Science.gov

Sample records for aided decision support

  1. Map-based decision aids for fire support

    NASA Astrophysics Data System (ADS)

    Yarosh, Victor

    1996-06-01

    The Fire Control Division at ARDEC is developing prototype decision aid tools to enable fire support echelons to rapidly respond to requests for fire support. Decision aids on fire support platforms can assist in route planning, site selection, and develop mobility overlays to enable the shooter to rapidly move into position and prepare for the fire mission. The Decision Aid system utilizes an integrated design approach which has each module interacting with the others by sharing data bases and common algorithms to provide recommended courses of action for route planning and generation, position selection, self defense, logistics estimates, situational awareness and fire mission planning aids such as tactical assessment, tactical planning, sustainment, etc. The Decision Aid system will use expert system artificial intelligence which will be developed from knowledge bases utilizing object oriented design. The modules currently reason on Defense Mapping Agency Interim Terrain Data and Digital Terrain Elevation Data and collect mission, intelligence, and sensor data from the digitized battlefield information distribution system to provide the crew or mission planners with intelligent recommendations. The system can provide a trade off analysis of time vs. safety, enable commanders to rapidly respond to fire support request, automatically generate OpOrders, and create overlays which depict mobility corridors, NBC areas, friendly units, overhead concealment, communications, and threat areas. The Decision Aids system can provide a vastly improved mobility, situational awareness, and decision cycle capabilities which can be utilized to increase the tempo of battle.

  2. A decision support system for AIDS intervention and prevention.

    PubMed

    Xu, L D

    1994-08-01

    In recent years, the importance of information systems has been identified as a vital issue to continuing success in AIDS intervention and prevention (AIP). The advances in information technology have resulted in integrative information systems including decision support systems (DSS). The concept of DSS for AIP was created at the intersection of two trends. The first trend was a growing belief that AIP information systems are successful in automating operations in AIP programs. The second was a continuing improvement in modeling and software development in the AIP area. This paper presents an integrated DSS for AIP. The system is integrated with a database and achieves its efficiency by incorporating various algorithms and models to support AIP decision processes. The application examples include screening AIDS-risky behaviors, evaluating educational interventions, and scheduling AIP sessions. The implementation results present evidence of the usefulness of the system in AIP.

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

    PubMed

    Siminoff, L A; Sandberg, D E

    2015-05-01

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

  4. Computer aided decision support system for cervical cancer classification

    NASA Astrophysics Data System (ADS)

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

    2012-10-01

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

  5. Supporting Parental Decisions About Genomic Sequencing for Newborn Screening: The NC NEXUS Decision Aid.

    PubMed

    Lewis, Megan A; Paquin, Ryan S; Roche, Myra I; Furberg, Robert D; Rini, Christine; Berg, Jonathan S; Powell, Cynthia M; Bailey, Donald B

    2016-01-01

    Advances in genomic sequencing technology have raised fundamental challenges to the traditional ways genomic information is communicated. These challenges will become increasingly complex and will affect a much larger population in the future if genomics is incorporated into standard newborn screening practice. Clinicians, public health officials, and other stakeholders will need to agree on the types of information that they should seek and communicate to parents. Currently, few evidence-based and validated tools are available to support parental informed decision-making. These tools will be necessary as genomics is integrated into clinical practice and public health systems. In this article we describe how the North Carolina Newborn Exome Sequencing for Universal Screening study is addressing the need to support parents in making informed decisions about the use of genomic testing in newborn screening. We outline the context for newborn screening and justify the need for parental decision support. We also describe the process of decision aid development and the data sources, processes, and best practices being used in development. By the end of the study, we will have an evidenced-based process and validated tools to support parental informed decision-making about the use of genomic sequencing in newborn screening. Data from the study will help answer important questions about which genomic information ought to be sought and communicated when testing newborns. PMID:26729698

  6. Supporting Parental Decisions About Genomic Sequencing for Newborn Screening: The NC NEXUS Decision Aid

    PubMed Central

    Lewis, Megan A.; Paquin, Ryan S.; Roche, Myra I.; Furberg, Robert D.; Rini, Christine; Berg, Jonathan S.; Powell, Cynthia M.; Bailey, Donald B.

    2016-01-01

    Advances in genomic sequencing technology have raised fundamental challenges to the traditional ways genomic information is communicated. These challenges will become increasingly complex and will affect a much larger population in the future if genomics is incorporated into standard newborn screening practice. Clinicians, public health officials, and other stakeholders will need to agree on the types of information that they should seek and communicate to parents. Currently, few evidence-based and validated tools are available to support parental informed decision-making. These tools will be necessary as genomics is integrated into clinical practice and public health systems. In this article we describe how the North Carolina Newborn Exome Sequencing for Universal Screening study is addressing the need to support parents in making informed decisions about the use of genomic testing in newborn screening. We outline the context for newborn screening and justify the need for parental decision support. We also describe the process of decision aid development and the data sources, processes, and best practices being used in development. By the end of the study, we will have an evidenced-based process and validated tools to support parental informed decision-making about the use of genomic sequencing in newborn screening. Data from the study will help answer important questions about which genomic information ought to be sought and communicated when testing newborns. PMID:26729698

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

    PubMed

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

    2012-01-01

    This study examined the use of deliberately anthropomorphic automation on younger and older adults' trust, dependence and performance on a diabetes decision-making task. Research with anthropomorphic interface agents has shown mixed effects in judgments of preferences but has rarely examined effects on performance. Meanwhile, research in automation has shown some forms of anthropomorphism (e.g. etiquette) have effects on trust and dependence on automation. Participants answered diabetes questions with no-aid, a non-anthropomorphic aid or an anthropomorphised aid. Trust and dependence in the aid was measured. A minimally anthropomorphic aide primarily affected younger adults' trust in the aid. Dependence, however, for both age groups was influenced by the anthropomorphic aid. Automation that deliberately embodies person-like characteristics can influence trust and dependence on reasonably reliable automation. However, further research is necessary to better understand the specific aspects of the aid that affect different age groups. Automation that embodies human-like characteristics may be useful in situations where there is under-utilisation of reasonably reliable aids by enhancing trust and dependence in that aid. Practitioner Summary: The design of decision-support aids on consumer devices (e.g. smartphones) may influence the level of trust that users place in that system and their amount of use. This study is the first step in articulating how the design of aids may influence user's trust and use of such systems. PMID:22799560

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

    PubMed

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

    2016-01-01

    Person-centred decision support combines the best available information on the considerations that matter to the individual, with the importance the person attaches to those considerations. Nurses and other health professionals can benefit from being able to draw on this support within a clinical conversation. A case study and storyline on four siblings facing a transplant coordinator's call to donate stem cells to their brother [1] is 'translated' and used to demonstrate how an interactive multi-criteria aid can be developed for each within a conversational mode. The personalized dialogue and decision aid are accessible online for interaction. Each sibling's decision exemplifies the communication including physical and psychosocial complexities within any decision cascade from call-to-test and to donate, if compatible. A shared template can embrace the informational and ethical aspects of a decision. By interactive decision support within a clinical conversation, each stakeholder can gain a personalised opinion, as well as increased generic health decision literacy [2]. PMID:27332459

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

    PubMed Central

    Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-01-01

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

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

    PubMed

    Kagan, Jonathan M; Gupta, Nitin; Varghese, Suresh; Virkar, Hemant

    2011-12-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2007-06-01

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

  12. Peircean Decision Aid

    SciTech Connect

    SENGLAUB, MICHAEL; & WHITFIELD, GREG

    2008-08-14

    The Peircean decision aid (PDA) is a decision support architecture and embedded functionality that supports a decision maker in very complex environments dealing with massive amounts of disparate data, information and knowledge. The solution generated is a hybrid system solution employing a number of technologies that are based on Peircean reasoning, modal logic, and formal concept analysis. The system convolves data/information with knowledge to create a virtual belief state that is passed to a decision maker for consideration. The system can capture categorized knowledge or it can inductively learn or acquire new knowledge from suites of observations. Captured knowledge is used to abductively generate hypotheses that are potential explanations to observations or collected data. The zero order modal logic architecture is designed to augment knowledge update and belief revision and can be extended to include disjunctive screening of collected data. While intended to be a library for integration into a decision support architecture it possesses a basic stand-alone GUI for use as an analysis support tool.

  13. Peircean Decision Aid

    2008-08-14

    The Peircean decision aid (PDA) is a decision support architecture and embedded functionality that supports a decision maker in very complex environments dealing with massive amounts of disparate data, information and knowledge. The solution generated is a hybrid system solution employing a number of technologies that are based on Peircean reasoning, modal logic, and formal concept analysis. The system convolves data/information with knowledge to create a virtual belief state that is passed to a decisionmore » maker for consideration. The system can capture categorized knowledge or it can inductively learn or acquire new knowledge from suites of observations. Captured knowledge is used to abductively generate hypotheses that are potential explanations to observations or collected data. The zero order modal logic architecture is designed to augment knowledge update and belief revision and can be extended to include disjunctive screening of collected data. While intended to be a library for integration into a decision support architecture it possesses a basic stand-alone GUI for use as an analysis support tool.« less

  14. Evaluating a Web-Based MMR Decision Aid to Support Informed Decision-Making by UK Parents: A Before-and-After Feasibility Study

    ERIC Educational Resources Information Center

    Jackson, Cath; Cheater, Francine M.; Peacock, Rose; Leask, Julie; Trevena, Lyndal

    2010-01-01

    Objective: The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from…

  15. The Role of Personalised Choice in Decision Support: A Randomized Controlled Trial of an Online Decision Aid for Prostate Cancer Screening

    PubMed Central

    Salkeld, Glenn; Cunich, Michelle; Dowie, Jack; Howard, Kirsten; Patel, Manish I.; Mann, Graham; Lipworth, Wendy

    2016-01-01

    Importance Decision support tools can assist people to apply population-based evidence on benefits and harms to individual health decisions. A key question is whether “personalising” choice within decisions aids leads to better decision quality. Objective To assess the effect of personalising the content of a decision aid for prostate cancer screening using the Prostate Specific Antigen (PSA) test. Design Randomized controlled trial. Setting Australia. Participants 1,970 men aged 40–69 years were approached to participate in the trial. Intervention 1,447 men were randomly allocated to either a standard decision aid with a fixed set of five attributes or a personalised decision aid with choice over the inclusion of up to 10 attributes. Outcome Measures To determine whether there was a difference between the two groups in terms of: 1) the emergent opinion (generated by the decision aid) to have a PSA test or not; 2) self-rated decision quality after completing the online decision aid; 3) their intention to undergo screening in the next 12 months. We also wanted to determine whether men in the personalised choice group made use of the extra decision attributes. Results 5% of men in the fixed attribute group scored ‘Have a PSA test’ as the opinion generated by the aid, as compared to 62% of men in the personalised choice group (χ2 = 569.38, 2df, p< 0001). Those men who used the personalised decision aid had slightly higher decision quality (t = 2.157, df = 1444, p = 0.031). The men in the personalised choice group made extensive use of the additional decision attributes. There was no difference between the two groups in terms of their stated intention to undergo screening in the next 12 months. Conclusions Together, these findings suggest that personalised decision support systems could be an important development in shared decision-making and patient-centered care. Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN

  16. Survey on computer aided decision support for diagnosis of celiac disease

    PubMed Central

    Hegenbart, Sebastian; Uhl, Andreas; Vécsei, Andreas

    2015-01-01

    Celiac disease (CD) is a complex autoimmune disorder in genetically predisposed individuals of all age groups triggered by the ingestion of food containing gluten. A reliable diagnosis is of high interest in view of embarking on a strict gluten-free diet, which is the CD treatment modality of first choice. The gold standard for diagnosis of CD is currently based on a histological confirmation of serology, using biopsies performed during upper endoscopy. Computer aided decision support is an emerging option in medicine and endoscopy in particular. Such systems could potentially save costs and manpower while simultaneously increasing the safety of the procedure. Research focused on computer-assisted systems in the context of automated diagnosis of CD has started in 2008. Since then, over 40 publications on the topic have appeared. In this context, data from classical flexible endoscopy as well as wireless capsule endoscopy (WCE) and confocal laser endomicrosopy (CLE) has been used. In this survey paper, we try to give a comprehensive overview of the research focused on computer-assisted diagnosis of CD. PMID:25770906

  17. Managing urinary incontinence through hand-held real-time decision support aid.

    PubMed

    Koutsojannis, Constantinos; Lithari, Chrysa; Hatzilygeroudis, Ioannis

    2012-07-01

    In this paper, we present an intelligent system for the diagnosis and treatment of urinary incontinence (UI) for males as well as females, called e-URIN. e-URIN is an intelligent system for diagnosis and treatment of urinary incontinence according to symptoms that are realized in one patient and usually recorded through his clinical examination as well as specific test results. The user-friendly proposed intelligent system is accommodated on a hospital server supporting e-health tools, for use through pocket PCs under wireless connection as a decision support system for resident doctors, as well as an educational tool for medical students. It is based on expert system knowledge representation provided from urology experts in combination with rich bibliographic search and study ratified with statistical results from clinical practice. Preliminary experimental results on a real patient hospital database provide acceptable performance that can be improved using more than one computational intelligence approaches in the future.

  18. Automation: Decision Aid or Decision Maker?

    NASA Technical Reports Server (NTRS)

    Skitka, Linda J.

    1998-01-01

    This study clarified that automation bias is something unique to automated decision making contexts, and is not the result of a general tendency toward complacency. By comparing performance on exactly the same events on the same tasks with and without an automated decision aid, we were able to determine that at least the omission error part of automation bias is due to the unique context created by having an automated decision aid, and is not a phenomena that would occur even if people were not in an automated context. However, this study also revealed that having an automated decision aid did lead to modestly improved performance across all non-error events. Participants in the non- automated condition responded with 83.68% accuracy, whereas participants in the automated condition responded with 88.67% accuracy, across all events. Automated decision aids clearly led to better overall performance when they were accurate. People performed almost exactly at the level of reliability as the automation (which across events was 88% reliable). However, also clear, is that the presence of less than 100% accurate automated decision aids creates a context in which new kinds of errors in decision making can occur. Participants in the non-automated condition responded with 97% accuracy on the six "error" events, whereas participants in the automated condition had only a 65% accuracy rate when confronted with those same six events. In short, the presence of an AMA can lead to vigilance decrements that can lead to errors in decision making.

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

    SciTech Connect

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

    1994-05-01

    The Department of Energy (DOE) plans to honor its commitment to government-to-government interactions by providing advance notice of DOE spent fuel and high-level waste shipments to Indian tribes whose jurisdictions are crossed by or adjacent to transportation routes. The tribes are important contributors to a regional response network, and providing tribes with advance notice of DOE shipping plans marks the start -- not the end -- of direct, government-to-government interactions with DOE. The Tribal Prenotification Analysis Support System (PASS) is being developed for the Office of Special Programs within the Department`s Office of Environmental Restoration and Waste Management. PASS will help DOE-Headquarters to coordinate field office activities and provide technical and institutional support to the DOE field offices. PASS is designed to be used by anyone with minimum computer literacy and having contemporary computer hardware and software. It uses on-screen maps to choose and display a shipment route, and to display the tribal jurisdictions. With forms that are easy to understand, it provides information about each jurisdiction and points of contact. PASS records all contacts, commitments made, and actions taken.

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

    The purpose of this study was to identify barriers and facilitators to patient-provider communication when discussing breast cancer risk to aid in the development of decision support tools. Four patient focus groups (N=34) and eight provider focus groups (N=10) took place in Northern Manhattan. A qualitative analysis was conducted using Atlas.ti software. The coding yielded 62.3%–94.5% agreement. The results showed that 1) barriers are time constraints, lack of knowledge, low health literacy, and language barriers, and 2) facilitators are information needs, desire for personalization, and autonomy when communicating risk in patient-provider encounters. These results will inform the development of a patient-centered decision aid (RealRisks) and a provider-facing breast cancer risk navigation (BNAV) tool, which are designed to facilitate patient-provider risk communication and shared decision-making about breast cancer prevention strategies, such as chemoprevention. PMID:26958276

  2. A spatial decision support tool for estimating population catchments to aid rural and remote health service allocation planning.

    PubMed

    Schuurman, Nadine; Randall, Ellen; Berube, Myriam

    2011-12-01

    There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote areas. Using this tool, health-care planners can model multiple scenarios to determine the optimal location for health services, as well as the number of people served in each instance.

  3. Legal briefing: Shared decision making and patient decision aids.

    PubMed

    Pope, Thaddeus Mason; Hexum, Melinda

    2013-01-01

    This "Legal Briefing" column covers recent legal developments involving patient decision aids.This topic has been the subject of recent articles in JCE. It is included in the 2010 Patient Protection and Affordable Care Act. And it has received significant attention in the biomedical literature, including a new book, a thematic issue of Health Affairs, and a recent article in the New England Journal of Medicine. Moreover, physicians and health systems across the United States are increasingly integrating decision aids into their clinical practice. Both federal and state laws play a significant role in promoting this expanded use. On the other hand, concerns about liability could stymie development and implementation. We categorize legal developments concerning patient decision aids into the following five sections: 1. Development of decision aids. 2. Effectiveness of decision aids. 3. Federal regulation of decision aids. 4. State regulation of decision aids. 5. Legal concerns regarding decision aids.

  4. Intelligent decision support in process environments

    SciTech Connect

    Hollnagel, E.; Mancini, G.; Woods, D.D.

    1986-01-01

    This book deals with the basis for design of intelligent systems to support human decision-making in supervisory control, and provides a view of how human and artificial cognitive systems can interact. It covers the design and development of intelligent decision aiding systems, as well as the testing and evaluation. Topics discussed include: decision theory; cognitive engineering; systems engineering; and artificial intelligence.

  5. Severe Weather Forecast Decision Aid

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

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

  6. Advanced decision aiding techniques applicable to space

    NASA Technical Reports Server (NTRS)

    Kruchten, Robert J.

    1987-01-01

    RADC has had an intensive program to show the feasibility of applying advanced technology to Air Force decision aiding situations. Some aspects of the program, such as Satellite Autonomy, are directly applicable to space systems. For example, RADC has shown the feasibility of decision aids that combine the advantages of laser disks and computer generated graphics; decision aids that interface object-oriented programs with expert systems; decision aids that solve path optimization problems; etc. Some of the key techniques that could be used in space applications are reviewed. Current applications are reviewed along with their advantages and disadvantages, and examples are given of possible space applications. The emphasis is to share RADC experience in decision aiding techniques.

  7. Adaptive Peircean decision aid project summary assessments.

    SciTech Connect

    Senglaub, Michael E.

    2007-01-01

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

  8. Clinical decision support systems.

    PubMed

    Beeler, Patrick Emanuel; Bates, David Westfall; Hug, Balthasar Luzius

    2014-01-01

    Clinical decision support (CDS) systems link patient data with an electronic knowledge base in order to improve decision-making and computerised physician order entry (CPOE) is a requirement to set up electronic CDS. The medical informatics literature suggests categorising CDS tools into medication dosing support, order facilitators, point-of-care alerts and reminders, relevant information display, expert systems and workflow support. To date, CDS has particularly been recognised for improving processes. CDS successfully fostered prevention of deep-vein thrombosis, improved adherence to guidelines, increased the use of vaccinations, and decreased the rate of serious medication errors. However, CDS may introduce errors, and therefore the term "e-iatrogenesis" has been proposed to address unintended consequences. At least two studies reported severe treatment delays due to CPOE and CDS. In addition, the phenomenon of "alert fatigue" - arising from a high number of CDS alerts of low clinical significance - may facilitate overriding of potentially critical notifications. The implementation of CDS needs to be carefully planned, CDS interventions should be thoroughly examined in pilot wards only, and then stepwise introduced. A crucial feature of CPOE in combination with CDS is speed, since time consumption has been found to be a major factor determining failure. In the near future, the specificity of alerts will be improved, notifications will be prioritised and offer detailed advice, customisation of CDS will play an increasing role, and finally, CDS is heading for patient-centred decision support. The most important research question remains whether CDS is able to improve patient outcomes beyond processes.

  9. Domain specific software design for decision aiding

    NASA Technical Reports Server (NTRS)

    Keller, Kirby; Stanley, Kevin

    1992-01-01

    McDonnell Aircraft Company (MCAIR) is involved in many large multi-discipline design and development efforts of tactical aircraft. These involve a number of design disciplines that must be coordinated to produce an integrated design and a successful product. Our interpretation of a domain specific software design (DSSD) is that of a representation or framework that is specialized to support a limited problem domain. A DSSD is an abstract software design that is shaped by the problem characteristics. This parallels the theme of object-oriented analysis and design of letting the problem model directly drive the design. The DSSD concept extends the notion of software reusability to include representations or frameworks. It supports the entire software life cycle and specifically leads to improved prototyping capability, supports system integration, and promotes reuse of software designs and supporting frameworks. The example presented in this paper is the task network architecture or design which was developed for the MCAIR Pilot's Associate program. The task network concept supported both module development and system integration within the domain of operator decision aiding. It is presented as an instance where a software design exhibited many of the attributes associated with DSSD concept.

  10. Computers in Medicine: A survey of decision aids for clinicians

    PubMed Central

    Young, D W

    1982-01-01

    Inconsistency in applying medical knowledge is a major reason for varying standards of medical care. Five types of aid have been introduced into medicine to help decision-making: questionnaires, algorithms, database systems, diagnostic systems, and, finally, computer-based decision-support systems. Of these, the most effective act as reminder or prompt systems to assist doctors without threatening their clinical freedom. PMID:6812701

  11. Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital.

    PubMed

    Sepucha, Karen R; Simmons, Leigh H; Barry, Michael J; Edgman-Levitan, Susan; Licurse, Adam M; Chaguturu, Sreekanth K

    2016-04-01

    Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital's integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005-15, more than 900 clinicians and other staff members were trained in shared decision making, and more than 28,000 orders for one of about forty patient decision aids were placed to support informed patient-centered decisions. We profile two different implementation initiatives that increased the use of patient decision aids at the hospital's eighteen adult primary care practices, and we summarize key elements of the shared decision making program.

  12. Aiding Lay Decision Making Using a Cognitive Competencies Approach

    PubMed Central

    Maule, A. J.; Maule, Simon

    2016-01-01

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

  13. Decision Support Systems in Libraries.

    ERIC Educational Resources Information Center

    Heindel, Allan; Napier, H. Albert

    Following a review of the contributions of computers and managerial science/operations research to the management of libraries, this paper introduces the concept of decision support systems. DSS, a blending of these techniques, can lead to more effective decisions by library managers. A case study of the utilization of a DSS in the budgeting…

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

    PubMed Central

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

    2011-01-01

    A computerized safety decision aid was developed and tested with Spanish or English-speaking abused women in shelters or domestic violence (DV) support groups (n = 90). The decision aid provides feedback about risk for lethal violence, options for safety, assistance with setting priorities for safety, and a safety plan personalized to the user. Women reported that the decision aid was useful and provided much-needed privacy for making safety decisions. The majority (69%) reported severe to extreme danger in their relationship as scored by Danger Assessment (DA); only 60% reported having made a safety plan. After using the safety decision aid, the women felt more supported in their decision (p = .012) and had less total decisional conflict (p = .014). The study demonstrated that a computerized safety decision aid improved the safety planning process, as demonstrated by reduced decisional conflict after only one use in a sample of abused women. PMID:20040709

  15. Computerized aid improves safety decision process for survivors of intimate partner violence.

    PubMed

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

    2010-11-01

    A computerized safety decision aid was developed and tested with Spanish or English-speaking abused women in shelters or domestic violence (DV) support groups (n = 90). The decision aid provides feedback about risk for lethal violence, options for safety, assistance with setting priorities for safety, and a safety plan personalized to the user. Women reported that the decision aid was useful and provided much-needed privacy for making safety decisions. The majority (69%) reported severe to extreme danger in their relationship as scored by Danger Assessment (DA); only 60% reported having made a safety plan. After using the safety decision aid, the women felt more supported in their decision (p = .012) and had less total decisional conflict (p = .014). The study demonstrated that a computerized safety decision aid improved the safety planning process, as demonstrated by reduced decisional conflict after only one use in a sample of abused women.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  17. Decision Support Framework (DSF) (Formerly Decision Support Platform)

    EPA Science Inventory

    The Science Advisory Board (SAB) provided several comments on the draft Ecosystem Services Research Program's (ESRP's) Multi-Year Plan (MYP). This presentation provides a response to comments related to the decision support framework (DSF) part of Long-Term Goal 1. The comments...

  18. A shotgun wedding: business decision support meets clinical decision support.

    PubMed

    Oliveira, Jason

    2002-01-01

    By effectively closing the loop between the data, analytics, processes, and methods supporting business and clinical decision making, a healthcare organization closes the loop between its knowledge generation activities and its actions at the bedside: knowledge guiding actions, actions generating knowledge.

  19. Automating hypertext for decision support

    NASA Technical Reports Server (NTRS)

    Bieber, Michael

    1990-01-01

    A decision support system (DSS) shell is being constructed that can support applications in a variety of fields, e.g., engineering, manufacturing, finance. The shell provides a hypertext-style interface for 'navigating' among DSS application models, data, and reports. The traditional notion of hypertext had to be enhanced. Hypertext normally requires manually, pre-defined links. A DSS shell, however, requires that hypertext connections to be built 'on the fly'. The role of hypertext is discussed in augmenting DSS applications and the decision making process. Also discussed is how hypertext nodes, links, and link markers tailored to an arbitrary DSS application were automatically generated.

  20. Real-Time Monitoring and Evaluation of a Visual-Based Cervical Cancer Screening Program Using a Decision Support Job Aid

    PubMed Central

    Peterson, Curtis W.; Rose, Donny; Mink, Jonah; Levitz, David

    2016-01-01

    In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal. In this paper, a new app feature that documents clinical decisions using an integrated job aid was deployed in a cervical cancer screening camp in Kenya. Six organizations conducting VIA used the EVA System to screen 824 patients over the course of a week, and providers recorded their diagnoses and treatments in the application. Real-time aggregated statistics were broadcast on a public website. Screening organizations were able to assess the number of patients screened, alongside treatment rates, and the patients who tested positive and required treatment in real time, which allowed them to make adjustments as needed. The real-time M&E enabled by “smart” diagnostic medical devices holds promise for broader use in screening programs in low-resource settings. PMID:27196932

  1. Real-Time Monitoring and Evaluation of a Visual-Based Cervical Cancer Screening Program Using a Decision Support Job Aid.

    PubMed

    Peterson, Curtis W; Rose, Donny; Mink, Jonah; Levitz, David

    2016-01-01

    In many developing nations, cervical cancer screening is done by visual inspection with acetic acid (VIA). Monitoring and evaluation (M&E) of such screening programs is challenging. An enhanced visual assessment (EVA) system was developed to augment VIA procedures in low-resource settings. The EVA System consists of a mobile colposcope built around a smartphone, and an online image portal for storing and annotating images. A smartphone app is used to control the mobile colposcope, and upload pictures to the image portal. In this paper, a new app feature that documents clinical decisions using an integrated job aid was deployed in a cervical cancer screening camp in Kenya. Six organizations conducting VIA used the EVA System to screen 824 patients over the course of a week, and providers recorded their diagnoses and treatments in the application. Real-time aggregated statistics were broadcast on a public website. Screening organizations were able to assess the number of patients screened, alongside treatment rates, and the patients who tested positive and required treatment in real time, which allowed them to make adjustments as needed. The real-time M&E enabled by "smart" diagnostic medical devices holds promise for broader use in screening programs in low-resource settings. PMID:27196932

  2. A decision aid for diagnosis of liver lesions on MRI.

    PubMed Central

    Tombropoulos, R.; Shiffman, S.; Davidson, C.

    1993-01-01

    Abdominal magnetic resonance imaging (MRI) plays an important role in the evaluation of liver abnormalities. The interpretation of MR images requires expert training in a rapidly changing field. DAFODILL (Decision Aid for Diagnosing Liver Lesions) is a decision-support tool designed to aid radiologists in the diagnosis of hepatic lesions seen on MRI. DAFODILL uses a knowledge base of MRI findings and a belief-network inference engine to generate probabilistic differential diagnoses of the most commonly encountered hepatic lesions. DAFODILL performs limited image processing to identify clinically relevant features, which are presented to the user for confirmation before they are used by the network. Preliminary evaluation of an initial version of the system suggests that DAFODILL may be a useful tool for radiology residents and nonexpert radiologists in interpreting MR images of the liver. PMID:8130512

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

    ERIC Educational Resources Information Center

    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…

  4. Decision Support Systems: An Introduction for Program Evaluators.

    ERIC Educational Resources Information Center

    O'Sullivan, Elizabethann

    1985-01-01

    Decision Support Systems (DSS) are automated information systems designed to aid administrative decision making. A literature review on the design, implementation, and evaluation of DSS, suggests that evaluators act as liasons between designers and managers, identify and collect data for DSS, and evaluate DSS. (Author/EGS)

  5. Strategic Decision Making and Group Decision Support Systems.

    ERIC Educational Resources Information Center

    McGrath, Michael Robert

    1986-01-01

    Institutional strategic decisions require the participation of every individual with a significant stake in the solution, and group decision support systems are being developed to respond to the political and consensual problems of collective decision-making. (MSE)

  6. EVALUATING ENVIRONMENTAL DECISION SUPPORT TOOLS.

    SciTech Connect

    SULLIVAN, T.

    2004-10-01

    Effective contaminated land management requires a number of decisions addressing a suite of technical, economic, and social concerns. These concerns include human health risks, ecological risks, economic costs, technical feasibility of proposed remedial actions, and the value society places on clean-up and re-use of formerly contaminated lands. Decision making, in the face of uncertainty and multiple and often conflicting objectives, is a vital and challenging role in environmental management that affects a significant economic activity. Although each environmental remediation problem is unique and requires a site-specific analysis, many of the key decisions are similar in structure. This has led many to attempt to develop standard approaches. As part of the standardization process, attempts have been made to codify specialist expertise into decision support tools. This activity is intended to facilitate reproducible and transparent decision making. The process of codifying procedures has also been found to be a useful activity for establishing and rationalizing management processes. This study will have two primary objectives. The first is to develop taxonomy for Decision Support Tools (DST) to provide a framework for understanding the different tools and what they are designed to address in the context of environmental remediation problems. The taxonomy will have a series of subject areas for the DST. From these subjects, a few key areas will be selected for further study and software in these areas will be identified. The second objective, will be to review the existing DST in the selected areas and develop a screening matrix for each software product.

  7. Decision Technology Systems: A Vehicle to Consolidate Decision Making Support.

    ERIC Educational Resources Information Center

    Forgionne, Guisseppi A.

    1991-01-01

    Discussion of management decision making and the support needed to manage successfully highlights a Decision Technology System (DTS) that integrates other information systems. Topics discussed include computer information systems (CISs); knowledge gateways; the decision-making process; decision support systems (DSS); expert systems; and facility…

  8. Computer-Aided Decision Support for Melanoma Detection Applied on Melanocytic and Nonmelanocytic Skin Lesions: A Comparison of Two Systems Based on Automatic Analysis of Dermoscopic Images

    PubMed Central

    Møllersen, Kajsa; Kirchesch, Herbert; Zortea, Maciel; Schopf, Thomas R.; Hindberg, Kristian; Godtliebsen, Fred

    2015-01-01

    Commercially available clinical decision support systems (CDSSs) for skin cancer have been designed for the detection of melanoma only. Correct use of the systems requires expert knowledge, hampering their utility for nonexperts. Furthermore, there are no systems to detect other common skin cancer types, that is, nonmelanoma skin cancer (NMSC). As early diagnosis of skin cancer is essential, there is a need for a CDSS that is applicable to all types of skin lesions and is suitable for nonexperts. Nevus Doctor (ND) is a CDSS being developed by the authors. We here investigate ND's ability to detect both melanoma and NMSC and the opportunities for improvement. An independent test set of dermoscopic images of 870 skin lesions, including 44 melanomas and 101 NMSCs, were analysed by ND. Its sensitivity to melanoma and NMSC was compared to that of Mole Expert (ME), a commercially available CDSS, using the same set of lesions. ND and ME had similar sensitivity to melanoma. For ND at 95% melanoma sensitivity, the NMSC sensitivity was 100%, and the specificity was 12%. The melanomas misclassified by ND at 95% sensitivity were correctly classified by ME, and vice versa. ND is able to detect NMSC without sacrificing melanoma sensitivity. PMID:26693486

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

    NASA Technical Reports Server (NTRS)

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

    1987-01-01

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

  10. Decision support for financial forecasting

    SciTech Connect

    Jairam, B.N.; Morris, J.D.; Emrich, M.L.; Hardee, H.K.

    1988-10-01

    A primary mission of the Budget Management Division of the Air Force is fiscal analysis. This involves formulating, justifying, and tracking financial data during budget preparation and execution. An essential requirement of this process is the ready availability and easy manipulation of past and current budget data. This necessitates the decentralization of the data. A prototypical system, BAFS (Budget Analysis and Forecasting System), that provides such a capability is presented. In its current state, the system is designed to be a decision support tool. A brief report of the budget decisions and activities is presented. The system structure and its major components are discussed. An insight into the implementation strategies and the tool used is provided. The paper concludes with a discussion of future enhancements and the system's evolution into an expert system. 4 refs., 3 figs.

  11. Decision Support Methods and Tools

    NASA Technical Reports Server (NTRS)

    Green, Lawrence L.; Alexandrov, Natalia M.; Brown, Sherilyn A.; Cerro, Jeffrey A.; Gumbert, Clyde r.; Sorokach, Michael R.; Burg, Cecile M.

    2006-01-01

    This paper is one of a set of papers, developed simultaneously and presented within a single conference session, that are intended to highlight systems analysis and design capabilities within the Systems Analysis and Concepts Directorate (SACD) of the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC). This paper focuses on the specific capabilities of uncertainty/risk analysis, quantification, propagation, decomposition, and management, robust/reliability design methods, and extensions of these capabilities into decision analysis methods within SACD. These disciplines are discussed together herein under the name of Decision Support Methods and Tools. Several examples are discussed which highlight the application of these methods within current or recent aerospace research at the NASA LaRC. Where applicable, commercially available, or government developed software tools are also discussed

  12. Decision aid for cigarette smokers scheduled for elective surgery

    PubMed Central

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

    2015-01-01

    Background Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. Methods In formative work, a decision aid was designed to facilitate patient-clinician discussion regarding three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good. A randomized, two-group pilot study was then conducted in smokers evaluated in preparation for elective surgery in a preoperative clinic to test the hypothesis that the decision aid would improve measures of decisional quality compared with usual care. Results The final decision aid consisted of three laminated cards. The front of each card included a colorful graphic describing each choice; the reverse including 2–3 pros and cons for each decision, a simple graphic illustrating the effects of smoking on the body, and a motivational phrase. In the randomized trial of 130 patients, the decision aid significantly (p<0.05) improved measures of decisional quality and patient involvement in decision making (Cohen’s d effect sizes of 0.76 and 1.20 for the Decisional Conflict and OPTION scales, respectively). However, the decision aid did not affect any aspect of perioperative smoking behavior, including the distribution of or adherence to choices. Conclusions Although use of a decision aid to facilitate clinician-patient discussions regarding tobacco use around the time of surgery substantially improved measures of decisional quality, it alone did not change perioperative tobacco use behavior. PMID:25978327

  13. Overview of environmental decision support software

    SciTech Connect

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

    1997-12-31

    Regulatory exposure limits form the basis for making decisions on the characterization, monitoring, and remediation of environmental contamination. This paper discusses the development of Decision Support Software (DSS) tools developed to support decisions pertaining to environmental management. Decision support software packages are computer-based programs that facilitate the use of data, models, and structured decision processes in decision making. They incorporate the information into an integrated package that presents results in a format useful for making environmental decisions. Six major analysis functions of DSS tools have been identified: site characterization, plume characterization, risk assessment including regulatory compliance assessment, remedy selection, remedy design optimization, and cost/benefit analysis. Decision support software is relatively new and is now beginning to see application in the field. This paper discusses existing DSS and the strengths and limitations of some of the DSS packages. General limitations of decision support software are also discussed.

  14. Decision support for clinical laboratory capacity planning.

    PubMed

    van Merode, G G; Hasman, A; Derks, J; Goldschmidt, H M; Schoenmaker, B; Oosten, M

    1995-01-01

    The design of a decision support system for capacity planning in clinical laboratories is discussed. The DSS supports decisions concerning the following questions: how should the laboratory be divided into job shops (departments/sections), how should staff be assigned to workstations and how should samples be assigned to workstations for testing. The decision support system contains modules for supporting decisions at the overall laboratory level (concerning the division of the laboratory into job shops) and for supporting decisions at the job shop level (assignment of staff to workstations and sample scheduling). Experiments with these modules are described showing both the functionality and the validity.

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

    PubMed

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

    2011-06-01

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

  16. Video May Aid End-of-Life Decision-Making

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159659.html Video May Aid End-of-Life Decision-Making Brief ... THURSDAY, June 30, 2016 (HealthDay News) -- Watching a video about end-of-life care options may help ...

  17. Decision Support Systems: The Need, The Challenge.

    ERIC Educational Resources Information Center

    Roberts, Michael M.

    1982-01-01

    The evolution of decision support systems (DSS) has enabled computer and information technology to assist the management process of decision making. Decision support systems are designed to look forward in time, to forecast outcomes of uncertain events. A 70-item bibliography is included. (MLW)

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

    PubMed Central

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

    2016-01-01

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

  19. Disclosing conflicts of interest in patient decision aids

    PubMed Central

    2013-01-01

    Background In 2005, the International Patient Decisions Aid Standards (IPDAS) Collaboration developed quality criteria for patient decisions aids; one of the quality dimensions dealt with disclosure of conflicts of interest (COIs). The purposes of this paper are to review newer evidence on dealing with COI in the development of patient decision aids and to readdress the theoretical justification and definition for this quality dimension. Methods The committee conducted a primary systematic literature review to seek published research addressing the question, "What is the evidence that disclosure of COIs in patient decision aids reduces biased decision making?" A secondary literature review included a systematic search for recent meta-analyses addressing COIs in other spheres of health care, including research and publication, medical education, and clinical care. Results No direct evidence was found addressing this quality dimension in the primary literature review. The secondary review yielded a comprehensive Institute of Medicine report, as well as four relevant meta-analyses addressing disclosure of COIs in health care. They revealed a broad consensus that disclosure of COIs is desirable in such areas as research publication, guideline development, medical education, and clinical care. Conclusions The committee recommends the criteria that are currently used to operationally define the quality dimension “disclosing conflicts of interest” be changed as follows (changes in italics): Does the patient decision aid: • report prominently and in plain language the source of funding to develop or exclusively distribute the patient decision aid? • report prominently and in plain language whether funders, authors, or their affiliations, stand to gain or lose by choices patients make after using the patient decision aid? Furthermore, based on a consensus that simple disclosure is insufficient to protect users from potentially biased information, the committee

  20. Decision-Making Amplification under Uncertainty: An Exploratory Study of Behavioral Similarity and Intelligent Decision Support Systems

    ERIC Educational Resources Information Center

    Campbell, Merle Wayne

    2013-01-01

    Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…

  1. Development of a new approach to aid in visual identification of murine iPS colonies using a fuzzy logic decision support system.

    PubMed

    Bassaneze, Vinicius; Sacramento, Chester Bittencourt; Freire, Rodolfo; De Alencar, Patrícia Fernandes; Ortega, Neli Regina Siqueira; Krieger, Jose Eduardo

    2013-01-01

    The a priori identification of induced pluripotent stem cells remains a challenge. Being able to quickly identify the most embryonic stem cell-similar induced pluripotent stem cells when validating results could help to reduce costs and save time. In this context, tools based on non-classic logic can be useful in creating aid-systems based on visual criteria. True colonies when viewed at 100x magnification have been found to have the following 3 characteristics: a high degree of border delineation, a more uniform texture, and the absence of a cracked texture. These visual criteria were used for fuzzy logic modeling. We investigated the possibility of predicting the presence of alkaline phosphatase activity, typical of true induced pluripotent stem cell colonies, after 25 individuals, with varying degrees of experience in working with murine iPS cells, categorized the images of 136 colonies based on visual criteria. Intriguingly, the performance evaluation by area under the ROC curve (16 individuals with satisfactory performance), Spearman correlation (all statistically significant), and Cohen's Kappa agreement analysis (all statistically significant) demonstrates that the discriminatory capacity of different evaluators are similar, even those who have never cultivated cells. Thus, we report on a new system to facilitate visual identification of murine- induced pluripotent stem cell colonies that can be useful for staff training and opens the possibility of exploring visual characteristics of induced pluripotent stem cell colonies with their functional peculiarities. The fuzzy model has been integrated as a web-based tool named "2see-iPS" which is freely accessed at http://genetica.incor.usp.br/2seeips/. PMID:23950970

  2. Development of a new approach to aid in visual identification of murine iPS colonies using a fuzzy logic decision support system.

    PubMed

    Bassaneze, Vinicius; Sacramento, Chester Bittencourt; Freire, Rodolfo; De Alencar, Patrícia Fernandes; Ortega, Neli Regina Siqueira; Krieger, Jose Eduardo

    2013-01-01

    The a priori identification of induced pluripotent stem cells remains a challenge. Being able to quickly identify the most embryonic stem cell-similar induced pluripotent stem cells when validating results could help to reduce costs and save time. In this context, tools based on non-classic logic can be useful in creating aid-systems based on visual criteria. True colonies when viewed at 100x magnification have been found to have the following 3 characteristics: a high degree of border delineation, a more uniform texture, and the absence of a cracked texture. These visual criteria were used for fuzzy logic modeling. We investigated the possibility of predicting the presence of alkaline phosphatase activity, typical of true induced pluripotent stem cell colonies, after 25 individuals, with varying degrees of experience in working with murine iPS cells, categorized the images of 136 colonies based on visual criteria. Intriguingly, the performance evaluation by area under the ROC curve (16 individuals with satisfactory performance), Spearman correlation (all statistically significant), and Cohen's Kappa agreement analysis (all statistically significant) demonstrates that the discriminatory capacity of different evaluators are similar, even those who have never cultivated cells. Thus, we report on a new system to facilitate visual identification of murine- induced pluripotent stem cell colonies that can be useful for staff training and opens the possibility of exploring visual characteristics of induced pluripotent stem cell colonies with their functional peculiarities. The fuzzy model has been integrated as a web-based tool named "2see-iPS" which is freely accessed at http://genetica.incor.usp.br/2seeips/.

  3. Practical Aspects of a Visual Aid to Decision Making

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  4. Anatomy of a Decision Support System.

    ERIC Educational Resources Information Center

    Chachra, Vinod; Heterick, Robert C.

    1982-01-01

    The decision support system (DSS) environment, the functional requirements of a DSS, and the architectural requirements of the computer systems and communications network necessary to support a DSS are discussed. Changes in the computing environment that are necessary to implement decision support systems are suggested. (Author/MLW)

  5. Decision Support Systems for Academic Administration.

    ERIC Educational Resources Information Center

    Moore, Laurence J.; Greenwood, Allen G.

    1984-01-01

    The history and features of Decision Support Systems (DSS) and use of the approach by academic administrators are discussed. The objective of DSS is to involve the manager/decision maker in the decision-analysis process while simultaneously relieving that person of the burden of developing and performing detailed analysis. DSS represents a…

  6. Decentralized Decision-Making. ERS Information Aid.

    ERIC Educational Resources Information Center

    Powell, Janet F.

    In this paper, the current debate over decentralized decisionmaking is highlighted and facts, figures, and models based on a recent nationwide survey are presented. Decentralization in decisionmaking is defined as the involvement of building-level principals in district-wide decisions. Advantages and disadvantages of decentralization, the nature…

  7. Cost Utility: An Aid to Decision Making.

    ERIC Educational Resources Information Center

    Costa, Crist H.

    A set of procedures were developed which assist in structuring tasks and objectives in a manner to permit rational decision making. The model uses a jury of experts to rank various objectives and program processes in terms of their importance. Values are generated which relate to costs in the form of a utility-cost ratio. The model was tested in a…

  8. Recent developments associated with decision support systems in water resources

    NASA Astrophysics Data System (ADS)

    Watkins, David W.; McKinney, Daene C.

    1995-07-01

    In order to limit the scope of this review, a working definition of a decision support system is needed. L. Adelman has defined decision support systems (DSSs) as "interactive computer programs that utilize analytical methods, such as decision analysis, optimization algorithms, program scheduling routines, and so on, for developing models to help decision makers formulate alternatives, analyze their impacts, and interpret and select appropriate options for implementation" (Adelman [1992], p. 2). Another definition has been offered by S. J. Andriole, who defined decision support as consisting of "any and all data, information, expertise or activities that contribute to option selection" (Andriole [1989], p. 3). A common idea explicit in each of these definitions is that DSSs integrate various technologies and aid in option selection. Implicit in each definition is that these are options for solving relatively large, unstructured problems. Thus, the following working definition of a DSS will be used in this review: A DSS is an integrated, interactive computer system, consisting of analytical tools and information management capabilities, designed to aid decision makers in solving relatively large, unstructured problems.

  9. Comparison of display enhancement with intelligent decision-aiding

    NASA Technical Reports Server (NTRS)

    Kirlik, Alex; Markert, Wendy J.; Kossack, Merrick

    1992-01-01

    Currently, two main approaches exist for improving the human-machine interface component of a system in order to improve overall system performance, display enhancement and intelligent decision aiding. Each of these two approaches has its own set of advantages and disadvantages, as well as introduce its own set of additional performance problems. These characteristics should help identify which types of problem situations and domains are better aided by which type of strategy. The characteristic issues are described of these two decision aiding strategies. Then differences in expert and novice decision making are described in order to help determine whether a particular strategy may be better for a particular type of user. Finally, research is outlined to compare and contrast the two technologies, as well as to examine the interaction effects introduced by the different skill levels and the different methods for training operators.

  10. Collaborative Platforms Aid Emergency Decision Making

    NASA Technical Reports Server (NTRS)

    2013-01-01

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

  11. Operational hydrological projections to aid decision making

    NASA Astrophysics Data System (ADS)

    Schnetler, Thomas; Davis, Richard; Waddingham, John; James, Karen

    2014-05-01

    The Environment Agency of England has wide ranging responsibility for environmental regulation that includes both water resources management and flood management. In order to best fulfil its role decisions need to be taken using the best available evidence in the time available. The manipulation of large amounts of hydrological data in a way that best meets the needs of decision makers is a complex challenge. Not only should any analysis be technically robust but it should also be presented in a way that communicates key messages clearly and quickly. The Environment Agency and its predecessor organisations has a long history of working with hydrological data but in recent years there has been a need to better incorporate risk and uncertainty into hydrological analysis so that subsequent decisions can take this into account. In the face of recent extreme weather events, there has been an increasing demand for forward look projections from water resource and flood risk practitioners, decision makers and contingency planners. These assessments are required to give appropriate lead in time to allow risk mitigation measures to be implemented to minimise impact upon people, the environment and infrastructure. This presentation will outline the methodologies developed by the Environment Agency to produce and publish monthly routine forward look projections using both a scenario and climate ensemble approach. It will cover how information is disseminated, providing a good example of communicating science to decision makers and to the public. Examples of practical applications of these methodologies include: • Risk based planning and forecasting of water availability for inter basin water transfers into water stressed catchments. • Assessment of water resources prospects during droughts for people and the environment • The likelihood and medium term risk of high groundwater levels impacting upon people and infrastructure. There are also a number of future challenges

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

    PubMed Central

    2013-01-01

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

  13. Periodicals collection management using a decision support system

    SciTech Connect

    Compton, M.L.; Moser, E.C.

    1993-12-31

    Sandia National Laboratories is a multiprogram national laboratory established in 1949. The Library currently uses DOBIS for its automated system, including the Periodicals Control function for periodical check-in. DOBIS performs processing and control functions adequately, but could not meet our reporting needs. Therefore the Library`s Periodicals Decision Team decided that they needed another ``system`` for collection management. A Periodicals Decision Support System was created using information downloaded from DOBIS and uploaded into dBASE IV. The Periodical Decision Support System functions as an information-processing system that has aided us in making collection management decisions for periodicals. It certainly allows us to do interactive ad-hoc analysis; although there are no modeling tools currently incorporated in the system. We hope that these modeling tools will come later. We have been gathering information and developing needed reports to achieve this goal.

  14. Using Visualization in Cockpit Decision Support Systems

    SciTech Connect

    Aragon, Cecilia R.

    2005-07-01

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

  15. Overdetection in breast cancer screening: development and preliminary evaluation of a decision aid

    PubMed Central

    Hersch, Jolyn; Jansen, Jesse; Barratt, Alexandra; Irwig, Les; Houssami, Nehmat; Jacklyn, Gemma; Thornton, Hazel; Dhillon, Haryana; McCaffery, Kirsten

    2014-01-01

    piloting of decision aids is recommended to further improve understanding of overdetection and support informed decision-making about screening. PMID:25256188

  16. Temporal pattern mining for multivariate clinical decision support.

    PubMed

    Saini, Sheetal; Dua, Sumeet

    2013-01-01

    Multivariate temporal data are collections of contiguous data values that reflect complex temporal changes over a given duration. Technological advances have resulted in significant amounts of such data in high-throughput disciplines, including EEG and iEEG data for effective and efficient healthcare informatics, and decision support. Most data analytics and data-mining algorithms are effective in capturing global trends, but fail to capture localized behavioral changes in large temporal data sets. We present a two-step algorithmic methodology to uncover temporal patterns and exploiting them for an efficient and accurate decision support system. This methodology aids the discovery of previously unknown, nontrivial, and potentially useful temporal patterns for enhanced patient-specific clinical decision support with high degrees of sensitivity and specificity. Classification results on multivariate time series iEEG data for epileptic seizure detection also demonstrate the efficacy and accuracy of the technique to uncover interesting and effective domain class-specific temporal patterns.

  17. Development and Evaluation of a Lung Cancer Screening Decision Aid.

    PubMed

    Hart, Katelyn; Tofthagen, Cindy; Wang, Hsiao-Lan

    2016-10-01

    Lung cancer is the second most common cancer; however, it often is not diagnosed until the advanced stages. Early-stage lung cancer is curable, but screening tools are not usually implemented in practice because of a lack of provider awareness. A lung cancer screening decision aid may increase screening use and, ultimately, reduce lung cancer deaths.
. PMID:27668377

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

    ERIC Educational Resources Information Center

    Chan, Siu Y.

    2001-01-01

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

  19. Isabel, a clinical decision support system.

    PubMed

    Vardell, Emily; Moore, Mary

    2011-01-01

    A clinical decision support system (CDSS) is an interactive tool designed to assist clinicians in making decisions, such as determining a diagnosis. The Isabel Database is a CDSS featuring a clinical checklist and topic-specific knowledge components. This column contains an overview of the database, provides searching tips, and places Isabel within the context of the CDSS field. PMID:21534115

  20. A Hyperknowledge Framework of Decision Support Systems.

    ERIC Educational Resources Information Center

    Chang, Ai-Mei; And Others

    1994-01-01

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

  1. Geospatial decision support systems for societal decision making

    USGS Publications Warehouse

    Bernknopf, R.L.

    2005-01-01

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

  2. A Decision Support System for Supervised Assignment in Banking Decisions

    NASA Astrophysics Data System (ADS)

    Rigopoulos, George; Psarras, John; Askounis, Dimitrios Th.

    This study presents a Decision Support System (DSS) which supports assignment of actions (e.g., numbers, projects, people etc.) into predefined categories according to their score on evaluation criteria. It implements a novel classification algorithm based on multicriteria analysis and fuzzy preference relations. More detailed, assignment to classes is based on the concept of category threshold, which defines at what degree an alternative can be included in a specific category. For each category a threshold is defined by the corresponding decision maker, which indicates its lower limit with respect to the evaluation criteria. Actions are then evaluated according to the criteria and fuzzy inclusion degrees are calculated for each category. Finally, an action is assigned to the category for which the inclusion degree is the maximum. The DSS implements the above classification algorithm, providing a user-friendly interface, which supports decision makers to formulate and solve similar problems. In addition to the DSS, we present a real world application at a classification problem within the environment of a Greek bank. Results derived from evaluation experiments in the business environment provide evidence that the proposed methodology and the DSS can effectively support decision makers in classification decisions. The methodology as well as the proposed DSS can be used to classification problems not only in financial domain but to a variety of domains such as production, environmental, or human resources.

  3. Group decision support using Toulmin argument structures

    SciTech Connect

    Janssen, T. |; Sage, A.P.

    1996-12-31

    This paper addresses the need for sound science, technology, and management assessment relative to environmental policy decision making through an approach that involves a logical structure for evidence, a framed decision-making process, and an environment that encourages group participation. Toulmin-based logic possesses these characteristics and is used as the basis for development of a group decision support system. This system can support several user groups, such as pesticide policy-making experts, who can use the support system to state arguments for or against an important policy issue, and pest management experts, who can use the system to assist in identifying and evaluating alternatives for controlling pests on agricultural commodities. The resulting decision support system assists in improving the clarity of the lines of reasoning used in specific situations; the warrants, grounds, and backings that are used to support claims and specific lines of reasoning; and the contradictions, rebuttals, and arguments surrounding each step in the reasoning process associated with evaluating a claim or counterclaim. Experts and decisions makers with differing views can better understand each other`s thought processes. The net effect is enhanced communications and understanding of the whole picture and, in many cases, consensus on decisions to be taken.

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

    PubMed

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

    2014-03-01

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

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

    PubMed

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

    2014-03-01

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

  6. Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids

    PubMed Central

    Donnelly, Kyla Z; Thompson, Rachel

    2015-01-01

    Introduction Currently, we lack understanding of the content, quality and impact of patient decision aids to support decision-making between medical and surgical methods of early abortion. We plan to undertake a systematic review of peer-reviewed literature to identify, appraise and describe the impact of early abortion method decision aids evaluated quantitatively (Part I), and an environmental scan to identify and appraise other early abortion method decision aids developed in the US (Part II). Methods and analysis For the systematic review, we will search PubMed, Cochrane Library, CINAHL, EMBASE and PsycINFO databases for articles describing experimental and observational studies evaluating the impact of an early abortion method decision aid on women's decision-making processes and outcomes. For the environmental scan, we will identify decision aids by supplementing the systematic review search with Internet-based searches and key informant consultation. The primary reviewer will assess all studies and decision aids for eligibility, and a second reviewer will also assess a subset of these. Both reviewers will independently assess risk of bias in the studies and abstract data using a piloted form. Finally, both reviewers will assess decision aid quality using the International Patient Decision Aid Standards criteria, ease of readability using Flesch/Flesch-Kincaid tests, and informational content using directed content analysis. Ethics and dissemination As this study does not involve human subjects, ethical approval will not be sought. We aim to disseminate the findings in a scientific journal, via academic and/or professional conferences and among the broader community to contribute knowledge about current early abortion method decision-making support. Trial registration number This protocol is registered in the International Prospective Register of Systematic Reviews (CRD42015016717). PMID:26173718

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

    NASA Astrophysics Data System (ADS)

    Strini, Robert A.; Strini, Keith

    2002-07-01

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

  8. Using Visualization in Cockpit Decision Support Systems

    NASA Technical Reports Server (NTRS)

    Aragon, Cecilia R.

    2005-01-01

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

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

    PubMed

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

    2007-01-01

    This article reports on the International Patient Decision Aid Standards Symposium held in 2006 at the annual meeting of the Society for Medical Decision Making in Cambridge, Massachusetts. The symposium featured a debate regarding the proposition that "decision aids are the best way to improve clinical decision making.'' The formal debate addressed the theoretical problem of the appropriate gold standard for an improved decision, efficacy of decision aids, and prospects for implementation. Audience comments and questions focused on both theory and practice: the often unacknowledged roots of decision aids in expected utility theory and the practical problems of limited patient decision aid implementation in health care. The participants' vote on the proposition was approximately half for and half against. PMID:17873257

  10. Bayesian Decision Support for Adaptive Lung Treatments

    NASA Astrophysics Data System (ADS)

    McShan, Daniel; Luo, Yi; Schipper, Matt; TenHaken, Randall

    2014-03-01

    Purpose: A Bayesian Decision Network will be demonstrated to provide clinical decision support for adaptive lung response-driven treatment management based on evidence that physiologic metrics may correlate better with individual patient response than traditional (population-based) dose and volume-based metrics. Further, there is evidence that information obtained during the course of radiation therapy may further improve response predictions. Methods: Clinical factors were gathered for 58 patients including planned mean lung dose, and the bio-markers IL-8 and TGF-β1 obtained prior to treatment and two weeks into treatment along with complication outcomes for these patients. A Bayesian Decision Network was constructed using Netica 5.0.2 from Norsys linking these clinical factors to obtain a prediction of radiation induced lung disese (RILD) complication. A decision node was added to the network to provide a plan adaption recommendation based on the trade-off between the RILD prediction and complexity of replanning. A utility node provides the weighting cost between the competing factors. Results: The decision node predictions were optimized against the data for the 58 cases. With this decision network solution, one can consider the decision result for a new patient with specific findings to obtain a recommendation to adaptively modify the originally planned treatment course. Conclusions: A Bayesian approach allows handling and propagating probabilistic data in a logical and principled manner. Decision networks provide the further ability to provide utility-based trade-offs, reflecting non-medical but practical cost/benefit analysis. The network demonstrated illustrates the basic concept, but many other factors may affect these decisions and work on building better models are being designed and tested. Acknowledgement: Supported by NIH-P01-CA59827

  11. Computerized Clinical Decision Support: Contributions from 2014

    PubMed Central

    Koutkias, V.

    2015-01-01

    Summary Objective To summarize recent research and propose a selection of best papers published in 2014 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 systems in order to select a list of candidate best papers to be then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the editorial team was finally organized to conclude on the selection of best papers. Results Among the 1,254 returned papers published in 2014, the full review process selected four best papers. The first one is an experimental contribution to a better understanding of unintended uses of CDSSs. The second paper describes the effective use of previously collected data to tailor and adapt a CDSS. The third paper presents an innovative application that uses pharmacogenomic information to support personalized medicine. The fourth paper reports on the long-term effect of the routine use of a CDSS for antibiotic therapy. Conclusions As health information technologies spread more and more meaningfully, CDSSs are improving to answer users’ needs more accurately. The exploitation of previously collected data and the use of genomic data for decision support has started to materialize. However, more work is still needed to address issues related to the correct usage of such technologies, and to assess their effective impact in the long term. PMID:26293858

  12. Assessment of Unconscious Decision Aids Applied to Complex Patient-Centered Medical Decisions

    PubMed Central

    Manigault, Andrew Wilhelm; Whillock, Summer Rain

    2015-01-01

    Background To improve patient health, recent research urges for medical decision aids that are designed to enhance the effectiveness of specific medically related decisions. Many such decisions involve complex information, and decision aids that independently use deliberative (analytical and slower) or intuitive (more affective and automatic) cognitive processes for such decisions result in suboptimal decisions. Unconscious thought can arguably use both intuitive and deliberative (slow and analytic) processes, and this combination may further benefit complex patient (or practitioner) decisions as medical decision aids. Indeed, mounting research demonstrates that individuals render better decisions generally if they are distracted from thinking consciously about complex information after it is presented (but can think unconsciously), relative to thinking about that information consciously or not at all. Objective The current research tested whether the benefits of unconscious thought processes can be replicated using an Internet platform for a patient medical decision involving complex information. This research also explored the possibility that judgments reported after a period of unconscious thought are actually the result of a short period of conscious deliberation occurring during the decision report phase. Methods A total of 173 participants in a Web-based experiment received information about four medical treatments, the best (worst) associated with mostly positive (negative) side-effects/attributes and the others with equal positive-negative ratios. Next, participants were either distracted for 3 minutes (unconscious thought), instructed to think about the information for 3 minutes (conscious thought), or moved directly to the decision task (immediate decision). Finally, participants reported their choice of, and attitudes toward, the treatments while experiencing high, low, or no cognitive load, which varied their ability to think consciously while

  13. Decision aids for advance care planning: an overview of the state of the science.

    PubMed

    Butler, Mary; Ratner, Edward; McCreedy, Ellen; Shippee, Nathan; Kane, Robert L

    2014-09-16

    Advance care planning honors patients' goals and preferences for future care by creating a plan for when illness or injury impedes the ability to think or communicate about health decisions. Fewer than 50% of severely or terminally ill patients have an advance directive in their medical record, and physicians are accurate only about 65% of the time when predicting patient preferences for intensive care. Decision aids can support the advance care planning process by providing a structured approach to informing patients about care options and prompting them to document and communicate their preferences. This review, commissioned as a technical brief by the Agency for Healthcare Research and Quality Effective Health Care Program, provides a broad overview of current use of and research related to decision aids for adult advance care planning. Using interviews of key informants and a search of the gray and published literature from January 1990 to May 2014, the authors found that many decision aids are widely available but are not assessed in the empirical literature. The 16 published studies testing decision aids as interventions for adult advance care planning found that most are proprietary or not publicly available. Some are constructed for the general population, whereas others address disease-specific conditions that have more predictable end-of-life scenarios and, therefore, more discrete choices. New decision aids should be designed that are responsive to diverse philosophical perspectives and flexible enough to change as patients gain experience with their personal illness courses. Future efforts should include further research, training of advance care planning facilitators, dissemination and access, and tapping potential opportunities in social media or other technologies. PMID:25069709

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

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

  15. Decision Support and Knowledge-Based Systems.

    ERIC Educational Resources Information Center

    Konsynski, Benn R.; And Others

    1988-01-01

    A series of articles addresses issues concerning decision support and knowledge based systems. Topics covered include knowledge-based systems for information centers; object oriented systems; strategic information systems case studies; user perception; manipulation of certainty factors by individuals and expert systems; spreadsheet program use;…

  16. Modeling uncertainty in requirements engineering decision support

    NASA Technical Reports Server (NTRS)

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

    2005-01-01

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

  17. Decision support system for nursing management control

    SciTech Connect

    Ernst, C.J.

    1983-01-01

    A knowledge representation approach for expert systems supporting decision processes in business is proposed. A description of a knowledge representation schema using a logic programming metalanguage is described, then the role of such a schema in a management expert system is demonstrated through the problem of nursing management control in hospitals. 18 references.

  18. Decision Support Systems in Academic Administration.

    ERIC Educational Resources Information Center

    Turban, Efraim; And Others

    1988-01-01

    Presents an overview of a computerized Decision Support System (DSS) for academic administrators. Following a discussion of its capabilities, the various components of a DSS are examined as well as the development tools needed. Examples follow of DSS in two universities, and various development and implementation issues are considered. (TE)

  19. Transferring Decision Support Concepts to Evaluation.

    ERIC Educational Resources Information Center

    Sauter, Vicki L.; Mandell, Marvin B.

    1990-01-01

    Use of decision support systems (DSS) to increase the utilization of management science models and accounting information is discussed. It is argued that application of the conceptual foundations of DSS to evaluation and other forms of applied social research is an effective means of increasing evaluation utilization by policymakers. (TJH)

  20. What can Natural Language Processing do for Clinical Decision Support?

    PubMed Central

    Demner-Fushman, Dina; Chapman, Wendy W.; McDonald, Clement J.

    2009-01-01

    Computerized Clinical Decision Support (CDS) aims to aid decision making of health care providers and the public by providing easily accessible health-related information at the point and time it is needed. Natural Language Processing (NLP) is instrumental in using free-text information to drive CDS, representing clinical knowledge and CDS interventions in standardized formats, and leveraging clinical narrative. The early innovative NLP research of clinical narrative was followed by a period of stable research conducted at the major clinical centers and a shift of mainstream interest to biomedical NLP. This review primarily focuses on the recently renewed interest in development of fundamental NLP methods and advances in the NLP systems for CDS. The current solutions to challenges posed by distinct sublanguages, intended user groups, and support goals are discussed. PMID:19683066

  1. A Flight Deck Decision Support Tool for Autonomous Airborne Operations

    NASA Technical Reports Server (NTRS)

    Ballin, Mark G.; Sharma, Vivek; Vivona, Robert A.; Johnson, Edward J.; Ramiscal, Ermin

    2002-01-01

    NASA is developing a flight deck decision support tool to support research into autonomous operations in a future distributed air/ground traffic management environment. This interactive real-time decision aid, referred to as the Autonomous Operations Planner (AOP), will enable the flight crew to plan autonomously in the presence of dense traffic and complex flight management constraints. In assisting the flight crew, the AOP accounts for traffic flow management and airspace constraints, schedule requirements, weather hazards, aircraft operational limits, and crew or airline flight-planning goals. This paper describes the AOP and presents an overview of functional and implementation design considerations required for its development. Required AOP functionality is described, its application in autonomous operations research is discussed, and a prototype software architecture for the AOP is presented.

  2. In search of tools to aid logical thinking and communicating about medical decision making.

    PubMed

    Hunink, M G

    2001-01-01

    To have real-time impact on medical decision making, decision analysts need a wide variety of tools to aid logical thinking and communication. Decision models provide a formal framework to integrate evidence and values, but they are commonly perceived as complex and difficult to understand by those unfamiliar with the methods, especially in the context of clinical decision making. The theory of constraints, introduced by Eliyahu Goldratt in the business world, provides a set of tools for logical thinking and communication that could potentially be useful in medical decision making. The author used the concept of a conflict resolution diagram to analyze the decision to perform carotid endarterectomy prior to coronary artery bypass grafting in a patient with both symptomatic coronary and asymptomatic carotid artery disease. The method enabled clinicians to visualize and analyze the issues, identify and discuss the underlying assumptions, search for the best available evidence, and use the evidence to make a well-founded decision. The method also facilitated communication among those involved in the care of the patient. Techniques from fields other than decision analysis can potentially expand the repertoire of tools available to support medical decision making and to facilitate communication in decision consults.

  3. A Multiple Objective Decision Support Tool (MODS)

    2003-12-14

    The Multiple Objective Decision Support (MODS) tool is an automated tool used to assist decision makers and policy analysts with multiple-objective decision problems. The classes of problems that this decision support tool addresses have both multiple objectives and multiple stakeholders. Decision problems, which have multiple objectives that in general cannot be maximized simultaneously, and multiple stakeholders, who have different perspectives about the relative importance of the objectives, require analytic approaches and tools that can providemore » flexible support to decision makers. This tool provides capabilities for the management, analysis, and graphical display for these types of decision problems drawn from diverse problem domains. The MODS tool is a unique integration of analysis algorithms, an information database, and a graphical user interface. This collection of algorithms, the combination of an information database with the analysis into a single tool, and the graphical user interface provides a technically advanced tool to decision makers and policy analysts. There are two main issues when addressing problems of this type: what set of attributes should be used to characterize the tokens in the domain of interest, and how should the values of these attributes and their weights be determined and combined to provide a relative ordering to the tokens. This tool addresses both of these issues. This decision support tool provides a flexible way to derive and use a chosen set of attributes. For example, the tool could be used to first perform a paired comparison of a large set of attributes and from this evaluation select those attributes that have the highest weights. The flexibility of the tool allows experimentation with various attribute sets and this capability, along with domain expertise, addresses the first issue. To address the second issue, several algorithms have been implemented. For example, two algorithms that have been implemented are

  4. The conceptual foundation of environmental decision support.

    PubMed

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

    2015-05-01

    Environmental decision support intends to use the best available scientific knowledge to help decision makers find and evaluate management alternatives. The goal of this process is to achieve the best fulfillment of societal objectives. This requires a careful analysis of (i) how scientific knowledge can be represented and quantified, (ii) how societal preferences can be described and elicited, and (iii) how these concepts can best be used to support communication with authorities, politicians, and the public in environmental management. The goal of this paper is to discuss key requirements for a conceptual framework to address these issues and to suggest how these can best be met. We argue that a combination of probability theory and scenario planning with multi-attribute utility theory fulfills these requirements, and discuss adaptations and extensions of these theories to improve their application for supporting environmental decision making. With respect to (i) we suggest the use of intersubjective probabilities, if required extended to imprecise probabilities, to describe the current state of scientific knowledge. To address (ii), we emphasize the importance of value functions, in addition to utilities, to support decisions under risk. We discuss the need for testing "non-standard" value aggregation techniques, the usefulness of flexibility of value functions regarding attribute data availability, the elicitation of value functions for sub-objectives from experts, and the consideration of uncertainty in value and utility elicitation. With respect to (iii), we outline a well-structured procedure for transparent environmental decision support that is based on a clear separation of scientific prediction and societal valuation. We illustrate aspects of the suggested methodology by its application to river management in general and with a small, didactical case study on spatial river rehabilitation prioritization. PMID:25748599

  5. The conceptual foundation of environmental decision support.

    PubMed

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

    2015-05-01

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

  6. Application of expert systems in project management decision aiding

    NASA Technical Reports Server (NTRS)

    Harris, Regina; Shaffer, Steven; Stokes, James; Goldstein, David

    1987-01-01

    The feasibility of developing an expert systems-based project management decision aid to enhance the performance of NASA project managers was assessed. The research effort included extensive literature reviews in the areas of project management, project management decision aiding, expert systems technology, and human-computer interface engineering. Literature reviews were augmented by focused interviews with NASA managers. Time estimation for project scheduling was identified as the target activity for decision augmentation, and a design was developed for an Integrated NASA System for Intelligent Time Estimation (INSITE). The proposed INSITE design was judged feasible with a low level of risk. A partial proof-of-concept experiment was performed and was successful. Specific conclusions drawn from the research and analyses are included. The INSITE concept is potentially applicable in any management sphere, commercial or government, where time estimation is required for project scheduling. As project scheduling is a nearly universal management activity, the range of possibilities is considerable. The INSITE concept also holds potential for enhancing other management tasks, especially in areas such as cost estimation, where estimation-by-analogy is already a proven method.

  7. Decision support for patient care: implementing cybernetics.

    PubMed

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

    2004-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  9. Decision support tools for policy and planning

    SciTech Connect

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

    1995-07-01

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

  10. Decision Support for Operations and Maintenance IV

    SciTech Connect

    2011-12-22

    DSOM (Decision Support for Operations and Maintenance) is an expert operations and maintenance system that integrates plant operations, fuel management, and maintenance processes. The DSOM package provides operators with the information they need for cost-effective operating decisions creating savings in fuel, personnel, maintenance, and plant life extension. DSOM provides operators real-time system performance information to allow them to determine if the plant is malfunctioning or running below expectations. By catching potential problems, DSOM enables plants to operate safely at peak efficiency, while providing a higher level of reliability and safety.

  11. Decision Support for Operations and Maintenance IV

    2011-12-22

    DSOM (Decision Support for Operations and Maintenance) is an expert operations and maintenance system that integrates plant operations, fuel management, and maintenance processes. The DSOM package provides operators with the information they need for cost-effective operating decisions creating savings in fuel, personnel, maintenance, and plant life extension. DSOM provides operators real-time system performance information to allow them to determine if the plant is malfunctioning or running below expectations. By catching potential problems, DSOM enables plantsmore » to operate safely at peak efficiency, while providing a higher level of reliability and safety.« less

  12. Decision Support Systems: Applications in Statistics and Hypothesis Testing.

    ERIC Educational Resources Information Center

    Olsen, Christopher R.; Bozeman, William C.

    1988-01-01

    Discussion of the selection of appropriate statistical procedures by educators highlights a study conducted to investigate the effectiveness of decision aids in facilitating the use of appropriate statistics. Experimental groups and a control group using a printed flow chart, a computer-based decision aid, and a standard text are described. (11…

  13. Assessing Sustainability of Coral Reef Ecosystem Services using a Spatially-Explicit Decision Support Tool

    EPA Science Inventory

    Forecasting and communicating the potential outcomes of decision options requires support tools that aid in evaluating alternative scenarios in a user-friendly context and that highlight variables relevant to the decision options and valuable stakeholders. Envision is a GIS-base...

  14. Decision Aids for Airborne Intercept Operations in Advanced Aircrafts

    NASA Technical Reports Server (NTRS)

    Madni, A.; Freedy, A.

    1981-01-01

    A tactical decision aid (TDA) for the F-14 aircrew, i.e., the naval flight officer and pilot, in conducting a multitarget attack during the performance of a Combat Air Patrol (CAP) role is presented. The TDA employs hierarchical multiattribute utility models for characterizing mission objectives in operationally measurable terms, rule based AI-models for tactical posture selection, and fast time simulation for maneuver consequence prediction. The TDA makes aspect maneuver recommendations, selects and displays the optimum mission posture, evaluates attackable and potentially attackable subsets, and recommends the 'best' attackable subset along with the required course perturbation.

  15. Shared Decision Making and Patient Decision Aids: Knowledge, Attitudes, and Practices Among Hawai‘i Physicians

    PubMed Central

    Friend, John; Chun, Maria BJ

    2013-01-01

    Background: As the health care field moves toward patient-centered care (PCC), increasing emphasis has been placed on the benefits of patient decision aids for promoting shared decision making (SDM). This study provides a baseline measure of knowledge, attitudes, and practices (KAP) among Hawai‘i's physicians with respect to patient decision aids (DAs). Physicians throughout the State of Hawai‘i were invited to complete a survey assessing their knowledge, attitudes, and practices with respect to the clinical use of DAs. One hundred and seventy four valid surveys were analyzed. Reported awareness and use of DAs were low, but recognition of the benefits of SDM and openness to the use of DAs were very high. The leading perceived barriers to the implementation of DAs were lack of awareness, lack of resources, and limited physician time to learn about DA technology. However, a significant majority of the respondents reported that DAs could empower patients by improving knowledge (88%), increasing satisfaction with the consultation process (81%), and increasing compliance (74%). Among physicians currently employing DAs, use of brochures or options matrix sheets was the most common aid tool. However, leading recommended DA formats were paper-based brochures for clinic use (75%) and interactive online website programs for outside clinic use (73.5%). Given growing emphasis on the PCC model and the recognized desire of many patients to participate in the medical decision making process, positive responses toward SDM and the use of DAs by Hawai‘i physicians are promising. PMID:24251086

  16. A systematic review of decision aids for patients making a decision about treatment for early breast cancer.

    PubMed

    Nicholas Zdenkowski; Butow, Phyllis; Tesson, Stephanie; Boyle, Frances

    2016-04-01

    Several complex treatment decisions may be offered to women with early stage breast cancer, about a range of treatments from different modalities including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids can facilitate shared decision-making and improve decision-related outcomes. We aimed to systematically identify, describe and appraise the literature on treatment decision aids for women with early breast cancer, synthesise the data and identify breast cancer decisions that lack a decision aid. A prospectively developed search strategy was applied to MEDLINE, the Cochrane databases, EMBASE, PsycINFO, Web of Science and abstract databases from major conferences. Data were extracted into a pre-piloted form. Quality and risk of bias were measured using Qualsyst criteria. Results were synthesised into narrative format. Thirty-three eligible articles were identified, evaluating 23 individual treatment decision aids, comprising 13 randomised controlled trial reports, seven non-randomised comparative studies, eight single-arm pre-post studies and five cross-sectional studies. The decisions addressed by these decision aids were: breast conserving surgery versus mastectomy (+/- reconstruction); use of chemotherapy and/or endocrine therapy; radiotherapy; and fertility preservation. Outcome measures were heterogeneous, precluding meta-analysis. Decisional conflict decreased, and knowledge and satisfaction increased, without any change in anxiety or depression, in most studies. No studies were identified that evaluated decision aids for neoadjuvant systemic therapy, or contralateral prophylactic mastectomy. Decision aids are available and improved decision-related outcomes for many breast cancer treatment decisions including surgery, radiotherapy, and endocrine and chemotherapy. Decision aids for neoadjuvant systemic therapy and contralateral prophylactic mastectomy could not be found, and may be warranted.

  17. Adoption and sustainability of decision support for patients facing health decisions: an implementation case study in nursing

    PubMed Central

    Stacey, Dawn; Pomey, Marie-Pascale; O'Connor, Annette M; Graham, Ian D

    2006-01-01

    Background Effective interventions prepare patients for making values-sensitive health decisions by helping them become informed and clarifying their values for each of the options. However, patient decision support interventions have not been widely implemented and little is known about effective models for delivering them to patients. The purpose of this study was to describe call centre nurses' adoption of a decision support protocol into practice following exposure to an implementation intervention and to identify factors influencing sustainable nursing practice changes. Methods Exploratory case study at a Canadian province-wide call centre guided by the Ottawa Model of Research Use. Data sources included a survey of nurses who participated in an implementation intervention (n = 31), 2 focus groups with nurses, interviews with 4 administrators, and a document review. Results Twenty-five of 31 nurses responded to the survey measuring adoption of decision support in practice. Of the 25 nurses, 11 had used the decision support protocol in their practice within one month of the intervention. Twenty-two of the 25 intended to use it within the next three months. Although some nurses found it challenging to begin using the protocol, most nurses reported that it: a) helped them recognize callers needing decision support; b) changed their approach to handling these calls; and c) was a positive enhancement to their practice. Strategies identified to promote sustainability of practice changes included integration of the decision support protocol in the call centre database, streamlining the patient decision aids for easier use via telephone, clarifying the administrative direction for the call centre's program, creating a call length guideline specific for these calls, incorporating decision support training in the staff development plan, and informing the public of this enhanced service. Conclusion Although most nurses adopted the decision support protocol for coaching

  18. Patient Decision Aids: A Case for Certification at the National Level in the United States.

    PubMed

    Poddar, Urbashi; Brownlee, Shannon; Stacey, Dawn; Volk, Robert J; Williams, John W; Elwyn, Glyn

    2015-01-01

    Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance-primarily as a quality measure that increases patients' safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in decision aids. Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient's decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved.

  19. From hydrological modelling to decision support

    NASA Astrophysics Data System (ADS)

    Haberlandt, U.

    2010-08-01

    Decision support for planning and management of water resources needs to consider many target criteria simultaneously like water availability, water quality, flood protection, agriculture, ecology, etc. Hydrologic models provide information about the water balance components and are fundamental for the simulation of ecological processes. Objective of this contribution is to discuss the suitability of classical hydrologic models on one hand and of complex eco-hydrologic models on the other hand to be used as part of decision support systems. The discussion is based on results from two model comparison studies. It becomes clear that none of the hydrologic models tested fulfils all requirements in an optimal sense. Regarding the simulation of water quality parameters like nitrogen leaching a high uncertainty needs to be considered. Recommended for decision support is a hybrid metamodel approach, which comprises a hydrologic model, empirical relationships for the less dynamic processes and makes use of simulation results from complex eco-hydrologic models through second-order modelling at a generalized level.

  20. A Conceptual Design of a Departure Planner Decision Aid

    NASA Technical Reports Server (NTRS)

    Anagnostakis, Ioannis; Idris, Husni R.; Clark, John-Paul; Feron, Eric; Hansman, R. John; Odoni, Amedeo R.; Hall, William D.

    2000-01-01

    Terminal area Air Traffic Management handles both arriving and departing traffic. To date, research work on terminal area operations has focused primarily on the arrival flow and typically departures are taken into account only in an approximate manner. However, arrivals and departures are highly coupled processes especially in the terminal airspace, with complex interactions and sharing of the same airport resources between arrivals and departures taking place in practically every important terminal area. Therefore, the addition of automation aids for departures, possibly in co-operation with existing arrival flow automation systems, could have a profound contribution in enhancing the overall efficiency of airport operations. This paper presents the conceptual system architecture for such an automation aid, the Departure Planner (DP). This architecture can be used as a core in the development of decision-aiding systems to assist air traffic controllers in improving the performance of departure operations and optimize runway time allocation among different operations at major congested airports. The design of such systems is expected to increase the overall efficiency of terminal area operations and yield benefits for all stakeholders involved in Air Traffic Management (ATM) operations, users as well as service providers.

  1. Toward image analysis and decision support for ultrasound technology.

    PubMed

    Crofts, Gillian; Padman, Rema; Maharaja, Nisha

    2013-01-01

    Ultrasound is a low cost and efficient method of detecting diseases and abnormalities in the body. Yet there is a lack of precision and reliability associated with the technology, partly due to the operator dependent nature of ultrasound scanning. When scanning is performed to an agreed protocol, ultrasound has been shown to be highly reliable. This research aims to minimize these limitations that arise during ultrasound training, scanning and reporting by developing and evaluating an image analysis and decision support system that can aid the decision making process. We hypothesize that this intervention will likely increase the role of ultrasound in diagnosis when compared with other imaging technologies, particularly in low resource settings. PMID:23920862

  2. Decision support system for drinking water management

    NASA Astrophysics Data System (ADS)

    Janža, M.

    2012-04-01

    The problems in drinking water management are complex and often solutions must be reached under strict time constrains. This is especially distinct in case of environmental accidents in the catchment areas of the wells that are used for drinking water supply. The beneficial tools that can help decision makers and make program of activities more efficient are decision support systems (DSS). In general they are defined as computer-based support systems that help decision makers utilize data and models to solve unstructured problems. The presented DSS was developed in the frame of INCOME project which is focused on the long-term stable and safe drinking water supply in Ljubljana. The two main water resources Ljubljana polje and Barje alluvial aquifers are characterized by a strong interconnection of surface and groundwater, high vulnerability, high velocities of groundwater flow and pollutant transport. In case of sudden pollution, reactions should be very fast to avoid serious impact to the water supply. In the area high pressures arising from urbanization, industry, traffic, agriculture and old environmental burdens. The aim of the developed DSS is to optimize the activities in cases of emergency water management and to optimize the administrative work regarding the activities that can improve groundwater quality status. The DSS is an interactive computer system that utilizes data base, hydrological modelling, and experts' and stakeholders' knowledge. It consists of three components, tackling the different abovementioned issues in water management. The first one utilizes the work on identification, cleaning up and restoration of illegal dumpsites that are a serious threat to the qualitative status of groundwater. The other two components utilize the predictive capability of the hydrological model and scenario analysis. The user interacts with the system by a graphical interface that guides the user step-by-step to the recommended remedial measures. Consequently, the

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

    PubMed

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

    2015-05-01

    Costs are an important component of patients' decision making, but a comparatively underemphasized aspect of formal shared decision making. We hypothesized that decision aids also avoid discussion of costs, despite their being tools designed to facilitate shared decision making about patient-centered outcomes. We sought to define the frequency of cost-related information and identify the common modes of presenting cost and cost-related information in the 290 decision aids catalogued in the Ottawa Hospital Research Institute's Decision Aid Library Inventory (DALI) system. We found that 56% (n = 161) of the decision aids mentioned cost in some way, but only 13% (n = 37) gave a specific price or range of prices. We identified 9 different ways in which cost was mentioned. The most common approach was as a "pro" of one of the treatment options (e.g., "you avoid the cost of medication"). Of the 37 decision aids that gave specific prices or ranges of prices for treatment options, only 2 were about surgery decisions despite the fact that surgery decision aids were the most common. Our findings suggest that presentation of cost information in decision aids is highly variable. Evidence-based guidelines should be developed by the International Patient Decision Aid Standards (IPDAS) Collaboration. PMID:25583552

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

    PubMed

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

    2015-05-01

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

  5. Web Support System for Group Collaborative Decisions

    NASA Astrophysics Data System (ADS)

    Rigopoulos, George; Psarras, John; Askounis, Dimitrios Th.

    In this research, we present a Group Decision Support System (GDSS) based on web technology, which can be used in asynchronous mode from group members. It supports small collaborative groups in classification decisions, implementing a supervised multicriteria methodology. A facilitator, who defines necessary parameters and initiates the procedure, coordinates the entire operation. Next, members evaluate the proposed parameter set and express their preferences in numeric format. Aggregation of individuals` preferences is executed at the parameter level by utilization of OWA operator and a group parameter set is produced which is used as input for the classification algorithm. A multicriteria classification algorithm is used for the classification of actions (people, projects etc.). Finally, group members evaluate results and consensus as well as satisfaction indexes are calculated. In case of low acceptance level, parameters are redefined and aggregation phase is repeated. The system has been utilized effectively to solve group classification problems in business environment. The overall architecture as well the methodology is presented, along with a sample application. Empirical findings from GDSS application and the methodology provide evidence that it is a valid approach for similar decision problems in numerous business environments, including production, human resources and operations.

  6. Apply creative thinking of decision support in electrical nursing record.

    PubMed

    Hao, Angelica Te-Hui; Hsu, Chien-Yeh; Li-Fang, Huang; Jian, Wen-Shan; Wu, Li-Bin; Kao, Ching-Chiu; Lu, Mei-Show; Chang, Her-Kung

    2006-01-01

    The nursing process consists of five interrelated steps: assessment, diagnosis, planning, intervention, and evaluation. In the nursing process, the nurse collects a great deal of data and information. The amount of data and information may exceed the amount the nurse can process efficiently and correctly. Thus, the nurse needs assistance to become proficient in the planning of nursing care, due to the difficulty of simultaneously processing a large set of information. Computer systems are viewed as tools to expand the capabilities of the nurse's mind. Using computer technology to support clinicians' decision making may provide high-quality, patient-centered, and efficient healthcare. Although some existing nursing information systems aid in the nursing process, they only provide the most fundamental decision support--i.e., standard care plans associated with common nursing diagnoses. Such a computerized decision support system helps the nurse develop a care plan step-by-step. But it does not assist the nurse in the decision-making process. The decision process about how to generate nursing diagnoses from data and how to individualize the care plans still reminds of the nurse. The purpose of this study is to develop a pilot structure in electronic nursing record system integrated with international nursing standard for improving the proficiency and accuracy of plan of care in clinical pathway process. The proposed pilot systems not only assist both student nurses and nurses who are novice in nursing practice, but also experts who need to work in a practice area which they are not familiar with.

  7. A systematic development process for patient decision aids

    PubMed Central

    2013-01-01

    Background The original version of the International Patient Decision Aid Standards (IPDAS) recommended that patient decision aids (PtDAs) should be carefully developed, user-tested and open to scrutiny, with a well-documented and systematically applied development process. We carried out a review to check the relevance and scope of this quality dimension and, if necessary, to update it. Methods Our review drew on three sources: a) published papers describing PtDAs evaluated in randomised controlled trials and included in the most recent Cochrane Collaboration review; b) linked papers cited in the trial reports that described how the PtDAs had been developed; and c) papers and web reports outlining the development process used by organisations experienced in developing multiple PtDAs. We then developed an extended model of the development process indicating the various steps on which documentation is required, as well as a checklist to assess the frequency with which each of the elements was publicly reported. Results Key features common to all patient decision aid (PtDA) development processes include: scoping and design; development of a prototype; ‘alpha’ testing with patients and clinicians in an iterative process; ‘beta’ testing in ‘real life’ conditions (field tests); and production of a final version for use and/or further evaluation. Only about half of the published reports on the development of PtDAs that we reviewed appear to have been field tested with patients, and even fewer had been reviewed or tested by clinicians not involved in the development process. Very few described a distribution strategy, and surprisingly few (17%) described a method for reviewing and synthesizing the clinical evidence. We describe a model development process that includes all the original elements of the original IPDAS criterion, expanded to include consideration of format and distribution plans as well as prototype development. Conclusions The case for including

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

    NASA Technical Reports Server (NTRS)

    1998-01-01

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

  9. IPDS: Integrated Planning Decision Support System

    SciTech Connect

    Mejia-Navarro, M.; Garcia, L.A.

    1995-12-31

    The Integrated Planning Decision Support System (IPDS) is designed as a decision support system (DSS) to assist governments and communities in evaluation of geological hazards, vulnerability, and risk. The IPDS system incorporates the Geographic Information Systems (GIS) Geographic Resource Analysis Support System (GRASS) and engineering numerical models within a Graphic User Interface (GUI), to provide the user with comprehensive modelling capabilities for geological hazards, vulnerability, and risk assessment. The methodology that IPDS follows for the evaluation of hazards takes into account the weight of each influencing factor within hazardous geologic processes. IPDS interactive algorithms compute the following parameters for each cell (based on the maximum resolution of the data): the related hazard, the vulnerability to geological hazards, and the risk. IPDS is designed to assess any generic hazard, such as debris flows, subsidence, and floods, with probable maximum precipitation and seismicity as triggering factors for susceptibility scenarios. The regular items considered in vulnerability analysis are (1) ecosystem sensitivity, (2) economic vulnerability, and (3) social infrastructure vulnerability. The risk is assessed as a function of hazard and vulnerability.

  10. Computational Support for Technology- Investment Decisions

    NASA Technical Reports Server (NTRS)

    Adumitroaie, Virgil; Hua, Hook; Lincoln, William; Block, Gary; Mrozinski, Joseph; Shelton, Kacie; Weisbin, Charles; Elfes, Alberto; Smith, Jeffrey

    2007-01-01

    Strategic Assessment of Risk and Technology (START) is a user-friendly computer program that assists human managers in making decisions regarding research-and-development investment portfolios in the presence of uncertainties and of non-technological constraints that include budgetary and time limits, restrictions related to infrastructure, and programmatic and institutional priorities. START facilitates quantitative analysis of technologies, capabilities, missions, scenarios and programs, and thereby enables the selection and scheduling of value-optimal development efforts. START incorporates features that, variously, perform or support a unique combination of functions, most of which are not systematically performed or supported by prior decision- support software. These functions include the following: Optimal portfolio selection using an expected-utility-based assessment of capabilities and technologies; Temporal investment recommendations; Distinctions between enhancing and enabling capabilities; Analysis of partial funding for enhancing capabilities; and Sensitivity and uncertainty analysis. START can run on almost any computing hardware, within Linux and related operating systems that include Mac OS X versions 10.3 and later, and can run in Windows under the Cygwin environment. START can be distributed in binary code form. START calls, as external libraries, several open-source software packages. Output is in Excel (.xls) file format.

  11. An overview and discussion of the Patient-Centered Outcomes Research Institute's decision aid portfolio.

    PubMed

    Gayer, Christopher C; Crowley, Matthew J; Lawrence, William F; Gierisch, Jennifer M; Gaglio, Bridget; Williams, John W; Myers, Evan R; Kendrick, Amy; Slutsky, Jean; Sanders, Gillian D

    2016-07-01

    Decision aids (DAs) help patients make informed healthcare decisions in a manner consistent with their values and preferences. Despite their promise, DAs developed with public research dollars are not being implemented and adopted in real-world patient care settings at a rate consistent with which they are being developed. To appraise the sum of the parts of the portfolio and create a strategic imperative surrounding future funding, the Patient-Centered Outcomes Research Institute (PCORI) tasked the Duke Evidence Synthesis Group with evaluating its DA portfolio. This paper describes PCORI's portfolio of DAs according to the Duke Evidence Synthesis Group's analysis in the context of PCORI's mission and the field of decision science. The results revealed a diversity within PCORI's portfolio of funded DA projects. Findings support the movement toward more rigorous DA development, assessment and maintenance. PCORI's funding priorities related to DAs are clarified and comparative questions of interest are posed. PMID:27298206

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

    EPA Science Inventory

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

  13. Sediment Analysis Network for Decision Support (SANDS)

    NASA Astrophysics Data System (ADS)

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

    2009-12-01

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

  14. Flood Impact Modelling to support decision making

    NASA Astrophysics Data System (ADS)

    Owen, Gareth; Quinn, Paul; O'Donnell, Greg

    2015-04-01

    Much of what is known about the impacts of landuse change and Natural Flood Management (NFM) is at the local/plot scale. Evidence of the downstream impacts at the larger catchment scale is limited. However, the strategic and financial decisions of land managers, stakeholders and policy makers are made at the larger scale. There are a number of techniques that have the potential to scale local impacts to the catchment scale. This poster will show findings for the 30km2 Leven catchment, North Yorkshire, England. A NFM approach has been adopted by the Environment Agency to reduce flood risk within the catchment. A dense network of stream level gauges were installed in the catchment at the commencement of this project to gain a detailed understanding of the catchment behaviour during storm events. A novel Flood Impact Modelling (FIM) approach has been adopted which uses the network of gauges to disaggregate the outlet hydrograph in terms of source locations. Using a combination of expert opinion and local evidence, the model can be used to assess the impacts of distributed changes in land use management and NFM on flood events. A number of potential future landuse and NFM scenarios have been modelled to investigate their impact on flood peaks. These modelled outcomes are mapped to a simple Decision Support Matrix (DSM). The DSM encourages end users (e.g. land managers and policy makers) to develop an NFM scheme by studying the degree to which local runoff can be attenuated and how that flow will propagate through the network to the point of impact. The DSM relates the impact on flood peaks in terms of alterations to soil management practices and landscape flow connectivity (e.g. soil underdrainage), which can be easily understood by farmers and land managers. The DSM and the FIM together provide a simple to use and transparent modelling tool, making best use of expert knowledge, to support decision making.

  15. An Advanced Decision Support Tool for Electricity Infrastructure Operations

    SciTech Connect

    Chen, Yousu; Huang, Zhenyu; Wong, Pak C.; Mackey, Patrick S.; Allwardt, Craig H.; Ma, Jian; Greitzer, Frank L.

    2010-01-31

    Electricity infrastructure, as one of the most critical infrastructures in the U.S., plays an important role in modern societies. Its failure would lead to significant disruption of people’s lives, industry and commercial activities, and result in massive economic losses. Reliable operation of electricity infrastructure is an extremely challenging task because human operators need to consider thousands of possible configurations in near real-time to choose the best option and operate the network effectively. In today’s practice, electricity infrastructure operation is largely based on operators’ experience with very limited real-time decision support, resulting in inadequate management of complex predictions and the inability to anticipate, recognize, and respond to situations caused by human errors, natural disasters, or cyber attacks. Therefore, a systematic approach is needed to manage the complex operational paradigms and choose the best option in a near-real-time manner. This paper proposes an advanced decision support tool for electricity infrastructure operations. The tool has the functions of turning large amount of data into actionable information to help operators monitor power grid status in real time; performing trend analysis to indentify system trend at the regional level or system level to help the operator to foresee and discern emergencies, studying clustering analysis to assist operators to identify the relationships between system configurations and affected assets, and interactively evaluating the alternative remedial actions to aid operators to make effective and timely decisions. This tool can provide significant decision support on electricity infrastructure operations and lead to better reliability in power grids. This paper presents examples with actual electricity infrastructure data to demonstrate the capability of this tool.

  16. [A computer-aided design assessment system for recovery life support technology options].

    PubMed

    Chen, J; Wang, F; Sun, J; Shang, C

    1997-04-01

    A specific computer-aided decision support system was designed and implemented for design computation and decision assessment of environmental control and life support system of manned space station. An advanced multiobjective decision methodology and a hierarchic structure model of assessment index of recovery life support system was developed. The program incorporates a database for each technology option, metabolic design loads associated with crew activity, mission model variables to accommodate evolving mission requirements, and algorithms to produce products criteria in order to provide recommendations relative to candidate technology selection and development. A specific structure was developed for the decision system which consists of a database, a methodology base and a model base as well as their management systems. Moreover, a centre control system with friendly user interface plays a very important role in the man-computer interaction.

  17. 12 CFR 1290.4 - Decision on community support statements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Decision on community support statements. 1290... COMMUNITY SUPPORT REQUIREMENTS § 1290.4 Decision on community support statements. (a) Action on community support statements. FHFA will act on each community support statement in accordance with the...

  18. Decision Support for Emergency Operations Centers

    NASA Technical Reports Server (NTRS)

    Harvey, Craig; Lawhead, Joel; Watts, Zack

    2005-01-01

    The Flood Disaster Mitigation Decision Support System (DSS) is a computerized information system that allows regional emergency-operations government officials to make decisions regarding the dispatch of resources in response to flooding. The DSS implements a real-time model of inundation utilizing recently acquired lidar elevation data as well as real-time data from flood gauges, and other instruments within and upstream of an area that is or could become flooded. The DSS information is updated as new data become available. The model generates realtime maps of flooded areas and predicts flood crests at specified locations. The inundation maps are overlaid with information on population densities, property values, hazardous materials, evacuation routes, official contact information, and other information needed for emergency response. The program maintains a database and a Web portal through which real-time data from instrumentation are gathered into the database. Also included in the database is a geographic information system, from which the program obtains the overlay data for areas of interest as needed. The portal makes some portions of the database accessible to the public. Access to other portions of the database is restricted to government officials according to various levels of authorization. The Flood Disaster Mitigation DSS has been integrated into a larger DSS named REACT (Real-time Emergency Action Coordination Tool), which also provides emergency operations managers with data for any type of impact area such as floods, fires, bomb

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

    NASA Technical Reports Server (NTRS)

    Elgin, Peter D.; Thomas, Rickey P.

    2004-01-01

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

  20. Semantic technologies in a decision support system

    NASA Astrophysics Data System (ADS)

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

    2015-10-01

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

  1. Computerised clinical decision support for suspected PE.

    PubMed

    Jiménez, David; Resano, Santiago; Otero, Remedios; Jurkojc, Carolina; Portillo, Ana Karina; Ruiz-Artacho, Pedro; Corres, Jesús; Vicente, Agustina; den Exter, Paul L; Huisman, Menno V; Moores, Lisa; Yusen, Roger D

    2015-09-01

    This study aimed to determine the effect of an evidence-based clinical decision support (CDS) algorithm on the use and yield of CT pulmonary angiography (CTPA) and on outcomes of patients evaluated in the emergency department (ED) for suspected PE. The study included 1363 consecutive patients evaluated for suspected PE in an ED during 12 months before and 12 months after initiation of CDS use. Introduction of CDS was associated with decreased CTPA use (55% vs 49%; absolute difference (AD), 6.3%; 95% CI 1.0% to 11.6%; p=0.02). The use of CDS was associated with fewer symptomatic venous thromboembolic events during follow-up in patients with an initial negative diagnostic evaluation for PE (0.7% vs 3.2%; AD 2.5%; 95% CI 0.9% to 4.6%; p<0.01).

  2. Clinical Decision Support for Colon and Rectal Surgery: An Overview

    PubMed Central

    McCoy, Allison B.; Melton, Genevieve B.; Wright, Adam; Sittig, Dean F.

    2013-01-01

    Clinical decision support (CDS) has been shown to improve clinical processes, promote patient safety, and reduce costs in healthcare settings, and it is now a requirement for clinicians as part of the Meaningful Use Regulation. However, most evidence for CDS has been evaluated primarily in internal medicine care settings, and colon and rectal surgery (CRS) has unique needs with CDS that are not frequently described in the literature. The authors reviewed published literature in informatics and medical journals, combined with expert opinion to define CDS, describe the evidence for CDS, outline the implementation process for CDS, and present applications of CDS in CRS.CDS functionalities such as order sets, documentation templates, and order facilitation aids are most often described in the literature and most likely to be beneficial in CRS. Further research is necessary to identify and better evaluate additional CDS systems in the setting of CRS. PMID:24436644

  3. A psychiatric medication decision support guide for social work practice with pregnant and postpartum women.

    PubMed

    Bentley, Kia J; Price, Sarah Kye; Cummings, Cory R

    2014-10-01

    In their work in human services organizations and community agencies across service sectors, social workers encounter pregnant and postpartum women experiencing mental health challenges. This article offers an evidence-informed Decision Support Guide designed for use by social workers working with pregnant and postpartum women who are struggling with complicated decisions about psychiatric medication use. The guide is built on contemporary notions of health literacy and shared decision making and is informed by three areas: (1) research into the lived experiences of pregnant and postpartum women and health care providers around psychiatric medication decision making, (2) a critical review of existing decision aids, and (3) feedback on the strategy from social work practitioners who work with pregnant and postpartum women. Emphasizing the relational nature of social work in supporting effective health-related decision making, the guide relies on maintaining a collaborative practice milieu and using a decision aid that engages clients in discussions about mental health during and around the time of pregnancy. The guide offers social workers a practice tool to support responsive and compassionate care by embracing their roles in problem solving and decision making, providing emotional and psychosocial support, and making appropriate referrals to prescribers.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  5. A decision support system for assessing landfill performance.

    PubMed

    Celik, Başak; Girgin, Sertan; Yazici, Adnan; Unlü, Kahraman

    2010-01-01

    Designing environmentally sound landfills is a challenging engineering task due to complex interactions of numerous design variables; such as landfill size, waste characteristics, and site hydrogeology. Decision support systems (DSS) can be utilized to handle these complex interactions and to aid in a performance-based landfill design by coupling system simulation models (SSM). The aim of this paper is to present a decision support system developed for a performance-based landfill design. The developed DSS is called Landfill Design Decision Support System - LFDSS. A two-step DSS framework, composed of preliminary design and detailed design phases, is set to effectively couple and run the SSMs and calculation modules. In preliminary design phase, preliminary design alternatives are proposed using general site data. In detailed design phase, proposed design alternatives are further simulated under site-specific data using SSMs for performance evaluation. LFDSS calculates the required landfill volume, performs landfill base contour design, proposes preliminary design alternatives based on general site conditions, evaluates the performance of the proposed designs, calculates the factor of safety values for slope stability analyses, and performs major cost calculations. The DSS evaluates the results of all landfill design alternatives, and determines whether the design satisfies the predefined performance criteria. The DSS ultimately enables comparisons among different landfill designs based on their performances (i.e. leachate head stability, and groundwater contamination), constructional stability and costs. The developed DSS was applied to a real site, and the results demonstrated the strengths of the developed system on designing environmentally sound and feasible landfills.

  6. A decision support system for assessing landfill performance

    SciTech Connect

    Celik, Basak; Girgin, Sertan; Yazici, Adnan; Unlue, Kahraman

    2010-01-15

    Designing environmentally sound landfills is a challenging engineering task due to complex interactions of numerous design variables; such as landfill size, waste characteristics, and site hydrogeology. Decision support systems (DSS) can be utilized to handle these complex interactions and to aid in a performance-based landfill design by coupling system simulation models (SSM). The aim of this paper is to present a decision support system developed for a performance-based landfill design. The developed DSS is called Landfill Design Decision Support System - LFDSS. A two-step DSS framework, composed of preliminary design and detailed design phases, is set to effectively couple and run the SSMs and calculation modules. In preliminary design phase, preliminary design alternatives are proposed using general site data. In detailed design phase, proposed design alternatives are further simulated under site-specific data using SSMs for performance evaluation. LFDSS calculates the required landfill volume, performs landfill base contour design, proposes preliminary design alternatives based on general site conditions, evaluates the performance of the proposed designs, calculates the factor of safety values for slope stability analyses, and performs major cost calculations. The DSS evaluates the results of all landfill design alternatives, and determines whether the design satisfies the predefined performance criteria. The DSS ultimately enables comparisons among different landfill designs based on their performances (i.e. leachate head stability, and groundwater contamination), constructional stability and costs. The developed DSS was applied to a real site, and the results demonstrated the strengths of the developed system on designing environmentally sound and feasible landfills.

  7. Diverter Decision Aiding for In-Flight Diversions

    NASA Technical Reports Server (NTRS)

    Rudolph, Frederick M.; Homoki, David A.; Sexton, George A.

    1990-01-01

    It was determined that artificial intelligence technology can provide pilots with the help they need in making the complex decisions concerning en route changes in a flight plan. A diverter system should have the capability to take all of the available information and produce a recommendation to the pilot. Phase three illustrated that using Joshua to develop rules for an expert system and a Statice database provided additional flexibility by permitting the development of dynamic weighting of diversion relevant parameters. This increases the fidelity of the AI functions cited as useful in aiding the pilot to perform situational assessment, navigation rerouting, flight planning/replanning, and maneuver execution. Additionally, a prototype pilot-vehicle interface (PVI) was designed providing for the integration of both text and graphical based information. Advanced technologies were applied to PVI design, resulting in a hierarchical menu based architecture to increase the efficiency of information transfer while reducing expected workload. Additional efficiency was gained by integrating spatial and text displays into an integrated user interface.

  8. An Information-Centric Framework for Designing Patient-Centered Medical Decision Aids and Risk Communication

    PubMed Central

    Franklin, Lyndsey; Plaisant, Catherine; Shneiderman, Ben

    2013-01-01

    Risk communication is a major challenge in productive patient-physician communication. Patient decision making responsibilities come with an implicit assumption that patients are sufficiently educated and confident in their abilities to make decisions about their care based on evidence based treatment recommendations. Attempts to improve health literacy in patients by way of graphical decision aids have met with success. Such decision aids typically have been designed for a general population and evaluated based on whether or not users of the decision aid can accurately report the data points in isolation. To classify decision aids, we present an information-centric framework for assessing the content delivered to patients. We provide examples of our framework from a literature survey and suggest ways improvements can be made by considering all dimensions of our framework. PMID:24551350

  9. The ECG as decision support in STEMI.

    PubMed

    Ripa, Maria Sejersten

    2012-03-01

    The electrocardiogram (ECG) can be used for determining the presence, location and extent of jeopardized myocardium during acute coronary occlusion. Accordingly, the ECG has become essential in the treatment of patients with acute coronary syndrome (ACS). This thesis aims at optimizing the decision support, provided by the ECG, for choosing the best treatment strategy in the individual patient with ST-segment elevation acute myocardial infarction (STEMI). ECG recorded in the prehospital setting has become the standard of care in many communities, but to achieve the full advantage of this early approach it is important that the ECG is recorded from accurately placed electrodes to produce an ECG that resembles the standard 12-lead ECG. Accurate electrode placement is difficult especially in the acute setting, and we investigated an alternative lead system with fewer electrodes in easily identified positions. We showed that the system produced waveforms similar to the standard 12-lead ECG. However, occasional diagnostic errors were seen, compromising general acceptance of the system. Once the ECG has been recorded a decision regarding triage must be made on the basis of a correct ECG diagnosis. We found that trained paramedics can diagnose STEMI correctly in patients without ECG confounding factors, while the presence of ECG confounding factors decreased their ability substantially. Consequently, since many patients do present with ECG confounding factors, transmission to an on-call cardiologist for an early correct diagnosis is needed. We showed that time to pPCI was reduced by more than 1 hour by transmitting prehospital ECG to a cardiologist's handheld device for diagnosis, triage, and activation of the catheterization laboratory when needed. The optimal treatment strategy is dependent on the duration of ischemia however patient information is often inaccurate. Accordingly, it would be advantageous if the first available ECG can help identify patients who will

  10. Quantitative Decision Support Requires Quantitative User Guidance

    NASA Astrophysics Data System (ADS)

    Smith, L. A.

    2009-12-01

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

  11. User Centered Clinical Decision Support Tools

    PubMed Central

    Sofianou, A.; Kannry, J.; Mann, D.M.; McGinn, T.G.

    2014-01-01

    Summary Background Dissemination and adoption of clinical decision support (CDS) tools is a major initiative of the Affordable Care Act’s Meaningful Use program. Adoption of CDS tools is multipronged with personal, organizational, and clinical settings factoring into the successful utilization rates. Specifically, the diffusion of innovation theory implies that ‘early adopters’ are more inclined to use CDS tools and younger physicians tend to be ranked in this category. Objective This study examined the differences in adoption of CDS tools across providers’ training level. Participants From November 2010 to 2011, 168 residents and attendings from an academic medical institution were enrolled into a randomized controlled trial. Intervention The intervention arm had access to the CDS tool through the electronic health record (EHR) system during strep and pneumonia patient visits. Main Measures The EHR system recorded details on how intervention arm interacted with the CDS tool including acceptance of the initial CDS alert, completion of risk-score calculators and the signing of medication order sets. Using the EHR data, the study performed bivariate tests and general estimating equation (GEE) modeling to examine the differences in adoption of the CDS tool across residents and attendings. Key Results The completion rates of the CDS calculator and medication order sets were higher amongst first year residents compared to all other training levels. Attendings were the less likely to accept the initial step of the CDS tool (29.3%) or complete the medication order sets (22.4%) that guided their prescription decisions, resulting in attendings ordering more antibiotics (37.1%) during an CDS encounter compared to residents. Conclusion There is variation in adoption of CDS tools across training levels. Attendings tended to accept the tool less but ordered more medications. CDS tools should be tailored to clinicians’ training levels. PMID:25589914

  12. The Contribution of Decision Support Systems (DSS) to Consolidation of Educational Policies

    ERIC Educational Resources Information Center

    Klein, Joseph; Wasserstein, Mark

    2005-01-01

    Educational policies proposed with and without the aid of Decision Support Systems (DSS) were compared. 120 teachers responded to a questionnaire describing two hypothetical incidents and presenting a series of options with respect to homogeneous and heterogeneous grouping of pupils according to achievement level. After selection of preferred…

  13. Trends in Facility Management Technology: The Emergence of the Internet, GIS, and Facility Assessment Decision Support.

    ERIC Educational Resources Information Center

    Teicholz, Eric

    1997-01-01

    Reports research on trends in computer-aided facilities management using the Internet and geographic information system (GIS) technology for space utilization research. Proposes that facility assessment software holds promise for supporting facility management decision making, and outlines four areas for its use: inventory; evaluation; reporting;…

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

    PubMed Central

    2013-01-01

    Background Patient preference is one of the main components of clinical decision making, therefore leading to the development of patient decision aids. The goal of this study was to describe physicians’ and patients’ viewpoints on the barriers and limitations of using patient decision aids in Iran, their proposed solutions, and, the benefits of using these tools. Methods This qualitative study was conducted in 2011 in Iran by holding in-depth interviews with 14 physicians and 8 arthritis patient. Interviewees were selected through purposeful and maximum variation sampling. As an example, a patient decision aid on the treatment of knee arthritis was developed upon literature reviews and gathering expert opinion, and was presented at the time of interview. Thematic analysis was conducted to analyze the data by using the OpenCode software. Results The results were summarized into three categories and ten codes. The extracted categories were the perceived benefits of using the tools, as well as the patient-related and physician-related barriers in using decision aids. The following barriers in using patient decision aids were identified in this study: lack of patients and physicians’ trainings in shared decision making, lack of specialist per capita, low treatment tariffs and lack of an exact evaluation system for patient participation in decision making. Conclusions No doubt these barriers demand the health authorities’ special attention. Hence, despite patients and physicians’ inclination toward using patient decision aids, these problems have hindered the practical usage of these tools in Iran - as a developing country. PMID:24066792

  15. Development and pilot testing of a decision aid for drivers with dementia

    PubMed Central

    2014-01-01

    Background An increasing number of older adults drive automobiles. Given that the prevalence of dementia is rising, it is necessary to address the issue of driving retirement. The purpose of this study is to evaluate how a self-administered decision aid contributed to decision making about driving retirement by individuals living with dementia. The primary outcome measure in this study was decisional conflict. Knowledge, decision, satisfaction with decision, booklet use and booklet acceptability were the secondary outcome measures. Methods A mixed methods approach was adopted. Drivers with dementia were recruited from an Aged Care clinic and a Primary Care center in NSW, Australia. Telephone surveys were conducted before and after participants read the decision aid. Results Twelve participants were recruited (mean age 75, SD 6.7). The primary outcome measure, decisional conflict, improved following use of the decision aid. Most participants felt that the decision aid: (i) was balanced; (ii) presented information well; and (iii) helped them decide about driving. In addition, mean knowledge scores improved after booklet use. Conclusions This decision aid shows promise as an acceptable, useful and low-cost tool for drivers with dementia. A self-administered decision aid can be used to assist individuals with dementia decide about driving retirement. A randomized controlled trial is underway to evaluate the effectiveness of the tool. PMID:24642051

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

    PubMed

    Bijkerk, Paul; Fanoy, Ewout B; Kardamanidis, Katina; van der Plas, Simone M; Te Wierik, Margreet J; Kretzschmar, Mirjam E; Haringhuizen, George B; van Vliet, Hans J; van der Sande, Marianne A

    2015-01-01

    Mandatory notification can be a useful tool to support infectious disease prevention and control. Guidelines are needed to help policymakers decide whether mandatory notification of an infectious disease is appropriate. We developed a decision aid, based on a range of criteria previously used in the Netherlands or in other regions to help decide whether to make a disease notifiable. Criteria were categorised as being effective, feasible and necessary with regard to the relevance of mandatory notification. Expert panels piloted the decision aid. Here we illustrate its use for three diseases (Vibrio vulnificus infection, chronic Q fever and dengue fever) for which mandatory notification was requested. For dengue fever, the expert panel advised mandatory notification; for V. vulnificus infection and chronic Q fever, the expert panel concluded that mandatory notification was not (yet) justified. Use of the decision aid led to a structured, transparent decision making process and a thorough assessment of the advantages and disadvantages of mandatory notification of these diseases. It also helped identify knowledge gaps that required further research before a decision could be made. We therefore recommend use of this aid for public health policy making.

  17. Prioritizing groundwater remediation policies: a fuzzy compatibility analysis decision aid.

    PubMed

    Nasiri, Fuzhan; Huang, Gordon; Fuller, Norma

    2007-01-01

    The implementation of groundwater remediation strategies in contaminated areas includes not only a cost-benefit analysis and an environmental risk assessment but also another type of study called compatibility analysis. A compatibility analysis targets the interactions between remediation technologies and site characteristics, such as the types of active contaminants and their concentrations, soil composition and geological features, etc. The purpose of this analysis is to identify the most compatible remediation plan for the contaminated site. In this paper, we introduce a decision support system for the prioritization of remediation plans based on their estimated compatibility index. As this model receives data in terms of linguistic judgments and experts' opinions, we use fuzzy sets theory to deal with these uncertainties. First, we break down the concept of compatibility into the measurable factors. Then by using a multiple-attribute decision-making (MADM) outline, we compute a factorial, regional and overall compatibility indicator for each plan. Finally, by comparing these generated indicators, we rank the remediation policies.

  18. Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions.

    PubMed

    Elwyn, Glyn; Frosch, Dominick; Volandes, Angelo E; Edwards, Adrian; Montori, Victor M

    2010-01-01

    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.

  19. 12 CFR 944.4 - Decision on community support statements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Decision on community support statements. 944.4 Section 944.4 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK MISSION COMMUNITY SUPPORT REQUIREMENTS § 944.4 Decision on community support statements. (a) Action on community...

  20. Ten years of the International Patient Decision Aid Standards Collaboration: evolution of the core dimensions for assessing the quality of patient decision aids.

    PubMed

    Volk, Robert J; Llewellyn-Thomas, Hilary; Stacey, Dawn; Elwyn, Glyn

    2013-01-01

    In 2003, the International Patient Decision Aid Standards (IPDAS) Collaboration was established to enhance the quality and effectiveness of patient decision aids by establishing an evidence-informed framework for improving their content, development, implementation, and evaluation. Over this 10 year period, the Collaboration has established: a) the background document on 12 core dimensions to inform the original modified Delphi process to establish the IPDAS checklist (74 items); b) the valid and reliable IPDAS instrument (47 items); and c) the IPDAS qualifying (6 items), certifying (6 items + 4 items for screening), and quality criteria (28 items). The objective of this paper is to describe the evolution of the IPDAS Collaboration and discuss the standardized process used to update the background documents on the theoretical rationales, evidence and emerging issues underlying the 12 core dimensions for assessing the quality of patient decision aids.

  1. Facilitating Support Groups for Professionals Working with People with AIDS.

    ERIC Educational Resources Information Center

    Grossman, Arnold H.; Silverstein, Charles

    1993-01-01

    Describes support groups for health care professionals who work with people with human immunodeficiency virus (HIV) or Acquired Immune Deficiency Syndrome (AIDS) and who are experiencing burnout from excessive demands on their energy, strength, and resources. Discusses group administration, effective intervention techniques, and issues of health…

  2. Case-based reasoning in Intelligent Health Decision Support Systems.

    PubMed

    González, Carolina; López, Diego M; Blobel, Bernd

    2013-01-01

    Decision-making is a crucial task for decision makers in healthcare, especially because decisions have to be made quickly, accurately and under uncertainty. Taking into account the importance of providing quality decisions, offering assistance in this complex process has been one of the main challenges of Artificial Intelligence throughout history. Decision Support Systems (DSS) have gained popularity in the medical field for their efficacy to assist decision-making. In this sense, many DSS have been developed, but only few of them consider processing and analysis of information contained in electronic health records, in order to identify individual or population health risk factors. This paper deals with Intelligent Decision Support Systems that are integrated into Electronic Health Records Systems (EHRS) or Public Health Information Systems (PHIS). It provides comprehensive support for a wide range of decisions with the purpose of improving quality of care delivered to patients or public health planning, respectively.

  3. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS

    EPA Science Inventory

    Decision makers using environmental decision support tools are often confronted with information that predicts a multitude of different human health effects due to environmental stressors. If these health effects need to be contrasted with costs or compared with alternative scena...

  4. Patient Decision Aids: A Case for Certification at the National Level in the United States.

    PubMed

    Poddar, Urbashi; Brownlee, Shannon; Stacey, Dawn; Volk, Robert J; Williams, John W; Elwyn, Glyn

    2015-01-01

    Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance-primarily as a quality measure that increases patients' safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in decision aids. Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient's decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved. PMID:26752384

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

    PubMed

    Amlani, Amyn M

    2016-05-01

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

  6. Reef Ecosystem Services and Decision Support Database

    EPA Science Inventory

    This scientific and management information database utilizes systems thinking to describe the linkages between decisions, human activities, and provisioning of reef ecosystem goods and services. This database provides: (1) Hierarchy of related topics - Click on topics to navigat...

  7. arriba-lib: Analyses of user interactions with an electronic library of decision aids on the basis of log data.

    PubMed

    Hirsch, Oliver; Szabo, Elisabeth; Keller, Heidemarie; Kramer, Lena; Krones, Tanja; Donner-Banzhoff, Norbert

    2012-12-01

    Computerised log files are important for analysing user behaviour in health informatics to gain insight into processes that lead to suboptimal user patterns. This is important for software training programmes or for changes to improve usability. Technical user behaviour regarding decision aids has not so far been thoroughly investigated with log files. The aim of our study was to examine more detailed user interactions of primary-care physicians and their patients with arriba-lib, our multimodular electronic library of decision aids used during consultations, on the basis of log data. We analysed 184 consultation log files from 28 primary-care physicians. The average consultation time of our modules was about 8 min. Two-thirds of the consultation time were spent in the history information part of the programme. In this part, mainly bar charts were used to display risk information. Our electronic library of decision aids does not generate specific user behaviour based on physician characteristics such as age, gender, years in practice, or prior experience with decision aids. This supports the widespread use of our e-library in the primary-care sector and probably beyond.

  8. Promoting perioperative advance care planning: a systematic review of advance care planning decision aids.

    PubMed

    Aslakson, Rebecca A; Schuster, Anne L R; Reardon, Jessica; Lynch, Thomas; Suarez-Cuervo, Catalina; Miller, Judith A; Moldovan, Rita; Johnston, Fabian; Anton, Blair; Weiss, Matthew; Bridges, John F P

    2015-11-01

    This systematic review identifies possible decision aids that promote perioperative advance care planning (ACP) and synthesizes the available evidence regarding their use. Using PubMed, EMBASE, Cochrane, SCOPUS, Web of Science, CINAHL, PsycINFO and Sociological Abstracts, researchers identified and screened articles for eligibility. Data were abstracted and risk of bias assessed for included articles. Thirty-nine of 5327 articles satisfied the eligibility criteria. Primarily completed in outpatient ambulatory populations, studies evaluated a variety of ACP decision aids. None were evaluated in a perioperative population. Fifty unique outcomes were reported with no head-to-head comparisons conducted. Findings are likely generalizable to a perioperative population and can inform development of a perioperative ACP decision aid. Future studies should compare the effectiveness of ACP decision aids.

  9. Aides' Involvement in Decision-Making and the Quality of Care in Institutional Settings

    ERIC Educational Resources Information Center

    Raynes, Norma V.; And Others

    1977-01-01

    The degree of participation in decision making by direct care staff aides, and its effect on the quality of care for mentally handicapped persons, was assessed among 125 staff of 3 state institutions averaging 1080 patients. (BB)

  10. A conceptual evolutionary aseismic decision support framework for hospitals

    NASA Astrophysics Data System (ADS)

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

    2012-12-01

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

  11. SERVIR: A Regional Monitoring and Decision Support System for Mesoamerica

    NASA Astrophysics Data System (ADS)

    Irwin, D.; Hardin, D. M.; Sever, T.; Graves, S.

    2008-05-01

    Mesoamerica is a prime example of a multi-national region with natural and human induced stresses that benefits from information provided by observation systems. The region is severely threatened by extensive deforestation, illegal logging, water pollution, and uncontrolled slash and burn agriculture. Additionally, Mesoamerica's distinct geology and geography result in disproportionate vulnerability of its population to natural disasters such as earthquakes, hurricanes, drought, and volcanic eruptions. NASA Marshall Space Flight Center, the University of Alabama in Huntsville and numerous SERVIR* partners are developing data products, knowledge extraction methods and decision support tools for environmental monitoring, disaster response and sustainable growth planning in Mesoamerica. The combination of space- based observations from NASA's Earth Observing Satellites with information management and knowledge extraction technologies has yielded a robust system for use by scientists, educators, environmental ministers and policy makers. These resources enhance the ability to monitor and forecast ecological changes, respond to natural disasters and better understand both natural and human induced effects. Now in its fourth year SERVIR has become a partner in the International Space and Major Disasters Charter. In the past year the Charter provided commercial satellite imagery to aid in disaster response to Hurricanes Dean, Felix and Noel. Overcoming roadblocks to coordination and data sharing between countries, organizations and disciplines SERVIR is providing environmental monitoring and decision support products and applications that directly map to several Observation GEOSS societal benefit areas. This paper provides an overview of the ongoing accomplishments of the SERVIR project. *SERVIR is a Spanish verb meaning "to serve" or "be useful" is also an acronym for the Spanish name of the capability: Sistema Regional de Visualizacion y Monitero.

  12. Home Health Aide Training: An Appeal for Organizational Support.

    PubMed

    Palesy, Debra

    2016-01-01

    How home healthcare aides (HHAs) adapt their classroom training to their workplaces is central to their own safety and that of their care recipients. A qualitative approach was adopted for this inquiry, where new workers were interviewed in-depth following their classroom training. Findings suggest a perceived lack of supervisor support for classroom training and lack of follow-up in the workplace. Moreover, the need for more peer support was contended, and more comprehensive written materials in clients' homes may also assist workers' learning and enacting safe manual handling techniques in the workplace. The article concludes with recommendations for supporting HHAs' learning, and includes suggestions for future research.

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

    PubMed

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

    2012-01-01

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

  14. The design of aircraft using the decision support problem technique

    NASA Technical Reports Server (NTRS)

    Mistree, Farrokh; Marinopoulos, Stergios; Jackson, David M.; Shupe, Jon A.

    1988-01-01

    The Decision Support Problem Technique for unified design, manufacturing and maintenance is being developed at the Systems Design Laboratory at the University of Houston. This involves the development of a domain-independent method (and the associated software) that can be used to process domain-dependent information and thereby provide support for human judgment. In a computer assisted environment, this support is provided in the form of optimal solutions to Decision Support Problems.

  15. Enhancing ethical decision making in sexuality and AIDS education.

    PubMed

    Bailey, C E; Piercy, F P

    1997-01-01

    Traditionally, sexuality education has consisted of teaching adolescents about human anatomy, reproduction, and sexually transmitted diseases. Most sexuality and AIDS education curricula have emphasized neither the relational aspects nor the ethical meaning of sexual behavior. However, current guidelines for comprehensive sexuality education from the National Guidelines Task Force acknowledge the ethical dimensions of sexuality. This paper advocates providing sexuality and AIDS education in a way that helps adolescents explore the ethical meaning of their sexual behavior. Principles from Rest's model of moral development are presented as one example of an ethical framework that could inform sexuality and AIDS education curricula. Rest describes four internal processes that produce moral behavior: moral sensitivity, moral judgment, moral motivation, and moral character. For each of these processes, illustrative questions and activities are suggested here which can be used by sexuality and AIDS educators to facilitate discussions with adolescents about the ethical meaning and implications of their sexual behavior.

  16. Automation and Accountability in Decision Support System Interface Design

    ERIC Educational Resources Information Center

    Cummings, Mary L.

    2006-01-01

    When the human element is introduced into decision support system design, entirely new layers of social and ethical issues emerge but are not always recognized as such. This paper discusses those ethical and social impact issues specific to decision support systems and highlights areas that interface designers should consider during design with an…

  17. Development of Asset Management Decision Support Tools for Power Equipment

    NASA Astrophysics Data System (ADS)

    Okamoto, Tatsuki; Takahashi, Tsuguhiro

    Development of asset management decision support tools become very intensive in order to reduce maintenance cost of power equipment due to the liberalization of power business. This article reviews some aspects of present status of asset management decision support tools development for power equipment based on the papers published in international conferences, domestic conventions, and several journals.

  18. Decision Support Systems in Elementary and Secondary Educational Administration.

    ERIC Educational Resources Information Center

    Fisher, Janet Cameron; And Others

    1990-01-01

    A decision support system (DSS) is an interactive computerized system capable of providing direct, personal support for complex managerial decisions. This paper reviews DDSs and their general capabilities, describes potential benefits to school administrators, presents DDS applications in several school districts, and discusses implementation…

  19. Integration of health services in the care of people living with aids: an approach using a decision tree.

    PubMed

    de Medeiros, Leidyanny Barbosa; Trigueiro, Débora Raquel Soares Guedes; da Silva, Daiane Medeiros; do Nascimento, João Agnaldo; Monroe, Aline Aparecida; Nogueira, Jordana de Almeida; Leadebal, Oriana Deyze Correia Paiva

    2016-02-01

    The care offer to people living with HIV/AIDS must transcend specialized outpatient services and include the participation of the Family Health Strategy. By understanding the importance of integration between these two points in the care network, the study aimed to build a decision support model to assist professionals of specialized health services in identifying behavior patterns in the use of Family Health Strategy services by people living with HIV/AIDS attended in the outpatient clinic. Thus, was proposed a model called decision tree, created from a database of 141 people with AIDS, users of a specialized outpatient clinic. The decision-making variable was the use of Family Health Strategy services by evaluating the integration of care. The model enabled the establishment of 23 rules with 80.1% hit percentage, what may support the decision-making of professionals in identifying situations in which it is necessary to stimulate the use of the Family Health Strategy by users. PMID:26910161

  20. A decision support system for map projections of small scale data

    USGS Publications Warehouse

    Finn, Michael P.; Usery, E. Lynn; Posch, Stephan T.; Seong, Jeong Chang

    2004-01-01

    The use of commercial geographic information system software to process large raster datasets of terrain elevation, population, land cover, vegetation, soils, temperature, and rainfall requires both projection from spherical coordinates to plane coordinate systems and transformation from one plane system to another. Decision support systems deliver information resulting in knowledge that assists in policies, priorities, or processes. This paper presents an approach to handling the problems of raster dataset projection and transformation through the development of a Web-enabled decision support system to aid users of transformation processes with the selection of appropriate map projections based on data type, areal extent, location, and preservation properties.

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

    PubMed Central

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

    2016-01-01

    Objectives Choosing Wisely is a remarkable physician-led campaign to reduce unnecessary or harmful health services. Some of the literature identifies Choosing Wisely as a shared decision-making approach. We evaluated the patient materials developed by Choosing Wisely Canada to determine whether they meet the criteria for shared decision-making tools known as patient decision aids. Design Descriptive analysis of all Choosing Wisely Canada patient materials. Data source In May 2015, we selected all Choosing Wisely Canada patient materials from its official website. Main outcomes and measures Four team members independently extracted characteristics of the English materials using the International Patient Decision Aid Standards (IPDAS) modified 16-item minimum criteria for qualifying and certifying patient decision aids. The research team discussed discrepancies between data extractors and reached a consensus. Descriptive analysis was conducted. Results Of the 24 patient materials assessed, 12 were about treatments, 11 were about screening and 1 was about prevention. The median score for patient materials using IPDAS criteria was 10/16 (range: 8–11) for screening topics and 6/12 (range: 6–9) for prevention and treatment topics. Commonly missed criteria were stating the decision (21/24 did not), providing balanced information on option benefits/harms (24/24 did not), citing evidence (24/24 did not) and updating policy (24/24 did not). Out of 24 patient materials, only 2 met the 6 IPDAS criteria to qualify as patient decision aids, and neither of these 2 met the 6 certifying criteria. Conclusions Patient materials developed by Choosing Wisely Canada do not meet the IPDAS minimal qualifying or certifying criteria for patient decision aids. Modifications to the Choosing Wisely Canada patient materials would help to ensure that they qualify as patient decision aids and thus as more effective shared decision-making tools. PMID:27566638

  2. Environmental Decision Support with Consistent Metrics

    EPA Science Inventory

    One of the most effective ways to pursue environmental progress is through the use of consistent metrics within a decision making framework. The US Environmental Protection Agency’s Sustainable Technology Division has developed TRACI, the Tool for the Reduction and Assessment of...

  3. Supporting Medical Decision Making with Argumentation Tools

    ERIC Educational Resources Information Center

    Lu, Jingyan; Lajoie, Susanne P.

    2008-01-01

    This study investigated the collaborative decision-making and communicative discourse of groups of learners engaged in a simulated medical emergency in two conditions. In one condition subgroups used a traditional whiteboard (TW group) to document medical arguments on how to solve a medical emergency. In the other condition subgroups used…

  4. Air Traffic Control Decision Support Tools for Noise Mitigation

    NASA Technical Reports Server (NTRS)

    Tobias, Leonard

    2001-01-01

    NASA has initiated a new five year program this year, the Quiet Aircraft Technology (QAT) Program, a program which will investigate airframe and engine system noise reduction. QAT will also address community noise impact. As part of this community noise impact component, NASA will investigate air traffic management (ATM) challenges in reducing noise. In particular, controller advisory automation aids will be developed to aid the air traffic controller in addressing noise concerns as he/she manages traffic in busy terminal areas. NASA has developed controller automation tools to address capacity concerns and the QAT strategy for ATM Low Noise Operations is to build upon this tool set to create added advisories for noise mitigation. The tools developed for capacity will be briefly reviewed, followed by the QAT plans to address ATM noise concerns. A major NASA goal in global civil aviation is to triple the aviation system throughput in all-weather conditions while maintaining safety. A centerpiece of this activity is the Center/TRACON Automation System (CTAS), an evolving suite of air traffic controller decision support tools (DSTs) to enhance capacity of arrivals and departures in both the enroute center and the TRACON. Two of these DSTs, the Traffic Management Advisor (TMA) and the passive Final approach Spacing Tool (pFAST), are in daily use at the Fort Worth Center and the Dallas/Fort Worth (DFW) TRACON, respectively, where capacity gains of 5-13% have been reported in recent NASA evaluations. Under the Federal Aviation Administration's (FAA) Free Flight Phase One Program, TMA and pFAST are each being implemented at six to eight additional sites. In addition, other DSTs are being developed by NASA under the umbrella of CTAS. This means that new software will be built upon CTAS, and the paradigm of real-time simulation evaluation followed by field site development and evaluation will be the pathway for the new tools. Additional information is included in the

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

    ERIC Educational Resources Information Center

    Erskine, Michael A.

    2013-01-01

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

  6. The Contribution of a Decision Support System to Educational Decision-Making Processes

    ERIC Educational Resources Information Center

    Klein, Joseph; Ronen, Herman

    2003-01-01

    In the light of reports of bias, the present study investigated the hypothesis that administrative educational decisions assisted by Decision Support Systems (DSS) are characterized by different pedagogical and organizational orientation than decisions made without computer assistance. One hundred and ten high school teachers were asked to suggest…

  7. Use of online safety decision aid by abused women: effect on decisional conflict in randomized controlled trial

    PubMed Central

    Eden, Karen B.; Perrin, Nancy A.; Hanson, Ginger C.; Messing, Jill T.; Bloom, Tina L.; Campbell, Jacquelyn C.; Gielen, Andrea C.; Clough, Amber S.; Barnes-Hoyt, Jamie S.; Glass, Nancy E.

    2014-01-01

    Background An Internet safety decision aid was developed to help abused women understand their risk for repeat and near-lethal intimate partner violence, clarify priorities related to safety, and develop an action plan customized to these priorities. Purpose The overall purpose of this study was to test the effectiveness of a safety decision aid compared with usual safety planning (control) delivered through a secure website, using a multi-state randomized controlled trial design. The paper evaluated the effectiveness of the safety decision aid in reducing decisional conflict after a single use by abused women. Design Randomized controlled trial referred to as IRIS, Internet Resource for Intervention and Safety Participants Abused women who spoke English (N = 708) were enrolled in a four-state, randomized controlled trial. Intervention and Control The intervention was an interactive safety decision aid with personalized safety plan; the control condition was usual safety planning resources. Both were delivered to participants through the secure study website. Main Outcome Measures This paper compared women’s decisional conflict about safety: total decisional conflict and the four subscales of this measure (feeling: uninformed, uncertain, unclear about safety priorities; and sensing lack of support) between intervention/control conditions. Data were collected 3/2011–5/2013 and analyzed 1/2014–3/2014. Results Immediately following the first use of the interactive safety decision aid, intervention women had significantly lower total decisional conflict than control women, controlling for baseline value of decisional conflict (p=0.002, effect size=.12). After controlling for baseline values, the safety decision aid group had significantly greater reduction in feeling uncertain (p=0.006, effect size=.07), and in feeling unsupported (p=0.008, effect size=.07) about safety than the usual safety planning group. Conclusions Abused women randomized to the safety

  8. Group Decision Support Systems and Group Communication: A Comparison of Decision Making in Computer-Supported and Nonsupported Groups.

    ERIC Educational Resources Information Center

    Poole, Marshall Scott; And Others

    1993-01-01

    Explores the effects of Group Decision Support Systems (GDSS) on small group communication and decision-making processes. Finds that comparing GDSS, manual, and baseline conditions enables separation of effects resulting from procedural structures from those resulting from computerization. Results support some aspects of the research model and…

  9. Exploration Clinical Decision Support System: Medical Data Architecture

    NASA Technical Reports Server (NTRS)

    Lindsey, Tony; Shetye, Sandeep; Shaw, Tianna (Editor)

    2016-01-01

    The Exploration Clinical Decision Support (ECDS) System project is intended to enhance the Exploration Medical Capability (ExMC) Element for extended duration, deep-space mission planning in HRP. A major development guideline is the Risk of "Adverse Health Outcomes & Decrements in Performance due to Limitations of In-flight Medical Conditions". ECDS attempts to mitigate that Risk by providing crew-specific health information, actionable insight, crew guidance and advice based on computational algorithmic analysis. The availability of inflight health diagnostic computational methods has been identified as an essential capability for human exploration missions. Inflight electronic health data sources are often heterogeneous, and thus may be isolated or not examined as an aggregate whole. The ECDS System objective provides both a data architecture that collects and manages disparate health data, and an active knowledge system that analyzes health evidence to deliver case-specific advice. A single, cohesive space-ready decision support capability that considers all exploration clinical measurements is not commercially available at present. Hence, this Task is a newly coordinated development effort by which ECDS and its supporting data infrastructure will demonstrate the feasibility of intelligent data mining and predictive modeling as a biomedical diagnostic support mechanism on manned exploration missions. The initial step towards ground and flight demonstrations has been the research and development of both image and clinical text-based computer-aided patient diagnosis. Human anatomical images displaying abnormal/pathological features have been annotated using controlled terminology templates, marked-up, and then stored in compliance with the AIM standard. These images have been filtered and disease characterized based on machine learning of semantic and quantitative feature vectors. The next phase will evaluate disease treatment response via quantitative linear

  10. Prioritization of information using decision support systems for seismic risk in Bucharest city

    NASA Astrophysics Data System (ADS)

    Armas, Iuliana; Gheorghe, Diana

    2014-05-01

    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.

  11. [A decision-support system for hematology].

    PubMed

    Straka, L; Stránský, P; Kmonícek, M

    1998-01-01

    Thrombocytopenia and following bleeding at the treatment of hematological malignancies is a dangerous complication. The indication of thrombocyte transfusion is the key point for the therapy and proylaxy of bleeding. The all problem is divided into two parts. Evaluation of the risk of bleeding (80% of decision), estimation of the risk of aloimunization and risk of connected with the transfusion (20% decision). For now we are concentrated to the evaluation of the risk of bleeding. In the first stage we are concentrated to statistical evaluation of values to define factors possibly highering the risk of bleeding. Factors were determined with help of two test, GUHA method and using literature. For recognized factors were trained 3 layer neuron nets with a non-linear method pack propagation. After that an application was developed to determine the risk of bleeding for a routine use in clinical practice.

  12. Optimizing Decision Support for Tailored Health Behavior Change Applications.

    PubMed

    Kukafka, Rita; Jeong, In cheol; Finkelstein, Joseph

    2015-01-01

    The Tailored Lifestyle Change Decision Aid (TLC DA) system was designed to provide support for a person to make an informed choice about which behavior change to work on when multiple unhealthy behaviors are present. TLC DA can be delivered via web, smartphones and tablets. The system collects a significant amount of information that is used to generate tailored messages to consumers to persuade them in certain healthy lifestyles. One limitation is the necessity to collect vast amounts of information from users who manually enter. By identifying an optimal set of self-reported parameters we will be able to minimize the data entry burden of the app users. The study was to identify primary determinants of health behavior choices made by patients after using the system. Using discriminant analysis an optimal set of predictors was identified. The resulting set included smoking status, smoking cessation success estimate, self-efficacy, body mass index and diet status. Predicting smoking cessation choice was the most accurate, followed by weight management. Physical activity and diet choices were better identified in a combined cluster. PMID:26262020

  13. Development and commissioning of decision support tools for sewerage management.

    PubMed

    Manic, G; Printemps, C; Zug, M; Lemoine, C

    2006-01-01

    Managing sewerage systems is a highly complex task due to the dynamic nature of the facilities. Their performance strongly depends on the know-how applied by the operators. In order to define optimal operational settings, two decision support tools based on mathematical models have been developed. Moreover, easy-to-use interfaces have been created as well, aiding operators who presumably do not have the necessary skills to use modelling software. The two developed programs simulate the behaviour of both wastewater treatment plants (WWTP) and sewer network systems, respectively. They have essentially the same structure, including raw data management and statistical analysis, a simulation layer using the application programming interface of the applied software and a layer responsible for the representation of the obtained results. Four user modes are provided in the two software including the simulation of historical data using the applied and novel operational settings, as well as modes concerning prediction of possible operation periods and updates. Concerning the WWTP software, it was successfully installed in Nantes (France) in June 2004. Moreover, the one managing sewer networks has been deployed in Saint-Malo (France) in January 2005. This paper presents the structure of the developed software and the first results obtained during the commissioning phase.

  14. Support service use by persons with AIDS and their caregivers.

    PubMed

    Wight, R G; LeBlanc, A J; Aneshensel, C S

    1995-01-01

    The purpose of this study was to identify factors related to the use and non-use of emotional and practical support services by persons with AIDS (PWAs) and their informal caregivers. Unmet need for PWA support services and perceived barriers to the use of these types of services were also identified. Structured interviews were conducted with 472 self-selected informal AIDS caregivers in greater Los Angeles and the San Francisco Bay area. Data from a cross-sectional survey interview were analysed using logistic regression models fit for three categories of service use. Use of support services was substantial in this sample. Case management, caregiver HIV status, education, co-residence, and type of interpersonal relationship were important predictors of service use. Unmet need for PWA services was also substantial. The PWA's unwillingness to use services and lack of access were identified as key barriers to service use. Even in the presence of an informal caregiver, PWAs require considerable supplemental assistance from institutional sources. The presence of informal assistance to PWAs does not eliminate the need for institutional support. Moreover, caregivers themselves demonstrate considerable need for support.

  15. Assessment of a decision aid to assist genetic testing research participants in the informed consent process.

    PubMed

    Sorenson, J R; Lakon, C; Spinney, T; Jennings-Grant, T

    2004-01-01

    Limited attention has been given to applying decision-making theories from psychology to the content and process of informed consent in genetic testing research. Data are presented from a study that developed and assessed a psychological theory-based decision aid as part of the informed consent process. This innovative approach assisted at-risk women in assessing the consequences of participating in a research project that offered them free hemophilia A genetic carrier testing. Results suggest: (1) the decision aid can be incorporated into the consent process with few problems; (2) women of varying educational backgrounds can complete the decision aid; (3) while women consider many consequences of genetic testing, their primary focus is on the implications for their family; and (4) this is in marked contrast to the typical benefit-harm statements prepared by researchers for genetic testing.

  16. New approaches for real time decision support systems

    NASA Technical Reports Server (NTRS)

    Hair, D. Charles; Pickslay, Kent

    1994-01-01

    NCCOSC RDT&E Division (NRaD) is conducting research into ways of improving decision support systems (DSS) that are used in tactical Navy decision making situations. The research has focused on the incorporation of findings about naturalistic decision-making processes into the design of the DSS. As part of that research, two computer tools were developed that model the two primary naturalistic decision-making strategies used by Navy experts in tactical settings. Current work is exploring how best to incorporate the information produced by those tools into an existing simulation of current Navy decision support systems. This work has implications for any applications involving the need to make decisions under time constraints, based on incomplete or ambiguous data.

  17. Decision support systems for robotic surgery and acute care

    NASA Astrophysics Data System (ADS)

    Kazanzides, Peter

    2012-06-01

    Doctors must frequently make decisions during medical treatment, whether in an acute care facility, such as an Intensive Care Unit (ICU), or in an operating room. These decisions rely on a various information sources, such as the patient's medical history, preoperative images, and general medical knowledge. Decision support systems can assist by facilitating access to this information when and where it is needed. This paper presents some research eorts that address the integration of information with clinical practice. The example systems include a clinical decision support system (CDSS) for pediatric traumatic brain injury, an augmented reality head- mounted display for neurosurgery, and an augmented reality telerobotic system for minimally-invasive surgery. While these are dierent systems and applications, they share the common theme of providing information to support clinical decisions and actions, whether the actions are performed with the surgeon's own hands or with robotic assistance.

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

    NASA Technical Reports Server (NTRS)

    Forthofer, M. J.

    1981-01-01

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

  19. Evidence-Based Medicine in Otolaryngology, Part 5: Patient Decision Aids.

    PubMed

    Pynnonen, Melissa A; Randolph, Gregory W; Shin, Jennifer J

    2015-09-01

    Modern medical decision making is a complex task requiring collaboration between patients and physicians. Related clinical evidence may delineate a clearly favorable path, but in other instances, uncertainty remains. Even in these circumstances, however, there are techniques that optimize decision making by blending existing evidence with individual patient values in the context of physician counseling. This installment of "Evidence-Based Medicine in Otolaryngology" focuses on the crucial issue of how practitioners may approach clinical situations where the data do not delineate a single irrefutable path. We describe decision aids-tools that can educate patients about data related to complex clinical decisions. We review their definition, quality standards, patient interface, benefits, and limitations. We also discuss the related concept of option grids and the role of decision aids in evidence-based practice.

  20. Decision Support Framework (DSF) Team Research Implementation Plan

    EPA Science Inventory

    The mission of ORD's Ecosystem Services Research Program (ESRP) is to provide the information and methods needed by decision-makers to assess the benefits of ecosystem goods and services to human well-being for inclusion in management alternatives. The Decision Support Framework...

  1. Computer-Based Support of Organizational Decision Making.

    ERIC Educational Resources Information Center

    Bonczek, Robert H.; And Others

    1979-01-01

    Explores the extent to which computer facilities can be used to support organizational decision-making processes beyond mere performance of information retrieval. Human perceptual and judgmental processes, as they apply to organizational decisions, are examined as a basis for the design of a generalized, intelligent problem processor. (Author/RAO)

  2. The Future of Decision Support Systems in Institutional Research.

    ERIC Educational Resources Information Center

    Rohrbaugh, John

    1986-01-01

    In the context of decision support systems (DSS) use, four perspectives on evaluating decisions (consensual, political, empirical, and rational) and four models of organizational effectiveness (human relations, open system, internal process, and rational goal) are examined for their implications for DSS implementation and evaluation. (MSE)

  3. A decision class analysis of critical care life-support decision-making.

    PubMed

    Seiver, A

    1993-02-01

    Decision analysis is a powerful methodology that can help clinicians make good decisions. Because it is not practical to place a decision analyst at the bedside in critical care units, the application of this methodology will require leveraging the analyst through computer-based systems. A decision class analysis is a collective analysis of a group of decisions that provides the high-level specification for such a computer system. This paper presents a decision class analysis of critical care life-support decisions. Key elements of this analysis are: the simplification of an otherwise extremely complex multistage sequential decision problem by using a sequence of two-stage models, and the use of six generic knowledge maps that capture the extremely complex relevant medical knowledge. PMID:8326214

  4. DECISION SUPPORT FRAMEWORK FOR STORMWATER MANAGEMENT IN URBAN WATERSHEDS

    EPA Science Inventory

    To assist stormwater management professionals in planning for best management practices (BMPs) implementation, the U.S. Environmental Protection Agency (USEPA) is developing a decision support system for placement of BMPs at strategic locations in urban watersheds. This tool wil...

  5. Interactive Decision Support for Academic Advising

    ERIC Educational Resources Information Center

    Mohamed, Abdallah

    2016-01-01

    Purpose: This paper aims to support academic advising, which plays a crucial role in student success and retention. The paper focuses on one of the most challenging tasks involved in academic advising: individual course scheduling. This task includes not only careful planning for different courses over several semesters according to students'…

  6. Integrating complex business processes for knowledge-driven clinical decision support systems.

    PubMed

    Kamaleswaran, Rishikesan; McGregor, Carolyn

    2012-01-01

    This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS. PMID:23366138

  7. Integrating complex business processes for knowledge-driven clinical decision support systems.

    PubMed

    Kamaleswaran, Rishikesan; McGregor, Carolyn

    2012-01-01

    This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS.

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

    PubMed

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

    2016-04-01

    Dashboard systems for clinical decision support integrate data from multiple sources. These systems, the newest in a long line of dose calculators and other decision support tools, utilize Bayesian approaches to fully individualize dosing using information gathered through therapeutic drug monitoring. In the treatment of inflammatory bowel disease patients with infliximab, dashboards may reduce therapeutic failures and treatment costs. The history and future development of modern Bayesian dashboard systems is described. PMID:26785109

  9. Personalizing Drug Selection Using Advanced Clinical Decision Support

    PubMed Central

    Pestian, John; Spencer, Malik; Matykiewicz, Pawel; Zhang, Kejian; Vinks, Alexander A.; Glauser, Tracy

    2009-01-01

    This article describes the process of developing an advanced pharmacogenetics clinical decision support at one of the United States’ leading pediatric academic medical centers. This system, called CHRISTINE, combines clinical and genetic data to identify the optimal drug therapy when treating patients with epilepsy or Attention Deficit Hyperactivity Disorder. In the discussion a description of clinical decision support systems is provided, along with an overview of neurocognitive computing and how it is applied in this setting. PMID:19898682

  10. Toward a synthesis of paradigms for decision support

    NASA Astrophysics Data System (ADS)

    Egner, Michael; Davis, Paul K.

    2004-08-01

    Over the past half-century, the study of human decision making has evolved from dry philosophy into a diverse set of experimentally-tested, behavior-centered theories. However, the sheer volume of disciplines and sub-disciplines-and the often-esoteric debates that divide them-threaten to obscure the very real advances that have been made in modeling human decision making. This paper, giving preliminary analysis from a longer study,[1] begins to address the "so-what" factor in decision making theory, specifically as related to Air Force modeling, simulation, and decision-support needs. While a general consensus is forming on how humans make decisions (descriptive), there are still major conflicts on how humans should make decisions (normative), and by extension, how human decision making can be improved (prescriptive). The first half of this paper surveys modern decision science, focusing on two of the most influential sub-disciplines: the heuristics & biases paradigm (HBP) and the naturalistic paradigm (NP). The second half of this paper will attempt to sketch out a normative/prescriptive synthesis between the two schools, and chart implications for design of decision support.

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

    NASA Astrophysics Data System (ADS)

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

    2000-10-01

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

  12. Intervention for advanced heart failure patients and their caregivers to support shared decision-making about implantation of a ventricular assist device.

    PubMed

    Gauthier, Marie-Andrée; Cossette, Sylvie; Ouimette, Marie-France; Harris, Virginie

    2016-01-01

    This project aimed to co-develop and pilot an intervention plan to support shared decision-making (SDM) for patients considering a ventricular assist device (VAD), their caregivers and the health care team. The project involved a focus group with patients and caregivers to explore their decision-making needs along with regular participation in team meetings resulting in the creation of a decision aid. The decision aid answered needs expressed by patients and caregivers, as well as the team's initial needsfor informational support, optimization of information exchange and process standardization. A workshop on SDM was also conducted to increase competence toward this approach and the use of the decision aid. This project is timely and relevant given the increase in VAD implantation in Canada. The intervention could also be applicable to other decision-making situations in which active participation can improve the quality of the decision process. PMID:27382666

  13. Radiological Decision Aid to determine suitability for medial unicompartmental knee arthroplasty

    PubMed Central

    Hamilton, T. W.; Pandit, H. G.; Lombardi, A. V.; Adams, J. B.; Oosthuizen, C. R.; Clavé, A.; Dodd, C. A. F.; Berend, K. R.; Murray, D. W.

    2016-01-01

    Aims An evidence-based radiographic Decision Aid for meniscal-bearing unicompartmental knee arthroplasty (UKA) has been developed and this study investigates its performance at an independent centre. Patients and Methods Pre-operative radiographs, including stress views, from a consecutive cohort of 550 knees undergoing arthroplasty (UKA or total knee arthroplasty; TKA) by a single-surgeon were assessed. Suitability for UKA was determined using the Decision Aid, with the assessor blinded to treatment received, and compared with actual treatment received, which was determined by an experienced UKA surgeon based on history, examination, radiographic assessment including stress radiographs, and intra-operative assessment in line with the recommended indications as described in the literature. Results The sensitivity and specificity of the Decision Aid was 92% and 88%, respectively. Excluding knees where a clear pre-operative plan was made to perform TKA, i.e. patient request, the sensitivity was 93% and specificity 96%. The false-positive rate was low (2.4%) with all affected patients readily identifiable during joint inspection at surgery. In patients meeting Decision Aid criteria and receiving UKA, the five-year survival was 99% (95% confidence intervals (CI) 97 to 100). The false negatives (3.5%), who received UKA but did not meet the criteria, had significantly worse functional outcomes (flexion p < 0.001, American Knee Society Score - Functional p < 0.001, University of California Los Angeles score p = 0.04), and lower implant survival of 93.1% (95% CI 77.6 to 100). Conclusion The radiographic Decision Aid safely and reliably identifies appropriate patients for meniscal-bearing UKA and achieves good results in this population. The widespread use of the Decision Aid should improve the results of UKA. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):3–10. PMID:27694509

  14. System-Agnostic Clinical Decision Support Services: Benefits and Challenges for Scalable Decision Support

    PubMed Central

    Kawamoto, Kensaku; Del Fiol, Guilherme; Orton, Charles; Lobach, David F

    2010-01-01

    System-agnostic clinical decision support (CDS) services provide patient evaluation capabilities that are independent of specific CDS systems and system implementation contexts. While such system-agnostic CDS services hold great potential for facilitating the widespread implementation of CDS systems, little has been described regarding the benefits and challenges of their use. In this manuscript, the authors address this need by describing potential benefits and challenges of using a system-agnostic CDS service. This analysis is based on the authors’ formal assessments of, and practical experiences with, various approaches to developing, implementing, and maintaining CDS capabilities. In particular, the analysis draws on the authors’ experience developing and leveraging a system-agnostic CDS Web service known as SEBASTIAN. A primary potential benefit of using a system-agnostic CDS service is the relative ease and flexibility with which the service can be leveraged to implement CDS capabilities across applications and care settings. Other important potential benefits include facilitation of centralized knowledge management and knowledge sharing; the potential to support multiple underlying knowledge representations and knowledge resources through a common service interface; improved simplicity and componentization; easier testing and validation; and the enabling of distributed CDS system development. Conversely, important potential challenges include the increased effort required to develop knowledge resources capable of being used in many contexts and the critical need to standardize the service interface. Despite these challenges, our experiences to date indicate that the benefits of using a system-agnostic CDS service generally outweigh the challenges of using this approach to implementing and maintaining CDS systems. PMID:21603281

  15. Decision support systems in water and wastewater treatment process selection and design: a review.

    PubMed

    Hamouda, M A; Anderson, W B; Huck, P M

    2009-01-01

    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. PMID:19809138

  16. Decision support system for theater missile defense

    NASA Astrophysics Data System (ADS)

    Gonsalves, Paul; Burge, Janet; Popp, Ben

    2003-08-01

    Military services require C4I systems that support a full spectrum of operations. This is specifically relevant to the theatre missile defense (TMD) mission planning and analysis community where there have been several recent concept changes; advancements in information technology, sensors, and weapons; and expansion in the diversity and capabilities of potential adversaries. To fully support campaign development and analysis in this new environment, there is a need for systems and tools that enhance understanding of adversarial behavior, assess potential threat capabilities and vulnerabilities, perform C4I system trades, and provide methods to identify macro-level novel or emergent combat tactics and behavior derived from simpler micro-level rules. Such systems must also be interactive, collaborative, and semi-autonomous, providing the INTEL analyst with the means for exploration and potential exploitation of novel enemy behavior patterns. To address these issues we have developed an Intelligent Threat Assessment Processor (ITAP) to provide prediction and interpretation of enemy courses of actions (eCOAs) for the TMD domain. This system uses a combination of genetic algorithm-based optimization in tandem with the spatial analysis and visualization capabilities of a commercial-off-the-shelf (COTS) geographic information system to generate and evaluate potential eCOAs.

  17. Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise

    PubMed Central

    Militello, Laura G.; Saleem, Jason J.; Borders, Morgan R.; Sushereba, Christen E.; Haverkamp, Donald; Wolf, Steven P.; Doebbeling, Bradley N.

    2016-01-01

    Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration’s EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability. PMID:26973441

  18. VisualDecisionLinc: a visual analytics approach for comparative effectiveness-based clinical decision support in psychiatry.

    PubMed

    Mane, Ketan K; Bizon, Chris; Schmitt, Charles; Owen, Phillips; Burchett, Bruce; Pietrobon, Ricardo; Gersing, Kenneth

    2012-02-01

    Comparative Effectiveness Research (CER) is designed to provide research evidence on the effectiveness and risks of different therapeutic options on the basis of data compiled from subpopulations of patients with similar medical conditions. Electronic Health Record (EHR) system contain large volumes of patient data that could be used for CER, but the data contained in EHR system are typically accessible only in formats that are not conducive to rapid synthesis and interpretation of therapeutic outcomes. In the time-pressured clinical setting, clinicians faced with large amounts of patient data in formats that are not readily interpretable often feel 'information overload'. Decision support tools that enable rapid access at the point of care to aggregate data on the most effective therapeutic outcomes derived from CER would greatly aid the clinical decision-making process and individualize patient care. In this manuscript, we highlight the role that visual analytics can play in CER-based clinical decision support. We developed a 'VisualDecisionLinc' (VDL) tool prototype that uses visual analytics to provide summarized CER-derived data views to facilitate rapid interpretation of large amounts of data. We highlight the flexibility that visual analytics offers to gain an overview of therapeutic options and outcomes and if needed, to instantly customize the evidence to the needs of the patient or clinician. The VDL tool uses visual analytics to help the clinician evaluate and understand the effectiveness and risk of different therapeutic options for different subpopulations of patients.

  19. Distributed Hydrologic Modeling Apps for Decision Support in the Cloud

    NASA Astrophysics Data System (ADS)

    Swain, N. R.; Latu, K.; Christiensen, S.; Jones, N.; Nelson, J.

    2013-12-01

    Advances in computation resources and greater availability of water resources data represent an untapped resource for addressing hydrologic uncertainties in water resources decision-making. The current practice of water authorities relies on empirical, lumped hydrologic models to estimate watershed response. These models are not capable of taking advantage of many of the spatial datasets that are now available. Physically-based, distributed hydrologic models are capable of using these data resources and providing better predictions through stochastic analysis. However, there exists a digital divide that discourages many science-minded decision makers from using distributed models. This divide can be spanned using a combination of existing web technologies. The purpose of this presentation is to present a cloud-based environment that will offer hydrologic modeling tools or 'apps' for decision support and the web technologies that have been selected to aid in its implementation. Compared to the more commonly used lumped-parameter models, distributed models, while being more intuitive, are still data intensive, computationally expensive, and difficult to modify for scenario exploration. However, web technologies such as web GIS, web services, and cloud computing have made the data more accessible, provided an inexpensive means of high-performance computing, and created an environment for developing user-friendly apps for distributed modeling. Since many water authorities are primarily interested in the scenario exploration exercises with hydrologic models, we are creating a toolkit that facilitates the development of a series of apps for manipulating existing distributed models. There are a number of hurdles that cloud-based hydrologic modeling developers face. One of these is how to work with the geospatial data inherent with this class of models in a web environment. Supporting geospatial data in a website is beyond the capabilities of standard web frameworks and it

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

    SciTech Connect

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

    1997-02-01

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

  1. Conceptual framework of knowledge management for ethical decision-making support in neonatal intensive care.

    PubMed

    Frize, Monique; Yang, Lan; Walker, Robin C; O'Connor, Annette M

    2005-06-01

    This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.

  2. Identifying the decision to be supported: a review of papers from environmental modelling and software

    USGS Publications Warehouse

    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

    2012-01-01

    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

  3. Structured decision making as a method for linking quantitative decision support to community fundamental objectives

    EPA Science Inventory

    Decision support intended to improve ecosystem sustainability requires that we link stakeholder priorities directly to quantitative tools and measures of desired outcomes. Actions taken at the community level can have large impacts on production and delivery of ecosystem service...

  4. Reducing Diagnostic Error with Computer-Based Clinical Decision Support

    ERIC Educational Resources Information Center

    Greenes, Robert A.

    2009-01-01

    Information technology approaches to delivering diagnostic clinical decision support (CDS) are the subject of the papers to follow in the proceedings. These will address the history of CDS and present day approaches (Miller), evaluation of diagnostic CDS methods (Friedman), and the role of clinical documentation in supporting diagnostic decision…

  5. Developing a Decision Support System: The Software and Hardware Tools.

    ERIC Educational Resources Information Center

    Clark, Phillip M.

    1989-01-01

    Describes some of the available software and hardware tools that can be used to develop a decision support system implemented on microcomputers. Activities that should be supported by software are discussed, including data entry, data coding, finding and combining data, and data compatibility. Hardware considerations include speed, storage…

  6. Designing Computerized Decision Support That Works for Clinicians and Families

    PubMed Central

    Fiks, Alexander G.

    2011-01-01

    Evidence-based decision-making is central to the practice of pediatrics. Clinical trials and other biomedical research provide a foundation for this process, and practice guidelines, drawing from their results, inform the optimal management of an increasing number of childhood health problems. However, many clinicians fail to adhere to guidelines. Clinical decision support delivered using health information technology, often in the form of electronic health records, provides a tool to deliver evidence-based information to the point of care and has the potential to overcome barriers to evidence-based practice. An increasing literature now informs how these systems should be designed and implemented to most effectively improve outcomes in pediatrics. Through the examples of computerized physician order entry, as well as the impact of alerts at the point of care on immunization rates, the delivery of evidence-based asthma care, and the follow-up of children with attention deficit hyperactivity disorder, the following review addresses strategies for success in using these tools. The following review argues that, as decision support evolves, the clinician should no longer be the sole target of information and alerts. Through the Internet and other technologies, families are increasingly seeking health information and gathering input to guide health decisions. By enlisting clinical decision support systems to deliver evidence-based information to both clinicians and families, help families express their preferences and goals, and connect families to the medical home, clinical decision support may ultimately be most effective in improving outcomes. PMID:21315295

  7. IBM’s Health Analytics and Clinical Decision Support

    PubMed Central

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

    2014-01-01

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

  8. Community Support and Adolescent Girls' Vulnerability to HIV/AIDS: Evidence From Botswana, Malawi, and Mozambique.

    PubMed

    Underwood, Carol; Schwandt, Hilary M

    2015-01-01

    Girls are vulnerable to HIV in part because the social systems in which they live have failed to support and protect them. The goal of this research was to develop a viable supportive community index and test its association with intermediate variables associated with HIV risk across 16 communities in Botswana, Malawi, and Mozambique. This cross-sectional survey with separate samples randomly drawn in each country (2010) yielded a total sample of 1,418 adolescent girls (aged 11-18). Multilevel, multivariate logistic regression, while controlling for vulnerability, age, religion, and residence, found that an increase in supportive community index is positively associated with the odds of indicating improved community support for girls and with the confidence to refuse unwanted sex with a boyfriend across the three countries, as well as with self-efficacy to insist on condom use in Botswana and Mozambique. Program implementers and decision makers alike can use the supportive community index to identify and measure structural factors associated with girls' vulnerability to HIV/AIDS; this will potentially contribute to judicious decision making regarding resource allocation to enhance community-level, protective factors for adolescent girls. PMID:26470396

  9. Radiological emergency response for community agencies with cognitive task analysis, risk analysis, and decision support framework.

    PubMed

    Meyer, Travis S; Muething, Joseph Z; Lima, Gustavo Amoras Souza; Torres, Breno Raemy Rangel; del Rosario, Trystyn Keia; Gomes, José Orlando; Lambert, James H

    2012-01-01

    Radiological nuclear emergency responders must be able to coordinate evacuation and relief efforts following the release of radioactive material into populated areas. In order to respond quickly and effectively to a nuclear emergency, high-level coordination is needed between a number of large, independent organizations, including police, military, hazmat, and transportation authorities. Given the complexity, scale, time-pressure, and potential negative consequences inherent in radiological emergency responses, tracking and communicating information that will assist decision makers during a crisis is crucial. The emergency response team at the Angra dos Reis nuclear power facility, located outside of Rio de Janeiro, Brazil, presently conducts emergency response simulations once every two years to prepare organizational leaders for real-life emergency situations. However, current exercises are conducted without the aid of electronic or software tools, resulting in possible cognitive overload and delays in decision-making. This paper describes the development of a decision support system employing systems methodologies, including cognitive task analysis and human-machine interface design. The decision support system can aid the coordination team by automating cognitive functions and improving information sharing. A prototype of the design will be evaluated by plant officials in Brazil and incorporated to a future trial run of a response simulation.

  10. Radiological emergency response for community agencies with cognitive task analysis, risk analysis, and decision support framework.

    PubMed

    Meyer, Travis S; Muething, Joseph Z; Lima, Gustavo Amoras Souza; Torres, Breno Raemy Rangel; del Rosario, Trystyn Keia; Gomes, José Orlando; Lambert, James H

    2012-01-01

    Radiological nuclear emergency responders must be able to coordinate evacuation and relief efforts following the release of radioactive material into populated areas. In order to respond quickly and effectively to a nuclear emergency, high-level coordination is needed between a number of large, independent organizations, including police, military, hazmat, and transportation authorities. Given the complexity, scale, time-pressure, and potential negative consequences inherent in radiological emergency responses, tracking and communicating information that will assist decision makers during a crisis is crucial. The emergency response team at the Angra dos Reis nuclear power facility, located outside of Rio de Janeiro, Brazil, presently conducts emergency response simulations once every two years to prepare organizational leaders for real-life emergency situations. However, current exercises are conducted without the aid of electronic or software tools, resulting in possible cognitive overload and delays in decision-making. This paper describes the development of a decision support system employing systems methodologies, including cognitive task analysis and human-machine interface design. The decision support system can aid the coordination team by automating cognitive functions and improving information sharing. A prototype of the design will be evaluated by plant officials in Brazil and incorporated to a future trial run of a response simulation. PMID:22317163

  11. ClinicalAccess: a clinical decision support tool.

    PubMed

    Crowell, Karen; Vardell, Emily

    2015-01-01

    ClinicalAccess is a new clinical decision support tool that uses a question-and-answer format to mirror clinical decision-making strategies. The unique format of ClinicalAccess delivers concise, authoritative answers to more than 120,000 clinical questions. This column presents a review of the product, a sample search, and a comparison with other point-of-care search engines.

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

    PubMed Central

    Elwyn, Glyn; Dannenberg, Michelle; Blaine, Arianna; Poddar, Urbashi; Durand, Marie-Anne

    2016-01-01

    Objective Our aim in this study was to examine the competing interest policies and procedures of organisations who develop and maintain patient decision aids. Design Descriptive and thematic analysis of data collected from a cross-sectional survey of patient decision aid developer's competing interest policies and disclosure forms. Results We contacted 25 organisations likely to meet the inclusion criteria. 12 eligible organisations provided data. 11 organisations did not reply and 2 declined to participate. Most patient decision aid developers recognise the need to consider the issue of competing interests. Assessment processes vary widely and, for the most part, are insufficiently robust to minimise the risk of competing interests. Only half of the 12 organisations had competing interest policies. Some considered disclosure to be sufficient, while others imposed differing levels of exclusion. Conclusions Patient decision aid developers do not have a consistent approach to managing competing interests. Some have developed policies and procedures, while others pay no attention to the issue. As is the case for clinical practice guidelines, increasing attention will need to be given to how the competing interests of contributors of evidence-based publications may influence materials, especially if they are designed for patient use. PMID:27612542

  13. Decision Aid Tool and Ontology-Based Reasoning for Critical Infrastructure Vulnerabilities and Threats Analysis

    NASA Astrophysics Data System (ADS)

    Choraś, Michał; Flizikowski, Adam; Kozik, Rafał; Hołubowicz, Witold

    In this paper, a decision aid tool (DAT) for Critical Infrastructure threats analysis and ranking is presented. We propose the ontology-based approach that provides classification, relationships and reasoning about vulnerabilities and threats of the critical infrastructures. Our approach is a part of research within INSPIRE project for increasing security and protection through infrastructure resilience.

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

    NASA Astrophysics Data System (ADS)

    Zhou, Jianlan; Sun, Koumei

    2007-06-01

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

  15. DocBot: a novel clinical decision support algorithm.

    PubMed

    Ninh, Andrew Q

    2014-01-01

    DocBot is a web-based clinical decision support system (CDSS) that uses patient interaction and electronic health record analytics to assist medical practitioners with decision making. It consists of two distinct HTML interfaces: a preclinical form wherein a patient inputs symptomatic and demographic information, and an interface wherein a medical practitioner views patient information and analysis. DocBot comprises an improved software architecture that uses patient information, electronic health records, and etiologically relevant binary decision questions (stored in a knowledgebase) to provide medical practitioners with information including, but not limited to medical assessments, treatment plans, and specialist referrals.

  16. Modular analytics management architecture for interoperability and decision support

    NASA Astrophysics Data System (ADS)

    Marotta, Stephen; Metzger, Max; Gorman, Joe; Sliva, Amy

    2016-05-01

    The Dual Node Decision Wheels (DNDW) architecture is a new approach to information fusion and decision support systems. By combining cognitive systems engineering organizational analysis tools, such as decision trees, with the Dual Node Network (DNN) technical architecture for information fusion, the DNDW can align relevant data and information products with an organization's decision-making processes. In this paper, we present the Compositional Inference and Machine Learning Environment (CIMLE), a prototype framework based on the principles of the DNDW architecture. CIMLE provides a flexible environment so heterogeneous data sources, messaging frameworks, and analytic processes can interoperate to provide the specific information required for situation understanding and decision making. It was designed to support the creation of modular, distributed solutions over large monolithic systems. With CIMLE, users can repurpose individual analytics to address evolving decision-making requirements or to adapt to new mission contexts; CIMLE's modular design simplifies integration with new host operating environments. CIMLE's configurable system design enables model developers to build analytical systems that closely align with organizational structures and processes and support the organization's information needs.

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

    PubMed

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

    2015-07-01

    Healthcare information technology systems are considered the ideal tool to inculcate evidence-based nursing practices. The wound clinical decision support system was built locally to support nurses to manage pressure ulcer wounds in their daily practice. However, its adoption rate is not optimal. The study's objective was to discover the concepts that informed the RNs' decisions to adopt the wound clinical decision support system as an evidence-based technology in their nursing practice. This was an exploratory, descriptive, and qualitative design using face-to-face interviews, individual interviews, and active participatory observation. A purposive, theoretical sample of 14 RNs was recruited from one of the largest public tertiary hospitals in Singapore after obtaining ethics approval. After consenting, the nurses were interviewed and observed separately. Recruitment stopped when data saturation was reached. All transcribed interview data underwent a concurrent thematic analysis, whereas observational data were content analyzed independently and subsequently triangulated with the interview data. Eight emerging themes were identified, namely, use of the wound clinical decision support system, beliefs in the wound clinical decision support system, influences of the workplace culture, extent of the benefits, professional control over nursing practices, use of knowledge, gut feelings, and emotions (fear, doubt, and frustration). These themes represented the nurses' mental outlook as they made decisions on adopting the wound clinical decision support system in light of the complexities of their roles and workloads. This research has provided insight on the nurses' thoughts regarding their decision to interact with the computer environment in a Singapore context. It captured the nurses' complex thoughts when deciding whether to adopt or reject information technology as they practice in a clinical setting. PMID:26066306

  18. Translational Cognition for Decision Support in Critical Care Environments: A Review

    PubMed Central

    Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

    2008-01-01

    The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

  19. Aeromedical evacuation planning using geospatial decision-support.

    PubMed

    Bastian, Nathaniel D; Fulton, Lawrence V

    2014-02-01

    In this study, we proffer an algorithmic, geospatial-based decision-support methodology that assists military decision-makers in determining which aeromedical evacuation (MEDEVAC) assets to launch after receiving an injury location, given knowledge only of terrain, aircraft location, and aircraft capabilities. The objective is for military medical planners to use this decision-support tool (1) to improve real-time situational awareness by visualization of MEDEVAC coverage, showing which areas can be reached within established timelines; (2) to support medical planning by visualizing the impact of changes in the medical footprint to the MEDEVAC coverage; and (3) to support decision-making by providing a time-sorted list of MEDEVAC asset packages to select from, given the location of the patients. This same geospatial-based decision tool can be used for proper emplacement of evacuation assets such that the theater is covered within a truly representative 1-hour response time. We conclude with a discussion of applicability of this tool in medical force structure planning.

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

    NASA Technical Reports Server (NTRS)

    Rodriquez, Luis F.

    2004-01-01

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

  1. Judgmental biases in decision support for strike operations

    NASA Astrophysics Data System (ADS)

    Kulick, Jonathan D.; Davis, Paul K.

    2003-09-01

    Human decisionmaking does not typically fit the classical analytic model, and the heuristics employed may yield a variety of biased judgments. These biases are often considered inherently adverse, but may be functional in some cases. Decision support systems can mitigate some biases, but often introduce others. "Debiasing" decision support systems entails designing DSS to address expected biases, and to preclude inducing new ones. High-level C2 decisionmaking processes are poorly understood, but these general principles and lessons learned in other fields are expected to obtain. A notional air campaign illustrates potential biases in a commander"s judgment during planning and execution, and the role of debiasing operational DSS.

  2. Development and feasibility testing of decision support for patients who are candidates for a prophylactic implantable defibrillator: a study protocol for a pilot randomized controlled trial

    PubMed Central

    2013-01-01

    Background Patients, identified to be at risk for but who have never experienced a potentially lethal cardiac arrhythmia, have the option of receiving an implantable cardioverter defibrillator (ICD) as prophylaxis against sudden cardiac death - a primary prevention indication. In Canada, there is no clear framework to support patients’ decision-making for these devices. Decision support, using a decision aid, could moderate treatment-related uncertainty and prepare patients to make well-informed decisions. Patient decision aids provide information on treatment options, risks, and benefits, to help patients clarify their values for outcomes of treatment options. The objectives of this research are: 1) develop a decision aid, 2) evaluate the decision aid, and 3) determine the feasibility of conducting a trial. Methods/design A development panel comprised of the core investigative team, health service researchers, decision science experts, cardiovascular healthcare practitioners, and ICD patient representatives will collaborate to provide input on the content and format of the aid. To generate probabilities to include in the aid, we will synthesize primary prevention ICD evidence. To obtain anonymous input about the facts and content, we will employ a modified Delphi process. To evaluate the draft decision aid will invite ICD patients and their families (n = 30) to rate its acceptability. After we evaluate the aid, to determine the feasibility, we will conduct a feasibility pilot randomized controlled trial (RCT) in new ICD candidates (n = 80). Participants will be randomized to receive a decision aid prior to specialist consultation versus usual care. Results from the pilot RCT will determine the feasibility of research processes; inform sample size calculation, measure decision quality (knowledge, values, decision conflict) and the influence of health related quality of life on decision-making. Discussion Our study seeks to develop a decision aid, for patients

  3. The Impact of Financial Aid on Learning, Career Decisions, and Employment: Evidence from Recent Chinese College Students

    ERIC Educational Resources Information Center

    Yang, Po

    2011-01-01

    China established a large-scale financial aid system in the late 1980s. This multilayered aid system aimed at enhancing educational and employment opportunities. However, very few studies have examined the impact of student aid on learning effort and outcome, career decisions, and early labor market performance. Using two recent Chinese college…

  4. Improving the Slum Planning Through Geospatial Decision Support System

    NASA Astrophysics Data System (ADS)

    Shekhar, S.

    2014-11-01

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

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

    PubMed Central

    2014-01-01

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

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

    PubMed

    Kim, Sangkyun

    2014-01-01

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

  7. Technology Infusion Challenges from a Decision Support Perspective

    NASA Technical Reports Server (NTRS)

    Adumitroaie, V.; Weisbin, C. R.

    2009-01-01

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

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

    PubMed

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

    2012-01-01

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

  9. Distributed decision support for the 21st century mission space

    NASA Astrophysics Data System (ADS)

    McQuay, William K.

    2002-07-01

    The past decade has produced significant changes in the conduct of military operations: increased humanitarian missions, asymmetric warfare, the reliance on coalitions and allies, stringent rules of engagement, concern about casualties, and the need for sustained air operations. Future mission commanders will need to assimilate a tremendous amount of information, make quick-response decisions, and quantify the effects of those decisions in the face of uncertainty. Integral to this process is creating situational assessment-understanding the mission space, simulation to analyze alternative futures, current capabilities, planning assessments, course-of-action assessments, and a common operational picture-keeping everyone on the same sheet of paper. Decision support tools in a distributed collaborative environment offer the capability of decomposing these complex multitask processes and distributing them over a dynamic set of execution assets. Decision support technologies can semi-automate activities, such as planning an operation, that have a reasonably well-defined process and provide machine-level interfaces to refine the myriad of information that is not currently fused. The marriage of information and simulation technologies provides the mission commander with a collaborative virtual environment for planning and decision support.

  10. Data Mining and Data Fusion for Enhanced Decision Support

    SciTech Connect

    Khan, Shiraj; Ganguly, Auroop R; Gupta, Amar

    2008-01-01

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

  11. The incorporation of high resolution climatological data into environmental tactical decision aids.

    SciTech Connect

    Hummel, J. R.; Campbell, A. P.; Kehrer, M. L.; Lurie, G. R.; Simunich, K. L.

    1999-09-23

    The environment can significantly impact the performance of weapons systems and how they are used in a theater of operations. A tool has been developed by the US Army Research Laboratory (ARL) to enable operators to assess the impact of environmental factors on the performance of military systems, subsystems, and components. The ARL system, the Integrated Weather Effects Decision Aid (IWEDA) takes weather and environmental data and compares them to a set of rules that relate environmental parameters to weapons system performance. The results from the IWEDA system can enable operators to identify regions and time periods when weapons system performance may be marginal or unfavorable. The Department of Defense (DOD) Air and Space Natural Environment (ASNE) Executive Agents have developed a program, the Advanced Climate Modeling and Environmental Simulations (ACMES), to produce high resolution gridded data for use in generating high resolution climate statistics from simulated weather observations at any desired location around the world. It is intended that data from the ACMES effort could be used by commanders to assess the environmental effects on operations. This paper describes an effort to use data generated from ACMES to drive the IWEDA rules on system performance. The results from this effort are high resolution, gridded values of weapons performance statistics that can be used to support the mission planning cycle.

  12. Establishing the effectiveness of patient decision aids: key constructs and measurement instruments

    PubMed Central

    2013-01-01

    Background Establishing the effectiveness of patient decision aids (PtDA) requires evidence that PtDAs improve the quality of the decision-making process and the quality of the choice made, or decision quality. The aim of this paper is to review the theoretical and empirical evidence for PtDA effectiveness and discuss emerging practical and research issues in the measurement of effectiveness. Methods This updated overview incorporates: a) an examination of the instruments used to measure five key decision-making process constructs (i.e., recognize decision, feel informed about options and outcomes, feel clear about goals and preferences, discuss goals and preferences with health care provider, and be involved in decisions) and decision quality constructs (i.e., knowledge, realistic expectations, values-choice agreement) within the 86 trials in the Cochrane review; and b) a summary of the 2011 Cochrane Collaboration’s review of PtDAs for these key constructs. Data on the constructs and instruments used were extracted independently by two authors from the 86 trials and any disagreements were resolved by discussion, with adjudication by a third party where required. Results The 86 studies provide considerable evidence that PtDAs improve the decision-making process and decision quality. A majority of the studies (76/86; 88%) measured at least one of the key decision-making process or decision quality constructs. Seventeen different measurement instruments were used to measure decision-making process constructs, but no single instrument covered all five constructs. The Decisional Conflict Scale was most commonly used (n = 47), followed by the Control Preference Scale (n = 9). Many studies reported one or more constructs of decision quality, including knowledge (n = 59), realistic expectation of risks and benefits (n = 21), and values-choice agreement (n = 13). There was considerable variability in how values-choice agreement was defined and determined. No study

  13. Stakeholder views of management and decision support tools to integrate climate change into Great Lakes Lake Whitefish management

    USGS Publications Warehouse

    Lynch, Abigail J.; Taylor, William W.; McCright, Aaron M.

    2016-01-01

    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.

  14. Physician Attitudes toward Adopting Genome-Guided Prescribing through Clinical Decision Support.

    PubMed

    Overby, Casey Lynnette; Erwin, Angelika Ludtke; Abul-Husn, Noura S; Ellis, Stephen B; Scott, Stuart A; Obeng, Aniwaa Owusu; Kannry, Joseph L; Hripcsak, George; Bottinger, Erwin P; Gottesman, Omri

    2014-01-01

    This study assessed physician attitudes toward adopting genome-guided prescribing through clinical decision support (CDS), prior to enlisting in the Clinical Implementation of Personalized Medicine through Electronic Health Records and Genomics pilot pharmacogenomics project (CLIPMERGE PGx). We developed a survey instrument that includes the Evidence Based Practice Attitude Scale, adapted to measure attitudes toward adopting genome-informed interventions (EBPAS-GII). The survey also includes items to measure physicians' characteristics (awareness, experience, and perceived usefulness), attitudes about personal genome testing (PGT) services, and comfort using technology. We surveyed 101 General Internal Medicine physicians from the Icahn School of Medicine at Mount Sinai (ISMMS). The majority were residency program trainees (~88%). Prior to enlisting into CLIPMERGE PGx, most physicians were aware of and had used decision support aids. Few physicians, however, were aware of and had used genome-guided prescribing. The majority of physicians viewed decision support aids and genotype data as being useful for making prescribing decisions. Most physicians had not heard of, but were willing to use, PGT services and felt comfortable interpreting PGT results. Most physicians were comfortable with technology. Physicians who perceived genotype data to be useful in making prescribing decisions, had more positive attitudes toward adopting genome-guided prescribing through CDS. Our findings suggest that internal medicine physicians have a deficit in their familiarity and comfort interpreting and using genomic information. This has reinforced the importance of gathering feedback and guidance from our enrolled physicians when designing genome-guided CDS and the importance of prioritizing genomic medicine education at our institutions. PMID:25562141

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

    SciTech Connect

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

    2007-11-01

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

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

    PubMed Central

    Holmes-Rovner, Margaret; Stableford, Sue; Fagerlin, Angela; Wei, John T; Dunn, Rodney L; Ohene-Frempong, Janet; Kelly-Blake, Karen; Rovner, David R

    2005-01-01

    Background Decision aids (DA) to assist patients in evaluating treatment options and sharing in decision making have proliferated in recent years. Most require high literacy and do not use plain language principles. We describe one of the first attempts to design a decision aid using principles from reading research and document design. The plain language DA prototype addressed treatment decisions for localized prostate cancer. Evaluation assessed impact on knowledge, decisions, and discussions with doctors in men newly diagnosed with prostate cancer. Methods Document development steps included preparing an evidence-based DA in standard medical parlance, iteratively translating it to emphasize shared decision making and plain language in three formats (booklet, Internet, and audio-tape). Scientific review of medical content was integrated with expert health literacy review of document structure and design. Formative evaluation methods included focus groups (n = 4) and survey of a new sample of men newly diagnosed with prostate cancer (n = 60), compared with historical controls (n = 184). Results A transparent description of the development process and design elements is reported. Formative evaluation among newly diagnosed prostate cancer patients found the DA to be clear and useful in reaching a decision. Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy. Conclusion The plain language DA presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men. PMID:15963238

  17. A Decision Support System for Solving Multiple Criteria Optimization Problems

    ERIC Educational Resources Information Center

    Filatovas, Ernestas; Kurasova, Olga

    2011-01-01

    In this paper, multiple criteria optimization has been investigated. A new decision support system (DSS) has been developed for interactive solving of multiple criteria optimization problems (MOPs). The weighted-sum (WS) approach is implemented to solve the MOPs. The MOPs are solved by selecting different weight coefficient values for the criteria…

  18. Team Machine: A Decision Support System for Team Formation

    ERIC Educational Resources Information Center

    Bergey, Paul; King, Mark

    2014-01-01

    This paper reports on the cross-disciplinary research that resulted in a decision-support tool, Team Machine (TM), which was designed to create maximally diverse student teams. TM was used at a large United States university between 2004 and 2012, and resulted in significant improvement in the performance of student teams, superior overall balance…

  19. DECISION SUPPORT FRAMEWORK FOR PLACEMENT OF BMPS IN URBAN WATERSHEDS

    EPA Science Inventory

    To assist stormwater management professionals in planning for best management practices (BMPs) implementation, the U.S. Environmental Protection Agency (USEPA) initiated a research in 2003 to develop a decision support system for placement of BMPs at strategic locations in urban ...

  20. Integrated decision support tools for Puget Sound salmon recovery planning

    EPA Science Inventory

    We developed a set of tools to provide decision support for community-based salmon recovery planning in Salish Sea watersheds. Here we describe how these tools are being integrated and applied in collaboration with Puget Sound tribes and community stakeholders to address restora...

  1. A Web-Based Decision Support Tool for Academic Advising

    ERIC Educational Resources Information Center

    Feghali, Tony; Zbib, Imad; Hallal, Sophia

    2011-01-01

    Student advising is an important and time-consuming effort in academic life. This paper attempts to solve a technology-based "last mile" problem by developing and evaluating a web-based decision support tool (the Online Advisor) that helps advisors and students make better use of an already present university student information system. Two…

  2. A decision support system for rainfed agricultural areas of Mexico

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rural inhabitants of arid lands lack sufficient water to fulfill their agricultural and household needs. They do not have readily available technical information to support decisions regarding the course of action they should follow to handle the agro-climatic risk. In this paper, a computer model (...

  3. Design and application of a generic clinical decision support system for multiscale data.

    PubMed

    Mattila, Jussi; Koikkalainen, Juha; Virkki, Arho; van Gils, Mark; Lötjönen, Jyrki

    2012-01-01

    Medical research and clinical practice are currently being redefined by the constantly increasing amounts of multiscale patient data. New methods are needed to translate them into knowledge that is applicable in healthcare. Multiscale modeling has emerged as a way to describe systems that are the source of experimental data. Usually, a multiscale model is built by combining distinct models of several scales, integrating, e.g., genetic, molecular, structural, and neuropsychological models into a composite representation. We present a novel generic clinical decision support system, which models a patient's disease state statistically from heterogeneous multiscale data. Its goal is to aid in diagnostic work by analyzing all available patient data and highlighting the relevant information to the clinician. The system is evaluated by applying it to several medical datasets and demonstrated by implementing a novel clinical decision support tool for early prediction of Alzheimer's disease.

  4. Tools to support evidence-informed public health decision making

    PubMed Central

    2014-01-01

    Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing

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

    PubMed

    Ray, S

    1992-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  7. A Decision Support System for Concrete Bridge Maintenance

    NASA Astrophysics Data System (ADS)

    Rashidi, Maria; Lemass, Brett; Gibson, Peter

    2010-05-01

    The maintenance of bridges as a key element in transportation infrastructure has become a major concern for asset managers and society due to increasing traffic volumes, deterioration of existing bridges and well-publicised bridge failures. A pivotal responsibility for asset managers in charge of bridge remediation is to identify the risks and assess the consequences of remediation programs to ensure that the decisions are transparent and lead to the lowest predicted losses in recognized constraint areas. The ranking of bridge remediation treatments can be quantitatively assessed using a weighted constraint approach to structure the otherwise ill-structured phases of problem definition, conceptualization and embodiment [1]. This Decision Support System helps asset managers in making the best decision with regards to financial limitations and other dominant constraints imposed upon the problem at hand. The risk management framework in this paper deals with the development of a quantitative intelligent decision support system for bridge maintenance which has the ability to provide a source for consistent decisions through selecting appropriate remediation treatments based upon cost, service life, product durability/sustainability, client preferences, legal and environmental constraints. Model verification and validation through industry case studies is ongoing.

  8. Computerized decision support system for kidney paired donation program.

    PubMed

    Chen, Yanhua; Song, Peter X-K

    2011-01-01

    In order to assist physicians and other health professionals for health care improvement, clinical decision support systems, through interactive computerized software, become very popular in clinical practice. The crisis associated with kidney organ shortage has triggered an innovative strategy, termed as Kidney Paired Donation (KPD) program, to address a rapidly expanding demand for donor kidneys. KPD program involves how to making optimal decision for allowing patients with incompatible living donors to receive compatible organs by best matching donors. Although some computerized optimization tools are being used in the current KPD program, there still lacks a general decision support system which enables us to evaluate and compare different kidney allocation strategies and effects of policy. In this paper, we discuss a general computer-based KPD decision model that appropriately reflects the real world clinical application. Also, the whole decision process is to be visualized by our Graphical User Interface (GUI) software, which offers a user friendly platform not only to provide a convenient interface for clinicians but also to assess different kidney exchange strategies of clinical importance. PMID:22255013

  9. Supporting registration decisions during 3D medical volume reconstructions

    NASA Astrophysics Data System (ADS)

    Bajcsy, Peter; Lee, Sang-Chul; Clutter, David

    2006-03-01

    We propose a methodology for making optimal registration decisions during 3D volume reconstruction in terms of (a) anticipated accuracy of aligned images, (b) uncertainty of obtained results during the registration process, (c) algorithmic repeatability of alignment procedure, and (d) computational requirements. We researched and developed a web-enabled, web services based, data-driven, registration decision support system. The registration decisions include (1) image spatial size (image sub-area or entire image), (2) transformation model (e.g., rigid, affine or elastic), (3) invariant registration feature (intensity, morphology or a sequential combination of the two), (4) automation level (manual, semi-automated, or fully-automated), (5) evaluations of registration results (multiple metrics and methods for establishing ground truth), and (6) assessment of resources (computational resources and human expertise, geographically local or distributed). Our goal is to provide mechanisms for evaluating the tradeoffs of each registration decision in terms of the aforementioned impacts. First, we present a medical registration methodology for making registration decisions that lead to registration results with well-understood accuracy, uncertainty, consistency and computational complexity characteristics. Second, we have built software tools that enable geographically distributed researchers to optimize their data-driven registration decisions by using web services and supercomputing resources. The support developed for registration decisions about 3D volume reconstruction is available to the general community with the access to the NCSA supercomputing resources. We illustrate performance by considering 3D volume reconstruction of blood vessels in histological sections of uveal melanoma from serial fluorescent labeled paraffin sections labeled with antibodies to CD34 and laminin. The specimens are studied by fluorescence confocal laser scanning microscopy (CLSM) images.

  10. Physician characteristics associated with decisions to withdraw life support.

    PubMed Central

    Christakis, N A; Asch, D A

    1995-01-01

    OBJECTIVE. This study was undertaken to identify attributes of physicians associated with physicians' decisions to withdraw life support. METHODS. Of the 862 Pennsylvania internists surveyed and asked to make decisions in response to hypothetical vignettes and to report their actual experience with the withdrawal of life support, 485 (56%) responded. The data were analyzed with regression models. RESULTS. With other factors controlled, physicians were more willing to withdraw life support if they were young, practiced in a tertiary care setting, or spent more time in clinical practice; they were less willing if they were Catholic or Jewish. Physicians reported a higher frequency of actually withdrawing life support if they were young, had more contact with ICU patients, spent more time in clinical practice, or were specialists. Physicians with a greater willingness to withdraw were more likely to report having done so. CONCLUSIONS. Physicians' personal characteristics are associated with both their preferences and their practice in the withdrawal of life support, and a greater willingness to withdraw is associated with a higher frequency of withdrawal. The influence of physician characteristics demonstrates that patient preferences and clinical circumstances do not exclusively govern such ethical decisions. PMID:7892921

  11. Needs assessment for diagnostic decision support systems (DDSS).

    PubMed Central

    Berner, E. S.; Shugerman, A. A.

    1991-01-01

    Diagnostic decision support systems are often developed without a clear idea of how well the system will meet the needs of its users. The present study was designed to assess the information needs of clinicians. A set of questions submitted to an information service by family physicians was used to determine how much need there was for diagnostic decision support, the types of support needed, and the general content areas of their questions. Results showed that less than half of the questions were related to diagnosis and that most of those were requests for general information about a given condition. In addition, the fewest diagnosis questions were for conditions that were seen frequently in ambulatory care in a survey of family practitioners. PMID:1807674

  12. Comparison of Two Modes of Delivery of First Aid Training Including Basic Life Support

    ERIC Educational Resources Information Center

    Lippmann, John; Livingston, Patricia; Craike, Melinda J.

    2011-01-01

    Aims: Flexible-learning first aid courses are increasingly common due to reduced classroom contact time. This study compared retention of first aid knowledge and basic life support (BLS) skills three months after a two-day, classroom-based first aid course (STD) to one utilizing on-line theory learning at home followed by one day of classroom…

  13. Development of patient decision support tools for motor neuron disease using stakeholder consultation: a study protocol

    PubMed Central

    Hogden, Anne; Greenfield, David; Caga, Jashelle; Cai, Xiongcai

    2016-01-01

    Introduction Motor neuron disease (MND) is a terminal, progressive, multisystem disorder. Well-timed decisions are key to effective symptom management. To date, there are few published decision support tools, also known as decision aids, to guide patients in making ongoing choices for symptom management and quality of life. This protocol is to develop and validate decision support tools for patients and families to use in conjunction with health professionals in MND multidisciplinary care. The tools will inform patients and families of the benefits and risks of each option, as well as the consequences of accepting or declining treatment. Methods and analysis The study is being conducted from June 2015 to May 2016, using a modified Delphi process. A 2-stage, 7-step process will be used to develop the tools, based on existing literature and stakeholder feedback. The first stage will be to develop the decision support tools, while the second stage will be to validate both the tools and the process used to develop them. Participants will form expert panels, to provide feedback on which the development and validation of the tools will be based. Participants will be drawn from patients with MND, family carers and health professionals, support association workers, peak body representatives, and MND and patient decision-making researchers. Ethics and dissemination Ethical approval for the study has been granted by Macquarie University Human Research Ethics Committee (HREC), approval number 5201500658. Knowledge translation will be conducted via publications, seminar and conference presentations to patients and families, health professionals and researchers. PMID:27053272

  14. Interactive Decision-Support Tool for Risk-Based Radiation Therapy Plan Comparison for Hodgkin Lymphoma

    SciTech Connect

    Brodin, N. Patrik; Maraldo, Maja V.; Aznar, Marianne C.; Vogelius, Ivan R.; Petersen, Peter M.; Bentzen, Søren M.; Specht, Lena

    2014-02-01

    Purpose: To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL). Methods and Materials: A decision-support tool for risk-based, individualized treatment plan comparison is presented. The tool displays dose–response relationships, derived from published clinical data, for a number of relevant side effects and thereby provides direct visualization of the trade-off between these endpoints. The Quantitative Analyses of Normal Tissue Effects in the Clinic reports were applied, complemented with newer data where available. A “relevance score” was assigned to each data source, reflecting how relevant the input data are to current RT for HL. Results: The tool is applied to visualize the local steepness of dose–response curves to drive the reoptimization of a volumetric modulated arc therapy treatment plan for an HL patient with head-and-neck involvement. We also use this decision-support tool to visualize and quantitatively evaluate the trade-off between a 3-dimensional conformal RT plan and a volumetric modulated arc therapy plan for a patient with mediastinal HL. Conclusion: This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options.

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

    PubMed

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

    2013-01-01

    Few studies have examined how specific emotions may affect decision-making processes. Anxiety may be especially relevant in health decisions such as those related to cancer in which thoughts of illness or death may be abundant. We examined associations between women's anxiety about developing breast cancer and variables related to their decision to take a medication that could reduce their chances of the disease. Six-hundred and thirty-two American women, who had an increased risk of breast cancer, reviewed a web-based decision aid about tamoxifen. We examined associations between their baseline, self-reported anxiety about developing the disease and post decision aid measures including knowledge about tamoxifen, attitude toward the medication, and behavioral intentions to look for more information and take the medication. Results showed that anxiety was not associated with knowledge about tamoxifen, but it was associated with attitude toward the medication such that women who were more anxious about developing breast cancer were more likely to think the benefits were worth the risks. Greater anxiety was also associated with greater behavioral intentions to look for additional information and take the medication in the next few months. Secondary analyses showed that behavioral intentions were related to knowledge of tamoxifen and attitude toward the medication only for women who were reporting low levels of anxiety. Overall, the findings suggest that anxiety about breast cancer may motivate interest in tamoxifen and not necessarily through affecting knowledge or attitudes. PMID:23200299

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

    PubMed Central

    2014-01-01

    Background We aimed to evaluate the effect of a decision aid (DA) with information only compared to a DA with values clarification exercise (VCE), and to study the role of personality and information seeking style in DA-use, decisional conflict (DC) and knowledge. Methods Two scenario-based experiments were conducted with two different groups of healthy female participants. Dependent measures were: DC, knowledge, and DA-use (time spent, pages viewed, VCE used). Respondents were randomized between a DA with information only (VCE-) and a DA with information plus a VCE(VCE+) (experiment 1), or between information only (VCE-), information plus VCE without referral to VCE(VCE+), and information plus a VCE with specific referral to the VCE, requesting participants to use the VCE(VCE++) (experiment 2). In experiment 2 we additionally measured personality (neuroticism/conscientiousness) and information seeking style (monitoring/blunting). Results Experiment 1. There were no differences in DC, knowledge or DA-use between VCE- (n=70) and VCE+ (n=70). Both DAs lead to a mean gain in knowledge from 39% at baseline to 73% after viewing the DA. Within VCE+, VCE-users (n=32, 46%) reported less DC compared to non-users. Since there was no difference in DC between VCE- and VCE+, this is likely an effect of VCE-use in a self-selected group, and not of the VCE per se. Experiment 2. There were no differences in DC or knowledge between VCE- (n=65), VCE+ (n=66), VCE++ (n=66). In all groups, knowledge increased on average from 42% at baseline to 72% after viewing the DA. Blunters viewed fewer DA-pages (R=0.38, p<.001). More neurotic women were less certain (R=0.18, p<.01) and felt less supported in decision making (R=0.15, p<.05); conscientious women felt more certain (R=-0.15, p<.05) and had more knowledge after viewing the DA (R=0.15, p<.05). Conclusions Both DAs lead to increased knowledge in healthy populations making hypothetical decisions, and use of the VCE did not improve

  17. Decision support for simulation-based operation planning

    NASA Astrophysics Data System (ADS)

    Schubert, Johan; Hörling, Pontus

    2016-05-01

    In this paper, we develop methods for analyzing large amounts of data from a military ground combat simulation system. Through a series of processes, we focus the big data set on situations that correspond to important questions and show advantageous outcomes. The result is a decision support methodology that provides commanders with results that answer specific questions of interest, such as what the consequences for the Blue side are in various Red scenarios or what a particular Blue force can withstand. This approach is a step toward taking the traditional data farming methodology from its analytical view into a prescriptive operation planning context and a decision making mode.

  18. Virtual medical record implementation for enhancing clinical decision support.

    PubMed

    Gomoi, Valentin-Sergiu; Dragu, Daniel; Stoicu-Tivadar, Vasile

    2012-01-01

    Development of clinical decision support systems (CDS) is a process which highly depends on the local databases, this resulting in low interoperability. To increase the interoperability of CDS a standard representation of clinical information is needed. The paper suggests a CDS architecture which integrates several HL7 standards and the new vMR (virtual Medical Record). The clinical information for the CDS systems (the vMR) is represented with Topic Maps technology. Beside the implementation of the vMR, the architecture integrates: a Data Manager, an interface, a decision making system (based on Egadss), a retrieving data module. Conclusions are issued.

  19. Semantic Interoperability in Clinical Decision Support Systems: A Systematic Review.

    PubMed

    Marco-Ruiz, Luis; Bellika, Johan Gustav

    2015-01-01

    The interoperability of Clinical Decision Support (CDS) systems with other health information systems has become one of the main limitations to their broad adoption. Semantic interoperability must be granted in order to share CDS modules across different health information systems. Currently, numerous standards for different purposes are available to enable the interoperability of CDS systems. We performed a literature review to identify and provide an overview of the available standards that enable CDS interoperability in the areas of clinical information, decision logic, terminology, and web service interfaces. PMID:26262260

  20. Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

    SciTech Connect

    Feldman, D.L.; Dobson, J.E.

    1990-08-01

    This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures, and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.

  1. Decision-aided sampling frequency offset compensation for reduced-guard-interval coherent optical OFDM systems.

    PubMed

    Wang, Wei; Zhuge, Qunbi; Morsy-Osman, Mohamed; Gao, Yuliang; Xu, Xian; Chagnon, Mathieu; Qiu, Meng; Hoang, Minh Thang; Zhang, Fangyuan; Li, Rui; Plant, David V

    2014-11-01

    We propose a decision-aided algorithm to compensate the sampling frequency offset (SFO) between the transmitter and receiver for reduced-guard-interval (RGI) coherent optical (CO) OFDM systems. In this paper, we first derive the cyclic prefix (CP) requirement for preventing OFDM symbols from SFO induced inter-symbol interference (ISI). Then we propose a new decision-aided SFO compensation (DA-SFOC) algorithm, which shows a high SFO tolerance and reduces the CP requirement. The performance of DA-SFOC is numerically investigated for various situations. Finally, the proposed algorithm is verified in a single channel 28 Gbaud polarization division multiplexing (PDM) RGI CO-OFDM experiment with QPSK, 8 QAM and 16 QAM modulation formats, respectively. Both numerical and experimental results show that the proposed DA-SFOC method is highly robust against the standard SFO in optical fiber transmission. PMID:25401902

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

    NASA Astrophysics Data System (ADS)

    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.

  3. Enhanced support for shared decision making reduced costs of care for patients with preference-sensitive conditions.

    PubMed

    Veroff, David; Marr, Amy; Wennberg, David E

    2013-02-01

    Shared decision making is an approach to care that seeks to fully inform patients about the risks and benefits of available treatments and engage them as participants in decisions about the treatments. Although recent federal and state policies pursue the expanded use of shared decision making as a way to improve care quality and patient experience, payers and providers want evidence that this emerging model of care is cost-effective. We examined data obtained from a year-long randomized investigation. The study compared the effects on patients of receiving a usual level of support in making a medical treatment decision with the effects of receiving enhanced support, which included more contact with trained health coaches through telephone, mail, e-mail, and the Internet. We found that patients who received enhanced support had 5.3 percent lower overall medical costs than patients who received the usual level of support. The enhanced-support group had 12.5 percent fewer hospital admissions than the usual-support group, and 9.9 percent fewer preference-sensitive surgeries, including 20.9 percent fewer preference-sensitive heart surgeries. These findings indicate that support for shared decision making can generate savings. They also suggest that a "remote" model of support-combining telephonic coaching with decision aids, for example-may constitute a relatively low-cost and effective intervention that could reach broader populations without the need for the direct involvement of regular medical care team members.

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

    PubMed Central

    Alley, William; Mahler, Simon A

    2015-01-01

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

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

    PubMed Central

    2012-01-01

    Background Self-tests, tests on body materials to detect medical conditions, are widely available to the general public. Self-testing does have advantages as well as disadvantages, and the debate on whether self-testing should be encouraged or rather discouraged is still ongoing. One of the concerns is whether consumers have sufficient knowledge to perform the test and interpret the results. An online decision aid (DA) with information on self-testing in general, and test specific information on cholesterol and diabetes self-testing was developed. The DA aims to provide objective information on these self-tests as well as a decision support tool to weigh the pros and cons of self-testing. The aim of this study is to evaluate the effect of the online decision aid on knowledge on self-testing, informed choice, ambivalence and psychosocial determinants. Methods/Design A single blind randomised controlled trial in which the online decision aid 'zelftestwijzer' is compared to short, non-interactive information on self-testing in general. The entire trial will be conducted online. Participants will be selected from an existing Internet panel. Consumers who are considering doing a cholesterol or diabetes self-test in the future will be included. Outcome measures will be assessed directly after participants have viewed either the DA or the control condition. Weblog files will be used to record participants' use of the decision aid. Discussion Self-testing does have important pros and cons, and it is important that consumers base their decision whether they want to do a self-test or not on knowledge and personal values. This study is the first to evaluate the effect of an online decision aid for self-testing. Trial registration Dutch Trial Register: NTR3149 PMID:22216905

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

    PubMed Central

    Clarinval, Caroline; Biller-Andorno, Nikola

    2014-01-01

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

  7. A Decision Support System for Optimum Use of Fertilizers

    SciTech Connect

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

    1999-07-01

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

  8. A Decision Support System for Optimum Use of Fertilizers

    SciTech Connect

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

    1999-07-01

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

  9. Hospital management decision support: a balanced scorecard approach.

    PubMed

    Gordon, D; Chapman, R; Kunov, H; Dolan, A; Carter, M

    1998-01-01

    Hospital management teams receive voluminous data from a wide variety of sources, but are unable to distill the essential data they require to make good decisions. We have used a methodology, which helps teams define and use important management data coupled with an information system that makes this data accessible. Results of our evaluation indicate that the process of developing a Balanced Scorecard indicator system helps management teams to define meaningful strategic objectives and measurable performance indicators. The framework combined with the information acts as an integrating force, providing a shared understanding of the unit's goals. We conclude that a customized decision support system, which integrates multiple measures in a balanced Scorecard framework, is a powerful tool for enabling complex decision making by a management team. PMID:10384497

  10. Middle Mississippi River decision support system: user's manual

    USGS Publications Warehouse

    Rohweder, Jason J.; Zigler, Steven J.; Fox, Timothy J.; Hulse, Steven N.

    2005-01-01

    This user's manual describes the Middle Mississippi River Decision Support System (MMRDSS) and gives detailed examples on its use. The MMRDSS provides a framework to assist decision makers regarding natural resource issues in the Middle Mississippi River floodplain. The MMRDSS is designed to provide users with a spatially explicit tool for tasks, such as inventorying existing knowledge, developing models to investigate the potential effects of management decisions, generating hypotheses to advance scientific understanding, and developing scientifically defensible studies and monitoring. The MMRDSS also includes advanced tools to assist users in evaluating differences in complexity, connectivity, and structure of aquatic habitats among river reaches. The Environmental Systems Research Institute ArcView 3.x platform was used to create and package the data and tools of the MMRDSS.

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

    NASA Technical Reports Server (NTRS)

    Tavana, Madjid

    1995-01-01

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

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

    ERIC Educational Resources Information Center

    Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive

    2015-01-01

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

  13. Human Decision Processes: Implications for SSA Support Tools

    NASA Astrophysics Data System (ADS)

    Picciano, P.

    2013-09-01

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

  14. Reducing diagnostic error with computer-based clinical decision support.

    PubMed

    Greenes, Robert A

    2009-09-01

    Information technology approaches to delivering diagnostic clinical decision support (CDS) are the subject of the papers to follow in the proceedings. These will address the history of CDS and present day approaches (Miller), evaluation of diagnostic CDS methods (Friedman), and the role of clinical documentation in supporting diagnostic decision making (Schiff). In addition, several other considerations relating to this topic are interesting to ponder. We are moving toward increased understanding of gene regulation and gene expression, identification of biomarkers, and the ability to predict patient response to disease and to tailor treatments to these individual variations-referred to as "personalized" or, more recently, "predictive" medicine. Consequently, diagnostic decision making is more and more linked to management decision making, and generic diagnostic labels like "diabetes" or "colon cancer" will no longer be sufficient, because they don't tell us what to do. Ultimately, if we have more complete data including more structured capture of phenomic data as well as the characterization of the patient's genome, direct prediction from responses of highly refined subsets of similar patients in a database can be used to select appropriate management, the effectiveness of which was demonstrated in projects in selected limited domains as early as the 1970s. In general, there are six classes of methodologies, including the above, which can be applied to delivering CDS. In addition, patients are becoming more knowledgeable and should be regarded as active participants, not only in helping to obtain data but also in their own status assessment and as recipients of decision support. With the above advances, this is a very promising time to be engaged in pursuit of methods of CDS. PMID:19669915

  15. Supported decision making: a review of the international literature.

    PubMed

    Davidson, Gavin; Kelly, Berni; Macdonald, Geraldine; Rizzo, Maria; Lombard, Louise; Abogunrin, Oluwaseye; Clift-Matthews, Victoria; Martin, Alison

    2015-01-01

    Supported decision making (SDM) refers to the process of supporting people, whose decision making ability may be impaired, to make decisions and so promote autonomy and prevent the need for substitute decision making. There have been developments in SDM but mainly in the areas of intellectual disabilities and end-of-life care rather than in mental health. The main aim of this review was to provide an overview of the available evidence relevant to SDM and so facilitate discussion of how this aspect of law, policy and practice may be further developed in mental health services. The method used for this review was a Rapid Evidence Assessment which involved: developing appropriate search strategies; searching relevant databases and grey literature; then assessing, including and reviewing relevant studies. Included studies were grouped into four main themes: studies reporting stakeholders' views on SDM; studies identifying barriers to the implementation of SDM; studies highlighting ways to improve implementation; and studies on the impact of SDM. The available evidence on implementation and impact, identified by this review, is limited but there are important rights-based, effectiveness and pragmatic arguments for further developing and researching SDM for people with mental health problems.

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

    NASA Astrophysics Data System (ADS)

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

    2016-04-01

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

  17. Decision support for subjects exposed to heat stress.

    PubMed

    Seeberg, Trine M; Vardøy, Astrid-Sofie B; Taklo, Maaike M Visser; Austad, Hanne Opsahl

    2013-03-01

    The physiological and activity strain index (PASI) has been developed to improve the online decision support for workers exposed to heat stress. Fire fighters (smoke divers) which are exposed to both heat-stress and high-risk situations have been used as test case. PASI combines a modified version of the relatively well-known physiological strain index (PSI) with activity data from accelerometers. The algorithm has been developed based on tests in a laboratory, and it has been verified in two field tests performed by smoke divers exposed to heat stress. The verification demonstrates that it is possible to distinguish between high- and low-risk situations when data from accelerometers are added to the situation analysis. This indicates that PASI can contribute to an improved risk assessment and online decision support for smoke divers compared to using PSI alone. PMID:24235112

  18. On the heuristic nature of medical decision-support systems.

    PubMed

    Aliferis, C F; Miller, R A

    1995-03-01

    In the realm of medical decision-support systems, the term "heuristic systems" is often considered to be synonymous with "medical artificial intelligence systems" or with "systems employing informal model(s) of problem solving". Such a view may be inaccurate and possibly impede the conceptual development of future systems. This article examines the nature of heuristics and the levels at which heuristic solutions are introduced during system design and implementation. The authors discuss why heuristics are ubiquitous in all medical decision-support systems operating at non-trivial domains, and propose a unifying definition of heuristics that encompasses formal and ad hoc systems. System developers should be aware of the heuristic nature of all problem solving done in complex real world domains, and characterize their own use of heuristics in describing system development and implementation. PMID:9082138

  19. Decision support system based semantic web for personalized patient care.

    PubMed

    Douali, Nassim; De Roo, Jos; Jaulent, Marie-Christine

    2012-01-01

    Personalized medicine may be considered an extension of traditional approaches to understanding and treating diseases, but with greater precision. A profile of a patient's genetic variation can guide the selection of drugs or treatment protocols that minimize harmful side effects or ensure a more successful outcome. In this paper we describe a decision support system designed to assist physicians for personalized care, and methodology for integration in the clinical workflow. A reasoning method for interacting heterogeneous knowledge and data is a necessity in the context of personalized medicine. Development of clinical decision support based semantic web for personalized patient care is to achieve its potential and improve the quality, safety and efficiency of healthcare.

  20. Supporting decision making and action selection under time pressure and uncertainty: the case of in-flight icing.

    PubMed

    Sarter, N B; Schroeder, B

    2001-01-01

    Operators in high-risk domains such as aviation often need to make decisions under time pressure and uncertainty. One way to support them in this task is through the introduction of decision support systems (DSSs). The present study examined the effectiveness of two different DSS implementations: status and command displays. Twenty-seven pilots (9 pilots each in a baseline, status, and command group) flew 20 simulated approaches involving icing encounters. Accuracy of the decision aid (a smart icing system), familiarity with the icing condition, timing of icing onset, and autopilot usage were varied within subjects. Accurate information from either decision aid led to improved handling of the icing encounter. However, when inaccurate information was presented, performance dropped below that of the baseline condition. The cost of inaccurate information was particularly high for command displays and in the case of unfamiliar icing conditions. Our findings suggest that unless perfect reliability of a decision aid can be assumed, status displays may be preferable to command displays in high-risk domains (e.g., space flight, medicine, and process control), as the former yield more robust performance benefits and appear less vulnerable to automation biases.

  1. Distributed collaborative decision support environments for predictive awareness

    NASA Astrophysics Data System (ADS)

    McQuay, William K.; Stilman, Boris; Yakhnis, Vlad

    2005-05-01

    The past decade has produced significant changes in the conduct of military operations: asymmetric warfare, the reliance on dynamic coalitions, stringent rules of engagement, increased concern about collateral damage, and the need for sustained air operations. Mission commanders need to assimilate a tremendous amount of information, rapidly assess the enemy"s course of action (eCOA) or possible actions and promulgate their own course of action (COA) - a need for predictive awareness. Decision support tools in a distributed collaborative environment offer the capability of decomposing complex multitask processes and distributing them over a dynamic set of execution assets that include modeling, simulations, and analysis tools. Revolutionary new approaches to strategy generation and assessment such as Linguistic Geometry (LG) permit the rapid development of COA vs. enemy COA (eCOA). LG tools automatically generate and permit the operators to take advantage of winning strategies and tactics for mission planning and execution in near real-time. LG is predictive and employs deep "look-ahead" from the current state and provides a realistic, reactive model of adversary reasoning and behavior. Collaborative environments provide the framework and integrate models, simulations, and domain specific decision support tools for the sharing and exchanging of data, information, knowledge, and actions. This paper describes ongoing research efforts in applying distributed collaborative environments to decision support for predictive mission awareness.

  2. African American Women Living with HIV/AIDS: Families as Sources of Support and Stress.

    ERIC Educational Resources Information Center

    Owens, Sharon

    2003-01-01

    Presents findings from interviews conducted with 18 African American women living with HIV/AIDS. Presents their perceptions of ways in which their families function as a source of support and as a source of stress in their dealings with HIV/AIDS issues. Provides information on supportive aspects provided by family in emotional, concrete, and…

  3. Supporting Lesotho Teachers to Develop Resilience in the Face of the HIV and AIDS Pandemic

    ERIC Educational Resources Information Center

    Wood, Lesley; Ntaote, Grace Makeletso; Theron, Linda

    2012-01-01

    HIV and AIDS threaten to erode the wellbeing of teachers who are faced with an increasing number of children rendered vulnerable by the pandemic. This article explores the usefulness of a supportive group intervention, Resilient Educators (REds), in supporting Lesotho teachers to respond to the HIV and AIDS-related challenges. A time-series pre-…

  4. Emulation Modeling with Bayesian Networks for Efficient Decision Support

    NASA Astrophysics Data System (ADS)

    Fienen, M. N.; Masterson, J.; Plant, N. G.; Gutierrez, B. T.; Thieler, E. R.

    2012-12-01

    Bayesian decision networks (BDN) have long been used to provide decision support in systems that require explicit consideration of uncertainty; applications range from ecology to medical diagnostics and terrorism threat assessments. Until recently, however, few studies have applied BDNs to the study of groundwater systems. BDNs are particularly useful for representing real-world system variability by synthesizing a range of hydrogeologic situations within a single simulation. Because BDN output is cast in terms of probability—an output desired by decision makers—they explicitly incorporate the uncertainty of a system. BDNs can thus serve as a more efficient alternative to other uncertainty characterization methods such as computationally demanding Monte Carlo analyses and others methods restricted to linear model analyses. We present a unique application of a BDN to a groundwater modeling analysis of the hydrologic response of Assateague Island, Maryland to sea-level rise. Using both input and output variables of the modeled groundwater response to different sea-level (SLR) rise scenarios, the BDN predicts the probability of changes in the depth to fresh water, which exerts an important influence on physical and biological island evolution. Input variables included barrier-island width, maximum island elevation, and aquifer recharge. The variability of these inputs and their corresponding outputs are sampled along cross sections in a single model run to form an ensemble of input/output pairs. The BDN outputs, which are the posterior distributions of water table conditions for the sea-level rise scenarios, are evaluated through error analysis and cross-validation to assess both fit to training data and predictive power. The key benefit for using BDNs in groundwater modeling analyses is that they provide a method for distilling complex model results into predictions with associated uncertainty, which is useful to decision makers. Future efforts incorporate

  5. Disaster Management with a Next Generation Disaster Decision Support System

    NASA Astrophysics Data System (ADS)

    Chen, Y.

    2015-12-01

    As populations become increasingly concentrated in large cities, the world is experiencing an inevitably growing trend towards the urbanisation of disasters. Scientists have contributed significant advances in understanding the geophysical causes of natural hazards and have developed sophisticated tools to predict their effects; while, much less attention has been devoted to tools that increase situational awareness, facilitate leadership, provide effective communication channels and data flow and enhance the cognitive abilities of decision makers and first responders. In this paper, we envisioned the capabilities of a next generation disaster decision support system and hence proposed a state-of-the-art system architecture design to facilitate the decision making process in natural catastrophes such as flood and bushfire by utilising a combination of technologies for multi-channel data aggregation, disaster modelling, visualisation and optimisation. Moreover, we put our thoughts into action by implementing an Intelligent Disaster Decision Support System (IDDSS). The developed system can easily plug in to external disaster models and aggregate large amount of heterogeneous data from government agencies, sensor networks, and crowd sourcing platforms in real-time to enhance the situational awareness of decision makers and offer them a comprehensive understanding of disaster impacts from diverse perspectives such as environment, infrastructure and economy, etc. Sponsored by the Australian Government and the Victorian Department of Justice (Australia), the system was built upon a series of open-source frameworks (see attached figure) with four key components: data management layer, model application layer, processing service layer and presentation layer. It has the potential to be adopted by a range of agencies across Australian jurisdictions to assist stakeholders in accessing, sharing and utilising available information in their management of disaster events.

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

    PubMed Central

    2011-01-01

    Background Decision Aids (DA) are well established in various fields of medicine. It can improve the quality of decision-making and reduce decisional conflict. In neonatal care, and due to scientific equipoise, neonatologists caring for extreme low birth weight (ELBW) infants are in need to elicit parents' preferences with regard to the use of indomethacin therapy in ELBW infants. We aimed to develop a DA that elicits parents' preferences with regard to indomethacin therapy in ELBW infants. Methods We developed a DA for the use of the indomethacin therapy in ELBW infants according to the Ottawa Decision Support Framework. The development process involved parents, neonatologists, DA developers and decision making experts. A pilot testing with healthy volunteers was conducted through an evaluation questionnaire, a knowledge scale, and a validated decisional conflict scale. Results The DA is a computer-based interactive tool. In the first part, the DA provides information about patent ductus arteriosus (PDA) as a disease, the different treatment options, and the benefits and downsides of using indomethacin therapy in preterm infants. In the second part, it coaches the parent in the decision making process through clarifying values and preferences. Volunteers rated 10 out of 13 items of the DA positively and showed significant improvement on both the knowledge scale (p = 0.008) and the decisional conflict scale (p = 0.008). Conclusion We have developed a computer based DA to assess parental preferences with regard to indomethacin therapy in preterm infants. Future research will involve measurement of parental preferences to guide and augment the clinical decisions in current neonatal practice. PMID:21888665

  7. Development of a patient decision aid for people with refractory angina: protocol for a three-phase pilot study

    PubMed Central

    2014-01-01

    to facilitate identification and inclusion of patients’ values and preferences in the decision making process. This is particularly important as refractory angina is an intractable condition, necessitating that the selected course of treatment be lifelong. This study will yield a much needed patient decision aid for people living with refractory angina and pilot data to support a subsequent effectiveness study. PMID:24920518

  8. Personalization and Patient Involvement in Decision Support Systems: Current Trends

    PubMed Central

    Sacchi, L.; Lanzola, G.; Viani, N.

    2015-01-01

    Summary Objectives This survey aims at highlighting the latest trends (2012-2014) on the development, use, and evaluation of Information and Communication Technologies (ICT) based decision support systems (DSSs) in medicine, with a particular focus on patient-centered and personalized care. Methods We considered papers published on scientific journals, by querying PubMed and Web of Science™. Included studies focused on the implementation or evaluation of ICT-based tools used in clinical practice. A separate search was performed on computerized physician order entry systems (CPOEs), since they are increasingly embedding patient-tailored decision support. Results We found 73 papers on DSSs (53 on specific ICT tools) and 72 papers on CPOEs. Although decision support through the delivery of recommendations is frequent (28/53 papers), our review highlighted also DSSs only based on efficient information presentation (25/53). Patient participation in making decisions is still limited (9/53), and mostly focused on risk communication. The most represented medical area is cancer (12%). Policy makers are beginning to be included among stakeholders (6/73), but integration with hospital information systems is still low. Concerning knowledge representation/management issues, we identified a trend towards building inference engines on top of standard data models. Most of the tools (57%) underwent a formal assessment study, even if half of them aimed at evaluating usability and not effectiveness. Conclusions Overall, we have noticed interesting evolutions of medical DSSs to improve communication with the patient, consider the economic and organizational impact, and use standard models for knowledge representation. However, systems focusing on patient-centered care still do not seem to be available at large. PMID:26293857

  9. TraumaTalk: content-to-speech generation for decision support at point of care.

    PubMed

    Bierner, G

    1998-01-01

    Communicating information in clinical environments is a crucial concern for medical decision support systems. Some systems can provide this support through text output that can be read by the clinician either from a screen or hard copy. However, speech is often a more appropriate way of conveying information in cases where the decision maker's eyes are already committed to another task or in cases where the telephone is the mode of communication. Some systems synthesize speech directly from text, while others piece together bits of pre-recorded human speech. In either case, producing correct intonation is vital because intonation both aids the listener's comprehension and conveys discourse meaning not necessarily evident in the words alone. Although systems that use text-to-speech or human recorded speech segments sometimes attempt to provide good intonation, they are severely hampered by the fact that intonation spans entire clauses. Systems that connect phonemes, words, or phrases fail to capture this. This paper describes a content-to-speech system that provides spoken decision support for trauma care that is correctly intoned over full clauses.

  10. TraumaTalk: content-to-speech generation for decision support at point of care.

    PubMed

    Bierner, G

    1998-01-01

    Communicating information in clinical environments is a crucial concern for medical decision support systems. Some systems can provide this support through text output that can be read by the clinician either from a screen or hard copy. However, speech is often a more appropriate way of conveying information in cases where the decision maker's eyes are already committed to another task or in cases where the telephone is the mode of communication. Some systems synthesize speech directly from text, while others piece together bits of pre-recorded human speech. In either case, producing correct intonation is vital because intonation both aids the listener's comprehension and conveys discourse meaning not necessarily evident in the words alone. Although systems that use text-to-speech or human recorded speech segments sometimes attempt to provide good intonation, they are severely hampered by the fact that intonation spans entire clauses. Systems that connect phonemes, words, or phrases fail to capture this. This paper describes a content-to-speech system that provides spoken decision support for trauma care that is correctly intoned over full clauses. PMID:9929309

  11. Human-Computer Interaction with Medical Decisions Support Systems

    NASA Technical Reports Server (NTRS)

    Adolf, Jurine A.; Holden, Kritina L.

    1994-01-01

    Decision Support Systems (DSSs) have been available to medical diagnosticians for some time, yet their acceptance and use have not increased with advances in technology and availability of DSS tools. Medical DSSs will be necessary on future long duration space missions, because access to medical resources and personnel will be limited. Human-Computer Interaction (HCI) experts at NASA's Human Factors and Ergonomics Laboratory (HFEL) have been working toward understanding how humans use DSSs, with the goal of being able to identify and solve the problems associated with these systems. Work to date consists of identification of HCI research areas, development of a decision making model, and completion of two experiments dealing with 'anchoring'. Anchoring is a phenomenon in which the decision maker latches on to a starting point and does not make sufficient adjustments when new data are presented. HFEL personnel have replicated a well-known anchoring experiment and have investigated the effects of user level of knowledge. Future work includes further experimentation on level of knowledge, confidence in the source of information and sequential decision making.

  12. Demonstration of Decision Support Tools for Sustainable Development

    SciTech Connect

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

    2000-11-01

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

  13. The economic valuation of improved process plant decision support technology.

    PubMed

    White, Douglas C

    2007-06-01

    How can investments that would potentially improve a manufacturing plant's decision process be economically justified? What is the value of "better information," "more flexibility," or "improved integration" and the technologies that provide these effects? Technology investments such as improved process modelling, new real time historians and other databases, "smart" instrumentation, better data analysis and visualization software, and/or improved user interfaces often include these benefits as part of their valuation. How are these "soft" benefits to be converted to a quantitative economic return? Quantification is important if rational management decisions are to be made about the correct amount of money to invest in the technologies, and which technologies to choose among the many available ones. Modelling the plant operational decision cycle-detect, analyse, forecast, choose and implement--provides a basis for this economic quantification. In this paper a new economic model is proposed for estimation of the value of decision support investments based on their effect upon the uncertainty in forecasting plant financial performance. This model leads to quantitative benefit estimates that have a realistic financial basis. An example is presented demonstrating the application of the method.

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

    USGS Publications Warehouse

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

    2013-01-01

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

  15. An Intelligent Polar Cyberinfrastrucuture to Support Spatiotemporal Decision Making

    NASA Astrophysics Data System (ADS)

    Song, M.; Li, W.; Zhou, X.

    2014-12-01

    In the era of big data, polar sciences have already faced an urgent demand of utilizing intelligent approaches to support precise and effective spatiotemporal decision-making. Service-oriented cyberinfrastructure has advantages of seamlessly integrating distributed computing resources, and aggregating a variety of geospatial data derived from Earth observation network. This paper focuses on building a smart service-oriented cyberinfrastructure to support intelligent question answering related to polar datasets. The innovation of this polar cyberinfrastructure includes: (1) a problem-solving environment that parses geospatial question in natural language, builds geoprocessing rules, composites atomic processing services and executes the entire workflow; (2) a self-adaptive spatiotemporal filter that is capable of refining query constraints through semantic analysis; (3) a dynamic visualization strategy to support results animation and statistics in multiple spatial reference systems; and (4) a user-friendly online portal to support collaborative decision-making. By means of this polar cyberinfrastructure, we intend to facilitate integration of distributed and heterogeneous Arctic datasets and comprehensive analysis of multiple environmental elements (e.g. snow, ice, permafrost) to provide a better understanding of the environmental variation in circumpolar regions.

  16. Decision support for integrated water-energy planning.

    SciTech Connect

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

    2009-10-01

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

  17. Healthcare Decision Support System for Administration of Chronic Diseases

    PubMed Central

    Woo, Ji-In; Yang, Jung-Gi; Lee, Young-Ho

    2014-01-01

    Objectives A healthcare decision-making support model and rule management system is proposed based on a personalized rule-based intelligent concept, to effectively manage chronic diseases. Methods A Web service was built using a standard message transfer protocol for interoperability of personal health records among healthcare institutions. An intelligent decision service is provided that analyzes data using a service-oriented healthcare rule inference function and machine-learning platform; the rules are extensively compiled by physicians through a developmental user interface that enables knowledge base construction, modification, and integration. Further, screening results are visualized for the self-intuitive understanding of personal health status by patients. Results A recommendation message is output through the Web service by receiving patient information from the hospital information recording system and object attribute values as input factors. The proposed system can verify patient behavior by acting as an intellectualized backbone of chronic diseases management; further, it supports self-management and scheduling of screening. Conclusions Chronic patients can continuously receive active recommendations related to their healthcare through the rule management system, and they can model the system by acting as decision makers in diseases management; secondary diseases can be prevented and health management can be performed by reference to patient-specific lifestyle guidelines. PMID:25152830

  18. Intelligent decision support tool for supply chain planning

    NASA Astrophysics Data System (ADS)

    Li, Dong; Barnes, Cathy; Axtell, C.; McKay, Alison; de Pennington, Alan

    2001-10-01

    A decision support system using extended quality function deployment model (EQFDM) and internet application for manufacturing supply chain (SC) planning has been developed in this research. In this paper, a customer-focused quality evaluation approach, the EQFDM with internet application is employed to develop a coordinated planning system in SCs and assist mapping decisions of strategic planning into each partner's internal planning processes. To facilitate cooperation of SC partners in strategic planning, the hybrid planning process has been programmed into a web tool. The local planning has been supported by fuzzy logic approach so that approximate optimal solutions can be obtained avoiding difficulties of acquiring quantitative data. Through this intelligent Web based architecture, individual planning processes can be efficiently co-ordinated by means of efficient communication and visualizing consequences of a decision to be made on SC performance. Case study in a manufacturing (packaging) SC has been conducted to implement a scenario planning process for strategies on re-engineering the manufacturing SC. The research result shows that the intelligent system could be a promising tool for assisting strategic planning in a SC cooperation context.

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

    SciTech Connect

    Schnabel, William; Brumbelow, Kelly

    2013-03-31

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

  20. A highly scalable, interoperable clinical decision support service

    PubMed Central

    Goldberg, Howard S; Paterno, Marilyn D; Rocha, Beatriz H; Schaeffer, Molly; Wright, Adam; Erickson, Jessica L; Middleton, Blackford

    2014-01-01

    Objective To create a clinical decision support (CDS) system that is shareable across healthcare delivery systems and settings over large geographic regions. Materials and methods The enterprise clinical rules service (ECRS) realizes nine design principles through a series of enterprise java beans and leverages off-the-shelf rules management systems in order to provide consistent, maintainable, and scalable decision support in a variety of settings. Results The ECRS is deployed at Partners HealthCare System (PHS) and is in use for a series of trials by members of the CDS consortium, including internally developed systems at PHS, the Regenstrief Institute, and vendor-based systems deployed at locations in Oregon and New Jersey. Performance measures indicate that the ECRS provides sub-second response time when measured apart from services required to retrieve data and assemble the continuity of care document used as input. Discussion We consider related work, design decisions, comparisons with emerging national standards, and discuss uses and limitations of the ECRS. Conclusions ECRS design, implementation, and use in CDS consortium trials indicate that it provides the flexibility and modularity needed for broad use and performs adequately. Future work will investigate additional CDS patterns, alternative methods of data passing, and further optimizations in ECRS performance. PMID:23828174

  1. Effects on Decision Quality of Supporting Multi-attribute Evaluation in Groups

    PubMed

    Timmermans; Vlek

    1996-11-01

    In this study the effectiveness of multi-attribute utility (MAU) decision support in groups is evaluated for personnel selection problems differing in complexity. Subjects were asked to make an initial individual decision with or without MAU decision support. Next individuals formed small groups and were asked to reach a decision about the same problem. Groups received either MAU support or no support. Results show that for relatively simple problems the most effective method is to provide subjects with both individual and group decision support. Here, decision support had a clear impact on subjects' preferences and the level of agreement between group members. In addition, satisfaction with the decision and the decision procedure was relatively high. Overall, decision support improved communication; subjects reported to find the problem easier, to have more influence on the group decision, and to find it easier to express their opinions. For more complex problems, however, decision making without group support (whether preceded by individual support or not) was evaluated most favorably. Individual decision support in this condition was sometimes better than no support; i.e., there was a lower reported problem difficulty, a higher satisfaction with the group decision, and a higher reported influence on the group decision. The effectiveness of group MAU decision support for complex problems was evaluated less favorably.

  2. Visualization-based decision support for value-driven system design

    NASA Astrophysics Data System (ADS)

    Tibor, Elliott

    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

  3. Use of Remote Sensing for Decision Support in Africa

    NASA Technical Reports Server (NTRS)

    Policelli, Frederick S.

    2007-01-01

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

  4. Water flow algorithm decision support tool for travelling salesman problem

    NASA Astrophysics Data System (ADS)

    Kamarudin, Anis Aklima; Othman, Zulaiha Ali; Sarim, Hafiz Mohd

    2016-08-01

    This paper discuss about the role of Decision Support Tool in Travelling Salesman Problem (TSP) for helping the researchers who doing research in same area will get the better result from the proposed algorithm. A study has been conducted and Rapid Application Development (RAD) model has been use as a methodology which includes requirement planning, user design, construction and cutover. Water Flow Algorithm (WFA) with initialization technique improvement is used as the proposed algorithm in this study for evaluating effectiveness against TSP cases. For DST evaluation will go through usability testing conducted on system use, quality of information, quality of interface and overall satisfaction. Evaluation is needed for determine whether this tool can assists user in making a decision to solve TSP problems with the proposed algorithm or not. Some statistical result shown the ability of this tool in term of helping researchers to conduct the experiments on the WFA with improvements TSP initialization.

  5. Decision support for workload assessment - Introducing WC FIELDE

    NASA Technical Reports Server (NTRS)

    Casper, Patricia A.; Shively, Robert J.; Hart, Sandra G.

    1987-01-01

    Currently there is a great demand for mental workload evaluation in the course of system design and modification. In light of this demand, a microprocessor-based decision support system has been created called WC FIELDE: Workload Consultant for FIELD Evaluation. The system helps the user select workload measures appropriate to his or her application from the large pool of currently available techniques. Both novices and those with some workload experience may benefit from using WC FIELDE, since the system's operation is entirely transparent and all rules involved in the decision process are available for the user to examine. WC FIELDE recommends several assessment methodologies in decreasing order of appropriateness, and provides additional information on each measure at the end of the program in the form of text files.

  6. Decision System Integrating Preferences to Support Sleep Staging.

    PubMed

    Ugon, Adrien; Sedki, Karima; Kotti, Amina; Seroussi, Brigitte; Philippe, Carole; Ganascia, Jean-Gabriel; Garda, Patrick; Bouaud, Jacques; Pinna, Andrea

    2016-01-01

    Scoring sleep stages can be considered as a classification problem. Once the whole recording segmented into 30-seconds epochs, features, extracted from raw signals, are typically injected into machine learning algorithms in order to build a model able to assign a sleep stage, trying to mimic what experts have done on the training set. Such approaches ignore the advances in sleep medicine, in which guidelines have been published by the AASM, providing definitions and rules that should be followed to score sleep stages. In addition, these approaches are not able to solve conflict situations, in which criteria of different sleep stages are met. This work proposes a novel approach based on AASM guidelines. Rules are formalized integrating, for some of them, preferences allowing to support decision in conflict situations. Applied to a doubtful epoch, our approach has taken the appropriate decision. PMID:27577436

  7. Creating shareable decision support services: an interdisciplinary challenge.

    PubMed

    Paterno, Marilyn D; Maviglia, Saverio M; Ramelson, Harley Z; Schaeffer, Molly; Rocha, Beatriz H; Hongsermeier, Tonya; Wright, Adam; Middleton, Blackford; Goldberg, Howard S

    2010-01-01

    Creating shareable decision support services is a complex task requiring effort from multiple interdisciplinary role players with a wide variety of experience and expertise. The CDS Consortium research project has developed such a service, defining a multi-layer representation of knowledge and building upon an architectural service design created at Partners Health Care, and is demonstrating its use in both a local and an external institutional setting. The process was iterative, and we encountered unexpected requirements based on decisions made at various points. We report in this paper on challenges we faced while pursuing this research: knowledge representation and modeling, data interchange and standards adoption, the process of getting agreement on content, logistics of integrating into a system that already has multiple CDS interventions, legal issues around privacy and access, inter-team communication and organization.

  8. Impact of a decision-support tool on decision making at the district level in Kenya

    PubMed Central

    2013-01-01

    Background In many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile (DHP) tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions. Methods Thirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts. Results Findings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement. Conclusions This paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation

  9. AIDS: Implications for Homosexual Self-Help and Support Efforts.

    ERIC Educational Resources Information Center

    Toro-Alfonso, Jose

    The Colectivo de Concientizacion Gay, a homosexual and lesbian organization in Puerto Rico, developed a brief analysis of what has happened since symptoms associated with acquired immunodeficiency syndrome (AIDS) were first reported by the Centers for Disease Control in 1981; the analysis also included implications for the gay community. Since…

  10. Financial Aid for Self-Supporting Students: Defining Independence.

    ERIC Educational Resources Information Center

    Wagner, Alan P.; Carlson, Nancy

    Current federal definitions and proposed alternative definitions of financially independent students, and the effect of the definitions on the numbers and attributes of independent students, are reviewed. Current federal law defines financial aid applicants as financially independent of their parents if they meet three criteria (the "tri-form"…

  11. New Decision Support for Landslide and Other Disaster Events

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  12. Interactive decision-making support model in MOSD

    NASA Astrophysics Data System (ADS)

    Liu, Yang; Lan, Ze-ying; Liu, Yao-lin; Qin, Liang-jun

    2009-10-01

    The Multi-objective spatial optimization problem is common in the word, which usually has a set of non-dominated resolutions, also called Pareto resolutions, instead of a single ideal one. So, the Multi-objectives spatial decision support system (MOSDSS) has two vital basements: how to acquire all the Pareto resolutions by Multi-objective optimization arithmetic, and how to analysis and appraise the candidates to determinate the final satisfying solution. At present, there are abundant research fruit for the former problem, however the latter one hasn't attracted abroad attention in the field. Nowadays, the findings about analyzing and evaluating the Pareto resolutions mainly focus on three aspects: the visual expression of candidates, appraising the comparability among the solutions, and designing the prototype system of visual support tools, which are lack of systemic conclusion and summarization. Hence, this paper emphasizes the latter problem of MOSDSS and puts up an interactive decision-making support model to largely improve the efficiency of analyzing and evaluating the Pareto resolutions. This model is composed of 3 pivotal parts: the geographic brush mechanism, the similarity querying operators as well as the interactive searching method. Then, the paper designs a prototype system on the base of the model, which is successfully tested in the exam.

  13. Coordinating complex decision support activities across distributed applications

    NASA Technical Reports Server (NTRS)

    Adler, Richard M.

    1994-01-01

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

  14. Evaluation of a Dispatcher's Route Optimization Decision Aid to Avoid Aviation Weather Hazards

    NASA Technical Reports Server (NTRS)

    Dorneich, Michael C.; Olofinboba, Olu; Pratt, Steve; Osborne, Dannielle; Feyereisen, Thea; Latorella, Kara

    2003-01-01

    This document describes the results and analysis of the formal evaluation plan for the Honeywell software tool developed under the NASA AWIN (Aviation Weather Information) 'Weather Avoidance using Route Optimization as a Decision Aid' project. The software tool aims to provide airline dispatchers with a decision aid for selecting optimal routes that avoid weather and other hazards. This evaluation compares and contrasts route selection performance with the AWIN tool to that of subjects using a more traditional dispatcher environment. The evaluation assesses gains in safety, in fuel efficiency of planned routes, and in time efficiency in the pre-flight dispatch process through the use of the AWIN decision aid. In addition, we are interested in how this AWIN tool affects constructs that can be related to performance. The construct of Situation Awareness (SA), workload, trust in an information system, and operator acceptance are assessed using established scales, where these exist, as well as through the evaluation of questionnaire responses and subject comments. The intention of the experiment is to set up a simulated operations area for the dispatchers to work in. They will be given scenarios in which they are presented with stored company routes for a particular city-pair and aircraft type. A diverse set of external weather information sources is represented by a stand-alone display (MOCK), containing the actual historical weather data typically used by dispatchers. There is also the possibility of presenting selected weather data on the route visualization tool. The company routes have not been modified to avoid the weather except in the case of one additional route generated by the Honeywell prototype flight planning system. The dispatcher will be required to choose the most appropriate and efficient flight plan route in the displayed weather conditions. The route may be modified manually or may be chosen from those automatically displayed.

  15. Clinical Decision Support for Immunizations (CDSi): A Comprehensive, Collaborative Strategy

    PubMed Central

    Arzt, Noam H.

    2016-01-01

    This article focuses on the requirements and current developments in clinical decision support technologies for immunizations (CDSi) in both the public health and clinical communities, with an emphasis on shareable solutions. The requirements of the Electronic Health Record Incentive Programs have raised some unique challenges for the clinical community, including vocabulary mapping, update of changing guidelines, single immunization schedule, and scalability. This article discusses new, collaborative approaches whose long-term goal is to make CDSi more sustainable for both the public and private sectors. PMID:27789956

  16. Database and knowledge base integration in decision support systems.

    PubMed Central

    Johansson, B.; Shahsavar, N.; Ahlfeldt, H.; Wigertz, O.

    1996-01-01

    Since decision support systems (DSS) in medicine often are linked to clinical databases it is important to find methods that facilitate the work for DSS developers to implement database queries in the knowledge base (KB). This paper presents a method for linking clinical databases to a KB with Arden Syntax modules. The method is based on a query meta database including templates for SQL queries. During knowledge module authoring the medical expert only refers to a code in the query meta database. Our method uses standard tools so it can be implemented on different platforms and linked to different clinical databases. PMID:8947666

  17. Knowledge-analytics synergy in Clinical Decision Support.

    PubMed

    Slonim, Noam; Carmeli, Boaz; Goldsteen, Abigail; Keller, Oliver; Kent, Carmel; Rinott, Ruty

    2012-01-01

    Clinical Decision Support (CDS) systems hold tremendous potential for improving patient care. Most existing systems are knowledge-based tools that rely on relatively simple rules. More recent approaches rely on analytics techniques to automatically mine EHR data to reveal meaningful insights. Here, we propose the Knowledge-Analytics Synergy paradigm for CDS, in which we synergistically combine existing relevant knowledge with analytics applied to EHR data. We propose a framework for implementing such a paradigm and demonstrate its principles over real-world clinical and genomic data of hypertensive patients.

  18. Use of decision support systems as a drought management tool

    USGS Publications Warehouse

    Frevert, D.; Lins, H.; ,

    2005-01-01

    Droughts present a unique challenge to water managers throughout the world and the current drought in the western United States is taxing facilities to the limit. Coping with this severe drought requires state of the art decision support systems including efficient and accurate hydrologic process models, detailed hydrologic data bases and effective river systems management modeling frameworks. This paper will outline a system of models developed by the Bureau of Reclamation, the US Geological Survey, the University of Colorado and a number of other governmental and university partners. The application of the technology to drought management in several key western river basins will be discussed.

  19. Artificial intelligence based decision support for trumpeter swan management

    USGS Publications Warehouse

    Sojda, Richard S.

    2002-01-01

    The number of trumpeter swans (Cygnus buccinator) breeding in the Tri-State area where Montana, Idaho, and Wyoming come together has declined to just a few hundred pairs. However, these birds are part of the Rocky Mountain Population which additionally has over 3,500 birds breeding in Alberta, British Columbia, Northwest Territories, and Yukon Territory. To a large degree, these birds seem to have abandoned traditional migratory pathways in the flyway. Waterfowl managers have been interested in decision support tools that would help them explore simulated management scenarios in their quest towards reaching population recovery and the reestablishment of traditional migratory pathways. I have developed a decision support system to assist biologists with such management, especially related to wetland ecology. Decision support systems use a combination of models, analytical techniques, and information retrieval to help develop and evaluate appropriate alternatives. Swan management is a domain that is ecologically complex, and this complexity is compounded by spatial and temporal issues. As such, swan management is an inherently distributed problem. Therefore, the ecological context for modeling swan movements in response to management actions was built as a multiagent system of interacting intelligent agents that implements a queuing model representing swan migration. These agents accessed ecological knowledge about swans, their habitats, and flyway management principles from three independent expert systems. The agents were autonomous, had some sensory capability, and could respond to changing conditions. A key problem when developing ecological decision support systems is empirically determining that the recommendations provided are valid. Because Rocky Mountain trumpeter swans have been surveyed for a long period of time, I was able to compare simulated distributions provided by the system with actual field observations across 20 areas for the period 1988

  20. The effect of positive emotion and perceived risk on usage intention to online decision aids.

    PubMed

    Ma, Qing-guo; Wang, Kai

    2009-10-01

    Although perceived risk has a negative effect on usage intention toward new information technology, both perceived risk and usage intention are the results of cognitive processes, so they are inevitably influenced by emotion. Based on positive mood theory and the appraisal-tendency framework (ATF), a laboratory experiment using online decision aids with 126 participants was conducted. The results indicate that positive emotion (happy emotion in the current study) can increase usage intention and decrease perceived risk, while perceived risk decreases usage intention. Further investigation finds that perceived risk is a mediator between emotion and usage intention.

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

    PubMed Central

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

    2016-01-01

    Background Decisions related to mental health are often complex, problems often remain undetected and untreated, information unavailable or not used, and treatment decisions frequently not informed by best practice or patient preferences. Objective The objective of this paper was to obtain the opinions of health professionals working in primary health care settings about a Web-based information decision aid (IDA) for patients concerning treatment options for depression and the dissemination of the resources in primary care settings. Methods Participants were recruited from primary care clinics in Winnipeg and Ottawa, Canada, and included 48 family physicians, nurses, and primary care staff. The study design was a qualitative framework analytic approach of 5 focus groups. Focus groups were conducted during regular staff meetings, were digitally recorded, and transcripts created. Analysis involved a content and theme analysis. Results Seven key themes emerged including the key role of the primary care provider, common questions about treatments, treatment barriers, sources of patient information, concern about quality and quantity of available information, positive opinions about the IDA, and disseminating the IDA. The most common questions mentioned were about medication and side effects and alternatives to medication. Patients have limited access to alternative treatment options owing to cost and availability. Conclusions Practitioners evaluated the IDA positively. The resources were described as useful, supportive of providers’ messages, and accessible for patients. There was unanimous consensus that information needs to be available electronically through the Internet. PMID:27277709

  2. Supporting Coral Reef Ecosystem Management Decisions Appropriate to Climate Change

    NASA Astrophysics Data System (ADS)

    Hendee, J. C.; Fletcher, P.; Shein, K. A.

    2013-05-01

    There has been a perception that the myriad of environmental information products derived from satellite and other instrumental sources means ipso facto that there is a direct use for them by environmental managers. Trouble is, as information providers, for the most part we don't really know what decisions managers face daily, nor is it a trivial matter to ascertain the effect of management decisions on the environment, at least in a time frame that facilitates timely maintenance and enhancement of decision support software. To bridge this gap in understanding, we conducted a Needs Assessment (using methodology from the NOAA/Coastal Services Center's Product Design and Evaluation training program) from December, 2011 through May, 2012, in which we queried 15 resource managers in southeast Florida to identify the types of climate data and information products they needed to understand the effects of climate change in their region of purview, and how best these products should be delivered and subsequently enhanced or corrected. Our intent has been to develop a suite of software and information products customized specifically for environmental managers. This report summarizes our success to date, including a report on the development of software for gathering and presenting specific types of climate data, and a narrative about how some U.S. government sponsored efforts, such as Giovanni and TerraVis, as well as non-governmental sponsored efforts such as Marxan, Zonation, SimCLIM, and other off-the-shelf software might be customized for use in specific regions.

  3. Striatal prediction errors support dynamic control of declarative memory decisions

    PubMed Central

    Scimeca, Jason M.; Katzman, Perri L.; Badre, David

    2016-01-01

    Adaptive memory requires context-dependent control over how information is retrieved, evaluated and used to guide action, yet the signals that drive adjustments to memory decisions remain unknown. Here we show that prediction errors (PEs) coded by the striatum support control over memory decisions. Human participants completed a recognition memory test that incorporated biased feedback to influence participants' recognition criterion. Using model-based fMRI, we find that PEs—the deviation between the outcome and expected value of a memory decision—correlate with striatal activity and predict individuals' final criterion. Importantly, the striatal PEs are scaled relative to memory strength rather than the expected trial outcome. Follow-up experiments show that the learned recognition criterion transfers to free recall, and targeting biased feedback to experimentally manipulate the magnitude of PEs influences criterion consistent with PEs scaled relative to memory strength. This provides convergent evidence that declarative memory decisions can be regulated via striatally mediated reinforcement learning signals. PMID:27713407

  4. Decision support system for the operating room rescheduling problem.

    PubMed

    van Essen, J Theresia; Hurink, Johann L; Hartholt, Woutske; van den Akker, Bernd J

    2012-12-01

    Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.

  5. The approaches for the decision support in case natural hazards

    NASA Astrophysics Data System (ADS)

    Vyazilov, Evgeny; Chunyaev, Nikita

    2013-04-01

    In spite of using highly automated systems of measurement, collecting, storing, handling, prediction and delivery of information on the marine environment, including natural hazards, the amount of damage from natural phenomena increases. Because information on the marine environment delivered to the industrial facilities not effectively used. To such information pays little attention by individual decision-makers and not always perform preventive measures necessary for reduce and prevent damage. Automation of information support will improve the efficiency management of the marine activities. In Russia develops "The Unified system of the information about World ocean" (ESIMO, http://esimo.ru/), that integrates observation, analysis, prognostic and climate data. Necessary to create tools to automatic selection natural disasters through all integrated data; notification decision-makers about arising natural hazards - software agent; provision of information in a compact form for the decision-makers; assessment of possible damage and costs to the preventive measures; providing information on the impacts of environment on economic facilities and recommendations for decision-making; the use of maps, diagrams, tables for reporting. Tools for automatic selection designed for identification of natural phenomena based on the resources ESIMO and corresponding critical values of the indicators environment. The result of this module will be constantly updated database of critical situations of environment for each object or technological process. To operational notify and provide current information about natural hazards proposes using a software agent that is installed on the computer decision-makers, which is activated in case critical situations and provides a minimum of information. In the event of natural disaster software agent should be able to inform decision-makers about this, providing information on the current situation, and the possibility for more and detailed

  6. Informed Choice for Participation in Down Syndrome Screening: Development and Content of a Web-Based Decision Aid

    PubMed Central

    Hansen, Helle Ploug; Draborg, Eva; Pedersen, Claus Duedal; Lamont, Ronald F; Jørgensen, Jan Stener

    2015-01-01

    Background In Denmark, all pregnant women are offered screening in early pregnancy to estimate the risk of having a fetus with Down syndrome. Pregnant women participating in the screening program should be provided with information and support to allow them to make an informed choice. There is increasing interest in the use of Web-based technology to provide information and digital solutions for the delivery of health care. Objective The aim of this study was to develop an eHealth tool that contained accurate and relevant information to allow pregnant women to make an informed choice about whether to accept or reject participation in screening for Down syndrome. Methods The development of the eHealth tool involved the cooperation of researchers, technology experts, clinicians, and users. The underlying theoretical framework was based on participatory design, the International Patient Decision Aid Standards (IPDAS) Collaboration guide to develop a patient decision aid, and the roadmap for developing eHealth technologies from the Center for eHealth Research and Disease Management (CeHRes). The methods employed were a systematic literature search, focus group interviews with 3 care providers and 14 pregnant women, and 2 weeks of field observations. A qualitative descriptive approach was used in this study. Results Relevant themes from pregnant women and care providers with respect to information about Down syndrome screening were identified. Based on formalized processes for developing patient decision aids and eHealth technologies, an interactive website containing information about Down syndrome, methods of screening, and consequences of the test was developed. The intervention was based on user requests and needs, and reflected the current hospital practice and national guidelines. Conclusions This paper describes the development and content of an interactive website to support pregnant women in making informed choices about Down syndrome screening. To develop the

  7. Critical infrastructure protection decision support system decision model : overview and quick-start user's guide.

    SciTech Connect

    Samsa, M.; Van Kuiken, J.; Jusko, M.; Decision and Information Sciences

    2008-12-01

    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.

  8. Adoption of Clinical Decision Support in Multimorbidity: A Systematic Review

    PubMed Central

    Arguello Casteleiro, Mercedes; Ainsworth, John; Buchan, Iain

    2015-01-01

    Background Patients with multiple conditions have complex needs and are increasing in number as populations age. This multimorbidity is one of the greatest challenges facing health care. Having more than 1 condition generates (1) interactions between pathologies, (2) duplication of tests, (3) difficulties in adhering to often conflicting clinical practice guidelines, (4) obstacles in the continuity of care, (5) confusing self-management information, and (6) medication errors. In this context, clinical decision support (CDS) systems need to be able to handle realistic complexity and minimize iatrogenic risks. Objective The aim of this review was to identify to what extent CDS is adopted in multimorbidity. Methods This review followed PRISMA guidance and adopted a multidisciplinary approach. Scopus and PubMed searches were performed by combining terms from 3 different thesauri containing synonyms for (1) multimorbidity and comorbidity, (2) polypharmacy, and (3) CDS. The relevant articles were identified by examining the titles and abstracts. The full text of selected/relevant articles was analyzed in-depth. For articles appropriate for this review, data were collected on clinical tasks, diseases, decision maker, methods, data input context, user interface considerations, and evaluation of effectiveness. Results A total of 50 articles were selected for the full in-depth analysis and 20 studies were included in the final review. Medication (n=10) and clinical guidance (n=8) were the predominant clinical tasks. Four studies focused on merging concurrent clinical practice guidelines. A total of 17 articles reported their CDS systems were knowledge-based. Most articles reviewed considered patients’ clinical records (n=19), clinical practice guidelines (n=12), and clinicians’ knowledge (n=10) as contextual input data. The most frequent diseases mentioned were cardiovascular (n=9) and diabetes mellitus (n=5). In all, 12 articles mentioned generalist doctor(s) as the

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

    PubMed Central

    2014-01-01

    Background In Japan, there is no decision-making guide regarding long-term tube feeding that specifically targets individuals making decisions on behalf of cognitively impaired older persons (substitute decision makers). The objective of this study was to describe the development and evaluation of such a decision aid. Methods In this before-and-after study, participants comprised substitute decision makers for 13 cognitively impaired inpatients aged 65 years and older who were being considered for placement of a percutaneous endoscopic gastrostomy tube in acute care hospitals and mixed-care hospitals in Japan. Questionnaires were used to compare substitute decision makers’ knowledge, decisional conflict, and predisposition regarding feeding tube placement before and after exposure to a decision aid. The acceptability of the decision aid was also assessed. Paired t-tests were used to compare participants’ knowledge and decisional conflict scores before and after using the decision aid. Results Substitute decision makers showed significantly increased knowledge (P < .001) and decreased decisional conflict (P < .01) regarding long-term tube feeding after using the decision aid. All substitute decision makers found the decision aid helpful and acceptable. Conclusions The decision aid facilitated the decision-making process of substitute decision makers by decreasing decisional conflict and increasing knowledge. PMID:24495735

  10. Evaluation of RxNorm for Medication Clinical Decision Support

    PubMed Central

    Freimuth, Robert R.; Wix, Kelly; Zhu, Qian; Siska, Mark; Chute, Christopher G.

    2014-01-01

    We evaluated the potential use of RxNorm to provide standardized representations of generic drug name and route of administration to facilitate management of drug lists for clinical decision support (CDS) rules. We found a clear representation of generic drug name but not route of administration. We identified several issues related to data quality, including erroneous or missing defined relationships, and the use of different concept hierarchies to represent the same drug. More importantly, we found extensive semantic precoordination of orthogonal concepts related to route and dose form, which would complicate the use of RxNorm for drug-based CDS. This study demonstrated that while RxNorm is a valuable resource for the standardization of medications used in clinical practice, additional work is required to enhance the terminology so that it can support expanded use cases, such as managing drug lists for CDS. PMID:25954360

  11. Towards a decision support system for hand dermatology.

    PubMed

    Mazzola, Luca; Cavazzina, Alice; Pinciroli, Francesco; Bonacina, Stefano; Pigatto, Paolo; Ayala, Fabio; De Pità, Ornella; Marceglia, Sara

    2014-01-01

    The complexity of the medical diagnosis is faced by practitioners relying mainly on their experiences. This can be acquired during daily practices and on-the-job training. Given the complexity and extensiveness of the subject, supporting tools that include knowledge extracted by highly specialized practitioners can be valuable. In the present work, a Decision Support System (DSS) for hand dermatology was developed based on data coming from a Visit Report Form (VRF). Using a Bayesian approach and factors significance difference over the population average for the case, we demonstrated the potentiality of creating an enhanced VRF that include a diagnoses distribution probability based on the DSS rules applied for the specific patient situation. PMID:25160145

  12. Knowledge-based decision support for patient monitoring in cardioanesthesia.

    PubMed

    Schecke, T; Langen, M; Popp, H J; Rau, G; Käsmacher, H; Kalff, G

    1992-01-01

    An approach to generating 'intelligent alarms' is presented that aggregates many information items, i.e. measured vital signs, recent medications, etc., into state variables that more directly reflect the patient's physiological state. Based on these state variables the described decision support system AES-2 also provides therapy recommendations. The assessment of the state variables and the generation of therapeutic advice follow a knowledge-based approach. Aspects of uncertainty, e.g. a gradual transition between 'normal' and 'below normal', are considered applying a fuzzy set approach. Special emphasis is laid on the ergonomic design of the user interface, which is based on color graphics and finger touch input on the screen. Certain simulation techniques considerably support the design process of AES-2 as is demonstrated with a typical example from cardioanesthesia. PMID:1402299

  13. Towards sustainable decision-support system facilitating EBM.

    PubMed

    Stolba, Nevena; Nguyen, Tho Manh; Tjoa, A Min

    2007-01-01

    Due to the immense volumes of medical data, the architecture of the future healthcare decision support systems focus more on interoperability than on integration. With the raising need for the creation of unified knowledge base, the federated approach to distributed data warehouses (DWH) is getting increasing attention. In this paper, we explore the idea of a federation technology and its uses within the domain of health, particularly in the conceptualization of DWH federation as a sustainable, appropriate and legitimate solution. Further, we present a federated DWH model which enables the interoperability between heterogeneous and distributed medical IS, which includes a sense and response mechanism and facilitates evidence-based medicine in order to primarily support the physicians at the point of care. A real-world scenario illustrates a possible application field in the area of emergency and intensive care.

  14. Decision Support for Integrated Energy-Water Planning

    NASA Astrophysics Data System (ADS)

    Tidwell, V. C.; William, H.; Klise, G.; Kobos, P. H.; Malczynski, L. A.

    2008-12-01

    Currently, electrical power generation uses about 140 billion gallons of water per day accounting for over 40% of all freshwater withdrawals thus competing with irrigated agriculture as the leading user of water. To meet their demand for water, proposed power plants must often target waterways and aquifers prone to overdraft or which may be home to environmentally sensitive species. Acquisition of water rights, permits and public support may therefore be a formidable hurdle when licensing new power plants. Given these current difficulties, what does the future hold when projected growth in population and the economy may require a 30% increase in power generation capacity by 2025? Technology solutions can only take us so far, as noted by the National Energy-Water Roadmap Exercise. This roadmap identified the need for long-term and integrated resource planning supported with scientifically credible models as a leading issue. To address this need a decision support framework is being 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 help identify potential trade-offs, and "best" alternatives among an overwhelming number of energy/water options and objectives. The decision support tool is comprised of three basic elements: a system dynamics model coupling the physical and economic systems important to integrated energy-water planning and management; an optimization toolbox; and a software wrapper that integrates the aforementioned elements along with additional external energy/water models, databases, and visualization products. An interactive interface allows direct interaction with the model and access to real-time results organized according to a variety of reference systems, e.g., from a political, watershed, or electric power grid perspective. With this unique synthesis of various

  15. The development of a disease oriented eFolder for multiple sclerosis decision support

    NASA Astrophysics Data System (ADS)

    Ma, Kevin; Jacobs, Colin; Fernandez, James; Amezcua, Lilyana; Liu, Brent

    2010-03-01

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. The chronic nature of MS necessitates multiple MRI studies to track disease progression. Currently, MRI assessment of multiple sclerosis requires manual lesion measurement and yields an estimate of lesion volume and change that is highly variable and user-dependent. In the setting of a longitudinal study, disease trends and changes become difficult to extrapolate from the lesions. In addition, it is difficult to establish a correlation between these imaged lesions and clinical factors such as treatment course. To address these clinical needs, an MS specific e-Folder for decision support in the evaluation and assessment of MS has been developed. An e-Folder is a disease-centric electronic medical record in contrast to a patient-centric electronic health record. Along with an MS lesion computer aided detection (CAD) package for lesion load, location, and volume, clinical parameters such as patient demographics, disease history, clinical course, and treatment history are incorporated to make the e-Folder comprehensive. With the integration of MRI studies together with related clinical data and informatics tools designed for monitoring multiple sclerosis, it provides a platform to improve the detection of treatment response in patients with MS. The design and deployment of MS e-Folder aims to standardize MS lesion data and disease progression to aid in decision making and MS-related research.

  16. Factors that influence the medication decision making of persons with HIV/AIDS: a taxonomic exploration.

    PubMed

    Russell, Cynthia K; Bunting, Sheila M; Graney, Marshall; Hartig, Margaret T; Kisner, Patricia; Brown, Brian

    2003-01-01

    It is well known that patients often alter their medication regimens and that these changes may have profound consequences for their health outcomes. Not so well known are the factors that influence the medication decision making of persons managing their own treatment in their day-to-day home situations. In this study, persons living with HIV/AIDS (PLWH) were asked about factors that affected the taking of their medications. Using semistructured interviews in this study of 57 PLWH, the authors used intensive analysis of the narratives to create taxonomies of the barriers and facilitators to taking HIV medications and the decisions that were involved. Categories of identified facilitators included motivation, factors of faith, routines, and others' influences. Categories of identified barriers included perceptions, psycho-emotional issues, provider/clinic issues, interpersonal factors, and disease and treatment factors. This study showed medication decision making to be a complex process, influenced by often-competing life and treatment issues and affected by participants' beliefs and values. These findings call for research into the everyday selfcare of PLWH to understand the reasoned decision-making that PLWH use in managing not only their medications but also their lives.

  17. Nutrients in the upper Mississippi River : scientific information to support management decisions

    USGS Publications Warehouse

    U.S. Geological Survey

    2003-01-01

    Studies of processes provide information for improved understanding of nutrient sources, cycling, and transport. This information can be used to improve model development and aid in management decisions for the protection of water quality and habitat.

  18. Integrated Decision Support for Global Environmental Change Adaptation

    NASA Astrophysics Data System (ADS)

    Kumar, S.; Cantrell, S.; Higgins, G. J.; Marshall, J.; VanWijngaarden, F.

    2011-12-01

    Environmental changes are happening now that has caused concern in many parts of the world; particularly vulnerable are the countries and communities with limited resources and with natural environments that are more susceptible to climate change impacts. Global leaders are concerned about the observed phenomena and events such as Amazon deforestation, shifting monsoon patterns affecting agriculture in the mountain slopes of Peru, floods in Pakistan, water shortages in Middle East, droughts impacting water supplies and wildlife migration in Africa, and sea level rise impacts on low lying coastal communities in Bangladesh. These environmental changes are likely to get exacerbated as the temperatures rise, the weather and climate patterns change, and sea level rise continues. Large populations and billions of dollars of infrastructure could be affected. At Northrop Grumman, we have developed an integrated decision support framework for providing necessary information to stakeholders and planners to adapt to the impacts of climate variability and change at the regional and local levels. This integrated approach takes into account assimilation and exploitation of large and disparate weather and climate data sets, regional downscaling (dynamic and statistical), uncertainty quantification and reduction, and a synthesis of scientific data with demographic and economic data to generate actionable information for the stakeholders and decision makers. Utilizing a flexible service oriented architecture and state-of-the-art visualization techniques, this information can be delivered via tailored GIS portals to meet diverse set of user needs and expectations. This integrated approach can be applied to regional and local risk assessments, predictions and decadal projections, and proactive adaptation planning for vulnerable communities. In this paper we will describe this comprehensive decision support approach with selected applications and case studies to illustrate how this

  19. Decision support system for predicting color change after tooth whitening.

    PubMed

    Thanathornwong, Bhornsawan; Suebnukarn, Siriwan; Ouivirach, Kan

    2016-03-01

    Tooth whitening is becoming increasingly popular among patients and dentists since it is a relatively noninvasive approach. However, the degree of color change after tooth whitening is known to vary substantially between studies. The present study aims to develop a clinical decision support system for predicting color change after in-office tooth whitening. We used the information from patients' data sets, and applied the multiple regression equation of CIELAB color coordinates including L*, a*, and b* of the original tooth color and the color difference (ΔE) that expresses the color change after tooth whitening. To evaluate the system performance, the patient's post-treatment color was used as "gold standard" to compare with the post-treatment color predicted by the system. There was a high degree of agreement between the patient's post-treatment color and the post-treatment color predicted by the system (kappa value=0.894). The results obtained have demonstrated that the decision support system is possible to predict the color change obtained using an in-office whitening system using colorimetric values. PMID:26657921

  20. Decision making by urgency gating: theory and experimental support.

    PubMed

    Thura, David; Beauregard-Racine, Julie; Fradet, Charles-William; Cisek, Paul

    2012-12-01

    It is often suggested that decisions are made when accumulated sensory information reaches a fixed accuracy criterion. This is supported by many studies showing a gradual build up of neural activity to a threshold. However, the proposal that this build up is caused by sensory accumulation is challenged by findings that decisions are based on information from a time window much shorter than the build-up process. Here, we propose that in natural conditions where the environment can suddenly change, the policy that maximizes reward rate is to estimate evidence by accumulating only novel information and then compare the result to a decreasing accuracy criterion. We suggest that the brain approximates this policy by multiplying an estimate of sensory evidence with a motor-related urgency signal and that the latter is primarily responsible for neural activity build up. We support this hypothesis using human behavioral data from a modified random-dot motion task in which motion coherence changes during each trial.

  1. Decision support system for predicting color change after tooth whitening.

    PubMed

    Thanathornwong, Bhornsawan; Suebnukarn, Siriwan; Ouivirach, Kan

    2016-03-01

    Tooth whitening is becoming increasingly popular among patients and dentists since it is a relatively noninvasive approach. However, the degree of color change after tooth whitening is known to vary substantially between studies. The present study aims to develop a clinical decision support system for predicting color change after in-office tooth whitening. We used the information from patients' data sets, and applied the multiple regression equation of CIELAB color coordinates including L*, a*, and b* of the original tooth color and the color difference (ΔE) that expresses the color change after tooth whitening. To evaluate the system performance, the patient's post-treatment color was used as "gold standard" to compare with the post-treatment color predicted by the system. There was a high degree of agreement between the patient's post-treatment color and the post-treatment color predicted by the system (kappa value=0.894). The results obtained have demonstrated that the decision support system is possible to predict the color change obtained using an in-office whitening system using colorimetric values.

  2. Ontology-based diagnostic decision support in radiology.

    PubMed

    Kahn, Charles E

    2014-01-01

    The Radiology Gamuts Ontology (RGO) is a knowledge model of diseases, interventions, and imaging manifestations. RGO incorporates 16,822 terms with their synonyms and abbreviations and 55,393 relationships between terms. Subsumption defines the relationship between more general and more specific terms; causality relates disorders and their imaging manifestations. We explored the application of the RGO to build an interactive decision support system for radiological diagnosis. The Gamuts DDx system was created to apply the RGO's knowledge: it identifies a list of potential diagnoses in response to one or more user-specified imaging observations. The system also identifies a set of observations that allow one to narrow the diagnosis, and dynamically narrows or expands the list of diagnoses as imaging findings are selected or deselected. The functionality has been implemented as a web-based user interface and as a web service. The current work demonstrates the feasibility of exploiting the RGO's causal knowledge to provide interactive decision support for diagnosis of imaging findings. Ongoing efforts include the further development of the system's knowledge base and evaluation of the system in clinical use. PMID:25160149

  3. How Turing and Wolf influenced my Decision Support Systems.

    PubMed

    Richards, Bernard

    2013-01-01

    Decision Support Systems (DSS) have a vital role to play in today's scenario for Patient Care. They can embody a vast knowledge not normally found in one individual where diagnosis and treatment are involved. This paper highlights the training in minute details and precise mathematics needed in a successful DSS and indicates how such attention-to-detail was instilled into the writer as a result of working with Alan Turing and Emil Wolf who have both since achieved world-wide recognition in their own fields as a result of international publicity by the current writer. The article discusses four Decision Support Systems written by the present writer all of which have been shown to improve patient treatment and care, and which are of such complexity that, without their use, patient care would fall short of optimum. The Systems considered are those for Intensive Care Units, Cardiovascular Surgery, a Programmed Investigation Unit, and Diagnosis of Congenital Abnormalities. All these Systems have performed better than the human alternatives and have shown their value in the improvement of patient care.

  4. Ontology-based diagnostic decision support in radiology.

    PubMed

    Kahn, Charles E

    2014-01-01

    The Radiology Gamuts Ontology (RGO) is a knowledge model of diseases, interventions, and imaging manifestations. RGO incorporates 16,822 terms with their synonyms and abbreviations and 55,393 relationships between terms. Subsumption defines the relationship between more general and more specific terms; causality relates disorders and their imaging manifestations. We explored the application of the RGO to build an interactive decision support system for radiological diagnosis. The Gamuts DDx system was created to apply the RGO's knowledge: it identifies a list of potential diagnoses in response to one or more user-specified imaging observations. The system also identifies a set of observations that allow one to narrow the diagnosis, and dynamically narrows or expands the list of diagnoses as imaging findings are selected or deselected. The functionality has been implemented as a web-based user interface and as a web service. The current work demonstrates the feasibility of exploiting the RGO's causal knowledge to provide interactive decision support for diagnosis of imaging findings. Ongoing efforts include the further development of the system's knowledge base and evaluation of the system in clinical use.

  5. How Turing and Wolf influenced my Decision Support Systems.

    PubMed

    Richards, Bernard

    2013-01-01

    Decision Support Systems (DSS) have a vital role to play in today's scenario for Patient Care. They can embody a vast knowledge not normally found in one individual where diagnosis and treatment are involved. This paper highlights the training in minute details and precise mathematics needed in a successful DSS and indicates how such attention-to-detail was instilled into the writer as a result of working with Alan Turing and Emil Wolf who have both since achieved world-wide recognition in their own fields as a result of international publicity by the current writer. The article discusses four Decision Support Systems written by the present writer all of which have been shown to improve patient treatment and care, and which are of such complexity that, without their use, patient care would fall short of optimum. The Systems considered are those for Intensive Care Units, Cardiovascular Surgery, a Programmed Investigation Unit, and Diagnosis of Congenital Abnormalities. All these Systems have performed better than the human alternatives and have shown their value in the improvement of patient care. PMID:23542962

  6. Comparing decision-support systems in adopting sustainable intensification criteria

    PubMed Central

    Ahmadi, Bouda Vosough; Moran, Dominic; Barnes, Andrew P.; Baret, Philippe V.

    2015-01-01

    Sustainable intensification (SI) is a multifaceted concept incorporating the ambition to increase or maintain the current level of agricultural yields while reduce negative ecological and environmental impacts. Decision-support systems (DSS) that use integrated analytical methods are often used to support decision making processes in agriculture. However, DSS often consist of set of values, objectives, and assumptions that may be inconsistent or in conflict with merits and objectives of SI. These potential conflicts will have consequences for adoption and up-take of agricultural research, technologies and related policies and regulations such as genetic technology in pursuit of SI. This perspective paper aimed at comparing a number of frequently used socio-economic DSS with respect to their capacity in incorporating various dimensions of SI, and discussing their application to analyzing farm animal genetic resources (FAnGR) policies. The case of FAnGR policies was chosen because of its great potential in delivering merits of SI. It was concluded that flexible DSS, with great integration capacity with various natural and social sciences, are needed to provide guidance on feasibility, practicality, and policy implementation for SI. PMID:25717336

  7. All Individuals Deserve Support: Collaborating To Prevent HIV/AIDS among Homeless Youth.

    ERIC Educational Resources Information Center

    Sherman, Nancy E.

    All Individuals Deserve Support (AIDS) is a collaborative prevention program between graduate students in a Community/Agency Counseling program and the Children's Home Homeless Youth Program in Peoria, Illinois. Graduate students developed a comprehensive HIV/AIDS prevention program for homeless youth as a class project. Project design involved:…

  8. [Knowledge management system for laboratory work and clinical decision support].

    PubMed

    Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

    2011-05-01

    This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

  9. [Knowledge management system for laboratory work and clinical decision support].

    PubMed

    Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

    2011-05-01

    This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support

  10. A Methodology to Support Decision Making in Flood Plan Mitigation

    NASA Astrophysics Data System (ADS)

    Biscarini, C.; di Francesco, S.; Manciola, P.

    2009-04-01

    The focus of the present document is on specific decision-making aspects of flood risk analysis. A flood is the result of runoff from rainfall in quantities too great to be confined in the low-water channels of streams. Little can be done to prevent a major flood, but we may be able to minimize damage within the flood plain of the river. This broad definition encompasses many possible mitigation measures. Floodplain management considers the integrated view of all engineering, nonstructural, and administrative measures for managing (minimizing) losses due to flooding on a comprehensive scale. The structural measures are the flood-control facilities designed according to flood characteristics and they include reservoirs, diversions, levees or dikes, and channel modifications. Flood-control measures that modify the damage susceptibility of floodplains are usually referred to as nonstructural measures and may require minor engineering works. On the other hand, those measures designed to modify the damage potential of permanent facilities are called non-structural and allow reducing potential damage during a flood event. Technical information is required to support the tasks of problem definition, plan formulation, and plan evaluation. The specific information needed and the related level of detail are dependent on the nature of the problem, the potential solutions, and the sensitivity of the findings to the basic information. Actions performed to set up and lay out the study are preliminary to the detailed analysis. They include: defining the study scope and detail, the field data collection, a review of previous studies and reports, and the assembly of needed maps and surveys. Risk analysis can be viewed as having many components: risk assessment, risk communication and risk management. Risk assessment comprises an analysis of the technical aspects of the problem, risk communication deals with conveying the information and risk management involves the decision process

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

    PubMed Central

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

    2014-01-01

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

  12. Verification and Validation of NASA-Supported Enhancements to Decision Support Tools of PECAD

    NASA Technical Reports Server (NTRS)

    Ross, Kenton W.; McKellip, Rodney; Moore, Roxzana F.; Fendley, Debbie

    2005-01-01

    This section of the evaluation report summarizes the verification and validation (V&V) of recently implemented, NASA-supported enhancements to the decision support tools of the Production Estimates and Crop Assessment Division (PECAD). The implemented enhancements include operationally tailored Moderate Resolution Imaging Spectroradiometer (MODIS) products and products of the Global Reservoir and Lake Monitor (GRLM). The MODIS products are currently made available through two separate decision support tools: the MODIS Image Gallery and the U.S. Department of Agriculture (USDA) Foreign Agricultural Service (FAS) MODIS Normalized Difference Vegetation Index (NDVI) Database. Both the Global Reservoir and Lake Monitor and MODIS Image Gallery provide near-real-time products through PECAD's CropExplorer. This discussion addresses two areas: 1. Assessments of the standard NASA products on which these enhancements are based. 2. Characterizations of the performance of the new operational products.

  13. Aggregation of Environmental Model Data for Decision Support

    NASA Astrophysics Data System (ADS)

    Alpert, J. C.

    2013-12-01

    model output offering access to probability and calibrating information for real time decision making. The aggregation content server reports over ensemble component and forecast time in addition to the other data dimensions of vertical layer and position for each variable. The unpacking, organization and reading of many binary packed files is accomplished most efficiently on the server while weather element event probability calculations, the thresholds for more accurate decision support, or display remain for the client. Our goal is to reduce uncertainty for variables of interest, e.g, agricultural importance. The weather service operational GFS model ensemble and short range ensemble forecasts can make skillful probability forecasts to alert users if and when their selected weather events will occur. A description of how this framework operates and how it can be implemented using existing NOMADS content services and applications is described.

  14. Decision Support: The Keys to Success. AIR 1986 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Oerly, Diane

    Characteristics of a decision support system (DSS) and factors that influence system design are described, along with a decision support database at the University of Missouri-Columbia. Reasons that the institutional research office is in a unique position to support decision-making are identified. A review of the literature of DSS briefly covers…

  15. Analysis and quantification of uncertainty for climate change decision aids for energy consumption in the southwestern US

    NASA Astrophysics Data System (ADS)

    Apling, D.; Higgins, G.; Kiley, H.; Darmenova, K.

    2010-12-01

    Outputs from current generation General Circulation Models (GCMs) are being downscaled to produce primary adaptation products used to investigate the utility of such products for aiding end-user decisions on enduring energy infrastructure as well as short and long-term production and conservation policy alternatives. Effective decision support products carry representations of both objective and subjective uncertainty through to the end-user, allowing them to appropriately weigh climate change factors in with myriad other relevant elements of their decisions. To that end, our methodology compares GCMs and their corresponding downscales with relevant objective historical measurements, systematically evaluates these products with respect to common baseline datasets, and then applies statistical bias correction and uncertainty analysis to establish objective confidence intervals. These primary products are then used to drive empirical energy consumption models fitted to end-user supplied energy consumption records, and undergo additional data quality control and model parameter uncertainty analysis. Our results show a high degree of fit for natural gas consumption involved in facility heating, a lesser degree for electrical power consumption for both heating and cooling, and illustrate a climate-change signal from the European Center/Hamburg Model (ECHAM5) GCM constrained Weather Research and Forecasting (WRF) runs for a parallel current period of 1999-2009, and a future period for 2029-2039; along with confidence bounds on monthly and cumulative annual changes base on these statistical analyses expressed as changes in millions of cubic feet of natural gas and megawatt-hours of electrical energy. Results indicate that our bias corrected energy products provide the necessary detailed output and uncertainty bounds required by public and private facility planners to support and develop their long term energy strategies.

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

    SciTech Connect

    Paulson, Patrick R.; Coles, Garill A.; Shoemaker, Steven V.

    2012-06-12

    Modernization of nuclear power operations control systems, in particular the move to digital control systems, creates an opportunity to modernize existing legacy infrastructure and extend plant life. We describe here decision support tools that allow the assessment of different facets of risk and support the optimization of available resources to reduce risk as plants are upgraded and maintained. This methodology could become an integrated part of the design review process and a part of the operations management systems. The methodology can be applied to the design of new reactors such as small nuclear reactors (SMR), and be helpful in assessing the risks of different configurations of the reactors. Our tool provides a low cost evaluation of alternative configurations and provides an expanded safety analysis by considering scenarios while early in the implementation cycle where cost impacts can be minimized. The effects of failures can be modeled and thoroughly vetted to understand their potential impact on risk. The process and tools presented here allow for an integrated assessment of risk by supporting traditional defense in depth approaches while taking into consideration the insertion of new digital instrument and control systems.

  17. Clinical decision support for perioperative information management systems.

    PubMed

    Wanderer, Jonathan P; Ehrenfeld, Jesse M

    2013-12-01

    Clinical decision support (CDS) systems are being used to optimize the increasingly complex care that our health care system delivers. These systems have become increasingly important in the delivery of perioperative care for patients undergoing cardiac, thoracic, and vascular procedures. The adoption of perioperative information management systems (PIMS) has allowed these technologies to enter the operating room and support the clinical work flow of anesthesiologists and operational processes. Constructing effective CDS systems necessitates an understanding of operative work flow and technical considerations as well as achieving integration with existing information systems. In this review, we describe published examples of CDS for PIMS, including support for cardiopulmonary bypass separation physiological alarms, β-blocker guideline adherence, enhanced revenue capture for arterial line placement, and detection of hemodynamic monitoring gaps. Although these and other areas are amenable to CDS systems, the challenges of latency and data reliability represent fundamental limitations on the potential application of these tools to specific types of clinical issues. Ultimately, we expect that CDS will remain an important tool in our efforts to optimize the quality of care delivered.

  18. Decision Support Systems for Launch and Range Operations Using Jess

    NASA Technical Reports Server (NTRS)

    Thirumalainambi, Rajkumar

    2007-01-01

    The virtual test bed for launch and range operations developed at NASA Ames Research Center consists of various independent expert systems advising on weather effects, toxic gas dispersions and human health risk assessment during space-flight operations. An individual dedicated server supports each expert system and the master system gather information from the dedicated servers to support the launch decision-making process. Since the test bed is based on the web system, reducing network traffic and optimizing the knowledge base is critical to its success of real-time or near real-time operations. Jess, a fast rule engine and powerful scripting environment developed at Sandia National Laboratory has been adopted to build the expert systems providing robustness and scalability. Jess also supports XML representation of knowledge base with forward and backward chaining inference mechanism. Facts added - to working memory during run-time operations facilitates analyses of multiple scenarios. Knowledge base can be distributed with one inference engine performing the inference process. This paper discusses details of the knowledge base and inference engine using Jess for a launch and range virtual test bed.

  19. Mining multi-dimensional data for decision support

    SciTech Connect

    Donato, J.M.; Schryver, J.C.; Hinkel, G.C.; Schmoyer, R.L. Jr.; Grady, N.W.; Leuze, M.R. |

    1998-06-01

    While it is widely recognized that data can be a valuable resource for any organization, extracting information contained within the data is often a difficult problem. Attempts to obtain information from data may be limited by legacy data storage formats, lack of expert knowledge about the data, difficulty in viewing the data, or the volume of data needing to be processed. The rapidly developing field of Data Mining or Knowledge Data Discovery is a blending of Artificial Intelligence, Statistics, and Human-Computer Interaction. Sophisticated data navigation tools to obtain the information needed for decision support do not yet exist. Each data mining task requires a custom solution that depends upon the character and quantity of the data. This paper presents a two-stage approach for handling the prediction of personal bankruptcy using credit card account data, combining decision tree and artificial neural network technologies. Topics to be discussed include the pre-processing of data, including data cleansing, the filtering of data for pertinent records, and the reduction of data for attributes contributing to the prediction of bankruptcy, and the two steps in the mining process itself.

  20. Query-handling in MLM-based decision support systems.

    PubMed

    Arkad, K; Gao, X M; Ahlfeldt, H

    1995-01-01

    Arden Syntax for Medical Logic Modules is a standard specification for creation and sharing of knowledge bases. The standard specification focuses on knowledge that can be represented as a set of independent Medical Logic Modules (MLMs) such as rules, formulas and protocols. The basic functions of an MLM are to retrieve patient data, manipulate the data, come to some decision, and possibly perform an action. All connections to the world outside an MLM are collected in the data-slot of the MLM. The institution specific parts of these connections are inside the notation of curly brackets ([]) to facilitate sharing of MLM between institutions. This paper focuses on some of the problems that occur in relation to Arden Syntax and connections to a patient database such as database queries. Problems related to possibilities of moving one or several module(s) are also discussed, with emphasis on database connections. As an example, an MLM based Decision Support System (DSS) developed at Linköping University is described. PMID:8882561

  1. Seasonal Stream Flow Forecasting and Decision Support in Central Texas

    NASA Astrophysics Data System (ADS)

    Watkins, D. W.; Nykanen, D. K.; Mahmoud, M.; Wei, W.

    2003-12-01

    A decision support model based on stream flow ensemble forecasts has been developed for the Lower Colorado River Authority in Central Texas, and predictive skill is added to climatology-based forecasts by conditioning the ensembles on observable climate indicators. These indicators include stream flow (persistence), soil moisture, and large-scale recurrent patterns such as the El Nino-Southern Oscillation, Pacific Decadal Oscillation, and the North Atlantic Oscillation. In the absence of historical soil moisture measurements, the Variable Infiltration Capacity (VIC) Retrospective Land Surface Data Set is applied. Strong correlation between observed runoff volumes and runoff volumes simulated by the (uncalibrated) VIC model indicates the viability of this approach. Following correlation analysis to screen potential predictors, a Bayesian procedure for updating ensemble probabilities is outlined, and various skill scores are reviewed for evaluating forecast performance. Verification of the ensemble forecasts using a resampling procedure indicates a small but potentially significant improvement in forecast skill over climatology that could be exploited in seasonal water management decisions. Future work involves evaluation of seasonal soil moisture forecasts, further evaluation of annual flow forecasts, incorporation of climate forecasts in reservoir operating rules, and estimation of the value of the forecasts.

  2. Decision Support for Iteration Scheduling in Agile Environments

    NASA Astrophysics Data System (ADS)

    Szőke, Ákos

    Today’s software business development projects often lay claim to low-risk value to the customers in order to be financed. Emerging agile processes offer shorter investment periods, faster time-to-market and better customer satisfaction. To date, however, in agile environments there is no sound methodological schedule support contrary to the traditional plan-based approaches. To address this situation, we present an agile iteration scheduling method whose usefulness is evaluated with post-mortem simulation. It demonstrates that the method can significantly improve load balancing of resources (cca. 5×), produce higher quality and lower-risk feasible schedule, and provide more informed and established decisions by optimized schedule production. Finally, the paper analyzes benefits and issues from the use of this method.

  3. Impact Decision Support Services in the Arctic - A Case Study

    NASA Astrophysics Data System (ADS)

    Scott, C. A.

    2015-12-01

    The National Weather Service Alaska Region's (AR) Regional Operation Center (ROC) provided weather and ice decision support services for the Bureau of Ocean and Energy Management (BOEM) oversight of Royal Dutch Shell's exploratory drilling operations in the Chukchi Sea during the summer and early fall of 2015. The AR ROC, coordinated input from WFO's Anchorage and Fairbanks, the NCEP/Ocean Prediction Center and Climate Prediction Center, and NOAA's National Ice Center. Briefings began in early Spring 2015, focused on melt-out and freeze up dates in the vicinity of the "Burger" drill site. Initially packages were prepared and briefed twice weekly. The frequency increased as the drilling season progressed, and included marine and aviation weather forecasts, current and forecast sea ice conditions as it impacts vessels and aircraft transiting to and from the drilling sites in the Chukchi Sea. Spot forecasts are also available for specific missions as needed.

  4. Spatio-temporal Visualization for Environmental Decision Support

    SciTech Connect

    Bhaduri, Budhendra L.; Shankar, Mallikarjun; Sorokine, Alexandre; Ganguly, Auroop R.

    2009-01-01

    Traditional visualization of earth surface features has been addressed through visual exploration, analysis, synthesis, and presentation of observable geospatial data. However, characterizing the changes in their observable and unobservable properties of geospatial features is critical for planning and policy formulation. Recent approaches are addressing modeling and visualization of the temporal dynamics that describe observed and/or predicted physical and socioeconomic processes using vast volumes of earth observation (imagery and other geophysical) data from remote sensor networks. This paper provides an overview of selected geospatial modeling and simulation, exploratory analysis of earth observation data, and high performance visualization research at Oak Ridge National Laboratory for developing novel data driven approaches for geospatial knowledge discovery and visualization relevant to environmental decision support.

  5. Intelligent decision support technologies for design and manufacturing

    SciTech Connect

    Zacharia, T.; Allen, J.D.; Ivezic, N.; Ludtka, G.M.

    1997-06-01

    For many of today`s complex manufacturing processes, there exists a solid body of knowledge that enables direct simulations of such processes yielding predictions about the final product and process characteristics using finite element or finite difference methods. However, the computational complexities of these simulations are such that they do not lend themselves easily to routine and timely use in optimization and control of manufacturing processes. More recently, neural network-based decision support technologies have been developed which hold the promise of bringing the body of analytical and simulation knowledge closer to the design and optimization processes in manufacturing industries. The paper discusses the application of a holistic approach wherein existing finite element, neural-network, and optical metrology methods are combined to develop a real time tool for optimization and control of the sheet metal stamping process. Significant issues in the development of such a tool and results from its application to a deformation process are discussed.

  6. Protective jacket enabling decision support for workers in cold climate.

    PubMed

    Seeberg, Trine M; Vardoy, Astrid-Sofie B; Austad, Hanne O; Wiggen, Oystein; Stenersen, Henning S; Liverud, Anders E; Storholmen, Tore Christian B; Faerevik, Hilde

    2013-01-01

    The cold and harsh climate in the High North represents a threat to safety and work performance. The aim of this study was to show that sensors integrated in clothing can provide information that can improve decision support for workers in cold climate without disturbing the user. Here, a wireless demonstrator consisting of a working jacket with integrated temperature, humidity and activity sensors has been developed. Preliminary results indicate that the demonstrator can provide easy accessible information about the thermal conditions at the site of the worker and local cooling effects of extremities. The demonstrator has the ability to distinguish between activity and rest, and enables implementation of more sophisticated sensor fusion algorithms to assess work load and pre-defined activities. This information can be used in an enhanced safety perspective as an improved tool to advice outdoor work control for workers in cold climate.

  7. A Framework for Decision Support Systems Based on Zachman Framework

    NASA Astrophysics Data System (ADS)

    Ostadzadeh, S. Shervin; Habibi, Jafar; Ostadzadeh, S. Arash

    Recent challenges have brought about an inevitable tendency for enterprises to lunge towards organizing their information activities in a comprehensive way. In this respect, Enterprise Architecture (EA) has proven to be the leading option for development and maintenance of information systems. EA clearly provides a thorough outline of the whole information system comprising an enterprise. To establish such an outline, a logical framework needs to be laid upon the entire information system. Zachman framework (ZF) has been widely accepted as a standard scheme for identifying and organizing descriptive representations that have critical roles in enterprise management and system development. In this paper, we propose a framework based on ZF for Decision Support Systems (DSS). Furthermore, a modeling approach based on Model-Driven Architecture (MDA) is utilized to obtain compatible models for all cells in the framework. The efficiency of the proposed framework is examined through a case study.

  8. Clinical Decision Support for Early Recognition of Sepsis.

    PubMed

    Amland, Robert C; Hahn-Cover, Kristin E

    2016-01-01

    Sepsis is an inflammatory response triggered by infection, with a high in-hospital mortality rate. Early recognition and treatment can reverse the inflammatory response, with evidence of improved patient outcomes. One challenge clinicians face is identifying the inflammatory syndrome against the background of the patient's infectious illness and comorbidities. An approach to this problem is implementation of computerized early warning tools for sepsis. This multicenter retrospective study sought to determine clinimetric performance of a cloud-based computerized sepsis clinical decision support system (CDS), understand the epidemiology of sepsis, and identify opportunities for quality improvement. Data encompassed 6200 adult hospitalizations from 2012 through 2013. Of 13% patients screened-in, 51% were already suspected to have an infection when the system activated. This study focused on a patient cohort screened-in before infection was suspected; median time from arrival to CDS activation was 3.5 hours, and system activation to diagnostic collect was another 8.6 hours. PMID:25385815

  9. Clinical Decision Support Knowledge Management: Strategies for Success.

    PubMed

    Khalifa, Mohamed; Alswailem, Osama

    2015-01-01

    Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital.

  10. NOAA Climate Information and Tools for Decision Support Services

    NASA Astrophysics Data System (ADS)

    Timofeyeva, M. M.; Higgins, W.; Strager, C.; Horsfall, F. M.

    2013-12-01

    NOAA is an active participant of the Global Framework for Climate Services (GFCS) contributing data, information, analytical capabilities, forecasts, and decision support services to the Climate Services Partnership (CSP). These contributions emerge from NOAA's own climate services, which have evolved to respond to the urgent and growing need for reliable, trusted, transparent, and timely climate information across all sectors of the U.S. economy. Climate services not only enhance development opportunities in many regions, but also reduce vulnerability to climate change around the world. The NOAA contribution lies within the NOAA Climate Goal mission, which is focusing its efforts on four key climate priority areas: water, extremes, coastal inundation, and marine ecosystems. In order to make progress in these areas, NOAA is exploiting its fundamental capabilities, including foundational research to advance understanding of the Earth system, observations to preserve and build the climate data record and monitor changes in climate conditions, climate models to predict and project future climate across space and time scales, and the development and delivery of decision support services focused on risk management. NOAA's National Weather Services (NWS) is moving toward provision of Decision Support Services (DSS) as a part of the Roadmap on the way to achieving a Weather Ready National (WRN) strategy. Both short-term and long-term weather, water, and climate information are critical for DSS and emergency services and have been integrated into NWS in the form of pilot projects run by National and Regional Operations Centers (NOC and ROCs respectively) as well as several local offices. Local offices with pilot projects have been focusing their efforts on provision of timely and actionable guidance for specific tasks such as DSS in support of Coastal Environments and Integrated Environmental Studies. Climate information in DSS extends the concept of climate services to

  11. Clinical Decision Support Knowledge Management: Strategies for Success.

    PubMed

    Khalifa, Mohamed; Alswailem, Osama

    2015-01-01

    Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital. PMID:26152955

  12. Examining the Relationship between Clinical Decision Support and Performance Measurement

    PubMed Central

    Haggstrom, David A.; Saleem, Jason J.; Militello, Laura G.; Arbuckle, Nicole; Flanagan, Mindy; Doebbeling, Bradley N.

    2009-01-01

    In concept and practice, clinical decision support (CDS) and performance measurement represent distinct approaches to organizational change, yet these two organizational processes are interrelated. We set out to better understand how the relationship between the two is perceived, as well as how they jointly influence clinical practice. To understand the use of CDS at benchmark institutions, we conducted semistructured interviews with key managers, information technology personnel, and clinical leaders during a qualitative field study. Improved performance was frequently cited as a rationale for the use of clinical reminders. Pay-for-performance efforts also appeared to provide motivation for the use of clinical reminders. Shared performance measures were associated with shared clinical reminders. The close link between clinical reminders and performance measurement causes these tools to have many of the same implementation challenges. PMID:20351854

  13. PATHway: Decision Support in Exercise Programmes for Cardiac Rehabilitation.

    PubMed

    Filos, Dimitris; Triantafyllidis, Andreas; Chouvarda, Ioanna; Buys, Roselien; Cornelissen, Véronique; Budts, Werner; Walsh, Deirdre; Woods, Catherine; Moran, Kieran; Maglaveras, Nicos

    2016-01-01

    Rehabilitation is important for patients with cardiovascular diseases (CVD) to improve health outcomes and quality of life. However, adherence to current exercise programmes in cardiac rehabilitation is limited. We present the design and development of a Decision Support System (DSS) for telerehabilitation, aiming to enhance exercise programmes for CVD patients through ensuring their safety, personalising the programme according to their needs and performance, and motivating them toward meeting their physical activity goals. The DSS processes data originated from a Microsoft Kinect camera, a blood pressure monitor, a heart rate sensor and questionnaires, in order to generate a highly individualised exercise programme and improve patient adherence. Initial results within the EU-funded PATHway project show the potential of our approach.

  14. The role of informatics and decision support in utilization management.

    PubMed

    Baron, Jason M; Dighe, Anand S

    2014-01-01

    Information systems provide a critical link between clinical laboratories and the clinicians and patients they serve. Strategic deployment of informatics resources can enable a wide array of utilization initiatives and can substantially improve the appropriateness of test selection and results interpretation. In this article, we review information systems including computerized provider order entry (CPOE) systems, laboratory information systems (LISs), electronic health records (EHRs), laboratory middleware, knowledge management systems and systems for data extraction and analysis, and describe the role that each can play in utilization management. We also discuss specific utilization strategies that laboratories can employ within these systems, citing examples both from our own institution and from the literature. Finally, we review how emerging applications of decision support technologies may help to further refine test utilization, "personalize" laboratory diagnosis, and enhance the diagnostic value of laboratory testing.

  15. Decision support systems and methods for complex networks

    DOEpatents

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

    2012-02-28

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

  16. Patterns of use of decision support tools by clinicians.

    PubMed

    Hayward, Robert S; El-Hajj, Mohamad; Voth, Tanya K; Deis, Kelly

    2006-01-01

    This paper analyses information behavior data automatically gathered by an integrated clinical information environment used by internal medicine physicians and trainees at the University of Alberta. The study reviews how clinical information systems, decision-support tools and evidence resources were used over a 13 month period. Aggregate and application-specific frequency and duration of use was compared for location, time of day, physician status, and application-type (clinical information system or 5 categories of knowledge resources). Significant differences are observed for when and where resources were used, diurnal patterns of use, minutes spent per encounter, and patterns of use for physicians and trainees. We find that evidence use is not restricted to either the place or time of clinical work, resources are used for very short periods at the point-of-care, and that use of filtered evidence-based resources is concentrated among trainees.

  17. Protective jacket enabling decision support for workers in cold climate.

    PubMed

    Seeberg, Trine M; Vardoy, Astrid-Sofie B; Austad, Hanne O; Wiggen, Oystein; Stenersen, Henning S; Liverud, Anders E; Storholmen, Tore Christian B; Faerevik, Hilde

    2013-01-01

    The cold and harsh climate in the High North represents a threat to safety and work performance. The aim of this study was to show that sensors integrated in clothing can provide information that can improve decision support for workers in cold climate without disturbing the user. Here, a wireless demonstrator consisting of a working jacket with integrated temperature, humidity and activity sensors has been developed. Preliminary results indicate that the demonstrator can provide easy accessible information about the thermal conditions at the site of the worker and local cooling effects of extremities. The demonstrator has the ability to distinguish between activity and rest, and enables implementation of more sophisticated sensor fusion algorithms to assess work load and pre-defined activities. This information can be used in an enhanced safety perspective as an improved tool to advice outdoor work control for workers in cold climate. PMID:24111230

  18. A Clinical Decision Support System for Breast Cancer Patients

    NASA Astrophysics Data System (ADS)

    Fernandes, Ana S.; Alves, Pedro; Jarman, Ian H.; Etchells, Terence A.; Fonseca, José M.; Lisboa, Paulo J. G.

    This paper proposes a Web clinical decision support system for clinical oncologists and for breast cancer patients making prognostic assessments, using the particular characteristics of the individual patient. This system comprises three different prognostic modelling methodologies: the clinically widely used Nottingham prognostic index (NPI); the Cox regression modelling and a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). All three models yield a different prognostic index that can be analysed together in order to obtain a more accurate prognostic assessment of the patient. Missing data is incorporated in the mentioned models, a common issue in medical data that was overcome using multiple imputation techniques. Risk group assignments are also provided through a methodology based on regression trees, where Boolean rules can be obtained expressed with patient characteristics.

  19. HIV/AIDS and family support systems: A situation analysis of people living with HIV/AIDS in Lagos State.

    PubMed

    Oluwagbemiga, Adeyemi Ezekiel

    2007-11-01

    Current statistics about the HIV/AIDS epidemic in Nigeria do not reveal the broader social and economic impacts of the disease on the family.The study therefore primarily aimed to address the socio-economic effects of HIV infection on individuals and their families.The study was carried out in Lagos State. In-depth interviews were employed to collect information from 188 people living with HIV/AIDS through support groups in the state, while four focus group discussions were conducted to elicit information from people affected by AIDS about the socio-economic impacts of HIV/AIDS on families in Nigeria. From the survey, among people living with HIV/AIDS, 66% of females and males were in the age group 21-40 years, while 10% were older people above 60 years of age. Findings revealed that as HIV/AIDS strikes at parents, grand parents are assuming responsibility for bringing up the children of the infected persons and the orphans of those killed by the virus. It was striking that some of the older caregivers could not meet the requirement of these children.They are often forced to work more than they would have, or borrow in order to cope with the needs of these extra mouths. Some of the infected people have sold their properties to enable them to cope with the economic effects of the virus, while their children have had to drop out of school, since they could not afford the school fees and other related expenses. It was suggested that PLWHA should be economically empowered with adequate medical treatment, in order to reduce the impact of the disease on the family. PMID:18185894

  20. An effort to spread decision aids in five California primary care practices yielded low distribution, highlighting hurdles.

    PubMed

    Lin, Grace A; Halley, Meghan; Rendle, Katharine A S; Tietbohl, Caroline; May, Suepattra G; Trujillo, Laurel; Frosch, Dominick L

    2013-02-01

    Despite the proven efficacy of decision aids as interventions for increasing patient engagement and facilitating shared decision making, they are not used routinely in clinical care. Findings from a project designed to achieve such integration, conducted at five primary care practices in 2010-12, document low rates of distribution of decision aids to eligible patients due for colorectal cancer screening (9.3 percent) and experiencing back pain (10.7 percent). There were also no lasting increases in distribution rates in response to training sessions and other promotional activities for physicians and clinic staff. The results of focus groups, ethnographic field notes, and surveys suggest that major structural and cultural changes in health care practice and policy are necessary to achieve the levels of use of decision aids and shared decision making in routine practice envisioned in current policy. Among these changes are ongoing incentives for use, physician training, and a team-based practice model in which all care team members bear formal responsibility for the use of decision aids in routine primary care.

  1. Facilitating knowledge transfer: decision support tools in environment and health.

    PubMed

    Liu, Hai-Ying; Bartonova, Alena; Neofytou, Panagiotis; Yang, Aileen; Kobernus, Michael J; Negrenti, Emanuele; Housiadas, Christos

    2012-01-01

    The HENVINET Health and Environment Network aimed to enhance the use of scientific knowledge in environmental health for policy making. One of the goals was to identify and evaluate Decision Support Tools (DST) in current use. Special attention was paid to four "priority" health issues: asthma and allergies, cancer, neurodevelopment disorders, and endocrine disruptors.We identified a variety of tools that are used for decision making at various levels and by various stakeholders. We developed a common framework for information acquisition about DSTs, translated this to a database structure and collected the information in an online Metadata Base (MDB).The primary product is an open access web-based MDB currently filled with 67 DSTs, accessible through the HENVINET networking portal http://www.henvinet.eu and http://henvinet.nilu.no. Quality assurance and control of the entries and evaluation of requirements to use the DSTs were also a focus of the work. The HENVINET DST MDB is an open product that enables the public to get basic information about the DSTs, and to search the DSTs using pre-designed attributes or free text. Registered users are able to 1) review and comment on existing DSTs; 2) evaluate each DST's functionalities, and 3) add new DSTs, or change the entry for their own DSTs. Assessment of the available 67 DSTs showed: 1) more than 25% of the DSTs address only one pollution source; 2) 25% of the DSTs address only one environmental stressor; 3) almost 50% of the DSTs are only applied to one disease; 4) 41% of the DSTs can only be applied to one decision making area; 5) 60% of the DSTs' results are used only by national authority and/or municipality/urban level administration; 6) almost half of the DSTs are used only by environmental professionals and researchers. This indicates that there is a need to develop DSTs covering an increasing number of pollution sources, environmental stressors and health end points, and considering links to other 'Driving

  2. Observations to support adaptation: Principles, scales and decision-making

    NASA Astrophysics Data System (ADS)

    Pulwarty, R. S.

    2012-12-01

    As has been long noted, a comprehensive, coordinated observing system is the backbone of any Earth information system. Demands are increasingly placed on earth observation and prediction systems and attendant services to address the needs of economically and environmentally vulnerable sectors and investments, including energy, water, human health, transportation, agriculture, fisheries, tourism, biodiversity, and national security. Climate services include building capacity to interpret information and recognize standards and limitations of data in the promotion of social and economic development in a changing climate. This includes improving the understanding of climate in the context of a variety of temporal and spatial scales (including the influence of decadal scale forcings and land surface feedbacks on seasonal forecast reliability). Climate data and information are central for developing decision options that are sensitive to climate-related uncertainties and the design of flexible adaptation pathways. Ideally monitoring should be action oriented to support climate risk assessment and adaptation including informing robust decision making to multiple risks over the long term. Based on the experience of global observations programs and empirical research we outline- Challenges in developing effective monitoring and climate information systems to support adaptation. The types of observations of critical importance needed for sector planning to enhance food, water and energy security, and to improve early warning for disaster risk reduction Observations needed for ecosystem-based adaptation including the identification of thresholds, maintenance of biological diversity and land degradation The benefits and limits of linking regional model output to local observations including analogs and verification for adaptation planning To support these goals a robust systems of integrated observations are needed to characterize the uncertainty surrounding emergent risks

  3. Gay men with AIDS and their families of origin: an analysis of social support.

    PubMed

    Kadushin, G

    1996-05-01

    This article reviews the literature on the relationships between gay men with AIDS and their families of origin to determine why the family is not a principal source of social support. Several reasons explain the absence of the family from the support network, including the family's lack of acceptance of homosexuality and the relationship with a male partner; the stigma associated with AIDS; the inability of family members to communicate openly about homosexuality and AIDS; the lack of competence among family members in dealing with HIV issues; and overprotective, infantilizing behavior by parents. A sibling, most often a sister, is the family member to whom the gay man with AIDS feels closest and from whom he is most likely to seek support. Implications for practice and research are discussed. PMID:8722141

  4. WEB-GIS Decision Support System for CO2 storage

    NASA Astrophysics Data System (ADS)

    Gaitanaru, Dragos; Leonard, Anghel; Radu Gogu, Constantin; Le Guen, Yvi; Scradeanu, Daniel; Pagnejer, Mihaela

    2013-04-01

    Environmental decision support systems (DSS) paradigm evolves and changes as more knowledge and technology become available to the environmental community. Geographic Information Systems (GIS) can be used to extract, assess and disseminate some types of information, which are otherwise difficult to access by traditional methods. In the same time, with the help of the Internet and accompanying tools, creating and publishing online interactive maps has become easier and rich with options. The Decision Support System (MDSS) developed for the MUSTANG (A MUltiple Space and Time scale Approach for the quaNtification of deep saline formations for CO2 storaGe) project is a user friendly web based application that uses the GIS capabilities. MDSS can be exploited by the experts for CO2 injection and storage in deep saline aquifers. The main objective of the MDSS is to help the experts to take decisions based large structured types of data and information. In order to achieve this objective the MDSS has a geospatial objected-orientated database structure for a wide variety of data and information. The entire application is based on several principles leading to a series of capabilities and specific characteristics: (i) Open-Source - the entire platform (MDSS) is based on open-source technologies - (1) database engine, (2) application server, (3) geospatial server, (4) user interfaces, (5) add-ons, etc. (ii) Multiple database connections - MDSS is capable to connect to different databases that are located on different server machines. (iii)Desktop user experience - MDSS architecture and design follows the structure of a desktop software. (iv)Communication - the server side and the desktop are bound together by series functions that allows the user to upload, use, modify and download data within the application. The architecture of the system involves one database and a modular application composed by: (1) a visualization module, (2) an analysis module, (3) a guidelines module

  5. Improvements in agricultural water decision support using remote sensing

    NASA Astrophysics Data System (ADS)

    Marshall, M. T.

    2012-12-01

    Population driven water scarcity, aggravated by climate-driven evaporative demand in dry regions of the world, has the potential of transforming ecological and social systems to the point of armed conflict. Water shortages will be most severe in agricultural areas, as the priority shifts to urban and industrial use. In order to design, evaluate, and monitor appropriate mitigation strategies, predictive models must be developed that quantify exposure to water shortage. Remote sensing data has been used for more than three decades now to parametrize these models, because field measurements are costly and difficult in remote regions of the world. In the past decade, decision-makers for the first time can make accurate and near real-time evaluations of field conditions with the advent of hyper- spatial and spectral and coarse resolution continuous remote sensing data. Here, we summarize two projects representing diverse applications of remote sensing to improve agricultural water decision support. The first project employs MODIS (coarse resolution continuous data) to drive an evapotranspiration index, which is combined with the Standardized Precipitation Index driven by meteorological satellite data to improve famine early warning in Africa. The combined index is evaluated using district-level crop yield data from Kenya and Malawi and national-level crop yield data from the United Nations Food and Agriculture Organization. The second project utilizes hyper- spatial (GeoEye 1, Quickbird, IKONOS, and RapidEye) and spectral (Hyperion/ALI), as well as multi-spectral (Landsat ETM+, SPOT, and MODIS) data to develop biomass estimates for key crops (alfalfa, corn, cotton, and rice) in the Central Valley of California. Crop biomass is an important indicator of crop water productivity. The remote sensing data is combined using various data fusion techniques and evaluated with field data collected in the summer of 2012. We conclude with a brief discussion on implementation of

  6. FRAMEWORK FOR DECISION SUPPORT USED IN CONTAMINATED LAND MANAGEMENT IN EUROPE AND NORTH AMERICA.

    SciTech Connect

    SULLIVAN,T.; BARDOS,R.P.; MAROT,C.; MARIOTTI,R.

    2000-06-01

    Effective contaminated land management requires a number of decisions addressing a suite of technical, economic and social concerns. This paper offers a common framework and terminology for describing decision support approaches, along with an overview of recent applications of decision support tools in Europe and the USA. A common problem with work on decision support approaches is a lack of a common framework and terminology to describe the process. These have been proposed in this paper.

  7. Using Google Earth in Marine Research and Operational Decision Support

    NASA Astrophysics Data System (ADS)

    Blower, J. D.; Bretherton, D.; Haines, K.; Liu, C.; Rawlings, C.; Santokhee, A.; Smith, I.

    2006-12-01

    A key advantage of Virtual Globes ("geobrowsers") such as Google Earth is that they can display many different geospatial data types at a huge range of spatial scales. In this demonstration and poster display we shall show how marine data from disparate sources can be brought together in a geobrowser in order to support both scientific research and operational search and rescue activities. We have developed the Godiva2 interactive website for browsing and exploring marine data, mainly output from supercomputer analyses and predictions of ocean circulation. The user chooses a number of parameters (e.g. sea temperature at 100m depth on 1st July 2006) and can load an image of the resulting data in Google Earth. Through the use of an automatically-refreshing NetworkLink the user can explore the whole globe at a very large range of spatial scales: the displayed data will automatically be refreshed to show data at increasingly fine resolution as the user zooms in. This is a valuable research tool for exploring these terabyte- scale datasets. Many coastguard organizations around the world use SARIS, a software application produced by BMT Cordah Ltd., to predict the drift pattern of objects in the sea in order to support search and rescue operations. Different drifting objects have different trajectories depending on factors such as their buoyancy and windage and so a computer model, supported by meteorological and oceanographic data, is needed to help rescuers locate their targets. We shall demonstrate how Google Earth is used to display output from the SARIS model (including the search target location and associated error polygon) alongside meteorological data (wind vectors) and oceanographic data (sea temperature, surface currents) from Godiva2 in order to support decision-making. We shall also discuss the limitations of using Google Earth in this context: these include the difficulties of working with time- dependent data and the need to access data securely. essc

  8. Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

    PubMed

    Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

    2009-04-01

    Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

  9. Low Literacy Decision Aid Enhances Knowledge and Reduces Decisional Conflict among Diverse Population of Adults with Rheumatoid Arthritis: Results of a Pilot Study

    PubMed Central

    Barton, Jennifer L.; Trupin, Laura; Schillinger, Dean; Evans-Young, Gina; Imboden, John; Montori, Victor M.; Yelin, Edward

    2016-01-01

    Objective Despite innovations in treatment of rheumatoid arthritis (RA), adherence is poor and disparities persist. Shared decision making (SDM) promotes patient engagement and enhances adherence, however few tools support SDM in RA. Our objective was to pilot a low literacy medication guide and decision aid to facilitate patient-clinician conversations about RA medications. Methods RA patients were consecutively enrolled into one of three arms: (1) control, patients received existing medication guide prior to clinic visit; (2) adapted guide prior to visit; (3) adapted guide prior plus decision aid during visit. Outcomes were collected immediately post-visit, at 1-week, 3- and 6-month interviews. Eligible adults had to have failed at least one DMARD and fulfill one of the following: age >65, immigrant, non-English speaker, < high school education, limited health literacy, racial/ethnic minority. Primary outcomes were knowledge of RA medications, decisional conflict, and acceptability of interventions. Results Majority of 166 patients were immigrants (66%), non-English speakers (54%), and had limited health literacy (71%). Adequate RA knowledge post visit in arm 3 was higher (78%) than arm 1 (53%, adjusted OR 2.7, 95% CI 1.2–6.1). Among patients with a medication change, there was lower (better) mean decisional conflict in arms 2 and 3 (p=0.03). No significant differences in acceptability. Conclusion A low literacy medication guide and decision aid was acceptable, improved knowledge, and reduced decisional conflict among vulnerable RA patients. Enhancing knowledge and patient engagement with decision support tools may lead to medication choices better aligned with patient values and preferences in RA. PMID:26605752

  10. A critical assessment of supported decision-making for persons aging with intellectual disabilities.

    PubMed

    Kohn, Nina A; Blumenthal, Jeremy A

    2014-01-01

    Supported decision-making is increasingly being promoted as an alternative to guardianship for persons aging with intellectual disabilities. Proponents argue that supported decision-making, unlike guardianship, empowers persons with disabilities by providing them with help in making their own decisions, rather than simply providing someone else to make decisions for them. To evaluate the empirical support for these claims, we reviewed the evidence base on supported decision-making. Our review found little such empirical research, suggesting that significant further research is warranted to determine whether--and under what conditions--supported decision-making can benefit persons with intellectual disabilities. Indeed, without more empirical evidence as to how supported decision-making functions in practice, it is too early to rule out the possibility it may actually disempower individuals with disabilities by facilitating undue influence by their alleged supporters. We therefore suggest several key areas for future research.

  11. Verification and Validation of NASA-Supported Enhancements to PECAD's Decision Support Tools

    NASA Technical Reports Server (NTRS)

    McKellipo, Rodney; Ross, Kenton W.

    2006-01-01

    The NASA Applied Sciences Directorate (ASD), part of the Earth-Sun System Division of NASA's Science Mission Directorate, has partnered with the U.S. Department of Agriculture (USDA) to enhance decision support in the area of agricultural efficiency-an application of national importance. The ASD integrated the results of NASA Earth science research into USDA decision support tools employed by the USDA Foreign Agricultural Service (FAS) Production Estimates and Crop Assessment Division (PECAD), which supports national decision making by gathering, analyzing, and disseminating global crop intelligence. Verification and validation of the following enhancements are summarized: 1) Near-real-time Moderate Resolution Imaging Spectroradiometer (MODIS) products through PECAD's MODIS Image Gallery; 2) MODIS Normalized Difference Vegetation Index (NDVI) time series data through the USDA-FAS MODIS NDVI Database; and 3) Jason-1 and TOPEX/Poseidon lake level estimates through PECAD's Global Reservoir and Lake Monitor. Where possible, each enhanced product was characterized for accuracy, timeliness, and coverage, and the characterized performance was compared to PECAD operational requirements. The MODIS Image Gallery and the GRLM are more mature and have achieved a semi-operational status, whereas the USDA-FAS MODIS NDVI Database is still evolving and should be considered

  12. Development of a decision support system to predict physicians' rehabilitation protocols for patients with knee osteoarthritis.

    PubMed

    Hawamdeh, Ziad M; Alshraideh, Mohammad A; Al-Ajlouni, Jihad M; Salah, Imad K; Holm, Margo B; Otom, Ali H

    2012-09-01

    To design a medical decision support system (MDSS) that would accurately predict the rehabilitation protocols prescribed by the physicians for patients with knee osteoarthritis (OA) using only their demographic and clinical characteristics. The demographic and clinical variables for 170 patients receiving one of three treatment protocols for knee OA were entered into the MDSS. Demographic variables in the model were age and sex. Clinical variables entered into the model were height, weight, BMI, affected side, severity of knee OA, and severity of pain. All patients in the study received one of three treatment protocols for patients with knee OA: (a) hot packs, followed by electrotherapy and exercise, (b) ice packs, followed by ultrasound and exercise and (c) exercise alone. The resilient back propagation artificial neural network algorithm was used, with a ten-fold cross-validation. It was estimated that the MDSS is able to accurately predict the treatment prescribed by the physician for 87% of the patients. We developed an artificial neural network-based decision support system that can viably aid physicians in determining which treatment protocol would best match the anthropometric and clinical characteristics of patients with knee OA. PMID:22508428

  13. Creating a GIS-Based Decision-Support System

    NASA Technical Reports Server (NTRS)

    Alvarado, Lori; Gates, Ann Q.; Gray, Bob; Reyes, Raul

    1998-01-01

    Tilting the Balance: Climate Variability and Water Resource Management in the Southwest, a regional conference hosted by the Pan American Center for Environmental Studies, will be held at The University of Texas at El Paso on March 2-4, 1998. The conference is supported through the US Global Change Research Program (USGCRP) established by the President in 1989, and codified by Congress in the Global Change Research Act of 1990. The NASA Mission to Planet Earth program is one of the workshops sponsors. The purpose of the regional workshops is to improve understanding of the consequences of global change. This workshop will be focused on issues along the border and the Rio Grande River and thus will bring together stakeholders from Mexico, California, Texas, New Mexico, Arizona and Colorado representing federal, state, and local governments; universities and laboratories; industry, agricultural and natural resource managers; and non-governmental organizations. This paper discusses the efforts of the NASA PACES center create a GIS-based decision-support system that can be used to facilitate discussion of the complex issues of resource management within the targeted international region.

  14. Object-oriented design and programming in medical decision support.

    PubMed

    Heathfield, H; Armstrong, J; Kirkham, N

    1991-12-01

    The concept of object-oriented design and programming has recently received a great deal of attention from the software engineering community. This paper highlights the realisable benefits of using the object-oriented approach in the design and development of clinical decision support systems. These systems seek to build a computational model of some problem domain and therefore tend to be exploratory in nature. Conventional procedural design techniques do not support either the process of model building or rapid prototyping. The central concepts of the object-oriented paradigm are introduced, namely encapsulation, inheritance and polymorphism, and their use illustrated in a case study, taken from the domain of breast histopathology. In particular, the dual roles of inheritance in object-oriented programming are examined, i.e., inheritance as a conceptual modelling tool and inheritance as a code reuse mechanism. It is argued that the use of the former is not entirely intuitive and may be difficult to incorporate into the design process. However, inheritance as a means of optimising code reuse offers substantial technical benefits.

  15. Decision support system for managing oil spill events.

    PubMed

    Keramitsoglou, Iphigenia; Cartalis, Constantinos; Kassomenos, Pavlos

    2003-08-01

    The Mediterranean environment is exposed to various hazards, including oil spills, forest fires, and floods, making the development of a decision support system (DSS) for emergency management an objective of utmost importance. The present work presents a complete DSS for managing marine pollution events caused by oil spills. The system provides all the necessary tools for early detection of oil-spills from satellite images, monitoring of their evolution, estimation of the accident consequences and provision of support to responsible Public Authorities during clean-up operations. The heart of the system is an image processing-geographic information system and other assistant individual software tools that perform oil spill evolution simulation and all other necessary numerical calculations as well as cartographic and reporting tasks related to a specific management of the oil spill event. The cartographic information is derived from the extant general maps representing detailed information concerning several regional environmental and land-cover characteristics as well as financial activities of the application area. Early notification of the authorities with up-to-date accurate information on the position and evolution of the oil spill, combined with the detailed coastal maps, is of paramount importance for emergency assessment and effective clean-up operations that would prevent environmental hazard. An application was developed for the Region of Crete, an area particularly vulnerable to oil spills due to its location, ecological characteristics, and local economic activities.

  16. Using an Electronic Decision Support Tool to Reduce Inappropriate Polypharmacy and Optimize Medicines: Rationale and Methods

    PubMed Central

    Tordoff, June; Dovey, Susan; Reith, David; Lloyd, Hywel; Tilyard, Murray; Smith, Alesha

    2016-01-01

    Background Polypharmacy and inappropriate continuation of medicines can lead to a significant risk of adverse drug events and drug interactions with patient harm and escalating health care costs as a result. Thorough review of patients’ medications focusing on the need for each drug can reduce the potential for harm. Limitations in performing effective medicine reviews in practice include consultation time constraints and funding for pharmacy services. We will aim to overcome these problems by designing an automatic electronic decision support tool (the medicines optimization/review and evaluation (MORE) module) that is embedded in general practice electronic records systems. The tool will focus on medicines optimization and reducing polypharmacy to aid prescribers in reviewing medicines and improve patient outcomes. Objective The objectives of this study are: (1) to develop an electronic decision support tool to assist prescribers in performing clinical medication reviews with a particular focus on patients experiencing multimorbidity and polypharmacy, and (2) evaluate and assess the use of the electronic decision support tool, providing pilot data on its usefulness in supporting prescribers during consultations with patients. Methods The first three study phases involve development of clinical rules outlining clinical interventions and the creation and validation of the MORE decision support tool. Phase four is a community-based, single-blind, prospective, 6-month controlled trial involving two interventions and two control general practices, matched for practice demographics. We will be measuring the number of times prescribers engage with the tool, total number of interventions suggested by the tool, and total number of times prescribers change medicines in response to recommendations. There will also be prospective follow-up of patients in the intervention group to examine whether changes to medications are upheld, and to determine the number of

  17. [Quality of support by artificial nutrition: difficulties with AIDS patients].

    PubMed

    Ayúcar Ruiz de Galarreta, A; Cordero Lorenzana, M L; García Filgueira, P; Martínez-Puga, E

    1998-01-01

    The use of Enteral Nutrition (EN) in patients with AIDS with a severe nutritional deterioration, is the most common route, not only because of the risk/benefit relation, bur also because this is a physiological route that is easily managed and is profitable in terms of renutrition. However, and given the characteristics of the affected population, whose origin in a large percentage is the addiction to parenteral drugs, implanting this route in these patients is a challenge, as these patients refuse in more than 50% of the cases. Moreover, the risk group is not only a factor in the difficulty for applying the ideal across route, but also the combination of other elements like sex or the disease itself, force the clinical to use more aggressive methods (Parenteral Nutrition) or those that are less profitable nutritionally (Supplements). The negative aspects with regard to tube feeding of these patients are shown, in relation to the factors, and these are compared with the negative aspects of other diagnosis groups (rest of the Hospital).

  18. Design model of computerized personal decision aid for youth: An expert review

    NASA Astrophysics Data System (ADS)

    Sarif, Siti Mahfuzah; Ibrahim, Norfiza; Shiratuddin, Norshuhada

    2016-08-01

    This paper provides a structured review of a design model of a computerized personal decision aid that is intended for youth, named as YouthPDA Design Model. The proposed design model was examined by experts in related areas to ensure the appropriateness of the proposed components and elements, relevancy of the terminologies used, logic of the flow, usability, and practicality of the design model towards development of YouthPDA application. Seven experts from related areas were involved in the evaluation. Discussions on the findings obtained from the expert review are included in this paper. Finally, a revised design model of YouthPDA is proposed as main guidance to develop YouthPDA application.

  19. Documentation of a decision framework to support enhanced sludge washing

    SciTech Connect

    Brothers, A.J.

    1995-12-31

    This document describes a proposed decision model that, if developed to its fullest, can provide a wide range of analysis options and insights to pretreatment/sludge washing alternatives. A recent decision has been made to terminate this work

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

    NASA Technical Reports Server (NTRS)

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

    1996-01-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1996-01-01

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

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

    PubMed Central

    Lee, Ji Eun; Shin, Dong Wook; Suh, Beomseok; Chun, Sohyun; Nam, You-Seon; Cho, Belong

    2016-01-01

    Introduction In Asian countries, reluctance to seek pharmacological intervention is a major barrier for smoking cessation. Culturally appropriate decision aids are expected to help people in the decision making for the use of smoking cessation medication. Objective The aim of this study was to develop a culturally tailored decision aid for smoking cessation and evaluate its effect on the use of smoking cessation medication. Patients and methods A 7-minute video on smoking cessation information and options was developed. Physicians were randomized into intervention and control groups. The decision aid was provided to patients in the intervention group, and they watched it, while those in the control group were provided usual medical care for smoking cessation. The primary outcome was the proportion of smokers who were prescribed smoking cessation medication within 1 month after consultation. The secondary outcomes were abstinence rate and use of smoking cessation medication within 6 months. A logistic regression analysis was used to assess the effect of the decision aid on the outcomes. Results In total, 414 current smokers (intervention group: 195; control group: 219) were enrolled. The mean age of the participants was 48.2 years, and 381 subjects (92%) were males. In total, 11.8% of the participants in the intervention group and 10.5% in the control group were prescribed smoking cessation medications within 1 month. The odds ratio was 1.02 (95% CI: 0.40–2.63) after adjustment for baseline characteristics. Within 6 months, 17.4% of the participants in the intervention group and 15% in the control group were prescribed medication (adjusted odds ratio 1.12, 95% CI: 0.59–2.13). Conclusion The culturally tailored smoking cessation decision aid developed in this study did not show a significant impact on the decision to use smoking cessation medication. Further research to develop more effective and more interactive interventions is expected. PMID:27703338

  3. Developing a Software for Fuzzy Group Decision Support System: A Case Study

    ERIC Educational Resources Information Center

    Baba, A. Fevzi; Kuscu, Dincer; Han, Kerem

    2009-01-01

    The complex nature and uncertain information in social problems required the emergence of fuzzy decision support systems in social areas. In this paper, we developed user-friendly Fuzzy Group Decision Support Systems (FGDSS) software. The software can be used for multi-purpose decision making processes. It helps the users determine the main and…

  4. Research on web-based decision support system for sports competitions

    NASA Astrophysics Data System (ADS)

    Huo, Hanqiang

    2010-07-01

    This paper describes the system architecture and implementation technology of the decision support system for sports competitions, discusses the design of decision-making modules, management modules and security of the system, and proposes the development idea of building a web-based decision support system for sports competitions.

  5. NWS Alaska Sea Ice Program: Operations and Decision Support Services

    NASA Astrophysics Data System (ADS)

    Schreck, M. B.; Nelson, J. A., Jr.; Heim, R.

    2015-12-01

    The National Weather Service's Alaska Sea Ice Program is designed to service customers and partners operating and planning operations within Alaska waters. The Alaska Sea Ice Program offers daily sea ice and sea surface temperature analysis products. The program also delivers a five day sea ice forecast 3 times each week, provides a 3 month sea ice outlook at the end of each month, and has staff available to respond to sea ice related information inquiries. These analysis and forecast products are utilized by many entities around the state of Alaska and nationally for safety of navigation and community strategic planning. The list of current customers stem from academia and research institutions, to local state and federal agencies, to resupply barges, to coastal subsistence hunters, to gold dredgers, to fisheries, to the general public. Due to a longer sea ice free season over recent years, activity in the waters around Alaska has increased. This has led to a rise in decision support services from the Alaska Sea Ice Program. The ASIP is in constant contact with the National Ice Center as well as the United States Coast Guard (USCG) for safety of navigation. In the past, the ASIP provided briefings to the USCG when in support of search and rescue efforts. Currently, not only does that support remain, but our team is also briefing on sea ice outlooks into the next few months. As traffic in the Arctic increases, the ASIP will be called upon to provide more and more services on varying time scales to meet customer needs. This talk will address the many facets of the current Alaska Sea Ice Program as well as delve into what we see as the future of the ASIP.

  6. Flight Deck Weather Avoidance Decision Support: Implementation and Evaluation

    NASA Technical Reports Server (NTRS)

    Wu, Shu-Chieh; Luna, Rocio; Johnson, Walter W.

    2013-01-01

    Weather related disruptions account for seventy percent of the delays in the National Airspace System (NAS). A key component in the weather plan of the Next Generation of Air Transportation System (NextGen) is to assimilate observed weather information and probabilistic forecasts into the decision process of flight crews and air traffic controllers. In this research we explore supporting flight crew weather decision making through the development of a flight deck predicted weather display system that utilizes weather predictions generated by ground-based radar. This system integrates and presents this weather information, together with in-flight trajectory modification tools, within a cockpit display of traffic information (CDTI) prototype. that the CDTI features 2D and perspective 3D visualization models of weather. The weather forecast products that we implemented were the Corridor Integrated Weather System (CIWS) and the Convective Weather Avoidance Model (CWAM), both developed by MIT Lincoln Lab. We evaluated the use of CIWS and CWAM for flight deck weather avoidance in two part-task experiments. Experiment 1 compared pilots' en route weather avoidance performance in four weather information conditions that differed in the type and amount of predicted forecast (CIWS current weather only, CIWS current and historical weather, CIWS current and forecast weather, CIWS current and forecast weather and CWAM predictions). Experiment 2 compared the use of perspective 3D and 21/2D presentations of weather for flight deck weather avoidance. Results showed that pilots could take advantage of longer range predicted weather forecasts in performing en route weather avoidance but more research will be needed to determine what combinations of information are optimal and how best to present them.

  7. Future of medical knowledge management and decision support.

    PubMed

    Greenes, Robert A

    2002-01-01

    Attempts to predict the future are typically off the mark. Beyond the challenges of forecasting the stock market or the weather, dramatic instances of notoriously inaccurate prognostications have been those by the US patent office in the late 1800s about the future of inventions, by Thomas Watson in the 1930s about the market for large computers, and by Bill Gates in the early 1990s about the significance of the Internet. When one seeks to make predictions about health care, one finds that, beyond the usual uncertainties regarding the future, additional impediments to forecasting are the discontinuities introduced by advances in biomedical science and technology, the impact of information technology, and the reorganizations and realignments attending various approaches to health care delivery and finance. Changes in all three contributing areas themselves can be measured in "PSPYs", or paradigm shifts per year. Despite these risks in forecasting, I believe that certain trends are sufficiently clear that I am willing to venture a few predictions. Further, the predictions I wish to make suggest a goal for the future that can be achieved, if we can align the prevailing political, financial, biomedical, and technical forces toward that end. Thus, in a sense this is a call to action, to shape the future rather than just let it happen. This chapter seeks to lay out the direction we are heading in knowledge management and decision support, and to delineate an information technology framework that appears desirable. I believe the framework to be discussed is of importance to the health care-related knowledge management and decision making activities of the consumer and patient, the health care provider, and health care delivery organizations and insurers. The approach is also relevant to the other dimensions of academic health care institution activities, notably the conduct of research and the processes of education and learning. PMID:12026135

  8. Information Systems to Support a Decision Process at Stanford.

    ERIC Educational Resources Information Center

    Chaffee, Ellen Earle

    1982-01-01

    When a rational decision process is desired, information specialists can contribute information and also contribute to the process in which that information is used, thereby promoting rational decision-making. The contribution of Stanford's information specialists to rational decision-making is described. (MLW)

  9. Is there a need for hydrological modelling in decision support systems for nuclear emergencies.

    PubMed

    Raskob, W; Heling, R; Zheleznyak, M

    2004-01-01

    This paper discusses the role of hydrological modelling in decision support systems for nuclear emergencies. In particular, most recent developments such as, the radionuclide transport models integrated in to the decision support system RODOS will be explored. Recent progress in the implementation of physically-based distributed hydrological models for operational forecasting in national and supranational centres, may support a closer cooperation between national hydrological services and therefore, strengthen the use of hydrological and radiological models implemented in decision support systems.

  10. Social support and response to AIDS and severe acute respiratory syndrome.

    PubMed

    Nandi, Arijit; Tracy, Melissa; Aiello, Allison; Des Jarlais, Don C; Galea, Sandro

    2008-05-01

    Negative public reactions to emerging infectious diseases can adversely affect population health. We assessed whether social support was associated with knowledge of, worry about, and attitudes towards AIDS and severe acute respiratory syndrome. Our findings suggest that social support may be central to our understanding of public responses to emerging infectious diseases.

  11. Data Management Standards in Computer-aided Acquisition and Logistic Support (CALS)

    NASA Technical Reports Server (NTRS)

    Jefferson, David K.

    1990-01-01

    Viewgraphs and discussion on data management standards in computer-aided acquisition and logistic support (CALS) are presented. CALS is intended to reduce cost, increase quality, and improve timeliness of weapon system acquisition and support by greatly improving the flow of technical information. The phase 2 standards, industrial environment, are discussed. The information resource dictionary system (IRDS) is described.

  12. Visualization Component of Vehicle Health Decision Support System

    NASA Technical Reports Server (NTRS)

    Jacob, Joseph; Turmon, Michael; Stough, Timothy; Siegel, Herbert; Walter, patrick; Kurt, Cindy

    2008-01-01

    The visualization front-end of a Decision Support System (DSS) also includes an analysis engine linked to vehicle telemetry, and a database of learned models for known behaviors. Because the display is graphical rather than text-based, the summarization it provides has a greater information density on one screen for evaluation by a flight controller.This tool provides a system-level visualization of the state of a vehicle, and drill-down capability for more details and interfaces to separate analysis algorithms and sensor data streams. The system-level view is a 3D rendering of the vehicle, with sensors represented as icons, tied to appropriate positions within the vehicle body and colored to indicate sensor state (e.g., normal, warning, anomalous state, etc.). The sensor data is received via an Information Sharing Protocol (ISP) client that connects to an external server for real-time telemetry. Users can interactively pan, zoom, and rotate this 3D view, as well as select sensors for a detail plot of the associated time series data. Subsets of the plotted data can be selected and sent to an external analysis engine to either search for a similar time series in an historical database, or to detect anomalous events. The system overview and plotting capabilities are completely general in that they can be applied to any vehicle instrumented with a collection of sensors. This visualization component can interface with the ISP for data streams used by NASA s Mission Control Center at Johnson Space Center. In addition, it can connect to, and display results from, separate analysis engine components that identify anomalies or that search for past instances of similar behavior. This software supports NASA's Software, Intelligent Systems, and Modeling element in the Exploration Systems Research and Technology Program by augmenting the capability of human flight controllers to make correct decisions, thus increasing safety and reliability. It was designed specifically as a

  13. Towards a Decision Support System for Space Flight Operations

    NASA Technical Reports Server (NTRS)

    Meshkat, Leila; Hogle, Charles; Ruszkowski, James

    2013-01-01

    The Mission Operations Directorate (MOD) at the Johnson Space Center (JSC) has put in place a Model Based Systems Engineering (MBSE) technological framework for the development and execution of the Flight Production Process (FPP). This framework has provided much added value and return on investment to date. This paper describes a vision for a model based Decision Support System (DSS) for the development and execution of the FPP and its design and development process. The envisioned system extends the existing MBSE methodology and technological framework which is currently in use. The MBSE technological framework currently in place enables the systematic collection and integration of data required for building an FPP model for a diverse set of missions. This framework includes the technology, people and processes required for rapid development of architectural artifacts. It is used to build a feasible FPP model for the first flight of spacecraft and for recurrent flights throughout the life of the program. This model greatly enhances our ability to effectively engage with a new customer. It provides a preliminary work breakdown structure, data flow information and a master schedule based on its existing knowledge base. These artifacts are then refined and iterated upon with the customer for the development of a robust end-to-end, high-level integrated master schedule and its associated dependencies. The vision is to enhance this framework to enable its application for uncertainty management, decision support and optimization of the design and execution of the FPP by the program. Furthermore, this enhanced framework will enable the agile response and redesign of the FPP based on observed system behavior. The discrepancy of the anticipated system behavior and the observed behavior may be due to the processing of tasks internally, or due to external factors such as changes in program requirements or conditions associated with other organizations that are outside of

  14. The cost-effectiveness of patient decision aids: A systematic review.

    PubMed

    Trenaman, Logan; Bryan, Stirling; Bansback, Nick

    2014-12-01

    The Affordable Care Act includes provisions to encourage patient-centered care through the use of shared decision making (SDM) and patient decision aids (PtDA). PtDAs are tools that can help encourage SDM by providing information about competing treatment options and elucidating patients׳ values and preferences. Implementing PtDAs into routine practice may incur additional costs through training or increases in physician time. Prominent commentaries have proposed that these costs might be offset if patients choose less expensive options than their providers. However, the cost-effectiveness of PtDAs to date is unclear. The aim of this study was to review the economic evidence from PtDA trials. Our search identified 5347 articles, with 29 included following full-text review. Only one economic evaluation of a PtDA has been completed, which found a PtDA to be cost-saving in women with menorrhagia. Other studies included in the review indicated that PtDAs will likely increase up-front costs, but in some contexts may reduce short-term costs by reducing the uptake of invasive treatments, such as elective surgery. Few studies comprehensively captured long-term costs or measured benefits in a manner conducive to economic evaluation (QALYs or general health utilities). Our review suggests that policy makers currently have insufficient economic evidence to appropriately consider their investments in PtDAs.

  15. Decentralizing Data through Decision-Support Systems: The Impact of Increased Access to Data on Decision Making

    ERIC Educational Resources Information Center

    Petrides, Lisa A.; McClelland, Sara I.

    2007-01-01

    This study examines the impact of a new Decision-Support System (DSS) on decision making in a community college in California. It looks at how attitudes and behaviors about data and their use were impacted by the implementation of a new DSS. The study found that the decentralization of data, through the DSS, produced a shift in terms of an…

  16. ESPRE: a knowledge-based system to support platelet transfusion decisions.

    PubMed

    Sielaff, B H; Connelly, D P; Scott, E P

    1989-05-01

    ESPRE is a knowledge-based system which aids in the review of requests for platelet transfusions in the hospital blood bank. It is a microcomputer-based decision support system written in LISP and utilizes a hybrid frame and rule architecture. By automatically obtaining most of the required patient data directly from the hospital's main laboratory computers via a direct link, very little keyboard entry is required. Assessment of time trends computed from the data constitutes an important aspect of this system. To aid the blood bank personnel in deciding on the appropriateness of the requested transfusion, the system provides an explanatory report which includes a list of patient-specific data, a list of the conditions for which a transfusion would be appropriate for the particular patient (given the clinical condition), and the conclusions drawn by the system. In an early clinical evaluation of ESPRE, out of a random sample of 75 platelet transfusion requests, there were only three disagreements between ESPRE and blood bank personnel. PMID:2656504

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

    PubMed Central

    2013-01-01

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

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

    SciTech Connect

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

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be enhanced by the use of a

  19. Generalized Tumor Dose for Treatment Planning Decision Support

    NASA Astrophysics Data System (ADS)

    Zuniga, Areli A.

    Modern radiation therapy techniques allow for improved target conformity and normal tissue sparing. These highly conformal treatment plans have allowed dose escalation techniques increasing the probability of tumor control. At the same time this conformation has introduced inhomogeneous dose distributions, making delivered dose characterizations more difficult. The concept of equivalent uniform dose (EUD) characterizes a heterogeneous dose distribution within irradiated structures as a single value and has been used in biologically based treatment planning (BBTP); however, there are no substantial validation studies on clinical outcome data supporting EUD's use and therefore has not been widely adopted as decision-making support. These highly conformal treatment plans have also introduced the need for safety margins around the target volume. These margins are designed to minimize geometrical misses, and to compensate for dosimetric and treatment delivery uncertainties. The margin's purpose is to reduce the chance of tumor recurrence. This dissertation introduces a new EUD formulation designed especially for tumor volumes, called generalized Tumor Dose (gTD). It also investigates, as a second objective, margins extensions for potential improvements in local control while maintaining or minimizing toxicity. The suitability of gTD to rank LC was assessed by means of retrospective studies in a head and neck (HN) squamous cell carcinoma (SCC) and non-small cell lung cancer (NSCLC) cohorts. The formulation was optimized based on two datasets (one of each type) and then, model validation was assessed on independent cohorts. The second objective of this dissertation was investigated by ranking the probability of LC of the primary disease adding different margin sizes. In order to do so, an already published EUD formula was used retrospectively in a HN and a NSCLC datasets. Finally, recommendations for the viability to implement this new formulation into a routine treatment

  20. Automation, decision support, and expert systems in nephrology.

    PubMed

    Soman, Sandeep; Zasuwa, Gerard; Yee, Jerry

    2008-01-01

    Increasing data suggest that errors in medicine occur frequently and result in substantial harm to the patient. The Institute of Medicine report described the magnitude of the problem, and public interest in this issue, which was already large, has grown. The traditional approach in medicine has been to identify the persons making the errors and recommend corrective strategies. However, it has become increasingly clear that it is more productive to focus on the systems and processes through which care is provided. If these systems are set up in ways that would both make errors less likely and identify those that do occur and, at the same time, improve efficiency, then safety and productivity would be substantially improved. Clinical decision support systems (CDSSs) are active knowledge systems that use 2 or more items of patient data to generate case specific recommendations. CDSSs are typically designed to integrate a medical knowledge base, patient data, and an inference engine to generate case specific advice. This article describes how automation, templating, and CDSS improve efficiency, patient care, and safety by reducing the frequency and consequences of medical errors in nephrology. We discuss practical applications of these in 3 settings: a computerized anemia-management program (CAMP, Henry Ford Health System, Detroit, MI), vascular access surveillance systems, and monthly capitation notes in the hemodialysis unit.

  1. Artificial neural networks for decision support in clinical medicine.

    PubMed

    Forsström, J J; Dalton, K J

    1995-10-01

    Connectionist models such as neural networks are alternatives to linear, parametric statistical methods. Neural networks are computer-based pattern recognition methods with loose similarities with the nervous system. Individual variables of the network, usually called 'neurones', can receive inhibitory and excitatory inputs from other neurones. The networks can define relationships among input data that are not apparent when using other approaches, and they can use these relationships to improve accuracy. Thus, neural nets have substantial power to recognize patterns even in complex datasets. Neural network methodology has outperformed classical statistical methods in cases where the input variables are interrelated. Because clinical measurements usually derive from multiple interrelated systems it is evident that neural networks might be more accurate than classical methods in multivariate analysis of clinical data. This paper reviews the use of neural networks in medical decision support. A short introduction to the basics of neural networks is given, and some practical issues in applying the networks are highlighted. The current use of neural networks in image analysis, signal processing and laboratory medicine is reviewed. It is concluded that neural networks have an important role in image analysis and in signal processing. However, further studies are needed to determine the value of neural networks in the analysis of laboratory data.

  2. Effectively marketing prepaid medical care with decision support systems.

    PubMed

    Forgionne, G A

    1991-01-01

    The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.

  3. Computerized decision support systems: improving patient safety in nephrology

    PubMed Central

    Chang, Jamison; Ronco, Claudio; Rosner, Mitchell H.

    2016-01-01

    Incorrect prescription and administration of medications account for a substantial proportion of medical errors in the USA, causing adverse drug events (ADEs) that result in considerable patient morbidity and enormous costs to the health-care system. Patients with chronic kidney disease or acute kidney injury often have impaired drug clearance as well as polypharmacy, and are therefore at increased risk of experiencing ADEs. Studies have demonstrated that recognition of these conditions is not uniform among treating physicians, and prescribed drug doses are often incorrect. Early interventions that ensure appropriate drug dosing in this group of patients have shown encouraging results. Both computerized physician order entry and clinical decision support systems have been shown to reduce the rate of ADEs. Nevertheless, these systems have been implemented at surprisingly few institutions. Economic stimulus and health-care reform legislation present a rare opportunity to refine these systems and understand how they could be implemented more widely. Failure to explore this technology could mean that the opportunity to reduce the morbidity associated with ADEs is missed. PMID:21502973

  4. Why decision support systems are important for medical education.

    PubMed

    Konstantinidis, Stathis Th; Bamidis, Panagiotis D

    2016-03-01

    During the last decades, the inclusion of digital tools in health education has rapidly lead to a continuously enlarging digital era. All the online interactions between learners and tutors, the description, creation, reuse and sharing of educational digital resources and the interlinkage between them in conjunction with cheap storage technology has led to an enormous amount of educational data. Medical education is a unique type of education due to accuracy of information needed, continuous changing competences required and alternative methods of education used. Nowadays medical education standards provide the ground for organising the educational data and the paradata. Analysis of such education data through education data mining techniques is in its infancy, but decision support systems (DSSs) for medical education need further research. To the best of our knowledge, there is a gap and a clear need for identifying the challenges for DSSs in medical education in the era of medical education standards. Thus, in this Letter the role and the attributes of such a DSS for medical education are delineated and the challenges and vision for future actions are identified.

  5. A Semantic Sensor Web for Environmental Decision Support Applications

    PubMed Central

    Gray, Alasdair J. G.; Sadler, Jason; Kit, Oles; Kyzirakos, Kostis; Karpathiotakis, Manos; Calbimonte, Jean-Paul; Page, Kevin; García-Castro, Raúl; Frazer, Alex; Galpin, Ixent; Fernandes, Alvaro A. A.; Paton, Norman W.; Corcho, Oscar; Koubarakis, Manolis; De Roure, David; Martinez, Kirk; Gómez-Pérez, Asunción

    2011-01-01

    Sensing devices are increasingly being deployed to monitor the physical world around us. One class of application for which sensor data is pertinent is environmental decision support systems, e.g., flood emergency response. For these applications, the sensor readings need to be put in context by integrating them with other sources of data about the surrounding environment. Traditional systems for predicting and detecting floods rely on methods that need significant human resources. In this paper we describe a semantic sensor web architecture for integrating multiple heterogeneous datasets, including live and historic sensor data, databases, and map layers. The architecture provides mechanisms for discovering datasets, defining integrated views over them, continuously receiving data in real-time, and visualising on screen and interacting with the data. Our approach makes extensive use of web service standards for querying and accessing data, and semantic technologies to discover and integrate datasets. We demonstrate the use of our semantic sensor web architecture in the context of a flood response planning web application that uses data from sensor networks monitoring the sea-state around the coast of England. PMID:22164110

  6. Agricultural Model for the Nile Basin Decision Support System

    NASA Astrophysics Data System (ADS)

    van der Bolt, Frank; Seid, Abdulkarim

    2014-05-01

    To analyze options for increasing food supply in the Nile basin the Nile Agricultural Model (AM) was developed. The AM includes state-of-the-art descriptions of biophysical, hydrological and economic processes and realizes a coherent and consistent integration of hydrology, agronomy and economics. The AM covers both the agro-ecological domain (water, crop productivity) and the economic domain (food supply, demand, and trade) and allows to evaluate the macro-economic and hydrological impacts of scenarios for agricultural development. Starting with the hydrological information from the NileBasin-DSS the AM calculates the available water for agriculture, the crop production and irrigation requirements with the FAO-model AquaCrop. With the global commodity trade model MAGNET scenarios for land development and conversion are evaluated. The AM predicts consequences for trade, food security and development based on soil and water availability, crop allocation, food demand and food policy. The model will be used as a decision support tool to contribute to more productive and sustainable agriculture in individual Nile countries and the whole region.

  7. Why decision support systems are important for medical education.

    PubMed

    Konstantinidis, Stathis Th; Bamidis, Panagiotis D

    2016-03-01

    During the last decades, the inclusion of digital tools in health education has rapidly lead to a continuously enlarging digital era. All the online interactions between learners and tutors, the description, creation, reuse and sharing of educational digital resources and the interlinkage between them in conjunction with cheap storage technology has led to an enormous amount of educational data. Medical education is a unique type of education due to accuracy of information needed, continuous changing competences required and alternative methods of education used. Nowadays medical education standards provide the ground for organising the educational data and the paradata. Analysis of such education data through education data mining techniques is in its infancy, but decision support systems (DSSs) for medical education need further research. To the best of our knowledge, there is a gap and a clear need for identifying the challenges for DSSs in medical education in the era of medical education standards. Thus, in this Letter the role and the attributes of such a DSS for medical education are delineated and the challenges and vision for future actions are identified. PMID:27222734

  8. A semantic sensor web for environmental decision support applications.

    PubMed

    Gray, Alasdair J G; Sadler, Jason; Kit, Oles; Kyzirakos, Kostis; Karpathiotakis, Manos; Calbimonte, Jean-Paul; Page, Kevin; García-Castro, Raúl; Frazer, Alex; Galpin, Ixent; Fernandes, Alvaro A A; Paton, Norman W; Corcho, Oscar; Koubarakis, Manolis; De Roure, David; Martinez, Kirk; Gómez-Pérez, Asunción

    2011-01-01

    Sensing devices are increasingly being deployed to monitor the physical world around us. One class of application for which sensor data is pertinent is environmental decision support systems, e.g., flood emergency response. For these applications, the sensor readings need to be put in context by integrating them with other sources of data about the surrounding environment. Traditional systems for predicting and detecting floods rely on methods that need significant human resources. In this paper we describe a semantic sensor web architecture for integrating multiple heterogeneous datasets, including live and historic sensor data, databases, and map layers. The architecture provides mechanisms for discovering datasets, defining integrated views over them, continuously receiving data in real-time, and visualising on screen and interacting with the data. Our approach makes extensive use of web service standards for querying and accessing data, and semantic technologies to discover and integrate datasets. We demonstrate the use of our semantic sensor web architecture in the context of a flood response planning web application that uses data from sensor networks monitoring the sea-state around the coast of England.

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

    PubMed Central

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

    2014-01-01

    Purpose First-degree relatives (FDRs) of prostate cancer (PC) patients should consider multiple concurrent personal risk factors when engaging in informed decision making (IDM) about PC screening. This study assessed perceptions of IDM recommendations and risk-appropriate strategies for IDM among FDRs of varied race/ethnicity. Design A cross-sectional, qualitative Setting Study setting was a cancer center in southwest Florida. Participants The study comprised 44 participants (24 PC patients and 20 unaffected FDRs). Method Focus groups and individual interviews were conducted and analyzed using content analysis and constant comparison methods. Results Patients and FDRs found the PC screening debate and IDM recommendations to be complex and counterintuitive. They overwhelmingly believed screening saves lives and does not have associated harms. There was a strongly expressed need to improve communication between patients and FDRs. A single decision aid that addresses the needs of all FDRs, rather than separating by race/ethnicity, was recommended as sufficient by study participants. These perspectives guided the development of an innovative decision aid that deconstructs the screening controversy and IDM processes into simpler concepts and provides step-by-step strategies for FDRs to engage in IDM. Conclusion Implementing IDM among FDRs is challenging because the IDM paradigm departs from historical messages promoting routine screening. These contradictions should be recognized and addressed for men to participate effectively in IDM. A randomized pilot study evaluating outcomes of the resulting decision aid is underway. PMID:24968183

  10. Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users.

    PubMed

    Jibaja-Weiss, Maria L; Volk, Robert J

    2007-01-01

    Decision aids have been developed by using various delivery methods, including interactive computer programs. Such programs, however, still rely heavily on written information, health and digital literacy, and reading ease. We describe an approach to overcome these potential barriers for low-literate, underserved populations by making design considerations for poor readers and naïve computer users and by using concepts from entertainment education to engage the user and to contextualize the content for the user. The system design goals are to make the program both didactic and entertaining and the navigation and graphical user interface as simple as possible. One entertainment education strategy, the soap opera, is linked seamlessly to interactive learning modules to enhance the content of the soap opera episodes. The edutainment decision aid model (EDAM) guides developers through the design process. Although designing patient decision aids that are educational, entertaining, and targeted toward poor readers and those with limited computer skills is a complex task, it is a promising strategy for aiding this population. Entertainment education may be a highly effective approach to promoting informed decision making for patients with low health literacy.

  11. Effects of a Web-Based Decision Aid Regarding Diagnostic Self-Testing. A Single-Blind Randomized Controlled Trial

    ERIC Educational Resources Information Center

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

    2016-01-01

    Currently, there are many diagnostic self-tests on body materials available to consumers. The aim of this study was to assess the effect of an online decision aid on diagnostic self-testing for cholesterol and diabetes on knowledge among consumers with an intention to take these tests. A randomized controlled trial was designed. A total of 1259…

  12. Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users.

    PubMed

    Jibaja-Weiss, Maria L; Volk, Robert J

    2007-01-01

    Decision aids have been developed by using various delivery methods, including interactive computer programs. Such programs, however, still rely heavily on written information, health and digital literacy, and reading ease. We describe an approach to overcome these potential barriers for low-literate, underserved populations by making design considerations for poor readers and naïve computer users and by using concepts from entertainment education to engage the user and to contextualize the content for the user. The system design goals are to make the program both didactic and entertaining and the navigation and graphical user interface as simple as possible. One entertainment education strategy, the soap opera, is linked seamlessly to interactive learning modules to enhance the content of the soap opera episodes. The edutainment decision aid model (EDAM) guides developers through the design process. Although designing patient decision aids that are educational, entertaining, and targeted toward poor readers and those with limited computer skills is a complex task, it is a promising strategy for aiding this population. Entertainment education may be a highly effective approach to promoting informed decision making for patients with low health literacy. PMID:17934944

  13. The Factors that Influence Data Utilization in Decision-Making: The Case of HIV/AIDS Programs in Mexico

    ERIC Educational Resources Information Center

    Rodriguez, Daniela Cristina

    2011-01-01

    In Mexico, as in many other countries, HIV/AIDS strategies are developed at the federal level and implemented at the state level. Local programs are expected to use data, in particular surveillance data, to drive their decisions on programmatic activities and prioritize populations with which the program will engage. Since the early 1980s Mexico…

  14. Health Care Decision Support System for the Pediatric Emeregency Department Management.

    PubMed

    Ben Othman, Sarah; Hammadi, Slim; Quilliot, Alain; Martinot, Alain; Renard, Jean-Marie

    2015-01-01

    Health organization management is facing a high amount of complexity due to the inherent dynamics of the processes and the distributed organization of hospitals. It is therefore necessary for health care institutions to focus on this issue in order to deal with patients' requirements and satisfy their needs. The main objective of this study is to develop and implement a Decision Support System which can help physicians to better manage their organization, to anticipate the overcrowding feature, and to establish avoidance proposals for it. This work is a part of HOST project (Hospital: Optimization, Simulation, and Crowding Avoidance) of the French National Research Agency (ANR). It aims to optimize the functioning of the Pediatric Emergency Department characterized by stochastic arrivals of patients which leads to its overcrowding and services overload. Our study is a set of tools to smooth out patient flows, enhance care quality and minimize long waiting times and costs due to resources allocation. So we defined a decision aided tool based on Multi-agent Systems where actors negotiate and cooperate under some constraints in a dynamic environment. These entities which can be either physical agents representing real actors in the health care institution or software agents allowing the implementation of optimizing tools, cooperate to satisfy the demands of patients while respecting emergency degrees. This paper is concerned with agents' negotiation. It proposes a new approach for multi-skill tasks scheduling based on interactions between agents. PMID:26262060

  15. Development of a Decision Support System for Analysis and Solutions of Prolonged Standing in the Workplace

    PubMed Central

    Halim, Isa; Arep, Hambali; Kamat, Seri Rahayu; Abdullah, Rohana; Omar, Abdul Rahman; Ismail, Ahmad Rasdan

    2014-01-01

    Background Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. Methods The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. Results Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. Conclusion The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially. PMID:25180141

  16. Decision-making orientation and AIDS-related knowledge, attitudes, and behaviors of Hispanic, African-American, and white adolescents.

    PubMed

    Langer, L M; Zimmerman, R S; Warheit, G J; Duncan, R C

    1993-05-01

    How adolescents' personal sense of directedness (i.e., peer, parent, or self-directed orientation) affects the decision-making processes of adolescent students regarding AIDS-related knowledge, attitudes, beliefs, behaviors, and skills (KABBS) is examined. The sample consisted of 10th-grade students in 8 public high schools (N = 2,515) in Dade County (greater Miami), Florida. The findings showed that decision-making orientation and directedness was a significant predictor of AIDS-related KABBS of adolescents. Overall, the level of AIDS-related KABBS that were associated with low risk was found significantly more often among self-directed students and least often among peer-directed students. The findings of this study suggest that future preadult health-risk research should incorporate the concept of differences of information processing across adolescents. PMID:8500453

  17. Climate Change, Public Health, and Decision Support: The New Threat of Vector-borne Disease

    NASA Astrophysics Data System (ADS)

    Grant, F.; Kumar, S.

    2011-12-01

    Climate change and vector-borne diseases constitute a massive threat to human development. It will not be enough to cut emissions of greenhouse gases-the tide of the future has already been established. Climate change and vector-borne diseases are already undermining the world's efforts to reduce extreme poverty. It is in the best interests of the world leaders to think in terms of concerted global actions, but adaptation and mitigation must be accomplished within the context of local community conditions, resources, and needs. Failure to act will continue to consign developed countries to completely avoidable health risks and significant expense. Failure to act will also reduce poorest of the world's population-some 2.6 billion people-to a future of diminished opportunity. Northrop Grumman has taken significant steps forward to develop the tools needed to assess climate change impacts on public health, collect relevant data for decision making, model projections at regional and local levels; and, deliver information and knowledge to local and regional stakeholders. Supporting these tools is an advanced enterprise architecture consisting of high performance computing, GIS visualization, and standards-based architecture. To address current deficiencies in local planning and decision making with respect to regional climate change and its effect on human health, our research is focused on performing a dynamical downscaling with the Weather Research and Forecasting (WRF) model to develop decision aids that translate the regional climate data into actionable information for users. For the present climate WRF was forced with the Max Planck Institute European Center/Hamburg Model version 5 (ECHAM5) General Circulation Model 20th century simulation. For the 21th century climate, we used an ECHAM5 simulation with the Special Report on Emissions (SRES) A1B emissions scenario. WRF was run in nested mode at spatial resolution of 108 km, 36 km and 12 km and 28 vertical levels

  18. Meeting the needs of people with AIDS: local initiatives and Federal support.

    PubMed Central

    Sundwall, D N; Bailey, D

    1988-01-01

    The Health Resources and Services Administration (HRSA), one of the seven agencies of the Public Health Service, is working to meet some of the resource and patient service needs engendered by the epidemic of acquired immune deficiency syndrome (AIDS). Those actions derived from, and support the continuation, expansion, and replication of, initiatives at the community and State levels. HRSA is carrying out many of the recommendations of the Intragovernmental Task Force on AIDS Health Care Delivery by enhancing the AIDS training of health care personnel in prevention, diagnosis, and care and by counseling and encouraging the expansion of facilities outside hospitals to care for AIDS patients. The agency, through its pediatric AIDS demonstration projects, is working on models for the care of children with HIV infections. The needs of AIDS patients are being addressed through a drug therapy reimbursement program; demonstration grants to 13 projects to promote coordinated, integrated systems of care in the community; and grants for the development of intermediate and long-term care facilities for patients. Ten regional education and training centers, funded in 1987 and 1988, will increase the supply of health care providers prepared to diagnose and treat persons with HIV infections. Programs will be conducted for several thousand providers over the next 3 years, using such modalities as televised programs and train-the-trainer courses. The centers will also offer support and referral services for providers. PMID:3131821

  19. Virtual Beach: Decision Support Tools for Beach Pathogen Prediction

    EPA Science Inventory

    The Virtual Beach Managers Tool (VB) is decision-making software developed to help local beach managers make decisions as to when beaches should be closed due to predicted high levels of water borne pathogens. The tool is being developed under the umbrella of EPA's Advanced Monit...

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  1. An Oceanographic Decision Support System for Scientific Field Experiments

    NASA Astrophysics Data System (ADS)

    Maughan, T.; Das, J.; McCann, M. P.; Rajan, K.

    2011-12-01

    Thom Maughan, Jnaneshwar Das, Mike McCann, Danelle Cline, Mike Godin, Fred Bahr, Kevin Gomes, Tom O'Reilly, Frederic Py, Monique Messie, John Ryan, Francisco Chavez, Jim Bellingham, Maria Fox, Kanna Rajan Monterey Bay Aquarium Research Institute Moss Lading, California, United States Many of the coastal ocean processes we wish to observe in order to characterize marine ecosystems have large spatial extant (tens of square km) and are dynamic moving kilometers in a day with biological processes spanning anywhere from minutes to days. Some like harmful algal blooms generate toxins which can significantly impact human health and coastal economies. In order to obtain a viable understanding of the biogeochemical processes which define their dynamics and ecology, it is necessary to persistently observe, track and sample within and near the dynamic fields using augmented methods of observation such as autonomous platforms like AUVs, gliders and surface craft. Field experiments to plan, execute and manage such multitude of assets are challenging. To alleviate this problem the autonomous systems group with its collaborators at MBARI and USC designed, built and fielded a prototype Oceanographic Decision Support System (ODSS) that provides situational awareness and a single portal to visualize and plan deployments for the large scale October 2010 CANON field program as well as a series of 2 week field programs in 2011. The field programs were conducted in Monterey Bay, a known 'red tide' incubator, and varied from as many as twenty autonomous platforms, four ships and 2 manned airplanes to coordinated AUV operations, drifters and a single ship. The ODSS web-based portal was used to assimilate information from a collection of sources at sea, including AUVs, moorings, radar data as well as remote sensing products generated by partner organizations to provide a synthesis of views useful to predict the movement of a chlorophyll patch in the confines of the northern Monterey Bay

  2. Sensitivity of disease management decision aids to temperature input errors associated with out-of-canopy and reduced time-resolution measurements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Plant disease management decision aids typically require inputs of weather elements such as air temperature. Whereas many disease models are created based on weather elements at the crop canopy, and with relatively fine time resolution, the decision aids commonly are implemented with hourly weather...

  3. Interactive decision support system to predict print quality.

    PubMed

    Leman, Sugani; Lehto, Mark R

    2003-01-15

    Customers using printers occasionally experience problems such as fuzzy images, bands, or streaks. The customer may call or otherwise contact the manufacturer, who attempts to diagnose the problem based on the customer's description of the problem. This study evaluated Bayesian inference as a tool for identifying or diagnosing 16 different types of print defects from such descriptions. The Bayesian model was trained using 1701 narrative descriptions of print defects obtained from 60 subjects with varying technical backgrounds. The Bayesian model was then implemented as an interactive decision support system, which was used by eight 'agents' to diagnose print defects reported by 16 'customers' in a simulated call centre. The 'agents' and 'customers' in the simulated call centre were all students at Purdue University. Each customer made eight telephone calls, resulting in a total of 128 telephone calls in which the customer reported defects to the agents. The results showed that the Bayesian model closely fitted the data in the training set of narratives. Overall, the model correctly predicted the actual defect category with its top prediction 70% of the time. The actual defect was in the top five predictions 94% of the time. The model in the simulated call centre performed nearly as well for the test subjects. The top prediction was correct 50% of the time, and the defect was one of the top five predictions 80% of the time. Agent accuracy in diagnosing the problem improved when using the tool. These results demonstrated that the Bayesian system learned enough from the existing narratives to accurately classify print defect categories.

  4. A decision support system for managing forest fire casualties.

    PubMed

    Bonazountas, Marc; Kallidromitou, Despina; Kassomenos, Pavlos; Passas, Nikos

    2007-09-01

    Southern Europe is exposed to anthropogenic and natural forest fires. These result in loss of lives, goods and infrastructure, but also deteriorate the natural environment and degrade ecosystems. The early detection and combating of such catastrophes requires the use of a decision support system (DSS) for emergency management. The current literature reports on a series of efforts aimed to deliver DSSs for the management of the forest fires by utilising technologies like remote sensing and geographical information systems (GIS), yet no integrated system exists. This manuscript presents the results of scientific research aiming to the development of a DSS for managing forest fires. The system provides a series of software tools for the assessment of the propagation and combating of forest fires based on Arc/Info, ArcView, Arc Spatial Analyst, Arc Avenue, and Visual C++ technologies. The system integrates GIS technologies under the same data environment and utilises a common user interface to produce an integrated computer system based on semi-automatic satellite image processing (fuel maps), socio-economic risk modelling and probabilistic models that would serve as a useful tool for forest fire prevention, planning and management. Its performance has been demonstrated via real time up-to-date accurate information on the position and evolution of the fire. The system can assist emergency assessment, management and combating of the incident. A site demonstration and validation has been accomplished for the island of Evoia, Greece, an area particularly vulnerable to forest fires due to its ecological characteristics and prevailing wind patterns. PMID:16928418

  5. Decision support system for monitoring environmental-human interactions.

    PubMed

    Delavari-Edalat, Farideh; Abdi, M Reza

    2009-06-01

    The specific aim of this study is to investigate popular attitudes toward trees. The paper is involved the understanding of biophilia tendencies with respect to people's views in an urban area. Biophilia is considered as the idea insisting on the dependency of human identity on his relationship with nature. The biophilia fundamental tendencies were explored to establish a biological framework for valuing and affiliating the natural world. Accordingly, the nine tendencies i.e. utilitarian, naturalistic, ecologistic-scientific, aesthetic, symbolic, humanistic, moralistic, dominionistic, and negativistic were investigate to find out how people relate to the nature especially trees. The investigation was based on a quantitative interview which was applied to the public population in the Liverpool urban parks. Data collected from the designed questionnaire was followed by analysis of the data to identify people's attitudes towards trees. The results indicated how important the physical appeal and beauty of trees was for the people and also showed the people's emotional attachments to trees. Furthermore, a decision support model was proposed to evaluate human instincts and preferences in relation to their surrounding areas using the Analytical Hierarchical Process (AHP). The proposed model composed the environmental factors and the biophilia tendencies as the criteria of evaluating environmental-human interactions. A case study was then conducted in Liverpool parks to examine theses interactions. The data gathered was used as the input to the AHP model for the attribute analysis. The AHP model would enable environment managers to compose the relevant information via a link between human feelings about urban trees, and environmental factors for monitoring purposes and performance analysis.

  6. A decision support system for managing forest fire casualties.

    PubMed

    Bonazountas, Marc; Kallidromitou, Despina; Kassomenos, Pavlos; Passas, Nikos

    2007-09-01

    Southern Europe is exposed to anthropogenic and natural forest fires. These result in loss of lives, goods and infrastructure, but also deteriorate the natural environment and degrade ecosystems. The early detection and combating of such catastrophes requires the use of a decision support system (DSS) for emergency management. The current literature reports on a series of efforts aimed to deliver DSSs for the management of the forest fires by utilising technologies like remote sensing and geographical information systems (GIS), yet no integrated system exists. This manuscript presents the results of scientific research aiming to the development of a DSS for managing forest fires. The system provides a series of software tools for the assessment of the propagation and combating of forest fires based on Arc/Info, ArcView, Arc Spatial Analyst, Arc Avenue, and Visual C++ technologies. The system integrates GIS technologies under the same data environment and utilises a common user interface to produce an integrated computer system based on semi-automatic satellite image processing (fuel maps), socio-economic risk modelling and probabilistic models that would serve as a useful tool for forest fire prevention, planning and management. Its performance has been demonstrated via real time up-to-date accurate information on the position and evolution of the fire. The system can assist emergency assessment, management and combating of the incident. A site demonstration and validation has been accomplished for the island of Evoia, Greece, an area particularly vulnerable to forest fires due to its ecological characteristics and prevailing wind patterns.

  7. MAROS: a decision support system for optimizing monitoring plans.

    PubMed

    Aziz, Julia J; Ling, Meng; Rifai, Hanadi S; Newell, Charles J; Gonzales, James R

    2003-01-01

    The Monitoring and Remediation Optimization System (MAROS), a decision-support software, was developed to assist in formulating cost-effective ground water long-term monitoring plans. MAROS optimizes an existing ground water monitoring program using both temporal and spatial data analyses to determine the general monitoring system category and the locations and frequency of sampling for future compliance monitoring at the site. The objective of the MAROS optimization is to minimize monitoring locations in the sampling network and reduce sampling frequency without significant loss of information, ensuring adequate future characterization of the contaminant plume. The interpretive trend analysis approach recommends the general monitoring system category for a site based on plume stability and site-specific hydrogeologic information. Plume stability is characterized using primary lines of evidence (i.e., Mann-Kendall analysis and linear regression analysis) based on concentration trends, and secondary lines of evidence based on modeling results and empirical data. The sampling optimization approach, consisting of a two-dimensional spatial sampling reduction method (Delaunay method) and a temporal sampling analysis method (Modified CES method), provides detailed sampling location and frequency results. The Delaunay method is designed to identify and eliminate redundant sampling locations without causing significant information loss in characterizing the plume. The Modified CES method determines the optimal sampling frequency for a sampling location based on the direction, magnitude, and uncertainty in its concentration trend. MAROS addresses a variety of ground water contaminants (fuels, solvents, and metals), allows import of various data formats, and is designed for continual modification of long-term monitoring plans as the plume or site conditions change over time.

  8. Wind Prediction Accuracy for Air Traffic Management Decision Support Tools

    NASA Technical Reports Server (NTRS)

    Cole, Rod; Green, Steve; Jardin, Matt; Schwartz, Barry; Benjamin, Stan

    2000-01-01

    The performance of Air Traffic Management and flight deck decision support tools depends in large part on the accuracy of the supporting 4D trajectory predictions. This is particularly relevant to conflict prediction and active advisories for the resolution of conflicts and the conformance with of traffic-flow management flow-rate constraints (e.g., arrival metering / required time of arrival). Flight test results have indicated that wind prediction errors may represent the largest source of trajectory prediction error. The tests also discovered relatively large errors (e.g., greater than 20 knots), existing in pockets of space and time critical to ATM DST performance (one or more sectors, greater than 20 minutes), are inadequately represented by the classic RMS aggregate prediction-accuracy studies of the past. To facilitate the identification and reduction of DST-critical wind-prediction errors, NASA has lead a collaborative research and development activity with MIT Lincoln Laboratories and the Forecast Systems Lab of the National Oceanographic and Atmospheric Administration (NOAA). This activity, begun in 1996, has focussed on the development of key metrics for ATM DST performance, assessment of wind-prediction skill for state of the art systems, and development/validation of system enhancements to improve skill. A 13 month study was conducted for the Denver Center airspace in 1997. Two complementary wind-prediction systems were analyzed and compared to the forecast performance of the then standard 60 km Rapid Update Cycle - version 1 (RUC-1). One system, developed by NOAA, was the prototype 40-km RUC-2 that became operational at NCEP in 1999. RUC-2 introduced a faster cycle (1 hr vs. 3 hr) and improved mesoscale physics. The second system, Augmented Winds (AW), is a prototype en route wind application developed by MITLL based on the Integrated Terminal Wind System (ITWS). AW is run at a local facility (Center) level, and updates RUC predictions based on an

  9. Integration of Visibility Sensors in NOAA PORTS® to aid in Decision Making for Safe Navigation

    NASA Astrophysics Data System (ADS)

    Roggenstein, E. B.

    2012-12-01

    The National Oceanic and Atmospheric Administration (NOAA) National Ocean Service (NOS) Physical Oceanographic Real-Time System (PORTS®) provides real-time water level, currents and meteorological data for aid to navigation in twenty-three major ports and harbors. In response to PORTS® users' requests for visibility data, NOS began testing several varieties of visibility sensors for operations in a marine environment. Extensive testing resulted in the selection of the Vaisala FS11 visibility sensor. The FS11 sensor uses forward scattering technology to measure the amount of scattering in a small volume of air between the transmitter and receiver, resulting in an extrapolated visibility at a set height out to 75 km. Two sensors have been successfully operating in the Mobile Bay PORTS® at Middle Bay Port and Pinto Island since installation in 2010. The sensors are positioned at a height of 3 m above the ground, 24 km apart along the western shore of the bay in areas susceptible to fog formation. Real-time data from these sensors are disseminated on NOAA's Center for Operational Oceanographic Products and Services (COOPS) PORTS® website every 6 minutes (min) and for distances up to 10 km (5.4 nm) from the instrument. This has proven to aid port pilots' decision making for safe movement of vessels in the harbor. Additionally, the Pinto Island sensor is located directly adjacent to the shipping channel - an area with high levels of atmospheric particulates of high carbon content. These particulates do not appear to have negatively affected sensor performance. This success has prompted interest in visibility sensors from other harbors with PORTS®. The ports of San Francisco, Narragansett Bay, Chesapeake Bay, Jacksonville FL, and Gulfport MS are planning or exploring the addition of visibility sensors to their PORTS® to aid in navigation. Additionally, the NOAA/COOPS Ocean System Test Evaluation Program (OSTEP) has continued with additional field testing of the FS11

  10. Supporting Students beyond Financial Aid: Low-Income Students Need Support That Goes Beyond Tuition Assistance

    ERIC Educational Resources Information Center

    Pierce, Dennis

    2016-01-01

    Low-income students face a number of obstacles that go beyond the cost of tuition and fees. For instance, their schooling often requires expenses that aren't covered by financial aid, such as books and commuting costs. What's more, education is often competing for their time with other responsibilities, such as the need to work or take care of…

  11. Data Driven Farming: Delivering the Benefits of Remotely Sensed Data and Decision Support Tools to Farmers

    NASA Astrophysics Data System (ADS)

    Shriver, J.; Soloff, J. A.; Molen, N.

    2014-12-01

    Web-based agricultural management software allows for the delivery of previously hard to access soil, weather and remotely sensed data to growers. While access to these data sources is beneficial, growers can realize large gains by leveraging field level data and integrating decision support tools that have been presented in the literature. Using a previously developed model for estimating the growth stage of maize (Sakamoto et al. 2010), we examine how remotely sensed data can be integrated into a web-based agricultural management tool, informing grower management decisions by providing near real-time estimates of crop growth stage and sub-field level variability in growing conditions. When combined with field-level soil and weather data, growers can use remote sensing based models to tailor management activities, taking variable (climate related) and invariant (site characteristic) yield determining factors into account.Time series of Wide Dynamic Range Vegetation Index (WDRVI) derived from Landsat observations were linked to 97 fields growing maize across the Mid-western region of the United States in 2013. Crop growth stage day of year (DOY) estimates (V2.5, R1, R5, and R6) were predicted for each field based on the WDRVI profile and compared to a growing degree day based estimate. These estimates aid in scheduling growth stage specific management activities and allow farmers to more efficiently monitor geographically remote fields. Within-field variation in growing conditions is presented on an ordinal scale (below average, average, above average) based on the field-level distribution of WDRVI values at each observation. Monitoring of sub-field level conditions allows growers to calibrate field-level yield estimates, prioritize field scouting activities and plan targeted interventions. Integration of these tools into existing web-based agricultural management tools allows growers to easily incorporate remotely sensed data into their decision making process

  12. User Oriented Techniques to Support Interaction and Decision Making with Large Educational Databases

    ERIC Educational Resources Information Center

    Hartley, Roger; Almuhaidib, Saud M. Y.

    2007-01-01

    Information Technology is developing rapidly and providing policy/decision makers with large amounts of information that require processing and analysis. Decision support systems (DSS) aim to provide tools that not only help such analyses, but enable the decision maker to experiment and simulate the effects of different policies and selection…

  13. SADA: Ecological Risk Based Decision Support System for Selective Remediation

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

  14. Hydrologic Drought Decision Support System (HyDroDSS)

    USGS Publications Warehouse

    Granato, Gregory E.

    2014-01-01

    The hydrologic drought decision support system (HyDroDSS) was developed by the U.S. Geological Survey (USGS) in cooperation with the Rhode Island Water Resources Board (RIWRB) for use in the analysis of hydrologic variables that may indicate the risk for streamflows to be below user-defined flow targets at a designated site of interest, which is defined herein as data-collection site on a stream that may be adversely affected by pumping. Hydrologic drought is defined for this study as a period of lower than normal streamflows caused by precipitation deficits and (or) water withdrawals. The HyDroDSS is designed to provide water managers with risk-based information for balancing water-supply needs and aquatic-habitat protection goals to mitigate potential effects of hydrologic drought. This report describes the theory and methods for retrospective streamflow-depletion analysis, rank correlation analysis, and drought-projection analysis. All three methods are designed to inform decisions made by drought steering committees and decisionmakers on the basis of quantitative risk assessment. All three methods use estimates of unaltered streamflow, which is the measured or modeled flow without major withdrawals or discharges, to approximate a natural low-flow regime. Retrospective streamflow-depletion analysis can be used by water-resource managers to evaluate relations between withdrawal plans and the potential effects of withdrawal plans on streams at one or more sites of interest in an area. Retrospective streamflow-depletion analysis indicates the historical risk of being below user-defined flow targets if different pumping plans were implemented for the period of record. Retrospective streamflow-depletion analysis also indicates the risk for creating hydrologic drought conditions caused by use of a pumping plan. Retrospective streamflow-depletion analysis is done by calculating the net streamflow depletions from withdrawals and discharges and applying these depletions

  15. New observations of scintillation climatology from the Scintillation Network Decision Aid (SCINDA)

    NASA Astrophysics Data System (ADS)

    Su, Y.; Caton, R. G.; Wiens, K.; Groves, K. M.

    2012-12-01

    The Scintillation Network Decision Aid (SCINDA) was established with three ground sites in the mid-1990's by the Air Force Research Laboratory and has continued to grow into a global scintillation observation network. This system consists of an array of VHF and GPS receivers which continually measure scintillation in the equatorial region. In the past few years, the extended network of ground stations has expanded into the African sector. Initial results from yearly scintillation data obtained from two VHF receivers in Narobi, Kenya and Bahir Dar, Ethiopia in 2011 indicate the presence of scintillation activity throughout the June-July -August (northern summer) season which is inconsistent with current state-of-the-art ionospheric climatology models. It is well known that seasonal equatorial scintillation patterns vary with longitude based on geographical location. For example, the scintillation activity at VHF frequencies are absent in the Pacific sector during the months of November to February while observations from South America show nearly continuous scintillation during this same time period. With little to no ground-based observations, the scintillation climatology over the African region has not been well understood. In the paper, we will present S4 measurements various longitudinal sectors, including the first look at solar maximum type conditions over the African sector, and provide comparisons with output from a global climatology model.

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

    NASA Technical Reports Server (NTRS)

    Nugent, Richard O.; Tucker, Richard W.

    1988-01-01

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

  17. A prototype decision aid for evaluating and selecting R&D proposals

    SciTech Connect

    Al-Ayat, R.A.; Lamont, A.; Sicherman, A.

    1992-05-01

    This report describes a prototype decision aid which has been developed to assist the Institutional Research and Development (IR&D) Committee in selecting proposals for funding. This tool was requested to help address the following concerns about the IR&D proposal selection process: Some good proposals might be overlooked simply because no one on the Committee advocates them forcefully. The process takes a lot of time. The final portfolio of proposals selected may not maximize the long-run benefits to the Laboratory. These concerns stem from the observation that there is no formal framework for making distinctions between proposals, or weighing and comparing those distinctions. It was felt that the process could be improved by a framework that: Provides explicit descriptors that Committee members can use to evaluate and compare different features of proposals. Encourages the Committee to use a uniform, systematic scheme for evaluating the proposals. Helps the Committee focus more quickly on the issues that are truly relevant for distinguishing between proposals.

  18. Wisconsin's Aid to Families with Dependent Children and Child Support Enforcement Programs Could Be Improved.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    This report from the General Accounting Office reviews selected aspects of Wisconsin's Aid to Families with Dependent Children (AFDC) program. Chapter 1 describes AFDC and specifies the scope of the program review. In Chapter 2 the potential for increasing child support collections from parents is explored. Actions which could increase collections…

  19. A Conceptual Analysis of State Support for Higher Education: Appropriations versus Need-Based Financial Aid

    ERIC Educational Resources Information Center

    Toutkoushian, Robert K.; Shafiq, M. Najeeb

    2010-01-01

    In this paper, we use economic concepts to examine the choice that states make between giving appropriations to public colleges or need-based financial aid to students. We begin by reviewing the economic justification for state support for higher education. Next, we introduce a simple economic model for comparing and contrasting appropriations and…

  20. Social Support Disparities for Caregivers of AIDS-Orphaned Children in South Africa

    ERIC Educational Resources Information Center

    Kuo, Caroline; Fitzgerald, Jane; Operario, Don; Casale, Marisa

    2012-01-01

    Drawing upon a sample of 1,599 adults caring for children in HIV-endemic Umlazi Township in South Africa, this cross-sectional survey investigated whether perceived social support varied among caregivers of AIDS-orphaned children (n = 359) as compared with caregivers of children orphaned by other causes (n = 171) and caregivers of nonorphaned…

  1. Facilitating adaptive management in the Chesapeake Bay Watershed through the use of online decision support tools

    USGS Publications Warehouse

    Mullinx, Cassandra; Phillips, Scott; Shenk, Kelly; Hearn, Paul; Devereux, Olivia

    2009-01-01

    The Chesapeake Bay Program (CBP) is attempting to more strategically implement management actions to improve the health of the Nation’s largest estuary. In 2007 the U.S. Geological Survey (USGS) and U.S. Environmental Protection Agency (USEPA) CBP office began a joint effort to develop a suite of Internetaccessible decision-support tools and to help meet the needs of CBP partners to improve water quality and habitat conditions in the Chesapeake Bay and its watersheds. An adaptive management framework is being used to provide a structured decision process for information and individual tools needed to implement and assess practices to improve the condition of the Chesapeake Bay ecosystem. The Chesapeake Online Adaptive Support Toolkit (COAST) is a collection of web-based analytical tools and information, organized in an adaptive management framework, intended to aid decisionmakers in protecting and restoring the integrity of the Bay ecosystem. The initial version of COAST is focused on water quality issues. During early and mid- 2008, initial ideas for COAST were shared and discussed with various CBP partners and other potential user groups. At these meetings, test cases were selected to help improve understanding of the types of information and analytical functionality that would be most useful for specific partners’ needs. These discussions added considerable knowledge about the nature of decisionmaking for Federal, State, local and nongovernmental partners. Version 1.0 of COAST, released in early winter of 2008, will be further reviewed to determine improvements needed to address implementation and assessment of water quality practices. Future versions of COAST may address other aspects of ecosystem restoration, including restoration of habitat and living resources and maintaining watershed health.

  2. A Decision Aid for Women Considering Neoadjuvant Systemic Therapy for Operable Invasive Breast Cancer: Development and Protocol of a Phase II Evaluation Study (ANZ1301 DOMINO)

    PubMed Central

    Butow, Phyllis; Hutchings, Elizabeth; Douglas, Charles; Coll, Joseph R; Boyle, Frances M

    2016-01-01

    Background Neoadjuvant systemic therapy is offered to selected women with large and/or highly proliferative operable breast cancers. This option adds further complexity to an already complex breast cancer treatment decision tree. Patient decision aids are an established method of increasing patient involvement and knowledge while decreasing decisional conflict. There is currently no decision aid available for women considering neoadjuvant systemic therapy. Objective We aimed to develop a decision aid for women diagnosed with operable breast cancer and considered suitable for neoadjuvant systemic therapy, and the protocol for a multicenter pre-post study evaluating the acceptability and feasibility of the decision aid. Methods The decision aid was developed through literature review, expert advisory panel, adherence to the International Patient Decision Aid Standards, and iterative review. The protocol for evaluation of the decision aid consists of the following: eligible women will undertake a series of questionnaires prior to and after using the decision aid. The primary endpoint is decision aid acceptability to patients and investigators and the feasibility of use. Secondary endpoints include change in decisional conflict, participant knowledge, and information involvement preference. Feasibility is defined as the proportion of eligible participants who use the decision aid to help inform their treatment decision. Results This study has recruited 29 out of a planned 50 participants at four Australian sites. A 12-month recruitment period is expected with a further 12-months follow-up. Conclusions The decision aid has the potential to allow patients with operable breast cancer, who have been offered neoadjuvant systemic therapy, decreased decisional conflict, and greater involvement in the decision. If this study finds that an online decision aid is feasible and acceptable, it will be made widely available for routine clinical practice. Trial Registration

  3. Visualization support for risk-informed decision making when planning and managing software developments

    NASA Technical Reports Server (NTRS)

    Feather, Martin S.; Kiper, James D.; Menzies, Tim

    2005-01-01

    Key decisions are made in the early stages of planning and management of software developments. The information basis for these decisions is often a mix of analogy with past developments, and the best judgments of domain experts. Visualization of this information can support to such decision making by clarifying the status of the information and yielding insights into the ramifications of that information vis-a-vis decision alternatives.

  4. Informal networks among women with HIV/AIDS: present support and future prospects.

    PubMed

    Ciambrone, Desirée

    2002-09-01

    Given the importance of informal support in the lives of chronically ill people, it is imperative to gain a deeper understanding of the nature and impact of HIV-positive women's informal networks. Through interviews with 37 women with HIV infection, the author explores women's social network composition and the extent to which these networks appear to facilitate or mediate the disruption caused by HIV/AIDS. Women reported having at least one person, usually a family member, on whom they could depend for emotional support. Although women report adequate levels of current support, the author questions the likelihood that their informal networks will provide support further along in women's illness trajectories.

  5. Structured decision making as a framework for linking quantitative decision support to community values

    EPA Science Inventory

    Community-level decisions can have large impacts on production and delivery of ecosystem services, which ultimately affects community well-being. But engaging stakeholders in a process to explore these impacts is a significant challenge. The principles of Structured Decision Ma...

  6. A Decision Support System For Assisting With Stocking Rate Decisions During And Following Drought

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Ranchers and range managers in the West are at the mercy of climatic conditions that determine the amount of annual forge available on rangeland. Typically, stocking or de-stocking decisions need to be made before the final forage production level is known. Erroneous stocking rate decisions can have...

  7. Effects of Instructional Aids on the Acquisition of Dynamic Decision-Making Skills

    ERIC Educational Resources Information Center

    Frederiksen, Christian; Kehoe, E. James; Wood, Robert

    2011-01-01

    This study tested the effects of two instructional aids in a complex, dynamic environment, specifically, a business simulation. Participants studied (1) a "causal map," which depicted key variables in an interconnected network, (2) a textual outline of the same relationships, or (3) no-aid. With the relevant aid still available, the participants…

  8. Socio-Demographic Factors, Social Support, Quality of Life, and HIV/AIDS in Ghana.

    PubMed

    Abrefa-Gyan, Tina; Cornelius, Llewellyn J; Okundaye, Joshua

    2016-01-01

    The increase in the access to biomedical interventions for people living with HIV/AIDS in the developing world has not been adequately matched with the requisite psychosocial treatments to help improve the effectiveness of biomedical interventions. Therefore, in this study the author seeks to determine whether socio-demographic characteristics and social support are associated with quality of life in individuals diagnosed with HIV/AIDS in Ghana. A convenience sample of 300 HIV/AIDS support group members was obtained via cross-sectional design survey. The Medical Outcome Studies (MOS) HIV Health Survey, the MOS Social Support Survey (MOS-SSS), and demographic questionnaire instruments were used to assess quality of life, social support, and demographic information respectively. Multiple regression analysis showed that there was a positive association between overall social support and overall quality of life (r = .51). It also showed that being younger, male, attending support group meetings for over a year, and having ≥ 13 years of schooling related to higher quality of life. Implications of the findings for practice, policy, and research in Ghana and the rest of the developing world are discussed.

  9. Sources and determinants of social support for caregivers of persons with AIDS.

    PubMed

    Turner, H A; Pearlin, L I; Mullan, J T

    1998-06-01

    This study examines the determinants of social support among a sample of 642 caregivers of persons with AIDS living in San Francisco and Los Angeles. Respondents include both traditional family caregivers (mothers, spouses, other relatives) and non-traditional caregivers (friends, homosexual partners). Multiple regression analyses are conducted to assess the independent effects of six sets of variables on emotional and instrumental support: social-structural factors (age, education, employment status), caregiver's relationship to the person with AIDS, situational variables (caregiver's HIV status, patient's functional disability, interpersonal conflict), social network factors (contact with family, contact with friends, community integration), personal resources (mastery, caregiving competence), and use of formal community services (patient-directed services, caregiver-directed services). A number of factors and conditions appear to be relevant for caregiver support. For example, results indicate that network factors, including frequency of contact, conflict, and community integration, are importantly related to caregivers' perceptions of emotional support. There is also a trend suggesting lower emotional support among traditional family caregivers, relative to nonfamily caregivers, within gender categories. With respect to instrumental assistance with caregiving, factors that place greater demands and time constraints on caregivers, such as being employed and caring for an AIDS patient with greater functional limitations, appear to increase the level of informal instrumental support the caregiver receives. Partners and spouses, however, receive significantly lower instrumental assistance, independent of other factors. Implications of the findings are discussed.

  10. A Cross-National CAI Tool To Support Learning Operations Decision-Making and Market Analysis.

    ERIC Educational Resources Information Center

    Mockler, Robert J.; Afanasiev, Mikhail Y.; Dologite, Dorothy G.

    1999-01-01

    Describes bicultural (United States and Russia) development of a computer-aided instruction (CAI) tool to learn management decision-making using information systems technologies. The program has been used with undergraduate and graduate students in both countries; it integrates free and controlled market concepts and combines traditional computer…

  11. Methodology for the use of DSSAT Models for Precision Agriculture Decision Support

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A prototype decision support system (DSS) called Apollo was developed to assist researchers in using the Decision Support System for Agrotechnology Transfer (DSSAT) crop growth models to analyze precision farming datasets. Because the DSSAT models are written to simulate crop growth and development...

  12. Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

    EPA Science Inventory

    A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

  13. Validation of a decision support system for improving irrigation system performance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To address water shortage and improve water delivery operations, decision support systems have been developed and utilized throughout the United States and the world. One critical aspect that is often neglected during the development and implementation of decision support systems is validation, whi...

  14. Decision Support Systems Project. Design Review Conference, October 14-15, 1984. Summary Report of Findings.

    ERIC Educational Resources Information Center

    Tetlow, William L.

    Findings of a conference that reviewed and evaluated design decisions concerning the Decision Support System (DSS) Demonstrator are summarized. The DSS Demonstrator was designed by the National Center for Higher Education Management Systems as an example of the way in which microcomputer technology can support and make more effective planning and…

  15. Academic Support Services and Career Decision-Making Self-Efficacy in Student Athletes

    ERIC Educational Resources Information Center

    Burns, Gary N.; Jasinski, Dale; Dunn, Steve; Fletcher, Duncan

    2013-01-01

    This study examined the relationship between evaluations of academic support services and student athletes' career decision-making self-efficacy. One hundred and fifty-eight NCAA athletes (68% male) from 11 Division I teams completed measures of satisfaction with their academic support services, career decision-making self-efficacy, general…

  16. Supporting patient autonomy: decision making in home care.

    PubMed

    Davitt, J K; Kaye, L W

    1996-01-01

    This study examines the policies and procedures that home health care agencies have developed to handle the incapacitated patient and life-sustaining treatment decisions. Data collected from a survey of 154 home health care agency directors and interviews with 92 local agency staff (including nurses and social workers) and 67 patients confirmed that directors, staff, and patients agree that patients are informed about their legal rights. When asked about specific rights, fewer patients were aware of their right to execute an advance directive, and even fewer patients had actually executed one. Only 67 percent of agencies reported having existing policies on advance directives and life-sustaining treatment decisions, whereas 41.5 percent had policies on how to handle the patient with questionable decision-making capacity. Consistent policies are needed for social workers, nurses, and other staff to handle such difficult ethical dilemmas. A review of specific agency policies is presented with recommendations for future policy changes and development.

  17. Nonword repetition in lexical decision: support for two opposing processes.

    PubMed

    Wagenmakers, Eric-Jan; Zeelenberg, René; Steyvers, Mark; Shiffrin, Richard; Raaijmakers, Jeroen

    2004-10-01

    We tested and confirmed the hypothesis that the prior presentation of nonwords in lexical decision is the net result of two opposing processes: (1) a relatively fast inhibitory process based on global familiarity; and (2) a relatively slow facilitatory process based on the retrieval of specific episodic information. In three studies, we manipulated speed-stress to influence the balance between the two processes. Experiment 1 showed item-specific improvement for repeated nonwords in a standard "respond-when-ready" lexical decision task. Experiment 2 used a 400-ms deadline procedure and showed performance for nonwords to be unaffected by up to four prior presentations. In Experiment 3 we used a signal-to-respond procedure with variable time intervals and found negative repetition priming for repeated nonwords. These results can be accounted for by dual-process models of lexical decision.

  18. Mountaineer`s gas facilities decision support system

    SciTech Connect

    1997-02-01

    Mountaineer Gas Co. of Charleston, W.Va., is justifiably proud of its capacity to combine electronic maps with a full database of information about its facilities and customers, and use that mix to make the decisions required in operating a gas company with better information and more quickly. Determining when a pipeline needs replacement or repair used to take several days at Mountaineer. With the new system in place, the decision can be made in a matter of minutes. The paper describes the system and its development, then discusses adding customer information as the next step.

  19. A Pain Management Decision Support System for Nurses

    PubMed Central

    Heriot, Cathy; Graves, Judith; Bouhaddou, Omar; Armstrong, Margaret; Wigertz, Gudrun; Ben Said, Mohamed

    1988-01-01

    This paper describes the development and uses of the Nursing Pain Management Consultation System, a prototype demonstration project for Integrated Academic Information Management System (IAIMS) at the University of Utah. A knowledge base representing the best current thinking regarding management of acute pain secondary to total hip arthroplasty (THA) is the knowledge core of the expert system. The decisions modeled range from assessment of the severity of pain to decisions related to both pharmacologic and non-pharmacologic approaches to the alleviation of pain. The system also advises the nurses on measures to assess and prevent complications of the treatments.

  20. Coordinated machine learning and decision support for situation awareness.

    PubMed

    Brannon, N G; Seiffertt, J E; Draelos, T J; Wunsch, D C

    2009-04-01

    Domains such as force protection require an effective decision maker to maintain a high level of situation awareness. A system that combines humans with neural networks is a desirable approach. Furthermore, it is advantageous for the calculation engine to operate in three learning modes: supervised for initial training and known updating, reinforcement for online operational improvement, and unsupervised in the absence of all external signaling. An Adaptive Resonance Theory based architecture capable of seamlessly switching among the three types of learning is discussed that can be used to help optimize the decision making of a human operator in such a scenario. This is followed by a situation assessment module.