The purposes of this review are to examine the types of clinical decision support systems in use and to identify patterns of how critical care advanced practice nurses (APNs) have integrated these systems into their nursing care patient management practices. The decision-making process itself is analyzed with a focus on how automated systems attempt to capture and reflect human decisional processes in critical care nursing, including how systems actually organize and process information to create outcome estimations based on patient clinical indicators and prognosis logarithms. Characteristics of APN clinicians and implications of these characteristics on decision system use, based on the body of decision system user research, are introduced. A review of the Medline, Ovid, CINAHL, and PubMed literature databases was conducted using "clinical decision support systems,"computerized clinical decision making," and "APNs"; an examination of components of several major clinical decision systems was also undertaken. Use patterns among APNs and other clinicians appear to vary; there is a need for original research to examine how APNs actually use these systems in their practices in critical care settings. Because APNs are increasingly responsible for admission to, and transfer from, critical care settings, more understanding is needed on how they interact with this technology and how they see automated decision systems impacting their practices. APNs who practice in critical care settings vary significantly in how they use the clinical decision systems that are in operation in their practice settings. These APNs must have an understanding of their use patterns with these systems and should critically assess whether their patient care decision making is affected by the technology.
Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.
A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes and cognitive analysis of the decision making problems faced by Navy tactical officers in a shipboard Combat Information Center. Baseline testing in high intensity, peace keeping, littoral scenarios indicated...
Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.
To appear in J. A. Cannon-Bowers & E. Salas (Eds.), Decision Making Under Stress: Implications for Training and Simulation. A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes, and cognitive analysis was conducted of the decision making problems faced by Navy ...
Giacomini, Mita; Cook, Deborah; DeJean, Deirdre
The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and
Hartmann, Timo; Javernick-Will, A.; Chinowsky, P.
In previous work, we showed that the critical engagement with a decision sup- port system during its implementation by a project team is an important an- tecedent for the successful later use of the technology. However, the mechanisms that trigger such critical engagement are so far not well
Samsa, M.; Van Kuiken, J.; Jusko, M.; Decision and Information Sciences
The Critical Infrastructure Protection Decision Support System Decision Model (CIPDSS-DM) is a useful tool for comparing the effectiveness of alternative risk-mitigation strategies on the basis of CIPDSS consequence scenarios. The model is designed to assist analysts and policy makers in evaluating and selecting the most effective risk-mitigation strategies, as affected by the importance assigned to various impact measures and the likelihood of an incident. A typical CIPDSS-DM decision map plots the relative preference of alternative risk-mitigation options versus the annual probability of an undesired incident occurring once during the protective life of the investment, assumed to be 20 years. The model also enables other types of comparisons, including a decision map that isolates a selected impact variable and displays the relative preference for the options of interest--parameterized on the basis of the contribution of the isolated variable to total impact, as well as the likelihood of the incident. Satisfaction/regret analysis further assists the analyst or policy maker in evaluating the confidence with which one option can be selected over another.
Pasqualini, D.; Witkowski, M.
The Critical Infrastructure Protection / Decision Support System (CIP/DSS) project, supported by the Science and Technology Office, has been developing a risk-informed Decision Support System that provides insights for making critical infrastructure protection decisions. The system considers seventeen different Department of Homeland Security defined Critical Infrastructures (potable water system, telecommunications, public health, economics, etc.) and their primary interdependencies. These infrastructures have been modeling in one model called CIP/DSS Metropolitan Model. The modeling approach used is a system dynamics modeling approach. System dynamics modeling combines control theory and the nonlinear dynamics theory, which is defined by a set of coupled differential equations, which seeks to explain how the structure of a given system determines its behavior. In this poster we present a system dynamics model for one of the seventeen critical infrastructures, a generic metropolitan potable water system (MPWS). Three are the goals: 1) to gain a better understanding of the MPWS infrastructure; 2) to identify improvements that would help protect MPWS; and 3) to understand the consequences, interdependencies, and impacts, when perturbations occur to the system. The model represents raw water sources, the metropolitan water treatment process, storage of treated water, damage and repair to the MPWS, distribution of water, and end user demand, but does not explicitly represent the detailed network topology of an actual MPWS. The MPWS model is dependent upon inputs from the metropolitan population, energy, telecommunication, public health, and transportation models as well as the national water and transportation models. We present modeling results and sensitivity analysis indicating critical choke points, negative and positive feedback loops in the system. A general scenario is also analyzed where the potable water system responds to a generic disruption.
Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard
The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.
In the present paper we discuss how to assist critical decisions taken under complex, contingent circumstances, with a high degree of uncertainty and short time frames. In such sharp-end decision regimes, standard rule-based decision support systems do not capture the complexity of the situation. At the same time, traditional risk analysis is of little use due to variability in the specific circumstances. How then, can an organisation provide assistance to, e.g. pilots in dealing with such emergencies? A method called 'contingent risk and decision analysis' is presented, to provide decision support for decisions under variable circumstances and short available time scales. The method consists of nine steps of definition, modelling, analysis and criteria definition to be performed 'off-line' by analysts, and procedure generation to transform the analysis result into an operational decision aid. Examples of pilots' decisions in response to sudden vibration in offshore helicopter transport method are used to illustrate the approach
Naderpour, Mohsen; Lu, Jie; Zhang, Guangquan
To ensure the safety of operations in safety-critical systems, it is necessary to maintain operators' situation awareness (SA) at a high level. A situation awareness support system (SASS) has therefore been developed to handle uncertain situations . This paper aims to systematically evaluate the enhancement of SA in SASS by applying a multi-perspective approach. The approach consists of two SA metrics, SAGAT and SART, and one workload metric, NASA-TLX. The first two metrics are used for the direct objective and subjective measurement of SA, while the third is used to estimate operator workload. The approach is applied in a safety-critical environment called residue treater, located at a chemical plant in which a poor human-system interface reduced the operator's SA and caused one of the worst accidents in US history. A counterbalanced within-subjects experiment is performed using a virtual environment interface with and without the support of SASS. The results indicate that SASS improves operators' SA, and specifically has benefits for SA levels 2 and 3. In addition, it is concluded that SASS reduces operator workload, although further investigations in different environments with a larger number of participants have been suggested. - Highlights: • The suitability of a cognitive decision support system is investigated. • An evaluation approach considering situation awareness and workload measures is proposed. • A computerized system based on the proposed approach is implemented. • The implemented system is used in a safety-critical environment.
Belard, Arnaud; Buchman, Timothy; Forsberg, Jonathan; Potter, Benjamin K; Dente, Christopher J; Kirk, Allan; Elster, Eric
Improving diagnosis and treatment depends on clinical monitoring and computing. Clinical decision support systems (CDSS) have been in existence for over 50 years. While the literature points to positive impacts on quality and patient safety, outcomes, and the avoidance of medical errors, technical and regulatory challenges continue to retard their rate of integration into clinical care processes and thus delay the refinement of diagnoses towards personalized care. We conducted a systematic review of pertinent articles in the MEDLINE, US Department of Health and Human Services, Agency for Health Research and Quality, and US Food and Drug Administration databases, using a Boolean approach to combine terms germane to the discussion (clinical decision support, tools, systems, critical care, trauma, outcome, cost savings, NSQIP, APACHE, SOFA, ICU, and diagnostics). References were selected on the basis of both temporal and thematic relevance, and subsequently aggregated around four distinct themes: the uses of CDSS in the critical and surgical care settings, clinical insertion challenges, utilization leading to cost-savings, and regulatory concerns. Precision diagnosis is the accurate and timely explanation of each patient's health problem and further requires communication of that explanation to patients and surrogate decision-makers. Both accuracy and timeliness are essential to critical care, yet computed decision support systems (CDSS) are scarce. The limitation arises from the technical complexity associated with integrating and filtering large data sets from diverse sources. Provider mistrust and resistance coupled with the absence of clear guidance from regulatory bodies further retard acceptance of CDSS. While challenges to develop and deploy CDSS are substantial, the clinical, quality, and economic impacts warrant the effort, especially in disciplines requiring complex decision-making, such as critical and surgical care. Improving diagnosis in health care
Schraagen, Johannes Martinus Cornelis; van de Ven, Josine G.M.
In this study, we describe how to use innovative techniques to improve the decision-making process in crisis response organizations. The focus was on building situation awareness of a crisis and overcoming pitfalls such as tunnel vision and information bias through using critical thinking. We
Goulart Coelho, Lineker M; Lange, Liséte C; Coelho, Hosmanny Mg
Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.
Aragon, Cecilia R.
In order to safely operate their aircraft, pilots must makerapid decisions based on integrating and processing large amounts ofheterogeneous information. Visual displays are often the most efficientmethod of presenting safety-critical data to pilots in real time.However, care must be taken to ensure the pilot is provided with theappropriate amount of information to make effective decisions and notbecome cognitively overloaded. The results of two usability studies of aprototype airflow hazard visualization cockpit decision support systemare summarized. The studies demonstrate that such a system significantlyimproves the performance of helicopter pilots landing under turbulentconditions. Based on these results, design principles and implicationsfor cockpit decision support systems using visualization arepresented.
Aragon, Cecilia R.
In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.
Khairat, Saif; Marc, David; Crosby, William; Al Sanousi, Ali
Clinical decision support systems (CDSSs) are an integral component of today's health information technologies. They assist with interpretation, diagnosis, and treatment. A CDSS can be embedded throughout the patient safety continuum providing reminders, recommendations, and alerts to health care providers. Although CDSSs have been shown to reduce medical errors and improve patient outcomes, they have fallen short of their full potential. User acceptance has been identified as one of the potential reasons for this shortfall. The purpose of this paper was to conduct a critical review and task analysis of CDSS research and to develop a new framework for CDSS design in order to achieve user acceptance. A critical review of CDSS papers was conducted with a focus on user acceptance. To gain a greater understanding of the problems associated with CDSS acceptance, we conducted a task analysis to identify and describe the goals, user input, system output, knowledge requirements, and constraints from two different perspectives: the machine (ie, the CDSS engine) and the user (ie, the physician). Favorability of CDSSs was based on user acceptance of clinical guidelines, reminders, alerts, and diagnostic suggestions. We propose two models: (1) the user acceptance and system adaptation design model, which includes optimizing CDSS design based on user needs/expectations, and (2) the input-process-output-engagemodel, which reveals to users the processes that govern CDSS outputs. This research demonstrates that the incorporation of the proposed models will improve user acceptance to support the beneficial effects of CDSSs adoption. Ultimately, if a user does not accept technology, this not only poses a threat to the use of the technology but can also pose a threat to the health and well-being of patients. ©Saif Khairat, David Marc, William Crosby, Ali Al Sanousi. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 18.04.2018.
Hu, Yufeng; Dargush, Gary F.; Shao, Xiaoyun
In this paper, aconceptual evolutionary framework for aseismic decision support for hospitalsthat attempts to integrate a range of engineering and sociotechnical models is presented. Genetic algorithms are applied to find the optimal decision sets. A case study is completed to demonstrate how the frameworkmay applytoa specific hospital.The simulations show that the proposed evolutionary decision support framework is able to discover robust policy sets in either uncertain or fixed environments. The framework also qualitatively identifies some of the characteristicbehavior of the critical care organization. Thus, by utilizing the proposedframework, the decision makers are able to make more informed decisions, especially toenhance the seismic safety of the hospitals.
Gøtze, John; Hijikata, Masao
Introducing the notion of Group Decision Process Support Systems (GDPSS) to traditional decision-support theorists.......Introducing the notion of Group Decision Process Support Systems (GDPSS) to traditional decision-support theorists....
Booth, Steven Richard [Los Alamos National Laboratory
AET-2 has expertise in process modeling, economics, business case analysis, risk assessment, Lean/Six Sigma tools, and decision analysis to provide timely decision support to LANS leading to continuous improvement. This capability is critical during the current tight budgetary environment as LANS pushes to identify potential areas of cost savings and efficiencies. An important arena is business systems and operations, where processes can impact most or all laboratory employees. Lab-wide efforts are needed to identify and eliminate inefficiencies to accomplish Director McMillan’s charge of “doing more with less.” LANS faces many critical and potentially expensive choices that require sound decision support to ensure success. AET-2 is available to provide this analysis support to expedite the decisions at hand.
Sittig, Dean F.; Wright, Adam; Osheroff, Jerome A.; Middleton, Blackford; Teich, Jonathan M.; Ash, Joan S.; Campbell, Emily; Bates, David W.
There is a pressing need for high-quality, effective means of designing, developing, presenting, implementing, evaluating, and maintaining all types of clinical decision support capabilities for clinicians, patients and consumers. Using an iterative, consensus-building process we identified a rank-ordered list of the top 10 grand challenges in clinical decision support. This list was created to educate and inspire researchers, developers, funders, and policy-makers. The list of challenges in order of importance that they be solved if patients and organizations are to begin realizing the fullest benefits possible of these systems consists of: Improve the human-computer interface; Disseminate best practices in CDS design, development, and implementation; Summarize patient-level information; Prioritize and filter recommendations to the user; Create an architecture for sharing executable CDS modules and services; Combine recommendations for patients with co-morbidities; Prioritize CDS content development and implementation; Create internet-accessible clinical decision support repositories; Use freetext information to drive clinical decision support; Mine large clinical databases to create new CDS. Identification of solutions to these challenges is critical if clinical decision support is to achieve its potential and improve the quality, safety and efficiency of healthcare. PMID:18029232
Schwartz, Mark W.; Cook, Carly N.; Pressey, Robert L.; Pullin, Andrew S.; Runge, Michael C.; Salafsky, Nick; Sutherland, William J.; Williamson, Matthew A.
The practice of conservation occurs within complex socioecological systems fraught with challenges that require transparent, defensible, and often socially engaged project planning and management. Planning and decision support frameworks are designed to help conservation practitioners increase planning rigor, project accountability, stakeholder participation, transparency in decisions, and learning. We describe and contrast five common frameworks within the context of six fundamental questions (why, who, what, where, when, how) at each of three planning stages of adaptive management (project scoping, operational planning, learning). We demonstrate that decision support frameworks provide varied and extensive tools for conservation planning and management. However, using any framework in isolation risks diminishing potential benefits since no one framework covers the full spectrum of potential conservation planning and decision challenges. We describe two case studies that have effectively deployed tools from across conservation frameworks to improve conservation actions and outcomes. Attention to the critical questions for conservation project planning should allow practitioners to operate within any framework and adapt tools to suit their specific management context. We call on conservation researchers and practitioners to regularly use decision support tools as standard practice for framing both practice and research.
While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the
Fortnum, Debbie; Smolonogov, Tatiana; Walker, Rachael; Kairaitis, Luke; Pugh, Debbie
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.
Harwood, Lori; Clark, Alexander M
Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease This paper examines home-dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self-management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home-dialysis has clear health, societal and economic benefits yet service usage is low despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home-dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re-conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology. © 2011 Blackwell Publishing Ltd.
Full Text Available In raw milk production decision support systems for control of food safety hazards has not been developed but main points of this system are available. The decision support systems’ elements include data identification at critical points in the milk supply chain, an information management system and data exchange. Decision supports systems has been developed on the basis of these elements. In dairy sector decision support systems are significant for controlling of food safety hazards and preferred by producers. When these systems are implemented in the milk supply chain, it can be prevented unnecessary sampling and analysis. In this article it will be underlined effects of decision support system elements on food safety of raw milk.
a crude and simple estimation of the actual sea state (Hs and Tz), information about the longitudinal hull girder loading, seakeeping performance of the ship, and decision support on how to operate the ship within acceptable limits. The system is able to identify critical forthcoming events and to give...... advice regarding speed and course changes to decrease the wave-induced loads. The SeaSense system is based on the combined use of a mathematical model and measurements from a set of sensors. The overall dependability of a shipboard monitoring and decision support system such as the SeaSense system can...
Sharman, Mahesh; Meert, Kathleen L; Sarnaik, Ashok P
Decisions to forgo life support from critically ill children are commonly faced by parents and physicians. Previous research regarding parents' perspectives on the decision-making process has been limited by retrospective methods and the use of closed-ended questionnaires. We prospectively identified and described parents' self-reported influences on decisions to forgo life support from their children. Deeper understanding of parents' views will allow physicians to focus end-of-life discussions on factors important to parents and help resolve conflicts. Prospective, qualitative pilot study. Pediatric intensive care unit of a university-affiliated children's hospital. A total of 14 parents of ten children whose pediatric intensive care unit physician had made a recommendation to limit or withdraw life support. : In-depth, semistructured interviews were conducted with parents during their decision-making process. Factors influencing the parents in this study in their decision to forgo life support included their previous experience with death and end-of-life decision making for others, their personal observations of their child's suffering, their perceptions of their child's will to survive, their need to protect and advocate for their child, and the family's financial resources and concerns regarding life-long care. Parents in this study expressed the desire to do what is best for their child but struggled with feelings of selfishness, guilt, and the need to avoid agony and sorrow. Physician recommendations, review of options, and joint formulation of a plan helped parents gain a sense of control over their situation. Parents of eight children agreed to forgo life support and parents of two did not. Prospective interviews with open-ended questions identified factors influencing parents' decision making not previously described in the critical care literature such as parents' past experiences with end-of-life decisions and their anticipated emotional adjustments and
Yang, L; Frize, M; Eng, P; Walker, R; Catley, C
Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.
Knox, Lucy; Douglas, Jacinta M; Bigby, Christine
To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.
Pulkkinen, U.; Simola, K.
The report describes the expert panel methodology developed for supporting risk-informed decision making. The aim of an expert panel is to achieve a balanced utilisation of information and expertise from several disciplines in decision-making including probabilistic safety assessment as one decision criterion. We also summarise the application of the methodology in the STUK's RI-ISI (Risk-Informed In-Service Inspection) pilot study, where the expert panel approach was used to combine the deterministic information on degradation mechanisms and probabilistic information on pipe break consequences. The expert panel served both as a critical review of the preliminary results and as a decision support for the final definition of risk categories of piping. (orig.)
Full Text Available Abstract The World Health Organization (WHO recommends that the cost-effectiveness (CE of introducing new vaccines be considered before such a programme is implemented. However, in low- and middle-income countries (LMICs, it is often challenging to perform and interpret the results of model-based economic appraisals of vaccines that benefit from locally relevant data. As a result, WHO embarked on a series of consultations to assess economic analytical tools to support vaccine introduction decisions for pneumococcal, rotavirus and human papillomavirus vaccines. The objectives of these assessments are to provide decision makers with a menu of existing CE tools for vaccines and their characteristics rather than to endorse the use of a single tool. The outcome will provide policy makers in LMICs with information about the feasibility of applying these models to inform their own decision making. We argue that if models and CE analyses are used to inform decisions, they ought to be critically appraised beforehand, including a transparent evaluation of their structure, assumptions and data sources (in isolation or in comparison to similar tools, so that decision makers can use them while being fully aware of their robustness and limitations.
Tseng, Chiu-Che; Gmytrasiewicz, Piotr J.
The challenge of the investment domain is that a large amount of diverse information can be potentially relevant to an investment decision, and that, frequently, the decisions have to be made in a timely manner. This presents the potential for better decision support, but poses the challenge of building a decision support agent that gathers information from different sources and incorporates it for timely decision support. These problems motivate us to investigate ways in which the investors can be equipped with a flexible real-time decision support system to be practical in time-critical situations. The flexible real-time decision support system considers a tradeoff between decision quality and computation cost. For this purpose, we propose a system that uses the object oriented Bayesian knowledge base (OOBKB) design to create a decision model at the most suitable level of detail to guide the information gathering activities, and to produce an investment recommendation within a reasonable length of time. The decision models our system uses are implemented as influence diagrams. We validate our system with experiments in a simplified investment domain. The experiments show that our system produces a quality recommendation under different urgency situations. The contribution of our system is that it provides the flexible decision recommendation for an investor under time constraints in a complex environment.
Ludin, Salizar Mohamed
A critical thinker may not necessarily be a good decision-maker, but critical care nurses are expected to utilise outstanding critical thinking skills in making complex clinical judgements. Studies have shown that critical care nurses' decisions focus mainly on doing rather than reflecting. To date, the link between critical care nurses' critical thinking and decision-making has not been examined closely in Malaysia. To understand whether critical care nurses' critical thinking disposition affects their clinical decision-making skills. This was a cross-sectional study in which Malay and English translations of the Short Form-Critical Thinking Disposition Inventory-Chinese Version (SF-CTDI-CV) and the Clinical Decision-making Nursing Scale (CDMNS) were used to collect data from 113 nurses working in seven critical care units of a tertiary hospital on the east coast of Malaysia. Participants were recruited through purposive sampling in October 2015. Critical care nurses perceived both their critical thinking disposition and decision-making skills to be high, with a total score of 71.5 and a mean of 48.55 for the SF-CTDI-CV, and a total score of 161 and a mean of 119.77 for the CDMNS. One-way ANOVA test results showed that while age, gender, ethnicity, education level and working experience factors significantly impacted critical thinking (pnurses' critical thinking and clinical decision-making (r=0.637, p=0.001). While this small-scale study has shown a relationship exists between critical care nurses' critical thinking disposition and clinical decision-making in one hospital, further investigation using the same measurement tools is needed into this relationship in diverse clinical contexts and with greater numbers of participants. Critical care nurses' perceived high level of critical thinking and decision-making also needs further investigation. Copyright © 2017 Elsevier Ltd. All rights reserved.
Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian
The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.
Zupan, B; Porenta, A; Vidmar, G; Aoki, N; Bratko, I; Beck, J R
One of the applications of clinical information systems is decision support. Although the advantages of utilizing such aids have never been theoretically disputed, they have been rarely used in practice. The factor that probably often limits the utility of clinical decision support systems is the need for computing power at the very site of decision making--at the place where the patient is interviewed, in discussion rooms, etc. The paper reports on a possible solution to this problem. A decision-support shell LogReg is presented, which runs on a handheld computer. A general schema for handheld-based decision support is also proposed, where decision models are developed on personal computers/workstations, encoded in XML and then transferred to handhelds, where the models are used within a decision support shell. A use case where LogReg has been applied to clinical outcome prediction in crush injury is presented.
Lee, Daphne Sk; Abdullah, Khatijah Lim; Subramanian, Pathmawathi; Bachmann, Robert Thomas; Ong, Swee Leong
. There is also a need for qualitative studies to provide a fresh approach in exploring the relationship between these variables uncovering currently unknown contributing factors. This review confirmed that evidence to support the existence of relationships between critical thinking and clinical decision-making is still unsubstantiated. Therefore, it serves as a call for nurse leaders and nursing academics to produce quality studies in order to firmly support or reject the hypothesis that there is a statistically significant correlation between critical thinking and clinical decision-making. © 2017 John Wiley & Sons Ltd.
Jørgensen, L.N.; Noe, E.; Langvad, A.M.
system Crop Protection Online is widely used by advisors and as a learning tool for students. Although the system has been validated in many field trials over the years and has shown reliable results, the number of end-users among farmers has been relatively low during the last 10 years (approximately...... 1000 farmers). A sociological investigation of farmers' decision-making styles in the area of crop protection has shown that arable farmers can be divided into three major groups: (a) system-orientated farmers, (b) experience-based farmers and (c) advisory-orientated farmers. The information required...... by these three groups to make their decisions varies and therefore different ways of using decision support systems need to be provided. Decision support systems need to be developed in close dialogue and collaboration with user groups....
Despite significant advances in computing power and artificial intelligence (AI), few critical decisions are made without a human decision maker in the loop. Space Situational Awareness (SSA) missions are both critical and complex, typically adhering to the human-in-the-loop (HITL) model. The collection of human operators injects a needed diversity of expert knowledge, experience, and authority required to successfully fulfill SSA tasking. A wealth of literature on human decision making exists citing myriad empirical studies and offering a varied set of prescriptive and descriptive models of judgment and decision making (Hastie & Dawes, 2001; Baron, 2000). Many findings have been proven sufficiently robust to allow information architects or system/interface designers to take action to improve decision processes. For the purpose of discussion, these concepts are bifurcated in two groups: 1) vulnerabilities to mitigate, and 2) capabilities to augment. These vulnerabilities and capabilities refer specifically to the decision process and should not be confused with a shortcoming or skill of a specific human operator. Thus the framing of questions and orders, the automated tools with which to collaborate, priming and contextual data, and the delivery of information all play a critical role in human judgment and choice. Evaluating the merits of any decision can be elusive; in order to constrain this discussion, ‘rational choice' will tend toward the economic model characteristics such as maximizing utility and selection consistency (e.g., if A preferred to B, and B preferred to C, than A should be preferred to C). Simple decision models often encourage one to list the pros and cons of a decision, perhaps use a weighting schema, but one way or another weigh the future benefit (or harm) of making a selection. The result (sought by the rationalist models) should drive toward higher utility. Despite notable differences in researchers' theses (to be discussed in the full
Karmperis, Athanasios C.; Aravossis, Konstantinos; Tatsiopoulos, Ilias P.; Sotirchos, Anastasios
Highlights: ► The mainly used decision support frameworks for solid waste management are reviewed. ► The LCA, CBA and MCDM models are presented and their strengths, weaknesses, similarities and possible combinations are analyzed. ► The game-theoretic approach in a solid waste management context is presented. ► The waste management bargaining game is introduced as a specific decision support framework. ► Cooperative and non-cooperative game-theoretic approaches to decision support for solid waste management are discussed. - Abstract: This paper surveys decision support models that are commonly used in the solid waste management area. Most models are mainly developed within three decision support frameworks, which are the life-cycle assessment, the cost–benefit analysis and the multi-criteria decision-making. These frameworks are reviewed and their strengths and weaknesses as well as their critical issues are analyzed, while their possible combinations and extensions are also discussed. Furthermore, the paper presents how cooperative and non-cooperative game-theoretic approaches can be used for the purpose of modeling and analyzing decision-making in situations with multiple stakeholders. Specifically, since a waste management model is sustainable when considering not only environmental and economic but also social aspects, the waste management bargaining game is introduced as a specific decision support framework in which future models can be developed
Karmperis, Athanasios C., E-mail: firstname.lastname@example.org [Sector of Industrial Management and Operational Research, School of Mechanical Engineering, National Technical University of Athens, Iroon Polytechniou 9, 15780 Athens (Greece); Army Corps of Engineers, Hellenic Army General Staff, Ministry of Defence (Greece); Aravossis, Konstantinos; Tatsiopoulos, Ilias P.; Sotirchos, Anastasios [Sector of Industrial Management and Operational Research, School of Mechanical Engineering, National Technical University of Athens, Iroon Polytechniou 9, 15780 Athens (Greece)
Highlights: ► The mainly used decision support frameworks for solid waste management are reviewed. ► The LCA, CBA and MCDM models are presented and their strengths, weaknesses, similarities and possible combinations are analyzed. ► The game-theoretic approach in a solid waste management context is presented. ► The waste management bargaining game is introduced as a specific decision support framework. ► Cooperative and non-cooperative game-theoretic approaches to decision support for solid waste management are discussed. - Abstract: This paper surveys decision support models that are commonly used in the solid waste management area. Most models are mainly developed within three decision support frameworks, which are the life-cycle assessment, the cost–benefit analysis and the multi-criteria decision-making. These frameworks are reviewed and their strengths and weaknesses as well as their critical issues are analyzed, while their possible combinations and extensions are also discussed. Furthermore, the paper presents how cooperative and non-cooperative game-theoretic approaches can be used for the purpose of modeling and analyzing decision-making in situations with multiple stakeholders. Specifically, since a waste management model is sustainable when considering not only environmental and economic but also social aspects, the waste management bargaining game is introduced as a specific decision support framework in which future models can be developed.
Power, Daniel J
Competition is becoming more intense and decision makers are encountering increasing complexity, rapid change, and higher levels of risk. In many situations, the solution is more and better computerized decision support, especially analytics and business intelligence. Today managers need to learn about and understand computerized decision support. If a business is to succeed, managers must know much more about information technology solutions. This second edition of a powerful introductory book is targeted at busy managers and MBA students who need to grasp the basics of computerized decision support, including the following: What are analytics? What is a decision support system? How can managers identify opportunities to create innovative computerized support? Inside, the author addresses these questions and some 60 more fundamental questions that are key to understanding the rapidly changing realm of computerized decision support. In a short period of time, you'll "get up to speed" on decision support, anal...
Lee, Seung Jun; Seong, Poong Hyun
Human error is recognized as one of the main causes of nuclear power plant (NPP) accidents, and there have been efforts to reduce and prevent human errors by developing various operator support systems. Before adapting these support systems to actual NPPs, it is necessary to validate their reliability and to evaluate their effect on operator performance. Particularly for safety-critical systems such as NPPs, the validation and evaluation of support systems is as important as the design of good systems. Such evaluations may be carried out through a theoretical modelling or experimentation. The objective of this study is to investigate the effects of decision support systems on operator performance by both theoretical and experimental methods. The target system is an integrated decision support system including four decision support sub-systems. In the results of both the theoretical and experimental evaluations, the decision support systems revealed positive effects, and several trends were observed. (authors)
Lee, Seung Jun [Korea Atomic Energy Research Institute, 1045 Daedeok-daero, Yuseong-gu, Daejeon, 305-353 (Korea, Republic of); Seong, Poong Hyun [Korea Advanced Institute of Science and Technology, Guseong-dong, Yuseong-gu, Daejeon, 305-703 (Korea, Republic of)
Human error is recognized as one of the main causes of nuclear power plant (NPP) accidents, and there have been efforts to reduce and prevent human errors by developing various operator support systems. Before adapting these support systems to actual NPPs, it is necessary to validate their reliability and to evaluate their effect on operator performance. Particularly for safety-critical systems such as NPPs, the validation and evaluation of support systems is as important as the design of good systems. Such evaluations may be carried out through a theoretical modelling or experimentation. The objective of this study is to investigate the effects of decision support systems on operator performance by both theoretical and experimental methods. The target system is an integrated decision support system including four decision support sub-systems. In the results of both the theoretical and experimental evaluations, the decision support systems revealed positive effects, and several trends were observed. (authors)
This paper reviews the issues on the support and criticism of historical cost accounting (HCA) and the incremental information content on current cost disclosures. Based on literature review this study find that historical cost is still relevant to use in decision making. Empirical studies show evidence both; supporting historical cost accounting and criticisms against the conventional historical cost based financial statements. Issues on historical cost are raised because of economic condit...
Schmickl, Christopher N; Shahjehan, Khurram; Li, Guangxi; Dhokarh, Rajanigandha; Kashyap, Rahul; Janish, Christopher; Alsara, Anas; Jaffe, Allan S; Hubmayr, Rolf D; Gajic, Ognjen
At the onset of acute hypoxic respiratory failure, critically ill patients with acute lung injury (ALI) may be difficult to distinguish from those with cardiogenic pulmonary edema (CPE). No single clinical parameter provides satisfying prediction. We hypothesized that a combination of those will facilitate early differential diagnosis. In a population-based retrospective development cohort, validated electronic surveillance identified critically ill adult patients with acute pulmonary edema. Recursive partitioning and logistic regression were used to develop a decision support tool based on routine clinical information to differentiate ALI from CPE. Performance of the score was validated in an independent cohort of referral patients. Blinded post hoc expert review served as gold standard. Of 332 patients in a development cohort, expert reviewers (κ, 0.86) classified 156 as having ALI and 176 as having CPE. The validation cohort had 161 patients (ALI = 113, CPE = 48). The score was based on risk factors for ALI and CPE, age, alcohol abuse, chemotherapy, and peripheral oxygen saturation/Fio(2) ratio. It demonstrated good discrimination (area under curve [AUC] = 0.81; 95% CI, 0.77-0.86) and calibration (Hosmer-Lemeshow [HL] P = .16). Similar performance was obtained in the validation cohort (AUC = 0.80; 95% CI, 0.72-0.88; HL P = .13). A simple decision support tool accurately classifies acute pulmonary edema, reserving advanced testing for a subset of patients in whom satisfying prediction cannot be made. This novel tool may facilitate early inclusion of patients with ALI and CPE into research studies as well as improve and rationalize clinical management and resource use.
Cara Okleshen Peters, Ph.D.
Full Text Available This paper highlights the potential of customer decision support systems (CDSS to assist students in education-related decision making. Faculty can use these resources to more effectively advise students on various elements of college life, while students can employ them to more actively participate in their own learning and improve their academic experience. This conceptual paper summarizes consumer decision support systems (CDSS concepts and presents exemplar websites students could utilize to support their education-related decision making. Finally, the authors discuss the potential benefits and drawbacks such resources engender from a student perspective and conclude with directions for future research.
Read, Martin; Gear, Tony; Minkes, Leonard; Irving, Ann
This paper is concerned with how decision making groups involved in making investment prioritisation decisions involving funding of technology and science projects may be supported by a group decision support system (GDSS). While interested in decision outcomes, the primary focus of this paper is the role of a group support system as an aid to developing shared understanding within a group. The paper develops the conceptual framework of decision-making, communication and group support, and de...
This paper reviews the issues on the support and criticism of historical cost accounting (HCA) and the incremental information content on current cost disclosures. Based on literature review this study find that historical cost is still relevant to use in decision making. Empirical studies show evidence both; supporting historical cost accounting and criticisms against the conventional historical cost based financial statements. Issues on historical cost are raised because of economic condit...
Day, W; Audsley, E; Frost, A R
Engineering research and development contributes to the advance of sustainable agriculture both through innovative methods to manage and control processes, and through quantitative understanding of the operation of practical agricultural systems using decision models. This paper describes how an engineering approach, drawing on mathematical models of systems and processes, contributes new methods that support decision making at all levels from strategy and planning to tactics and real-time control. The ability to describe the system or process by a simple and robust mathematical model is critical, and the outputs range from guidance to policy makers on strategic decisions relating to land use, through intelligent decision support to farmers and on to real-time engineering control of specific processes. Precision in decision making leads to decreased use of inputs, less environmental emissions and enhanced profitability-all essential to sustainable systems.
Liming, James K.; Johnson, David H.; Kee, Ernest J.; Sun, Alice Y.; Young, Garry G.
The objective of this paper is to provide electric utilities with a concept for developing and applying effective decision support metrics via integrated risk-informed asset management (RIAM) programs for power stations and generating companies. RIAM is a process by which analysts review historical performance and develop predictive logic models and data analyses to predict critical decision support figures-of-merit (or metrics) for generating station managers and electric utility company executives. These metrics include, but are not limited to, the following; profitability, net benefit, benefit-to-cost ratio, projected return on investment, projected revenue, projected costs, asset value, safety (catastrophic facility damage frequency and consequences, etc.), power production availability (capacity factor, etc.), efficiency (heat rate), and others. RIAM applies probabilistic safety assessment (PSA) techniques and generates predictions probabilistically so that metrics information can be supplied to managers in terms of probability distributions as well as point estimates. This enables the managers to apply the concept of 'confidence levels' in their critical decision-making processes. (author)
Liming, J.K.; Salter, J.E.
The objective of this paper is to provide electric utilities with a concept for developing and applying effective decision support metrics via integrated risk-informed asset management (RIAM) programs for power stations and generating companies. RIAM is a process by which analysts review historical performance and develop predictive logic models and data analyses to predict critical decision support figures-of-merit (or metrics) for generating station managers and electric utility company executives. These metrics include, but are not limited to, the following: profitability, net benefit, benefit-to-cost ratio, projected return on investment, projected revenue, projected costs, asset value, safety (catastrophic facility damage frequency and consequences, etc.), power production availability (capacity factor, etc.), efficiency (heat rate), and others. RIAM applies probabilistic safety assessment (PSA) techniques and generates predictions in a probabilistic way so that metrics information can be supplied to managers in terms of probability distributions as well as point estimates. This enables the managers to apply the concept of 'confidence levels' in their critical decision-making processes. (authors)
Rahulamathavan, Yogachandran; Veluru, Suresh; Phan, Raphael C-W; Chambers, Jonathon A; Rajarajan, Muttukrishnan
A clinical decision support system forms a critical capability to link health observations with health knowledge to influence choices by clinicians for improved healthcare. Recent trends toward remote outsourcing can be exploited to provide efficient and accurate clinical decision support in healthcare. In this scenario, clinicians can use the health knowledge located in remote servers via the Internet to diagnose their patients. However, the fact that these servers are third party and therefore potentially not fully trusted raises possible privacy concerns. In this paper, we propose a novel privacy-preserving protocol for a clinical decision support system where the patients' data always remain in an encrypted form during the diagnosis process. Hence, the server involved in the diagnosis process is not able to learn any extra knowledge about the patient's data and results. Our experimental results on popular medical datasets from UCI-database demonstrate that the accuracy of the proposed protocol is up to 97.21% and the privacy of patient data is not compromised.
Westrom, G.; Vance, J.N.; Gelhaus, F.E.
The purpose of the Radwaste Decision Support System (RDSS) is to provide expert advice, analysis results and instructional material relative to the treatment, handling, transport and disposal of low-level radioactive waste produced in nuclear power plants. This functional specification addresses the following topics: Functions of the RDSS, Relationships and interfaces between the function, Development of the decisions and logic tree structures embodied in waste management, Elements of the database and the characteristics required to support the decision-making process, Specific User requirements for the RDSS, Development of the user interface, Basic software architecture, and Concepts for the RDSS usage including updating and maintenance
Lee, Seung Jun; Seong, Poong Hyun
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
A short introduction will be given to the Nordic project ''NKA/INF: Information Technology for Accident and Emergency Management'', which is now in its final phase. To perform evaluation of the project, special scenarious have been developed, and experiments based on these will be fulfilled and compared with experiments without use of the decision support system. Furthermore, the succeeding European project, ''IT Support for Emergency Management - ISEM'', with the purpose of developing a decision support system for complex and distributed decision making in emergency management in full scale, will be described and the preliminary conceptual model for the system will be presented. (author)
Yu, Peter Paul
One of the most important benefits of health information technology is to assist the cognitive process of the human mind in the face of vast amounts of health data, limited time for decision making, and the complexity of the patient with cancer. Clinical decision support tools are frequently cited as a technologic solution to this problem, but to date useful clinical decision support systems (CDSS) have been limited in utility and implementation. This article describes three unique sources of health data that underlie fundamentally different types of knowledge bases which feed into CDSS. CDSS themselves comprise a variety of models which are discussed. The relationship of knowledge bases and CDSS to rapid learning health systems design is critical as CDSS are essential drivers of rapid learning in clinical care. Copyright © 2015 by American Society of Clinical Oncology.
Donovan, Sarah-Louise; Salmon, Paul M; Horberry, Timothy; Lenné, Michael G
Safety leadership is an important factor in supporting safe performance in the workplace. The present case study examined the role of safety leadership during the Bingham Canyon Mine high-wall failure, a significant mining incident in which no fatalities or injuries were incurred. The Critical Decision Method (CDM) was used in conjunction with a self-reporting approach to examine safety leadership in terms of decisions, behaviours and actions that contributed to the incidents' safe outcome. Mapping the analysis onto Rasmussen's Risk Management Framework (Rasmussen, 1997), the findings demonstrate clear links between safety leadership decisions, and emergent behaviours and actions across the work system. Communication and engagement based decisions featured most prominently, and were linked to different leadership practices across the work system. Further, a core sub-set of CDM decision elements were linked to the open flow and exchange of information across the work system, which was critical to supporting the safe outcome. The findings provide practical implications for the development of safety leadership capability to support safety within the mining industry. Copyright © 2017 Elsevier Ltd. All rights reserved.
Lean Keng, Soon; AlQudah, Hani Nawaf Ibrahim
To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery. The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan. Two-phase mixed methods sequential explanatory design and grounded theory. critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20). Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis. Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance. There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making. © 2016 John Wiley & Sons Ltd.
Huysegoms, Lies; Cappuyns, Valérie
In Europe alone, there are more than 2,5 million potentially contaminated sites of which 14% are expected to require remediation. Contaminated soil and groundwater can cause damage to human health as well as to valuable ecosystems. Globally more attention has been paid to this problem of soil contamination in the past decades. For example, more than 58 000 sites have been remediated in Europe between 2006 and 2011. Together with this increase in remediation projects there has been a surge in the development of new remediation technologies and decision support tools to be able to match every site and its specific characteristics to the best possible remediation alternative. In the past years the development of decision support tools (DST) has evolved in a more sustainable direction. Several DSTs added the claim not only to denote effective or technologically and economically feasible remediation alternatives but also to point out the more or most sustainable remediation alternatives. These trends in the evaluation of site remediation options left users with a confusing clew of possibly applicable tools to assist them in decision making for contaminated site remediation. This review provides a structured overview on the extent decision support tools for contaminated site remediation, that claim to assist in choosing the most sustainable remediation alternative, actually include the different elements of sustainability proposed in our assessment framework. The review contains an in-depth analysis of thirteen tools specifically developed to assess the sustainability of site remediation alternatives. This analysis is based on six criteria derived from the definition of sustainable development of the Brundtland report. The six criteria were concretized by using the three pillars of sustainability, applied to site remediation according to the SuRF-UK framework, two criteria derived from Life Cycle Assessment and Cost-Benefit Analysis, and an 'User friendly' criterion
Full Text Available Due to the rapid spread of computer technologies into day-to-day lives many purchases or purchase-related decisions are made in the electronic environment of the Web. In order to handle information overload that is the result of the availability of many web-based stores, products and services, consumers use decision support aids that help with need recognition, information retrieval, filtering, comparisons and choice making. Decision support systems (DSS discipline spreads about 40 years back and was mostly focused on assisting managers. However, online environments and decision support in such environments bring new opportunities also to the customers. The focus on decision support for consumers is also not investigated to the large extent and not documented in the literature. Providing customers with well designed decision aids can lead to lower cognitive decision effort associated with the purchase decision which results in significant increase of consumer’s confidence, satisfaction, and cost savings. During decision making process the subjects can chose from several methods (optimizing, reasoning, analogizing, and creating, DSS types (data-, model-, communication-, document-driven, and knowledge-based and benefit from different modern technologies. The paper investigates popular customer decision making aids, such as search, filtering, comparison, e-negotiations and auctions, recommendation systems, social network systems, product design applications, communication support etc. which are frequently related to e-commerce applications. Results include the overview of such decision supporting tools, specific examples, classification according the way how the decisions are supported, and possibilities of applications of progressive technologies. The paper thus contributes to the process of development of the interface between companies and the customers where customer decisions take place.
Raskin, R. G.
Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.
MCarthur, Stephen; Chen, Minjiang; Marinelli, Mattia
Deliverable 8.3 reports on the consolidation of experiences from visualisation, decision support prototypes experiments and recommendations on future developments of decision support systems......Deliverable 8.3 reports on the consolidation of experiences from visualisation, decision support prototypes experiments and recommendations on future developments of decision support systems...
Jackson, Cath; Cheater, Francine M.; Reid, Innes
Abstract Objective To identify the decision support needs of parents attempting to make an informed health decision on behalf of a child. Context The first step towards implementing patient decision support is to assess patients’ information and decision‐making needs. Search strategy A systematic search of key bibliographic databases for decision support studies was performed in 2005. Reference lists of relevant review articles and key authors were searched. Three relevant journals were hand searched. Inclusion criteria Non‐intervention studies containing data on decision support needs of parents making child health decisions. Data extraction and synthesis Data were extracted on study characteristics, decision focus and decision support needs. Studies were quality assessed using a pre‐defined set of criteria. Data synthesis used the UK Evidence for Policy and Practice Information and Co‐ordinating Centre approach. Main results One‐hundred and forty nine studies were included across various child health decisions, settings and study designs. Thematic analysis of decision support needs indicated three key issues: (i) information (including suggestions about the content, delivery, source, timing); (ii) talking to others (including concerns about pressure from others); and (iii) feeling a sense of control over the process that could be influenced by emotionally charged decisions, the consultation process, and structural or service barriers. These were consistent across decision type, study design and whether or not the study focused on informed decision making. PMID:18816320
The increasing pressure to reduce costs and improve outcomes is driving the health care industry to view information as a competitive advantage. Timely information is required to help reduce inefficiencies and improve patient care. Numerous disparate operational or transactional information systems with inconsistent and often conflicting data are no longer adequate to meet the information needs of integrated care delivery systems and networks in competitive managed care environments. This article reviews decision support system characteristics and describes a process to assess the preparedness of an organization to implement and use decision support systems to achieve a more effective, information-based decision process. Decision support tools included in this article range from reports to data mining.
Dongen, C.J.G. van; Schraagen, J.M.C.; Eikelboom, A.; Brake, G.M. te
Building up situation understanding is one of the most difficult tasks in the beginning stages of largescale accidents. As ambiguous information about the events becomes available, decision-makers are often tempted to quickly develop a particular story to explain the observed events. As the accident
Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan
Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.
J. Collins (John); W. Ketter (Wolfgang); M. Gini (Maria)
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
emotional rebuttal. Conversely, people cannot make good rational decisions without at least a twinge of emotion attached to the decision . 2) Our minds... decision they make . If emotions overwhelm reason, then decisions should be postponed.27 Service biases are one of the strongest emotional bias. Any...FINAL 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE How Critical Thinking Shapes the Military Decision Making Process 5a. CONTRACT
Van Der Merwe, A
Full Text Available The goal of the study is to lend decision support to management a a wine cellar in three areas of expertise, with Wamakersvallei Winery serving as a special case study. This decision support system is to be delivered in the form of Excel spreadsheet...
Helsdingen, A.S.; Bosch, K. van den; Gog, T. van; Merriënboer, J.J.G. van
Objective : Two field studies assessed the effects of critical thinking instruction on training and transfer of a complex decision-making skill. Background : Critical thinking instruction is based on studies of how experienced decision makers approach complex problems. Method : Participants
Vyazilov, Evgeny; Chunyaev, Nikita
In spite of using highly automated systems of measurement, collecting, storing, handling, prediction and delivery of information on the marine environment, including natural hazards, the amount of damage from natural phenomena increases. Because information on the marine environment delivered to the industrial facilities not effectively used. To such information pays little attention by individual decision-makers and not always perform preventive measures necessary for reduce and prevent damage. Automation of information support will improve the efficiency management of the marine activities. In Russia develops "The Unified system of the information about World ocean" (ESIMO, http://esimo.ru/), that integrates observation, analysis, prognostic and climate data. Necessary to create tools to automatic selection natural disasters through all integrated data; notification decision-makers about arising natural hazards - software agent; provision of information in a compact form for the decision-makers; assessment of possible damage and costs to the preventive measures; providing information on the impacts of environment on economic facilities and recommendations for decision-making; the use of maps, diagrams, tables for reporting. Tools for automatic selection designed for identification of natural phenomena based on the resources ESIMO and corresponding critical values of the indicators environment. The result of this module will be constantly updated database of critical situations of environment for each object or technological process. To operational notify and provide current information about natural hazards proposes using a software agent that is installed on the computer decision-makers, which is activated in case critical situations and provides a minimum of information. In the event of natural disaster software agent should be able to inform decision-makers about this, providing information on the current situation, and the possibility for more and detailed
Su, Szu-Huei; Wu, Li-Min
The severity of diseases and high mortality rates that typify the intensive care unit often make it difficult for surrogate decision makers to make decisions for critically ill patients regarding whether to continue medical treatments or to accept palliative care. To explore the behavioral intentions that underlie the medical decisions of surrogate decision makers of critically ill patients and the related factors. A cross-sectional, correlation study design was used. A total of 193 surrogate decision makers from six ICUs in a medical center in southern Taiwan were enrolled as participants. Three structured questionnaires were used, including a demographic datasheet, the Family Relationship Scale, and the Behavioral Intention of Medical Decisions Scale. Significantly positive correlations were found between the behavioral intentions underlying medical decisions and the following variables: the relationship of the participant to the patient (Eta = .343, p = .020), the age of the patient (r = .295, p medical decisions of the surrogate decision makers, explaining 13.9% of the total variance. In assessing the behavioral intentions underlying the medical decisions of surrogate decision makers, health providers should consider the relationship between critical patients and their surrogate decision makers, patient age, the length of ICU stay, and whether the patient has a pre-signed advance healthcare directive in order to maximize the effectiveness of medical care provided to critically ill patients.
Full Text Available Generalised uncertainty, a phenomenon that today’s managers are facing as part of their professional experience, makes it impossible to anticipate the way the business environment will evolve or what will be the consequences of the decisions they plan to implement. Any decision making process within the company entails the simultaneous presence of a number of economic, technical, juridical, human and managerial variables. The development and the approval of a decision is the result of decision making activities developed by the decision maker and sometimes by a decision support team or/and a decision support system (DSS. These aspects related to specific applications of decision support systems in risk management will be approached in this research paper. Decisions in general and management decisions in particular are associated with numerous risks, due to their complexity and increasing contextual orientation. In each business entity, there are concerns with the implementation of risk management in order to improve the likelihood of meeting objectives, the trust of the parties involved, increase the operational safety and security as well as the protection of the environment, minimise losses, improve organisational resilience in order to diminish the negative impact on the organisation and provide a solid foundation for decision making. Since any business entity is considered to be a wealth generator, the analysis of their performance should not be restricted to financial efficiency alone, but will also encompass their economic efficiency as well. The type of research developed in this paper entails different dimensions: conceptual, methodological, as well as empirical testing. Subsequently, the conducted research entails a methodological side, since the conducted activities have resulted in the presentation of a simulation model that is useful in decision making processes on the capital market. The research conducted in the present paper
Khong, Peck Chui Betty; Hoi, Shu Yin; Holroyd, Eleanor; Wang, Wenru
Healthcare information technology systems are considered the ideal tool to inculcate evidence-based nursing practices. The wound clinical decision support system was built locally to support nurses to manage pressure ulcer wounds in their daily practice. However, its adoption rate is not optimal. The study's objective was to discover the concepts that informed the RNs' decisions to adopt the wound clinical decision support system as an evidence-based technology in their nursing practice. This was an exploratory, descriptive, and qualitative design using face-to-face interviews, individual interviews, and active participatory observation. A purposive, theoretical sample of 14 RNs was recruited from one of the largest public tertiary hospitals in Singapore after obtaining ethics approval. After consenting, the nurses were interviewed and observed separately. Recruitment stopped when data saturation was reached. All transcribed interview data underwent a concurrent thematic analysis, whereas observational data were content analyzed independently and subsequently triangulated with the interview data. Eight emerging themes were identified, namely, use of the wound clinical decision support system, beliefs in the wound clinical decision support system, influences of the workplace culture, extent of the benefits, professional control over nursing practices, use of knowledge, gut feelings, and emotions (fear, doubt, and frustration). These themes represented the nurses' mental outlook as they made decisions on adopting the wound clinical decision support system in light of the complexities of their roles and workloads. This research has provided insight on the nurses' thoughts regarding their decision to interact with the computer environment in a Singapore context. It captured the nurses' complex thoughts when deciding whether to adopt or reject information technology as they practice in a clinical setting.
Brush, David R.; Brown, Crystal E.; Alexander, G. Caleb
Objective To describe how critical care physicians manage conflicts with surrogates about withdrawing or withholding patients’ life support. Design Qualitative analysis of key informant interviews with critical care physicians during 2010. We transcribed interviews verbatim and used grounded theory to code and revise a taxonomy of themes and to identify illustrative quotes. Setting 3 academic medical centers, 1 academic-affiliated medical center and 4 private practice groups or private hospitals in a large Midwestern city Subjects 14 critical care physicians Measurements and main results Physicians reported tailoring their approach to address specific reasons for disagreement with surrogates. Five common approaches were identified: (1) building trust, (2) educating and informing, (3) providing surrogates more time, (4) adjusting surrogate and physician roles, and (5) highlighting specific values. When mistrust was an issue, physicians endeavored to build a more trusting relationship with the surrogate before re-addressing decision making. Physicians also reported correcting misunderstandings by providing targeted education, and some reported highlighting specific patient, surrogate, or physician values that they hoped would guide surrogates to agree with them. When surrogates struggled with decision making roles, physicians attempted to reinforce the concept of substituted judgment. Physicians noted that some surrogates needed time to “come to terms” with the patent’s illness before agreeing with physicians. Many physicians had witnessed colleagues negotiate in ways they found objectionable, such as providing misleading information, injecting their own values into the negotiation, or behaving unprofessionally towards surrogates. While some physicians viewed their efforts to encourage surrogates’ agreement as persuasive, others strongly denied persuading surrogates and described their actions as “guiding” or “negotiating.” Conclusions Physicians
Pertl, Michael; Weckesser, Johannes Tilman Gabriel; Rezkalla, Michel M.N.
The paper presents a decision support tool for transient stability preventive control contributing to increased situation awareness of control room operators by providing additional information about the state of the power system in terms of transient stability. A time-domain approach is used...... a predefined minimum critical clearing time for faults at all buses is proposed, while costs are minimized. The results of the assessment are presented to the control room operator, who decides to accept the suggested dispatch or to repeat the assessment considering additional user-specific constraints...
The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".
Puig, Daniel; Aparcana Robles, Sandra Roxana
. For example, in the case of life-cycle analysis, the evaluation criterion entails that the impacts of interest are examined across the entire life-cycle of the product under study, from extraction of raw materials, to product disposal. Effectively, then, the choice of decision-support tool directs......This document describes three decision-support tools that can aid the process of planning climate change mitigation actions. The phrase ‘decision-support tools’ refers to science-based analytical procedures that facilitate the evaluation of planning options (individually or compared to alternative...... options) against a particular evaluation criterion or set of criteria. Most often decision-support tools are applied with the help of purpose-designed software packages and drawing on specialised databases.The evaluation criteria alluded to above define and characterise each decision-support tool...
Ahmad M. Kabil
Full Text Available Decision makers have considerable autonomy on how they make decisions and what type of support they receive. This situation places the DSS analyst in a different relationship with the client than his colleagues who support regular MIS applications. This paper addresses an ethical dilemma in “Inverse Decision Support,” when the analyst supports a decision maker who requires justification for a preconceived selection that does not correspond to the best option that resulted from the professional resolution of the problem. An extended application of the AHP model is proposed for evaluating the ethical responsibility in selecting a suboptimal alternative. The extended application is consistent with the Inverse Decision Theory that is used extensively in medical decision making. A survey of decision analysts is used to assess their perspective of using the proposed extended application. The results show that 80% of the respondents felt that the proposed extended application is useful in business practices. 14% of them expanded the usability of the extended application to academic teaching of the ethics theory. The extended application is considered more usable in a country with a higher Transparency International Corruption Perceptions Index (TICPI than in a country with a lower one.
This document provides an overview of the Federal Highway Administration's winter Maintenance Decision Support System (MDSS). The MDSS is a decision support tool that has the ability to provide weather predictions focused toward the road surface. The...
Islam, Roosan; Weir, Charlene R; Jones, Makoto; Del Fiol, Guilherme; Samore, Matthew H
Clinical experts' cognitive mechanisms for managing complexity have implications for the design of future innovative healthcare systems. The purpose of the study is to examine the constituents of decision complexity and explore the cognitive strategies clinicians use to control and adapt to their information environment. We used Cognitive Task Analysis (CTA) methods to interview 10 Infectious Disease (ID) experts at the University of Utah and Salt Lake City Veterans Administration Medical Center. Participants were asked to recall a complex, critical and vivid antibiotic-prescribing incident using the Critical Decision Method (CDM), a type of Cognitive Task Analysis (CTA). Using the four iterations of the Critical Decision Method, questions were posed to fully explore the incident, focusing in depth on the clinical components underlying the complexity. Probes were included to assess cognitive and decision strategies used by participants. The following three themes emerged as the constituents of decision complexity experienced by the Infectious Diseases experts: 1) the overall clinical picture does not match the pattern, 2) a lack of comprehension of the situation and 3) dealing with social and emotional pressures such as fear and anxiety. All these factors contribute to decision complexity. These factors almost always occurred together, creating unexpected events and uncertainty in clinical reasoning. Five themes emerged in the analyses of how experts deal with the complexity. Expert clinicians frequently used 1) watchful waiting instead of over- prescribing antibiotics, engaged in 2) theory of mind to project and simulate other practitioners' perspectives, reduced very complex cases into simple 3) heuristics, employed 4) anticipatory thinking to plan and re-plan events and consulted with peers to share knowledge, solicit opinions and 5) seek help on patient cases. The cognitive strategies to deal with decision complexity found in this study have important
Ozaltin, Nur Ozge; Besterfield-Sacre, Mary; Clark, Renee M.
Learning how to design innovatively is a critical process skill for undergraduate engineers in the 21st century. To this end, our paper discusses the development and validation of a Bayesian network decision support tool that can be used by engineering educators to make recommendations that positively impact the innovativeness of product designs.…
Gonzalez, Ainhoa, E-mail: email@example.com [Trinity Centre for Biodiversity Research, School of Natural Sciences, Trinity College Dublin, College Green, Dublin 2 (Ireland); Donnelly, Alison, E-mail: firstname.lastname@example.org [Centre for the Environment, School of Natural Sciences, Trinity College Dublin (Ireland); Jones, Mike, E-mail: email@example.com [Discipline of Botany, School of Natural Sciences, Trinity College Dublin (Ireland); Chrysoulakis, Nektarios, E-mail: firstname.lastname@example.org [Foundation for Research and Technology-Hellas, Institute of Applied and Computational Mathematics (Greece); Lopes, Myriam, E-mail: email@example.com [Departamento de Ambiente e Ordenamento and CESAM, University of Aveiro (Portugal)
Urban metabolism components define the energy and material exchanges within a city and, therefore, can provide valuable information on the environmental quality of urban areas. Assessing the potential impact of urban planning alternatives on urban metabolism components (such as energy, water, carbon and pollutants fluxes) can provide a quantitative estimation of their sustainability performance. Urban metabolism impact assessment can, therefore, contribute to the identification of sustainable urban structures with regards, for example, to building types, materials and layout, as well as to location and capacity of transportation and infrastructural developments. In this way, it enables the formulation of planning and policy recommendations to promote efficient use of resources and enhance environmental quality in urban areas. The European FP7 project BRIDGE (sustainaBle uRban plannIng Decision support accountinG for urban mEtabolism) has developed a decision-support system (DSS) that systematically integrates urban metabolism components into impact assessment processes with the aim of accurately quantifying the potential effects of proposed planning interventions. The DSS enables integration of multiple spatial and non-spatial datasets (e.g. physical flows of energy and material with variables of social and economic change) in a systematic manner to obtain spatially defined assessment results and to thus inform planners and decision-makers. This multi-criteria approach also enables incorporation of stakeholders' perceptions in order to prioritise decisive assessment criteria. This paper describes the methodological framework used to develop the DSS and critically examines the results of its practical application in five European cities. - Highlights: Black-Right-Pointing-Pointer Urban metabolism in sustainability assessment of planning alternatives. Black-Right-Pointing-Pointer European FP7 project applied to 5 real life case studies across Europe. Black
González, Ainhoa; Donnelly, Alison; Jones, Mike; Chrysoulakis, Nektarios; Lopes, Myriam
Urban metabolism components define the energy and material exchanges within a city and, therefore, can provide valuable information on the environmental quality of urban areas. Assessing the potential impact of urban planning alternatives on urban metabolism components (such as energy, water, carbon and pollutants fluxes) can provide a quantitative estimation of their sustainability performance. Urban metabolism impact assessment can, therefore, contribute to the identification of sustainable urban structures with regards, for example, to building types, materials and layout, as well as to location and capacity of transportation and infrastructural developments. In this way, it enables the formulation of planning and policy recommendations to promote efficient use of resources and enhance environmental quality in urban areas. The European FP7 project BRIDGE (sustainaBle uRban plannIng Decision support accountinG for urban mEtabolism) has developed a decision-support system (DSS) that systematically integrates urban metabolism components into impact assessment processes with the aim of accurately quantifying the potential effects of proposed planning interventions. The DSS enables integration of multiple spatial and non-spatial datasets (e.g. physical flows of energy and material with variables of social and economic change) in a systematic manner to obtain spatially defined assessment results and to thus inform planners and decision-makers. This multi-criteria approach also enables incorporation of stakeholders' perceptions in order to prioritise decisive assessment criteria. This paper describes the methodological framework used to develop the DSS and critically examines the results of its practical application in five European cities. - Highlights: ► Urban metabolism in sustainability assessment of planning alternatives. ► European FP7 project applied to 5 real life case studies across Europe. ► Decision support system enables incorporating scientific
Musen, M A
Interest in decision-support programs for clinical medicine soared in the 1970s. Since that time, workers in medical informatics have been particularly attracted to rule-based systems as a means of providing clinical decision support. Although developers have built many successful applications using production rules, they also have discovered that creation and maintenance of large rule bases is quite problematic. In the 1980s, several groups of investigators began to explore alternative programming abstractions that can be used to build decision-support systems. As a result, the notions of "generic tasks" and of reusable problem-solving methods became extremely influential. By the 1990s, academic centers were experimenting with architectures for intelligent systems based on two classes of reusable components: (1) problem-solving methods--domain-independent algorithms for automating stereotypical tasks--and (2) domain ontologies that captured the essential concepts (and relationships among those concepts) in particular application areas. This paper highlights how developers can construct large, maintainable decision-support systems using these kinds of building blocks. The creation of domain ontologies and problem-solving methods is the fundamental end product of basic research in medical informatics. Consequently, these concepts need more attention by our scientific community.
Lajic, Zoran; Blanke, Mogens; Nielsen, Ulrik Dam
Fault detection and fault isolation for in-service decision support systems for marine surface vehicles will be presented in this paper. The stochastic wave elevation and the associated ship responses are modeled in the frequency domain. The paper takes as an example fault isolation of a containe......Fault detection and fault isolation for in-service decision support systems for marine surface vehicles will be presented in this paper. The stochastic wave elevation and the associated ship responses are modeled in the frequency domain. The paper takes as an example fault isolation...... to the quality of decisions given to navigators....
Rodriquez, Luis F.
Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.
Rothman, Brian; Leonard, Joan C; Vigoda, Michael M
The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data
Balson, W.E.; Wilson, D.S.
This paper reviews a number of decision support methods developed and applied by Decision Focus Incorporated to help utility personnel manage current environmental problems. This work has been performed for the Environmental Risk Analysis Program of EPRI's Environment Division, and also for a number of electric utilities across the country. These are two distinct types of decision support software tools that have been created: economic risk management and environmental risk analysis. These types differ primarily in the identification of who will make a decision. Economic risk management tools are directed primarily at decisions made by electric utilities. Environmental risk analysis tools are directed primarily at decisions made by legislative or regulatory agencies, about which a utility may wish to comment
Filip, Florin Gheorghe; Ciurea, Cristian
This is a book about how management and control decisions are made by persons who collaborate and possibly use the support of an information system. The decision is the result of human conscious activities aiming at choosing a course of action for attaining a certain objective (or a set of objectives). The act of collaboration implies that several entities who work together and share responsibilities to jointly plan, implement and evaluate a program of activities to achieve the common goals. The book is intended to present a balanced view of the domain to include both well-established concepts and a selection of new results in the domains of methods and key technologies. It is meant to answer several questions, such as: a) “How are evolving the business models towards the ever more collaborative schemes?”; b) “What is the role of the decision-maker in the new context?” c) “What are the basic attributes and trends in the domain of decision-supporting information systems?”; d) “Which are the basic...
Sdouz, G.; Mueck, K.
In order to adopt countermeasures to protect the public after an accident in a nuclear power plant in an appropriate and optimum way, decision support systems offer a valuable assistance in supporting the decision maker in choosing and optimizing protective actions. Such decision support systems may range from simple systems to accumulate relevant parameters for the evaluation of the situation over prediction models for the rapid evaluation of the dose to be expected to systems which permit the evaluation and comparison of possible countermeasures. Since the establishment of a decision support systems obviously is also required in Austria, an evaluation of systems available or in the state of development in other countries or unions was performed. The aim was to determine the availability of decision support systems in various countries and to evaluate them with regard to depth and extent of the system. The evaluation showed that in most industrialized countries the requirement for a decision support system was realized, but in only few countries actual systems are readily available and operable. Most systems are limited to early phase consequences, i.e. dispersion calculations of calculated source terms and the estimation of exposure in the vicinity of the plant. Only few systems offer the possibility to predict long-term exposures by ingestion. Few systems permit also an evaluation of potential countermeasures, in most cases, however, limited to a few short-term countermeasures. Only one system which is presently not operable allows the evaluation of a large number of agricultural countermeasures. In this report the different systems are compared. The requirements with regard to an Austrian decision support system are defined and consequences for a possible utilization of a DSS or parts thereof for the Austrian decision support system are derived. (author)
Sullivan, T.M.; Moskowitz, P.D.; Gitten, M.
Decision Support Software (DSS) continues to be developed to support analysis of decisions pertaining to environmental management. Decision support systems are computer-based systems that facilitate the use of data, models, and structured decision processes in decision making. The optimal DSS should attempt to integrate, analyze, and present environmental information to remediation project managers in order to select cost-effective cleanup strategies. The optimal system should have a balance between the sophistication needed to address the wide range of complicated sites and site conditions present at DOE facilities, and ease of use (e.g., the system should not require data that is typically unknown and should have robust error checking of problem definition through input, etc.). In the first phase of this study, an extensive review of the literature, the Internet, and discussions with sponsors and developers of DSS led to identification of approximately fifty software packages that met the preceding definition
This book presents different methods for analyzing the body language (movement, position, use of personal space, silences, pauses and tone, the eyes, pupil dilation or constriction, smiles, body temperature and the like) for better understanding people’s needs and actions, including biometric data gathering and reading. Different studies described in this book indicate that sufficiently much data, information and knowledge can be gained by utilizing biometric technologies. This is the first, wide-ranging book that is devoted completely to the area of intelligent decision support systems, biometrics technologies and their integrations. This book is designated for scholars, practitioners and doctoral and master’s degree students in various areas and those who are interested in the latest biometric and intelligent decision making support problems and means for their resolutions, biometric and intelligent decision making support systems and the theory and practice of their integration and the opportunities fo...
Hawryluck, Laura; Baker, Andrew J; Faith, Andrew; Singh, Jeffrey M
The Supreme Court of Canada (SCC) ruling on Cuthbertson v. Rasouli has implications for all acute healthcare providers. This well-publicized case involved a disagreement between healthcare providers and a patient's family regarding the principles surrounding withdrawal of life support, which the physicians involved considered no longer of medical benefit and outside the standard of care, and whether consent was required for such withdrawals. Our objective in writing this article is to clarify the implications of this ruling on the care of critically ill patients. SCC ruling Cuthbertson v. Rasouli. The SCC ruled that consent must be obtained for all treatments that serve a "health-related purpose", including withdrawal of such treatments. The SCC did not fully consider what the standard of care should be. Health-related purpose is not sufficient in and of itself to mandate treatment, and clinicians must still ensure that their patients or decision-makers are aware of the possible medical benefits, risks, and expected outcomes of treatments. The provision of treatments that have no potential to provide medical benefit and carry only risks would still fall outside the standard of care. Nevertheless, due to their health-related purpose, physicians must seek consent for the discontinuation of these treatments. The SCC ruled that due to the legal definition of "health-related purpose", which is distinct from medical benefit, consent is required to withdraw life-support and outlined the steps to be taken should conflict arise. The SCC decision did not directly address the role of medical standard of care in these situations. In order to ensure optimal decision-making and communication with patients and their families, it is critical for healthcare providers to have a clear understanding of the implications of this legal ruling on medical practice.
Adult learning, critical thinking, and decision-making are fields that receive attention individually, although they are interspersed with elements of each other's theories and philosophies. In addressing adult learning precepts, it is essential to include critical thinking and decision-making. One without the other creates weakness; all must be…
Lewandowski, A.; Wierzbicki, A.P.
Research in methodology of Decision Support Systems is one of the activities within the System and Decision Sciences Program which was initiated seven years ago and is still in the center of interests of SDS. During these years several methodological approaches and software tools have been developed; among others the DIDAS (Dynamic Interactive Decision Analysis and Support) and SCDAS (Selection Committed Decision Analysis and Support). Both methodologies gained a certain level of popularity a...
Sànchez-Marrè, Miquel; Gilbert, Karina; Sojda, Rick S.; Steyer, Jean Philippe; Struss, Peter; Rodríguez-Roda, Ignasi; Voinov, A.A.; Jakeman, A.J.; Rizzoli, A.E.
There are inherent open problems arising when developing and running Intelligent Environmental Decision Support Systems (IEDSS). During daily operation of IEDSS several open challenge problems appear. The uncertainty of data being processed is intrinsic to the environmental system, which is being monitored by several on-line sensors and off-line data. Thus, anomalous data values at data gathering level or even uncertain reasoning process at later levels such as in diagnosis or decision support or planning can lead the environmental process to unsafe critical operation states. At diagnosis level or even at decision support level or planning level, spatial reasoning or temporal reasoning or both aspects can influence the reasoning processes undertaken by the IEDSS. Most of Environmental systems must take into account the spatial relationships between the environmental goal area and the nearby environmental areas and the temporal relationships between the current state and the past states of the environmental system to state accurate and reliable assertions to be used within the diagnosis process or decision support process or planning process. Finally, a related issue is a crucial point: are really reliable and safe the decisions proposed by the IEDSS? Are we sure about the goodness and performance of proposed solutions? How can we ensure a correct evaluation of the IEDSS? Main goal of this paper is to analyse these four issues, review some possible approaches and techniques to cope with them, and study new trends for future research within the IEDSS field.
Miller, Matthew James; McGuire, Kerry M; Feigh, Karen M
The design and adoption of decision support systems within complex work domains is a challenge for cognitive systems engineering (CSE) practitioners, particularly at the onset of project development. This article presents an example of applying CSE techniques to derive design requirements compatible with traditional systems engineering to guide decision support system development. Specifically, it demonstrates the requirements derivation process based on cognitive work analysis for a subset of human spaceflight operations known as extravehicular activity . The results are presented in two phases. First, a work domain analysis revealed a comprehensive set of work functions and constraints that exist in the extravehicular activity work domain. Second, a control task analysis was performed on a subset of the work functions identified by the work domain analysis to articulate the translation of subject matter states of knowledge to high-level decision support system requirements. This work emphasizes an incremental requirements specification process as a critical component of CSE analyses to better situate CSE perspectives within the early phases of traditional systems engineering design.
Erin K. Noonan-Wright; Tonja S. Opperman
In response to federal wildfire policy changes, risk-informed decision-making by way of improved decision support, is increasingly becoming a component of managing wildfires. As fire incidents escalate in size and complexity, the Wildland Fire Decision Support System (WFDSS) provides support with different analytical tools as fire conditions change. We demonstrate the...
Full Text Available In any contemporary business, decision makers are confronted with increasing amount of information, not necessarily incorporated properly into decision making process. Moreover, decision makers show several cognitive limitations and biases. Managerial decision support systems are intended to assist decision makers in taking advantage of available information. Research proved that that these systems could compensate for the relative weaknesses of the managers as decision makers. They prevent common biases of human decision-making and foster objective and reliable information. With number of variables that must be taken into consideration, internal and external, technological, financial and market related, the new product development and the specifics of that process in fast moving consumer goods industries is perfect for application of computerized decision support system. The results of implementation of such system based on Exsys Corvid in processed food industry are presented with review of overall impressions for the usefulness of the new software, provided by the managers involved in the process. They found that the system consistently offers realistic decisions, that the system is convenient for capturing the institutional knowledge of the process, but also that the system not always follows the standard procedure. They think that the system is user-friendly. However, the implemented system will be useful and consistently outperform expectations only if the company is ready to continuously upgrade the embedded tacit institutional knowledge and experience. However, doing so, the company should never neglect the consumers changing preferences as the most important environmental domain of information critical for new product development.
Wahl, Stacy E; Thompson, Anita M
Newly graduated registered nurses who were hired into a critical care intensive care unit showed a lack of critical thinking skills to inform their clinical decision-making abilities. This study evaluated the effectiveness of concept mapping as a teaching tool to improve critical thinking and clinical decision-making skills in novice nurses. A self-evaluation tool was administered before and after the learning intervention. The 25-item tool measured five key indicators of the development of critical thinking skills: problem recognition, clinical decision-making, prioritization, clinical implementation, and reflection. Statistically significant improvements were seen in 10 items encompassing all five indicators. Concept maps are an effective tool for educators to use in assisting novice nurses to develop their critical thinking and clinical decision-making skills. Copyright 2013, SLACK Incorporated.
Erskine, Michael A.
As many consumer and business decision makers are utilizing Spatial Decision Support Systems (SDSS), a thorough understanding of how such decisions are made is crucial for the information systems domain. This dissertation presents six chapters encompassing a comprehensive analysis of the impact of geospatial reasoning ability on…
Barfod, Michael Bruhn; Salling, Kim Bang; Leleur, Steen
This paper concerns composite decision support based on combining cost-benefit analysis (CBA) with multi-criteria decision analysis (MCDA) for the assessment of economic as well as strategic impacts within transport projects. Specifically a composite model for assessment (COSIMA) is presented...
Full Text Available An innovative newly developed modular and standards based Decision Support System (DSS is presented which forms part of the German Indonesian Tsunami Early Warning System (GITEWS. The GITEWS project stems from the effort to implement an effective and efficient Tsunami Early Warning and Mitigation System for the coast of Indonesia facing the Sunda Arc along the islands of Sumatra, Java and Bali. The geological setting along an active continental margin which is very close to densely populated areas is a particularly difficult one to cope with, because potential tsunamis' travel times are thus inherently short. National policies require an initial warning to be issued within the first five minutes after an earthquake has occurred. There is an urgent requirement for an end-to-end solution where the decision support takes the entire warning chain into account. The system of choice is based on pre-computed scenario simulations and rule-based decision support which is delivered to the decision maker through a sophisticated graphical user interface (GUI using information fusion and fast information aggregation to create situational awareness in the shortest time possible. The system also contains risk and vulnerability information which was designed with the far end of the warning chain in mind – it enables the decision maker to base his acceptance (or refusal of the supported decision also on regionally differentiated risk and vulnerability information (see Strunz et al., 2010. While the system strives to provide a warning as quickly as possible, it is not in its proper responsibility to send and disseminate the warning to the recipients. The DSS only broadcasts its messages to a dissemination system (and possibly any other dissemination system which is operated under the responsibility of BMKG – the meteorological, climatological and geophysical service of Indonesia – which also hosts the tsunami early warning center. The system is to be seen
Kon, Alexander A; Davidson, Judy E; Morrison, Wynne; Danis, Marion; White, Douglas B
Shared decision making is endorsed by critical care organizations; however, there remains confusion about what shared decision making is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define shared decision making, recommend when shared decision making should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. The American College of Critical Care Medicine and American Thoracic Society Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of American College of Critical Care Medicine and American Thoracic Society were included in the statement. Six recommendations were endorsed: 1) DEFINITION: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient's values, goals, and preferences. 2) Clinicians should engage in a shared decision making process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their "default" approach a shared decision making process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable, including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision
Swota Alissa H
Full Text Available Abstract Background Communication may affect perceptions of fair process for intensive care unit bed allocation decisions through its impact on the publicity condition of accountability for reasonableness. Methods We performed a qualitative case study to describe participant perceptions of the communication of bed allocation decisions in an 18-bed university affiliated, medical-surgical critical care unit at Sunnybrook and Women's College Health Sciences Centre. Interviewed participants were 3 critical care physicians, 4 clinical fellows in critical care, 4 resource nurses, 4 "end-users" (physicians who commonly referred patients to the unit, and 3 members of the administrative staff. Median bed occupancy during the study period (Jan-April 2003 was 18/18; daily admissions and discharges (median were 3. We evaluated our description using the ethical framework "accountability for reasonableness" (A4R to identify opportunities for improvement. Results The critical care physician, resource nurse, critical care fellow and end-users (trauma team leader, surgeons, neurosurgeons, anesthesiologists functioned independently in unofficial "parallel tracks" of bed allocation decision-making; this conflicted with the official designation of the critical care physician as the sole authority. Communication between key decision-makers was indirect and could exclude those affected by the decisions; notably, family members. Participants perceived a lack of publicity for bed allocation rationales. Conclusion The publicity condition should be improved for critical care bed allocation decisions. Decision-making in the "parallel tracks" we describe might be unavoidable within usual constraints of time, urgency and demand. Formal guidelines for direct communication between key participants in such circumstances would help to improve the fairness of these decisions.
In the past 50 years, the military, communication, and transportation systems that permeate our world, have grown exponentially in size and complexity. The development and production of these systems has seen ballooning costs and increased risk. This is particularly critical for the aerospace industry. The inability to deal with growing system complexity is a crippling force in the advancement of engineered systems. Value-Driven Design represents a paradigm shift in the field of design engineering that has potential to help counteract this trend. The philosophy of Value-Driven Design places the desires of the stakeholder at the forefront of the design process to capture true preferences and reveal system alternatives that were never previously thought possible. Modern aerospace engineering design problems are large, complex, and involve multiple levels of decision-making. To find the best design, the decision-maker is often required to analyze hundreds or thousands of combinations of design variables and attributes. Visualization can be used to support these decisions, by communicating large amounts of data in a meaningful way. Understanding the design space, the subsystem relationships, and the design uncertainties is vital to the advancement of Value-Driven Design as an accepted process for the development of more effective, efficient, robust, and elegant aerospace systems. This research investigates the use of multi-dimensional data visualization tools to support decision-making under uncertainty during the Value-Driven Design process. A satellite design system comprising a satellite, ground station, and launch vehicle is used to demonstrate effectiveness of new visualization methods to aid in decision support during complex aerospace system design. These methods are used to facilitate the exploration of the feasible design space by representing the value impact of system attribute changes and comparing the results of multi-objective optimization formulations
Gent, David H; De Wolf, Erick; Pethybridge, Sarah J
Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.
Watson, Joanne; Wilson, Erin; Hagiliassis, Nick
Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…
Moqeem, Aasia; Baig, Mirza; Gholamhosseini, Hamid; Mirza, Farhaan; Lindén, Maria
This research involves the design and development of a novel Android smartphone application for real-time vital signs monitoring and decision support. The proposed application integrates market available, wireless and Bluetooth connected medical devices for collecting vital signs. The medical device data collected by the app includes heart rate, oxygen saturation and electrocardiograph (ECG). The collated data is streamed/displayed on the smartphone in real-time. This application was designed by adopting six screens approach (6S) mobile development framework and focused on user-centered approach and considered clinicians-as-a-user. The clinical engagement, consultations, feedback and usability of the application in the everyday practices were considered critical from the initial phase of the design and development. Furthermore, the proposed application is capable to deliver rich clinical decision support in real-time using the integrated medical device data.
Full Text Available Cork oak (Quercus suber L. and holm oak (Quercus rotundifolia ecosystems are characteristic of Mediterranean forestry in Portugal. Even though cork is the most valuable product, these ecosystems provide multiple products and services. Assessing trade-offs between multiple goals is thus critical for the effectiveness of oak ecosystem management planning. This paper focuses on the development of a decision support system for oak ecosystems’ scenario analysis including multiple criteria. It includes an innovative decision support systems (DSS functionality to assess trade-offs between the criteria that may support negotiation and consensus building between decision-makers and forest stakeholders. Specifically, a module that encapsulates the Feasible Goals Method/Interactive Decision Maps (FGM/IDM technique is developed for interactive visualization of the Pareto frontier. The Pareto frontier illustrates the degree to which improving one particular criterion requires accepting sacrifices in the achievements of others. It thus provides information about trade-offs between competing decision-makers’ preferences. Results are discussed for a large-scale application encompassing over 1 million ha of cork and holm oak forest ecosystems in Southern Portugal. This study demonstrates the potential of the new DSS functionality to enhance multi-objective forest planning, namely by facilitating participation by stakeholders and providing transparency to the decision-making processes.
The objective of SCK-CEN's R and D programme on decision strategy research are (1) to support and advise the Belgian authorities on specific problems concerning existing and potential hazards from exposure to ionising radiation, both in normal and emergency situations; (2) to perform research on relevant topics that might have an important impact on decision making related to nuclear applications, including social and economic sciences. Main achievements in this area in 1999 are described
Paul C Langley
Full Text Available A critical question, given the growing importance of more targeted therapies to support personalized and precision medicine, is the credibility of the evidence base to support formulary decisions and pricing. On the one hand, for those who subscribe to the reference case model of the National Institute of Health and Care Excellence (NICE in the UK, the decision rests upon the creation of modeled or simulated imaginary worlds and the application of threshold willingness-to-pay cost-per-QALY thresholds. On the other hand, for those who subscribe to the standards of normal science, the decision rests upon the ability to evaluate competing claims, both clinical and cost-effective, in a timeframe that is meaningful to a formulary committee. If we subscribe to the scientific method where the focus is on the discovery of new facts, untestable claims for clinical benefit and cost-effectiveness, such as created claims for lifetime cost per-quality-adjusted discounted life years (QALYs, are properly relegated to the category of pseudoscience. We have no idea, and will never know, whether the claims are right or even if they are wrong. If formulary decisions are to respect the standards of normal science then there has to be a commitment to claims evaluation. A willingness to accept new products provisionally, subject to an agreed protocol to support the evaluation of clinical and cost-effectiveness claims. This dichotomy between the standards of normal science and pseudoscience is explored in the context of published claims for cost-effectiveness and recommendations for product pricing in the US. Type: Commentary
Catterson, Victoria; MCarthur, Stephen; Chen, Minjiang
ELECTRA Deliverable 8.2 reports on the demonstration of decision support within the future control room in light of voltage and frequency control in the 2030+ power system. The decision support must identify key threats and vulnerabilities, and propose and prioritise appropriate interventions....
U.S. Department of Health & Human Services — The Clinical Decision Support (CDS) Inventory contains descriptions of past and present CDS projects across the Federal Government. It includes Federal projects,...
Full Text Available The paper proposes an overview of decision support systems in order to define the role of a system to assist decision in university management. The authors present new technologies and the basic concepts of multidimensional data analysis using models of business processes within the universities. Based on information provided by scientific literature and on the authors’ experience, the study aims to define selection criteria in choosing a development environment for designing a support system dedicated to university management. The contributions consist in designing a data warehouse model and models of OLAP analysis to assist decision in university management.
Tsou, Ming-Cheng; Kao, Sheng-Long; Su, Chien-Min
When an officer of the watch (OOW) faces complicated marine traffic, a suitable decision support tool could be employed in support of collision avoidance decisions, to reduce the burden and greatly improve the safety of marine traffic. Decisions on routes to avoid collisions could also consider economy as well as safety. Through simulating the biological evolution model, this research adopts the genetic algorithm used in artificial intelligence to find a theoretically safety-critical recommendation for the shortest route of collision avoidance from an economic viewpoint, combining the international regulations for preventing collisions at sea (COLREGS) and the safety domain of a ship. Based on this recommendation, an optimal safe avoidance turning angle, navigation restoration time and navigational restoration angle will also be provided. A Geographic Information System (GIS) will be used as the platform for display and operation. In order to achieve advance notice of alerts and due preparation for collision avoidance, a Vessel Traffic Services (VTS) operator and the OOW can use this system as a reference to assess collision avoidance at present location.
This concise volume covers nonparametric statistics topics that most are most likely to be seen and used from a practical decision support perspective. While many degree programs require a course in parametric statistics, these methods are often inadequate for real-world decision making in business environments. Much of the data collected today by business executives (for example, customer satisfaction opinions) requires nonparametric statistics for valid analysis, and this book provides the reader with a set of tools that can be used to validly analyze all data, regardless of type. Through numerous examples and exercises, this book explains why nonparametric statistics will lead to better decisions and how they are used to reach a decision, with a wide array of business applications. Online resources include exercise data, spreadsheets, and solutions.
Full Text Available that are not always explicitly linked to development outcomes. Throughout this process, scope exists to aid decision makers, through a simplistic set of decision models, to make better decisions. The emphasis is on decisions that support long-term value creation...
Grant H. Kruger
Full Text Available Information overload of the anesthesiologist through technological advances have threatened the safety of patients under anesthesia in the operating room (OR. Traditional monitoring and alarm systems provide independent, spatially distributed indices of patient physiological state. This creates the potential to distract caregivers from direct patient care tasks. To address this situation, a novel reactive agent decision support system with graphical human machine interface was developed. The system integrates the disparate data sources available in the operating room, passes the data though a decision matrix comprising a deterministic physiologic rule base established through medical research. Patient care is improved by effecting change to the care environment by displaying risk factors and alerts as an intuitive color coded animation. The system presents a unified, contextually appropriate snapshot of the patient state including current and potential risk factors, and alerts of critical patient events to the operating room team without requiring any user intervention. To validate the efficacy of the system, a retrospective analysis focusing on the hypotension rules were performed. Results show that even with vigilant and highly trained clinicians, deviations from ideal patient care exist and it is here that the proposed system may allow more standardized and improved patient care and potentially outcomes.
Søndergaard, Erik Stefan; Ahmed-Kristensen, Saeema
This paper investigates how global product development decisions are made through a multiple-case study in three Danish engineering. The paper identifies which information and methods are applied for making decisions and how decision-making can be supported based on previous experience. The paper...... presents results from 51 decisions made in the three companies, and based on the results of the studies a framework for a decision-support tool is outlined and discussed. The paper rounds off with an identification of future research opportunities in the area of global product development and decision-making....
Background Pain management is a critical but complex issue for the relief of acute pain, particularly for postoperative pain and severe pain in cancer patients. It also plays important roles in promoting quality of care. The introduction of pain management decision support systems (PM-DSS) is considered a potential solution for addressing the complex problems encountered in pain management. This study aims to investigate factors affecting acceptance of PM-DSS from a nurse anesthetist perspective. Methods A questionnaire survey was conducted to collect data from nurse anesthetists in a case hospital. A total of 113 questionnaires were distributed, and 101 complete copies were returned, indicating a valid response rate of 89.3%. Collected data were analyzed by structure equation modeling using the partial least square tool. Results The results show that perceived information quality (γ=.451, pDSS. Information quality (γ=.267, pDSS ease of use. Furthermore, both perceived ease of use (β=.436, pDSS acceptance (R2=.640). Thus, the critical role of information quality in the development of clinical decision support system is demonstrated. Conclusions The findings of this study enable hospital managers to understand the important considerations for nurse anesthetists in accepting PM-DSS, particularly for the issues related to the improvement of information quality, perceived usefulness and perceived ease of use of the system. In addition, the results also provide useful suggestions for designers and implementers of PM-DSS in improving system development. PMID:23360305
Pulwarty, R. S.
The demand for improved climate knowledge and information is well documented. As noted in the IPCC (SREX, AR5), the UNISDR Global Assessment Reports and other assessments, this demand has increased pressure for information to support planning under changing rates and emergence of multiple hazards including climate extremes (drought, heat waves, floods). "Decision support" is now a popular term in the climate applications research community. While existing decision support activities can be identified in many disparate settings (e.g. federal, academic, private), the challenge of changing environments (coupled physical and social) is actually one of crafting implementation strategies for improving decision quality (not just meeting "user needs"). This includes overcoming weaknesses in co-production models, moving beyond DSSs as simply "software", coordinating innovation mapping and diffusion, and providing fora and gaming tools to identify common interests and differences in the way risks are perceived and managed among the affected groups. We outline the development and evolution of multi-hazard early warning systems in the United States and elsewhere, focusing on climate-related hazards. In particular, the presentation will focus on the climate science and information needed for (1) improved monitoring and modeling, (2) generating risk profiles, (3) developing information systems and scenarios for critical thresholds, (4) the net benefits of using new information (5) characterizing and bridging the "last mile" in the context of longer-term risk management.
Jacyk, P.; Schultz, D.; Spangenberg, L.
A decision support system (DSS) is being developed at the Radioactive Liquid Waste Treatment Facility, Los Alamos National Laboratory (LANL). The DSS will be used to evaluate alternatives for improving LANL's existing central radioactive waste water treatment plant and to evaluate new site-wide liquid waste treatment schemes that are required in order to handle the diverse waste streams produced at LANL. The decision support system consists of interacting modules that perform the following tasks: rigorous process simulation, configuration management, performance analysis, cost analysis, risk analysis, environmental impact assessment, transportation modeling, and local, state, and federal regulation compliance checking. Uncertainty handling techniques are used with these modules and also with a decision synthesis module which combines results from the modules listed above. We believe the DSS being developed can be applied to almost any other industrial water treatment facility with little modification because in most situations the waste streams are less complex, fewer regulations apply, and the political environment is simpler. The techniques being developed are also generally applicable to policy and planning decision support systems in the chemical process industry
Fogel, Sandy L; Baker, Christopher C
The use of computerized decision support systems (CDSS) in glucose control for critically ill surgical patients has been reported in both diabetic and nondiabetic patients. Prospective studies evaluating its effect on glucose control are, however, lacking. The objective of this study was to evaluate patient-specific computerized IV insulin dosing on blood glucose levels (BGLs) by comparing patients treated pre-CDSS with those treated post-CDSS. A prospective study was performed in 4 surgical ICUs and 1 progressive care unit comparing patient data pre- and post-implementation of CDSS. The primary outcomes measures were the impact of the CDSS on glycemic control in this population and on reducing the incidence of severe hypoglycemia. Data on 1,682 patient admissions were evaluated, which corresponded to 73,290 BGLs post-CDSS compared with 44,972 BGLs pre-CDSS. The percentage of hyperglycemic events improved, with BGLs of >150 mg/dL decreasing by 50% compared with 6-month historical controls during the 18-month study period from July 2010 through December 2011. This was true for all 5 units individually (p < 0.0001, by one sample sign test). In addition, severe hypoglycemia (defined as BGL <40 mg/dL) decreased from 1% to 0.05% after implementing CDSS (p < 0.0001 by 2-sided binomial test). Patients whose BGLs were managed using CDSS were statistically significantly more likely to have a glucose reading under control (<150 mg/dL) than in the 6-month historical controls and to avoid serious hypoglycemia (p < 0.0001). Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
Full Text Available Management of higher education must continue to evaluate on an ongoing basis in order to improve the quality of institutions. This will be able to do the necessary evaluation of various data, information, and knowledge of both internal and external institutions. They plan to use more efficiently the collected data, develop tools so that to collect and direct management information, in order to support managerial decision making. The collected data could be utilized to evaluate quality, perform analyses and diagnoses, evaluate dependability to the standards and practices of curricula and syllabi, and suggest alternatives in decision processes. Data minings to support decision making are well suited methods to provide decision support in the education environments, by generating and presenting relevant information and knowledge towards quality improvement of education processes. In educational domain, this information is very useful since it can be used as a base for investigating and enhancing the current educational standards and managements. In this paper, a review on data mining for academic decision support in education field is presented. The details of this paper will review on recent data mining in educational field and outlines future researches in educational data mining.
One way to frame the job of planetary defense is to “find the optimal approach for finding the optimal approach” to NEO mitigation. This requires a framework for defining in advance what should be done under various circumstances. The two-dimensional action matrix from the recent NRC report “Defending Planet Earth” can be generalized to a notional “Impact Decision Support Diagram” by extending it into a third dimension. The NRC action matrix incorporated two important axes: size and time-to-impact, but probability of impact is also critical (it is part of the definitions of both the Torino and Palermo scales). Uncertainty has been neglected, but is also crucial. It can be incorporated by subsuming it into the NEO size axis by redefining size to be three standard deviations greater than the best estimate, thereby providing a built-in conservative margin. The independent variable is time-to-impact, which is known with high precision. The other two axes are both quantitative assessments of uncertainty and are both time dependent. Thus, the diagram is entirely an expression of uncertainty. The true impact probability is either one or zero, and the true size does not change. The domain contains information about the current uncertainty, which changes with time (as opposed to reality, which does not change).
Hajkowicz, Stefan A
This paper examines how multiple criteria analysis (MCA) can be used to support multi-stakeholder environmental management decisions. It presents a study through which 48 stakeholders from environmental, primary production and community interest groups used MCA to prioritise 30 environmental management problems in the Mackay-Whitsunday region of Queensland, Australia. The MCA model, with procedures for aggregating multi-stakeholder output, was used to inform a final decision on the priority of the region's environmental management problems. The result was used in the region's environmental management plan as required under Australia's Natural Heritage Trust programme. The study shows how relatively simple MCA methods can help stakeholders make group decisions, even when they hold strongly conflicting preferences.
Subject of study is the possible organisation of the Olympic Games of 2028 in the Netherlands, as seen from an urban development viewpoint. The project focuses on the decision-making process in the initiative phase. Aim of the project is the development of a decision support tool for the complex,
Leiva Portocarrero, Maria Esther; Garvelink, Mirjam M; Becerra Perez, Maria Margarita; Giguère, Anik; Robitaille, Hubert; Wilson, Brenda J; Rousseau, François; Légaré, France
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
Kalina, Jan; Seidl, Libor; Zvára, Karel; Grünfeldová, Hana; Slovák, Dalibor; Zvárová, Jana
We implemented a prototype of a decision support system called SIR which has a form of a web-based classification service for diagnostic decision support. The system has the ability to select the most relevant variables and to learn a classification rule, which is guaranteed to be suitable also for high-dimensional measurements. The classification system can be useful for clinicians in primary care to support their decision-making tasks with relevant information extracted from any available clinical study. The implemented prototype was tested on a sample of patients in a cardiological study and performs an information extraction from a high-dimensional set containing both clinical and gene expression data.
At Darlington Nuclear aggregate assessment of plant conditions is carried out in support of Operational Decision Making. This paper discusses how aggregate assessments have been applied to Operator Workarounds leading to improved prioritisation and alignment of work programs in different departments. As well, aggregate assessment of plant and human performance factors has been carried out to identify criteria which support conservative decision making in the main control room during unit transients. (author)
Scherer, Jennifer S; Holley, Jean L
Technologic advances, such as continuous RRT, provide lifesaving therapy for many patients. AKI in the critically ill patient, a fatal diagnosis in the past, is now often a survivable condition. Dialysis decision making for the critically ill patient with AKI is complex. What was once a question solely of survival now is nuanced by an individual's definition of quality of life, personal values, and short- and long-term prognoses. Clinical evaluation of AKI in the critically ill is multifaceted. Treatment decision making requires consideration of the natural evolution of the patient's AKI within the context of the global prognosis. Situations are often marked by prognostic uncertainty and clinical unknowns. In the face of these uncertainties, establishment of patient-directed therapies is imperative. A time-limited trial of continuous RRT in this setting is often appropriate but difficult to execute. Using patient preferences as a clinical guide, a proper time-limited trial requires assessment of prognosis, elicitation of patient values, strong communication skills, clear documentation, and often, appropriate integration of palliative care services. A well conducted time-limited trial can avoid interprofessional conflict and provide support for the patient, family, and staff. Copyright © 2016 by the American Society of Nephrology.
Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L
To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.
Jamieson, Rhiann; Theodore, Kate; Raczka, Roman
Little is known about how women with intellectual disabilities make decisions in relation to pregnancy. Social support is important for mothers with intellectual disabilities in many areas. This study explored how the support network influenced the decision-making of women with intellectual disabilities in relation to pregnancy. The study extended…
Lajic, Zoran; Nielsen, Ulrik Dam
In this paper a basic idea of a fault-tolerant monitoring and decision support system will be explained. Fault detection is an important part of the fault-tolerant design for in-service monitoring and decision support systems for ships. In the paper, a virtual example of fault detection...... will be presented for a containership with a real decision support system onboard. All possible faults can be simulated and detected using residuals and the generalized likelihood ratio (GLR) algorithm....
Allen, Will; Cruz, Jennyffer; Warburton, Bruce
Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.
Allen, Will; Cruz, Jennyffer; Warburton, Bruce
Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.
Herrmann, Ivan Tengbjerg
for the application of decision support and evaluation of uncertainty in LCA. From a decision maker’s (DM’s) point of view there are at least three main “illness” factors influencing the quality of the information that the DM uses for making decisions. The factors are not independent of each other, but it seems......) refrain from making a decision based on an LCA and thus support a decision on other parameters than the LCA environmental parameters. Conversely, it may in some decision support contexts be acceptable to base a decision on highly uncertain information. This all depends on the specific decision support...... the different steps. A deterioration of the quality in each step is likely to accumulate through the statistical value chain in terms of increased uncertainty and bias. Ultimately this can make final decision support problematic. The "Law of large numbers" (LLN) is the methodological tool/probability theory...
The listing of a species as endangered under the Endangered Species Act invokes a suite of responses to help improve conditions for the recovery of that species, to include identification of stressors contributing to population loss, decision analysis of the impacts of proposed recovery options, and implementation of optimal recovery measures. The ability of a decision support system to quantify inherent stressor uncertainties and to identify the key stressors that can be controlled or eliminated becomes key to ensuring the recovery of an endangered species. The listing of the Snake River sockeye, spring/summer chinook, and fall chinook salmon species in the Snake River as endangered provides a vivid example of the importance of sophisticated decision support systems. Operational and physical changes under consideration at eight of the hydroelectric dams along the Columbia and Lower Snake River pose significant financial impacts to a variety of stakeholders involved in the salmon population recovery process and carry significant uncertainties of outcome. A decision support system is presented to assist in the identification of optimal recovery actions for this example that includes the following: creation of datamarts of information on environmental, engineering, and ecological values that influence species survival; incorporation of decision analysis tools to determine optimal decision policies; and the use of geographic information systems (GIS) to provide a context for decision analysis and to communicate the impacts of decision policies
Sun, J.; Knoop, S.; Shabo, A.; Carmeli, B.; Sow, D.; Syed-Mahmood, T.; Rapp, W.
Summary Objectives This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Methods Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. Results There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Conclusion Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation. PMID:25123736
Burn-Thornton, Kath E.; Thorpe, Simon I.
Physicians, in their ever-demanding jobs, are looking to decision support systems for aid in clinical diagnosis. However, clinical decision support systems need to be of sufficiently high accuracy that they help, rather than hinder, the physician in his/her diagnosis. Decision support systems with accuracies, of patient state determination, of greater than 80 percent, are generally perceived to be sufficiently accurate to fulfill the role of helping the physician. We have previously shown that data mining techniques have the potential to provide the underpinning technology for clinical decision support systems. In this paper, an extension of the work in reverence 2, we describe how changes in data mining methodologies, for the analysis of 12-lead ECG data, improve the accuracy by which data mining algorithms determine which patients are suffering from heart disease. We show that the accuracy of patient state prediction, for all the algorithms, which we investigated, can be increased by up to 6 percent, using the combination of appropriate test training ratios and 5-fold cross-validation. The use of cross-validation greater than 5-fold, appears to reduce the improvement in algorithm classification accuracy gained by the use of this validation method. The accuracy of 84 percent in patient state predictions, obtained using the algorithm OCI, suggests that this algorithm will be capable of providing the required accuracy for clinical decision support systems.
Renardel de Lavalette, G R; Groenboom, R.; Rotterdam, E; van Harmelen, F; ten Teije, A; de Geus, F.
This paper reports on research for decision support for anaesthesiologists at the University Hospital in Groningen, the Netherlands. Based on CAROLA, an existing automated operation documentation system, we designed a support environment that will assist in real-time diagnosis. The core of the work
Kydonaki, Kalliopi; Huby, Guro; Tocher, Jennifer; Aitken, Leanne M
To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well-described. A descriptive ethnographic study exploring critical care nurses' decision-making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Scottish and Greek critical care nurses acquired patient-centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision-making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Nurses used patient-centred information to make a judgment about the patients' ability to wean. Decision-making strategies that involve categorisation of patient-centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Advanced clinical reasoning skills and accurate detection of cues in
V. V. Nadurak
Full Text Available Purpose of the research is a critical analysis of the reliability of intuitive moral decisions. Methodology. The work is based on the methodological attitude of empirical ethics, involving the use of findings from empirical research in ethical reflection and decision making. Originality. The main kinds of intuitive moral decisions are identified: 1 intuitively emotional decisions (i.e. decisions made under the influence of emotions that accompanies the process of moral decision making; 2 decisions made under the influence of moral risky psychological aptitudes (unconscious human tendencies that makes us think in a certain way and make decisions, unacceptable from the logical and ethical point of view; 3 intuitively normative decisions (decisions made under the influence of socially learned norms, that cause evaluative feeling «good-bad», without conscious reasoning. It was found that all of these kinds of intuitive moral decisions can lead to mistakes in the moral life. Conclusions. Considering the fact that intuition systematically leads to erroneous moral decisions, intuitive reaction cannot be the only source for making such decisions. The conscious rational reasoning can compensate for weaknesses of intuition. In this case, there is a necessity in theoretical model that would structure the knowledge about the interactions between intuitive and rational factors in moral decisions making and became the basis for making suggestions that would help us to make the right moral decision.
Full Text Available Abstract Background Efficient rule authoring tools are critical to allow clinical Knowledge Engineers (KEs, Software Engineers (SEs, and Subject Matter Experts (SMEs to convert medical knowledge into machine executable clinical decision support rules. The goal of this analysis was to identify the critical success factors and challenges of a fully functioning Rule Authoring Environment (RAE in order to define requirements for a scalable, comprehensive tool to manage enterprise level rules. Methods The authors evaluated RAEs in active use across Partners Healthcare, including enterprise wide, ambulatory only, and system specific tools, with a focus on rule editors for reminder and medication rules. We conducted meetings with users of these RAEs to discuss their general experience and perceived advantages and limitations of these tools. Results While the overall rule authoring process is similar across the 10 separate RAEs, the system capabilities and architecture vary widely. Most current RAEs limit the ability of the clinical decision support (CDS interventions to be standardized, sharable, interoperable, and extensible. No existing system meets all requirements defined by knowledge management users. Conclusions A successful, scalable, integrated rule authoring environment will need to support a number of key requirements and functions in the areas of knowledge representation, metadata, terminology, authoring collaboration, user interface, integration with electronic health record (EHR systems, testing, and reporting.
Heidari, Mohammad; Ebrahimi, Parvin
Critical-thinking ability would enable students to think creatively and make better decisions and makes them make a greater effort to concentrate on situations related to clinical matters and emergencies. This can bridge the gap between the clinical and theoretical training. Therefore, the aim of the present study is to examine the relationship between critical-thinking ability and decision-making skills of the students of Emergency Medicine. This descriptive and analytical research was conducted on all the students of medical emergency students ( n = 86) in Shahrekord, Iran. The demographic information questionnaire, the California Critical Thinking Skills Test, and a decision-making researcher-made questionnaire were used to collect data. The data were analyzed by SPSS software version 16 using descriptive and analytical statistical tests and Pearson's correlation coefficient. The results of the present study indicate that the total mean score for the critical thinking was 8.32 ± 2.03 and for decision making 8.66 ± 1.89. There is a significant statistical relationship between the critical-thinking score and decision-making score ( P critical-thinking skills and decision-making ability are essential for medical emergency professional competence, the results of this study show that these skills are poor among the students.
Doctor, P.G.; Mahaffey, J.A.; Cowley, P.J.; Freshley, M.D.; Hassig, N.L.; Brothers, J.W.; Glantz, C.S.; Strachan, D.M.
To help integrate activities in the environmental restoration and waste management mission of the Hanford Site, the Hanford Integrated Planning Project (HIPP) was established and funded by the US Department of Energy. The project is divided into three key program elements, the first focusing on an explicit, defensible and comprehensive method for evaluating technical options. Based on the premise that computer technology can be used to support the decision-making process and facilitate integration among programs and activities, the Decision Support Tools Task was charged with assessing the status of computer technology for those purposes at the Site. The task addressed two types of tools: tools need to provide technical information and management support tools. Technical tools include performance and risk assessment models, information management systems, data and the computer infrastructure to supports models, data, and information management systems. Management decision support tools are used to synthesize information at a high' level to assist with making decisions. The major conclusions resulting from the assessment are that there is much technical information available, but it is not reaching the decision-makers in a form to be used. Many existing tools provide components that are needed to integrate site activities; however, some components are missing and, more importantly, the ''glue'' or connections to tie the components together to answer decision-makers questions is largely absent. Top priority should be given to decision support tools that support activities given in the TPA. Other decision tools are needed to facilitate and support the environmental restoration and waste management mission
Doctor, P.G.; Mahaffey, J.A.; Cowley, P.J.; Freshley, M.D.; Hassig, N.L.; Brothers, J.W.; Glantz, C.S.; Strachan, D.M.
To help integrate activities in the environmental restoration and waste management mission of the Hanford Site, the Hanford Integrated Planning Project (HIPP) was established and funded by the US Department of Energy. The project is divided into three key program elements, the first focusing on an explicit, defensible and comprehensive method for evaluating technical options. Based on the premise that computer technology can be used to support the decision-making process and facilitate integration among programs and activities, the Decision Support Tools Task was charged with assessing the status of computer technology for those purposes at the Site. The task addressed two types of tools: tools need to provide technical information and management support tools. Technical tools include performance and risk assessment models, information management systems, data and the computer infrastructure to supports models, data, and information management systems. Management decision support tools are used to synthesize information at a high' level to assist with making decisions. The major conclusions resulting from the assessment are that there is much technical information available, but it is not reaching the decision-makers in a form to be used. Many existing tools provide components that are needed to integrate site activities; however, some components are missing and, more importantly, the glue'' or connections to tie the components together to answer decision-makers questions is largely absent. Top priority should be given to decision support tools that support activities given in the TPA. Other decision tools are needed to facilitate and support the environmental restoration and waste management mission.
Doctor, P.G.; Mahaffey, J.A.; Cowley, P.J.; Freshley, M.D.; Hassig, N.L.; Brothers, J.W.; Glantz, C.S.; Strachan, D.M.
To help integrate activities in the environmental restoration and waste management mission of the Hanford Site, the Hanford Integrated Planning Project (HIPP) was established and funded by the US Department of Energy. The project is divided into three key program elements, the first focusing on an explicit, defensible and comprehensive method for evaluating technical options. Based on the premise that computer technology can be used to support the decision-making process and facilitate integration among programs and activities, the Decision Support Tools Task was charged with assessing the status of computer technology for those purposes at the Site. The task addressed two types of tools: tools need to provide technical information and management support tools. Technical tools include performance and risk assessment models, information management systems, data and the computer infrastructure to supports models, data, and information management systems. Management decision support tools are used to synthesize information at a high` level to assist with making decisions. The major conclusions resulting from the assessment are that there is much technical information available, but it is not reaching the decision-makers in a form to be used. Many existing tools provide components that are needed to integrate site activities; however, some components are missing and, more importantly, the ``glue`` or connections to tie the components together to answer decision-makers questions is largely absent. Top priority should be given to decision support tools that support activities given in the TPA. Other decision tools are needed to facilitate and support the environmental restoration and waste management mission.
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.
Reichert, Peter; Langhans, Simone D; Lienert, Judit; Schuwirth, Nele
Environmental decision support intends to use the best available scientific knowledge to help decision makers find and evaluate management alternatives. The goal of this process is to achieve the best fulfillment of societal objectives. This requires a careful analysis of (i) how scientific knowledge can be represented and quantified, (ii) how societal preferences can be described and elicited, and (iii) how these concepts can best be used to support communication with authorities, politicians, and the public in environmental management. The goal of this paper is to discuss key requirements for a conceptual framework to address these issues and to suggest how these can best be met. We argue that a combination of probability theory and scenario planning with multi-attribute utility theory fulfills these requirements, and discuss adaptations and extensions of these theories to improve their application for supporting environmental decision making. With respect to (i) we suggest the use of intersubjective probabilities, if required extended to imprecise probabilities, to describe the current state of scientific knowledge. To address (ii), we emphasize the importance of value functions, in addition to utilities, to support decisions under risk. We discuss the need for testing "non-standard" value aggregation techniques, the usefulness of flexibility of value functions regarding attribute data availability, the elicitation of value functions for sub-objectives from experts, and the consideration of uncertainty in value and utility elicitation. With respect to (iii), we outline a well-structured procedure for transparent environmental decision support that is based on a clear separation of scientific prediction and societal valuation. We illustrate aspects of the suggested methodology by its application to river management in general and with a small, didactical case study on spatial river rehabilitation prioritization. Copyright © 2015 The Authors. Published by
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.
Full Text Available This paper reviews the issues on the support and criticism of historical cost accounting (HCA and the incremental information content on current cost disclosures. Based on literature review this study find that historical cost is still relevant to use in decision making. Empirical studies show evidence both; supporting historical cost accounting and criticisms against the conventional historical cost based financial statements. Issues on historical cost are raised because of economic condition, inflation, the change in high tech environment, price movements, and regulators statements. Studies shows that historical cost accounting. over the decade: still have power explanatory for investors, which indicates that its benefits outweigh its cost. However, Barth et al. (1996 provide strong evidence on incremental information of current cost disclosures for certain assets and liabilities. This paper concludes that even there are weaknesses (against HCA, still there are more benefits that we can gain through HCA.
Evans, R.W.; Elwyn, G.; Edwards, A.
Interactive decision support applications might help patients to make difficult decisions about their health care. They lie in the context of traditional decision aids, which are known to have effects on a number of patient outcomes, including knowledge and decisional conflict. The problem of
Augusto, Juan Carlos
Handling time-related concepts is essential in medicine. During diagnosis it can make a substantial difference to know the temporal order in which some symptoms occurred or for how long they lasted. During prognosis the potential evolutions of a disease are conceived as a description of events unfolding in time. In therapy planning the different steps of treatment must be applied in a precise order, with a given frequency and for a certain span of time in order to be effective. This article offers a survey on the use of temporal reasoning for decision support-related tasks in medicine. Key publications of the area, mainly circumscribed to the latest two decades, are reviewed and classified according to three important stages of patient treatment requiring decision support: diagnosis, prognosis and therapy planning/management. Other complementary publications, like those on time-centered information storage and retrieval, are also considered as they provide valuable support to the above mentioned three stages. Key areas are highlighted and used to organize the latest contributions. The survey of previous research is followed by an analysis of what can still be improved and what is needed to make the next generation of decision support systems for medicine more effective. It can be observed that although the area has been considerably developed, there are still areas where more research is needed to make time-based systems of widespread use in decision support-related areas of medicine. Several suggestions for further exploration are proposed as a result of the survey.
Mould, D. R.; D'Haens, G.; Upton, R. N.
Dashboard systems for clinical decision support integrate data from multiple sources. These systems, the newest in a long line of dose calculators and other decision support tools, utilize Bayesian approaches to fully individualize dosing using information gathered through therapeutic drug
McKeown, Charles; Adelaja, Adesoji; Calnin, Benjamin
This paper presents the rudiments of a Wind Prospecting Tool designed to inform private and public decision makers involved in wind industry development in reducing transaction costs associated with identifying areas of mutual focus within a state. The multiple layer decision support framework has proven to be valuable to industry, state government and local decision makers. Information on wind resources, land availability, potential land costs, potential NIMBYism concerns and economic development potential were integrated to develop a framework for decision support. The paper also highlights implications for decision support research and the role of higher education in providing anticipatory science to enhance private and public choices in economic development. - Research Highlights: →In this paper we explore the building and value of a wind industry location decision support tool. →We examine the development process from the industry perspective. →We discuss the creation of a decision support tool that was designed for industry, state policy makers and local decision makers. →We build a model framework for wind prospecting decision support. →Finally we discuss the impact on local and state decision making as a result of being informed by science based decision support.
Chang, Ai-Mei; And Others
Presents a hyperknowledge framework of decision support systems (DSS). This framework formalizes specifics about system functionality, representation of knowledge, navigation of the knowledge system, and user-interface traits as elements of a DSS environment that conforms closely to human cognitive processes in decision making. (Contains 52…
Intelligent decision support system for operators of the supply department of oil and gas extracting industry. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... abnormal situations, pre-crash sensing, industrial drilling, decision-making support systems. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
Full Text Available Information hasbecome an essentialresource for managing modern organizations. This is so because today’sbusiness environment is volatile, dynamic, turbulent and necessitates the burgeoning demand for accurate, relevant, complete,timely and economical information needed to drive the decision-making process in order to accentuate organizational abilities to manage opportunities and threat. MIS work on online mode with an average processing speed. Generally, it is used by low level management. Decision support system are powerful tool that assist corporate executives, administrators and other senior officials in making decision regarding the problem. Management Information Systems is a useful tool that provided organized and summarized information in a proper time to decision makers and enable making accurate decision for managers in organizations. This paper will discuss the concept, characteristics, types of MIS, the MIS model, and in particular it will highlight the impact and role of MIS on decision making.
Full Text Available In this article, we describe simulation-based decision support techniques for evaluation of operational plans within effects-based planning. Using a decision support tool, developers of operational plans are able to evaluate thousands of alternative plans against possible courses of events and decide which of these plans are capable of achieving a desired end state. The objective of this study is to examine the potential of a decision support system that helps operational analysts understand the consequences of numerous alternative plans through simulation and evaluation. Operational plans are described in the effects-based approach to operations concept as a set of actions and effects. For each action, we examine several different alternative ways to perform the action. We use a representation where a plan consists of several actions that should be performed. Each action may be performed in one of several different alternative ways. Together these action alternatives make up all possible plan instances, which are represented as a tree of action alternatives that may be searched for the most effective sequence of alternative actions. As a test case, we use an expeditionary operation with a plan of 43 actions and several alternatives for these actions, as well as a scenario of 40 group actors. Decision support for planners is provided by several methods that analyze the impact of a plan on the 40 actors, e.g., by visualizing time series of plan performance. Detailed decision support for finding the most influential actions of a plan is presented by using sensitivity analysis and regression tree analysis. Finally, a decision maker may use the tool to determine the boundaries of an operation that it must not move beyond without risk of drastic failure. The significant contribution of this study is the presentation of an integrated approach for evaluation of operational plans.
The MSRC Spill Operation System (SOS) is a tool for the support of decision-making at the time of a catastrophic oil spill. SOS provides MSRC decision-makers with access to information about the source of the spill, the spill environment, and the availability of spill response resources. This system is designed to meet the information needs of a Response Supervisor, an Environmental Advisor, Logistics/Maintenance Supervisor, Operations Supervisor, and the MSRC Regional General Manager. The SOS project Objectives are: (1) integrate currently available data, systems, and technologies; (2) develop an application that effectively supports mobilized operations and can be adapted to support normal operations; (3) ensure that the development of computer applications is driven by user needs and not by technology; and (4) coordinate with government and other industry organizations to avoid duplication of effort. Design Objectives for SOS are: (1) centralize management information storage while decentralizing decision making capabilities; (2) boost User confidence by providing a system that is easy to learn, easy to use, and is open-quotes Sailor Proofclose quotes; and (3) use visualization technology in providing spill related information. This approach includes the use of Geographic Information System (GIS) technology for maps and geographically associated resource; and support MSRC's concept of operation which includes - a swift notification of response personnel; fast mobilization of response resources; and accurate tracking of resources during a spill. MSRC is organized into five responsibility regions
able to construct a checklist of a clinical and physiologic model and then a computerised decision support system that will perform two functions: the...the provision of nutritional therapy, and assessment of use by nursing and physician staff KEYWORDS Nutrition, severe burn, decision support... clinical testing. Checklist and Decision Support in Nutritional Care for Burned Patients Proposal Number: 12340011 W81XWH-12-2-0074 PI: Steven E
Arslanian-Engoren, Cynthia; Scott, Linda D
Decision regret is a negative cognitive emotion associated with experiences of guilt and situations of interpersonal harm. These negative affective responses may contribute to emotional exhaustion in critical care nurses (CCNs), increased staff turnover rates and high medication error rates. Yet, little is known about clinical decision regret among CCNs or the conditions or situations (e.g., feeling sleepy) that may precipitate its occurrence. To examine decision regret among CCNs, with an emphasis on clinical decisions made when nurses were most sleepy. A content analytic approach was used to examine the narrative descriptions of clinical decisions by CCNs when sleepy. Six decision regret themes emerged that represented deviations in practice or performance behaviors that were attributed to fatigued CCNs. While 157 CCNs disclosed a clinical decision they made at work while sleepy, the prevalence may be underestimated and warrants further investigation. Copyright © 2014 Elsevier Inc. All rights reserved.
G.H. van Bruggen (Gerrit); B. Wierenga (Berend)
textabstractMarketing management support systems (MMSS) are computer-enabled devices that help marketers to make better decisions. Marketing processes can be quite complex, involving large numbers of variables and mostly outcomes are the results of the actions of many different stakeholders (e.g.,
Jones, M.; Pitts, R.
For emergency managers, government officials, and others who must respond to rapidly changing natural disasters, timely access to detailed information related to affected terrain, population and infrastructure is critical for planning, response and recovery operations. Accessing, analyzing and disseminating such disparate information in near real-time are critical decision support components. However, finding a way to handle a variety of informative yet complex datasets poses a challenge when preparing for and responding to disasters. Here, we discuss the implementation of a web-based data integration and decision support tool for earthquakes developed by the Federal Emergency Management Agency (FEMA) as a solution to some of these challenges. While earthquakes are among the most well- monitored and measured of natural hazards, the spatially broad impacts of shaking, ground deformation, landslides, liquefaction, and even tsunamis, are extremely difficult to quantify without accelerated access to data, modeling, and analytics. This web-based application, deemed the "Earthquake Incident Journal", provides real-time access to authoritative and event-specific data from external (e.g. US Geological Survey, NASA, state and local governments, etc.) and internal (FEMA) data sources. The journal includes a GIS-based model for exposure analytics, allowing FEMA to assess the severity of an event, estimate impacts to structures and population in near real-time, and then apply planning factors to exposure estimates to answer questions such as: What geographic areas are impacted? Will federal support be needed? What resources are needed to support survivors? And which infrastructure elements or essential facilities are threatened? This presentation reviews the development of the Earthquake Incident Journal, detailing the data integration solutions, the methodology behind the GIS-based automated exposure model, and the planning factors as well as other analytical advances that
Shirley Jie Xuan Wang
Full Text Available This article addresses the possibility of incorporating intelligent decision support systems into reinsurance decision-making. This involves the insurance company and the reinsurance company, and is negotiated through reinsurance intermediaries. The article proposes a decision flow to model the reinsurance design and selection process. This article focuses on adopting more than one optimality criteria under a more generic combinational design of commonly used reinsurance products, i.e., proportional reinsurance and stop-loss reinsurance. In terms of methodology, the significant contribution of the study the incorporation of the well-established decision analysis tool multiple-attribute decision-making (MADM into the modelling of reinsurance selection. To illustrate the feasibility of incorporating intelligent decision supporting systems in the reinsurance market, the study includes a numerical case study using the simulation software @Risk in modeling insurance claims, as well as programming in MATLAB to realize MADM. A list of managerial implications could be drawn from the case study results. Most importantly, when choosing the most appropriate type of reinsurance, insurance companies should base their decisions on multiple measurements instead of single-criteria decision-making models so that their decisions may be more robust.
Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin
Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.
Summary Objective To summarize recent research and select the best papers published in 2015 in the field of computerized clinical decision support for the Decision Support section of the IMIA yearbook. Method A literature review was performed by searching two bibliographic databases for papers related to clinical decision support systems (CDSSs) and computerized provider order entry (CPOE) systems. The aim was to identify a list of candidate best papers from the retrieved papers that were then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the IMIA editorial team was finally conducted to conclude in the best paper selection. Results Among the 974 retrieved papers, the entire review process resulted in the selection of four best papers. One paper reports on a CDSS routinely applied in pediatrics for more than 10 years, relying on adaptations of the Arden Syntax. Another paper assessed the acceptability and feasibility of an important CPOE evaluation tool in hospitals outside the US where it was developed. The third paper is a systematic, qualitative review, concerning usability flaws of medication-related alerting functions, providing an important evidence-based, methodological contribution in the domain of CDSS design and development in general. Lastly, the fourth paper describes a study quantifying the effect of a complex, continuous-care, guideline-based CDSS on the correctness and completeness of clinicians’ decisions. Conclusions While there are notable examples of routinely used decision support systems, this 2015 review on CDSSs and CPOE systems still shows that, despite methodological contributions, theoretical frameworks, and prototype developments, these technologies are not yet widely spread (at least with their full functionalities) in routine clinical practice. Further research, testing, evaluation, and training are still needed for these tools to be adopted in clinical practice and, ultimately, illustrate
Kalina, Jan; Zvárová, Jana
Roč. 5, č. 1 (2017), s. 21-27 ISSN 1805-8698 R&D Projects: GA ČR GA17-01251S Institutional support: RVO:67985807 Keywords : decision support systems * decision rules * statistical analysis * nonparametric regression Subject RIV: IN - Informatics, Computer Science OBOR OECD: Statistics and probability
Schimmer, C; Hamouda, K; Oezkur, M; Sommer, S-P; Leistner, M; Leyh, R
Ethical and medical criteria in the decision-making process of withholding or withdrawal of life support therapy in critically ill patients present a great challenge in intensive care medicine. The purpose of this work was to assess medical and ethical criteria that influence the decision-making process for changing the aim of therapy in critically ill cardiac surgery patients. A questionnaire was distributed to all German cardiac surgery centers (n = 79). All clinical directors, intensive care unit (ICU) consultants and ICU head nurses were asked to complete questionnaires (n = 237). In all, 86 of 237 (36.3 %) questionnaires were returned. Medical reasons which influence the decision-making process for changing the aim of therapy were cranial computed tomography (cCT) with poor prognosis (91.9 %), multi-organ failure (70.9 %), and failure of assist device therapy (69.8 %). Concerning ethical reasons, poor expected quality of life (48.8 %) and the presumed patient's wishes (40.7 %) were reported. There was a significant difference regarding the perception of the three different professional groups concerning medical and ethical criteria as well as the involvement in the decision-making process. In critically ill cardiac surgery patients, medical reasons which influence the decision-making process for changing the aim of therapy included cCT with poor prognosis, multi-organ failure, and failure of assist device therapy. Further studies are mandatory in order to be able to provide adequate answers to this difficult topic.
Full Text Available Identifying and making the correct decision on the best health treatment or screening test option can become a difficult task. Therefore is important that the patients get all types of information appropriate to manage their health. Decision aids can be very useful when there is more than one reasonable option about a treatment or uncertain associated with screening tests. The decision aids tools help people to understand their clinical condition, through the description of the different options available. The purpose of this paper is to present the project “Supporting Informed Decision Making In Prevention of Prostate Cancer” (SIDEMP. This project is focused on the creation of a Web-based decision platform specifically directed to screening prostate cancer, that will support the patient in the process of making an informed decision
Sowder, A.G.; Machiels, A.J.; Dykes, A.A.; Johnson, D.H.
To address challenges and gaps in nuclear fuel cycle option assessment and to support research, develop and demonstration programs oriented toward commercial deployment, EPRI (Electric Power Research Institute) is seeking to develop and maintain an independent analysis and assessment capability by building a suite of assessment tools based on a platform of software, simplified relationships, and explicit decision-making and evaluation guidelines. As a demonstration of the decision-support framework, EPRI examines a relatively near-term fuel cycle option, i.e., use of reactor-grade mixed-oxide fuel (MOX) in U.S. light water reactors. The results appear as a list of significant concerns (like cooling of spent fuels, criticality risk...) that have to be taken into account for the final decision
Steven Walczak; Deborah L. Kellogg; Dawn G. Gregg
Purchase processes often require complex decision making and consumers frequently use Web information sources to support these decisions. However, increasing amounts of information can make finding appropriate information problematic. This information overload, coupled with decision complexity, can increase time required to make a decision and reduce decision quality. This creates a need for tools that support these decision-making processes. Online tools that bring together data and partial ...
Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin
Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians’ cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems. PMID:27990498
Pinto, Tiago; Sousa, Tiago M.; Praça, Isabel
. The ALBidS system allows MASCEM market negotiating players to take the best possible advantages from the market context. This paper presents the application of a Support Vector Machines (SVM) based approach to provide decision support to electricity market players. This strategy is tested and validated...... by being included in ALBidS and then compared with the application of an Artificial Neural Network (ANN), originating promising results: an effective electricity market price forecast in a fast execution time. The proposed approach is tested and validated using real electricity markets data from MIBEL......׳ research group has developed a multi-agent system: Multi-Agent System for Competitive Electricity Markets (MASCEM), which simulates the electricity markets environment. MASCEM is integrated with Adaptive Learning Strategic Bidding System (ALBidS) that works as a decision support system for market players...
This study developed a web-based prototype decision support platform to demonstrate the benefits of transportation asset management in monitoring asset performance, supporting asset funding decisions, planning budget tradeoffs, and optimizing resourc...
Scott, Linda D; Arslanian-Engoren, Cynthia; Engoren, Milo C
The effects of inadequate sleep on clinical decisions may be important for patients in critical care units, who are often more vulnerable than patients in other units. Fatigued nurses are more likely than well-rested nurses to make faulty decisions that lead to decision regret, a negative cognitive emotion that occurs when the actual outcome differs from the desired or expected outcome. To examine the association between selected sleep variables, impairment due to fatigue, and clinical-decision self-efficacy and regret among critical care nurses. Decision regret was the primary outcome variable. Methods A nonexperimental, descriptive design and extant measures were used to obtain data from a random sample of full-time nurses. Binary logistic regression models were used to examine the association between sleep variables, fatigue, and clinical-decision self-efficacy and regret. The discrimination of the models was compared with the C statistic, the area under the receiver operating characteristic curve. A total of 605 nurses returned the questionnaires (17% response rate). Among these, decision regret was reported by 157 of 546 (29%). Nurses with decision regret reported more fatigue, more daytime sleepiness, less intershift recovery, and worse sleep quality than did nurses without decision regret. Being male, working a 12-hour shift, and clinical-decision satisfaction were significantly associated with decision regret (C statistic, 0.719; SE, 0.024). Nurses who experience impairments due to fatigue, loss of sleep, and inability to recover between shifts are more likely than unimpaired nurses to report decision regret.
Wu, Defang; Luo, Yang; Liao, Xinyu
There is universal agreement on the essential role of critical thinking in nursing practice. Most studies into this topic have provided descriptive statistical information and insights on related external factors such as educational environment and teaching strategies. However, there has been limited research into the psychological factors that may predict the disposition of students toward critical thinking. This study explored the relationship between the disposition of nursing students toward critical thinking and their mental self-supporting ability to obtain a profile and determine the psychological predictors of critical thinking. A cross-sectional descriptive study was conducted in 2013 using a convenience sample from four nursing schools. Four hundred six Chinese nursing undergraduates completed two questionnaires including (a) the California Critical Thinking Disposition Inventory (Chinese version) and (b) the Mental Self-Supporting Questionnaire for University Students. Pearson's correlation and linear regression analysis were used to investigate the relationship between these two variables and the predicted positive psychological qualities for the critical thinking disposition of participants. Average participant scores for critical thinking disposition and mental self-supporting were 280.91 ± 28.43 and 76.40 ± 8.47, respectively. Positive correlations were observed between these two variables (r = .583, p critical thinking disposition (R = .435, p critical thinking and mental self-supporting abilities.The four factors that had a major influence on critical thinking disposition included self-decision, self-cognition, self-confidence, and self-responsibility. Nursing educators should focus on improving the critical thinking ability of their students in these four aspects.
Spahr, K.; Hogue, T. S.
Selecting the most appropriate green, gray, and / or hybrid system for stormwater treatment and conveyance can prove challenging to decision markers across all scales, from site managers to large municipalities. To help streamline the selection process, a multi-disciplinary team of academics and professionals is developing an industry standard for selecting and evaluating the most appropriate stormwater management technology for different regions. To make the tool more robust and comprehensive, life-cycle cost assessment and optimization modules will be included to evaluate non-monetized and ecosystem benefits of selected technologies. Initial work includes surveying advisory board members based in cities that use existing decision support tools in their infrastructure planning process. These surveys will qualify the decisions currently being made and identify challenges within the current planning process across a range of hydroclimatic regions and city size. Analysis of social and other non-technical barriers to adoption of the existing tools is also being performed, with identification of regional differences and institutional challenges. Surveys will also gage the regional appropriateness of certain stormwater technologies based off experiences in implementing stormwater treatment and conveyance plans. In additional to compiling qualitative data on existing decision support tools, a technical review of components of the decision support tool used will be performed. Gaps in each tool's analysis, like the lack of certain critical functionalities, will be identified and ease of use will be evaluated. Conclusions drawn from both the qualitative and quantitative analyses will be used to inform the development of the new decision support tool and its eventual dissemination.
This presentation provides an overview about different approaches of the mobile learning group of the Welten Institute regarding the design and evaluation of mobile learning games for critical decision making and crisis simulation.
This study evaluates the usability of a U.S. Navy Decision Support System (DSS). The DSS was developed to enhance the performance of tactical decision makers within a Navy Combat Information Center...
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.
Huser, Vojtech; Rasmussen, Luke V; Oberg, Ryan; Starren, Justin B
Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. We describe an implementation of a free workflow technology
Background Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. Results We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. Conclusions We describe an implementation of
A critical role of pavement management is to provide decision makers with estimates of the required budget level to achieve specific steady-state network conditions, and to recommend the best allocation of available budget among competing needs for m...
The goal of this project is to develop decision support tools to support traffic management operations based on collected intelligent transportation system (ITS) data. The project developments are in accordance with the needs of traffic management ce...
Wei Yanhui; Su Desong; Chen Weihua; Zhang Jianbo
The article first reviewed three operation support systems currently used in NPP: real-time information surveillance system, important equipment surveillance system and plant process control and monitoring system, then presents the structure and function of three expert support sub-systems (intelligent alarm monitoring system, computer-based operating procedure support system, safety information expert decision support system). Finally the article discussed the meaning of a kind of operation decision making support system. (authors)
Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A
The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.
Tudor B. Ionescu
Full Text Available This paper introduces a novel method of continuous verification of simulation software used in decision-support systems for nuclear emergency management (DSNE. The proposed approach builds on methods from the field of software reliability engineering, such as N-Version Programming, Recovery Blocks, and Consensus Recovery Blocks. We introduce a new acceptance test for dispersion simulation results and a new voting scheme based on taxonomies of simulation results rather than individual simulation results. The acceptance test and the voter are used in a new scheme, which extends the Consensus Recovery Block method by a database of result taxonomies to support machine-learning. This enables the system to learn how to distinguish correct from incorrect results, with respect to the implemented numerical schemes. Considering that decision-support systems for nuclear emergency management are used in a safety-critical application context, the methods introduced in this paper help improve the reliability of the system and the trustworthiness of the simulation results used by emergency managers in the decision making process. The effectiveness of the approach has been assessed using the atmospheric dispersion forecasts of two test versions of the widely used RODOS DSNE system.
Full Text Available Decision Support Systems (DSS form a specific class of computerized information systems that support business and managerial decision-making activities. Making the right decision in business primarily depends on the quality of data. It also depends on the ability to analyze the data with a view to identifying trends that can suggest solutions and strategies. A “cooperative” decision support system means the data are collected, analyzed and then provided to a human agent who can help the system to revise or refine the data. It means that both a human component and computer component work together to come up with the best solution. This paper describes the usage of a software product (Vanguard System to a specific economic application (evaluating the financial risk assuming that the rate of the economic profitability can be under the value of the interest rate.
Adumitroaie, V.; Weisbin, C. R.
In a restricted science budget environment and increasingly numerous required technology developments, the technology investment decisions within NASA are objectively more and more difficult to make such that the end results are satisfying the technical objectives and all the organizational constraints. Under these conditions it is rationally desirable to build an investment portfolio, which has the highest possible technology infusion rate. Arguably the path to infusion is subject to many influencing factors, but here only the challenges associated with the very initial stages are addressed: defining the needs and the subsequent investment decision-support process. It is conceivable that decision consistency and possibly its quality suffer when the decision-making process has limited or no traceability. This paper presents a structured decision-support framework aiming to provide traceable, auditable, infusion- driven recommendations towards a selection process in which these recommendations are used as reference points in further discussions among stakeholders. In this framework addressing well-defined requirements, different measures of success can be defined based on traceability to specific selection criteria. As a direct result, even by using simplified decision models the likelihood of infusion can be probed and consequently improved.
Ferguson, Alison; Duffield, Gemma; Worrall, Linda
The assessment and management of a person with aphasia for whom decision-making capacity is queried represents a highly complex clinical issue. In addition, there are few published guidelines and even fewer published accounts of empirical research to assist. The research presented in this paper aimed to identify the main issues for speech pathologists when decision-making capacity for legal and related matters arose for their clients with aphasia, and to describe qualitatively the nature of these issues and the practices of the speech pathologists in these situations. The methodology was informed by the qualitative research paradigm and made use of the semi-structured interview methods developed for the Critical Incident Technique. Nine speech pathologists, with a range of clinical experience between three and 27 years, were interviewed by telephone, with verbatim notes being taken on-line by the interviewer. The speech pathologists described a total of 21 clients (15 male, six female) with acquired neurological communication disorders (including cerebral vascular accident, traumatic brain injury, and tumour) whose care had raised critical incidents for the speech pathologist in relation to legal and related matters. These verbatim notes were qualitatively analysed using NVivo qualitative analysis software. The main incidents related to legal decisions (for example, power of attorney, will-making), as well as decisions involving consent for medical treatment, discharge, accommodation, and business/financial decisions. In all but one of the incidents recounted, the issues centred on a situation of conflict between the person with aphasia and their family, friends or with the multidisciplinary team. The roles taken by the speech pathologists ranged from those expected within a speech pathology scope of practice, such as that of assessor and consultant, to those which arguably present dilemmas and conflict of interest, for example, interpreter, advocate. The
Baig, S.; Zaehringer, M.
The aim of the European Research and Development project MODEM (Monitoring Data and Information Exchange Among Decision Support Systems) is to achieve practical improvements for data exchange among decision support systems (DSS). Hence, the results of model calculations become comparable. This is a precondition for harmonised decision making. Based on the analysis of existing procedures, it was decided to use the PUSH-PULL concept. Notifications are actively and automatically sent by the DSS (PUSH). The data can then be downloaded form an in-formation server (PULL). The format of the data is defined in XML (extended markup language). Participants of the project are the DSS: RODOS, ARGOS and RECASS. First, the data is comprised of the source term and meteorological information. Results of the prognoses and measurement data are also to be exchanged. Exercises testing and improving the pro-cedures form an integral part of the project. (orig.)
Glasscoe, M. T.; Stough, T. M.; Parker, J. W.; Burl, M. C.; Donnellan, A.; Blom, R. G.; Pierce, M. E.; Wang, J.; Ma, Y.; Rundle, J. B.; Yoder, M. R.
Earthquake Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response (E-DECIDER) is a NASA-funded project developing capabilities for decision-making utilizing remote sensing data and modeling software in order to provide decision support for earthquake disaster management and response. E-DECIDER incorporates earthquake forecasting methodology and geophysical modeling tools developed through NASA's QuakeSim project in order to produce standards-compliant map data products to aid in decision-making following an earthquake. Remote sensing and geodetic data, in conjunction with modeling and forecasting tools, help provide both long-term planning information for disaster management decision makers as well as short-term information following earthquake events (i.e. identifying areas where the greatest deformation and damage has occurred and emergency services may need to be focused). E-DECIDER utilizes a service-based GIS model for its cyber-infrastructure in order to produce standards-compliant products for different user types with multiple service protocols (such as KML, WMS, WFS, and WCS). The goal is to make complex GIS processing and domain-specific analysis tools more accessible to general users through software services as well as provide system sustainability through infrastructure services. The system comprises several components, which include: a GeoServer for thematic mapping and data distribution, a geospatial database for storage and spatial analysis, web service APIs, including simple-to-use REST APIs for complex GIS functionalities, and geoprocessing tools including python scripts to produce standards-compliant data products. These are then served to the E-DECIDER decision support gateway (http://e-decider.org), the E-DECIDER mobile interface, and to the Department of Homeland Security decision support middleware UICDS (Unified Incident Command and Decision Support). The E-DECIDER decision support gateway features a web interface that
Jauregui, Barbara; Janusz, Cara Bess; Clark, Andrew D; Sinha, Anushua; Garcia, Ana Gabriela Felix; Resch, Stephen; Toscano, Cristiana M; Sanderson, Colin; Andrus, Jon Kim
The Pan American Health Organization (PAHO) created the ProVac Initiative in 2004 with the goal of strengthening national technical capacity to make evidence-based decisions on new vaccine introduction, focusing on economic evaluations. In view of the 10th anniversary of the ProVac Initiative, this article describes its progress and reflects on lessons learned to guide the next phase. We quantified the output of the Initiative's capacity-building efforts and critically assess its progress toward achieving the milestones originally proposed in 2004. Additionally, we reviewed how country studies supported by ProVac have directly informed and strengthened the deliberations around new vaccine introduction. Since 2004, ProVac has conducted four regional workshops and supported 24 health economic analyses in 15 Latin American and Caribbean countries. Five Regional Centers of Excellence were funded, resulting in six operational research projects and nine publications. Twenty four decisions on new vaccine introductions were supported with ProVac studies. Enduring products include the TRIVAC and CERVIVAC cost-effectiveness models, the COSTVAC program costing model, methodological guides, workshop training materials and the OLIVES on-line data repository. Ten NITAGs were strengthened through ProVac activities. The evidence accumulated suggests that initiatives with emphasis on sustainable training and direct support for countries to generate evidence themselves, can help accelerate the introduction of the most valuable new vaccines. International and Regional Networks of Collaborators are necessary to provide technical support and tools to national teams conducting analyses. Timeliness, integration, quality and country ownership of the process are four necessary guiding principles for national economic evaluations to have an impact on policymaking. It would be an asset to have a model that offers different levels of complexity to choose from depending on the vaccine being
Pieterse, Arwen H; de Vries, Marieke
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.
This book is organized into three sections in accordance with the structure of the conference program. First section contains four major papers which were commissioned by the Programme Committee to set the tone for the conference and to provide a structured source of relevant material from contributing disciplines. The second section contains specific papers submitted to the conference, and concerned with the following topics of specific interest: epistemological issues for decision support systems (DSS), capturing organizational knowledge for DSS, complementarity between human and formal DSS, and representations for adaption. The third section contains the short papers on any topic of relevance to the theme of the conference. It is hoped that the two working conferences organized by WG 8.3 will contribute to the development of a coherent knowledge and understanding of the class of computerized information systems called Decision Support Systems. (Auth.)
Kalina, Jan; Zvárová, Jana
Roč. 4, č. 1 (2016), s. 30-34 ISSN 1805-8698 Grant - others:Nadační fond na opdporu vědy(CZ) Neuron Institutional support: RVO:67985807 Keywords : decision support * data mining * multivariate statistics * psychiatry * information based medicine Subject RIV: BB - Applied Statistics, Operational Research
Lin, Zhihang; Chen, Hang; Chen, Kuen; Che, Ada
This paper describes the work on the development of a group decision support system for customer driven product design. The customer driven is to develop products, which meet all customer requirements in whole life cycle of products. A process model of decision during product primary design is proposed to formulate the structured, semi-structured and unstructured decision problems. The framework for the decision support system is presented that integrated both advances in the group decision making and distributed artificial intelligent. The system consists of the product primary design tool kit and the collaborative platform with multi-agent structure. The collaborative platform of the system and the product primary design tool kit, including the VOC (Voice of Customer) tool, QFD (Quality Function Deployment) tool, the Conceptual design tool, Reliability analysis tool and the cost and profit forecasting tool, are indicated.
van Hillegersberg, Jos; Koenen, Sebastiaan
While organizations have massively adopted enterprise information systems to support business processes, business meetings in which key decisions are made about products, services and processes are usually held without much support of information systems. This is remarkable as group decision support
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
Oosterhuis, B [Twente Univ., Enschede (Netherlands). Computer Science Dept.
The Containment and Release Management project was carried out within the Reinforced Concerted Action Programme for Accident Management Support and partly financed by the European Union. In this report a prototype of an accident management support system is presented. The support system integrates several concepts from accident management research, like safety objective trees, severe accident phenomena, calculation models and an emergency response data system. These concepts are provided by the prototype in such a way that the decision making process of accident management is supported. The prototype application is demonstrated by process data taken from a severe accident scenario for a pressurized water reactor (PWR) that was simulated with the thermohydraulic computer program MAAP. The prototype was derived from a decision support framework based on a decision theory. For established and innovative concepts from accident management research it is pointed out in which way these concepts can support accident management and how these concepts can be integrated. This approach is generic in two ways; it applies to both pressurized and boiling water reactors and it applies to both in vessel management and containment and release management. The prototype application was developed in Multimedia Toolbox 3.0 and requires at least a 386 PC with 4 MB memory, 6 MB free disk space and MS Windows 3.1. (orig.).
The Containment and Release Management project was carried out within the Reinforced Concerted Action Programme for Accident Management Support and partly financed by the European Union. In this report a prototype of an accident management support system is presented. The support system integrates several concepts from accident management research, like safety objective trees, severe accident phenomena, calculation models and an emergency response data system. These concepts are provided by the prototype in such a way that the decision making process of accident management is supported. The prototype application is demonstrated by process data taken from a severe accident scenario for a pressurized water reactor (PWR) that was simulated with the thermohydraulic computer program MAAP. The prototype was derived from a decision support framework based on a decision theory. For established and innovative concepts from accident management research it is pointed out in which way these concepts can support accident management and how these concepts can be integrated. This approach is generic in two ways; it applies to both pressurized and boiling water reactors and it applies to both in vessel management and containment and release management. The prototype application was developed in Multimedia Toolbox 3.0 and requires at least a 386 PC with 4 MB memory, 6 MB free disk space and MS Windows 3.1. (orig.)
Over the past decade, health care consumers have begun to benefit from new Web-based communications tools to guide decision making on treatments and tests. Using today's online tools, consumers who have Internet connections can: watch and listen to videos of physicians; watch and hear the stories of other consumers who have faced the same decisions; join an online social support network; receive estimates of their own chances of experiencing various outcomes; and do it all at home. To review currently-available Internet consumer health decision-support tools. Five Web sites offering consumer health decision-support tools are analyzed for their use of 4 key Web-enabled features: the presentation of outcomes probability data tailored to the individual user; the use of videotaped patient interviews in the final product to convey the experiences of people who have faced similar diagnoses in the past; the ability to interact with others in a social support network; and the accessibility of the tool to any health care consumers with an Internet connection. None of the 5 Web sites delivers all 4 target features to all Web users. The reasons for these variations in the use of key Web functionality--features that make the Web distinctive--are not immediately clear. Consumers trying to make health care decisions may benefit from current Web-based decision-support tools. But, variations in Web developers' use of 4 key Web-enabled features leaves the online decision-support experience less than what it could be. Key research questions are identified that could help in the development of new hybrid patient decision-support tools.
Mioc, Darka; Anton, François; Liang, Gengsheng
In this paper the development of Web GIS based decision support system for flood events is presented. To improve flood prediction we developed the decision support system for flood prediction and monitoring that integrates hydrological modelling and CARIS GIS. We present the methodology for data...... integration, floodplain delineation, and online map interfaces. Our Web-based GIS model can dynamically display observed and predicted flood extents for decision makers and the general public. The users can access Web-based GIS that models current flood events and displays satellite imagery and digital...... elevation model integrated with flood plain area. The system can show how the flooding prediction based on the output from hydrological modeling for the next 48 hours along the lower Saint John River Valley....
McCannon, Jessica B; O'Donnell, Walter J; Thompson, B Taylor; El-Jawahri, Areej; Chang, Yuchiao; Ananian, Lillian; Bajwa, Ednan K; Currier, Paul F; Parikh, Mihir; Temel, Jennifer S; Cooper, Zara; Wiener, Renda Soylemez; Volandes, Angelo E
Effective communication between intensive care unit (ICU) providers and families is crucial given the complexity of decisions made regarding goals of therapy. Using video images to supplement medical discussions is an innovative process to standardize and improve communication. In this six-month, quasi-experimental, pre-post intervention study we investigated the impact of a cardiopulmonary resuscitation (CPR) video decision support tool upon knowledge about CPR among surrogate decision makers for critically ill adults. We interviewed surrogate decision makers for patients aged 50 and over, using a structured questionnaire that included a four-question CPR knowledge assessment similar to those used in previous studies. Surrogates in the post-intervention arm viewed a three-minute video decision support tool about CPR before completing the knowledge assessment and completed questions about perceived value of the video. We recruited 23 surrogates during the first three months (pre-intervention arm) and 27 surrogates during the latter three months of the study (post-intervention arm). Surrogates viewing the video had more knowledge about CPR (p=0.008); average scores were 2.0 (SD 1.1) and 2.9 (SD 1.2) (out of a total of 4) in pre-intervention and post-intervention arms. Surrogates who viewed the video were comfortable with its content (81% very) and 81% would recommend the video. CPR preferences for patients at the time of ICU discharge/death were distributed as follows: pre-intervention: full code 78%, DNR 22%; post-intervention: full code 59%, DNR 41% (p=0.23).
Full Text Available Nowadays, modern organizations cannot resort to the decision-making process without relying on information and communication technology if they want to be successful. Thus, besides information as an important input of this process, the tools and techniques used by decision-makers are equally important in the support and validation of their decisions. All this is also valid for the military organizations and their specific tasks and activities. A fortiori military commanders face some of the most diff cult and high-stake decision issues meaningful not only at the level of the military, but also for the humankind. Under these circumstances and as a result of an increase in the diversity and complexity of conflict situations, in the information and technology means employed by opponents in warfare and in the amount of information needed to be processed in real time, decision support systems become a necessity. Starting from the aforementioned inevitable requirement, the aim of this article is to emphasize the possibilities and constraints in developing an intelligent decision support system that assists commanders in making scientific decisions on time, under the right circumstances, for the right costs.
Summary Optimization-based decision support systems for planning problems in processing industries Nowadays, efficient planning of material flows within and between supply chains is of vital importance and has become one of the most challenging problems for decision support in practice. The tremendous progress in hard- and software of the past decades was an important gateway for developing computerized systems that are able to support decision making on different levels within enterprises. T...
Siminoff, L A; Sandberg, D E
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.
Singer, Alexander; Salman, Mo; Thulke, Hans-Hermann
Animal health is of societal importance as it affects human welfare, and anthropogenic interests shape decision making to assure animal health. Scientific advice to support decision making is manifold. Modelling, as one piece of the scientific toolbox, is appreciated for its ability to describe and structure data, to give insight in complex processes and to predict future outcome. In this paper we study the application of scientific modelling to support practical animal health decisions. We reviewed the 35 animal health related scientific opinions adopted by the Animal Health and Animal Welfare Panel of the European Food Safety Authority (EFSA). Thirteen of these documents were based on the application of models. The review took two viewpoints, the decision maker's need and the modeller's approach. In the reviewed material three types of modelling questions were addressed by four specific model types. The correspondence between tasks and models underpinned the importance of the modelling question in triggering the modelling approach. End point quantifications were the dominating request from decision makers, implying that prediction of risk is a major need. However, due to knowledge gaps corresponding modelling studies often shed away from providing exact numbers. Instead, comparative scenario analyses were performed, furthering the understanding of the decision problem and effects of alternative management options. In conclusion, the most adequate scientific support for decision making - including available modelling capacity - might be expected if the required advice is clearly stated. Copyright © 2011 Elsevier B.V. All rights reserved.
Lemieux, P.; Thorneloe, S.; Hayes, C.; Rodgers, M.; Christman, R.
Unique challenges exist for the handling, transport, and disposal of debris resulting from homeland security incidents, disasters or other national emergencies. Access to guidance for facilitating decision making in the safe and timely disposal of debris is critical to helping restore a community or region and prevent further contamination or spread of disease. For a radiological dispersal device (RDD) or other radiological incident, proper characterization of the quantity, properties, and level of contamination of debris and decontamination residue can have a significant impact on cleanup costs and timelines. A suite of decision support tools (DSTs) is being developed by the U.S. EPA's Office of Research and Development to assist individuals responsible for making decisions associated with handling, transport, treatment, and disposal of such debris. The DSTs are location-specific to help identify specific facilities and contacts for making final disposal decisions. The DSTs provide quick reference to technical information, regulations, and other information to provide decision makers with assistance in guiding disposal decisions that are important for the protection of public health, first responders, and the environment. This tool is being developed in partnership with other U.S. government agencies, EPA program offices, industry, and state and local emergency response programs. (authors)
Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab
A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.
Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F
Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.
Full Text Available The scientific production in a certain field shows, in great extent, the research interests in that field. Decision Support Systems are a particular class of information systems which are gaining more popularity in various domains. In order to identify the evolution in time of the publications number, authors, subjects, publications in the Decision Support Systems (DSS field, and therefore the scientific world interest for this field, in November 2010 there have been organized a series of queries on three major international scientific databases: ScienceDirect, IEEE Xplore Digital Library and ACM Digital Library. The results presented in this paper shows that, even the decision support systems research field started in 1960s, the interests for this type of systems grew exponentially with each year in the last decades.
Randleff, Lars Rosenberg
During a mission over enemy territory a fighter aircraft may be engaged by ground based threats. The pilot can use different measures to avoid the aircraft from being detected by e.g. enemy radar systems. If the enemy detects the aircraft a missile may be fired to seek and destroy the aircraft...... and countermeasures that can be applied to mitigate threats. This work is concerned with finding proper evasive actions when a fighter aircraft is engaged by ground based threats. To help the pilot in deciding on these actions a decision support system may be implemented. The environment in which such a system must....... When new threats occur the decision support system must be able to provide suggestions within a fraction of a second. Since the time it takes to find an optimal solution to the mathematical model can not comply with this requirement solutions are sought using a metaheuristic....
Gonçalves, José M.; Pereira, L.S.
The SADREG decision support system was developed to help decision makers in the process of design and selection of farm surface irrigation systems to respond to requirements of modernization of surface irrigation—furrow, basin, and border irrigation. It includes a database, simulation models, user-friendly interfaces, and multicriteria analysis models. SADREG is comprised of two components: design and selection. The first component applies database information, and through several si...
Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular
Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz
Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may
Brunner, Julian; Chuang, Emmeline; Goldzweig, Caroline; Cain, Cindy L; Sugar, Catherine; Yano, Elizabeth M
A growing literature has demonstrated the ability of user-centered design to make clinical decision support systems more effective and easier to use. However, studies of user-centered design have rarely examined more than a handful of sites at a time, and have frequently neglected the implementation climate and organizational resources that influence clinical decision support. The inclusion of such factors was identified by a systematic review as "the most important improvement that can be made in health IT evaluations." (1) Identify the prevalence of four user-centered design practices at United States Veterans Affairs (VA) primary care clinics and assess the perceived utility of clinical decision support at those clinics; (2) Evaluate the association between those user-centered design practices and the perceived utility of clinical decision support. We analyzed clinic-level survey data collected in 2006-2007 from 170 VA primary care clinics. We examined four user-centered design practices: 1) pilot testing, 2) provider satisfaction assessment, 3) formal usability assessment, and 4) analysis of impact on performance improvement. We used a regression model to evaluate the association between user-centered design practices and the perceived utility of clinical decision support, while accounting for other important factors at those clinics, including implementation climate, available resources, and structural characteristics. We also examined associations separately at community-based clinics and at hospital-based clinics. User-centered design practices for clinical decision support varied across clinics: 74% conducted pilot testing, 62% conducted provider satisfaction assessment, 36% conducted a formal usability assessment, and 79% conducted an analysis of impact on performance improvement. Overall perceived utility of clinical decision support was high, with a mean rating of 4.17 (±.67) out of 5 on a composite measure. "Analysis of impact on performance
The objective of SCK-CEN's R and D programme on decision strategies and policy support is: (1) to investigate the decision making process, with all its relevant dimensions, in the context of radiation protection or other nuclear issues (with particular emphasis on emergency preparedness); (2) to disseminate knowledge on decision making and nuclear emergencies, including the organisation of training courses, the contribution to manuals or guidelines, the participation in working groups or discussion forums; (3) to assist the authorities and the industry on any topic related to radiation protection and to make expertise and infrastructure available; (4) to participate in and contribute to initiatives related to social sciences and their implementation into SCK-CEN; (5) to co-ordinate efforts of SCK-CEN related to medical applications of ionising radiation. Principal achievements in 2001 are described
Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.
Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact
Donald Nute; Geneho Kim; Walter D. Potter; Mark J. Twery; H. Michael Rauscher; Scott Thomasma; Deborah Bennett; Peter Kollasch
We describe a research project that has as its goal development of a full-featured decision support system for managing forested land to satisfy multiple criteria represented as timber, wildlife, water, ecological, and wildlife objectives. The decision process proposed for what was originally conceived of as a Northeast Decision Model (NED) includes data acquisition,...
Full Text Available Purpose. In conditions of active development of e-learning the high quality of e-learning resources is very important. Providing the high quality of e-learning resources in situation with mass higher education and rapid obsolescence of information requires the automation of information decision support for improving the quality of e-learning resources by development of decision support system. Methodology. The problem is solved by methods of artificial intelligence. The knowledge base of information structure of decision support system that is based on frame model of knowledge representation and inference production rules are developed. Findings. According to the results of the analysis of life cycle processes and requirements to the e-learning resources quality the information model of the structure of the knowledge base of the decision support system, the inference rules for the automatically generating of recommendations and the software implementation are developed. Practical value. It is established that the basic requirements for quality are performance, validity, reliability and manufacturability. It is shown that the using of a software implementation of decision support system for researched courses gives a growth of the quality according to the complex quality criteria. The information structure of a knowledge base system to support decision-making and rules of inference can be used by methodologists and content developers of learning systems.
Smith, L. A.
Is it conceivable that models run on 2007 computer hardware could provide robust and credible probabilistic information for decision support and user guidance at the ZIP code level for sub-daily meteorological events in 2060? In 2090? Retrospectively, how informative would output from today’s models have proven in 2003? or the 1930’s? Consultancies in the United Kingdom, including the Met Office, are offering services to “future-proof” their customers from climate change. How is a US or European based user or policy maker to determine the extent to which exciting new Bayesian methods are relevant here? or when a commercial supplier is vastly overselling the insights of today’s climate science? How are policy makers and academic economists to make the closely related decisions facing them? How can we communicate deep uncertainty in the future at small length-scales without undermining the firm foundation established by climate science regarding global trends? Three distinct aspects of the communication of the uses of climate model output targeting users and policy makers, as well as other specialist adaptation scientists, are discussed. First, a brief scientific evaluation of the length and time scales at which climate model output is likely to become uninformative is provided, including a note on the applicability the latest Bayesian methodology to current state-of-the-art general circulation models output. Second, a critical evaluation of the language often employed in communication of climate model output, a language which accurately states that models are “better”, have “improved” and now “include” and “simulate” relevant meteorological processed, without clearly identifying where the current information is thought to be uninformative and misleads, both for the current climate and as a function of the state of the (each) climate simulation. And thirdly, a general approach for evaluating the relevance of quantitative climate model output
Wilson, Michael E; Rhudy, Lori M; Ballinger, Beth A; Tescher, Ann N; Pickering, Brian W; Gajic, Ognjen
Our aim was to explore reasons for physician variability in decisions to limit life support in the intensive care unit (ICU) utilizing qualitative methodology. Single center study consisting of semi-structured interviews with experienced physicians and nurses. Seventeen intensivists from medical (n = 7), surgical (n = 5), and anesthesia (n = 5) critical care backgrounds, and ten nurses from medical (n = 5) and surgical (n = 5) ICU backgrounds were interviewed. Principles of grounded theory were used to analyze the interview transcripts. Eleven factors within four categories were identified that influenced physician variability in decisions to limit life support: (1) physician work environment-workload and competing priorities, shift changes and handoffs, and incorporation of nursing input; (2) physician experiences-of unexpected patient survival, and of limiting life support in physician's family; (3) physician attitudes-investment in a good surgical outcome, specialty perspective, values and beliefs; and (4) physician relationship with patient and family-hearing the patient's wishes firsthand, engagement in family communication, and family negotiation. We identified several factors which physicians and nurses perceived were important sources of physician variability in decisions to limit life support. Ways to raise awareness and ameliorate the potentially adverse effects of factors such as workload, competing priorities, shift changes, and handoffs should be explored. Exposing intensivists to long term patient outcomes, formalizing nursing input, providing additional training, and emphasizing firsthand knowledge of patient wishes may improve decision making.
Barfod, Michael Bruhn; Salling, Kim Bang
. The proposed framework is based on the use of cost-benefit analysis featuring feasibility risk assessment in combination with multi-criteria decision analysis and is supported by the concept of decision conferencing. The framework is applied for a transport related case study dealing with the complex decision....... The outcome of the case study demonstrates the decision making framework as a valuable decision support system (DSS), and it is concluded that appraisals of transport projects can be effectively supported by the use of the DSS. Finally, perspectives of the future modelling work are given.......This paper concerns the development of a new decision support framework for the appraisal of transport infrastructure projects. In such appraisals there will often be a need for including both conventional transport impacts as well as criteria of a more strategic and/or sustainable character...
Dehlendorf, Christine; Fitzpatrick, Judith; Steinauer, Jody; Swiader, Lawrence; Grumbach, Kevin; Hall, Cara; Kuppermann, Miriam
We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection. Drawing upon formative work around women's preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted. We obtained feedback from patient and provider advisory groups throughout the development process. Ninety-six percent of women who used the tool in pilot testing reported that it helped them choose a method, and qualitative interviews indicated acceptability of the tool's content and presentation. Compared to the control group, women who used the tool demonstrated trends toward increased likelihood of complete satisfaction with their method. Participant responses to cognitive testing were used in tool refinement. Our decision support tool appears acceptable to women in the family planning setting. Formative evaluation of the tool supports its utility among patients making contraceptive decisions, which can be further evaluated in a randomized controlled trial. Copyright © 2017 Elsevier B.V. All rights reserved.
Franco de los Ríos, Camilo; Hougaard, Jens Leth; Nielsen, Kurt
Intelligent decision support should allow integrating human knowledge with efficient algorithms for making interpretable and useful recommendations on real world decision problems. Attitudes and preferences articulate and come together under a decision process that should be explicitly modeled...
Armenian, H. K
.... 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...
Wright, Adam; Sittig, Dean F
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.
Sørup, Christian Michel; Jacobsen, Peter
from the healthcare sector, the results obtained could be restricted to this sector. Inclusion of data from Arbejdsmarkedets Tillægspension (ATP) showed no deviation from the results in the healthcare sector. Practical implications – The product of the study is a decision support tool for leaders...
Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky
Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards
Decision support systems are often not empirically evaluated, especially the underlying modelling components. This can be attributed to such systems necessarily being designed to handle complex and poorly structured problems and decision making. Nonetheless, evaluation is critical and should be focused on empirical testing whenever possible. Verification and validation, in combination, comprise such evaluation. Verification is ensuring that the system is internally complete, coherent, and logical from a modelling and programming perspective. Validation is examining whether the system is realistic and useful to the user or decision maker, and should answer the question: “Was the system successful at addressing its intended purpose?” A rich literature exists on verification and validation of expert systems and other artificial intelligence methods; however, no single evaluation methodology has emerged as preeminent. At least five approaches to validation are feasible. First, under some conditions, decision support system performance can be tested against a preselected gold standard. Second, real-time and historic data sets can be used for comparison with simulated output. Third, panels of experts can be judiciously used, but often are not an option in some ecological domains. Fourth, sensitivity analysis of system outputs in relation to inputs can be informative. Fifth, when validation of a complete system is impossible, examining major components can be substituted, recognizing the potential pitfalls. I provide an example of evaluation of a decision support system for trumpeter swan (Cygnus buccinator) management that I developed using interacting intelligent agents, expert systems, and a queuing system. Predicted swan distributions over a 13-year period were assessed against observed numbers. Population survey numbers and banding (ringing) studies may provide long term data useful in empirical evaluation of decision support.
Roldán-Molina, G.; Almache-Cueva, M.; Silva-Rabadão, C.; Yevseyeva, Iryna; Basto-Fernandes, V.
This paper presents ongoing work on a decision aiding software intended to support cyber risks and cyber threats analysis of an information and communications technological infrastructure. The software will help corporations Chief Information Security Officers on cyber security risk analysis, decision-making, prevention measures and risk strategies for the infrastructure and information assets protection.
The objective of SCK-CEN's R and D programme on decision strategies and policy support is: (1) to investigate the decision making process, with all its relevant dimensions, in the context of radiation protection or other nuclear issues (with particular emphasis on emergency preparedness); (2) to disseminate knowledge on decision making and nuclear emergencies, including the organisation of training courses, the contribution to manuals or guidelines, the participation in working groups or discussion forums; (3) to assist the authorities and the industry on any topic related to radiation protection and to make expertise and infrastructure available; (4) to participate in and contribute to initiatives related to social sciences and their implementation into SCK-CEN; (5) to co-ordinate efforts of SCK-CEN related to medical applications of ionising radiation. Principal achievements in 2001 are described.
Remembering, understanding and reconstructing past activities is a necessary part of any learning, sense-making or decision making process. It is also essential for any collaborative activity. This dissertation investigates the design and evaluation of systems to support decision remembering, understanding and reconstruction by groups and individuals. By conducting three qualitative case studies of small professional groups, we identify the critical activities where history functionality is n...
Vreeker, R.; Nijkamp, P.; ter Welle, C.
Rational decision-making requires an assessment of advantages and disadvantages of choice possibilities, including non-market effects (such as externalities). This also applies to strategic decision-making in the transport sector (including aviation). In the past decades various decision support and
Franklin, Amy; Gantela, Swaroop; Shifarraw, Salsawit; Johnson, Todd R; Robinson, David J; King, Brent R; Mehta, Amit M; Maddow, Charles L; Hoot, Nathan R; Nguyen, Vickie; Rubio, Adriana; Zhang, Jiajie; Okafor, Nnaemeka G
Providing timely and effective care in the emergency department (ED) requires the management of individual patients as well as the flow and demands of the entire department. Strategic changes to work processes, such as adding a flow coordination nurse or a physician in triage, have demonstrated improvements in throughput times. However, such global strategic changes do not address the real-time, often opportunistic workflow decisions of individual clinicians in the ED. We believe that real-time representation of the status of the entire emergency department and each patient within it through information visualizations will better support clinical decision-making in-the-moment and provide for rapid intervention to improve ED flow. This notion is based on previous work where we found that clinicians' workflow decisions were often based on an in-the-moment local perspective, rather than a global perspective. Here, we discuss the challenges of designing and implementing visualizations for ED through a discussion of the development of our prototype Throughput Dashboard and the potential it holds for supporting real-time decision-making. Copyright © 2017. Published by Elsevier Inc.
McMillan, Sara S; Thangarajah, Thachaayini; Anderson, Claire; Kelly, Fiona
Various factors influence decision making in over-the-counter (OTC) medicine consultations, yet limited studies have focused, in-depth, on the thought process of pharmacy staff. This includes pharmacy students as pharmacists-in-training. To explore the factors that influence pharmacy students' decisions in relation to OTC consultations and choice of OTC medicine/s. Semi-structured interviews using the critical incident technique were undertaken with ten pharmacy students in Australia, who also worked as part-time pharmacy staff. Nine key themes were identified to influence pharmacy student decision making in OTC consultations, including customer response, confidence and scope of practice. Product requests were reported as more challenging due to customer expectations and experiences in other pharmacies, states or countries. Although negative customer response influenced some students to supply medicines in contradiction of evidence, an overarching concern for safety meant that a medicine was only supplied if unlikely to cause harm. Students reported developing confidence in OTC decision making more from real-life practice than university training; greater confidence was identified for inquiries more frequently experienced in the pharmacy. Students perceived that customers had assumptions around support staff, and were happier to talk to students than assistants. This study further identified that OTC decision making is a complex process for pharmacy students. Additional opportunities for experiential learning within this area are suggested, such as work-based placements or in-class activities such as role-plays with simulated patients. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available The support of decision-making activities in small and medium-sized enterprises (SME has its specific features. When suggesting steps for the implementation of decision-support tools in the enterprise, we identified two main ways of decision-making support based on the data analysis: ERP (Enterprise Resource Planning without BI (Business Intelligence and ERP with BI. In our contribution, we present costs models of both mentioned decision support systems and their practical interpretation.
Keith Reynolds; Micahel Saunders; Richard Olson; Daniel Schmoldt; Michael Foster; Donald Latham; Bruce Miller; John Steffenson; Lawrence Bednar; Patrick Cunningham
The Pacific Northwest Research Station (USDA Forest Service) is developing a knowledge-based information management system to provide decision support for watershed analysis in the Pacific Northwest region of the U.S. The decision support system includes: (1) a GIS interface that allows users to graphically navigate to specific provinces and watersheds and display a...
Dotson, G Scott; Hudson, Naomi L; Maier, Andrew
Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management.
Hupcey, J E
Social support has been shown to be important for the critically ill patient. However, what constitutes adequate support for these patients has not been investigated. Thus, the purpose of this qualitative study was to investigate patients' perceptions of their need for and adequacy of the social support received while they were critically ill. Thirty adult patients who were critical during some point of their stay in the intensive care unit (ICU) stay were interviewed, once stable. Interviews were tape-recorded and began with an open-ended question regarding the ICU experience. This was followed by open-ended focused questions regarding social support, such as 'Who were your greatest sources of social support while you were critically ill?' 'What did they do that was supportive or unsupportive?' Data were analyzed according to Miles and Huberman (1994). The categories that emerged were need for social support based on patient perceptions (not number of visitors), quality of support (based on perceptions of positive and negative behaviors of supporters) and lack of support. This study found that quality of support was more important than the actual number of visitors. Patients with few visitors may have felt supported, while those with numerous visitors felt unsupported. Patients who felt unsupported also were more critical of the staff and the care they received. Nurses need to individually assess patients regarding their need for support, and assist family/friends to meet these needs.
Nielsen, Michael Havbro Faber; Qin, J.; Miragliaa, S.
in Bayesian decision analysis and probabilistic systems performance modelling. A principal example for decision support at regulatory level is presented for a coupled system comprised of infrastructure, social, hazard and environmental subsystems. The infrastructure systems is modelled as multi...
Full Text Available The paper proposes a multicriteria decision analysis (MCDA framework for a comparative evaluation of nuclear waste management strategies taking into account different local perspectives (expert and stakeholder opinions. Of note, a novel approach is taken using a multiple-criteria formulation that is methodologically adapted to tackle various conflicting criteria and a large number of expert/stakeholder groups involved in the decision-making process. The purpose is to develop a framework and to show its application to qualitative comparison and ranking of options in a hypothetical case of three waste management alternatives: interim storage at and/or away from the reactor site for the next 100 years, interim decay storage followed in midterm by disposal in a national repository, and disposal in a multinational repository. Additionally, major aspects of a decision-making aid are identified and discussed in separate paper sections dedicated to application context, decision supporting process, in particular problem structuring, objective hierarchy, performance evaluation modeling, sensitivity/robustness analyses, and interpretation of results (practical impact. The aim of the paper is to demonstrate the application of the MCDA framework developed to a generic hypothetical case and indicate how MCDA could support a decision on nuclear waste management policies in a “small” newcomer country embarking on nuclear technology in the future.
Campbell, Merle Wayne
Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…
Suner, A; Karakülah, G; Dicle, O; Sökmen, S; Çelikoğlu, C C
The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians' decision making. The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratiodecisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options.
Meseguer, Jordi; Mirats-Tur, Josep M.; Cembrano, Gabriela; Puig, Vicenç; Quevedo, Joseba; Pérez, Ramon; Sanz, Gerard; Ibarra, David
This paper describes a model-driven decision-support system (software tool) implementing a model-based methodology for on-line leakage detection and localization which is useful for a large class of water distribution networks. Since these methods present a certain degree of complexity which limits their use to experts, the proposed software tool focuses on the integration of a method emphasizing its use by water network managers as a decision support system. The proposed software tool integr...
Verdaasdonk, P.J.A.; Wouters, M.J.F.
Information systems are generally unable to generate information about the financial consequences of operations management decisions. This is because the procedures for determining the relevant accounting information for decision support are not formalised in ways that can be implemented in
Ebidia, A; Mulder, C; Tripp, B; Morgan, M W
Health care has taken advantage of computers to streamline many clinical and administrative processes. However, the potential of health care information technology as a source of data for clinical and administrative decision support has not been fully explored. This paper describes the process of developing on-line analytical processing (OLAP) capacity from data generated in an on-line transaction processing (OLTP) system (the electronic patient record). We discuss the steps used to evaluate the EPR system, retrieve the data, and create an analytical data warehouse accessible for analysis. We also summarize studies based on the data (lab re-engineering, practice variation in diagnostic decision-making and evaluation of a clinical alert). Besides producing a useful data warehouse, the process also increased understanding of organizational and cost considerations in purchasing OLAP tools. We discuss the limitations of our approach and ways in which these limitations can be addressed.
The present lecture summarises the main results of a review and assessment of state-of-the-art models implemented in computerised decision support systems aimed at assisting the management of fresh water ecosystems contaminated by radioactive substances. The approaches of the various models to simulate the complex behaviour of radionuclides in the aquatic environment were discussed. A critical analysis of the whole sector was carried out in order to frame in a comprehensive perspective several complementary issues: model uncertainty, environmental variability, information incompleteness, multi-model approach, use of models for the decision making. (author)
National Aeronautics and Space Administration — GRID has had a successfully completed Phase I 'Mobile Online Intelligent Decision Support System' (MOIDSS). The system developed into a total solution that supports...
Wokke, M.E.; Cleeremans, A.; Ridderinkhof, K.R.
Successful decision-making critically involves metacognitive processes such as monitoring and control of our decision process. Metacognition enables agents to adaptively modify on-going behavior and to determine what to do next in situations where external feedback is not (immediately) available.
Full Text Available Competitive advantage in logistics operations is possible by analyzing data to create information and turning that information into decision. Supply chain optimization depends on effective management of chain knowledge. Analyzing data from supply chain and making a decision creates complex operations. Therefore, these operations require benefitting from information technology. In today’s global world, businesses use outsourcing for logistics services to focus on their own field, so are seeking to achieve competitive advantage against competitors. Outsourcing requires sharing of various information and data with companies that provide logistical support. Effective strategies are based on well-analyzed the data and information. Best options for right decisions can be created only from good analysis. That’s why companies that supply logistics services achieve competitive advantage using decision support systems (DSS in industrial competition. In short, DSS has become driving force for every business in today’s knowledge-based economy.
Kaltoft, Mette Kjer; Salkeld, Glenn; Dowie, Jack
Person-centred decision support combines the best available information on the considerations that matter to the individual, with the importance the person attaches to those considerations. Nurses and other health professionals can benefit from being able to draw on this support within a clinical...... of a decision. By interactive decision support within a clinical conversation, each stakeholder can gain a personalised opinion, as well as increased generic health decision literacy ....... conversation. A case study and storyline on four siblings facing a transplant coordinator's call to donate stem cells to their brother  is 'translated' and used to demonstrate how an interactive multi-criteria aid can be developed for each within a conversational mode. The personalized dialogue and decision...
Heidari, Mohammad; Shahbazi, Sara
Background: The aim of this study was to determine the effect of problem-solving training on decision-making skill and critical thinking in emergency medical personnel. Materials and Methods: This study is an experimental study that performed in 95 emergency medical personnel in two groups of control (48) and experimental (47). Then, a short problem-solving course based on 8 sessions of 2 h during the term, was performed for the experimental group. Of data gathering was used demographic and researcher made decision-making and California critical thinking skills questionnaires. Data were analyzed using SPSS software. Results: The finding revealed that decision-making and critical thinking score in emergency medical personnel are low and problem-solving course, positively affected the personnel’ decision-making skill and critical thinking after the educational program (P problem-solving in various emergency medicine domains such as education, research, and management, is recommended. PMID:28149823
During the last 1-2 years, rapid developments have occurred in the development of decision support systems and expert systems to aid in decision making related to risk and safety of industrial plants. These activities are most noteworthy in the nuclear industry where numerous systems are under development with implementation often being made on personal computers. An overview of some of these developments is provided, and an example of one recently developed decision support system is given. This example deals with CADET, a system developed to aid the U.S. Nuclear Regulatory Commission in making decisions related to the topical issue of source terms resulting from degraded core accidents in light water reactors. The paper concludes with some comments on the likely directions of future developments in decision support systems and expert systems to aid in the management of risk and safety in industrial plants. (author)
Optimization-based decision support systems for planning problems in processing industries
Nowadays, efficient planning of material flows within and between supply chains is of vital importance and has become one of the most challenging problems for decision support in
Gerven, M.A.J. van
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
Shaker H. El-Sappagh
Full Text Available This paper proposes an open and distributed clinical decision support system architecture. This technical architecture takes advantage of Electronic Health Record (EHR, data mining techniques, clinical databases, domain expert knowledge bases, available technologies and standards to provide decision-making support for healthcare professionals. The architecture will work extremely well in distributed EHR environments in which each hospital has its own local EHR, and it satisfies the compatibility, interoperability and scalability objectives of an EHR. The system will also have a set of distributed knowledge bases. Each knowledge base will be specialized in a specific domain (i.e., heart disease, and the model achieves cooperation, integration and interoperability between these knowledge bases. Moreover, the model ensures that all knowledge bases are up-to-date by connecting data mining engines to each local knowledge base. These data mining engines continuously mine EHR databases to extract the most recent knowledge, to standardize it and to add it to the knowledge bases. This framework is expected to improve the quality of healthcare, reducing medical errors and guaranteeing the safety of patients by helping clinicians to make correct, accurate, knowledgeable and timely decisions.
Salling, Kim Bang; Banister, David
informed decision support towards decision-makers and stakeholders in terms of accumulated descending graphs. The decision support method developed in this paper aims to provide assistance in the analysis and ultimately the choice of action, while accounting for the uncertainties surrounding any transport......This paper presents the final version of the CBA-DK decision support model for assessment of transport projects. The model makes use of conventional cost-benefit analysis resulting in aggregated single point estimates and quantitative risk analysis using Monte Carlo simulation resulting in interval...... result, and the determination of suitable probability distributions. Use is made of the reference class forecasting information, such as that developed in Optimism Bias for adjustments to investment decisions that relate to all modes of transport. The CBA-DK decision support model results in more...
Gaebel, Jan; Schreiber, Erik; Oeser, Alexander; Oeltze-Jafra, Steffen
Model-based decision support systems promise to be a valuable addition to oncological treatments and the implementation of personalized therapies. For the integration and sharing of decision models, the involved systems must be able to communicate with each other. In this paper, we propose a modularized architecture of dedicated systems for the integration of probabilistic decision models into existing hospital environments. These systems interconnect via web services and provide model sharing and processing capabilities for clinical information systems. Along the lines of IHE integration profiles from other disciplines and the meaningful reuse of routinely recorded patient data, our approach aims for the seamless integration of decision models into hospital infrastructure and the physicians' daily work.
Fritzsche, Mathias; Picht, Michael; Gilani, Wasif; Spence, Ivor; Brown, John; Kilpatrick, Peter
What-if Simulations have been identified as one solution for business performance related decision support. Such support is especially useful in cases where it can be automatically generated out of Business Process Management (BPM) Environments from the existing business process models and performance parameters monitored from the executed business process instances. Currently, some of the available BPM Environments offer basic-level performance prediction capabilities. However, these functionalities are normally too limited to be generally useful for performance related decision support at business process level. In this paper, an approach is presented which allows the non-intrusive integration of sophisticated tooling for what-if simulations, analytic performance prediction tools, process optimizations or a combination of such solutions into already existing BPM environments. The approach abstracts from process modelling techniques which enable automatic decision support spanning processes across numerous BPM Environments. For instance, this enables end-to-end decision support for composite processes modelled with the Business Process Modelling Notation (BPMN) on top of existing Enterprise Resource Planning (ERP) processes modelled with proprietary languages.
Lee, Kwang Hyeang; Park, Kyu Ho; Kim, Tak Kon; Jo, Choong Ho; Seong, Kyeong A; Lee, Keon Myeong; Kim, Yeong Dal; Kim, Chang Beom; Kim, Jong Kyu; Jo, Hee Chang; Lee, Ji Hyeong; Jeong, Yoon Soo; Chio, Jong Hyeong; Jeong, Bong Joon; Hong, Joon Seong; Kim, Bong Wan; Seong, Byeong Hak [Korea Advanced Institute Science and Technology, Taejon (Korea, Republic of)
The objective of this study is to develop an operator decision support system by computerizing the sodium circuit. This study developed graphical display interface for the control panel which provides the safety control of equipment, the recognition of experimental process states and sodium circuit states. In this study, basic work to develop an operator decision support real-time expert system for sodium loop was carried out. Simplification of control commands and effective operation of various real-time data and signals by equipment code standardization are studied. The cost ineffectiveness of the single processor structure provides the ground for the development of cost effective parallel processing system. The important tasks of this study are (1) design and implementation of control state surveillance panel of sodium loop, (2) requirement analysis of operator support real-time expert system for sodium loop, (3) design of standard code rule for operating equipment and research on the cost effective all purpose parallel processing system and (4) requirement analysis of expert system and design of control state variables and user interface for experimental process. 10 refs., 36 figs., 20 tabs.
Garfin, G. M.; Petersen, A.; Shafer, M.; MacClune, K.; Hayhoe, K.; Riley, R.; Nasser, E.; Kos, L.; Allan, C.; Stults, M.; LeRoy, S. R.
Many communities in the United States are already vulnerable to extreme events; many of these vulnerabilities are likely to increase with climate change. In order to promote the development of effective community responses to climate change, we tested a participatory process for developing usable climate science, in which our project team worked with decision-makers to identify extreme event parameters and critical thresholds associated with policy development and adaptation actions. Our hypothesis is that conveying climate science and data through user-defined parameters and thresholds will help develop capacity to streamline the use of climate projections in developing strategies and actions, and motivate participation by a variety of preparedness planners. Our team collaborated with urban decision-makers, in departments that included resilience, planning, public works, public health, emergency management, and others, in four cities in the semi-arid south-central plains and intermountain areas of Colorado, New Mexico, Oklahoma, and Texas. Through an iterative process, we homed in on both simple and hybrid indicators for which we could develop credible city-specific projections, to stimulate discussion about adaptation actions; throughout the process, we communicated information about confidence and uncertainty, in order to develop a blend of historic and projected climate data, as appropriate, depending on levels of uncertainty. Our collaborations have resulted in (a) the identification of more than 50 unique indicators and thresholds across the four communities, (b) the development of adaptation action strategies in each community, and (c) the implementation of actions, ranging from a climate leadership training program for city staff members, to a rainwater capture project to improve responses to expected increases in both stormwater runoff and water capture for drought episodes.
The evaluation and prioritization of Engineering Support Requests (ESR's) is a particularly difficult task at the Kennedy Space Center (KSC) -- Shuttle Project Engineering Office. This difficulty is due to the complexities inherent in the evaluation process and the lack of structured information. The evaluation process must consider a multitude of relevant pieces of information concerning Safety, Supportability, O&M Cost Savings, Process Enhancement, Reliability, and Implementation. Various analytical and normative models developed over the past have helped decision makers at KSC utilize large volumes of information in the evaluation of ESR's. The purpose of this project is to build on the existing methodologies and develop a multiple criteria decision support system that captures the decision maker's beliefs through a series of sequential, rational, and analytical processes. The model utilizes the Analytic Hierarchy Process (AHP), subjective probabilities, the entropy concept, and Maximize Agreement Heuristic (MAH) to enhance the decision maker's intuition in evaluating a set of ESR's.
Safety is an important element in business decision making processes in nuclear power plants. Information about component reliability, structures and systems, data recorded during the nuclear power plant's operation and outage periods, as well as experiences from other power plants are located in different database systems throughout the power plant. It would be possible to create a decision support system which would collect data, transform it into a standardized form and store it in a single location in a format more suitable for analyses and knowledge discovery. This single location where the data would be stored would be a data warehouse. Such data warehouse based decision support system could help make decision making processes more efficient by providing more information about business processes and predicting possible consequences of different decisions. Two main functionalities in this decision support system would be an OLAP (On Line Analytical Processing) and a data mining system. An OLAP system would enable the users to perform fast, simple and efficient multidimensional analysis of existing data and identify trends. Data mining techniques and algorithms would help discover new, previously unknown information from the data as well as hidden dependencies between various parameters. Data mining would also enable analysts to create relevant prediction models that could predict behaviour of different systems during operation and inspection results during outages. The basic characteristics and theoretical foundations of such decision support system are described and the reasons for choosing a data warehouse as the underlying structure are explained. The article analyzes obvious business benefits of such system as well as potential uses of OLAP and data mining technologies. Possible implementation methodologies and problems that may arise, especially in the field of data integration, are discussed and analyzed.(author)
Sutcliffe, Alistair; Al-Qaed, Faisal
The paper describes a set of tools designed to support a variety of user decision-making strategies. The tools are complemented by an online advisor so they can be adapted to different domains and users can be guided to adopt appropriate tools for different choices in e-commerce, e.g. purchasing high-value products, exploring product fit to users’ needs, or selecting products which satisfy requirements. The tools range from simple recommenders to decision support by interactive querying and comparison matrices. They were evaluated in a scenario-based experiment which varied the users’ task and motivation, with and without an advisor agent. The results show the tools and advisor were effective in supporting users and agreed with the predictions of ADM (adaptive decision making) theory, on which the design of the tools was based.
Full Text Available A workshop held at the University of Cambridge in May 2017 brought developers, researchers, knowledge brokers, and users together to discuss user-centred design of decision support tools. Decision support tools are designed to take users through logical decision steps towards an evidence-informed final decision. Although they may exist in different forms, including on paper, decision support tools are generally considered to be computer- (online, software or app-based. Studies have illustrated the potential value of decision support tools for conservation, and there are several papers describing the design of individual tools. Rather less attention, however, has been placed on the desirable characteristics for use, and even less on whether tools are actually being used in practice. This is concerning because if tools are not used by their intended end user, for example a policy-maker or practitioner, then its design will have wasted resources. Based on an analysis of papers on tool use in conservation, there is a lack of social science research on improving design, and relatively few examples where users have been incorporated into the design process. Evidence from other disciplines, particularly human-computer interaction research, illustrates that involving users throughout the design of decision support tools increases the relevance, usability, and impact of systems. User-centred design of tools is, however, seldom mentioned in the conservation literature. The workshop started the necessary process of bringing together developers and users to share knowledge about how to conduct good user-centred design of decision support tools. This will help to ensure that tools are usable and make an impact in conservation policy and practice.
Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane
This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.
Siregar, Dodi; Arisandi, Diki; Usman, Ari; Irwan, Dedy; Rahim, Robbi
One of the roles of decision support system is that it can assist the decision maker in obtaining the appropriate alternative with the desired criteria, one of the methods that could apply for the decision maker is SMART method with multicriteria decision making. This multi-criteria decision-making theory has meaning where every alternative has criteria and has value and weight, and the author uses this approach to facilitate decision making with a compelling case. The problems discussed in this paper are classified into problems of a variety Multiobjective (multiple goals to be accomplished) and multicriteria (many of the decisive criteria in reaching such decisions).
R?muzat, C?cile; Urbinati, Duccio; Kornfeld, ?sa; Vataire, Anne-Lise; Cetinsoy, Laurent; Aball?a, Samuel; Mzoughi, Olfa; Toumi, Mondher
Background and objective: With constant incentives for healthcare payers to contain their pharmaceutical budgets, modelling policy decision impact became critical. The objective of this project was to test the impact of various policy decisions on pharmaceutical budget (developed for the European Commission for the project ‘European Union (EU) Pharmaceutical expenditure forecast’ – http://ec.europa.eu/health/healthcare/key_documents/index_en.htm).Methods: A model was built to assess policy sc...
Nergård, Henrik; Sandberg, Marcus; Larsson, Tobias
In this paper a decision support tool with the focus on how to generate and visualize decision base coupled to the business agreement is outlined and discussed. Decision support tools for the early design phases are few and especially tools that visualize the readiness level of activities throughout the product life-cycle. Aiming for the sustainable society there is an indication that business-to-business manufacturers move toward providing a function rather than selling off the hardware and ...
Rajabali Nejad, Mohammadreza; Spitas, Christos
Decision-making in design is of great importance, resulting in success or failure of a system (Liu et al., 2010; Roozenburg and Eekels, 1995; Spitas, 2011a). This paper describes a robust decision-support tool for engineering design process, which can be used throughout the design process in either
Gibert, Karina; García-Alonso, Carlos; Salvador-Carulla, Luis
Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA), which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK) to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1) Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA), and 2) Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR). In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. EbCA is a new methodology composed by 6 steps:. 1) Data collection and data preparation; 2) acquisition of "Prior Expert Knowledge" (PEK) and design of the "Prior Knowledge Base" (PKB); 3) PKB-guided analysis; 4) support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited); 5) incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6) post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering), applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. This paper presents EbCA and shows the convenience of
Full Text Available Abstract Background Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. Method This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA, which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1 Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA, and 2 Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR. In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. Results EbCA is a new methodology composed by 6 steps:. 1 Data collection and data preparation; 2 acquisition of "Prior Expert Knowledge" (PEK and design of the "Prior Knowledge Base" (PKB; 3 PKB-guided analysis; 4 support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited; 5 incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6 post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering, applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. Discussion This
Mimbs, Scott M.
The goal of a Quality Management System (QMS) as specified in ISO 9001 and AS9100 is to provide assurance to the customer that end products meet specifications. Measuring devices, often called measuring and test equipment (MTE), are used to provide the evidence of product conformity to specified requirements. Unfortunately, processes that employ MTE can become a weak link to the overall QMS if proper attention is not given to the measurement process design, capability, and implementation. Documented "decision rules" establish the requirements to ensure measurement processes provide the measurement data that supports the needs of the QMS. Measurement data are used to make the decisions that impact all areas of technology. Whether measurements support research, design, production, or maintenance, ensuring the data supports the decision is crucial. Measurement data quality can be critical to the resulting consequences of measurement-based decisions. Historically, most industries required simplistic, one-size-fits-all decision rules for measurements. One-size-fits-all rules in some cases are not rigorous enough to provide adequate measurement results, while in other cases are overly conservative and too costly to implement. Ideally, decision rules should be rigorous enough to match the criticality of the parameter being measured, while being flexible enough to be cost effective. The goal of a decision rule is to ensure that measurement processes provide data with a sufficient level of quality to support the decisions being made - no more, no less. This paper discusses the basic concepts of providing measurement-based evidence that end products meet specifications. Although relevant to all measurement-based conformance tests, the target audience is the MTE end-user, which is anyone using MTE other than calibration service providers. Topics include measurement fundamentals, the associated decision risks, verifying conformance to specifications, and basic measurement
Beerlage-de Jong, Nienke; Wentzel, Jobke; Hendrix, Ron; van Gemert-Pijnen, Lisette
Background: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily
Beerlage-de Jong, Nienke; Wentzel, M.J.; Hendrix, Ron; van Gemert-Pijnen, Julia E.W.C.
Background Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily
Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.
Objectives Shared decision-making (SDM) is endorsed by critical care organizations, however there remains confusion about what SDM is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define SDM, recommend when SDM should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. Methods The American College of Critical Care Medicine (ACCM) and American Thoracic Society (ATS) Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of ACCM and ATS were included in the statement. Main Results Six recommendations were endorsed: 1) Definition: Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences. 2) Clinicians should engage in a SDM process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their “default” approach a SDM process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Conclusions Patient and surrogate preferences for decision-making roles regarding value
Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform. PMID:24892075
Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.
Full Text Available Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.
Diomidous, Marianna; Chardalias, Kostis; Koutonias, Panagiotis; Magnita, Adrianna; Andrianopoulos, Charalampos; Zimeras, Stelios; Mechili, Enkeleint Aggelos
Decision Support Systems (DSS) is a powerful tool, for facilitates researchers to choose the correct decision based on their final results. Especially in medical cases where doctors could use these systems, to overcome the problem with the clinical misunderstanding. Based on these systems, queries must be constructed based on the particular questions that doctors must answer. In this work, combination between questions and queries would be presented via relational algebra.
Payne, Emily G. I.; Pham, Tracey; Deletic, Ana; Hatt, Belinda E.; Cook, Perran L. M.; Fletcher, Tim D.
Plant species are diverse in form, function and environmental response. This provides enormous potential for designing nature-based stormwater treatment technologies, such as biofiltration systems. However, species can vary dramatically in their pollutant-removal performance, particularly for nitrogen removal. Currently, there is a lack of information on how to efficiently select from the vast palette of species. This study aimed to identify plant traits beneficial to performance and create a decision-support tool to screen species for further testing. A laboratory experiment using 220 biofilter columns paired plant morphological characteristics with nitrogen removal and water loss for 20 Australian native species and two lawn grasses. Testing was undertaken during wet and dry conditions, for two biofilter designs (saturated zone and free-draining). An extensive root system and high total biomass were critical to the effective removal of total nitrogen (TN) and nitrate (NO3-), driven by high nitrogen assimilation. The same characteristics were key to performance under dry conditions, and were associated with high water use for Australian native plants; linking assimilation and transpiration. The decision-support tool uses these scientific relationships and readily-available information to identify the morphology, natural distribution and stress tolerances likely to be good predictors of plant nitrogen and water uptake.
Full Text Available The right to equal recognition before the law, protected by Article 12 of the United Nations (UN Convention on the Rights of Persons with Disabilities (CRPD, mandates the use of supported decision-making practices to enable disabled people, particularly those with intellectual and/or psychosocial disabilities, to enjoy their legal capacity. Finding ways to translate this theoretical mandate into practice poses a number of particularly challenging socio-legal issues, which this research seeks to address. The English Mental Capacity Act 2005 (MCA sets out a right to support with decision-making (s.1(3, underpinned by a presumption of capacity (s.1(2. Qualitative interviews with intellectually disabled people, their supporters, and care and support professionals were undertaken to explore how disabled people make decisions in their everyday lives, the kinds of support they need, and the strategies for supported decision-making used in practice. Analysis of these interviews suggests that a range of supported decision-making techniques have been developed in practice and are effective in supporting everyday preferences and some life choices. Paradoxically, it appears that as decisions become more complex, the support available to disabled people reduces. Specifically, much less support is available for more difficult decisions around finances, healthcare and legal matters. We argue that the reasons for this are due to a web of regulatory, social and policy issues. We conclude that implementing the right to enjoy legal capacity through supported decision-making will require a combination of regulatory reform, social change and policy amendment.
Elwyn, Glyn; Frosch, Dominick; Volandes, Angelo E; Edwards, Adrian; Montori, Victor M
This article provides an analysis of 'decision aids', interventions to support patients facing tough decisions. Interest has increased since the concept of shared decision making has become widely considered to be a means of achieving desirable clinical outcomes. We consider the aims of these interventions and examine assumptions about their use. We propose three categories, interventions that are used in face-to-face encounters, those designed for use outside clinical encounters and those which are mediated, using telephone or other communication media. We propose the following definition: decision support interventions help people think about choices they face; they describe where and why choice exists; they provide information about options, including, where reasonable, the option of taking no action. These interventions help people to deliberate, independently or in collaboration with others, about options, by considering relevantattributes; they support people to forecast how they might feel about short, intermediate and long-term outcomes which have relevant consequences, in ways which help the process of constructing preferences and eventual decision making, appropriate to their individual situation. Although quality standards have been published for these interventions, we are also cautious about premature closure and consider that the need for short versions for use inside clinical encounters and long versions for external use requires further research. More work is also needed on the use of narrative formats and the translation of theory into practical designs. The interest in decision support interventions for patients heralds a transformation in clinical practice although many important areas remain unresolved.
Full Text Available Abstract Background In patients with Stage 5 Chronic Kidney Disease who require renal replacement therapy a major decision concerns modality choice. However, many patients defer the decision about modality choice or they have an urgent or emergent need of RRT, which results in them starting hemodialysis with a Central Venous Catheter. Thereafter, efforts to help patients make more timely decisions about access choices utilizing education and resource allocation strategies met with limited success resulting in a high prevalent CVC use in Canada. Providing decision support tailored to meet patients' decision making needs may improve this situation. The Registered Nurses Association of Ontario has developed a clinical practice guideline to guide decision support for adults living with Chronic Kidney Disease (Decision Support for Adults with Chronic Kidney Disease. The purpose of this study is to determine the impact of implementing selected recommendations this guideline on priority provincial targets for hemodialysis access in patients with Stage 5 CKD who currently use Central Venous Catheters for vascular access. Methods/Design A non-experimental intervention study with repeated measures will be conducted at St. Michaels Hospital in Toronto, Canada. Decisional conflict about dialysis access choice will be measured using the validated SURE tool, an instrument used to identify decisional conflict. Thereafter a tailored decision support intervention will be implemented. Decisional conflict will be re-measured and compared with baseline scores. Patients and staff will be interviewed to gain an understanding of how useful this intervention was for them and whether it would be feasible to implement more widely. Quantitative data will be analyzed using descriptive and inferential statistics. Statistical significance of difference between means over time for aggregated SURE scores (pre/post will be assessed using a paired t-test. Qualitative analysis
Kaltoft, Mette Kjer; Almeida, J.; Moncho Mas, Vicent
Healthcare lacks a generic language for decisional communication. We aim to enhance health decision literacy via specific e-decision support. Given the multi-criterial, preference-sensitive nature of decision-making, we implement the Multi-Criteria Decision Analysis (MCDA) technique online...... in an interactive and visual template (Annalisa), developing decision-specific tools at the clinical/personal and group/policy levels. Our current nationally funded project on bone health caters for home-prepared, informed and preference-based consent and taps into existing e-health infrastructures towards person...
Ma, Zhangbao; Qi, Qingwen; Xu, Li
In this paper, the existing problems of current tourism management information system are analyzed. GIS, tourism as well as spatial decision support system are introduced, and the application of geographic information system technology and spatial decision support system to tourism management and the establishment of tourism spatial decision support system based on GIS are proposed. System total structure, system hardware and software environment, database design and structure module design of this system are introduced. Finally, realization methods of this systemic core functions are elaborated.
Full Text Available The first part of this text deals with a convention site selection as one of the most lucrative areas in the tourism industry. The second part gives a further description of a method for decision making - the analytic hierarchy process. The basic characteristics: hierarchy constructions and pair wise comparison on the given level of the hierarchy are allured. The third part offers an example of application. This example is solved using the Super - Decision software, which is developed as a computer support for the analytic hierarchy process. This indicates that the AHP approach is a useful tool to help support a decision of convention site selection. .
Godoy, David R.; Pascual, Rodrigo; Knights, Peter
Asset-intensive companies face great pressure to reduce operation costs and increase utilization. This scenario often leads to over-stress on critical equipment and its spare parts associated, affecting availability, reliability, and system performance. As these resources impact considerably on financial and operational structures, the opportunity is given by demand for decision-making methods for the management of spare parts processes. We proposed an ordering decision-aid technique which uses a measurement of spare performance, based on the stress–strength interference theory; which we have called Condition-Based Service Level (CBSL). We focus on Condition Managed Critical Spares (CMS), namely, spares which are expensive, highly reliable, with higher lead times, and are not available in store. As a mitigation measure, CMS are under condition monitoring. The aim of the paper is orienting the decision time for CMS ordering or just continuing the operation. The paper presents a graphic technique which considers a rule for decision based on both condition-based reliability function and a stochastic/fixed lead time. For the stochastic lead time case, results show that technique is effective to determine the time when the system operation is reliable and can withstand the lead time variability, satisfying a desired service level. Additionally, for the constant lead time case, the technique helps to define insurance spares. In conclusion, presented ordering decision rule is useful to asset managers for enhancing the operational continuity affected by spare parts
Hoffman, Aubri S; Llewellyn-Thomas, Hilary A; Tosteson, Anna N A; O'Connor, Annette M; Volk, Robert J; Tomek, Ivan M; Andrews, Steven B; Bartels, Stephen J
Over 100 trials show that patient decision aids effectively improve patients' information comprehension and values-based decision making. However, gaps remain in our understanding of several fundamental and applied questions, particularly related to the design of interactive, personalized decision aids. This paper describes an interdisciplinary development process for, and early field testing of, a web-based patient decision support research platform, or virtual decision lab, to address these questions. An interdisciplinary stakeholder panel designed the web-based research platform with three components: a) an introduction to shared decision making, b) a web-based patient decision aid, and c) interactive data collection items. Iterative focus groups provided feedback on paper drafts and online prototypes. A field test assessed a) feasibility for using the research platform, in terms of recruitment, usage, and acceptability; and b) feasibility of using the web-based decision aid component, compared to performance of a videobooklet decision aid in clinical care. This interdisciplinary, theory-based, patient-centered design approach produced a prototype for field-testing in six months. Participants (n = 126) reported that: the decision aid component was easy to use (98%), information was clear (90%), the length was appropriate (100%), it was appropriately detailed (90%), and it held their interest (97%). They spent a mean of 36 minutes using the decision aid and 100% preferred using their home/library computer. Participants scored a mean of 75% correct on the Decision Quality, Knowledge Subscale, and 74 out of 100 on the Preparation for Decision Making Scale. Completing the web-based decision aid reduced mean Decisional Conflict scores from 31.1 to 19.5 (p development of a web-based patient decision support research platform that was feasible for use in research studies in terms of recruitment, acceptability, and usage. Within this platform, the web
Chin, L. (Bentley College, Waltham, MA (United States)); Vollmann, T.E. (International Inst. for Management Development, Lausanne (Switzerland))
A decision support model is presented which will give utilities the support tools to manage the purchasing of natural gas supplies in the most cost effective manner without reducing winter safety stocks to below minimum levels. In Business As Usual (BAU) purchasing quantities vary with the daily forecasts. With Material Requirements Planning (MRP) and Linear Programming (LP), two types of factors are used: seasonal weather and decision rule. Under current practices, BAU simulation uses the least expensive gas source first, then adding successively more expensive sources. Material Requirements Planning is a production planning technique which uses a parent item master production schedule to determine time phased requirements for component points. Where the MPS is the aggregate gas demand forecasts for the contract year. This satisfies daily demand with least expensive gas and uses more expensive when necessary with automatic computation of available-to-promise (ATP) gas a dispacher knows daily when extra gas supplies may be ATP. Linear Programming is a mathematical algorithm used to determine optimal allocations of scarce resources to achieve a desired result. The LP model determines optimal daily gas purchase decisions with respect to supply cost minimization. Using these models, it appears possible to raise gross income margins 6 to 10% with minimal additions of customers and no new gas supply.
Chin, L.; Vollmann, T.E.
A decision support model is presented which will give utilities the support tools to manage the purchasing of natural gas supplies in the most cost effective manner without reducing winter safety stocks to below minimum levels. In Business As Usual (BAU) purchasing quantities vary with the daily forecasts. With Material Requirements Planning (MRP) and Linear Programming (LP), two types of factors are used: seasonal weather and decision rule. Under current practices, BAU simulation uses the least expensive gas source first, then adding successively more expensive sources. Material Requirements Planning is a production planning technique which uses a parent item master production schedule to determine time phased requirements for component points. Where the MPS is the aggregate gas demand forecasts for the contract year. This satisfies daily demand with least expensive gas and uses more expensive when necessary with automatic computation of available-to-promise (ATP) gas a dispacher knows daily when extra gas supplies may be ATP. Linear Programming is a mathematical algorithm used to determine optimal allocations of scarce resources to achieve a desired result. The LP model determines optimal daily gas purchase decisions with respect to supply cost minimization. Using these models, it appears possible to raise gross income margins 6 to 10% with minimal additions of customers and no new gas supply
Tidwell, Vincent Carroll; Malczynski, Leonard A.; Kobos, Peter Holmes; Castillo, Cesar; Hart, William Eugene; Klise, Geoffrey T.
Currently, electrical power generation uses about 140 billion gallons of water per day accounting for over 39% of all freshwater withdrawals thus competing with irrigated agriculture as the leading user of water. Coupled to this water use is the required pumping, conveyance, treatment, storage and distribution of the water which requires on average 3% of all electric power generated. While water and energy use are tightly coupled, planning and management of these fundamental resources are rarely treated in an integrated fashion. Toward this need, a decision support framework has been developed that targets the shared needs of energy and water producers, resource managers, regulators, and decision makers at the federal, state and local levels. The framework integrates analysis and optimization capabilities to identify trade-offs, and 'best' alternatives among a broad list of energy/water options and objectives. The decision support framework is formulated in a modular architecture, facilitating tailored analyses over different geographical regions and scales (e.g., national, state, county, watershed, NERC region). An interactive interface allows direct control of the model and access to real-time results displayed as charts, graphs and maps. Ultimately, this open and interactive modeling framework provides a tool for evaluating competing policy and technical options relevant to the energy-water nexus.
Morrey, M.; Higgins, N.; Dovgiy, S.; Grekov, L.; Yatsalo, B.; Likhtariov, I.; Dreicer, M.; Lochard, J.; Savkin, M.; Demin, V.; Khramtsov, P.; Utkina, T.
, milk, and meat. A risk module has been developed which includes a database d demographic data on health protection for different territories, and which can calculate risk for any population structure. It can be used for risk estimation for different age groups in any region for which data is provided. A module on indirect countermeasures has been developed to assist in the selection of counter-measures that will improve conditions for a population that inhabits a contaminated area, in a way that is distinct from a direct reduction in the effective contamination level of the environment and its products. These types of countermeasure can be taken both as separate actions or in combination with direct countermeasures to increase the efficiency of the latter. The tools and interfaces developed within JSP2 enable the decision maker to estimate consequences and analyze the post-emergency situation according to his own criteria and in a user-friendly manner. The available analyses include: forecast calculations (concerning the estimated contamination of agricultural products, the levels of doses in the local population and the associated radiation risks); the identification of the critical factors that influence the health nf the affected population; a simulation of human intervention taking into account the countermeasures chosen or a time ordered set of countermeasures; an estimation of the influence such factors as dose, risk, cost/benefit and time, etc. have on decisions. The results can be presented in the form of maps, diagrams, and tables. In this paper, work carried out on the development of computer based decision support systems for the post-emergency management of contaminated territories is discussed, together with possibilities for further development of such systems
Morrey, M; Higgins, N; Dovgiy, S; Grekov, L; Yatsalo, B; Likhtariov, I; Dreicer, M; Lochard, J; Savkin, M; Demin, V; Khramtsov, P; Utkina, T
, milk, and meat. A risk module has been developed which includes a database d demographic data on health protection for different territories, and which can calculate risk for any population structure. It can be used for risk estimation for different age groups in any region for which data is provided. A module on indirect countermeasures has been developed to assist in the selection of counter-measures that will improve conditions for a population that inhabits a contaminated area, in a way that is distinct from a direct reduction in the effective contamination level of the environment and its products. These types of countermeasure can be taken both as separate actions or in combination with direct countermeasures to increase the efficiency of the latter. The tools and interfaces developed within JSP2 enable the decision maker to estimate consequences and analyze the post-emergency situation according to his own criteria and in a user-friendly manner. The available analyses include: forecast calculations (concerning the estimated contamination of agricultural products, the levels of doses in the local population and the associated radiation risks); the identification of the critical factors that influence the health nf the affected population; a simulation of human intervention taking into account the countermeasures chosen or a time ordered set of countermeasures; an estimation of the influence such factors as dose, risk, cost/benefit and time, etc. have on decisions. The results can be presented in the form of maps, diagrams, and tables. In this paper, work carried out on the development of computer based decision support systems for the post-emergency management of contaminated territories is discussed, together with possibilities for further development of such systems.
Ronald E. McRoberts; R. James Barbour; Krista M. Gebert; Greg C. Liknes; Mark D. Nelson; Dacia M. Meneguzzo; et al.
Sustainable management of natural resources requires informed decision making and post-decision assessments of the results of those decisions. Increasingly, both activities rely on analyses of spatial data in the forms of maps and digital data layers. Fortunately, a variety of supporting maps and data layers rapidly are becoming available. Unfortunately, however, user-...
Volk, Michael L; Goodrich, Nathan; Lai, Jennifer C; Sonnenday, Christopher; Shedden, Kerby
Organ offers in liver transplantation are high-risk medical decisions with a low certainty of whether a better liver offer will come along before death. We hypothesized that decision support could improve the decision to accept or decline. With data from the Scientific Registry of Transplant Recipients, survival models were constructed for 42,857 waiting-list patients and 28,653 posttransplant patients from 2002 to 2008. Daily covariate-adjusted survival probabilities from these 2 models were combined into a 5-year area under the curve to create an individualized prediction of whether an organ offer should be accepted for a given patient. Among 650,832 organ offers from 2008 to 2013, patient survival was compared by whether the clinical decision was concordant or discordant with model predictions. The acceptance benefit (AB)--the predicted gain or loss of life by accepting a given organ versus waiting for the next organ--ranged from 3 to -22 years (harm) and varied geographically; for example, the average benefit of accepting a donation after cardiac death organ ranged from 0.47 to -0.71 years by donation service area. Among organ offers, even when AB was >1 year, the offer was only accepted 10% of the time. Patient survival from the time of the organ offer was better if the model recommendations and the clinical decision were concordant: for offers with AB > 0, the 3-year survival was 80% if the offer was accepted and 66% if it was declined (P decision support may improve patient survival in liver transplantation. © 2015 American Association for the Study of Liver Diseases.
Timofeyeva, M. M.; Higgins, W.; Strager, C.; Horsfall, F. M.
NOAA is an active participant of the Global Framework for Climate Services (GFCS) contributing data, information, analytical capabilities, forecasts, and decision support services to the Climate Services Partnership (CSP). These contributions emerge from NOAA's own climate services, which have evolved to respond to the urgent and growing need for reliable, trusted, transparent, and timely climate information across all sectors of the U.S. economy. Climate services not only enhance development opportunities in many regions, but also reduce vulnerability to climate change around the world. The NOAA contribution lies within the NOAA Climate Goal mission, which is focusing its efforts on four key climate priority areas: water, extremes, coastal inundation, and marine ecosystems. In order to make progress in these areas, NOAA is exploiting its fundamental capabilities, including foundational research to advance understanding of the Earth system, observations to preserve and build the climate data record and monitor changes in climate conditions, climate models to predict and project future climate across space and time scales, and the development and delivery of decision support services focused on risk management. NOAA's National Weather Services (NWS) is moving toward provision of Decision Support Services (DSS) as a part of the Roadmap on the way to achieving a Weather Ready National (WRN) strategy. Both short-term and long-term weather, water, and climate information are critical for DSS and emergency services and have been integrated into NWS in the form of pilot projects run by National and Regional Operations Centers (NOC and ROCs respectively) as well as several local offices. Local offices with pilot projects have been focusing their efforts on provision of timely and actionable guidance for specific tasks such as DSS in support of Coastal Environments and Integrated Environmental Studies. Climate information in DSS extends the concept of climate services to
National Aeronautics and Space Administration — We propose to build and commercialize a working prototype Geospatial Decision Support Toolkit (GeoKit). GeoKit will enable scientists, agencies, and stakeholders to...
Stone, J.J.; Paige, G.; Hakonson, T.E.; Lane, L.J.
The overall objective of the Prototype Decision Support System for shallow land burial project is to ''Develop a Decision Support System tool which incorporates simulation modeling and multi-objective decision theory for the purpose of designing and evaluating alternative trench cap designs for mixed waste landfill covers. The goal is to improve the quality of technical information used by the risk manager to select landfill cover designs while taking into account technological, economical, and regulatory factors.'' The complexity of the technical and non-technical information, and how the information varies in importance across sites, points to the need for decision analysis tools that provide a common basis for integrating, synthesizing, and valuing the decision input. Because the cost of remediating thousands of contaminated DOE sites is projected to be in the 10's--100's of billions of dollars, methods will be needed to establish cleanup priorities and to help in the selection and evaluation of cost effective remediation alternatives. Even at this early stage in DOE's cleanup program, it is certain that capping technologies will be heavily relied upon to remediate the 3000+ landfills on DOE property. Capping is favored in remediating most DOE landfills because, based on preliminary baseline risk assessments, human and ecological risks are considered to be low at most of these sites and the regulatory requirements for final closure of old landfills can be met using a well designed cap to isolate the buried waste. This report describes a program plan to design, develop, and test a decision support system (DSS) for assisting the DOE risk manager in evaluating capping alternatives for radioactive and hazardous waste landfills. The DOE DSS will incorporate methods for calculating, integrating and valuing technical, regulatory, and economic criteria
Moßgraber, J.; Middleton, S.; Hammitzsch, M.; Poslad, S.
The presentation will describe work on the system architecture that is being developed in the EU FP7 project TRIDEC on "Collaborative, Complex and Critical Decision-Support in Evolving Crises". The challenges for a Tsunami Early Warning System (TEWS) are manifold and the success of a system depends crucially on the system's architecture. A modern warning system following a system-of-systems approach has to integrate various components and sub-systems such as different information sources, services and simulation systems. Furthermore, it has to take into account the distributed and collaborative nature of warning systems. In order to create an architecture that supports the whole spectrum of a modern, distributed and collaborative warning system one must deal with multiple challenges. Obviously, one cannot expect to tackle these challenges adequately with a monolithic system or with a single technology. Therefore, a system architecture providing the blueprints to implement the system-of-systems approach has to combine multiple technologies and architectural styles. At the bottom layer it has to reliably integrate a large set of conventional sensors, such as seismic sensors and sensor networks, buoys and tide gauges, and also innovative and unconventional sensors, such as streams of messages from social media services. At the top layer it has to support collaboration on high-level decision processes and facilitates information sharing between organizations. In between, the system has to process all data and integrate information on a semantic level in a timely manner. This complex communication follows an event-driven mechanism allowing events to be published, detected and consumed by various applications within the architecture. Therefore, at the upper layer the event-driven architecture (EDA) aspects are combined with principles of service-oriented architectures (SOA) using standards for communication and data exchange. The most prominent challenges on this layer
This book offers a state of the art collection covering themes related to Advanced Intelligent Computational Technologies and Decision Support Systems which can be applied to fields like healthcare assisting the humans in solving problems. The book brings forward a wealth of ideas, algorithms and case studies in themes like: intelligent predictive diagnosis; intelligent analyzing of medical images; new format for coding of single and sequences of medical images; Medical Decision Support Systems; diagnosis of Down’s syndrome; computational perspectives for electronic fetal monitoring; efficient compression of CT Images; adaptive interpolation and halftoning for medical images; applications of artificial neural networks for real-life problems solving; present and perspectives for Electronic Healthcare Record Systems; adaptive approaches for noise reduction in sequences of CT images etc.
Full Text Available The successful development of financial and banking activities requires a strong information support to ensure the competitive edge over the other competitors on the market. The exponential growth in the volume of lending financial operations made the use of modern information technology in banking has become fundamental to improving lending activity. Thus, the design and use of a computer system adapted to specific requirements of bank lending will provide opportunities to diversify and modernize the procedures for granting, repayment and credit guarantee to correlate products offer credit demands and customer needs. In this regard, the related objectives of this work are oriented to emphasize the positive impact of the adoption of modern information technologies in decision making in the banking field. The proposed objectives are justified by presenting solutions support system of credit decision which aims to automate ongoing operations specific to a banking allowing bank clerks to process a large number of loan applications in a time very short and to the right decisions and substantiated.
Adler, Richard M.
Knowledge-based technologies have been applied successfully to automate planning and scheduling in many problem domains. Automation of decision support can be increased further by integrating task-specific applications with supporting database systems, and by coordinating interactions between such tools to facilitate collaborative activities. Unfortunately, the technical obstacles that must be overcome to achieve this vision of transparent, cooperative problem-solving are daunting. Intelligent decision support tools are typically developed for standalone use, rely on incompatible, task-specific representational models and application programming interfaces (API's), and run on heterogeneous computing platforms. Getting such applications to interact freely calls for platform independent capabilities for distributed communication, as well as tools for mapping information across disparate representations. Symbiotics is developing a layered set of software tools (called NetWorks! for integrating and coordinating heterogeneous distributed applications. he top layer of tools consists of an extensible set of generic, programmable coordination services. Developers access these services via high-level API's to implement the desired interactions between distributed applications.
van Beusekom, Frits; Brazier, Frances; Schipper, Piet; Treur, Jan; del Pobil, A.P.
In this paper a knowledge-based decision support system is described that determines the abiotic (chemical and physical) characteristics of a site on the basis of in-homogeneous samples of plant species. Techniques from the area of non-monotonic reasoning are applied to model multi-interpretable
Martinková, Patrícia; Zvára Jr., Karel; Dostálová, T.; Zvárová, Jana
Roč. 1, č. 1 (2013), s. 40-40 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : education * decision support * knowledge evaluation * e-learning Subject RIV: IN - Informatics, Computer Science
Ballantine, R. Malcolm
Decision Support Systems (DSSs) are computer-based decision aids to use when making decisions which are partially amenable to rational decision-making procedures but contain elements where intuitive judgment is an essential component. In such situations, DSSs are used to improve the quality of decision-making. The DSS approach is based on Simon's…
Based on the communications presented in the session on local scale decision support systems, some common trends for those models have been identified. During the last decade the evolutionary change of those models is related with the better insight in decisions to be taken with respect to interventions, the acceptance of large uncertainties, the perceived importance of social and economic factors and shift of the identity of the user. A more revolutionary change is predicted for the near future, putting most emphasis on the predictive mode, extending the integration of monitoring data in the decision support system, and the use of pre-established scenarios. The local scale decision support system will become the key module of the off-site emergency control room. (author)
Span, M.; Smits, C.; Groen-van der Ven, L.; Jukema, J.; Cremers, A.H.M.; Vernooij-Dassen, M.; Eefsting, J.; Hettinga, M.
People with dementia are confronted with many decisions. However, they are often not involved in the process of the decision-making. Shared Decision-Making (SDM) enables involvement of persons with dementia in the decision-making process. In our study, we develop a supportive IT application aiming
MacDonald-Wilson, Kim L; Hutchison, Shari L; Karpov, Irina; Wittman, Paul; Deegan, Patricia E
Individual involvement in treatment decisions with providers, often through the use of decision support aids, improves quality of care. This study investigates an implementation strategy to bring decision support to community mental health centers (CMHC). Fifty-two CMHCs implemented a decision support toolkit supported by a 12-month learning collaborative using the Breakthrough Series model. Participation in learning collaborative activities was high, indicating feasibility of the implementation model. Progress by staff in meeting process aims around utilization of components of the toolkit improved significantly over time (p < .0001). Survey responses by individuals in service corroborate successful implementation. Community-based providers were able to successfully implement decision support in mental health services as evidenced by improved process outcomes and sustained practices over 1 year through the structure of the learning collaborative model.
Full Text Available This article describes PostGeoOlap, a free software open source tool for decision support that integrates OLAP (On-Line Analytical Processing and GIS (Geographical Information Systems. Besides describing the tool, we show how it can be used to achieve effective and low cost decision support that is adequate for small and medium companies and for small public offices.
Full Text Available This paper deals with formalization of business rules by formal grammars. In our work we focus on methods for high frequency data processing. We process data by using complex event platforms (CEP which allow to process high volume of data in nearly real time. Decision making process is contained by one level of processing of CEP. Business rules are used for decision making process description. For the business rules formalization we chose matrix grammar. The use of formal grammars is quite natural as the structure of rules and its rewriting is very similar both for the business rules and for formal grammar. In addition the matrix grammar allows to simulate dependencies and correlations between the rules. The result of this work is a model for data processing of knowledge-based decision support system described by the rules of formal grammar. This system will support the decision making in CEP. This solution may contribute to the speedup of decision making process in complex event processing and also to the formal verification of these systems.
Wright, Adam; Sittig, Dean F
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:
Maneval, Rhonda; Fowler, Kimberly A; Kays, John A; Boyd, Tiffany M; Shuey, Jennifer; Harne-Britner, Sarah; Mastrine, Cynthia
This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear. Copyright 2012, SLACK Incorporated.
Effective decision support for site characterization is key to determining the nature and extent of contamination and the associated human and environmental risks. Site characterization data, however, present particular problems to technical analysts and decision-makers. Such data are four dimensional, incorporating temporal and spatial components. Their sheer volume can be daunting -- sites with hundreds of monitoring wells and thousands of samples sent for laboratory analyses are not uncommon. Data are derived from a variety of sources including laboratory analyses, non-intrusive geophysical surveys, historical information, bore logs, in-field estimates of key physical parameters such as aquifer transmissivity, soil moisture content, depth-to-water table, etc. Ultimately, decisions have to be made based on data that are always incomplete, often confusing, inaccurate, or inappropriate, and occasionally wrong. In response to this challenge, two approaches to environmental decision support have arisen, Data Quality Objectives (DQOS) and the Observational Approach (OA). DQOs establish criteria for data collection by clearly defining the decisions that need to be made, the uncertainty that can be tolerated, and the type and amount of data that needs to be collected to satisfy the uncertainty requirements. In practice, DQOs are typically based on statistical measures. The OA accepts the fact that the process of characterizing and remediating contaminated sites is always uncertain. Decision-making with the OA is based on what is known about a site, with contingencies developed for potential future deviations from the original assumptions about contamination nature, extent, and risks posed
Full Text Available Aim of study: In this paper, we present a decision support system (DSS to support decision making where different stakeholders have to generate landscape and forest level strategic plans. We further present an interactive approach that may take advantage of a posteriori preference modelling (i.e. Pareto frontier technique to facilitate the specification of the levels of achievement of various objectives.Area of study: The approach was applied to one planning cycle of a real world study case, the Leiria National Forest in Portugal. The Leiria National Forest, a managed area of approximately eleven thousand hectares in which 8,679 hectares are even aged stands of maritime pine (Pinus pinaster Ait aimed at the production of wood.Material and methods: The interactive approach, at first, tries to generate Pareto efficient frontiers for different objectives. Then, multiple decision makers are involved in the process to seek an agreement towards the definition of a consensual strategic plan.Main results: The system developed in this article integrates an information management subsystem, a module to generate alternative management regimes, growth model routines and a decision module that generates and solves mathematical formulations. It also provides a module to display reports and view the resulting solutions (management plans. We also build the Pareto frontier for different criteria. The results show that the proposed DSS can help solve strategic planning problems subject to sustainable management constraints where people organize themselves and participate jointly to manage their natural resources.Research highlights: The interactive approach facilitates the involvement of multiple stakeholders in the decision making process.Keywords: decision support system; participatory planning; linear programming; mixed integer goal programming; sustainable forest management.
Pulwarty, R. S.
As has been long noted, a comprehensive, coordinated observing system is the backbone of any Earth information system. Demands are increasingly placed on earth observation and prediction systems and attendant services to address the needs of economically and environmentally vulnerable sectors and investments, including energy, water, human health, transportation, agriculture, fisheries, tourism, biodiversity, and national security. Climate services include building capacity to interpret information and recognize standards and limitations of data in the promotion of social and economic development in a changing climate. This includes improving the understanding of climate in the context of a variety of temporal and spatial scales (including the influence of decadal scale forcings and land surface feedbacks on seasonal forecast reliability). Climate data and information are central for developing decision options that are sensitive to climate-related uncertainties and the design of flexible adaptation pathways. Ideally monitoring should be action oriented to support climate risk assessment and adaptation including informing robust decision making to multiple risks over the long term. Based on the experience of global observations programs and empirical research we outline- Challenges in developing effective monitoring and climate information systems to support adaptation. The types of observations of critical importance needed for sector planning to enhance food, water and energy security, and to improve early warning for disaster risk reduction Observations needed for ecosystem-based adaptation including the identification of thresholds, maintenance of biological diversity and land degradation The benefits and limits of linking regional model output to local observations including analogs and verification for adaptation planning To support these goals a robust systems of integrated observations are needed to characterize the uncertainty surrounding emergent risks
Kalina, Jan; Seidl, L.; Zvára, K.; Grünfeldová, H.; Slovák, Dalibor; Zvárová, Jana
Roč. 1, č. 1 (2013), s. 46-46 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : decision support system * web-service * information extraction * high-dimension * gene expressions Subject RIV: IN - Informatics, Computer Science
Havelaar, A.H.; Bräunig, J.; Christiansen, K.; Cornu, M.; Hald, T.; Mangen, M.J.J.; Molbak, K.; Pielaat, A.; Snary, E.; Pelt, van W.; Velthuis, A.G.J.; Wahlström, H.
Decisions on food safety involve consideration of a wide range of concerns including the public health impact of foodborne illness, the economic importance of the agricultural sector and the food industry, and the effectiveness and efficiency of interventions. To support such decisions, we propose
Full Text Available Managers are often mobile and a large proportion of their work is dealing with decisions. Although many managers currently use tablet computers in their work, there is little research on the use of tablets for managerial decision-support. This exploratory study aims to investigate the ways in which managers use tablets to support their decision-making and the reasons why they do so. Using Task-Technology Fit theory, semi-structured interviews were conducted with 20 managers, 17 of whom used tablets for their work-related decision-making. The study reveals managers’ tablet usage patterns in terms of location, tablet applications, decision activities and types. This study has also found that a range of tablet characteristics and decision-task characteristics affect managers’ use of tablets to support decision-making at work. This exploratory study contributes to both academia and industry by providing evidence on the tablet decision-support area, and affording organisations, tablet vendors and tablet application developers informative findings for further improvement in the provision of tablet-based decision support.
Voss, Stefan; Sebastian, Hans-Jürgen; Pahl, Julia
Intelligent Decision Support and Big Data for Logistics and Supply Chain Management” features theoretical developments, real-world applications and information systems related to solving decision problems in logistics and supply chain management. Methods include optimization, heuristics, metaheur......Intelligent Decision Support and Big Data for Logistics and Supply Chain Management” features theoretical developments, real-world applications and information systems related to solving decision problems in logistics and supply chain management. Methods include optimization, heuristics......, metaheuristics and matheuristics, simulation, agent technologies, and descriptive methods. In a sense, we were and are representing the future of logistics over the years....
Lang, Eric L; Youpa, Daniel G; Berman, Sandi; Leggitt, John S
The present research is the second in a series of studies to test preliminary decision rules and provide automated approval estimates for a Department of Defense Adjudication Decision Support (ADS) system...
Horsky, Jan; Phansalkar, Shobha; Desai, Amrita; Bell, Douglas; Middleton, Blackford
Describe optimal design attributes of clinical decision support (CDS) interventions for medication prescribing, emphasizing perceptual, cognitive and functional characteristics that improve human-computer interaction (HCI) and patient safety. Findings from published reports on success, failures and lessons learned during implementation of CDS systems were reviewed and interpreted with regard to HCI and software usability principles. We then formulated design recommendations for CDS alerts that would reduce unnecessary workflow interruptions and allow clinicians to make informed decisions quickly, accurately and without extraneous cognitive and interactive effort. Excessive alerting that tends to distract clinicians rather than provide effective CDS can be reduced by designing only high severity alerts as interruptive dialog boxes and less severe warnings without explicit response requirement, by curating system knowledge bases to suppress warnings with low clinical utility and by integrating contextual patient data into the decision logic. Recommended design principles include parsimonious and consistent use of color and language, minimalist approach to the layout of information and controls, the use of font attributes to convey hierarchy and visual prominence of important data over supporting information, the inclusion of relevant patient data in the context of the alert and allowing clinicians to respond with one or two clicks. Although HCI and usability principles are well established and robust, CDS and EHR system interfaces rarely conform to the best known design conventions and are seldom conceived and designed well enough to be truly versatile and dependable tools. These relatively novel interventions still require careful monitoring, research and analysis of its track record to mature. Clarity and specificity of alert content and optimal perceptual and cognitive attributes, for example, are essential for providing effective decision support to clinicians
Full Text Available The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.
Bal, Mert; Amasyali, M Fatih; Sever, Hayri; Kose, Guven; Demirhan, Ayse
The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.
B. Wierenga (Berend); P.A.M. Oude Ophuis (Peter)
textabstractThis paper deals with marketing decision support systems (MDSS) in companies. In a conceptual framework five categories of factors are distinguished that potentially affect adoption, use, and satisfaction: external environment factors, organizational factors, task environment factors,
Helu, Moneer; Libes, Don; Lubell, Joshua; Lyons, Kevin; Morris, KC
Smart manufacturing combines advanced manufacturing capabilities and digital technologies throughout the product lifecycle. These technologies can provide decision-making support to manufacturers through improved monitoring, analysis, modeling, and simulation that generate more and better intelligence about manufacturing systems. However, challenges and barriers have impeded the adoption of smart manufacturing technologies. To begin to address this need, this paper defines requirements for data-driven decision making in manufacturing based on a generalized description of decision making. Using these requirements, we then focus on identifying key barriers that prevent the development and use of data-driven decision making in industry as well as examples of technologies and standards that have the potential to overcome these barriers. The goal of this research is to promote a common understanding among the manufacturing community that can enable standardization efforts and innovation needed to continue adoption and use of smart manufacturing technologies. PMID:28649678
Full Text Available The aim of the present paper is to introduce how to analyse the qualitative data from the Critical Decision Method. At first, characterizing the method provides the meaningful introduction into the issue. This method used in naturalistic decision making research is one of the cognitive task analysis methods, it is based on the retrospective semistructured interview about critical incident from the work and it may be applied in various domains such as emergency services, military, transport, sport or industry. Researchers can make two types of methodological adaptation. Within-method adaptations modify the way of conducting the interviews and cross-method adaptations combine this method with other related methods. There are many decsriptions of conducting the interview, but the descriptions how the data should be analysed are rare. Some researchers use conventional approaches like content analysis, grounded theory or individual procedures with reference to the objectives of research project. Wong (2004 describes two approaches to data analysis proposed for this method of data collection, which are described and reviewed in the details. They enable systematic work with a large amount of data. The structured approach organizes the data according to an a priori analysis framework and it is suitable for clearly defined object of research. Each incident is studied separately. At first, the decision chart showing the main decision points and then the incident summary are made. These decision points are used to identify the relevant statements from the transcript, which are analysed in terms of the Recognition-Primed Decision Model. Finally, the results from all the analysed incidents are integrated. The limitation of the structured approach is it may not reveal some interesting concepts. The emergent themes approach helps to identify these concepts while maintaining a systematic framework for analysis and it is used for exploratory research design. It
McConville, Jennifer R; Künzle, Rahel; Messmer, Ulrike; Udert, Kai M; Larsen, Tove A
This paper offers a methodology for structuring the design space for innovative process engineering technology development. The methodology is exemplified in the evaluation of a wide variety of treatment technologies for source-separated domestic wastewater within the scope of the Reinvent the Toilet Challenge. It offers a methodology for narrowing down the decision-making field based on a strict interpretation of treatment objectives for undiluted urine and dry feces and macroenvironmental factors (STEEPLED analysis) which influence decision criteria. Such an evaluation identifies promising paths for technology development such as focusing on space-saving processes or the need for more innovation in low-cost, energy-efficient urine treatment methods. Critical macroenvironmental factors, such as housing density, transportation infrastructure, and climate conditions were found to affect technology decisions regarding reactor volume, weight of outputs, energy consumption, atmospheric emissions, investment cost, and net revenue. The analysis also identified a number of qualitative factors that should be carefully weighed when pursuing technology development; such as availability of O&M resources, health and safety goals, and other ethical issues. Use of this methodology allows for coevolution of innovative technology within context constraints; however, for full-scale technology choices in the field, only very mature technologies can be evaluated.
Tools are proposed for carbon footprint estimation of transportation construction projects and decision support : for construction firms that must make equipment choice and usage decisions that affect profits, project duration : and greenhouse gas em...
Smith, R.; Kasprzyk, J. R.; Balaji, R.
In light of deeply uncertain factors like future climate change and population shifts, responsible resource management will require new types of information and strategies. For water utilities, this entails potential expansion and efficient management of water supply infrastructure systems for changes in overall supply; changes in frequency and severity of climate extremes such as droughts and floods; and variable demands, all while accounting for conflicting long and short term performance objectives. Multiobjective Evolutionary Algorithms (MOEAs) are emerging decision support tools that have been used by researchers and, more recently, water utilities to efficiently generate and evaluate thousands of planning portfolios. The tradeoffs between conflicting objectives are explored in an automated way to produce (often large) suites of portfolios that strike different balances of performance. Once generated, the sets of optimized portfolios are used to support relatively subjective assertions of priorities and human reasoning, leading to adoption of a plan. These large tradeoff sets contain information about complex relationships between decisions and between groups of decisions and performance that, until now, has not been quantitatively described. We present a novel use of Multivariate Regression Trees (MRTs) to analyze tradeoff sets to reveal these relationships and critical decisions. Additionally, when MRTs are applied to tradeoff sets developed for different realizations of an uncertain future, they can identify decisions that are robust across a wide range of conditions and produce fundamental insights about the system being optimized.
S. M. Seyedhosseini; A. Makui; M. Ghadami
Globalization and therefore increasing tight competition among companies, have resulted to increase the importance of making well-timed decision. Devising and employing effective strategies, that are flexible and adaptive to changing market, stand a greater chance of being effective in the long-term. In other side, a clear focus on managing the entire product lifecycle has emerged as critical areas for investment. Therefore, applying wellorganized tools to employ past experience in new case, ...
Klemke, Roland; Börner, Dirk; Suarez, Angel; Schneider, Jan; Antonaci, Alessandra
This interactive workshop session introduces mobile serious games as situated, contextualized learning games. Example cases for mobile serious games for decision support training are introduced and discussed. Participants will get to know contextualization techniques used in modern mobile
Wierenga, B.; Oude Ophuis, P.A.M.
This paper deals with marketing decision support systems (MDSS) in companies. In a conceptual framework five categories of factors are distinguished that potentially affect adoption, use, and satisfaction: external environment factors, organizational factors, task environment factors, user factors
Franco de los Ríos, Camilo; Pedersen, Søren Marcus; Papaharalampos, Haris
Decision support methodologies in precision agriculture should integrate the different dimensions composing the added complexity of operational decision problems. Special attention has to be given to the adequate knowledge extraction techniques for making sense of the collected data, processing...... the information for assessing decision makers and farmers in the efficient and sustainable management of the field. Focusing on weed management, the integration of operational aspects for weed spraying is an open challenge for modeling the farmers’ decision problem, identifying satisfactory solutions...... for the implementation of automatic weed recognition procedures. The objective of this paper is to develop a decision support methodology for detecting the undesired weed from aerial images, building an image-based viewpoint consisting in relevant operational knowledge for applying precision spraying. In this way...
Christensen, Andreas Aagaard; Piil, Kristoffer; Andersen, Peter Stubkjær
data model for land use data – the dNmark landscape model. Based on input data which is corrected and edited by workshop participants, the tool estimates the effect of potential land use scenarios on nutrient emissions. The tool was tested in 5 scenario workshops in case areas in Denmark in 2016...... in Denmark to develop and improve a functioning decision support tool for landscape scale N-management. The aim of the study is to evaluate how a decision support tool can best be designed in order to enable landscape scale strategic N-management practices. Methods: A prototype GIS-tool for capturing......, storing, editing, displaying and modelling landscape scale farming practices and associated emission consequences was developed. The tool was designed to integrate locally held knowledge with national scale datasets in live scenario situations through the implementation of a flexible, uniform and editable...
Hsieh, Min-Han; Hwang, Sheue-Ling; Liu, Kang-Hong; Liang, Sheau-Farn Max; Chuang, Chang-Fu
Highlights: ► A decision support system has been constructed and verified. ► The operator's decision-making time was decreased by about 25%. ► The accuracy was increased by about 18%. ► The system prevents overlooking important information. ► Fewer erroneous solutions were implemented, and the mental workload was reduced. - Abstract: In order to prevent safety hazards that can result from inappropriate decisions made by the operators of a nuclear power plant (NPP), this study was undertaken to develop a decision support system to reduce the complexity of the decision-making process by aiding operators’ cognitive activities, integrating unusual symptoms, and identifying the most suitable abnormal operating procedure (AOP) for operators. The study was conducted from the perspective of human factors engineering in order to compare the process that operators originally used to select an AOP with a process that included a support system for AOP identification. The results of the study indicated that the existence of a support system reduces errors by quickly suggesting likely AOPs. With such a support system in place, there were clear improvements in human performance, i.e., decision-making time decreased by about 25%, and the accuracy of the operators’ decisions, judged by the successful resolution of specific problems, increased by about 18%. In addition, there were fewer erroneous solutions implemented, and the mental workload was reduced. Hence, the decision support system is proposed as a training tool in identifying AOPs in the main control room (MCR).
Full Text Available Aim of study: To examine methods of incorporating risk and uncertainty to stand level forest decisions. Area of study: A case study examines a small forest holding from Jönköping, Sweden. Material and methods: We incorporate empirically estimated uncertainty into the simulation through a Monte Carlo approach when simulating the forest stands for the next 100 years. For the iterations of the Monte Carlo approach, errors were incorporated into the input data which was simulated according to the Heureka decision support system. Both the Value at Risk and the Conditional Value at Risk of the net present value are evaluated for each simulated stand. Main results: Visual representation of the errors can be used to highlight which decision would be most beneficial dependent on the decision maker’s opinion of the forest inventory results. At a stand level, risk preferences can be rather easily incorporated into the current forest decision support software. Research highlights: Forest management operates under uncertainty and risk. Methods are available to describe this risk in an understandable fashion for the decision maker.
Full Text Available The Theory of Universals in Values (TUV, a reliable and validated conceptualization of personal values used in psychology, is used to examine the effect of system feedback delivered by a Decision Support System (DSS on personal values. The results indicate that value-based decision-making behavior can be influenced by DSS feedback to address value congruence in decision-making. User behavior was shown to follow the outcomes expected by operant theory when feedback was supportive and to follow the outcomes of reactance theory when feedback was challenging. This result suggests that practitioners and Information System (IS researchers should consider user values when designing computerized decision feedback to adjust a system’s design such that the potential user backlash is avoided or congruence between organizational and personal values is achieved.
Raskob, W.; Heling, R.; Zheleznyak, M.
This paper discusses the role of hydrological modelling in decision support systems for nuclear emergencies. In particular, most recent developments such as, the radionuclide transport models integrated in to the decision support system RODOS will be explored. Recent progress in the implementation of physically-based distributed hydrological models for operational forecasting in national and supranational centres, may support a closer cooperation between national hydrological services and therefore, strengthen the use of hydrological and radiological models implemented in decision support systems. (authors)
This interactive workshop session introduces mobile serious games as situated, contextualized learning games. Example cases for mobile serious games for decision support training are introduced and discussed. Participants will get to know contextualization techniques used in modern mobile devices
V. A. Rybak
Full Text Available A new technology of intelligent decision support on Forex, including forming algorithms of trading signals, rules for the training sample based on technical indicators, which have the highest correlation with the price, the method of reducing the number of losing trades, is proposed. The last is based on an analysis of the wave structure of the market, while the beginning of the cycle (the wave number one is offered to be identified using Bill Williams Oscillator (Awesome oscillator. The process chain of constructing neuro-fuzzy model using software package MatLab is described.
Crossland, Neal; Broussard, Steve
...) Process Improvement and Decision Support System (DSS) Development. Discussion sequence is: Why the study? Objectives; Areas of inquiry; Study products; Observations; Recommendations; Decision Support System.
Toscani, F.; Steen, J.T. van der; Finetti, S.; Giunco, F.; Pettenati, F.; Villani, D.; Monti, M.; Gentile, S.; Charrier, L.; Giulio, P. Di
OBJECTIVE: To describe and compare the decisions critical for survival or quality of life [critical decisions (CDs)] made for patients with advanced dementia in nursing homes (NHs) and home care (HC) services. DESIGN: Prospective cohort study with a follow-up of 6 months. SETTING: Lombardy Region
Hamouda, M A; Anderson, W B; Huck, P M
The continuously changing drivers of the water treatment industry, embodied by rigorous environmental and health regulations and the challenge of emerging contaminants, necessitates the development of decision support systems for the selection of appropriate treatment trains. This paper explores a systematic approach to developing decision support systems, which includes the analysis of the treatment problem(s), knowledge acquisition and representation, and the identification and evaluation of criteria controlling the selection of optimal treatment systems. The objective of this article is to review approaches and methods used in decision support systems developed to aid in the selection, sequencing of unit processes and design of drinking water, domestic wastewater, and industrial wastewater treatment systems. Not surprisingly, technical considerations were found to dominate the logic of the developed systems. Most of the existing decision-support tools employ heuristic knowledge. It has been determined that there is a need to develop integrated decision support systems that are generic, usable and consider a system analysis approach.
Andersson, Kasper Grann; Astrup, Poul; Mikkelsen, Torben
It is described how ongoing work will extend European standard decision support systems currently integrated in the nuclear power plant preparedness in many countries, to enable estimation of the radiological consequences of atmospheric dispersion of contaminants following a terror attack in a city....... Factors relating to the contaminant release processes, dispersion, deposition and post deposition migration are discussed, and non-radiological issues are highlighted in relation to decision making....
The DSSNET network was established in October 2000 with the overall objective to create an effective and accepted framework for better communication and understanding between the community of institutions involved in operational off-site emergency management and the many and diverse RTD institutes further developing methods and tools in this area, in particular decision support systems (DSS), for making well informed and consistent judgements with respect to practical improvements of emergency response in Europe. 37 institutions from 21 countries of East and West Europe have been members of the network with about half of them responsible for operational emergency management. The objectives of the network have been numerous and the more important ones include: to ensure that future RTD is more responsive to user needs, to inform the user community of new developments and their potential for improving emergency response, to improve operational decision support systems from feedback of operational experience, to identify how information and data exchange between countries can be improved, to promote greater coherence among operational decision support systems and to encourage shared development of new and improved decision support systems features, and to improve the practicability of operational decision support systems. To stimulate the communication and feedback between the operational and the RTD community, problem-oriented emergency exercises were performed, which covered the various time phases of an accident and which extended from the near range to farther distances with frontier crossing transport of radionuclides. The report describes the objectives of the DSSNET, the five emergency exercises performed and the results of their evaluation. They provided valuable insight and lessons for operators and users of decision support systems, in particular the need for much more intensive training and exercising with decision support systems and their interaction with
Benham, Brian; Hawley, Diane
resolved through discussion or with a third reviewer. Data was extracted independently by each reviewer from papers included in the review using a Microsoft Excel spreadsheet. Included data included study type, 'r' values, number of subjects and reported 'p' values. These were indexed by author, year and study title. The meta-analysis was performed using the method for effect size analysis from Hunter and Schmidt. The syntax for equations was transposed into a Microsoft Excel spreadsheet for data entry, analysis and graph creation. No articles or paper addressing unique tools for ascertaining critical decision making skills met the inclusion criteria. Standard tools, which were represented in the literature, assess critical decision making skills via prediction of academic and clinical success, which indicates the presence of critical decision making skills in graduate healthcare students. A total of 16 studies addressing standard tools were included in this review. All were retrospective case series studies. The date range for the included studies was 1970 to 2009. The strongest relationship was undergraduate grade point average's correlation to graduate grade point average (small effect size with an 'r' value of 0.27, credibility interval of 0.18-0.37). The second strongest relationship was between Graduate Record Examination’s verbal section and graduate grade point average (small effect size with an r value of 0.24, CrI of 0.11-0.37). An applicant’s undergraduate GPA has the strongest correlation with graduate healthcare program success of the indicators analyzed (r = 0.27, small effect size). The next best predictor of graduate healthcare program success was the GRE Verbal score (r = 0.24, small effect size). However, all of the variables carried positive correlations with graduate success, just of lesser effect size strength. This review supports the continued use of traditional indicators of graduate school potential in the undergraduate grade point average and
Hirsch, Gary B.; Homer, Jack (Homer Consulting); Chenoweth, Brooke N.; Backus, George A.; Strip, David R.
As Sandia National Laboratories serves its mission to provide support for the security-related interests of the United States, it is faced with considering the behavioral responses that drive problems, mitigate interventions, or lead to unintended consequences. The effort described here expands earlier works in using healthcare simulation to develop behavior-aware decision support systems. This report focuses on using qualitative choice techniques and enhancing two analysis models developed in a sister project.
Bernat-Adell, M D; Ballester-Arnal, R; Abizanda-Campos, R
Emotional factors may lead to cognitive impairment that can adversely affect the capacity of patients to reason, and thereby, limit their participation in decision taking. To analyze critical patient aptitude for decision taking, and to identify variables that may influence competence. An observational descriptive study was carried out. Intensive care unit. Participants were 29 critically ill patients. Social, demographic and psychological variables were analyzed. Functional capacities and psychological reactions during stay in the ICU were assessed. The patients are of the firm opinion that they should have the last word in the taking of decisions; they prefer bad news to be given by the physician; and feel that the presence of a psychologist would make the process easier. Failure on the part of the professional to answer their questions is perceived as the greatest stress factor. Increased depression results in lesser cognitive capacity, and for patients with impaired cognitive capacity, participation in the decision taking process constitutes a burden. The variables anxiety and depression are significantly related to decision taking capacity. Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.
Lin, Yanxia; Myall, Michelle; Jarrett, Nikki
To understand how decisions are made to transfer dying patients home from critical care units. Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. Integrative review. Seven bibliographic databases (origin-2015), grey literature and reference lists were searched. An integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework. The number of patients transferred home ranged from 1-346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders' involvement in decision-making, collective work and limited understanding of individuals' experiences. The practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients' wishes to die at home. © 2017 John Wiley & Sons Ltd.
Pomier Baez, L.; Troncoso Fleitas, M.; Valhuerdi Debesa, C.; Valle Cepero, R.; Hernandez, J.L.
Features of different safety analysis techniques by means of calculation thermohydraulic a probabilistic and severe accidents used in the safety assessment, as well as the development of these techniques in Cuba and their use in support of regulatory decision making are presented
for Strategic Management. The book was published in 2012 by Springer-Verlag, London, as a research monograph in the publisher’s series about Decision Engineering. The intention behind this new book – with its focus upon ‘greening’ of strategic decisions – is to provide a general and less technical description......The book is based on my participation in the SUSTAIN research project 2012-2017 about National Sustainable Transport Planning funded by the Danish Research Council (Innovationsfonden). Many of the issues treated here have a backdrop in my book Complex Strategic Choices – Applying Systemic Planning...... to this application area. In fact a company relocation decision case has been used to introduce the potential of SP as regards providing decision support for strategic decision making. A main concern in this presentation of SP, which deviates from the Springer book referred to above, is to highlight that ‘greening...
Ajay Kumar Saxena
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.
Complex decision-making is a prominent aspect of requirements engineering (RE) and the need for improved decision support for RE decision-makers has been identified by a number of authors in the research literature. The fundamental viewpoint that permeates this thesis is that RE decision-making can be substantially improved by RE decision support systems (REDSS) based on the actual needs of RE decision-makers as well as the actual generic human decision-making activities that take place in th...
Recent legislation concerning personnel security has vastly increased the responsibility and accountability of the security manager. Access authorization, fitness for duty, and personnel security access programs require decisions regarding an individual's trustworthiness and reliability based on the findings of a background investigation. While these guidelines provide significant data and are useful as a tool, limited resources are available to the adjudicator of derogatory information on what is and is not acceptable in terms of granting access to sensitive areas of nuclear plants. The reason why one individual is deemed unacceptable and the next acceptable may be questioned and cause discriminatory accusations. This paper is continuation of discussion on workforce reliability, focusing on the use of artificial intelligence to support the decisions of a security manager. With this support, the benefit of previous decisions helps ensure consistent adjudication of background investigations
de Mello, Adriana Marotti; School of Economics, Business and Accounting at the University of São Paulo; Marx, Roberto; Polytechnic School, University of São Paulo; Zilbovicius, Mauro; Polytechnic School – University of São Paulo
This article presents the development of a Methodology of Decision Support for Work Allocation in complex production processes. It is known that this decision is frequently taken empirically and that the methodologies available to support it are few and restricted in terms of its conceptual basis. The study of Times and Motion is one of these methodologies, but its applicability is restricted in cases of more complex production processes. The method presented here was developed as a result of...
Olyazadeh, Roya; Jaboyedoff, Michel; van Westen, Cees; Bakker, Wim
Multi-Criteria Evaluation (MCE) module is one of the five modules of RiskChanges spatial decision support system. RiskChanges web-based platform aims to analyze changes in hydro-meteorological risk and provides tools for selecting the best risk reduction alternative. It is developed under CHANGES framework (changes-itn.eu) and INCREO project (increo-fp7.eu). MCE tool helps decision makers and spatial planners to evaluate, sort and rank the decision alternatives. The users can choose among different indicators that are defined within the system using Risk and Cost Benefit analysis results besides they can add their own indicators. Subsequently the system standardizes and prioritizes them. Finally, the best decision alternative is selected by using the weighted sum model (WSM). The Application of this work is to facilitate the effect of MCE for analyzing changing risk over the time under different scenarios and future years by adopting a group decision making into practice and comparing the results by numeric and graphical view within the system. We believe that this study helps decision-makers to achieve the best solution by expressing their preferences for strategies under future scenarios. Keywords: Multi-Criteria Evaluation, Spatial Decision Support System, Weighted Sum Model, Natural Hazard Risk Management
Webb, Colleen T.; Ferrari, Matthew; Lindström, Tom; Carpenter, Tim; Dürr, Salome; Garner, Graeme; Jewell, Chris; Stevenson, Mark; Ward, Michael P.; Werkman, Marleen; Backer, Jantien; Tildesley, Michael
Epidemiological models in animal health are commonly used as decision-support tools to understand the impact of various control actions on infection spread in susceptible populations. Different models contain different assumptions and parameterizations, and policy decisions might be improved by
Ya Zheng; Zhong Yang; Zhong Yang; Chunlan Jin; Yue Qi; Yue Qi; Xun Liu; Xun Liu
Fairness-related decision making is an important issue in the field of decision making. Traditional theories emphasize the roles of inequity aversion and reciprocity, whereas recent research increasingly shows that emotion plays a critical role in this type of decision making. In this review, we summarize the influences of three types of emotions (i.e., the integral emotion experienced at the time of decision making, the incidental emotion aroused by a task-unrelated dispositional or situatio...
Vadde, S.; Allen, J. K.; Mistree, F.
In this paper an extension to the traditional compromise Decision Support Problem (DSP) formulation is presented. Bayesian statistics is used in the formulation to model uncertainties associated with the information being used. In an earlier paper a compromise DSP that accounts for uncertainty using fuzzy set theory was introduced. The Bayesian Decision Support Problem is described in this paper. The method for hierarchical design is demonstrated by using this formulation to design a portal frame. The results are discussed and comparisons are made with those obtained using the fuzzy DSP. Finally, the efficacy of incorporating Bayesian statistics into the traditional compromise DSP formulation is discussed and some pending research issues are described. Our emphasis in this paper is on the method rather than the results per se.
SULLIVAN,T.; ARMSTRONG,A.; OSLEEB,J.
This demonstration is focused on evaluating the utility of decision support software in addressing environmental problems. Three endpoints have been selected for evaluation: (1) Visualization, (2) Sample Optimization, and (3) Cost/Benefit Analysis. The definitions for these three areas in this program are listed.
Full Text Available The selection of an optimal transportation mode is one of the most important factors in supply chain and logistic planning. Furthermore, the selection transportation mode is a complex, multi-criteria decision problem. The decision makers have to face and take attention with a lot of criteria; such as cost, quality, delivery time, safety, accessibility and etc while choosing the best mode. Under these criteria, there must be a selection between motorway, seaway, airway, pipeline, railway and also intermodal modes. Selection the transportation mode is very promising issue because it affects about 60-65 % of total logistic cake. There are some techniques which can be heuristics and logical approaches are used to reach the best option. The analytical hierarchy process (AHP which is one of the mathematical methods can be very useful in involving several decision makers with different conflicting objectives to arrive at a consensus decision. In this paper, the selection of an optimal transportation mode using an AHP-based model was evaluated for logistic activities. To solve this transportation mode selection problem, we developed a decision support system based AHP. By using the developed decision support system, the best transportation modes is determined and discussed.
Feather, Martin S.; Maynard-Zhang, Pedrito; Kiper, James D.
One inherent characteristic of requrements engineering is a lack of certainty during this early phase of a project. Nevertheless, decisions about requirements must be made in spite of this uncertainty. Here we describe the context in which we are exploring this, and some initial work to support elicitation of uncertain requirements, and to deal with the combination of such information from multiple stakeholders.
Armas, Iuliana; Gheorghe, Diana
Nowadays, because of the ever increasing volume of information, policymakers are faced with decision making problems. Achieving an objective and suitable decision making may become a challenge. In such situations decision support systems (DSS) have been developed. DSS can assist in the decision making process, offering support on how a decision should be made, rather than what decision should be made (Simon, 1979). This in turn potentially involves a huge number of stakeholders and criteria. Regarding seismic risk, Bucharest City is highly vulnerable (Mandrescu et al., 2007). The aim of this study is to implement a spatial decision support system in order to secure a suitable shelter in case of an earthquake occurrence in the historical centre of Bucharest City. In case of a seismic risk, a shelter is essential for sheltering people who lost their homes or whose homes are in danger of collapsing while people at risk receive first aid in the post-disaster phase. For the present study, the SMCE Module for ILWIS 3.4 was used. The methodology included structuring the problem by creating a decision tree, standardizing and weighting of the criteria. The results showed that the most suitable buildings are Tania Hotel, Hanul lui Manuc, The National Bank of Romania, The Romanian Commercial Bank and The National History Museum.
Caraballo, Pedro J; Parkulo, Mark; Blair, David; Elliott, Michelle; Schultz, Cloann; Sutton, Joseph; Rao, Padma; Bruflat, Jamie; Bleimeyer, Robert; Crooks, John; Gabrielson, Donald; Nicholson, Wayne; Rohrer Vitek, Carolyn; Wix, Kelly; Bielinski, Suzette J; Pathak, Jyotishman; Kullo, Iftikhar
The level of CYP2D6 metabolic activity can be predicted by pharmacogenomic testing, and concomitant use of clinical decision support has the potential to prevent adverse effects from those drugs metabolized by this enzyme. Our initial findings after implementation of clinical decision support alerts integrated in the electronic health records suggest high feasibility, but also identify important challenges.
Schenker-Wicki, A G.M.
The Institute for Automation and Operations Research at the University of Fribourg has been charged by the Swiss government to design a concept for a Crisis Management Decision Support System CMDSS to evaluate acceptable countermeasures to reduce ingestion dose after an accidental release of radioactivity and to implement a prototype. The study is divided in two parts. In the first part all the necessary modules and techniques for efficient decision making, based on the most recent developments in decision theory, as well as the necessary structuring of the decision making process are discussed, while in the second part the plausibility of the evaluated system is tested using a case study. For the time being no empirical research has been carried out. The decision making concept presented in this book comprehends decision making on two different levels, a technical and a political one. The division of decision power corresponds to the Swiss legal prescriptions for accidental release of radioactivity. To guarantee decisions of high quality, as many countermeasures as possible have to be presented to the decision makers. Due to the difficulty of evaluating all the possible countermeasures an expert-system is provided for the decision makers to generate the space of alternatives. The use of an expert-system should further help to reduce systematically the huge amount of information which is characteristic in crises situations. To support the comparison and ranking of the different alternatives a multi-criteria approach, the PROMETHEE method, which is based upon outranking relationships, is used. Due to the complexity of the decision making process, its poorly defined mathematical context and the unwillingness of the decision makers to use a method which requires defined substitution rates, decision methods based on utility theory will not be applied in this study. (Abstract Truncated)
Full Text Available A group decision support system is required on a value-based decision because there are different concern caused by differing preferences, experiences, and background. It is to enable each decision-maker to evaluate and rank the solution alternatives before engaging into negotiation with other decision-makers. Stakeholder of multi-criteria decision making problems usually evaluates the alternative solution from different perspective, making it possible to have a dominant solution among the alternatives. Each stakeholder needs to identify the goals that can be optimized and those that can be compromised in order to reach an agreement with other stakeholders. This paper presents group decision model involving three decision-makers on the selection of suitable system for a building’s roof. The objective of the research is to find an agreement options model and coalition algorithms for multi person decision with two main preferences of value which are function and cost. The methodology combines value analysis method using Function Analysis System Technique (FAST; Life Cycle Cost analysis, group decision analysis method based on Analytical Hierarchy Process (AHP in a satisfying options, and Game theory-based agent system to develop agreement option and coalition formation for the support system. The support system bridges theoretical gap between automated design in construction domain and automated negotiation in information technology domain by providing a structured methodology which can lead to systematic support system and automated negotiation. It will contribute to value management body of knowledge as an advanced method for creativity and analysis phase, since the practice of this knowledge is teamwork based. In the case of roof system selection, it reveals the start of the first negotiation round. Some of the solutions are not an option because no individual stakeholder or coalition of stakeholders desires to select it. The result indicates
Arandjelovic, Katarina; Eyre, Harris A; Lenze, Eric; Singh, Ajeet B; Berk, Michael; Bousman, Chad
Patients discontinue antidepressant medications due to lack of knowledge, unrealistic expectations, and/or unacceptable side effects. Shared decision making (SDM) invites patients to play an active role in their treatment and may indirectly improve outcomes through enhanced engagement in care, adherence to treatment, and positive expectancy of medication outcomes. We believe decisional aids, such as pharmacogenetic decision support tools (PDSTs), facilitate SDM in the clinical setting. PDSTs may likewise predict drug tolerance and efficacy, and therefore adherence and effectiveness on an individual-patient level. There are several important ethical considerations to be navigated when integrating PDSTs into clinical practice. The field requires greater empirical research to demonstrate clinical utility, and the mechanisms thereof, as well as exploration of the ethical use of these technologies.
Gabriel, Roland; Lux, Thomas
The German health care market is under a rapid rate of change, forcing especially hospitals to provide high-quality services at low costs. Appropriate measures for more effective and efficient service provision are process orientation and decision support by information technology of clinical pathway of a patient. The essential requirements are adequate modelling of clinical pathways as well as usage of adequate systems, which are capable of assisting the complete path of a patient within a hospital, and preferably also outside of it, in a digital way. To fulfil these specifications the authors present a suitable concept, which meets the challenges of well-structured clinical pathways as well as rather poorly structured diagnostic and therapeutic decisions, by interplay of process-oriented and knowledge-based hospital information systems.
.... The research suggests the feasibility of a PC based Decision Support System to assist Commander, Naval Surface Reserve Force improve the effectiveness and efficiency of the unit location decision...
Boza, Andrés; Ortiz, Angel; Vicens, Eduardo; Poler, Raul
Decision Support System (DSS) tools provide useful information to decision makers. In an Extended Enterprise, a new goal, changes in the current objectives or small changes in the extended enterprise configuration produce a necessary adjustment in its decision system. A DSS in this context must be flexible and agile to make suitable an easy and quickly adaptation to this new context. This paper proposes to extend the Hierarchical Production Planning (HPP) structure to an Extended Enterprise decision making context. In this way, a framework for DSS in Extended Enterprise context is defined using components of HPP. Interoperability details have been reviewed to identify the impact in this framework. The proposed framework allows overcoming some interoperability barriers, identifying and organizing components for a DSS in Extended Enterprise context, and working in the definition of an architecture to be used in the design process of a flexible DSS in Extended Enterprise context which can reuse components for futures Extended Enterprise configurations.
with an overview of the web-based Decision Support System (DSS) developed to facilitate its wide adop- tion. .... contributes significant catchment management and water supply functions .... experience in engagement and facilitation methods.
Gudmundsson, Henrik; Ericsson, Eva; Tight, Miles
but also the difficulty of unpicking its exact role in each case. Stockholm presented the most successful case, with a mix of academic and experience-based knowledge inputs facilitating understanding and acceptance. The cycle plan example revealed very limited influence of cycling design guidance. The UK......Improved decision support is deemed essential for the planning and implementation of sustainable transport solutions, but limited evidence exists that decision-relevant information is effectively used for these purposes. This paper applies a framework inspired by research in “knowledge utilization......” to examine to what extent various kinds of decision support are used and have become influential in three different planning situations—a local cycle plan in Copenhagen, the Stockholm congestion charging trial and the UK national transport strategy. The results reveal the extensive use of decision support...
Phansalkar, S; Wright, A; Kuperman, G J; Vaida, A J; Bobb, A M; Jenders, R A; Payne, T H; Halamka, J; Bloomrosen, M; Bates, D W
Clinical decision support (CDS) can improve safety, quality, and cost-effectiveness of patient care, especially when implemented in computerized provider order entry (CPOE) applications. Medication-related decision support logic forms a large component of the CDS logic in any CPOE system. However, organizations wishing to implement CDS must either purchase the computable clinical content or develop it themselves. Content provided by vendors does not always meet local expectations. Most organizations lack the resources to customize the clinical content and the expertise to implement it effectively. In this paper, we describe the recommendations of a national expert panel on two basic medication-related CDS areas, specifically, drug-drug interaction (DDI) checking and duplicate therapy checking. The goals of this study were to define a starter set of medication-related alerts that healthcare organizations can implement in their clinical information systems. We also draw on the experiences of diverse institutions to highlight the realities of implementing medication decision support. These findings represent the experiences of institutions with a long history in the domain of medication decision support, and the hope is that this guidance may improve the feasibility and efficiency CDS adoption across healthcare settings.
Hailu, Yohannes G.
A significant number of African States have adapted energy access targets. In evaluating progress towards these goals, measuring and monitoring energy access becomes relevant. This paper reviews energy access indicators and identifies their utility and challenges in their application. By focusing on Africa, a broader framework for energy access measurement and monitoring is discussed, along with implementation barriers and potential solutions. To demonstrate the utility of energy access decision-support tool in Africa, a scenario analysis in five regional energy pools is conducted using the Energy Spending Model tool. Institutionalizing monitoring and decision-support tools can provide valuable feedback to policymakers aiming to design and implement effective energy access programs serving a growing population in Africa. - Highlights: ► Most African countries have adapted energy access targets. ► To monitor and evaluate performance, monitoring and decision-support tools are required. ► Framework for tool development should consider data, cost, political and other factors. ► Implementation constraints include technical, data, resource and urban/rural issues. ► Electricity Spending Needs model is one decision support tool that ties access targets to investment needs. ► Monitoring tools provide crucial feedback on Africa's energy access progress.
Conforti, R.; Leoni, de M.; La Rosa, M.; Aalst, van der W.M.P.; Salinesi, C.; Norrie, M.C.; Pastor, O.
This paper proposes a technique that supports process participants in making risk-informed decisions, with the aim to reduce the process risks. Risk reduction involves decreasing the likelihood and severity of a process fault from occurring. Given a process exposed to risks, e.g. a financial process
Rojas-Palma, C.; Madsen, H.; Gering, F.
. The process of combining model predictions and observations, usually referred to as data assimilation, is described in this article within the framework of the real time on-line decision support system (RODOS) for off-site nuclear emergency management in Europe. Data assimilation capabilities, based on Kalman...
Körner, O.; Straten, van G.
Earlier, different dynamic greenhouse climate regimes were designed with various aims as energy saving, biocide reduction or reduction of chemical growth retardants that are used for quality improvement. The aim of this research was to create a decision support tool in order to decide at which week
Downing, Gregory J; Boyle, Scott N; Brinner, Kristin M; Osheroff, Jerome A
Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized
Brinner Kristin M
Full Text Available Abstract Background Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Discussion Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures, and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. Summary This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In
Full Text Available stream_source_info Naidoo1_2009.pdf.txt stream_content_type text/plain stream_size 24551 Content-Encoding UTF-8 stream_name Naidoo1_2009.pdf.txt Content-Type text/plain; charset=UTF-8 1 Modelling & Simulation...-Based Acquisition Decision Support: Present & Future Shahen Naidoo Abstract The Ground Based Air Defence System (GBADS) Programme, of the South African Army has been applying modelling and simulation (M&S) to provide acquisition decision and doctrine...
Gil, A.V.; Gamble, R.P.
The mission of the US Department of Energy (DOE) is to provide the basis for a national decision regarding the development of a geological repository for spent nuclear fuel and high-level radioactive waste at the Yucca Mountain site in Nevada. There are a number of steps in the decision process defined by US law that must be completed prior to development of a repository at this site. The DOE's focus is currently on the first two steps in this process: characterization of the site to support a determination by the DOE on whether the site is suitable for a geologic repository and a decision by the Secretary of Energy (the Secretary) on whether to recommend to the President that the site be approved for a repository. To enhance the confidence of multiple audiences in the basis for these actions, and to provide a basis for subsequent action by the President and the US Congress, information supporting the decision process must include the elements of a safety case consistent with the statutory and regulatory framework for these decisions. The idea of a safety case is to broaden the basis for confidence by decision-makers and the public in conclusions about safety. A safety case should cite multiple lines of evidence, or reasoning, beyond the results of a safety assessment to support the demonstration of safety, which includes compliance with applicable safety criteria. The multiple lines of evidence should show the basis for confidence in safety. To be most effective, such evidence requires information not directly used in the safety assessment. (author)
Shimizu, Shunichi; Sakurai, Shoji; Takaoka, Kazushi; Kanemoto, Shigeru; Fukutomi, Shigeki
Inspection and maintenance planning in nuclear power plants is conducted by decision making based on experts' collective consensus. However, since a great deal of time and effort is required to reach a consensus among expert judgments, the establishment of effective decision making methods is necessary. Therefore, the authors developed a method for supporting collective decision making, based on a combination of three types of decision making methods; the Characteristic Diagram method, Interpretative Structural Modeling method, and the Analytic Hierarchy Process method. The proposed method enables us to determine the evaluation criteria systematically for collective decision making, and also allows extracting collective decisions using simplified questionnaires. The proposed method can support reaching a consensus of groups effectively through the evaluation of collective decision structural models and their characteristics. In this paper, the effectiveness of the proposed method was demonstrated through its application to the decision making problem concerning whether or not the improved ultrasonic testing equipment should be adopted at nuclear power plants. (author)
Aminu, M; Yusof, K W; Matori, A N
The study describes a methodological approach based on an integrated use of Geographic Information System (GIS) and Analytic Network Process (ANP) of Multi Criteria Evaluation (MCE) to determine nature conservation and tourism development priorities among the highland areas. A set of criteria and indicators were defined to evaluate the highlands biodiversity conservation and tourism development. Pair wise comparison technique was used in order to support solution of a decision problem by evaluating possible alternatives from different perspectives. After the weights have been derived from the pairwise comparison technique, the next step was to compute the unweighted supermatrix, weighted supermatrix and the limit matrix. The limit matrix was normalized to obtain the priorities and the results transferred into GIS environment. Elements evaluated and ranked were represented by criterion maps. Map layers reflecting the opinion of different experts involved were summed using the weighted overlay approach of GIS. Subsequently sustainable tourism development scenarios were generated. The generation of scenarios highlighted the critical issues of the decision problem because it allows one to gradually narrow down a problem
Aminu, M.; Matori, A. N.; Yusof, K. W.
The study describes a methodological approach based on an integrated use of Geographic Information System (GIS) and Analytic Network Process (ANP) of Multi Criteria Evaluation (MCE) to determine nature conservation and tourism development priorities among the highland areas. A set of criteria and indicators were defined to evaluate the highlands biodiversity conservation and tourism development. Pair wise comparison technique was used in order to support solution of a decision problem by evaluating possible alternatives from different perspectives. After the weights have been derived from the pairwise comparison technique, the next step was to compute the unweighted supermatrix, weighted supermatrix and the limit matrix. The limit matrix was normalized to obtain the priorities and the results transferred into GIS environment. Elements evaluated and ranked were represented by criterion maps. Map layers reflecting the opinion of different experts involved were summed using the weighted overlay approach of GIS. Subsequently sustainable tourism development scenarios were generated. The generation of scenarios highlighted the critical issues of the decision problem because it allows one to gradually narrow down a problem.
Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive
In this paper, a model and tool is proposed to assist universities and other mission-based organisations to ascertain systematically the optimal portfolio of projects, in any year, meeting the organisations risk tolerances and available funds. The model and tool presented build on previous work on university operations and decision support systems…
Keith M. Reynolds
The USDA Forest Service Pacific Northwest Research Station in Corvallis, Oregon, has developed the ecosystem management decision support (EMDS) system. The system integrates the logical formalism of knowledge-based reasoning into a geographic information system (GIS) environment to provide decision support for ecological landscape assessment and evaluation. The...
Herrmann, Ivan Tengbjerg; Hauschild, Michael Zwicky; Sohn, Michael D.
the decision maker (DM) in making the best possible choice for the environment. At present, some DMs do not trust the LCA to be a reliable decisionsupport tool—often because DMs consider the uncertainty of an LCA to be too large. The standard evaluation of uncertainty in LCAs is an ex-post approach that can...... regarding which type of LCA study to employ for the decision context at hand. This taxonomy enables the derivation of an LCA classification matrix to clearly identify and communicate the type of a given LCA. By relating the LCA classification matrix to statistical principles, we can also rank the different......The aim of this article is to help confront uncertainty in life cycle assessments (LCAs) used for decision support. LCAs offer a quantitative approach to assess environmental effects of products, technologies, and services and are conducted by an LCA practitioner or analyst (AN) to support...
Jensen, Rune Møller; Leknes, Eilif; Bebbington, Thomas
Low cost containerized shipping requires high quality stowage plans. Scalable stowage planning optimization algorithms have been developed recently. All of these algorithms, however, produce monolithic solutions that are hard for stowage coordinators to modify, which is necessary in practice due ...... fast, complete, and backtrack-free decision support. Our computational results show that the approach can solve real-sized instances when breaking symmetries among similar containers...
Kalina, Jan; Zvárová, Jana
Roč. 4, č. 2 (2014), s. 53-65 ISSN 1947-3133 Grant - others:GA MŠk(CZ) ED2.1.00/03.0078 Institutional support: RVO:67985807 Keywords : big data * classification rule * decision support systems * e-health * mental health care Subject RIV: IN - Informatics, Computer Science
Wilczynski Nancy L; Haynes R Brian
Abstract Background Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this...
Iván José Ardila Gómez
Full Text Available Critically ill children require nutritional support that will give them nutritional and non-nutritional support to successfully deal with their disease. In the past few years, we have been able to better understand the pathophysiology of critical illness, which has made possible the establishment of nutritional strategies resulting in an improved nutritional status, thus optimizing the pediatric intensive care unit (PICU stay and decreasing morbidity and mortality. Critical illness is associated with significant metabolic stress. It is crucial to understand the physiological response to stress to create nutritional recommendations for critically ill pediatric patients in the PICU.
lying properties. Existing decision support systems available in the field of water distribution system maintenance mainly focus on leak detection and pipe rehabilitation/replacement strategies. These existing systems, however, do not address the ...
Sojda, Richard S.; Chen, Serena H.; El Sawah, Sondoss; Guillaume, Joseph H.A.; Jakeman, A.J.; Lautenbach, Sven; McIntosh, Brian S.; Rizzoli, A.E.; Seppelt, Ralf; Struss, Peter; Voinov, Alexey; Volk, Martin
Two of the basic tenets of decision support system efforts are to help identify and structure the decisions to be supported, and to then provide analysis in how those decisions might be best made. One example from wetland management would be that wildlife biologists must decide when to draw down water levels to optimise aquatic invertebrates as food for breeding ducks. Once such a decision is identified, a system or tool to help them make that decision in the face of current and projected climate conditions could be developed. We examined a random sample of 100 papers published from 2001-2011 in Environmental Modelling and Software that used the phrase “decision support system” or “decision support tool”, and which are characteristic of different sectors. In our review, 41% of the systems and tools related to the water resources sector, 34% were related to agriculture, and 22% to the conservation of fish, wildlife, and protected area management. Only 60% of the papers were deemed to be reporting on DSS. This was based on the papers reviewed not having directly identified a specific decision to be supported. We also report on the techniques that were used to identify the decisions, such as formal survey, focus group, expert opinion, or sole judgment of the author(s). The primary underlying modelling system, e.g., expert system, agent based model, Bayesian belief network, geographical information system (GIS), and the like was categorised next. Finally, since decision support typically should target some aspect of unstructured decisions, we subjectively determined to what degree this was the case. In only 23% of the papers reviewed, did the system appear to tackle unstructured decisions. This knowledge should be useful in helping workers in the field develop more effective systems and tools, especially by being exposed to the approaches in different, but related, disciplines. We propose that a standard blueprint for reporting on DSS be developed for
Md Golam Rabiul Alam
Full Text Available The aim of this research is to explore factors influencing the management decisions to adopt human resource information system (HRIS in the hospital industry of Bangladesh-an emerging developing country. To understand this issue, this paper integrates two prominent adoption theories-Human-Organization-Technology fit (HOT-fit model and Technology-Organization-Environment (TOE framework. Thirteen factors under four dimensions were investigated to explore their influence on HRIS adoption decisions in hospitals. Employing non-probability sampling method, a total of 550 copies of structured questionnaires were distributed among HR executives of 92 private hospitals in Bangladesh. Among the respondents, usable questionnaires were 383 that suggesting a valid response rate of 69.63%. We classify the sample into 3 core groups based on the HRIS initial implementation, namely adopters, prospectors, and laggards. The obtained results specify 5 most critical factors i.e. IT infrastructure, top management support, IT capabilities of staff, perceived cost, and competitive pressure. Moreover, the most significant dimension is technological dimension followed by organisational, human, and environmental among the proposed 4 dimensions. Lastly, the study found existence of significant differences in all factors across different adopting groups. The study results also expose constructive proposals to researchers, hospitals, and the government to enhance the likelihood of adopting HRIS. The present study has important implications in understanding HRIS implementation in developing countries.
Alam, Md Golam Rabiul; Masum, Abdul Kadar Muhammad; Beh, Loo-See; Hong, Choong Seon
The aim of this research is to explore factors influencing the management decisions to adopt human resource information system (HRIS) in the hospital industry of Bangladesh—an emerging developing country. To understand this issue, this paper integrates two prominent adoption theories—Human-Organization-Technology fit (HOT-fit) model and Technology-Organization-Environment (TOE) framework. Thirteen factors under four dimensions were investigated to explore their influence on HRIS adoption decisions in hospitals. Employing non-probability sampling method, a total of 550 copies of structured questionnaires were distributed among HR executives of 92 private hospitals in Bangladesh. Among the respondents, usable questionnaires were 383 that suggesting a valid response rate of 69.63%. We classify the sample into 3 core groups based on the HRIS initial implementation, namely adopters, prospectors, and laggards. The obtained results specify 5 most critical factors i.e. IT infrastructure, top management support, IT capabilities of staff, perceived cost, and competitive pressure. Moreover, the most significant dimension is technological dimension followed by organisational, human, and environmental among the proposed 4 dimensions. Lastly, the study found existence of significant differences in all factors across different adopting groups. The study results also expose constructive proposals to researchers, hospitals, and the government to enhance the likelihood of adopting HRIS. The present study has important implications in understanding HRIS implementation in developing countries. PMID:27494334
Alam, Md Golam Rabiul; Masum, Abdul Kadar Muhammad; Beh, Loo-See; Hong, Choong Seon
The aim of this research is to explore factors influencing the management decisions to adopt human resource information system (HRIS) in the hospital industry of Bangladesh-an emerging developing country. To understand this issue, this paper integrates two prominent adoption theories-Human-Organization-Technology fit (HOT-fit) model and Technology-Organization-Environment (TOE) framework. Thirteen factors under four dimensions were investigated to explore their influence on HRIS adoption decisions in hospitals. Employing non-probability sampling method, a total of 550 copies of structured questionnaires were distributed among HR executives of 92 private hospitals in Bangladesh. Among the respondents, usable questionnaires were 383 that suggesting a valid response rate of 69.63%. We classify the sample into 3 core groups based on the HRIS initial implementation, namely adopters, prospectors, and laggards. The obtained results specify 5 most critical factors i.e. IT infrastructure, top management support, IT capabilities of staff, perceived cost, and competitive pressure. Moreover, the most significant dimension is technological dimension followed by organisational, human, and environmental among the proposed 4 dimensions. Lastly, the study found existence of significant differences in all factors across different adopting groups. The study results also expose constructive proposals to researchers, hospitals, and the government to enhance the likelihood of adopting HRIS. The present study has important implications in understanding HRIS implementation in developing countries.
Nair, U. S.; Keiser, K.; Wu, Y.; Kaulfus, A.; Srinivasan, K.; Anderson, E. R.; McEniry, M.
An Event-Driven Data delivery (ED3) framework has been created that provides reusable services and configurations to support better data preparedness for decision support of disasters and other events by rapidly providing pre-planned access to data, special processing, modeling and other capabilities, all executed in response to criteria-based events. ED3 facilitates decision makers to plan in advance of disasters and other types of events for the data necessary for decisions and response activities. A layer of services provided in the ED3 framework allows systems to support user definition of subscriptions for data plans that will be triggered when events matching specified criteria occur. Pre-planning for data in response to events lessens the burden on decision makers in the aftermath of an event and allows planners to think through the desired processing for specialized data products. Additionally the ED3 framework provides support for listening for event alerts and support for multiple workflow managers that provide data and processing functionality in response to events. Landslides are often costly and, at times, deadly disaster events. Whereas intense and/or sustained rainfall is often the primary trigger for landslides, soil type and slope are also important factors in determining the location and timing of slope failure. Accounting for the substantial spatial variability of these factors is one of the major difficulties when predicting the timing and location of slope failures. A wireless sensor network (WSN), developed by NASA SERVIR and USRA, with peer-to-peer communication capability and low power consumption, is ideal for high spatial in situ monitoring in remote locations. In collaboration with the University of Huntsville at Alabama, WSN equipped with accelerometer, rainfall and soil moisture sensors is being integrated into an end-to-end landslide warning system. The WSN is being tested to ascertain communication capabilities and the density of
For an optimal mastitis management on farms with an automatic milking system (AMS), two individual cow decisions are important. First, there is a need for decision support on which mastitis alerts have the highest priority for visual checking for clinical mastitis (CM). In essence, all cows with
Marschollek, Michael; Bott, Oliver J; Wolf, Klaus-H; Gietzelt, Matthias; Plischke, Maik; Madiesh, Moaaz; Song, Bianying; Haux, Reinhold
The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary. The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules. Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules. Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system. Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine.
Schenker-Wicki, A.; Gibbert, R.
Environmental accidents such as extensive radioactive or chemical contamination can have more serious consequences for a population than any other kind of accidents known before. Owing to the serious consequences and the high number of people who may be affected, the selection of the best countermeasures to ameliorate the imminent impact is very difficult and the political responsibility is enormous. To help overcome such problems the National Emergency Operations Center in Zurich (Switzerland) has developed a decision support system to evaluate acceptable countermeasures for reducing ingestion dose after an accidental release of radioactive material. The system involves all the necessary modules and techniques for efficient decision making, based on the most recent developments in decision theory as well as the necessary structuring of the decision-making process. The decision-making concept comprehends decision making on two different levels, a technical and a political one. (author)
The Institute for Automation and Operations Research at the University of Fribourg has been charged by the Swiss government to design a concept for a Crisis Management Decision Support System CMDSS to evaluate acceptable countermeasures to reduce ingestion dose after an accidental release of radioactivity and to implement a prototype. The study is divided in two parts. In the first part all the necessary modules and techniques for efficient decision making, based on the most recent developments in decision theory, as well as the necessary structuring of the decision making process are discussed, while in the second part the plausibility of the evaluated system is tested using a case study. For the time being no empirical research has been carried out. The decision making concept presented in this book comprehends decision making on two different levels, a technical and a political one. The division of decision power corresponds to the Swiss legal prescriptions for accidental release of radioactivity. To guarantee decisions of high quality, as many countermeasures as possible have to be presented to the decision makers. Due to the difficulty of evaluating all the possible countermeasures an expert-system is provided for the decision makers to generate the space of alternatives. The use of an expert-system should further help to reduce systematically the huge amount of information which is characteristic in crises situations. To support the comparison and ranking of the different alternatives a multi-criteria approach, the PROMETHEE method, which is based upon outranking relationships, is used. Due to the complexity of the decision making process, its poorly defined mathematical context and the unwillingness of the decision makers to use a method which requires defined substitution rates, decision methods based on utility theory will not be applied in this study. The outranking approach presented in this book provides its users with more transparent and intelligible
Beinat E; Berg R van den; Vrije Universiteit van; Fraunhofer Institue for Environmental Chemistry; International Centre of Pesticide Safety, Busto; LBG
EUPHIDS (EUropean Pesticide Hazard Information and Decision-support System) is the result of a research project carried out during 1993-1995 with the support of the Environment Research Programme (1990-1994) of the European Union. The system is meant to become an aid in the process of registering a
Palmer-Wackerly, Angela L; Krieger, Janice L; Rhodes, Nancy D
Cancer patients rely on multiple sources of support when making treatment decisions; however, most research studies examine the influence of health care provider support while the influence of family member support is understudied. The current study fills this gap by examining the influence of health care providers and partners on decision-making satisfaction. In a cross-sectional study via an online Qualtrics panel, we surveyed cancer patients who reported that they had a spouse or romantic partner when making cancer treatment decisions (n = 479). Decisional support was measured using 5-point, single-item scales for emotional support, informational support, informational-advice support, and appraisal support. Decision-making satisfaction was measured using Holmes-Rovner and colleagues' (1996) Satisfaction With Decision Scale. We conducted a mediated regression analysis to examine treatment decision-making satisfaction for all participants and a moderated mediation analysis to examine treatment satisfaction among those patients offered a clinical trial. Results indicated that partner support significantly and partially mediated the relationship between health care provider support and patients' decision-making satisfaction but that results did not vary by enrollment in a clinical trial. This study shows how and why decisional support from partners affects communication between health care providers and cancer patients.
The performance evaluation of innovative and alternative environmental technologies is an integral part of the US Environmental Protection Agency's (EPA) mission. Early efforts focused on evaluating technologies that supported the implementation of the Clean Air and Clean Water Acts. In 1986 the Agency began to demonstrate and evaluate the cost and performance of remediation and monitoring technologies under the Superfund Innovative Technology Evaluation (SITE) program (in response to the mandate in the Superfund Amendments and Reauthorization Act of 1986 (SARA)). In 1990, the US Technology Policy was announced. This policy placed a renewed emphasis on making the best use of technology in achieving the national goals of improved quality of life for all Americans, continued economic growth, and national security. In the spirit of the technology policy, the Agency began to direct a portion of its resources toward the promotion, recognition, acceptance, and use of US-developed innovative environmental technologies both domestically and abroad. Decision Support Software (DSS) packages integrate environmental data and simulation models into a framework for making site characterization, monitoring, and cleanup decisions. To limit the scope which will be addressed in this demonstration, three endpoints have been selected for evaluation: Visualization; Sample Optimization; and Cost/Benefit Analysis. Five topics are covered in this report: the objectives of the demonstration; the elements of the demonstration plan; an overview of the Site Characterization and Monitoring Technology Pilot; an overview of the technology verification process; and the purpose of this demonstration plan.
Gert, Sdouz; Manfred, Pachole
In the case of a nuclear accident in Europe the integral decision support system R.O.D.O.S. ( real-time on-line decision support system for off-site emergency management) supplies comprehensive information on the present and future radiological situation, and the consequences of measures to protect the population. These data comprise mainly map information such as population distribution, rivers, roads, vegetation areas and production data of various food products. This work concentrates on the customization of the data for the food chain and dose module for terrestrial pathways. During the last fifteen years two different codes have been used in Austria for support during accidents with radioactive releases: O.E.C.O.S.Y.S. and R.O.D.O.S.. Adaptations and improvements have been performed to give better tools, they are detailed in this paper. (N.C.)
Gert, Sdouz; Manfred, Pachole [ARC Seibersdorf research, Seibersdorf (Austria)
In the case of a nuclear accident in Europe the integral decision support system R.O.D.O.S. ( real-time on-line decision support system for off-site emergency management) supplies comprehensive information on the present and future radiological situation, and the consequences of measures to protect the population. These data comprise mainly map information such as population distribution, rivers, roads, vegetation areas and production data of various food products. This work concentrates on the customization of the data for the food chain and dose module for terrestrial pathways. During the last fifteen years two different codes have been used in Austria for support during accidents with radioactive releases: O.E.C.O.S.Y.S. and R.O.D.O.S.. Adaptations and improvements have been performed to give better tools, they are detailed in this paper. (N.C.)
Wang, Wenchao; Cui, Yuanlai
Irrigation has played an important role in agricultural production. Irrigation decision support system is developed for irrigation water management, which can raise irrigation efficiency with few added engineering services. An online irrigation decision support system (OIDSS), in consist of in-field sensors and central computer system, is designed for surface irrigation management in large irrigation district. Many functions have acquired in OIDSS, such as data acquisition and detection, real-time irrigation forecast, water allocation decision and irrigation information management. The OIDSS contains four parts: Data acquisition terminals, Web server, Client browser and Communication system. Data acquisition terminals are designed to measure paddy water level, soil water content in dry land, ponds water level, underground water level, and canals water level. A web server is responsible for collecting meteorological data, weather forecast data, the real-time field data, and manager's feedback data. Water allocation decisions are made in the web server. Client browser is responsible for friendly displaying, interacting with managers, and collecting managers' irrigation intention. Communication system includes internet and the GPRS network used by monitoring stations. The OIDSS's model is based on water balance approach for both lowland paddy and upland crops. Considering basic database of different crops water demands in the whole growth stages and irrigation system engineering information, the OIDSS can make efficient decision of water allocation with the help of real-time field water detection and weather forecast. This system uses technical methods to reduce requirements of user's specialized knowledge and can also take user's managerial experience into account. As the system is developed by the Browser/Server model, it is possible to make full use of the internet resources, to facilitate users at any place where internet exists. The OIDSS has been applied in
This paper summarizes the recent trends and highlights the challenges and opportunities in decision support and knowledge management for patient-centered, personalized, and personal health care. The discussions are based on a broad survey of related references, focusing on the most recent publications. Major advances are examined in the areas of i) shared decision making paradigms, ii) continuity of care infrastructures and architectures, iii) human factors and system design approaches, iv) knowledge management innovations, and v) practical deployment and change considerations. Many important initiatives, projects, and plans with promising results have been identified. The common themes focus on supporting the individual patients who are playing an increasing central role in their own care decision processes. New collaborative decision making paradigms and information infrastructures are required to ensure effective continuity of care. Human factors and usability are crucial for the successful development and deployment of the relevant systems, tools, and aids. Advances in personalized medicine can be achieved through integrating genomic, phenotypic and other biological, individual, and population level information, and gaining useful insights from building and analyzing biological and other models at multiple levels of abstraction. Therefore, new Information and Communication Technologies and evaluation approaches are needed to effectively manage the scale and complexity of biomedical and health information, and adapt to the changing nature of clinical decision support. Recent research in decision support and knowledge management combines heterogeneous information and personal data to provide cost-effective, calibrated, personalized support in shared decision making at the point of care. Current and emerging efforts concentrate on developing or extending conventional paradigms, techniques, systems, and architectures for the new predictive, preemptive, and
Kureychik, V. M.; Safronenkova, I. B.
Uncertainty is an essential part of a decision-making procedure. The paper deals with the problem of decision-making under criteria uncertainty. In this context, decision-making under uncertainty, types and conditions of uncertainty were examined. The decision-making problem under uncertainty was formalized. A modification of the mathematical decision support method under uncertainty via ontologies was proposed. A critical distinction of the developed method is ontology usage as its base elements. The goal of this work is a development of a decision-making method under criteria uncertainty with the use of ontologies in the area of multilayer board designing. This method is oriented to improvement of technical-economic values of the examined domain.
Full Text Available Using distributed hydrological models to evaluate the effectiveness of reducing non-point source pollution by applying best management practices (BMPs is an important support to decision making for watershed management. However, complex interfaces and time-consuming simulations of the models have largely hindered the applications of these models. We designed and developed a prototype web-based decision support system for watershed management (DSS-WMRJ, which is user friendly and supports quasi-real-time decision making. DSS-WMRJ is based on integrating an open-source Web-based Geographical Information Systems (Web GIS tool (Geoserver, a modeling component (SWAT, Soil and Water Assessment Tool, a cloud computing platform (Hadoop and other open source components and libraries. In addition, a private cloud is used in an innovative manner to parallelize model simulations, which are time consuming and computationally costly. Then, the prototype DSS-WMRJ was tested with a case study. Successful implementation and testing of the prototype DSS-WMRJ lay a good foundation to develop DSS-WMRJ into a fully-fledged tool for watershed management. DSS-WMRJ can be easily customized for use in other watersheds and is valuable for constructing other environmental decision support systems, because of its performance, flexibility, scalability and economy.
Full Text Available This paper reports the results of an empirical examination of the effectiveness of one type of knowledge management technology, namely 'contextual knowledge repository', for supporting individual decision makers in a predictive judgement task context. 31 volunteer subjects participated in the study. The results indicate that a given technology was fairly useful, but insufficient to maximally enhance individual decision making. On one hand, subjects were found to extract more knowledge and make significantly smaller decision errors than their notional naive counterparts. On the other hand, subjects tended to extract less knowledge and make significantly larger decision errors compared to notional optimal counterparts. These findings suggest that individuals could potentially benefit from those knowledge management technologies that would provide additional explicit analytical and procedural knowledge, or those that would facilitate sharing of tacit knowledge through interaction with others. Future research is necessary to address these issues.
Full Text Available A lack of mature domain knowledge and well established guidelines makes the medical diagnosis of skeletal dysplasias (a group of rare genetic disorders a very complex process. Machine learning techniques can facilitate objective interpretation of medical observations for the purposes of decision support. However, building decision support models using such techniques is highly problematic in the context of rare genetic disorders, because it depends on access to mature domain knowledge. This paper describes an approach for developing a decision support model in medical domains that are underpinned by relatively sparse knowledge bases. We propose a solution that combines association rule mining with the Dempster-Shafer theory (DST to compute probabilistic associations between sets of clinical features and disorders, which can then serve as support for medical decision making (e.g., diagnosis. We show, via experimental results, that our approach is able to provide meaningful outcomes even on small datasets with sparse distributions, in addition to outperforming other Machine Learning techniques and behaving slightly better than an initial diagnosis by a clinician.
In India, a number of schemes and programmes have been launched from time to time in order to promote integrated city development and to enable the slum dwellers to gain access to the basic services. Despite the use of geospatial technologies in planning, the local, state and central governments have only been partially successful in dealing with these problems. The study on existing policies and programmes also proved that when the government is the sole provider or mediator, GIS can become a tool of coercion rather than participatory decision-making. It has also been observed that local level administrators who have adopted Geospatial technology for local planning continue to base decision-making on existing political processes. In this juncture, geospatial decision support system (GSDSS) can provide a framework for integrating database management systems with analytical models, graphical display, tabular reporting capabilities and the expert knowledge of decision makers. This assists decision-makers to generate and evaluate alternative solutions to spatial problems. During this process, decision-makers undertake a process of decision research - producing a large number of possible decision alternatives and provide opportunities to involve the community in decision making. The objective is to help decision makers and planners to find solutions through a quantitative spatial evaluation and verification process. The study investigates the options for slum development in a formal framework of RAY (Rajiv Awas Yojana), an ambitious program of Indian Government for slum development. The software modules for realizing the GSDSS were developed using the ArcGIS and Community -VIZ software for Gulbarga city.
Sandberg, Peter; Soederstroem, Mats
Global competition, commitment to the Kyoto Protocol and a deregulated, integrated European electricity market will in all probability increase the demand for energy efficiency on the part of companies in Sweden. Investment decisions are an important part of meeting the new demands, because they decide the future efficiency of industrial energy systems. The objective of this study is to investigate, from a managerial perspective, the need to improve decision support in some industries, which can help to facilitate and improve investment decisions concerning energy efficiency. This work has been conducted through in-depth interviews with representatives for a number of energy-intensive companies and non-energy-intensive companies from different sectors. One need that was identified was the improvement of working methods in order to support the decision-making process. Here, external players seem to be playing an increasingly important role. Access to correct information, better follow-up activities, and transparent, understandable calculations are also considered to be important. The study will form the foundation for subsequent work on decision support and energy efficiency in industry
Shogren, Karrie A.; Wehmeyer, Michael L.; Lassmann, Heather; Forber-Pratt, Anjali J.
Supported decision making (SDM) has begun to receive significant attention as means to enable people to exercise autonomy and self-determination over decisions about their life. Practice frameworks that can be used to promote the provision of supports for decision making are needed. This paper integrates the literature across intellectual and…
Livieris, Ioannis E.; Mikropoulos, Tassos A.; Pintelas, Panagiotis
Educational data mining is an emerging research field concerned with developing methods for exploring the unique types of data that come from educational context. These data allow the educational stakeholders to discover new, interesting and valuable knowledge about students. In this paper, we present a new user-friendly decision support tool for…
... stands within the context of a ground based air defence system (GBADS) at the turn of the twenty first century. However, much of the contents of the paper maye generalized to military environments other than a GBADS one. Keywords: Threat evaluation, weapon assignment, decision support. ORiON Vol. 23 (2) 2007: pp.
Clark, Rachel; Waters, Elizabeth; Armstrong, Rebecca; Conning, Rebecca; Allender, Steven; Swinburn, Boyd
Public health practitioners make decisions based on research evidence in combination with a variety of other influences. Evidence summaries are one of a range of knowledge translation options used to support evidence-informed decision making. The literature relevant to obesity prevention requires synthesis for it to be accessible and relevant to…
Zhao, Shuai; Wellings, Andy; Korsholm, Stephan Erbs
The current version of the Safety Critical Java (SCJ) specification defines three compliance levels. Level 0 targets single processor programs while Level 1 and 2 can support multiprocessor platforms. Level 1 programs must be fully partitioned but Level 2 programs can also be more globally...... scheduled. As of yet, there is no official Reference Implementation for SCJ. However, the icecap project has produced a Safety-Critical Java Run-time Environment based on the Hardware-near Virtual Machine (HVM). This supports SCJ at all compliance levels and provides an implementation of the safety......-critical Java (javax.safetycritical) package. This is still work-in-progress and lacks certain key features. Among these is the ability to support multiprocessor platforms. In this paper, we explore two possible options to adding multiprocessor support to this environment: the “green thread” and the “native...
Full Text Available In a globalization scenario, uncertainty and high competitive edge between the companies, every manager needs to make decisions that bring competitive advantage to his/her organization. These decisions are increasingly complex, which demands more rapid and precise information to allow efficient decision-making. It is in this scenario that Information Systems (IS have gained importance in the decision-making process. Yet, many of these IS may not be adequate to the manager’s needs. This study aims to identify the perception of the managers of an Organizational Unit at an oil and derivatives company about the support given by ISs regarding their decision making. To obtain the expected results, a questionnaire based on the critical factors involved in IS quality and directed to the managers of the Organizational Unit. Results of this study will enable professionals responsible for developing ISs, as well as managers and those working with these systems to identify strengths and weaknesses of existing systems.
Zhou, Jianlan; Sun, Koumei
It is important to make decisions on how to attract foreign direct investment (FDI) to China and know how the inequality of FDI introduction by locational different provinces. Following background descriptions on China's FDI economic environments and FDI-related policies, this paper demonstrates the uses of geographical information system (GIS) and multi-criterion decision-making (MCDM) framework in solving a spatial multi-objective problem of evaluating and ranking China's provinces for FDI introduction. It implements a foreign direct investment decision support system, which reveals the main determinants of FDI in China and gives some results of regional geographical analysis over spatial data.
Flynn, Darren; Ford, Gary A; Stobbart, Lynne; Rodgers, Helen; Murtagh, Madeleine J; Thomson, Richard G
Tools to support clinical or patient decision-making in the treatment/management of a health condition are used in a range of clinical settings for numerous preference-sensitive healthcare decisions. Their impact in clinical practice is largely dependent on their quality across a range of domains. We critically analysed currently available tools to support decision making or patient understanding in the treatment of acute ischaemic stroke with intravenous thrombolysis, as an exemplar to provide clinicians/researchers with practical guidance on development, evaluation and implementation of such tools for other preference-sensitive treatment options/decisions in different clinical contexts. Tools were identified from bibliographic databases, Internet searches and a survey of UK and North American stroke networks. Two reviewers critically analysed tools to establish: information on benefits/risks of thrombolysis included in tools, and the methods used to convey probabilistic information (verbal descriptors, numerical and graphical); adherence to guidance on presenting outcome probabilities (IPDASi probabilities items) and information content (Picker Institute Checklist); readability (Fog Index); and the extent that tools had comprehensive development processes. Nine tools of 26 identified included information on a full range of benefits/risks of thrombolysis. Verbal descriptors, frequencies and percentages were used to convey probabilistic information in 20, 19 and 18 tools respectively, whilst nine used graphical methods. Shortcomings in presentation of outcome probabilities (e.g. omitting outcomes without treatment) were identified. Patient information tools had an aggregate median Fog index score of 10. None of the tools had comprehensive development processes. Tools to support decision making or patient understanding in the treatment of acute stroke with thrombolysis have been sub-optimally developed. Development of tools should utilise mixed methods and
Golightly, David; Dadashi, Nastaran
While automation of signal and route setting is routine, the use of automation or decision support in disruption management processes is far less common. Such support offers significant advantages in optimising re-planning of both timetable and resources (crew and rolling stock), and has value in offering a 'shared view' of re-planning across the many actors manage disruption. If this vision is to be realised, however, disruption management decision support and automation must adhere to prove...
R. L. Hoskinson; J. R. Hess; R. K. Fink
The Decision Support System for Agriculture (DSS4Ag) is an expert system being developed by the Site-Specific Technologies for Agriculture (SST4Ag) precision farming research project at the INEEL. DSS4Ag uses state-of-the-art artificial intelligence and computer science technologies to make spatially variable, site-specific, economically optimum decisions on fertilizer use. The DSS4Ag has an open architecture that allows for external input and addition of new requirements and integrates its results with existing agricultural systems' infrastructures. The DSS4Ag reflects a paradigm shift in the information revolution in agriculture that is precision farming. We depict this information revolution in agriculture as an historic trend in the agricultural decision-making process.
Hoskinson, Reed Louis; Hess, John Richard; Fink, Raymond Keith
The Decision Support System for Agriculture (DSS4Ag) is an expert system being developed by the Site-Specific Technologies for Agriculture (SST4Ag) precision farming research project at the INEEL. DSS4Ag uses state-of-the-art artificial intelligence and computer science technologies to make spatially variable, site-specific, economically optimum decisions on fertilizer use. The DSS4Ag has an open architecture that allows for external input and addition of new requirements and integrates its results with existing agricultural systems’ infrastructures. The DSS4Ag reflects a paradigm shift in the information revolution in agriculture that is precision farming. We depict this information revolution in agriculture as an historic trend in the agricultural decision-making process.
Jovanovic, A.; Auerkari, P.; Brear, J.M.
A multi-criteria decision making tool for engineering applications has been developed in the European project BE5935. The tool has been developed and applied in the area of power plants, primarily for the decisions regarding the inspection and maintenance planning in the area of power plants. Practical application of the methodology and of the software is shown here for the damage assessment of critical components. (authors)
Vamanu, D.; Mateescu, Gh.; Berinde, A.; Slavnicu, D.; Acasandrei, V.; Slavnicu, E.
The paper addresses the issue of securing the compatibility and inter-operability of computer packages designed to perform as decision support tools in the management of radiological emergencies, over the transition times towards the implementation and uniform acceptance and uniform acceptance of internationally-shared reference tools such as the European Union's RODOS (Real Time On-Line Decision Support System for Off-Site Nuclear Emergencies in Europe). One submits that a harmonization between the currently operational, domestic, and the reference tool can be contemplated, based on extensive code comparison and benchmarking. A case in point is presented, paralleling selected RODOS applications on simulated abnormal nuclear events, and the concurrent application of a resident software package, NOTEPAD, developed to emulate RODOS-wise function at IFIH-HH Bucharest. The reproducible similarity may make domestic decision support system (DSS) facilities useful as both practical tools and factors promoting the emergency preparedness awareness, during the interim time laps till the full development and deployment of RODOS as a reference DSS in Europe. (authors)
Plant, Katherine L; Stanton, Neville A
Aeronautical decision-making is complex as there is not always a clear coupling between the decision made and decision outcome. As such, there is a call for process-orientated decision research in order to understand why a decision made sense at the time it was made. Schema theory explains how we interact with the world using stored mental representations and forms an integral part of the perceptual cycle model (PCM); proposed here as a way to understand the decision-making process. This paper qualitatively analyses data from the critical decision method (CDM) based on the principles of the PCM. It is demonstrated that the approach can be used to understand a decision-making process and highlights how influential schemata can be at informing decision-making. The reliability of this approach is established, the general applicability is discussed and directions for future work are considered. This paper introduces the PCM, and the associated schema theory, as a framework to structure and explain data collected from the CDM. The reliability of both the method and coding scheme is addressed.
Korukonda, Appa Rao; Korukonda, Saritha
Although electronic healthcare can boast of a remarkable origin in modern-day e-commerce in the form of Electronic Data Interchange (EDI), its mission-critical nature in information-based strategising is yet to be realised. Restricting the scope of e-healthcare management to product advertisements and website management reflects an unfortunate trend of underutilisation of the scope of electronic decision support systems in pricing and other business strategies. This paper aims to illustrate how this trend can be corrected by transforming e-healthcare into a full-fledged business strategy for strategic positioning and corporate profitability. This argument is illustrated with the aid of a business example related to transfer pricing.
The objective of the research effort is to investigate and formulate methods and tools to improve the decision-making processes of managers in uncertain environments by researching decision support systems (DSS). DSS was coined by researchers in the field to describe a system which integrates extensive decision analysis with a comprehensive management information system (MIS). The results of this research are expected to enhance management decision-making in uncertain environments where traditional management techniques have failed
Koopmann, Regine; Dämmrich, Michaela; Ploeger, Harm
Control of gastrointestinal worms is crucial to any pasture system for ruminants. To support the farmer's foresighted planning of pasturage and to avoid excessive deworm-ing in Germany we created four decision trees and put them online. They are freely accessible at www.weide-parasiten.de. There is one decision tree for young first season cattle in intensive dairy husbandry, one decision tree for young cattle in suckling-cow management and one decision tree for sheep and goats, respectively.
Shropshire, David Earl; Jacobson, Jacob Jordan; Berrett, Sharon; Cobb, D. A.; Worhach, P.
The Demonstration of Decision Support Tools for Sustainable Development project integrated the Bechtel/Nexant Industrial Materials Exchange Planner and the Idaho National Engineering and Environmental Laboratory System Dynamic models, demonstrating their capabilities on alternative fuel applications in the Greater Yellowstone-Teton Park system. The combined model, called the Dynamic Industrial Material Exchange, was used on selected test cases in the Greater Yellow Teton Parks region to evaluate economic, environmental, and social implications of alternative fuel applications, and identifying primary and secondary industries. The test cases included looking at compressed natural gas applications in Teton National Park and Jackson, Wyoming, and studying ethanol use in Yellowstone National Park and gateway cities in Montana. With further development, the system could be used to assist decision-makers (local government, planners, vehicle purchasers, and fuel suppliers) in selecting alternative fuels, vehicles, and developing AF infrastructures. The system could become a regional AF market assessment tool that could help decision-makers understand the behavior of the AF market and conditions in which the market would grow. Based on this high level market assessment, investors and decision-makers would become more knowledgeable of the AF market opportunity before developing detailed plans and preparing financial analysis.
Zhen, Tong; Ge, Hongyi; Jiang, Yuying; Che, Yi
Grain logistics is the important component of the social logistics, which can be attributed to frequent circulation and the great quantity. At present time, there is no modern grain logistics distribution management system, and the logistics cost is the high. Geographic Information Systems (GIS) have been widely used for spatial data manipulation and model operations and provide effective decision support through its spatial database management capabilities and cartographic visualization. In the present paper, a spatial decision support system (SDSS) is proposed to support policy makers and to reduce the cost of grain logistics. The system is composed of two major components: grain logistics goods tracking model and vehicle routing problem optimization model and also allows incorporation of data coming from external sources. The proposed system is an effective tool to manage grain logistics in order to increase the speed of grain logistics and reduce the grain circulation cost.
Wismans, Luc Johannes Josephus; de Romph, E.; Friso, K.; Zantema, K.
Reliable and accurate short-term traffic state prediction can improve the performance of real-time traffic management systems significantly. Using this short-time prediction based on current measurements delivered by advanced surveillance systems will support decision-making processes on various
Wismans, L.; De Romph, E.; Friso, K.; Zantema, K.
Reliable and accurate short-term traffic state prediction can improve the performance of real-time traffic management systems significantly. Using this short-time prediction based on current measurements delivered by advanced surveillance systems will support decision-making processes on various
Peleška, Jan; Švejda, David; Zvárová, Jana
Roč. 45, 1/2 (1997), s. 25-29 ISSN 1386-5056 R&D Projects: GA ČR GA313/93/0616 Grant - others:COPERNICUS(XE) JRP-10053 Keywords : computer supported decision making * microsoft access language * therapy of arterial hypertension
Geneho Kim; Donald Nute; H. Michael Rauscher; David L. Loftis
A programming environment for developing complex decision support systems (DSSs) should support rapid prototyping and modular design, feature a flexible knowledge representation scheme and sound inference mechanisms, provide project management, and be domain independent. We have previously developed DSSTools (Decision Support System Tools), a reusable, domain-...
Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke
Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this
Pierce, Penny Fay
This project is developing a computer-assisted prototype of an individualized decision support system, called Choices, to assist women newly diagnosed with breast cancer in making stressful treatment...
.... Specifically, the thesis evaluated the effectiveness of the Army Task Force XXI AWE in providing information to support investment decisions and refinement of requirements for information age technologies...
Morvan , Gildas; Jolly , Daniel; Dupont , Daniel; Kubiak , Philippe
International audience; This paper presents a multiagent-based model of insect development on a dead body and a three layers Decision Support System architecture able to perform retrodictive (abductive) reasoning from multiagent-based models or more generally, complex systems models. This architecture is used in order to compute post-mortem intervals from entomological data sampled on cadavers. Knowing the exact time of a death is fundamental in criminal investigations. Thus, it is necessary ...
Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel; Sainz-de-Abajo, Beatriz; Robles, Montserrat; García-Gómez, Juan Miguel
The latest advances in eHealth and mHealth have propitiated the rapidly creation and expansion of mobile applications for health care. One of these types of applications are the clinical decision support systems, which nowadays are being implemented in mobile apps to facilitate the access to health care professionals in their daily clinical decisions. The aim of this paper is twofold. Firstly, to make a review of the current systems available in the literature and in commercial stores. Secondly, to analyze a sample of applications in order to obtain some conclusions and recommendations. Two reviews have been done: a literature review on Scopus, IEEE Xplore, Web of Knowledge and PubMed and a commercial review on Google play and the App Store. Five applications from each review have been selected to develop an in-depth analysis and to obtain more information about the mobile clinical decision support systems. Ninety-two relevant papers and 192 commercial apps were found. Forty-four papers were focused only on mobile clinical decision support systems. One hundred seventy-one apps were available on Google play and 21 on the App Store. The apps are designed for general medicine and 37 different specialties, with some features common in all of them despite of the different medical fields objective. The number of mobile clinical decision support applications and their inclusion in clinical practices has risen in the last years. However, developers must be careful with their interface or the easiness of use, which can impoverish the experience of the users.
Khan, Shiraj [ORNL; Ganguly, Auroop R [ORNL; Gupta, Amar [University of Arizona
The process of Data Mining converts information to knowledge by utilizing tools from the disciplines of computational statistics, database technologies, machine learning, signal processing, nonlinear dynamics, process modeling, simulation, and allied disciplines. Data Mining allows business problems to be analyzed from diverse perspectives, including dimensionality reduction, correlation and co-occurrence, clustering and classification, regression and forecasting, anomaly detection, and change analysis. The predictive insights generated from Data Mining can be further utilized through real-time analysis and decision sciences, as well as through human-driven analysis based on management by exceptions or by objectives, to generate actionable knowledge. The tools that enable the transformation of raw data to actionable predictive insights are collectively referred as Decision Support tools. This chapter presents a new formalization of the decision process, leading to a new Decision Superiority model, partially motivated by the Joint Directors of Laboratories (JDL) Data Fusion Model. In addition, it examines the growing importance of Data Fusion concepts.
Horey, Dell; Kealy, Michelle; Davey, Mary-Ann; Small, Rhonda; Crowther, Caroline A
Pregnant women who have previously had a caesarean birth and who have no contraindication for vaginal birth after caesarean (VBAC) may need to decide whether to choose between a repeat caesarean birth or to commence labour with the intention of achieving a VBAC. Women need information about their options and interventions designed to support decision-making may be helpful. Decision support interventions can be implemented independently, or shared with health professionals during clinical encounters or used in mediated social encounters with others, such as telephone decision coaching services. Decision support interventions can include decision aids, one-on-one counselling, group information or support sessions and decision protocols or algorithms. This review considers any decision support intervention for pregnant women making birth choices after a previous caesarean birth. To examine the effectiveness of interventions to support decision-making about vaginal birth after a caesarean birth.Secondary objectives are to identify issues related to the acceptability of any interventions to parents and the feasibility of their implementation. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2013), Current Controlled Trials (22 July 2013), the WHO International Clinical Trials Registry Platform Search Portal (ICTRP) (22 July 2013) and reference lists of retrieved articles. We also conducted citation searches of included studies to identify possible concurrent qualitative studies. All published, unpublished, and ongoing randomised controlled trials (RCTs) and quasi-randomised trials with reported data of any intervention designed to support pregnant women who have previously had a caesarean birth make decisions about their options for birth. Studies using a cluster-randomised design were eligible for inclusion but none were identified. Studies using a cross-over design were not eligible for inclusion. Studies published in abstract form
Guillaume, J. H. A.; Helgeson, C.; Elsawah, S.; Jakeman, A. J.; Kummu, M.
Uncertainty is recognised as an essential issue in environmental decision making and decision support. As modellers, we notably use a variety of tools and techniques within an analysis, for example related to uncertainty quantification and model validation. We also address uncertainty by how we present results. For example, experienced modellers are careful to distinguish robust conclusions from those that need further work, and the precision of quantitative results is tailored to their accuracy. In doing so, the modeller frames how uncertainty should be interpreted by their audience. This is an area which extends beyond modelling to fields such as philosophy of science, semantics, discourse analysis, intercultural communication and rhetoric. We propose that framing of uncertainty deserves greater attention in the context of decision support, and that there are opportunities in this area for fundamental research, synthesis and knowledge transfer, development of teaching curricula, and significant advances in managing uncertainty in decision making. This presentation reports preliminary results of a study of framing practices. Specifically, we analyse the framing of uncertainty that is visible in the abstracts from a corpus of scientific articles. We do this through textual analysis of the content and structure of those abstracts. Each finding that appears in an abstract is classified according to the uncertainty framing approach used, using a classification scheme that was iteratively revised based on reflection and comparison amongst three coders. This analysis indicates how frequently the different framing approaches are used, and provides initial insights into relationships between frames, how the frames relate to interpretation of uncertainty, and how rhetorical devices are used by modellers to communicate uncertainty in their work. We propose initial hypotheses for how the resulting insights might influence decision support, and help advance decision making to
Donald Nute; Walter D. Potter; Frederick Maier; Jin Wang; Mark Twery; H. Michael Rauscher; Peter Knopp; Scott Thomasma; Mayukh Dass; Hajime Uchiyama
Decision making for forest ecosystem management can include the use of a wide variety of modeling tools. These tools include vegetation growth models, wildlife models, silvicultural models, GIS, and visualization tools. NED-2 is a robust, intelligent, goal-driven decision support system that integrates tools in each of these categories. NED-2 uses a blackboard...
Schwaegerl, Christine; Seifert, Olaf; Buschmann, Robert; Dellwing, Hermann; Geretshuber, Stefan; Leick, Claus
The increased interconnection and automation of critical infrastructures enlarges the complexity of the dependency structures and - as consequence - the danger of cascading effects, e.g. causing area-wide blackouts in power supply networks that are currently after deregulation operated closer to their limits. New tools or an intelligent combination of existing approaches are required to increase the survivability of critical infrastructures. Within the IRRIIS project the expert system CRIPS was developed based on network simulations realised with PSS®SINCAL, an established tool to support the analysis and planning of electrical power, gas, water or heat networks. CRIPS assesses the current situation in power supply networks analysing the simulation results of the physical network behaviour and recommends corresponding decisions.
Full Text Available This paper deals with a gradually deteriorating system operating under an uncertain environment whose state is only known on a finite rolling horizon. As such, the system is subject to constraints. Maintenance actions can only be planned at imposed times called maintenance opportunities that are available on a limited visibility horizon. This system can, for example, be a commercial vehicle with a monitored critical component that can be maintained only in some specific workshops. Based on the considered system, we aim to use the monitoring data and the time-limited information for maintenance decision support in order to reduce its costs. We propose two predictive maintenance policies based, respectively, on cost and reliability criteria. Classical age-based and condition-based policies are considered as benchmarks. The performance assessment shows the value of the different types of information and the best way to use them in maintenance decision making.
Lynch, Abigail J.; Taylor, William W.; McCright, Aaron M.
Decision support tools can aid decision making by systematically incorporating information, accounting for uncertainties, and facilitating evaluation between alternatives. Without user buy-in, however, decision support tools can fail to influence decision-making processes. We surveyed fishery researchers, managers, and fishers affiliated with the Lake Whitefish Coregonus clupeaformis fishery in the 1836 Treaty Waters of Lakes Huron, Michigan, and Superior to assess opinions of current and future management needs to identify barriers to, and opportunities for, developing a decision support tool based on Lake Whitefish recruitment projections with climate change. Approximately 64% of 39 respondents were satisfied with current management, and nearly 85% agreed that science was well integrated into management programs. Though decision support tools can facilitate science integration into management, respondents suggest that they face significant implementation barriers, including lack of political will to change management and perceived uncertainty in decision support outputs. Recommendations from this survey can inform development of decision support tools for fishery management in the Great Lakes and other regions.
This thesis focuses on developing a spreadsheet decision support model that can be used by combat engineer platoon and company commanders in determining the material requirements and estimated costs...
Clarke, L.; Smith, L. A.
How exactly can decision-support and policy making benefit from the use of multiple climate model experiments in terms of coping with the uncertainties on climate change projections? Climate modelling faces challenges beyond those of weather forecasting or even seasonal forecasting, as with climate we are now (and will probably always be) required to extrapolate to regimes in which we have no relevant forecast-verification archive. This suggests a very different approach from traditional methods of mixing models and skill based weighting to gain profitable probabilistic information when a large forecast-verification archive is in hand. In the case of climate, it may prove more rational to search for agreement between our models (in distribution), the aim being to determine the space and timescales on which, given our current understanding, the details of the simulation models are unimportant. This suggestion and others from Smith (2002, Proc. National Acad. Sci. USA 4 (99): 2487-2492) are interpreted in the light of recent advances. Climate models are large nonlinear dynamical systems which insightfully but imperfectly reflect the evolving weather patterns of the Earth. Their use in policy making and decision support assumes both that they contain sufficient information regarding reality to inform the decision, and that this information can be effectively communicated to the decision makers. There is nothing unique about climate modeling and these constraints, they apply in all cases where scientific modeling is applied to real-word actions (other than, perhaps, the action of improving our models). Starting with the issue of communication, figures from the 2007 IPCC Summary for Policy Makers will be constructively criticized from the perspective of decision makers, specifically those of the energy sector and the insurance/reinsurance sector. More information on basic questions of reliability and robustness would be of significant value when determining how heavily
Full Text Available Smart levees are being increasingly investigated as a flood protection technology. However, in large-scale emergency situations, a flood decision support system may need to collect and process data from hundreds of kilometers of smart levees; such a scenario requires a resilient and scalable IT infrastructure, capable of providing urgent computing services in order to perform frequent data analyses required in decision making, and deliver their results in a timely fashion. We present the ISMOP IT infrastructure for smart levee monitoring, designed to support decision making in large-scale emergency situations. Most existing approaches to urgent computing services in decision support systems dealing with natural disasters focus on delivering quality of service for individual, isolated subsystems of the IT infrastructure (such as computing, storage, or data transmission. We propose a holistic approach to dynamic system management during both urgent (emergency and normal (non-emergency operation. In this approach, we introduce a Holistic Computing Controller which calculates and deploys a globally optimal configuration for the entire IT infrastructure, based on cost-of-operation and quality-of-service (QoS requirements of individual IT subsystems, expressed in the form of Service Level Agreements (SLAs. Our approach leads to improved configuration settings and, consequently, better fulfilment of the system’s cost and QoS requirements than would have otherwise been possible had the configuration of all subsystems been managed in isolation.
van Til, Janine Astrid; Groothuis-Oudshoorn, Catharina Gerarda Maria; Lieferink, Marijke; Dolan, James; Goetghebeur, Mireille
Background There is an increased interest in the use of multi-criteria decision analysis (MCDA) to support regulatory and reimbursement decision making. The EVIDEM framework was developed to provide pragmatic multi-criteria decision support in health care, to estimate the value of healthcare
Kasprzyk, J. R.; Smith, R.; Raseman, W. J.; DeRousseau, M. A.; Dilling, L.; Ozekin, K.; Summers, R. S.; Balaji, R.; Livneh, B.; Rosario-Ortiz, F.; Sprain, L.; Srubar, W. V., III
This presentation will report on three projects that used interactive workshops with stakeholders to develop problem formulations for Multi-Objective Evolutionary Algorithm (MOEA)-based decision support in diverse fields - water resources planning, water quality engineering under climate extremes, and sustainable materials design. When combined with a simulation model of a system, MOEAs use intelligent search techniques to provide new plans or designs. This approach is gaining increasing prominence in design and planning for environmental sustainability. To use this technique, a problem formulation - objectives and constraints (quantitative measures of performance) and decision variables (actions that can be modified to improve the system) - must be identified. Although critically important for MOEA effectiveness, the problem formulations are not always developed with stakeholders' interests in mind. To ameliorate this issue, project workshops were organized to improve the tool's relevance as well as collaboratively build problem formulations that can be used in applications. There were interesting differences among the projects, which altered the findings of each workshop. Attendees ranged from a group of water managers on the Front Range of Colorado, to water utility representatives from across the country, to a set of designers, academics, and trade groups. The extent to which the workshop participants were already familiar with simulation tools contributed to their willingness to accept the solutions that were generated using the tool. Moreover, in some instances, brainstorming new objectives to include within the MOEA expanded the scope of the problem formulation, relative to the initial conception of the researchers. Through describing results across a diversity of projects, the goal of this presentation is to report on how our approach may inform future decision support collaboration with a variety of stakeholders and sectors.
Dixon, Brian E; Simonaitis, Linas; Goldberg, Howard S; Paterno, Marilyn D; Schaeffer, Molly; Hongsermeier, Tonya; Wright, Adam; Middleton, Blackford
Implement and perform pilot testing of web-based clinical decision support services using a novel framework for creating and managing clinical knowledge in a distributed fashion using the cloud. The pilot sought to (1) develop and test connectivity to an external clinical decision support (CDS) service, (2) assess the exchange of data to and knowledge from the external CDS service, and (3) capture lessons to guide expansion to more practice sites and users. The Clinical Decision Support Consortium created a repository of shared CDS knowledge for managing hypertension, diabetes, and coronary artery disease in a community cloud hosted by Partners HealthCare. A limited data set for primary care patients at a separate health system was securely transmitted to a CDS rules engine hosted in the cloud. Preventive care reminders triggered by the limited data set were returned for display to clinician end users for review and display. During a pilot study, we (1) monitored connectivity and system performance, (2) studied the exchange of data and decision support reminders between the two health systems, and (3) captured lessons. During the six month pilot study, there were 1339 patient encounters in which information was successfully exchanged. Preventive care reminders were displayed during 57% of patient visits, most often reminding physicians to monitor blood pressure for hypertensive patients (29%) and order eye exams for patients with diabetes (28%). Lessons learned were grouped into five themes: performance, governance, semantic interoperability, ongoing adjustments, and usability. Remote, asynchronous cloud-based decision support performed reasonably well, although issues concerning governance, semantic interoperability, and usability remain key challenges for successful adoption and use of cloud-based CDS that will require collaboration between biomedical informatics and computer science disciplines. Decision support in the cloud is feasible and may be a reasonable
Molina, Gabriela del Rocio Roldan
This thesis presents a decision aiding system named C3-SEC (Contex-aware Corporative Cyber Security), developed in the context of a master program at Polytechnic Institute of Leiria, Portugal. The research dimension and the corresponding software development process that followed are presented and validated with an application scenario and case study performed at Universidad de las Fuerzas Armadas ESPE – Ecuador. C3-SEC is a decision aiding software intended to support cyber ri...
Venkatraman, Vinod; Huettel, Scott
Complex economic decisions – whether investing money for retirement or purchasing some new electronic gadget – often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, to evaluate outcomes against a variety of contexts, and to flexibly match behavior to changes in the environment. In recent years, substantial research implicates the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision making. This region contains a functional topography such that the posterior dmPFC supports response-related control while the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue both for generalized contributions of the dmPFC to cognitive control, and for specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are also likely to be critical for decision making in other domains, including interpersonal interactions in social settings. PMID:22487037
Ali, A; Riaz, Zahid
This book is dedicated to applied computational intelligence and soft computing techniques with special reference to decision support in Cyber Physical Systems (CPS), where the physical as well as the communication segment of the networked entities interact with each other. The joint dynamics of such systems result in a complex combination of computers, software, networks and physical processes all combined to establish a process flow at system level. This volume provides the audience with an in-depth vision about how to ensure dependability, safety, security and efficiency in real time by making use of computational intelligence in various CPS applications ranging from the nano-world to large scale wide area systems of systems. Key application areas include healthcare, transportation, energy, process control and robotics where intelligent decision support has key significance in establishing dynamic, ever-changing and high confidence future technologies. A recommended text for graduate students and researche...
Schraagen, J.M.C.; Eikelboom, A.R.; Dongen, C.J.G. van; Brake, G.M. te
Building up proper situation awareness is one of the most difficult tasks in the beginning stages of large-scale accidents. As ambiguous information about the events becomes available, decision makers are often tempted to quickly choose a particular story to explain the events. Subsequent
Liang, J.W. [Tianjin Univ. (China). Dept. of Civil Engineering
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.
Mohammad Ali Beheheshtinia
Full Text Available Nowadays, the application of effective and efficient decisions on complex issues require the use of decision support systems. This Paper provided a decision support system based on the genetic algorithm for production and transportation scheduling problem in a supply chain. It is assumed that there are number of orders that should be produced by suppliers and should be transported to the plant by a transportation fleet. The aim is to assign orders to the suppliers, specify the order of their production, allocate processed orders to the vehicles for transport and to arrange them in a way that minimizes the total delivery time. It has been shown that the complexity of the problem was related to Np-hard and there was no possibility of using accurate methods to solve the problem in a reasonable time. So, the genetic algorithm was used in this paper to solve the problem. By using this decision support system, a new approach to supply chain management was proposed. The analysis of the approach proposed in this study compared to the conventional approaches by the decision support system indicated the preference of our proposed approach
Westrom, G.B.; Kurrasch, E.R.; Carlton, R.E.; Vance, J.N.
It is generally recognized that decisions relative to the treatment, handling, transportation and disposal of low-level wastes produced in nuclear power plants involve a complex array of many inter-related elements or considerations. Complex decision processes can be aided through the use of computer-based expert systems which are based on the knowledge of experts and the inferencing of that knowledge to provide advice to an end-user. To determine the feasibility of developing and applying an expert system in nuclear plant low level waste operations, a Functional Specification for a Radwaste Decision Support System (RDSS) was developed. All areas of radwaste management, from the point of waste generation to the disposition of the waste in the final disposal location were considered for inclusion within the scope of the RDSS. 27 figs., 8 tabs
Bhaduri, B. L.; Tuttle, M.; Rose, A.; Sanyal, J.; Thakur, G.; White, D.; Yang, H. H.; Laverdiere, M.; Whitehead, M.; Taylor, H.; Jacob, M.
A strong spatial data infrastructure and geospatial analysis capabilities are nucleus to the decision-making process during emergency preparedness, response, and recovery operations. For over a decade, the U.S. Department of Energy's Oak Ridge National Laboratory has been developing critical data and analytical capabilities that provide the Federal Emergency Management Agency (FEMA) and the rest of the federal response community assess and evaluate impacts of natural hazards on population and critical infrastructures including the status of the national electricity and oil and natural gas networks. These capabilities range from identifying structures or buildings from very high-resolution satellite imagery, utilizing machine learning and high-performance computing, to daily assessment of electricity restoration highlighting changes in nighttime lights for the impacted region based on the analysis of NOAA JPSS VIIRS Day/Night Band (DNB) imagery. This presentation will highlight our time critical mission support efforts for the 2017 hurricane season that witnessed unprecedented devastation from hurricanes Harvey, Irma, and Maria. ORNL provided 90m resolution LandScan USA population distribution data for identifying vulnerable population as well as structure (buildings) data extracted from 1m imagery for damage assessment. Spatially accurate data for solid waste facilities were developed and delivered to the response community. Human activity signatures were assessed from large scale collection of open source social media data around points of interests (POI) to ascertain level of destruction. The electricity transmission system was monitored in real time from data integration from hundreds of utilities and electricity outage information were provided back to the response community via standardized web-services.
Full Text Available In the last decade the development of the economical and social life increased the complexity of transportation systems. In this context, the role of Decision Support Systems (DSS became more and more important. The paper presents the characteristics, necessity, and usage of DSS in transportation and describes a practical application in the railroad field. To compute the optimal transportation capacity and flow on a certain railroad, specialized decision-support software which is available on the market was used.
Heng Yi Teah
Full Text Available A shrimp farmer in Taiwan practices innovation through trial-and-error for better income and a better environment, but such farmer-based innovation sometimes fails because the biological mechanism is unclear. Systematic field experimentation and laboratory research are often too costly, and simulating ground conditions is often too challenging. To solve this dilemma, we propose a decision support framework that explicitly utilizes farmer experiential knowledge through a participatory approach to alternatively estimate prospective change in shrimp farming productivity, and to co-design options for improvement. Data obtained from the farmer enable us to quantitatively analyze the production cost and greenhouse gas (GHG emission with a life cycle assessment (LCA methodology. We used semi-quantitative graphical representations of indifference curves and mixing triangles to compare and show better options for the farmer. Our results empower the farmer to make decisions more systematically and reliably based on the frequency of heterotrophic bacteria application and the revision of feed input. We argue that experiential knowledge may be less accurate due to its dependence on varying levels of farmer experience, but this knowledge is a reasonable alternative for immediate decision-making. More importantly, our developed framework advances the scope of LCA application to support practically important yet scientifically uncertain cases.
Vissers, J M; Van Der Bij, J D; Kusters, R J
This paper considers the phenomenon of waiting lists in a healthcare setting, which is characterised by limitations on the national expenditure, to explore the potentials of an operations management perspective. A reference framework for waiting list management is described, distinguishing different levels of planning in healthcare--national, regional, hospital and process--that each contributes to the existence of waiting lists through managerial decision making. In addition, different underlying mechanisms in demand and supply are distinguished, which together explain the development of waiting lists. It is our contention that within this framework a series of situation specific models should be designed to support communication and decision making. This is illustrated by the modelling of the demand for cataract treatment in a regional setting in the south-eastern part of the Netherlands. An input-output model was developed to support decisions regarding waiting lists. The model projects the demand for treatment at a regional level and makes it possible to evaluate waiting list impacts for different scenarios to meet this demand.
Schnabel, William; Brumbelow, Kelly
The objective of this project was to enhance the water resource decision-making process with respect to oil and gas exploration/production activities on Alaska’s North Slope. To this end, a web-based software tool was developed to allow stakeholders to assemble, evaluate, and communicate relevant information between and amongst themselves. The software, termed North Slope Decision Support System (NSDSS), is a visually-referenced database that provides a platform for running complex natural system, planning, and optimization models. The NSDSS design was based upon community input garnered during a series of stakeholder workshops, and the end product software is freely available to all stakeholders via the project website. The tool now resides on servers hosted by the UAF Water and Environmental Research Center, and will remain accessible and free-of-charge for all interested stakeholders. The development of the tool fostered new advances in the area of data evaluation and decision support technologies, and the finished product is envisioned to enhance water resource planning activities on Alaska’s North Slope.
Dehghani Soufi, Mahsa; Samad-Soltani, Taha; Shams Vahdati, Samad; Rezaei-Hachesu, Peyman
Fast and accurate patient triage for the response process is a critical first step in emergency situations. This process is often performed using a paper-based mode, which intensifies workload and difficulty, wastes time, and is at risk of human errors. This study aims to design and evaluate a decision support system (DSS) to determine the triage level. A combination of the Rule-Based Reasoning (RBR) and Fuzzy Logic Classifier (FLC) approaches were used to predict the triage level of patients according to the triage specialist's opinions and Emergency Severity Index (ESI) guidelines. RBR was applied for modeling the first to fourth decision points of the ESI algorithm. The data relating to vital signs were used as input variables and modeled using fuzzy logic. Narrative knowledge was converted to If-Then rules using XML. The extracted rules were then used to create the rule-based engine and predict the triage levels. Fourteen RBR and 27 fuzzy rules were extracted and used in the rule-based engine. The performance of the system was evaluated using three methods with real triage data. The accuracy of the clinical decision support systems (CDSSs; in the test data) was 99.44%. The evaluation of the error rate revealed that, when using the traditional method, 13.4% of the patients were miss-triaged, which is statically significant. The completeness of the documentation also improved from 76.72% to 98.5%. Designed system was effective in determining the triage level of patients and it proved helpful for nurses as they made decisions, generated nursing diagnoses based on triage guidelines. The hybrid approach can reduce triage misdiagnosis in a highly accurate manner and improve the triage outcomes. Copyright © 2018 Elsevier B.V. All rights reserved.
Yager, Ronald R.
We first formulate the problem of decision making under uncertainty. The importance of the representation of our knowledge about the uncertainty in formulating a decision process is pointed out. We begin with a brief discussion of the case of probabilistic uncertainty. Next, in considerable detail, we discuss the case of decision making under ignorance. For this case the fundamental role of the attitude of the decision maker is noted and its subjective nature is emphasized. Next the case in which a Dempster-Shafer belief structure is used to model our knowledge of the uncertainty is considered. Here we also emphasize the subjective choices the decision maker must make in formulating a decision function. The case in which the uncertainty is represented by a fuzzy measure (monotonic set function) is then investigated. We then return to the Dempster-Shafer belief structure and show its relationship to the fuzzy measure. This relationship allows us to get a deeper understanding of the formulation the decision function used Dempster- Shafer framework. We discuss how this deeper understanding allows a decision analyst to better make the subjective choices needed in the formulation of the decision function
Advanced management technique and Decision Support System (DSS) are needed to solve the problems of the nuclear reactor decommissioning decision-making. In this study, a kind of new DSS technique for nuclear reactor decommissioning is introduced. It is based on the Virtual Reality (VR) and Geography Information System (GIS), which combine with the scientific management method, operational research, cybernetics and behavior science. The proposed DDSS (Decommissioning Decision Support System) can provide decision-maker the real time 3-D virtual Environment, GIS information and background material of the decommissioning reactor, help to ascertain the decision-making target, modify the decision module and optimize the dismantling plan. The data from three modules (VR Environment Module, VR-DOSE Management Module and Route Layout GIS Module) are used to continuously update and show the statistic at the same time, and the final advice will be given to decision-maker. (authors)
The objective of this technology is to provide risk managers with a defensible, objective way to select capping alternatives for remediating radioactive and mixed waste landfills. The process of selecting containment cover technologies for mixed waste landfills requires consideration of many complex and interrelated technical, regulatory, and economic issues. A Decision Support System (DSS) is needed to integrate the knowledge of experts from scientific, engineering, and management disciplines to help in selecting the best capping practice for the site
Windhouwer, C.J.; Klunder, G.A.; Sanders, F.M.
The Decision Support System (DSS) Emergency Planning is designed for use in the event of sea or river flooding. It makes accessible all the information related to the decision whether to evacuate an area. An important factor in this decision is the time required for the evacuation. The model used by
Dagnino, A; Viarengo, A
In recent years, contamination and its interaction with climate-change variables have been recognized as critical stressors in coastal areas, emphasizing the need for a standardized framework encompassing chemical and biological data into risk indices to support decision-making. We therefore developed an innovative, expert decision support system (Exp-DSS) for the management of contamination in marine coastal ecosystems. The Exp-DSS has two main applications: (i) to determine environmental risk and biological vulnerability in contaminated sites; and (ii) to support the management of waters and sediments by assessing the risk due to the exposure of biota to these matrices. The Exp-DSS evaluates chemical data, both as single compounds and as total toxic pressure of the mixture, to compare concentrations to effect-based thresholds (TELs and PELs). Sites are then placed into three categories of contamination: uncontaminated, mildly contaminated, and highly contaminated. In highly contaminated sites, effects on high-level ecotoxicological endpoints (i.e. survival and reproduction) are used to determine risk at the organism-population level, while ecological parameters (i.e. alterations in community structure and ecosystem functions) are considered for assessing effects on biodiversity. Changes in sublethal biomarkers are utilized to assess the stress level of the organisms in mildly contaminated sites. In Triad studies, chemical concentrations, ecotoxicological high-level effects, and ecological data are combined to determine the level of environmental risk in highly contaminated sites; chemical concentration and ecotoxicological sublethal effects are evaluated to determine biological vulnerability in mildly contaminated sites. The Exp-DSS was applied to data from the literature about sediment quality in estuarine areas of Spain, and ranked risks related to exposure to contaminated sediments from high risk (Huelva estuary) to mild risk (Guadalquivir estuary and Bay of
Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri
Increasingly, risk information is widely available with the help of advanced technologies such as earth observation satellites, global positioning technologies, coupled with hazard modeling and analysis, and geographical information systems (GIS). Even though it exists, no effort will be put into action if it is not properly presented to the decision makers. These information need to be communicated clearly and show its usefulness so that people can make better informed decision. Therefore, communicating available risk information has become an important challenge and decision support systems have been one of the significant approaches which can help not only in presenting risk information to the decision makers but also in making efficient decisions while reducing human resources and time needed. In this study, the conceptual framework of an internet-based decision support system is presented to highlight its importance role in risk management framework and how it can be applied in case study areas chosen. The main purpose of the proposed system is to facilitate the available risk information in risk reduction by taking into account of the changes in climate, land use and socio-economic along with the risk scenarios. It allows the users to formulate, compare and select risk reduction scenarios (mainly for floods and landslides) through an enhanced participatory platform with diverse stakeholders' involvement in the decision making process. It is based on the three-tier (client-server) architecture which integrates web-GIS plus DSS functionalities together with cost benefit analysis and other supporting tools. Embedding web-GIS provides its end users to make better planning and informed decisions referenced to a geographical location, which is the one of the essential factors in disaster risk reduction programs. Different risk reduction measures of a specific area (local scale) will be evaluated using this web-GIS tool, available risk scenarios obtained from
G. van Valkenhoef (Gert); T. Tervonen (Tommi); T. Zwinkels (Tijs); B. de Brock (Bert); H.L. Hillege (Hans)
textabstractClinical trials are the main source of information for the efficacy and safety evaluation of medical treatments. Although they are of pivotal importance in evidence-based medicine, there is a lack of usable information systems providing data-analysis and decision support capabilities for
Knowlton, Robert G.; Melton, Brad J; Einfeld, Wayne; Tucker, Mark D; Franco, David Oliver; Yang, Lynn I.
The Prioritization Analysis Tool for All-Hazards/Analyzer for Wide Area Restoration Effectiveness (PATH/AWARE) software system, developed by Sandia National Laboratories, is a comprehensive decision support tool designed to analyze situational awareness, as well as response and recovery actions, following a wide-area release of chemical, biological or radiological materials. The system provides capability to prioritize critical infrastructure assets and services for restoration. It also provides a capability to assess resource needs (e.g., number of sampling teams, laboratory capacity, decontamination units, etc.), timelines for consequence management activities, and costs. PATH/AWARE is a very comprehensive tool set with a considerable amount of database information managed through a Microsoft SQL (Structured Query Language) database engine, a Geographical Information System (GIS) engine that provides comprehensive mapping capabilities, as well as comprehensive decision logic to carry out the functional aspects of the tool set. This document covers the basic installation and operation of the PATH/AWARE tool in order to give the user enough information to start using the tool. A companion users manual is under development with greater specificity of the PATH/AWARE functionality.
Rees, Stephen Edward; Karbing, Dan Stieper; Allerød, Charlotte
Management of mechanical ventilation in intensive care patients is complicated by conflicting clinical goals. Decision support systems (DSS) may support clinicians in finding the correct balance. The objective of this study was to evaluate a computerized model-based DSS for its advice on inspired...
Spratt, Trevor; Devaney, John; Hayes, David
The aims of this study were to identify the themes Social Workers regard as important in supporting decisions to remove children from, or return them to, the care of their parents. To further elicit underlying hypotheses that are discernible in interpretation of evidence. A case study, comprising a two-part vignette with a questionnaire, recorded demographic information, child welfare attitudes and risk assessments, using scales derived from standardised instruments, was completed by 202 Social Workers in Northern Ireland. There were two manipulated variables, mother's attitude to removal and child's attitude to reunification 2 years later. In this paper we use data derived from respondents' qualitative comments explaining their reasoning for in and out of home care decisions. Some 60.9% of respondent's chose the parental care option at part one, with 94% choosing to have the child remain in foster care at part two. The manipulated variables were found to have no significant statistical effect. However, three underlying hypotheses were found to underpin decisions; (a) child rescue, (b) kinship defence and (c) a hedged position on calculation of risk subject to further assessment. Reasoning strategies utilised by social workers to support their decision making suggest that they tend to selectively interpret information either positively or negatively to support pre-existing underlying hypotheses. This finding is in keeping with the literature on 'confirmation bias.' The research further draws attention to the need to incorporate open questions in quantitative studies, to help guard against surface reading of data, which often does not 'speak for itself.' Copyright © 2015 Elsevier Ltd. All rights reserved.
Thieme, R.J.; Song, Michael; Calantone, R.J.
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
Galar Pascual, Diego
Artificial Intelligence Tools: Decision Support Systems in Condition Monitoring and Diagnosis discusses various white- and black-box approaches to fault diagnosis in condition monitoring (CM). This indispensable resource: Addresses nearest-neighbor-based, clustering-based, statistical, and information theory-based techniques Considers the merits of each technique as well as the issues associated with real-life application Covers classification methods, from neural networks to Bayesian and support vector machines Proposes fuzzy logic to explain the uncertainties associated with diagnostic processes Provides data sets, sample signals, and MATLAB® code for algorithm testing Artificial Intelligence Tools: Decision Support Systems in Condition Monitoring and Diagnosis delivers a thorough evaluation of the latest AI tools for CM, describing the most common fault diagnosis techniques used and the data acquired when these techniques are applied.
Kelly, G.N.; Ehrhardt, J.
The decision support system, RODOS, for off-site emergency management in the event of a future accident is being developed with support from the European Commission. The development is being carried out within a large and fully integrated international project involving about forty institutes from sixteen countries in Eastern and Western Europe. RODOS has been designed to provide comprehensive (i.e. applicable at all distances, at all times and to all important countermeasures) decision support and to be applicable throughout Europe. The background to the development of RODOS is described in this paper together with its basic features, its current status and plans for its further development. Given the context of this Special Issue, particular attention is given to the contribution made by institutes in the former Soviet Union to the development of RODOS and plans for its implementation in these countries. The benefits of the system are increasingly being recognised following the completion of the pilot version in 1995. Of particular importance is its potential role as part of a wider European network, the existence of which would promote a more effective and coherent response to any future nuclear accident that might affect Europe. (Author)
Marshall, Andrea P; West, Sandra H; Aitken, Leanne M
Variability in clinical practice may result from the use of diverse information sources to guide clinical decisions. In routine clinical practice, nurses privilege information from colleagues over more formal information sources. It is not clear whether similar information-seeking behaviour is exhibited when critical care nurses make decisions about a specific clinical practice, where extensive practice variability exists alongside a developing research base. This study explored the preferred sources of information intensive care nurses used and their perceptions of the accessibility and usefulness of this information for making decisions in clinically uncertain situations specific to enteral feeding practice. An instrumental case study design, incorporating concurrent verbal protocols, Q methodology and focus groups, was used to determine intensive care nurses' perspectives of information use in the resolution of clinical uncertainty. A preference for information from colleagues to support clinical decisions was observed. People as information sources were considered most useful and most accessible in the clinical setting. Text and electronic information sources were seen as less accessible, mainly because of the time required to access the information within the documents. When faced with clinical uncertainty, obtaining information from colleagues allows information to be quickly accessed and applied within the context of a specific clinical presentation. Seeking information from others also provides opportunities for shared decision-making and potential validation of clinical judgment, although differing views may exacerbate clinical uncertainty. The social exchange of clinical information may meet the needs of nurses working in a complex, time-pressured environment but the extent of the evidence base for information passed through verbal communication is unclear. The perceived usefulness and accessibility of information is premised on the ease of use and access
Olyazadeh, Roya; van Westen, Cees; Bakker, Wim H.; Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri
Natural hazard risk management requires decision making in several stages. Decision making on alternatives for risk reduction planning starts with an intelligence phase for recognition of the decision problems and identifying the objectives. Development of the alternatives and assigning the variable by decision makers to each alternative are employed to the design phase. Final phase evaluates the optimal choice by comparing the alternatives, defining indicators, assigning a weight to each and ranking them. This process is referred to as Multi-Criteria Decision Making analysis (MCDM), Multi-Criteria Evaluation (MCE) or Multi-Criteria Analysis (MCA). In the framework of the ongoing 7th Framework Program "CHANGES" (2011-2014, Grant Agreement No. 263953) of the European Commission, a Spatial Decision Support System is under development, that has the aim to analyse changes in hydro-meteorological risk and provide support to selecting the best risk reduction alternative. This paper describes the module for Multi-Criteria Decision Making analysis (MCDM) that incorporates monetary and non-monetary criteria in the analysis of the optimal alternative. The MCDM module consists of several components. The first step is to define criteria (or Indicators) which are subdivided into disadvantages (criteria that indicate the difficulty for implementing the risk reduction strategy, also referred to as Costs) and advantages (criteria that indicate the favorability, also referred to as benefits). In the next step the stakeholders can use the developed web-based tool for prioritizing criteria and decision matrix. Public participation plays a role in decision making and this is also planned through the use of a mobile web-version where the general local public can indicate their agreement on the proposed alternatives. The application is being tested through a case study related to risk reduction of a mountainous valley in the Alps affected by flooding. Four alternatives are evaluated in
National Aeronautics and Space Administration — SMH Consulting proposes to develop a web-based decision support system to assist in Rapid Assessment, Monitoring, and Management (RAMM-DSS) on a regional scale. SMH...
Bazzani, Guido M
The paper presents a decision support designed to conduct an economic-environmental assessment of the agricultural activity focusing on irrigation called 'Decision Support for IRRigated Agriculture' (DSIRR). The program describes the effect at catchment scale of choices taken at micro scale by independent actors, the farmers, by simulating their decision process. The decision support (DS) has been thought of as a support tool for participatory water policies as requested by the Water Framework Directive and it aims at analyzing alternatives in production and technology, according to different market, policy and climate conditions. The tool uses data and models, provides a graphical user interface and can incorporate the decision makers' own insights. Heterogeneity in preferences is admitted since it is assumed that irrigators try to optimize personal multi-attribute utility functions, subject to a set of constraints. Consideration of agronomic and engineering aspects allows an accurate description of irrigation. Mathematical programming techniques are applied to find solutions. The program has been applied in the river Po basin (northern Italy) to analyze the impact of a pricing policy in a context of irrigation technology innovation. Water demand functions and elasticity to water price have been estimated. Results demonstrate how different areas and systems react to the same policy in quite a different way. While in the annual cropping system pricing seems effective to save the resource at the cost of impeding Water Agencies cost recovery, the same policy has an opposite effect in the perennial fruit system which shows an inelastic response to water price. The multidimensional assessment conducted clarified the trades-off among conflicting economic-social-environmental objectives, thus generating valuable information to design a more tailored mix of measures.
Salling, Kim Bang; Pryn, Marie Ridley
is adopted. The SUSTAIN-DSS model rests upon multi-criteria decision analysis and planning workshops in order to combine the use of qualitative and quantitative assessments. This article stresses the necessity of revising current planning paradigms such as cost-benefit analysis (CBA) but also to make clear......This article will expose the necessity for a sustainable planning and decision support framework for transport infrastructure assessment. This will be operationalized through a set of planning criteria and scenario alternatives, which is assessed in the SUSTAIN decision support system (SUSTAIN......-DSS) model. A part of the decision support framework will be tested in a case study in Denmark, concerning the problem of congestion on the current bridge crossing Roskilde Fjord in the city of Frederikssund. This article suggests including in a combination both reference class forecasting and quantitative...
Saito, Yoshihito; Matsuo, Tokuro
Education institutions such as universities have a lot of information including book information, equipment administrative information, student information, and several others. The institutions also have multiple information in time series. As collective intelligence in campus, integrating and reusing these preserved information regarding career and taking a class, university can effectively support students' decision making of their getting jobs and subjects choice. Our purpose of support is to increase student's motivation. In this paper, we focus on course record and job information included in students' information, and propose the method to analyze correlation between a pattern of taking class and job lined up. Afterwards, we propose a support system regarding getting a job and taking class by using our proposed method. For a student who has his/her favorite job to get, the system supports his/her decision making of lecture choice by recommending a set of appropriate lecture groups. On another hand, for a student who does not have favorite job to get, the system supports his/her decision making of getting job by presenting appropriate job families related with lecture group in which he/she has ever taken. The contribution of this paper is showing a concrete method to reuse the campus collective information, implementing a system, and user perspectives.
Richards, Claire A; Starks, Helene; O'Connor, M Rebecca; Bourget, Erica; Hays, Ross M; Doorenbos, Ardith Z
Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. To understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments. Semistructured interviews were conducted with 22 physicians from neonatal, pediatric, and cardiothoracic intensive care units in a single quaternary care pediatric hospital. Transcribed interviews were analyzed using content and thematic analysis. We identified 3 main themes: (1) beliefs about child and family interests; (2) disagreement about the child's best interest; and (3) decision-making strategies, including limiting options, being directive, staying neutral, and allowing parents to come to their own conclusions. Physicians described challenges to implementing shared decision-making including unequal power and authority, clinical uncertainty, and complexity of balancing child and family interests. They acknowledged determining the level of engagement in shared decision-making with parents (vs routine engagement) based on their perceptions of the best interests of the child and parent. Due to power imbalances, families' values and preferences may not be integrated in decisions or families may be excluded from discussions about goals of care. We suggest that a systematic approach to identify parental preferences and needs for decisional roles and information may reduce variability in parental involvement.
Stacey, Gemma; Felton, Anne; Morgan, Alastair; Stickley, Theo; Willis, Martin; Diamond, Bob; Houghton, Philip; Johnson, Beverley; Dumenya, John
Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-mak