basic event information (start time, source/rates, local meteorology, local measurements, etc.) and calculated assessment

  14. A single-blind randomised controlled trial of the effects of a web-based decision aid on self-testing for cholesterol and diabetes. study protocol

    Directory of Open Access Journals (Sweden)

    Ickenroth Martine HP

    2012-01-01

    Full Text Available Abstract Background Self-tests, tests on body materials to detect medical conditions, are widely available to the general public. Self-testing does have advantages as well as disadvantages, and the debate on whether self-testing should be encouraged or rather discouraged is still ongoing. One of the concerns is whether consumers have sufficient knowledge to perform the test and interpret the results. An online decision aid (DA with information on self-testing in general, and test specific information on cholesterol and diabetes self-testing was developed. The DA aims to provide objective information on these self-tests as well as a decision support tool to weigh the pros and cons of self-testing. The aim of this study is to evaluate the effect of the online decision aid on knowledge on self-testing, informed choice, ambivalence and psychosocial determinants. Methods/Design A single blind randomised controlled trial in which the online decision aid 'zelftestwijzer' is compared to short, non-interactive information on self-testing in general. The entire trial will be conducted online. Participants will be selected from an existing Internet panel. Consumers who are considering doing a cholesterol or diabetes self-test in the future will be included. Outcome measures will be assessed directly after participants have viewed either the DA or the control condition. Weblog files will be used to record participants' use of the decision aid. Discussion Self-testing does have important pros and cons, and it is important that consumers base their decision whether they want to do a self-test or not on knowledge and personal values. This study is the first to evaluate the effect of an online decision aid for self-testing. Trial registration Dutch Trial Register: NTR3149

  15. Pilot trial of telemedicine as a decision aid for patients with chronic wounds.

    Science.gov (United States)

    Dobke, Marek K; Bhavsar, Dhaval; Gosman, Amanda; De Neve, Joan; De Neve, Brian

    2008-04-01

    The study goal was to evaluate the impact of the telemedicine consult on patients with chronic wounds. Thirty patients from long-term care skilled nursing facilities, referred to the ambulatory wound care program for wound assessment and preparation of management plans, were the subject of this prospective, randomized trial. To facilitate communication with a surgical wound care specialist, telemedicine feedback was provided prior to face-to-face consultation to 15 patients. The telemedicine consult included (1) wound assessment, (2) rationale for the suggested wound management with emphasis on wound risk projections, and (3) prevention and benefits of surgical intervention. This was communicated to the patient by the field wound care nurse. The telemedicine impact was measured by assessing the duration of the subsequent face-to-face consultation and patient satisfaction with further care decisions as well as by validation of a decisional conflict scale. The average duration of the face-to-face consultation was 50 +/- 12 minutes versus 35 +/- 6 (p face-to-face evaluation improved patient satisfaction and understanding of their care as well as increased the perception of shared decision making regarding the wound care.

  16. Reliability of the MDi Psoriasis® Application to Aid Therapeutic Decision-Making in Psoriasis.

    Science.gov (United States)

    Moreno-Ramírez, D; Herrerías-Esteban, J M; Ojeda-Vila, T; Carrascosa, J M; Carretero, G; de la Cueva, P; Ferrándiz, C; Galán, M; Rivera, R; Rodríguez-Fernández, L; Ruiz-Villaverde, R; Ferrándiz, L

    2017-09-01

    Therapeutic decisions in psoriasis are influenced by disease factors (e.g., severity or location), comorbidity, and demographic and clinical features. We aimed to assess the reliability of a mobile telephone application (MDi-Psoriasis) designed to help the dermatologist make decisions on how to treat patients with moderate to severe psoriasis. We analyzed interobserver agreement between the advice given by an expert panel and the recommendations of the MDi-Psoriasis application in 10 complex cases of moderate to severe psoriasis. The experts were asked their opinion on which treatments were most appropriate, possible, or inappropriate. Data from the same 10 cases were entered into the MDi-Psoriasis application. Agreement was analyzed in 3 ways: paired interobserver concordance (Cohen's κ), multiple interobserver concordance (Fleiss's κ), and percent agreement between recommendations. The mean percent agreement between the total of 1210 observations was 51.3% (95% CI, 48.5-54.1%). Cohen's κ statistic was 0.29 and Fleiss's κ was 0.28. Mean agreement between pairs of human observers only, excluding the MDi-Psoriasis recommendations, was 50.5% (95% CI, 47.6-53.5%). Paired agreement between the recommendations of the MDi-Psoriasis tool and the majority opinion of the expert panel (Cohen's κ) was 0.44 (68.2% agreement). The MDi-Psoriasis tool can generate recommendations that are comparable to those of experts in psoriasis. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. 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.

  18. 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.

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

    Science.gov (United States)

    2011-01-01

    pressure and subliminal seduction; but always through a sequence of decisions, either conscious or not. Network characteristics cannot be deduced from the...Time, Communication , and the Nervous System”, in Norbert Wiener: Collected Works, Volume IV, pp.220-252, The MIT Press, Cambridge, MA (1985). 16. P

  20. 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

  1. Global and Long-Distance Decision-Making, Environmental Issues and Network Potentials.

    Science.gov (United States)

    Samuelson, K.; And Others

    FID/TM, an international group concerned with theory and methods of systems cybernetics and information networks, held a panel session at the 34th Annual American Society for Information Science (ASIS) Meeting in November 1971. This report contains the seven papers presented by that panel, concerning issues in global decision-making and the role…

  2. 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,

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

    KAUST Repository

    Busbait, Monther I.

    2014-01-01

    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

  4. 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

    2018-06-01

    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.

  5. Influence of a patient decision aid on decisional conflict related to PSA testing: a structural equation model.

    Science.gov (United States)

    Stephens, Robert L; Xu, Ye; Volk, Robert J; Scholl, Lawrence E; Kamin, Stephanie L; Holden, E Wayne; Stroud, Leonardo A

    2008-11-01

    To examine the impact of a decision aid (DA) designed to promote informed decision making for screening with the prostate-specific antigen (PSA) test and to test a theoretical model of factors influencing decisional conflict. Structural equation modeling examined pathways between DA exposure, knowledge, schema, prostate cancer risk perceptions, decisional anxiety, and decisional conflict. Sample participants included 200 men from the general population (exclusive of African Americans) and 200 African American men. Half of the men in each subsample were randomly assigned to receive the DA. Decisional conflict regarding prostate cancer screening. The DA influences level of decisional conflict by increasing patient knowledge. This effect of knowledge on decisional conflict is indirect, however, through an association with greater perceived risk and lower decisional anxiety. Also, positive PSA schema was associated with lower decisional anxiety and decisional conflict. It is important that exposure to the DA had no impact on PSA schema. Schemas about testing must be considered in developing messages about the risks and benefits of testing. If schemas are counter to message content, mechanisms for modifying schemas must be incorporated into interventions.

  6. 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.

  7. 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.

  8. Fuzzy Neural Networks for Decision Support in Negotiation

    International Nuclear Information System (INIS)

    Sakas, D. P.; Vlachos, D. S.; Simos, T. E.

    2008-01-01

    There is a large number of parameters which one can take into account when building a negotiation model. These parameters in general are uncertain, thus leading to models which represents them with fuzzy sets. On the other hand, the nature of these parameters makes them very difficult to model them with precise values. During negotiation, these parameters play an important role by altering the outcomes or changing the state of the negotiators. One reasonable way to model this procedure is to accept fuzzy relations (from theory or experience). The action of these relations to fuzzy sets, produce new fuzzy sets which describe now the new state of the system or the modified parameters. But, in the majority of these situations, the relations are multidimensional, leading to complicated models and exponentially increasing computational time. In this paper a solution to this problem is presented. The use of fuzzy neural networks is shown that it can substitute the use of fuzzy relations with comparable results. Finally a simple simulation is carried in order to test the new method.

  9. 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.

  10. Emergency environmental monitoring for the decision-aiding on public protective actions during a nuclear accident

    International Nuclear Information System (INIS)

    Choi, Yong Ho; Choi, Geun Sik; Han, Moon Hee; Lee, Han Soo; Lee, Chang Woo

    2005-01-01

    In a nuclear emergency, protective actions for the public should be taken in time. It is internationally proposed that Generic Intervention Levels (GILs) and generic action levels, determined based on cost-benefit analyses, be used as the decision criteria for protective actions. Operational Intervention Levels (OILs) are directly or easily measurable quantities corresponding to these generic levels. To assess the necessity of protective actions in a nuclear emergency, it is important that the environmental monitoring data required for applying and revising OILs should be promptly produced. It is discussed what and how to do for this task in the course of the emergency response. For an emergency environmental monitoring to be performed effectively, a through preparedness has to be made including maintenance of the organization and equipments, establishment of various procedure manuals, development of a supporting computer system and periodical training and exercises. It is pointed out that Korean legal provisions concerning GILs and OILs need to be amended or newly established

  11. A P2P Botnet detection scheme based on decision tree and adaptive multilayer neural networks.

    Science.gov (United States)

    Alauthaman, Mohammad; Aslam, Nauman; Zhang, Li; Alasem, Rafe; Hossain, M A

    2018-01-01

    In recent years, Botnets have been adopted as a popular method to carry and spread many malicious codes on the Internet. These malicious codes pave the way to execute many fraudulent activities including spam mail, distributed denial-of-service attacks and click fraud. While many Botnets are set up using centralized communication architecture, the peer-to-peer (P2P) Botnets can adopt a decentralized architecture using an overlay network for exchanging command and control data making their detection even more difficult. This work presents a method of P2P Bot detection based on an adaptive multilayer feed-forward neural network in cooperation with decision trees. A classification and regression tree is applied as a feature selection technique to select relevant features. With these features, a multilayer feed-forward neural network training model is created using a resilient back-propagation learning algorithm. A comparison of feature set selection based on the decision tree, principal component analysis and the ReliefF algorithm indicated that the neural network model with features selection based on decision tree has a better identification accuracy along with lower rates of false positives. The usefulness of the proposed approach is demonstrated by conducting experiments on real network traffic datasets. In these experiments, an average detection rate of 99.08 % with false positive rate of 0.75 % was observed.

  12. 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

  13. Development of Patients’ Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    International Nuclear Information System (INIS)

    Wong, Jennifer; D’Alimonte, Laura; Angus, Jan; Paszat, Larry; Metcalfe, Kelly; Whelan, Tim; Llewellyn-Thomas, Hilary; Warner, Eiran; Franssen, Edmee; Szumacher, Ewa

    2012-01-01

    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

  14. Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol.

    Science.gov (United States)

    Oostendorp, Linda J M; Ottevanger, Petronella B; van der Graaf, Winette T A; Stalmeier, Peep F M

    2011-02-14

    There is a continuing debate on the desirability of informing patients with cancer and thereby involving them in treatment decisions. On the one hand, information uptake may be hampered, and additional stress could be inflicted by involving these patients. On the other hand, even patients with advanced cancer desire information on risks and prognosis. To settle the debate, a decision aid will be developed and presented to patients with advanced disease at the point of decision making. The aid is used to assess the amount of information desired. Factors related to information desire are explored, as well as the ability of the medical oncologist to judge the patient's information desire. The effects of the information on patient well-being are assessed by comparing the decision aid group with a usual care group. This study is a randomized controlled trial of patients with advanced colorectal, breast, or ovarian cancer who have started treatment with first-line palliative chemotherapy. The trial will consist of 100 patients in the decision aid group and 70 patients in the usual care group. To collect complete data of 170 patients, 246 patients will be approached for the study. Patients will complete a baseline questionnaire on sociodemographic data, well-being measures, and psychological measures, believed to predict information desire. The medical oncologist will judge the patient's information desire. After disease progression is diagnosed, the medical oncologist offers the choice between second-line palliative chemotherapy plus best supportive care (BSC) and BSC alone. Randomization will take place to determine whether patients will receive usual care (n = 70) or usual care and the decision aid (n = 100). The aid offers information about the potential risks and benefits of both treatment options, in terms of adverse events, tumour response, and survival. Patients decide for each item whether they desire the information or not. Two follow-up questionnaires will

  15. Constructing a clinical decision-making framework for image-guided radiotherapy using a Bayesian Network

    International Nuclear Information System (INIS)

    Hargrave, C; Deegan, T; Gibbs, A; Poulsen, M; Moores, M; Harden, F; Mengersen, K

    2014-01-01

    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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. Decision-making aid for operational crews. Status of the EPRI DASS project

    International Nuclear Information System (INIS)

    Spurgin, A.J.; Cain, D.G.; Long, A.B.

    1983-01-01

    The paper covers recent work on the development of the Disturbance Analysis and Surveillance System (DASS) of the Electric Power Research Institute (EPRI), Palo Alto. The work at EPRI covered a BWR application and the development of advance concepts as applied to a PWR. The paper starts by considering the environment in which the DASS developments are taking place, especially the effect of observations resulting from evaluations of the Safety Parameter Display System (SPDS) in actual control rooms. It is pointed out that insights are being gained into the behaviour of reactor control room crews. The DASS group at EPRI has designed the control room operator aids for the process manager or systems manager. The paper covers the work on DASS in 1981 and 1982. The foundation of the work done in 1982 was established in 1981 when the DASS user and the functional design of software were defined, a working DASS was demonstrated and a portable test vehicle which could be used for dynamic evaluation of displays was developed. Both the philosophy and characteristics of the displays for the PWR and BWR DASS applications are discussed and pictures of the actual displays are included. The development and execution of a human factors plan is an integral part of the EPRI DASS programme and some discussion of the plan is included in the paper. It is concluded that there is a need for DASS-type systems and that such systems might be developed from an enhanced SPDS which would include the newly proposed emergency procedures based on identification of symptoms rather than events. (author)

  2. Impact of a decision aid about stratified ovarian cancer risk-management on women’s knowledge and intentions: a randomised online experimental survey study

    Directory of Open Access Journals (Sweden)

    Susanne F. Meisel

    2017-11-01

    Full Text Available Abstract Background Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influence key informed decision-related outcomes, e.g. knowledge. The primary aim of this study was to compare informed decision-related outcomes between women given one of two versions (gist vs. extended of a decision aid about stratified ovarian cancer risk-management. Methods This was an experimental survey study comparing the effects of brief (gist information with lengthier, more detailed (extended information on cognitions relevant to informed decision-making about participating in risk-stratified ovarian cancer screening. Women with no personal history of ovarian cancer were recruited through an online survey company and randomised to view the gist (n = 512 or extended (n = 519 version of a website-based decision aid and completed an online survey. Primary outcomes were knowledge and intentions. Secondary outcomes included attitudes (values and decisional conflict. Results There were no significant differences between the gist and extended conditions in knowledge about ovarian cancer (time*group interaction: F = 0.20, p = 0.66 or intention to participate in ovarian cancer screening based on genetic risk assessment (t(1029 = 0.43, p = 0.67. There were also no between-groups differences in secondary outcomes. In the sample overall (n = 1031, knowledge about ovarian cancer increased from before to after exposure to the decision aid (from 5.71 to 6.77 out of a possible 10: t = 19.04, p < 0.001, and 74% of participants said that they would participate in ovarian cancer screening based on genetic risk assessment. Conclusions No differences in knowledge or

  3. Quality assurance in the HIV/AIDS laboratory network of China.

    Science.gov (United States)

    Jiang, Yan; Qiu, Maofeng; Zhang, Guiyun; Xing, Wenge; Xiao, Yao; Pan, Pinliang; Yao, Jun; Ou, Chin-Yih; Su, Xueli

    2010-12-01

    In 2009, there were 8273 local screening laboratories, 254 confirmatory laboratories, 35 provincial confirmatory central laboratories and 1 National AIDS Reference Laboratory (NARL) in China. These laboratories were located in Center for Disease Control and Prevention (CDC) facilities, hospitals, blood donation clinics, maternal and child health (MCH) hospitals and border health quarantine health-care facilities. The NARL and provincial laboratories provide quality assurance through technical, bio-safety and managerial training; periodic proficiency testing; on-site supervisory inspections; and commercial serologic kit evaluations. From 2002 to 2009, more than 220 million HIV antibody tests were performed at screening laboratories, and all reactive and indeterminate samples were confirmed at confirmatory laboratories. The use of highly technically complex tests, including CD4 cell enumeration, viral load, dried blood spot (DBS)-based early infant diagnosis (EID), drug resistance (DR) genotyping, HIV-1 subtyping and incidence assays, have increased in recent years and their performance quality is closely monitored. China has made significant progress in establishing a well-coordinated HIV laboratory network and QA systems. However, the coverage and intensity of HIV testing and quality assurance programmes need to be strengthened so as to ensure that more infected persons are diagnosed and that they receive timely prevention and treatment services.

  4. 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.

  5. Computer aided detection of ureteral stones in thin slice computed tomography volumes using Convolutional Neural Networks.

    Science.gov (United States)

    Längkvist, Martin; Jendeberg, Johan; Thunberg, Per; Loutfi, Amy; Lidén, Mats

    2018-06-01

    Computed tomography (CT) is the method of choice for diagnosing ureteral stones - kidney stones that obstruct the ureter. The purpose of this study is to develop a computer aided detection (CAD) algorithm for identifying a ureteral stone in thin slice CT volumes. The challenge in CAD for urinary stones lies in the similarity in shape and intensity of stones with non-stone structures and how to efficiently deal with large high-resolution CT volumes. We address these challenges by using a Convolutional Neural Network (CNN) that works directly on the high resolution CT volumes. The method is evaluated on a large data base of 465 clinically acquired high-resolution CT volumes of the urinary tract with labeling of ureteral stones performed by a radiologist. The best model using 2.5D input data and anatomical information achieved a sensitivity of 100% and an average of 2.68 false-positives per patient on a test set of 88 scans. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. International exchange of emergency phase information and assessments: An aid to national/international decision makers

    International Nuclear Information System (INIS)

    Sullivan, T. J.; Chino, M.; Ehrhardt, J.; Shershakov, V.

    2004-01-01

    This paper discusses a collaborative project (1) to demonstrate the feasibility and benefit of a system seeking early review, 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 calculations to respective national authorities followed by (2) sharing these results with responsible national/international authorities, (3) development of an affordable/accessible system to distribute results to countries without prediction capabilities and (4) utilisation for exercises and collaboration studies. The project exploits Internet browser technology and low-cost PC hardware, incorporates an Internet node, with access control, for depositing a minimal set of XML-based graphics files for presentation in an identical map format. Side-by-side viewing and tele-video conferencing will permit rapid evaluation, data elaboration and recalculation (if necessary) and should produce strong consensus among decision makers. Successful completion affords easy utilisation by national/international organisations and non-nuclear states at risk of trans-boundary incursion. (authors)

  7. 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.

  8. 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.

  9. The use of the analytic hierarchy process to aid decision making in acquired equinovarus deformity.

    Science.gov (United States)

    van Til, Janine A; Renzenbrink, Gerbert J; Dolan, James G; Ijzerman, Maarten J

    2008-03-01

    To increase the transparency of decision making about treatment in patients with equinovarus deformity poststroke. The analytic hierarchy process (AHP) was used as a structured methodology to study the subjective rationale behind choice of treatment. An 8-hour meeting at a centrally located rehabilitation center in The Netherlands, during which a patient video was shown to all participants (using a personal computer and a large screen) and the patient details were provided on paper. A panel of 10 health professionals from different backgrounds. Not applicable. The performance of the applicable treatments on outcome, impact, comfort, cosmetics, daily effort, and risks and side effects of treatment, as well as the relative importance of criteria in the choice of treatment. According to the model, soft-tissue surgery (.413) ranked first as the preferred treatment, followed by orthopedic footwear (.181), ankle-foot orthosis (.147), surface electrostimulation (.137), and finally implanted electrostimulation (.123). Outcome was the most influential consideration affecting treatment choice (.509), followed by risk and side effects (.194), comfort (.104), daily effort (.098), cosmetics (.065), and impact of treatment (.030). Soft-tissue surgery was judged best on outcome, daily effort, comfortable shoe wear, and cosmetically acceptable result and was thereby preferred as a treatment alternative by the panel in this study. In contrast, orthosis and orthopedic footwear are usually preferred in daily practice. The AHP method was found to be suitable methodology for eliciting subjective opinions and quantitatively comparing treatments in the absence of scientific evidence.

  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. 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; 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:

  12. Impact of a decision aid about stratified ovarian cancer risk-management on women's knowledge and intentions: a randomised online experimental survey study.

    Science.gov (United States)

    Meisel, Susanne F; Freeman, Maddie; Waller, Jo; Fraser, Lindsay; Gessler, Sue; Jacobs, Ian; Kalsi, Jatinderpal; Manchanda, Ranjit; Rahman, Belinda; Side, Lucy; Wardle, Jane; Lanceley, Anne; Sanderson, Saskia C

    2017-11-16

    Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk of ovarian cancer and reducing unnecessary interventions for women at lower risk. Amounts of information given to women may influence key informed decision-related outcomes, e.g. knowledge. The primary aim of this study was to compare informed decision-related outcomes between women given one of two versions (gist vs. extended) of a decision aid about stratified ovarian cancer risk-management. This was an experimental survey study comparing the effects of brief (gist) information with lengthier, more detailed (extended) information on cognitions relevant to informed decision-making about participating in risk-stratified ovarian cancer screening. Women with no personal history of ovarian cancer were recruited through an online survey company and randomised to view the gist (n = 512) or extended (n = 519) version of a website-based decision aid and completed an online survey. Primary outcomes were knowledge and intentions. Secondary outcomes included attitudes (values) and decisional conflict. There were no significant differences between the gist and extended conditions in knowledge about ovarian cancer (time*group interaction: F = 0.20, p = 0.66) or intention to participate in ovarian cancer screening based on genetic risk assessment (t(1029) = 0.43, p = 0.67). There were also no between-groups differences in secondary outcomes. In the sample overall (n = 1031), knowledge about ovarian cancer increased from before to after exposure to the decision aid (from 5.71 to 6.77 out of a possible 10: t = 19.04, p type of content for decision aids about stratified ovarian cancer risk-management. This study was registered with the ISRCTN registry; registration number: ISRCTN48627877 .

  13. 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

  14. Decision aids for enhancing intergovernmental interactions: The Prenotification Analysis Support System (PASS)

    International Nuclear Information System (INIS)

    Lester, M.; Liebow, E.; Holm, J.

    1994-01-01

    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

  15. Decision-aids for enhancing intergovernmental interactions: The Pre-notification Analysis Support System (PASS)

    International Nuclear Information System (INIS)

    Lester, M.; Liebow, E.; Holm, J.

    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

  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. 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.

  18. DSSNET, a network of users and developers of decision support systems for emergency response in Europe

    International Nuclear Information System (INIS)

    Salfeld, H.C.; Raskob, W.

    2002-01-01

    Following the Chernobyl accident, computerised systems for off-site management and response in case of a nuclear accident were developed and installed in many European countries. Some of the systems are in use in only one country, whereas other systems have found broader application in Europe. Examples of these systems are IMIS (D), ARGOS (DK), running in Denmark, Lithuania and Poland and RODOS, a real-time on-line decision support system for nuclear emergency management in Europe, which is now installed for operational or test-operational use in many European countries. During the development and installation phases of these decision support systems the necessity emerged, that there is a need for an intensive feedback between developers and users. Therefore, under the 5. Framework Programme of the European Commission a network has been installed to intensify the communication and increase the understanding between the operational community and the many and diverse disciplines involved in RD for improvement, extension and integration of operational decision support systems for nuclear emergency management, called DSSNET. This poster demonstrates how the network is organised, namely with different work groups, exercises and meetings. Each working group addresses one of seven work packages: - Preparation and conduct of exercises (WP1), - User interfaces, results and interaction with decision makers (WP2), - Exchange of data information relevant for decision-making (WP3), System functions, networks and processing of on-line data (WP4), European database (WP5), Coordination of the network (WP6), Hydrological modelling (WP7). Main focus is given to WP4, in which information of on-line monitoring from more than 10 European counties is collected. Information was collated with the help of questionnaires which are send out on a regular basis. The evaluation of the various questionnaires summarises the different systems in use for stack monitoring, retrieving on

  19. 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.

  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. Effect of decision aid for breast cancer prevention on decisional conflict in women with a BRCA1 or BRCA2 mutation: a multisite, randomized, controlled trial.

    Science.gov (United States)

    Metcalfe, Kelly A; Dennis, Cindy-Lee; Poll, Aletta; Armel, Susan; Demsky, Rochelle; Carlsson, Lindsay; Nanda, Sonia; Kiss, Alexander; Narod, Steven A

    2017-03-01

    Women with a BRCA1 or BRCA2 mutation are at high risk for breast cancer and must make important decisions about breast cancer prevention and screening. In the current study, we report a multisite, randomized, controlled trial evaluating the effectiveness of a decision aid for breast cancer prevention in women with a BRCA mutation with no previous diagnosis of cancer. Within 1 month of receiving a positive BRCA result, women were randomized to receive either usual care (control group) or decision aid (intervention group). Participants were followed at 3, 6, and 12 months; were asked about preventive measures; and completed standardized questionnaires assessing decision making and psychosocial functioning. One hundred fifty women were randomized. Mean cancer-related distress scores were significantly lower in the intervention group compared with the control group at 6 months (P = 0.01) and at 12 months postrandomization (P = 0.05). Decisional conflict scores declined over time for both groups and at no time were there statistical differences between the two groups. The decision aid for breast cancer prevention in women with a BRCA1 or BRCA2 mutation is effective in significantly decreasing cancer-related distress within the year following receipt of positive genetic test results.Genet Med 19 3, 330-336.

  2. 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.

  3. 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.

  4. 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.

  5. A complex systems approach to planning, optimization and decision making for energy networks

    International Nuclear Information System (INIS)

    Beck, Jessica; Kempener, Ruud; Cohen, Brett; Petrie, Jim

    2008-01-01

    This paper explores a new approach to planning and optimization of energy networks, using a mix of global optimization and agent-based modeling tools. This approach takes account of techno-economic, environmental and social criteria, and engages explicitly with inherent network complexity in terms of the autonomous decision-making capability of individual agents within the network, who may choose not to act as economic rationalists. This is an important consideration from the standpoint of meeting sustainable development goals. The approach attempts to set targets for energy planning, by determining preferred network development pathways through multi-objective optimization. The viability of such plans is then explored through agent-based models. The combined approach is demonstrated for a case study of regional electricity generation in South Africa, with biomass as feedstock

  6. Disclosure Pattern of Self-Labeled People Living with HIV/AIDS on Chinese Social Networking Site: An Exploratory Study.

    Science.gov (United States)

    Han, Jin; Tian, Xianyun; Yu, Guang; He, Fang

    2016-08-01

    HIV/AIDS is an important public health issue in China. The number of people living with HIV/AIDS (PLWHA) has been increasing since the introduction of highly active antiretroviral therapy. PLWHA's life quality is becoming an important issue, with lack of research in China. In this study, a group of PLWHA (n = 663) was identified using HIV/AIDS relevant usernames on a Chinese social networking site (Weibo) to study their daily living situations. We found that more than 99.10% of PLWHA were male, among whom 90.80% turned out to be homosexual. They had significantly more fans and followees, but fewer postings compared to the general population. The mean age of the PLWHA was 28.96 (SD = 5.05) years old, and southwest and northwest China had a high prevalence of HIV/AIDS. In addition, PLWHA's postings were coded and we found that more than half of the postings (n = 769, 51.03%) contained strong emotions. Less than one-fifth of the postings were directly related to HIV/AIDS topics (n = 269, 17.85%), while seeking emotional support, such as looking for stable partnership, was ranked as the first priority of support seeking. In summary, we found that the majority of the self-labeled PLWHA were likely to be men who have sex with men. They used Weibo to share their daily life events and seek emotional support. Implications for promoting HIV/AIDS education and prevention through Chinese social networking sites were also discussed.

  7. Barriers and Facilitators to Patient-Provider Communication When Discussing Breast Cancer Risk to Aid in the Development of Decision Support Tools.

    Science.gov (United States)

    Yi, Haeseung; Xiao, Tong; Thomas, Parijatham S; Aguirre, Alejandra N; Smalletz, Cindy; Dimond, Jill; Finkelstein, Joseph; Infante, Katherine; Trivedi, Meghna; David, Raven; Vargas, Jennifer; Crew, Katherine D; Kukafka, Rita

    2015-01-01

    The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%-94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention.

  8. The importance of decision-making aids in the energy area: from planning to the management of disorder and climate change

    International Nuclear Information System (INIS)

    Taverdet-Popiolek, N.

    2011-01-01

    The purpose of this article is to situate decision-making aids in the energy area in France and show how the tools have changed over time as a function of the changing economic and political context. The challenges faced, already important in the post-war era due to reconstruction, are now huge due to supply constraints and global warming. While it is the State's responsibility to address these issues, as the players in the energy area currently are mainly in the private sphere, we look at decisions taken both by the State and by companies. Schematically, we compare two major periods: that of post-war planning through the eighties, and that of risk management, which has been current practice since market deregulation. From the methodological standpoint, we show that decision-making aids borrow tools from varied disciplines ranging from economics through management to futurology and long range planning. (author)

  9. Boosted decision trees as an alternative to artificial neural networks for particle identification

    International Nuclear Information System (INIS)

    Roe, Byron P.; Yang Haijun; Zhu Ji; Liu Yong; Stancu, Ion; McGregor, Gordon

    2005-01-01

    The efficacy of particle identification is compared using artificial neutral networks and boosted decision trees. The comparison is performed in the context of the MiniBooNE, an experiment at Fermilab searching for neutrino oscillations. Based on studies of Monte Carlo samples of simulated data, particle identification with boosting algorithms has better performance than that with artificial neural networks for the MiniBooNE experiment. Although the tests in this paper were for one experiment, it is expected that boosting algorithms will find wide application in physics

  10. Detection of cyst using image segmentation and building knowledge-based intelligent decision support system as an aid to telemedicine

    Science.gov (United States)

    Janet, J.; Natesan, T. R.; Santhosh, Ramamurthy; Ibramsha, Mohideen

    2005-02-01

    An intelligent decision support tool to the Radiologist in telemedicine is described. Medical prescriptions are given based on the images of cyst that has been transmitted over computer networks to the remote medical center. The digital image, acquired by sonography, is converted into an intensity image. This image is then subjected to image preprocessing which involves correction methods to eliminate specific artifacts. The image is resized into a 256 x 256 matrix by using bilinear interpolation method. The background area is detected using distinct block operation. The area of the cyst is calculated by removing the background area from the original image. Boundary enhancement and morphological operations are done to remove unrelated pixels. This gives us the cyst volume. This segmented image of the cyst is sent to the remote medical center for analysis by Knowledge based artificial Intelligent Decision Support System (KIDSS). The type of cyst is detected and reported to the control mechanism of KIDSS. Then the inference engine compares this with the knowledge base and gives appropriate medical prescriptions or treatment recommendations by applying reasoning mechanisms at the remote medical center.

  11. Summary of the systems prioritization method as a decision-aiding method for the waste isolation pilot plant

    International Nuclear Information System (INIS)

    Boak, D.M.; Prindle, N.H.; Lincoln, R.

    1996-12-01

    In March 1994, the U.S. Department of Energy Carlsbad Area Office (DOE/CAO) implemented a performance-based decision-aiding method to assist in programmatic prioritization within the Waste Isolation Pilot Plant (WIPP) Project with respect to applicable U.S. Environmental Protection Agency (EPA) long-term performance requirements in 40 CFR 191.13(a) (radionuclide containment requirements) and 40 CFR 268.6 (hazardous constituent concentration requirements). This method, the Systems Prioritization Method (SPM), was designed by Sandia National Laboratories (SNL) to: (1) identify programmatic options (activities) and their costs and durations; (2) analyze combinations of activities (activity sets) in terms of their predicted contribution to long-term performance of the WIPP disposal system; and (3) analyze cost, duration, and performance tradeoffs. The results of the second iteration of SPM (SPM-2) were the basis for recommendations to DOE/CAO in May 1995 for programmatic prioritization within the WIPP project. This paper presents a summary of the SPM implementation, key results, and lessons learned

  12. Summary of the systems prioritization method as a decision-aiding method for the waste isolation pilot plant

    Energy Technology Data Exchange (ETDEWEB)

    Boak, D.M.; Prindle, N.H.; Lincoln, R. [and others

    1996-12-01

    In March 1994, the U.S. Department of Energy Carlsbad Area Office (DOE/CAO) implemented a performance-based decision-aiding method to assist in programmatic prioritization within the Waste Isolation Pilot Plant (WIPP) Project with respect to applicable U.S. Environmental Protection Agency (EPA) long-term performance requirements in 40 CFR 191.13(a) (radionuclide containment requirements) and 40 CFR 268.6 (hazardous constituent concentration requirements). This method, the Systems Prioritization Method (SPM), was designed by Sandia National Laboratories (SNL) to: (1) identify programmatic options (activities) and their costs and durations; (2) analyze combinations of activities (activity sets) in terms of their predicted contribution to long-term performance of the WIPP disposal system; and (3) analyze cost, duration, and performance tradeoffs. The results of the second iteration of SPM (SPM-2) were the basis for recommendations to DOE/CAO in May 1995 for programmatic prioritization within the WIPP project. This paper presents a summary of the SPM implementation, key results, and lessons learned.

  13. 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 (T c ) 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.

  14. DASS: A decision aid integrating the safety parameter display system and emergency functional recovery procedures. Final report

    International Nuclear Information System (INIS)

    Johnson, S.E.

    1984-08-01

    Using a stand-alone developmental test-bed consisting of a minicomputer and a high-resolution color graphics computer, displays and supporting software incorporating advanced on-line decision-aid concepts were developed and evaluated. The advanced concepts embodied in displays designed for the operating crew of a PWR plant include: (1) an integrated display format which supports a top-down approach to problem detection, recovery planning, and control; (2) introduction of nonobservable plant parameters derived from first principles mass and energy balances as part of the displayed information; and (3) systematic processing and display of key success path (plant safety system) attributes. The prototype system, referred to as the PWR-DASS (Disturbance Analysis and Surveillance System), consists of 18 displays targeted for principal use by the control room systems manager. PWR-DASS was conceived to fulfill an operational void not fully supported by safety parameter display systems or reformulated emergency procedure guidelines. The results from the evaluation by licensed operators suggest that organization and display of desired critical safety function and success path information as incorporated in the PWR-DASS prototype can support the systems manager's overview. The results also point to the need for several refinements required for a field grade system, and to the need for a simulator-based evaluation of the prototype or its successor. (author)

  15. 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.

  16. Condensed summary of the systems prioritization method as a decision-aiding approach for the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Boak, D.M.; Prindle, N.H.; Lincoln, R.

    1997-01-01

    In March 1994, the US Department of Energy Carlsbad Area Office (DOE/CAO) implemented a performance based decision-aiding method to assist in programmatic prioritization within the Waste Isolation Pilot Plant (WIPP) project. The prioritization was with respect to 40 CFR Part 191.13(a) and 40 CFR part 268.6. U.S. Environmental Protection Agency (EPA) requirements for long-term isolation of radioactive and hazardous wastes. The Systems Prioritization Method (SPM), was designed by Sandia National Laboratories to: (1) identify programmatic options (activities), their costs and durations; (2) analyze combinations of activities in terms of their predicted contribution to long-term performance of the WIPP disposal system; and (3) analyze cost, duration, and performance tradeoffs. SPM results were the basis for activities recommended to DOE/CAO in May 1995. SPM identified eight activities (less than 15% of the 58 proposed for consideration) predicted to be essential in addressing key regulatory issues. The SPM method proved useful for risk or performance-based prioritization in which options are interdependent and system behavior is nonlinear. 10 refs., 2 figs., 1 tab

  17. Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

    Science.gov (United States)

    Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F

    2015-03-01

    Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology-related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. A cross-sectional approach was used to obtain online and paper-based concept ratings. Participants were 43 adults (age range, 45-85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated "the importance of each of the statements in a person's decision to purchase a hearing aid" on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ra