Sample records for decision analysis tool

  1. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: PUBLISHED REPORT

    EPA Science Inventory

    NRMRL-CIN-1351A Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. EPA/600/R-01/104 (NTIS PB2002-102119). Decision makers using environmental decision support tools are often ...

  2. HUMAN HEALTH METRICS FOR ENVIRONMENTAL DECISION SUPPORT TOOLS: LESSONS FROM HEALTH ECONOMICS AND DECISION ANALYSIS: JOURNAL ARTICLE

    EPA Science Inventory

    NRMRL-CIN-1351 Hofstetter**, P., and Hammitt, J. K. Human Health Metrics for Environmental Decision Support Tools: Lessons from Health Economics and Decision Analysis. Risk Analysis 600/R/01/104, Available: on internet, www.epa.gov/ORD/NRMRL/Pubs/600R01104, [NET]. 03/07/2001 D...

  3. An Introduction to Solar Decision-Making Tools

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Mow, Benjamin

    2017-09-12

    The National Renewable Energy Laboratory (NREL) offers a variety of models and analysis tools to help decision makers evaluate and make informed decisions about solar projects, policies, and programs. This fact sheet aims to help decision makers determine which NREL tool to use for a given solar project or policy question, depending on its scope.

  4. A new spatial multi-criteria decision support tool for site selection for implementation of managed aquifer recharge.

    PubMed

    Rahman, M Azizur; Rusteberg, Bernd; Gogu, R C; Lobo Ferreira, J P; Sauter, Martin

    2012-05-30

    This study reports the development of a new spatial multi-criteria decision analysis (SMCDA) software tool for selecting suitable sites for Managed Aquifer Recharge (MAR) systems. The new SMCDA software tool functions based on the combination of existing multi-criteria evaluation methods with modern decision analysis techniques. More specifically, non-compensatory screening, criteria standardization and weighting, and Analytical Hierarchy Process (AHP) have been combined with Weighted Linear Combination (WLC) and Ordered Weighted Averaging (OWA). This SMCDA tool may be implemented with a wide range of decision maker's preferences. The tool's user-friendly interface helps guide the decision maker through the sequential steps for site selection, those steps namely being constraint mapping, criteria hierarchy, criteria standardization and weighting, and criteria overlay. The tool offers some predetermined default criteria and standard methods to increase the trade-off between ease-of-use and efficiency. Integrated into ArcGIS, the tool has the advantage of using GIS tools for spatial analysis, and herein data may be processed and displayed. The tool is non-site specific, adaptive, and comprehensive, and may be applied to any type of site-selection problem. For demonstrating the robustness of the new tool, a case study was planned and executed at Algarve Region, Portugal. The efficiency of the SMCDA tool in the decision making process for selecting suitable sites for MAR was also demonstrated. Specific aspects of the tool such as built-in default criteria, explicit decision steps, and flexibility in choosing different options were key features, which benefited the study. The new SMCDA tool can be augmented by groundwater flow and transport modeling so as to achieve a more comprehensive approach to the selection process for the best locations of the MAR infiltration basins, as well as the locations of recovery wells and areas of groundwater protection. The new spatial multicriteria analysis tool has already been implemented within the GIS based Gabardine decision support system as an innovative MAR planning tool. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. THE FUTURE OF SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS-ELECTRONIC (SMARTE): 2006-2010

    EPA Science Inventory

    SMARTe is being developed to give stakeholders information resources, analytical tools, communication strategies, and a decision analysis approach to be able to make better decisions regarding future uses of property. The development of the communication tools and decision analys...

  6. FRAMEWORK FOR ENVIRONMENTAL DECISION-MAKING, FRED: A TOOL FOR ENVIRONMENTALLY-PREFERABLE PURCHASING

    EPA Science Inventory

    In support of the Environmentally Preferable Purchasing Program of the US EPA, the Systems Analysis Branch has developed a decision-making tool based on life cycle assessment. This tool, the Framework for Responsible Environmental Decision-making or FRED streamlines LCA by choosi...

  7. Multicriteria decision analysis: Overview and implications for environmental decision making

    USGS Publications Warehouse

    Hermans, Caroline M.; Erickson, Jon D.; Erickson, Jon D.; Messner, Frank; Ring, Irene

    2007-01-01

    Environmental decision making involving multiple stakeholders can benefit from the use of a formal process to structure stakeholder interactions, leading to more successful outcomes than traditional discursive decision processes. There are many tools available to handle complex decision making. Here we illustrate the use of a multicriteria decision analysis (MCDA) outranking tool (PROMETHEE) to facilitate decision making at the watershed scale, involving multiple stakeholders, multiple criteria, and multiple objectives. We compare various MCDA methods and their theoretical underpinnings, examining methods that most realistically model complex decision problems in ways that are understandable and transparent to stakeholders.

  8. 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...

  9. Sustainability Tools Inventory - Initial Gaps Analysis | Science ...

    EPA Pesticide Factsheets

    This report identifies a suite of tools that address a comprehensive set of community sustainability concerns. The objective is to discover whether "gaps" exist in the tool suite’s analytic capabilities. These tools address activities that significantly influence resource consumption, waste generation, and hazard generation including air pollution and greenhouse gases. In addition, the tools have been evaluated using four screening criteria: relevance to community decision making, tools in an appropriate developmental stage, tools that may be transferrable to situations useful for communities, and tools with requiring skill levels appropriate to communities. This document provides an initial gap analysis in the area of community sustainability decision support tools. It provides a reference to communities for existing decision support tools, and a set of gaps for those wishing to develop additional needed tools to help communities to achieve sustainability. It contributes to SHC 1.61.4

  10. GET SMARTE: DECISION TOOLS TO REVITALIZE BROWNFIELDS

    EPA Science Inventory

    SMARTe (Sustainable Management Approaches and Revitalization Tools-electronic) is an open-source, web-based, decision-support system for developing and evaluating future use scenarios for potentially contaminated sites (i.e., brownfields). It contains resources and analysis tools...

  11. Lean production tools and decision latitude enable conditions for innovative learning in organizations: a multilevel analysis.

    PubMed

    Fagerlind Ståhl, Anna-Carin; Gustavsson, Maria; Karlsson, Nadine; Johansson, Gun; Ekberg, Kerstin

    2015-03-01

    The effect of lean production on conditions for learning is debated. This study aimed to investigate how tools inspired by lean production (standardization, resource reduction, visual monitoring, housekeeping, value flow analysis) were associated with an innovative learning climate and with collective dispersion of ideas in organizations, and whether decision latitude contributed to these associations. A questionnaire was sent out to employees in public, private, production and service organizations (n = 4442). Multilevel linear regression analyses were used. Use of lean tools and decision latitude were positively associated with an innovative learning climate and collective dispersion of ideas. A low degree of decision latitude was a modifier in the association to collective dispersion of ideas. Lean tools can enable shared understanding and collective spreading of ideas, needed for the development of work processes, especially when decision latitude is low. Value flow analysis played a pivotal role in the associations. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  12. GET SMARTE: DECISION TOOLS TO REVITALIZE COMMUNITIES (MAY 2006)

    EPA Science Inventory

    SMARTe (Sustainable Management Approaches and Revitalization Tools-electronic) is an open-source, web-based, decision-support system for developing and evaluating future use scenarios for potentially contaminated sites (i.e., brownfields). It contains resources and analysis tools...

  13. Enhancement of the EPA Stormwater BMP Decision-Support Tool (SUSTAIN)

    EPA Science Inventory

    U.S. Environmental Protection Agency (EPA) has been developing and improving a decision-support tool for placement of stormwater best management practices (BMPs) at strategic locations in urban watersheds. The tool is called the System for Urban Stormwater Treatment and Analysis...

  14. Combining multi-criteria decision analysis and mini-health technology assessment: A funding decision-support tool for medical devices in a university hospital setting.

    PubMed

    Martelli, Nicolas; Hansen, Paul; van den Brink, Hélène; Boudard, Aurélie; Cordonnier, Anne-Laure; Devaux, Capucine; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

    2016-02-01

    At the hospital level, decisions about purchasing new and oftentimes expensive medical devices must take into account multiple criteria simultaneously. Multi-criteria decision analysis (MCDA) is increasingly used for health technology assessment (HTA). One of the most successful hospital-based HTA approaches is mini-HTA, of which a notable example is the Matrix4value model. To develop a funding decision-support tool combining MCDA and mini-HTA, based on Matrix4value, suitable for medical devices for individual patient use in French university hospitals - known as the IDA tool, short for 'innovative device assessment'. Criteria for assessing medical devices were identified from a literature review and a survey of 18 French university hospitals. Weights for the criteria, representing their relative importance, were derived from a survey of 25 members of a medical devices committee using an elicitation technique involving pairwise comparisons. As a test of its usefulness, the IDA tool was applied to two new drug-eluting beads (DEBs) for transcatheter arterial chemoembolization. The IDA tool comprises five criteria and weights for each of two over-arching categories: risk and value. The tool revealed that the two new DEBs conferred no additional value relative to DEBs currently available. Feedback from participating decision-makers about the IDA tool was very positive. The tool could help to promote a more structured and transparent approach to HTA decision-making in French university hospitals. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. 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

  16. Enhancement of the EPA Stormwater BMP Decision-Support Tool (SUSTAIN) - slides

    EPA Science Inventory

    U.S. Environmental Protection Agency (EPA) has been developing and improving a decision-support tool for placement of stormwater best management practices (BMPs) at strategic locations in urban watersheds. The tool is called the System for Urban Stormwater Treatment and Analysis...

  17. Decision support tools for proton therapy ePR: intelligent treatment planning navigator and radiation toxicity tool for evaluating of prostate cancer treatment

    NASA Astrophysics Data System (ADS)

    Le, Anh H.; Deshpande, Ruchi; Liu, Brent J.

    2010-03-01

    The electronic patient record (ePR) has been developed for prostate cancer patients treated with proton therapy. The ePR has functionality to accept digital input from patient data, perform outcome analysis and patient and physician profiling, provide clinical decision support and suggest courses of treatment, and distribute information across different platforms and health information systems. In previous years, we have presented the infrastructure of a medical imaging informatics based ePR for PT with functionality to accept digital patient information and distribute this information across geographical location using Internet protocol. In this paper, we present the ePR decision support tools which utilize the imaging processing tools and data collected in the ePR. The two decision support tools including the treatment plan navigator and radiation toxicity tool are presented to evaluate prostate cancer treatment to improve proton therapy operation and improve treatment outcomes analysis.

  18. An experiment with interactive planning models

    NASA Technical Reports Server (NTRS)

    Beville, J.; Wagner, J. H.; Zannetos, Z. S.

    1970-01-01

    Experiments on decision making in planning problems are described. Executives were tested in dealing with capital investments and competitive pricing decisions under conditions of uncertainty. A software package, the interactive risk analysis model system, was developed, and two controlled experiments were conducted. It is concluded that planning models can aid management, and predicted uses of the models are as a central tool, as an educational tool, to improve consistency in decision making, to improve communications, and as a tool for consensus decision making.

  19. EnviroAtlas Webinar

    EPA Pesticide Factsheets

    EnviroAtlas is a web-based decision support tool that combines maps, analysis tools, downloadable data and informational resources that states, tribes and communities can use to help inform policy and planning decisions impacting their surroundings.

  20. Advancing Alternative Analysis: Integration of Decision Science.

    PubMed

    Malloy, Timothy F; Zaunbrecher, Virginia M; Batteate, Christina M; Blake, Ann; Carroll, William F; Corbett, Charles J; Hansen, Steffen Foss; Lempert, Robert J; Linkov, Igor; McFadden, Roger; Moran, Kelly D; Olivetti, Elsa; Ostrom, Nancy K; Romero, Michelle; Schoenung, Julie M; Seager, Thomas P; Sinsheimer, Peter; Thayer, Kristina A

    2017-06-13

    Decision analysis-a systematic approach to solving complex problems-offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. We assessed whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and were prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups' findings. We concluded that the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients and would also advance the science of decision analysis. We advance four recommendations: a ) engaging the systematic development and evaluation of decision approaches and tools; b ) using case studies to advance the integration of decision analysis into alternatives analysis; c ) supporting transdisciplinary research; and d ) supporting education and outreach efforts. https://doi.org/10.1289/EHP483.

  1. A decision-making tool for incorporating sustainability measures into pavement design : research project capsule.

    DOT National Transportation Integrated Search

    2016-10-01

    The objective of the proposed study is to conceive and develop a decision-making tool : for evaluating sustainability of pavement designs based on a cradle-to-grave analysis. : This tool will utilize EPDs to enhance the reliability of the assessment ...

  2. 75 FR 35457 - Draft of the 2010 Causal Analysis/Diagnosis Decision Information System (CADDIS)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... Causal Analysis/Diagnosis Decision Information System (CADDIS) AGENCY: Environmental Protection Agency... site, ``2010 release of the Causal Analysis/Diagnosis Decision Information System (CADDIS).'' The... analyses, downloadable software tools, and links to outside information sources. II. How to Submit Comments...

  3. Evaluation of the Effectiveness of Stormwater Decision Support Tools for Infrastructure Selection and the Barriers to Implementation

    NASA Astrophysics Data System (ADS)

    Spahr, K.; Hogue, T. S.

    2016-12-01

    Selecting the most appropriate green, gray, and / or hybrid system for stormwater treatment and conveyance can prove challenging to decision markers across all scales, from site managers to large municipalities. To help streamline the selection process, a multi-disciplinary team of academics and professionals is developing an industry standard for selecting and evaluating the most appropriate stormwater management technology for different regions. To make the tool more robust and comprehensive, life-cycle cost assessment and optimization modules will be included to evaluate non-monetized and ecosystem benefits of selected technologies. Initial work includes surveying advisory board members based in cities that use existing decision support tools in their infrastructure planning process. These surveys will qualify the decisions currently being made and identify challenges within the current planning process across a range of hydroclimatic regions and city size. Analysis of social and other non-technical barriers to adoption of the existing tools is also being performed, with identification of regional differences and institutional challenges. Surveys will also gage the regional appropriateness of certain stormwater technologies based off experiences in implementing stormwater treatment and conveyance plans. In additional to compiling qualitative data on existing decision support tools, a technical review of components of the decision support tool used will be performed. Gaps in each tool's analysis, like the lack of certain critical functionalities, will be identified and ease of use will be evaluated. Conclusions drawn from both the qualitative and quantitative analyses will be used to inform the development of the new decision support tool and its eventual dissemination.

  4. Advancing Alternative Analysis: Integration of Decision Science

    PubMed Central

    Zaunbrecher, Virginia M.; Batteate, Christina M.; Blake, Ann; Carroll, William F.; Corbett, Charles J.; Hansen, Steffen Foss; Lempert, Robert J.; Linkov, Igor; McFadden, Roger; Moran, Kelly D.; Olivetti, Elsa; Ostrom, Nancy K.; Romero, Michelle; Schoenung, Julie M.; Seager, Thomas P.; Sinsheimer, Peter; Thayer, Kristina A.

    2017-01-01

    Background: Decision analysis—a systematic approach to solving complex problems—offers tools and frameworks to support decision making that are increasingly being applied to environmental challenges. Alternatives analysis is a method used in regulation and product design to identify, compare, and evaluate the safety and viability of potential substitutes for hazardous chemicals. Objectives: We assessed whether decision science may assist the alternatives analysis decision maker in comparing alternatives across a range of metrics. Methods: A workshop was convened that included representatives from government, academia, business, and civil society and included experts in toxicology, decision science, alternatives assessment, engineering, and law and policy. Participants were divided into two groups and were prompted with targeted questions. Throughout the workshop, the groups periodically came together in plenary sessions to reflect on other groups’ findings. Results: We concluded that the further incorporation of decision science into alternatives analysis would advance the ability of companies and regulators to select alternatives to harmful ingredients and would also advance the science of decision analysis. Conclusions: We advance four recommendations: a) engaging the systematic development and evaluation of decision approaches and tools; b) using case studies to advance the integration of decision analysis into alternatives analysis; c) supporting transdisciplinary research; and d) supporting education and outreach efforts. https://doi.org/10.1289/EHP483 PMID:28669940

  5. Demonstration of the application of traffic management center decision support tools.

    DOT National Transportation Integrated Search

    2013-03-01

    Decision support tools were developed in previous Florida Department of Transportation (FDOT) : research projects to allow for better analysis and visualization of historical traffic and incident : data, in support of incident management and traffic ...

  6. Application of risk analysis in water resourses management

    NASA Astrophysics Data System (ADS)

    Varouchakis, Emmanouil; Palogos, Ioannis

    2017-04-01

    A common cost-benefit analysis approach, which is novel in the risk analysis of hydrologic/hydraulic applications, and a Bayesian decision analysis are applied to aid the decision making on whether or not to construct a water reservoir for irrigation purposes. The alternative option examined is a scaled parabolic fine variation in terms of over-pumping violations in contrast to common practices that usually consider short-term fines. Such an application, and in such detail, represents new feedback. The results indicate that the probability uncertainty is the driving issue that determines the optimal decision with each methodology, and depending on the unknown probability handling, each methodology may lead to a different optimal decision. Thus, the proposed tool can help decision makers (stakeholders) to examine and compare different scenarios using two different approaches before making a decision considering the cost of a hydrologic/hydraulic project and the varied economic charges that water table limit violations can cause inside an audit interval. In contrast to practices that assess the effect of each proposed action separately considering only current knowledge of the examined issue, this tool aids decision making by considering prior information and the sampling distribution of future successful audits. This tool is developed in a web service for the easier stakeholders' access.

  7. Decision Analysis Tools for Volcano Observatories

    NASA Astrophysics Data System (ADS)

    Hincks, T. H.; Aspinall, W.; Woo, G.

    2005-12-01

    Staff at volcano observatories are predominantly engaged in scientific activities related to volcano monitoring and instrumentation, data acquisition and analysis. Accordingly, the academic education and professional training of observatory staff tend to focus on these scientific functions. From time to time, however, staff may be called upon to provide decision support to government officials responsible for civil protection. Recognizing that Earth scientists may have limited technical familiarity with formal decision analysis methods, specialist software tools that assist decision support in a crisis should be welcome. A review is given of two software tools that have been under development recently. The first is for probabilistic risk assessment of human and economic loss from volcanic eruptions, and is of practical use in short and medium-term risk-informed planning of exclusion zones, post-disaster response, etc. A multiple branch event-tree architecture for the software, together with a formalism for ascribing probabilities to branches, have been developed within the context of the European Community EXPLORIS project. The second software tool utilizes the principles of the Bayesian Belief Network (BBN) for evidence-based assessment of volcanic state and probabilistic threat evaluation. This is of practical application in short-term volcano hazard forecasting and real-time crisis management, including the difficult challenge of deciding when an eruption is over. An open-source BBN library is the software foundation for this tool, which is capable of combining synoptically different strands of observational data from diverse monitoring sources. A conceptual vision is presented of the practical deployment of these decision analysis tools in a future volcano observatory environment. Summary retrospective analyses are given of previous volcanic crises to illustrate the hazard and risk insights gained from use of these tools.

  8. Channel CAT: A Tactical Link Analysis Tool

    DTIC Science & Technology

    1997-09-01

    NAVAL POSTGRADUATE SCHOOL Monterey, California THESIS CHANNEL CAT : A TACTICAL LINK ANALYSIS TOOL by Michael Glenn Coleman September 1997 Thesis...REPORT TYPE AND DATES COVERED September 1997 Master’s Thesis 4. TITLE AND SUBTITLE CHANNEL CAT : A TACTICAL LINK ANALYSIS TOOL 5. FUNDING NUMBERS 6...tool, the Channel Capacity Analysis Tool (Channel CAT ), designed to provide an automated tool for the anlysis of design decisions in developing client

  9. 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 easier and faster. The visual synthesis of data facilitates the use of information in health decision making at the district level of a health system and promotes program improvement. The experience in Kenya can be applied to other countries that face challenges making district-level, data-informed decisions with data from fragmented information systems. PMID:24011028

  10. TBell: A mathematical tool for analyzing decision tables

    NASA Technical Reports Server (NTRS)

    Hoover, D. N.; Chen, Zewei

    1994-01-01

    This paper describes the development of mathematical theory and software to analyze specifications that are developed using decision tables. A decision table is a tabular format for specifying a complex set of rules that chooses one of a number of alternative actions. The report also describes a prototype tool, called TBell, that automates certain types of analysis.

  11. Application of Bayesian and cost benefit risk analysis in water resources management

    NASA Astrophysics Data System (ADS)

    Varouchakis, E. A.; Palogos, I.; Karatzas, G. P.

    2016-03-01

    Decision making is a significant tool in water resources management applications. This technical note approaches a decision dilemma that has not yet been considered for the water resources management of a watershed. A common cost-benefit analysis approach, which is novel in the risk analysis of hydrologic/hydraulic applications, and a Bayesian decision analysis are applied to aid the decision making on whether or not to construct a water reservoir for irrigation purposes. The alternative option examined is a scaled parabolic fine variation in terms of over-pumping violations in contrast to common practices that usually consider short-term fines. The methodological steps are analytically presented associated with originally developed code. Such an application, and in such detail, represents new feedback. The results indicate that the probability uncertainty is the driving issue that determines the optimal decision with each methodology, and depending on the unknown probability handling, each methodology may lead to a different optimal decision. Thus, the proposed tool can help decision makers to examine and compare different scenarios using two different approaches before making a decision considering the cost of a hydrologic/hydraulic project and the varied economic charges that water table limit violations can cause inside an audit interval. In contrast to practices that assess the effect of each proposed action separately considering only current knowledge of the examined issue, this tool aids decision making by considering prior information and the sampling distribution of future successful audits.

  12. GET SMARTE: A DECISION SUPPORT SYSTEM TO REVITALIZE COMMUNITIES - CABERNET 2007

    EPA Science Inventory

    Sustainable Management Approaches and Revitalization Tools - electronic (SMARTe), is an open-source, web-based, decision support system for developing and evaluating future reuse scenarios for potentially contaminated land. SMARTe contains information and analysis tools for all a...

  13. "Black Magic" and "Gold Dust": The Epistemic and Political Uses of Evidence Tools in Public Health Policy Making

    ERIC Educational Resources Information Center

    Stewart, Ellen; Smith, Katherine E.

    2015-01-01

    Concerns about the limited influence of research on decision making have prompted the development of tools intended to mediate evidence for policy audiences. This article focuses on three examples, prominent in public health: impact assessments; systematic reviews; and economic decision-making tools (cost-benefit analysis and scenario modelling).…

  14. A problem solving and decision making toolbox for approaching clinical problems and decisions.

    PubMed

    Margolis, C; Jotkowitz, A; Sitter, H

    2004-08-01

    In this paper, we begin by presenting three real patients and then review all the practical conceptual tools that have been suggested for systematically analyzing clinical problems. Each of these conceptual tools (e.g. Evidence-Based Medicine, Clinical Practice Guidelines, Decision Analysis) deals mainly with a different type or aspect of clinical problems. We suggest that all of these conceptual tools can be thought of as belonging in the clinician's toolbox for solving clinical problems and making clinical decisions. A heuristic for guiding the clinician in using the tools is proposed. The heuristic is then used to analyze management of the three patients presented at the outset. Copyright 2004 Birkhäuser Verlag, Basel

  15. Developing an Ecosystem Services online Decision Support Tool to Assess the Impacts of Climate Change and Urban Growth in the Santa Cruz Watershed; Where We Live, Work, and Play

    EPA Science Inventory

    Processes through which ecosystems provide goods or benefit people can be referred to as "ecosystems services”, which may be quantified to clarify decision-making, with techniques including cost-benefit analysis. We are developing an online decision support tool, the Santa Cruz W...

  16. Multi-criteria development and incorporation into decision tools for health technology adoption.

    PubMed

    Poulin, Paule; Austen, Lea; Scott, Catherine M; Waddell, Cameron D; Dixon, Elijah; Poulin, Michelle; Lafrenière, René

    2013-01-01

    When introducing new health technologies, decision makers must integrate research evidence with local operational management information to guide decisions about whether and under what conditions the technology will be used. Multi-criteria decision analysis can support the adoption or prioritization of health interventions by using criteria to explicitly articulate the health organization's needs, limitations, and values in addition to evaluating evidence for safety and effectiveness. This paper seeks to describe the development of a framework to create agreed-upon criteria and decision tools to enhance a pre-existing local health technology assessment (HTA) decision support program. The authors compiled a list of published criteria from the literature, consulted with experts to refine the criteria list, and used a modified Delphi process with a group of key stakeholders to review, modify, and validate each criterion. In a workshop setting, the criteria were used to create decision tools. A set of user-validated criteria for new health technology evaluation and adoption was developed and integrated into the local HTA decision support program. Technology evaluation and decision guideline tools were created using these criteria to ensure that the decision process is systematic, consistent, and transparent. This framework can be used by others to develop decision-making criteria and tools to enhance similar technology adoption programs. The development of clear, user-validated criteria for evaluating new technologies adds a critical element to improve decision-making on technology adoption, and the decision tools ensure consistency, transparency, and real-world relevance.

  17. Tools, information sources, and methods used in deciding on drug availability in HMOs.

    PubMed

    Barner, J C; Thomas, J

    1998-01-01

    The use and importance of specific decision-making tools, information sources, and drug-use management methods in determining drug availability and use in HMOs were studied. A questionnaire was sent to 303 randomly selected HMOs. Respondents were asked to rate their use of each of four formal decision-making tools and its relative importance, as well as the use and importance of eight information sources and 11 methods for managing drug availability and use, on a 5-point scale. The survey response rate was 28%. Approximately half of the respondents reported that their HMOs used decision analysis or multiattribute analysis in deciding on drug availability. If used, these tools were rated as very important. There were significant differences in levels of use by HMO type, membership size, and age. Journal articles and reference books were reported most often as information sources. Retrospective drug-use review was used very often and perceived to be very important in managing drug use. Other management methods were used only occasionally, but the importance placed on these tools when used ranged from moderately to very important. Older organizations used most of the management methods more often than did other HMOs. Decision analysis and multiattribute analysis were the most commonly used tools for deciding on which drugs to make available to HMO members, and reference books and journal articles were the most commonly used information sources. Retrospective and prospective drug-use reviews were the most commonly applied methods for managing HMO members' access to drugs.

  18. An Environmental Decision Support System for Spatial Assessment and Selective Remediation

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates environmental assessment tools for effective problem-solving. The software integrates modules for GIS, visualization, geospatial analysis, statistical analysis, human health and ecolog...

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

    PubMed

    Yost, Jennifer; Dobbins, Maureen; Traynor, Robyn; DeCorby, Kara; Workentine, Stephanie; Greco, Lori

    2014-07-18

    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. 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. 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 and sustaining evidence-informed decision making. Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools' application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice.

  20. Development of a support tool for complex decision-making in the provision of rural maternity care.

    PubMed

    Hearns, Glen; Klein, Michael C; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

    2010-02-01

    Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology.

  1. Development of a Support Tool for Complex Decision-Making in the Provision of Rural Maternity Care

    PubMed Central

    Hearns, Glen; Klein, Michael C.; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

    2010-01-01

    Context: Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. Objective: To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Design: Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Setting: Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Participants: Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). Results: We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Conclusions: Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology. PMID:21286270

  2. Business Intelligence: Turning Knowledge into Power

    ERIC Educational Resources Information Center

    Endsley, Krista

    2009-01-01

    Today, many school districts are turning to business intelligence tools to retrieve, organize, and share knowledge for faster analysis and more effective, guided decision making. Business intelligence (BI) tools are the technologies and applications that gather and report information to help an organization's leaders make better decisions. BI…

  3. 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.

  4. 78 FR 45992 - National Science and Technology Council; Notice of Meeting: Open Meeting of the National Science...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-30

    ..., and the general public; analysis of the role of comparative risk assessment in these evaluations, including decision analysis tools and gap analysis tools; identification, through case study presentations...

  5. 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 and sustaining evidence-informed decision making. Conclusion Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools’ application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice. PMID:25034534

  6. SADA: A FREEWARE DECISION SUPPORT TOOL INTEGRATING GIS, SAMPLE DESIGN, SPATIAL MODELING AND RISK ASSESSMENT (SLIDE PRESENTATION)

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates tools from environmental assessment into an effective problem-solving environment. SADA was developed by the Institute for Environmental Modeling at the University of Tennessee and inc...

  7. MEETING IN CHICAGO: SADA: A FREEWARE DECISION SUPPORT TOOL INTEGRATING GIS, SAMPLE DESIGN, SPATIAL MODELING, AND ENVIRONMENTAL RISK ASSESSMENT

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates tools from environmental assessment into an effective problem-solving environment. SADA was developed by the Institute for Environmental Modeling at the University of Tennessee and inc...

  8. MEETING IN CZECH REPUBLIC: SADA: A FREEWARE DECISION SUPPORT TOOL INTEGRATING GIS, SAMPLE DESIGN, SPATIAL MODELING, AND RISK ASSESSMENT

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates tools from environmental assessment into an effective problem-solving environment. SADA was developed by the Institute for Environmental Modeling at the University of Tennessee and inc...

  9. Applications of urban tree canopy assessment and prioritization tools: supporting collaborative decision making to achieve urban sustainability goals

    Treesearch

    Dexter H. Locke; J. Morgan Grove; Michael Galvin; Jarlath P.M. ONeil-Dunne; Charles Murphy

    2013-01-01

    Urban Tree Canopy (UTC) Prioritizations can be both a set of geographic analysis tools and a planning process for collaborative decision-making. In this paper, we describe how UTC Prioritizations can be used as a planning process to provide decision support to multiple government agencies, civic groups and private businesses to aid in reaching a canopy target. Linkages...

  10. Structured Analysis and the Data Flow Diagram: Tools for Library Analysis.

    ERIC Educational Resources Information Center

    Carlson, David H.

    1986-01-01

    This article discusses tools developed to aid the systems analysis process (program evaluation and review technique, Gantt charts, organizational charts, decision tables, flowcharts, hierarchy plus input-process-output). Similarities and differences among techniques, library applications of analysis, structured systems analysis, and the data flow…

  11. Synthesis of research on work zone delays and simplified application of QuickZone analysis tool.

    DOT National Transportation Integrated Search

    2010-03-01

    The objectives of this project were to synthesize the latest information on work zone safety and management and identify case studies in which FHWAs decision support tool QuickZone or other appropriate analysis tools could be applied. The results ...

  12. A decision framework for identifying models to estimate forest ecosystem services gains from restoration

    USGS Publications Warehouse

    Christin, Zachary; Bagstad, Kenneth J.; Verdone, Michael

    2016-01-01

    Restoring degraded forests and agricultural lands has become a global conservation priority. A growing number of tools can quantify ecosystem service tradeoffs associated with forest restoration. This evolving “tools landscape” presents a dilemma: more tools are available, but selecting appropriate tools has become more challenging. We present a Restoration Ecosystem Service Tool Selector (RESTS) framework that describes key characteristics of 13 ecosystem service assessment tools. Analysts enter information about their decision context, services to be analyzed, and desired outputs. Tools are filtered and presented based on five evaluative criteria: scalability, cost, time requirements, handling of uncertainty, and applicability to benefit-cost analysis. RESTS uses a spreadsheet interface but a web-based interface is planned. Given the rapid evolution of ecosystem services science, RESTS provides an adaptable framework to guide forest restoration decision makers toward tools that can help quantify ecosystem services in support of restoration.

  13. SPATIAL ANALYSIS AND DECISION ASSISTANCE (SADA) TRAINING COURSE

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates tools from environmental assessment into an effective problem-solving environment. SADA was developed by the Institute for Environmental Modeling at the University of Tennessee and inc...

  14. The development of a multi-criteria decision analysis aid to help with contraceptive choices: My Contraception Tool.

    PubMed

    French, Rebecca S; Cowan, Frances M; Wellings, Kaye; Dowie, Jack

    2014-04-01

    My Contraception Tool (MCT) applies the principles of multi-criteria decision analysis to the choice of contraceptive method. Its purpose is to make the decision-making process transparent to the user and to suggest a method to them based on their own preferences. The contraceptive option that emerges as optimal from the analysis takes account of the probability of a range of outcomes and the relative weight ascribed to them by the user. The development of MCT was a collaborative project between London School of Hygiene & Tropical Medicine, Brook, FPA and Maldaba Ltd. MCT is available online via the Brook and FPA websites. In this article we describe MCT's development and how it works. Further work is needed to assess the impact it has on decision quality and contraceptive behaviour.

  15. 75 FR 58374 - 2010 Release of CADDIS (Causal Analysis/Diagnosis Decision Information System)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... 2010 version of the Causal Analysis/Diagnosis Decision Information System (CADDIS). This Web site was... methods; information on basic and advanced data analyses; downloadable software tools; and an online... ENVIRONMENTAL PROTECTION AGENCY [FRL-9206-7] 2010 Release of CADDIS (Causal Analysis/Diagnosis...

  16. 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…

  17. Soak Up the Rain New England Webinar Series: National ...

    EPA Pesticide Factsheets

    Presenters will provide an introduction to the most recent EPA green infrastructure tools to R1 stakeholders; and their use in making decisions about implementing green infrastructure. We will discuss structuring your green infrastructure decision, finding appropriate information and tools, evaluating options and selecting the right Best Management Practices mix for your needs.WMOST (Watershed Management Optimization Support Tool)- for screening a wide range of practices for cost-effectiveness in achieving watershed or water utilities management goals.GIWiz (Green Infrastructure Wizard)- a web application connecting communities to EPA Green Infrastructure tools and resources.Opti-Tool-designed to assist in developing technically sound and optimized cost-effective Stormwater management plans. National Stormwater Calculator- a desktop application for estimating the impact of land cover change and green infrastructure controls on stormwater runoff. DASEES-GI (Decision Analysis for a Sustainable Environment, Economy, and Society) – a framework for linking objectives and measures with green infrastructure methods. Presenters will provide an introduction to the most recent EPA green infrastructure tools to R1 stakeholders; and their use in making decisions about implementing green infrastructure. We will discuss structuring your green infrastructure decision, finding appropriate information and tools, evaluating options and selecting the right Best Management Pr

  18. EPA Growing DASEES (Decision Analysis For A Sustainable Environment, Economy & Society) - To Aid In Making Decisions On Complex Environmental Issues

    EPA Science Inventory

    Having a framework and tools to help sort through complicated environmental issues in an objective way would be useful to communities and risk managers, and all the stakeholders affected by these issues. This is one need that DASEES (Decision Analysis for a Sustainable En...

  19. Multi-Metric Sustainability Analysis

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cowlin, Shannon; Heimiller, Donna; Macknick, Jordan

    2014-12-01

    A readily accessible framework that allows for evaluating impacts and comparing tradeoffs among factors in energy policy, expansion planning, and investment decision making is lacking. Recognizing this, the Joint Institute for Strategic Energy Analysis (JISEA) funded an exploration of multi-metric sustainability analysis (MMSA) to provide energy decision makers with a means to make more comprehensive comparisons of energy technologies. The resulting MMSA tool lets decision makers simultaneously compare technologies and potential deployment locations.

  20. Distributed collaborative environments for predictive battlespace awareness

    NASA Astrophysics Data System (ADS)

    McQuay, William K.

    2003-09-01

    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, make quick-response decisions, and quantify the effects of those decisions in the face of uncertainty. Situational assessment is crucial in understanding the battlespace. 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. Decision support technologies can semi-automate activities, such as analysis and planning, that have a reasonably well-defined process and provide machine-level interfaces to refine the myriad of information that the commander must fused. 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 AFRL research efforts in applying distributed collaborative environments to predictive battlespace awareness.

  1. Restoring and Managing Gulf of Mexico Fisheries: A Path Toward Creative Decision-Making

    EPA Science Inventory

    This chapter introduces decision analysis concepts with examples for managing fisheries. Decision analytic methods provide useful tools for structuring environmental management problems and separating technical judgments from preference judgments to better weigh the prospects fro...

  2. A methodology and decision support tool for informing state-level bioenergy policymaking: New Jersey biofuels as a case study

    NASA Astrophysics Data System (ADS)

    Brennan-Tonetta, Margaret

    This dissertation seeks to provide key information and a decision support tool that states can use to support long-term goals of fossil fuel displacement and greenhouse gas reductions. The research yields three outcomes: (1) A methodology that allows for a comprehensive and consistent inventory and assessment of bioenergy feedstocks in terms of type, quantity, and energy potential. Development of a standardized methodology for consistent inventorying of biomass resources fosters research and business development of promising technologies that are compatible with the state's biomass resource base. (2) A unique interactive decision support tool that allows for systematic bioenergy analysis and evaluation of policy alternatives through the generation of biomass inventory and energy potential data for a wide variety of feedstocks and applicable technologies, using New Jersey as a case study. Development of a database that can assess the major components of a bioenergy system in one tool allows for easy evaluation of technology, feedstock and policy options. The methodology and decision support tool is applicable to other states and regions (with location specific modifications), thus contributing to the achievement of state and federal goals of renewable energy utilization. (3) Development of policy recommendations based on the results of the decision support tool that will help to guide New Jersey into a sustainable renewable energy future. The database developed in this research represents the first ever assessment of bioenergy potential for New Jersey. It can serve as a foundation for future research and modifications that could increase its power as a more robust policy analysis tool. As such, the current database is not able to perform analysis of tradeoffs across broad policy objectives such as economic development vs. CO2 emissions, or energy independence vs. source reduction of solid waste. Instead, it operates one level below that with comparisons of kWh or GGE generated by different feedstock/technology combinations at the state and county level. Modification of the model to incorporate factors that will enable the analysis of broader energy policy issues as those mentioned above, are recommended for future research efforts.

  3. Understanding the stakeholders' intention to use economic decision-support tools: A cross-sectional study with the tobacco return on investment tool.

    PubMed

    Cheung, Kei Long; Evers, Silvia M A A; Hiligsmann, Mickaël; Vokó, Zoltán; Pokhrel, Subhash; Jones, Teresa; Muñoz, Celia; Wolfenstetter, Silke B; Józwiak-Hagymásy, Judit; de Vries, Hein

    2016-01-01

    Despite an increased number of economic evaluations of tobacco control interventions, the uptake by stakeholders continues to be limited. Understanding the underlying mechanism in adopting such economic decision-support tools by stakeholders is therefore important. By applying the I-Change Model, this study aims to identify which factors determine potential uptake of an economic decision-support tool, i.e., the Return on Investment tool. Stakeholders (decision-makers, purchasers of services/pharma products, professionals/service providers, evidence generators and advocates of health promotion) were interviewed in five countries, using an I-Change based questionnaire. MANOVA's were conducted to assess differences between intenders and non-intenders regarding beliefs. A multiple regression analysis was conducted to identify the main explanatory variables of intention to use an economic decision-support tool. Ninety-three stakeholders participated. Significant differences in beliefs were found between non-intenders and intenders: risk perception, attitude, social support, and self-efficacy towards using the tool. Regression showed that demographics, pre-motivational, and motivational factors explained 69% of the variation in intention. This study is the first to provide a theoretical framework to understand differences in beliefs between stakeholders who do or do not intend to use economic decision-support tools, and empirically corroborating the framework. This contributes to our understanding of the facilitators and barriers to the uptake of these studies. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  4. Rapid Benefit Indicators (RBI) Spatial Analysis Tools

    EPA Science Inventory

    The Rapid Benefit Indicators (RBI) approach consists of five steps and is outlined in Assessing the Benefits of Wetland Restoration - A Rapid Benefits Indicators Approach for Decision Makers. This spatial analysis tool is intended to be used to analyze existing spatial informatio...

  5. 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…

  6. Amy Rose | NREL

    Science.gov Websites

    Rose is a member of the Markets & Policy Analysis Group in the Strategic Energy Analysis Center integration of renewable energy Research Interests Energy policy and regulation Decision support tools to inform power sector policy and regulatory decisions Energy and development International energy policy

  7. Automated Modular Magnetic Resonance Imaging Clinical Decision Support System (MIROR): An Application in Pediatric Cancer Diagnosis

    PubMed Central

    Zarinabad, Niloufar; Meeus, Emma M; Manias, Karen; Foster, Katharine

    2018-01-01

    Background Advances in magnetic resonance imaging and the introduction of clinical decision support systems has underlined the need for an analysis tool to extract and analyze relevant information from magnetic resonance imaging data to aid decision making, prevent errors, and enhance health care. Objective The aim of this study was to design and develop a modular medical image region of interest analysis tool and repository (MIROR) for automatic processing, classification, evaluation, and representation of advanced magnetic resonance imaging data. Methods The clinical decision support system was developed and evaluated for diffusion-weighted imaging of body tumors in children (cohort of 48 children, with 37 malignant and 11 benign tumors). Mevislab software and Python have been used for the development of MIROR. Regions of interests were drawn around benign and malignant body tumors on different diffusion parametric maps, and extracted information was used to discriminate the malignant tumors from benign tumors. Results Using MIROR, the various histogram parameters derived for each tumor case when compared with the information in the repository provided additional information for tumor characterization and facilitated the discrimination between benign and malignant tumors. Clinical decision support system cross-validation showed high sensitivity and specificity in discriminating between these tumor groups using histogram parameters. Conclusions MIROR, as a diagnostic tool and repository, allowed the interpretation and analysis of magnetic resonance imaging images to be more accessible and comprehensive for clinicians. It aims to increase clinicians’ skillset by introducing newer techniques and up-to-date findings to their repertoire and make information from previous cases available to aid decision making. The modular-based format of the tool allows integration of analyses that are not readily available clinically and streamlines the future developments. PMID:29720361

  8. "Best Case/Worst Case": Qualitative Evaluation of a Novel Communication Tool for Difficult in-the-Moment Surgical Decisions.

    PubMed

    Kruser, Jacqueline M; Nabozny, Michael J; Steffens, Nicole M; Brasel, Karen J; Campbell, Toby C; Gaines, Martha E; Schwarze, Margaret L

    2015-09-01

    To evaluate a communication tool called "Best Case/Worst Case" (BC/WC) based on an established conceptual model of shared decision-making. Focus group study. Older adults (four focus groups) and surgeons (two focus groups) using modified questions from the Decision Aid Acceptability Scale and the Decisional Conflict Scale to evaluate and revise the communication tool. Individuals aged 60 and older recruited from senior centers (n = 37) and surgeons from academic and private practices in Wisconsin (n = 17). Qualitative content analysis was used to explore themes and concepts that focus group respondents identified. Seniors and surgeons praised the tool for the unambiguous illustration of multiple treatment options and the clarity gained from presentation of an array of treatment outcomes. Participants noted that the tool provides an opportunity for in-the-moment, preference-based deliberation about options and a platform for further discussion with other clinicians and loved ones. Older adults worried that the format of the tool was not universally accessible for people with different educational backgrounds, and surgeons had concerns that the tool was vulnerable to physicians' subjective biases. The BC/WC tool is a novel decision support intervention that may help facilitate difficult decision-making for older adults and their physicians when considering invasive, acute medical treatments such as surgery. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  9. HISTORICAL ANALYSIS, A VALUABLE TOOL IN COMMUNITY-BASED ENVIRONMENTAL PROTECTION

    EPA Science Inventory

    A historical analysis of the ecological consequences of development can be a valuable tool in community-based environmental protection. These studies can engage the public in environmental issues and lead to informed decision making. Historical studies provide an understanding of...

  10. Analytical and CASE study on Limited Search, ID3, CHAID, C4.5, Improved C4.5 and OVA Decision Tree Algorithms to design Decision Support System

    NASA Astrophysics Data System (ADS)

    Kaur, Parneet; Singh, Sukhwinder; Garg, Sushil; Harmanpreet

    2010-11-01

    In this paper we study about classification algorithms for farm DSS. By applying classification algorithms i.e. Limited search, ID3, CHAID, C4.5, Improved C4.5 and One VS all Decision Tree on common data set of crop with specified class, results are obtained. The tool used to derive results is SPINA. The graphical results obtained from tool are compared to suggest best technique to develop farm Decision Support System. This analysis would help to researchers to design effective and fast DSS for farmer to take decision for enhancing their yield.

  11. Systems Analysis - a new paradigm and decision support tools for the water framework directive

    NASA Astrophysics Data System (ADS)

    Bruen, M.

    2008-05-01

    In the early days of Systems Analysis the focus was on providing tools for optimisation, modelling and simulation for use by experts. Now there is a recognition of the need to develop and disseminate tools to assist in making decisions, negotiating compromises and communicating preferences that can easily be used by stakeholders without the need for specialist training. The Water Framework Directive (WFD) requires public participation and thus provides a strong incentive for progress in this direction. This paper places the new paradigm in the context of the classical one and discusses some of the new approaches which can be used in the implementation of the WFD. These include multi-criteria decision support methods suitable for environmental problems, adaptive management, cognitive mapping, social learning and cooperative design and group decision-making. Concordance methods (such as ELECTRE) and the Analytical Hierarchy Process (AHP) are identified as multi-criteria methods that can be readily integrated into Decision Support Systems (DSS) that deal with complex environmental issues with very many criteria, some of which are qualitative. The expanding use of the new paradigm provides an opportunity to observe and learn from the interaction of stakeholders with the new technology and to assess its effectiveness.

  12. Designing Real-time Decision Support for Trauma Resuscitations

    PubMed Central

    Yadav, Kabir; Chamberlain, James M.; Lewis, Vicki R.; Abts, Natalie; Chawla, Shawn; Hernandez, Angie; Johnson, Justin; Tuveson, Genevieve; Burd, Randall S.

    2016-01-01

    Background Use of electronic clinical decision support (eCDS) has been recommended to improve implementation of clinical decision rules. Many eCDS tools, however, are designed and implemented without taking into account the context in which clinical work is performed. Implementation of the pediatric traumatic brain injury (TBI) clinical decision rule at one Level I pediatric emergency department includes an electronic questionnaire triggered when ordering a head computed tomography using computerized physician order entry (CPOE). Providers use this CPOE tool in less than 20% of trauma resuscitation cases. A human factors engineering approach could identify the implementation barriers that are limiting the use of this tool. Objectives The objective was to design a pediatric TBI eCDS tool for trauma resuscitation using a human factors approach. The hypothesis was that clinical experts will rate a usability-enhanced eCDS tool better than the existing CPOE tool for user interface design and suitability for clinical use. Methods This mixed-methods study followed usability evaluation principles. Pediatric emergency physicians were surveyed to identify barriers to using the existing eCDS tool. Using standard trauma resuscitation protocols, a hierarchical task analysis of pediatric TBI evaluation was developed. Five clinical experts, all board-certified pediatric emergency medicine faculty members, then iteratively modified the hierarchical task analysis until reaching consensus. The software team developed a prototype eCDS display using the hierarchical task analysis. Three human factors engineers provided feedback on the prototype through a heuristic evaluation, and the software team refined the eCDS tool using a rapid prototyping process. The eCDS tool then underwent iterative usability evaluations by the five clinical experts using video review of 50 trauma resuscitation cases. A final eCDS tool was created based on their feedback, with content analysis of the evaluations performed to ensure all concerns were identified and addressed. Results Among 26 EPs (76% response rate), the main barriers to using the existing tool were that the information displayed is redundant and does not fit clinical workflow. After the prototype eCDS tool was developed based on the trauma resuscitation hierarchical task analysis, the human factors engineers rated it to be better than the CPOE tool for nine of 10 standard user interface design heuristics on a three-point scale. The eCDS tool was also rated better for clinical use on the same scale, in 84% of 50 expert–video pairs, and was rated equivalent in the remainder. Clinical experts also rated barriers to use of the eCDS tool as being low. Conclusions An eCDS tool for diagnostic imaging designed using human factors engineering methods has improved perceived usability among pediatric emergency physicians. PMID:26300010

  13. 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

  14. Formal analysis of the surgical pathway and development of a new software tool to assist surgeons in the decision making in primary breast surgery.

    PubMed

    Catanuto, Giuseppe; Pappalardo, Francesco; Rocco, Nicola; Leotta, Marco; Ursino, Venera; Chiodini, Paolo; Buggi, Federico; Folli, Secondo; Catalano, Francesca; Nava, Maurizio B

    2016-10-01

    The increased complexity of the decisional process in breast cancer surgery is well documented. With this study we aimed to create a software tool able to assist patients and surgeons in taking proper decisions. We hypothesized that the endpoints of breast cancer surgery could be addressed combining a set of decisional drivers. We created a decision support system software tool (DSS) and an interactive decision tree. A formal analysis estimated the information gain derived from each feature in the process. We tested the DSS on 52 patients and we analyzed the concordance of decisions obtained by different users and between the DSS suggestions and the actual surgery. We also tested the ability of the system to prevent post breast conservation deformities. The information gain revealed that patients preferences are the root of our decision tree. An observed concordance respectively of 0.98 and 0.88 was reported when the DSS was used twice by an expert operator or by a newly trained operator vs. an expert one. The observed concordance between the DSS suggestion and the actual decision was 0.69. A significantly higher incidence of post breast conservation defects was reported among patients who did not follow the DSS decision (Type III of Fitoussi, N = 4; 33.3%, p = 0.004). The DSS decisions can be reproduced by operators with different experience. The concordance between suggestions and actual decision is quite low, however the DSS is able to prevent post- breast conservation deformities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Evaluating the Utility of Web-Based Consumer Support Tools Using Rough Sets

    NASA Astrophysics Data System (ADS)

    Maciag, Timothy; Hepting, Daryl H.; Slezak, Dominik; Hilderman, Robert J.

    On the Web, many popular e-commerce sites provide consumers with decision support tools to assist them in their commerce-related decision-making. Many consumers will rank the utility of these tools quite highly. Data obtained from web usage mining analyses, which may provide knowledge about a user's online experiences, could help indicate the utility of these tools. This type of analysis could provide insight into whether provided tools are adequately assisting consumers in conducting their online shopping activities or if new or additional enhancements need consideration. Although some research in this regard has been described in previous literature, there is still much that can be done. The authors of this paper hypothesize that a measurement of consumer decision accuracy, i.e. a measurement preferences, could help indicate the utility of these tools. This paper describes a procedure developed towards this goal using elements of rough set theory. The authors evaluated the procedure using two support tools, one based on a tool developed by the US-EPA and the other developed by one of the authors called cogito. Results from the evaluation did provide interesting insights on the utility of both support tools. Although it was shown that the cogito tool obtained slightly higher decision accuracy, both tools could be improved from additional enhancements. Details of the procedure developed and results obtained from the evaluation will be provided. Opportunities for future work are also discussed.

  16. Aneurysmal subarachnoid hemorrhage prognostic decision-making algorithm using classification and regression tree analysis.

    PubMed

    Lo, Benjamin W Y; Fukuda, Hitoshi; Angle, Mark; Teitelbaum, Jeanne; Macdonald, R Loch; Farrokhyar, Forough; Thabane, Lehana; Levine, Mitchell A H

    2016-01-01

    Classification and regression tree analysis involves the creation of a decision tree by recursive partitioning of a dataset into more homogeneous subgroups. Thus far, there is scarce literature on using this technique to create clinical prediction tools for aneurysmal subarachnoid hemorrhage (SAH). The classification and regression tree analysis technique was applied to the multicenter Tirilazad database (3551 patients) in order to create the decision-making algorithm. In order to elucidate prognostic subgroups in aneurysmal SAH, neurologic, systemic, and demographic factors were taken into account. The dependent variable used for analysis was the dichotomized Glasgow Outcome Score at 3 months. Classification and regression tree analysis revealed seven prognostic subgroups. Neurological grade, occurrence of post-admission stroke, occurrence of post-admission fever, and age represented the explanatory nodes of this decision tree. Split sample validation revealed classification accuracy of 79% for the training dataset and 77% for the testing dataset. In addition, the occurrence of fever at 1-week post-aneurysmal SAH is associated with increased odds of post-admission stroke (odds ratio: 1.83, 95% confidence interval: 1.56-2.45, P < 0.01). A clinically useful classification tree was generated, which serves as a prediction tool to guide bedside prognostication and clinical treatment decision making. This prognostic decision-making algorithm also shed light on the complex interactions between a number of risk factors in determining outcome after aneurysmal SAH.

  17. Multi-criteria decision analysis tools for prioritising emerging or re-emerging infectious diseases associated with climate change in Canada.

    PubMed

    Cox, Ruth; Sanchez, Javier; Revie, Crawford W

    2013-01-01

    Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software 'M-MACBETH'. The tools were trialed on nine 'test' pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should be pursued.

  18. Multi-Criteria Decision Analysis Tools for Prioritising Emerging or Re-Emerging Infectious Diseases Associated with Climate Change in Canada

    PubMed Central

    Cox, Ruth; Sanchez, Javier; Revie, Crawford W.

    2013-01-01

    Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software ‘M-MACBETH’. The tools were trialed on nine ‘test’ pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should be pursued. PMID:23950868

  19. Screening and Evaluation Tool (SET) Users Guide

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pincock, Layne

    This document is the users guide to using the Screening and Evaluation Tool (SET). SET is a tool for comparing multiple fuel cycle options against a common set of criteria and metrics. It does this using standard multi-attribute utility decision analysis methods.

  20. Decisions and Reasons: Examining Preservice Teacher Decision-Making through Video Self-Analysis

    ERIC Educational Resources Information Center

    Rich, Peter J.; Hannafin, Michael J.

    2008-01-01

    Methods used to study teacher thinking have both provided insight into the cognitive aspects of teaching and resulted in new, as yet unresolved, relationships between practice and theory. Recent developments in video-analysis tools have allowed preservice teachers to analyze both their practices and thinking, providing important feedback for…

  1. Searching for Tools versus Asking for Answers: A Taxonomy of Counselee Behavioral Styles during Career Counseling.

    ERIC Educational Resources Information Center

    Sagiv, Lilach

    1999-01-01

    A taxonomy of decision behavior styles (independence/dependence, active/passive, insightful/not) tested with 372 career counseling clients was supported by similar structure analysis and confirmatory factor analysis. Counselors were more likely to be satisfied with decisions of clients they perceived to be insightful. (SK)

  2. SMARTe 2008

    EPA Science Inventory

    Sustainable Management Approaches and Revitalization Tools - electronic (SMARTe), is an open-source, web-based, decision support system for developing and evaluating future reuse scenarios for potentially contaminated land. SMARTe contains resources and analysis tools for all asp...

  3. SMARTe 2011

    EPA Science Inventory

    Sustainable Management Approaches and Revitalization Tools - electronic (SMARTe), is an open-source, web-based, decisions support system for developing and evaluating future reuse scenarios for potentially contaminated land. SMARTe contains resources and analysis tools for all a...

  4. SMARTE 2007

    EPA Science Inventory

    Sustainable Management Approaches and Revitalization Tools-electronic (SMARTe), is an open-source, web-based, decision support system for developing and evaluating future reuse scenarios for potentially contaminated land. SMARTe contains guidance and analysis tools for all aspect...

  5. On a learning curve for shared decision making: Interviews with clinicians using the knee osteoarthritis Option Grid.

    PubMed

    Elwyn, Glyn; Rasmussen, Julie; Kinsey, Katharine; Firth, Jill; Marrin, Katy; Edwards, Adrian; Wood, Fiona

    2018-02-01

    Tools used in clinical encounters to illustrate to patients the risks and benefits of treatment options have been shown to increase shared decision making. However, we do not have good information about how these tools are viewed by clinicians and how clinicians think patients would react to their use. Our aim was to examine clinicians' views about the possible and actual use of tools designed to support patients and clinicians to collaborate and deliberate about treatment options, namely, Option Grid decision aids. We conducted a thematic analysis of qualitative interviews embedded in the intervention phase of a trial of an Option Grid decision aid for osteoarthritis of the knee. Interviews were conducted with 6 participating clinicians before they used the tool and again after clinicians had used the tool with 6 patients. In the first interview, clinicians voiced concerns that the tool would lead to an increase in encounter duration, patient resistance regarding involvement in decision making, and potential information overload. At the second interview, after minimal training, the clinicians reported that the tool had changed their usual way of communicating, and it was generally acceptable and helpful to integrate it into practice. After experiencing the use of Option Grids, clinicians became more willing to use the tools in their clinical encounters with patients. How best to introduce Option Grids to clinicians and adopt their use into practice will need careful consideration of context, workflow, and clinical pathways. © 2016 John Wiley & Sons, Ltd.

  6. Market value: an underused financial planning tool.

    PubMed

    Harris, J P; Schimmel, V E

    1987-04-01

    Two issues facing CFOs are capital formation and the long-range financial impact of strategic planning decisions. For not-for-profit organizations, debt capacity is the main determining factor of capital formation while investment analysis is the key to the financial evaluation of strategic planning options. And, the market, or sale, value of the organization can serve as an effective tool to manage current debt capacity and future investment decisions.

  7. Class Evolution Tree: A Graphical Tool to Support Decisions on the Number of Classes in Exploratory Categorical Latent Variable Modeling for Rehabilitation Research

    ERIC Educational Resources Information Center

    Kriston, Levente; Melchior, Hanne; Hergert, Anika; Bergelt, Corinna; Watzke, Birgit; Schulz, Holger; von Wolff, Alessa

    2011-01-01

    The aim of our study was to develop a graphical tool that can be used in addition to standard statistical criteria to support decisions on the number of classes in explorative categorical latent variable modeling for rehabilitation research. Data from two rehabilitation research projects were used. In the first study, a latent profile analysis was…

  8. Use of multicriteria decision analysis to address conservation conflicts.

    PubMed

    Davies, A L; Bryce, R; Redpath, S M

    2013-10-01

    Conservation conflicts are increasing on a global scale and instruments for reconciling competing interests are urgently needed. Multicriteria decision analysis (MCDA) is a structured, decision-support process that can facilitate dialogue between groups with differing interests and incorporate human and environmental dimensions of conflict. MCDA is a structured and transparent method of breaking down complex problems and incorporating multiple objectives. The value of this process for addressing major challenges in conservation conflict management is that MCDA helps in setting realistic goals; entails a transparent decision-making process; and addresses mistrust, differing world views, cross-scale issues, patchy or contested information, and inflexible legislative tools. Overall we believe MCDA provides a valuable decision-support tool, particularly for increasing awareness of the effects of particular values and choices for working toward negotiated compromise, although an awareness of the effect of methodological choices and the limitations of the method is vital before applying it in conflict situations. © 2013 Society for Conservation Biology.

  9. Helping decision makers frame, analyze, and implement decisions

    USGS Publications Warehouse

    Runge, Michael C.; McDonald-Madden, Eve

    2018-01-01

    All decisions have the same recognizable elements. Context, objectives, alternatives, consequences, and deliberation. Decision makers and analysts familiar with these elements can quickly see the underlying structure of a decision.There are only a small number of classes of decisions. These classes differ in the cognitive and scientific challenge they present to the decision maker; the ability to recognize the class of decision leads a decision maker to tools to aid in the analysis.Sometimes we need more information, sometimes we don’t. The role of science in a decision-making process is to provide the predictions that link the alternative actions to the desired outcomes. Investing in more science is only valuable if it helps to choose a better action.Implementation. The successful integration of decision analysis into environmental decisions requires careful attention to the decision, the people, and the institutions involved.

  10. Spatial decision support system to evaluate crop residue energy potential by anaerobic digestion.

    PubMed

    Escalante, Humberto; Castro, Liliana; Gauthier-Maradei, Paola; Rodríguez De La Vega, Reynel

    2016-11-01

    Implementing anaerobic digestion (AD) in energy production from crop residues requires development of decision tools to assess its feasibility and sustainability. A spatial decision support system (SDSS) was constructed to assist decision makers to select appropriate feedstock according to biomethanation potential, identify the most suitable location for biogas facilities, determine optimum plant capacity and supply chain, and evaluate associated risks and costs. SDSS involves a spatially explicit analysis, fuzzy multi-criteria analysis, and statistical and optimization models. The tool was validated on seven crop residues located in Santander, Colombia. For example, fique bagasse generates about 0.21millionm(3)CH4year(-1) (0.329m(3)CH4kg(-1) volatile solids) with a minimum profitable plant of about 2000tonyear(-1) and an internal rate of return of 10.5%. SDSS can be applied to evaluate other biomass resources, availability periods, and co-digestion potential. Copyright © 2016. Published by Elsevier Ltd.

  11. Decision support tool for used oil regeneration technologies assessment and selection.

    PubMed

    Khelifi, Olfa; Dalla Giovanna, Fabio; Vranes, Sanja; Lodolo, Andrea; Miertus, Stanislav

    2006-09-01

    Regeneration is the most efficient way of managing used oil. It saves money by preventing costly cleanups and liabilities that are associated with mismanagement of used oil, it helps to protect the environment and it produces a technically renewable resource by enabling an indefinite recycling potential. There are a variety of processes and licensors currently offering ways to deal with used oils. Selecting a regeneration technology for used oil involves "cross-matching" key criteria. Therefore, the first prototype of spent oil regeneration (SPORE), a decision support tool, has been developed to help decision-makers to assess the available technologies and select the preferred used oil regeneration options. The analysis is based on technical, economical and environmental criteria. These criteria are ranked to determine their relative importance for a particular used oil regeneration project. The multi-criteria decision analysis (MCDA) is the core of the SPORE using the PROMETHEE II algorithm.

  12. A Practical Tutorial on Modified Condition/Decision Coverage

    NASA Technical Reports Server (NTRS)

    Hayhurst, Kelly J.; Veerhusen, Dan S.; Chilenski, John J.; Rierson, Leanna K.

    2001-01-01

    This tutorial provides a practical approach to assessing modified condition/decision coverage (MC/DC) for aviation software products that must comply with regulatory guidance for DO-178B level A software. The tutorial's approach to MC/DC is a 5-step process that allows a certification authority or verification analyst to evaluate MC/DC claims without the aid of a coverage tool. In addition to the MC/DC approach, the tutorial addresses factors to consider in selecting and qualifying a structural coverage analysis tool, tips for reviewing life cycle data related to MC/DC, and pitfalls common to structural coverage analysis.

  13. Assessment of the effects of decision aids about breast cancer screening: a systematic review and meta-analysis.

    PubMed

    Martínez-Alonso, Montserrat; Carles-Lavila, Misericòrdia; Pérez-Lacasta, Maria José; Pons-Rodríguez, Anna; Garcia, Montse; Rué, Montserrat

    2017-10-06

    The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) and observational studies is to assess the effect of decision aids (DAs) in women aged 50 and below facing the decision to be screened for breast cancer. Screening for breast cancer. DAs aimed to help women make a deliberative choice regarding participation in mammography screening by providing information on the options and outcomes. We included published original, non-pilot, studies that assess the effect of DAs for breast cancer screening. We excluded the studies that evaluated only participation intention or actual uptake. The studies' risk of bias was assessed with the Cochrane Collaboration's tool for RCTs and the National Institutes of Health Quality Assessment Tool for non-RCTs. The main outcome measures were informed choice, decisional conflict and/or confidence, and knowledge. Secondary outcomes were values, attitudes, uncertainty and intention to be screened. A total of 607 studies were identified, but only 3 RCTs and 1 before-after study were selected. The use of DAs increased the proportion of women making an informed decision by 14%, 95% CI (2% to 27%) and the proportion of women with adequate knowledge by 12%, 95% CI (7% to 16%). We observed heterogeneity among the studies in confidence in the decision. The meta-analysis of the RCTs showed a significant decrease in confidence in the decision and in intention to be screened. Tools to aid decision making in screening for breast cancer improve knowledge and promote informed decision; however, we found divergent results on decisional conflict and confidence in the decision. Under the current paradigm change, which favours informed choice rather than maximising uptake, more research is necessary for the improvement of DAs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  14. Use of Cost-Utility Decision Models in Business Education.

    ERIC Educational Resources Information Center

    Lewis, Darrell R.

    1989-01-01

    Explains how cost-utility analysis can be applied to the selection of curriculum and instructional methods. Describes the use of multiattribute utility models of decision making as a tool for more informed judgment in educational administration. (SK)

  15. Decision-Making, Information Communication Technology, and Data Analysis by School Leaders about Student Achievement

    ERIC Educational Resources Information Center

    Akoma, Ahunna Margaux

    2012-01-01

    This case study of one school district examined how school leaders use student performance data and technology-based data analysis tools to engage in data-informed decision-making for continuous improvement. School leaders in this context included leaders at the district, school, and classroom levels. An extensive literature review provided the…

  16. LANL Institutional Decision Support By Process Modeling and Analysis Group (AET-2)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Booth, Steven Richard

    2016-04-04

    AET-2 has expertise in process modeling, economics, business case analysis, risk assessment, Lean/Six Sigma tools, and decision analysis to provide timely decision support to LANS leading to continuous improvement. This capability is critical during the current tight budgetary environment as LANS pushes to identify potential areas of cost savings and efficiencies. An important arena is business systems and operations, where processes can impact most or all laboratory employees. Lab-wide efforts are needed to identify and eliminate inefficiencies to accomplish Director McMillan’s charge of “doing more with less.” LANS faces many critical and potentially expensive choices that require sound decision supportmore » to ensure success. AET-2 is available to provide this analysis support to expedite the decisions at hand.« less

  17. Needs and challenges for assessing the environmental impacts of engineered nanomaterials (ENMs)

    PubMed Central

    Romero-Franco, Michelle; Godwin, Hilary A; Bilal, Muhammad

    2017-01-01

    The potential environmental impact of nanomaterials is a critical concern and the ability to assess these potential impacts is top priority for the progress of sustainable nanotechnology. Risk assessment tools are needed to enable decision makers to rapidly assess the potential risks that may be imposed by engineered nanomaterials (ENMs), particularly when confronted by the reality of limited hazard or exposure data. In this review, we examine a range of available risk assessment frameworks considering the contexts in which different stakeholders may need to assess the potential environmental impacts of ENMs. Assessment frameworks and tools that are suitable for the different decision analysis scenarios are then identified. In addition, we identify the gaps that currently exist between the needs of decision makers, for a range of decision scenarios, and the abilities of present frameworks and tools to meet those needs. PMID:28546894

  18. The Development of a Humanitarian Health Ethics Analysis Tool.

    PubMed

    Fraser, Veronique; Hunt, Matthew R; de Laat, Sonya; Schwartz, Lisa

    2015-08-01

    Introduction Health care workers (HCWs) who participate in humanitarian aid work experience a range of ethical challenges in providing care and assistance to communities affected by war, disaster, or extreme poverty. Although there is increasing discussion of ethics in humanitarian health care practice and policy, there are very few resources available for humanitarian workers seeking ethical guidance in the field. To address this knowledge gap, a Humanitarian Health Ethics Analysis Tool (HHEAT) was developed and tested as an action-oriented resource to support humanitarian workers in ethical decision making. While ethical analysis tools increasingly have become prevalent in a variety of practice contexts over the past two decades, very few of these tools have undergone a process of empirical validation to assess their usefulness for practitioners. A qualitative study consisting of a series of six case-analysis sessions with 16 humanitarian HCWs was conducted to evaluate and refine the HHEAT. Participant feedback inspired the creation of a simplified and shortened version of the tool and prompted the development of an accompanying handbook. The study generated preliminary insight into the ethical deliberation processes of humanitarian health workers and highlighted different types of ethics support that humanitarian workers might find helpful in supporting the decision-making process.

  19. Developing an Interactive Data Visualization Tool to Assess the Impact of Decision Support on Clinical Operations.

    PubMed

    Huber, Timothy C; Krishnaraj, Arun; Monaghan, Dayna; Gaskin, Cree M

    2018-05-18

    Due to mandates from recent legislation, clinical decision support (CDS) software is being adopted by radiology practices across the country. This software provides imaging study decision support for referring providers at the point of order entry. CDS systems produce a large volume of data, providing opportunities for research and quality improvement. In order to better visualize and analyze trends in this data, an interactive data visualization dashboard was created using a commercially available data visualization platform. Following the integration of a commercially available clinical decision support product into the electronic health record, a dashboard was created using a commercially available data visualization platform (Tableau, Seattle, WA). Data generated by the CDS were exported from the data warehouse, where they were stored, into the platform. This allowed for real-time visualization of the data generated by the decision support software. The creation of the dashboard allowed the output from the CDS platform to be more easily analyzed and facilitated hypothesis generation. Integrating data visualization tools into clinical decision support tools allows for easier data analysis and can streamline research and quality improvement efforts.

  20. Multi-criteria decision analysis in environmental sciences: ten years of applications and trends.

    PubMed

    Huang, Ivy B; Keisler, Jeffrey; Linkov, Igor

    2011-09-01

    Decision-making in environmental projects requires consideration of trade-offs between socio-political, environmental, and economic impacts and is often complicated by various stakeholder views. Multi-criteria decision analysis (MCDA) emerged as a formal methodology to face available technical information and stakeholder values to support decisions in many fields and can be especially valuable in environmental decision making. This study reviews environmental applications of MCDA. Over 300 papers published between 2000 and 2009 reporting MCDA applications in the environmental field were identified through a series of queries in the Web of Science database. The papers were classified by their environmental application area, decision or intervention type. In addition, the papers were also classified by the MCDA methods used in the analysis (analytic hierarchy process, multi-attribute utility theory, and outranking). The results suggest that there is a significant growth in environmental applications of MCDA over the last decade across all environmental application areas. Multiple MCDA tools have been successfully used for environmental applications. Even though the use of the specific methods and tools varies in different application areas and geographic regions, our review of a few papers where several methods were used in parallel with the same problem indicates that recommended course of action does not vary significantly with the method applied. Published by Elsevier B.V.

  1. Perceptions of disease risk: from social construction of subjective judgments to rational decision making.

    PubMed

    McRoberts, N; Hall, C; Madden, L V; Hughes, G

    2011-06-01

    Many factors influence how people form risk perceptions. Farmers' perceptions of risk and levels of risk aversion impact on decision-making about such things as technology adoption and disease management practices. Irrespective of the underlying factors that affect risk perceptions, those perceptions can be summarized by variables capturing impact and uncertainty components of risk. We discuss a new framework that has the subjective probability of disease and the cost of decision errors as its central features, which might allow a better integration of social science and epidemiology, to the benefit of plant disease management. By focusing on the probability and cost (or impact) dimensions of risk, the framework integrates research from the social sciences, economics, decision theory, and epidemiology. In particular, we review some useful properties of expected regret and skill value, two measures of expected cost that are particularly useful in the evaluation of decision tools. We highlight decision-theoretic constraints on the usefulness of decision tools that may partly explain cases of failure of adoption. We extend this analysis by considering information-theoretic criteria that link model complexity and relative performance and which might explain why users reject forecasters that impose even moderate increases in the complexity of decision making despite improvements in performance or accept very simple decision tools that have relatively poor performance.

  2. A Comparative Analysis of Life-Cycle Assessment Tools for End-of-Life Materials Management Systems

    EPA Science Inventory

    We identified and evaluated five life-cycle assessment tools that community decision makers can use to assess the environmental and economic impacts of end-of-life (EOL) materials management options. The tools evaluated in this report are waste reduction mode (WARM), municipal s...

  3. Automated Modular Magnetic Resonance Imaging Clinical Decision Support System (MIROR): An Application in Pediatric Cancer Diagnosis.

    PubMed

    Zarinabad, Niloufar; Meeus, Emma M; Manias, Karen; Foster, Katharine; Peet, Andrew

    2018-05-02

    Advances in magnetic resonance imaging and the introduction of clinical decision support systems has underlined the need for an analysis tool to extract and analyze relevant information from magnetic resonance imaging data to aid decision making, prevent errors, and enhance health care. The aim of this study was to design and develop a modular medical image region of interest analysis tool and repository (MIROR) for automatic processing, classification, evaluation, and representation of advanced magnetic resonance imaging data. The clinical decision support system was developed and evaluated for diffusion-weighted imaging of body tumors in children (cohort of 48 children, with 37 malignant and 11 benign tumors). Mevislab software and Python have been used for the development of MIROR. Regions of interests were drawn around benign and malignant body tumors on different diffusion parametric maps, and extracted information was used to discriminate the malignant tumors from benign tumors. Using MIROR, the various histogram parameters derived for each tumor case when compared with the information in the repository provided additional information for tumor characterization and facilitated the discrimination between benign and malignant tumors. Clinical decision support system cross-validation showed high sensitivity and specificity in discriminating between these tumor groups using histogram parameters. MIROR, as a diagnostic tool and repository, allowed the interpretation and analysis of magnetic resonance imaging images to be more accessible and comprehensive for clinicians. It aims to increase clinicians' skillset by introducing newer techniques and up-to-date findings to their repertoire and make information from previous cases available to aid decision making. The modular-based format of the tool allows integration of analyses that are not readily available clinically and streamlines the future developments. ©Niloufar Zarinabad, Emma M Meeus, Karen Manias, Katharine Foster, Andrew Peet. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 02.05.2018.

  4. Identifying evaluation considerations for the recovery and restoration from the 2010 Gulf of Mexico oil spill: An initial appraisal of stakeholder concerns and values

    EPA Science Inventory

    Understanding what can be achieved and what should be avoided by environmental management decisions requires an understanding of values or what is cared about in a decision. Decision analysis provides tools and processes for constructing objectives that transparently reflect the ...

  5. Environmental Tools and Radiological Assessment

    EPA Science Inventory

    This presentation details two tools (SADA and FRAMES) available for use in environmental assessments of chemicals that can also be used for radiological assessments of the environment. Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporate...

  6. Ranking of Business Process Simulation Software Tools with DEX/QQ Hierarchical Decision Model.

    PubMed

    Damij, Nadja; Boškoski, Pavle; Bohanec, Marko; Mileva Boshkoska, Biljana

    2016-01-01

    The omnipresent need for optimisation requires constant improvements of companies' business processes (BPs). Minimising the risk of inappropriate BP being implemented is usually performed by simulating the newly developed BP under various initial conditions and "what-if" scenarios. An effectual business process simulations software (BPSS) is a prerequisite for accurate analysis of an BP. Characterisation of an BPSS tool is a challenging task due to the complex selection criteria that includes quality of visual aspects, simulation capabilities, statistical facilities, quality reporting etc. Under such circumstances, making an optimal decision is challenging. Therefore, various decision support models are employed aiding the BPSS tool selection. The currently established decision support models are either proprietary or comprise only a limited subset of criteria, which affects their accuracy. Addressing this issue, this paper proposes a new hierarchical decision support model for ranking of BPSS based on their technical characteristics by employing DEX and qualitative to quantitative (QQ) methodology. Consequently, the decision expert feeds the required information in a systematic and user friendly manner. There are three significant contributions of the proposed approach. Firstly, the proposed hierarchical model is easily extendible for adding new criteria in the hierarchical structure. Secondly, a fully operational decision support system (DSS) tool that implements the proposed hierarchical model is presented. Finally, the effectiveness of the proposed hierarchical model is assessed by comparing the resulting rankings of BPSS with respect to currently available results.

  7. A Web-Based Decision Tool to Improve Contraceptive Counseling for Women With Chronic Medical Conditions: Protocol For a Mixed Methods Implementation Study

    PubMed Central

    Damschroder, Laura J; Fetters, Michael D; Zikmund-Fisher, Brian J; Crabtree, Benjamin F; Hudson, Shawna V; Ruffin IV, Mack T; Fucinari, Juliana; Kang, Minji; Taichman, L Susan; Creswell, John W

    2018-01-01

    Background Women with chronic medical conditions, such as diabetes and hypertension, have a higher risk of pregnancy-related complications compared with women without medical conditions and should be offered contraception if desired. Although evidence based guidelines for contraceptive selection in the presence of medical conditions are available via the United States Medical Eligibility Criteria (US MEC), these guidelines are underutilized. Research also supports the use of decision tools to promote shared decision making between patients and providers during contraceptive counseling. Objective The overall goal of the MiHealth, MiChoice project is to design and implement a theory-driven, Web-based tool that incorporates the US MEC (provider-level intervention) within the vehicle of a contraceptive decision tool for women with chronic medical conditions (patient-level intervention) in community-based primary care settings (practice-level intervention). This will be a 3-phase study that includes a predesign phase, a design phase, and a testing phase in a randomized controlled trial. This study protocol describes phase 1 and aim 1, which is to determine patient-, provider-, and practice-level factors that are relevant to the design and implementation of the contraceptive decision tool. Methods This is a mixed methods implementation study. To customize the delivery of the US MEC in the decision tool, we selected high-priority constructs from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework to drive data collection and analysis at the practice and provider level, respectively. A conceptual model that incorporates constructs from the transtheoretical model and the health beliefs model undergirds patient-level data collection and analysis and will inform customization of the decision tool for this population. We will recruit 6 community-based primary care practices and conduct quantitative surveys and semistructured qualitative interviews with women who have chronic medical conditions, their primary care providers (PCPs), and clinic staff, as well as field observations of practice activities. Quantitative survey data will be summarized with simple descriptive statistics and relationships between participant characteristics and contraceptive recommendations (for PCPs), and current contraceptive use (for patients) will be examined using Fisher exact test. We will conduct thematic analysis of qualitative data from interviews and field observations. The integration of data will occur by comparing, contrasting, and synthesizing qualitative and quantitative findings to inform the future development and implementation of the intervention. Results We are currently enrolling practices and anticipate study completion in 15 months. Conclusions This protocol describes the first phase of a multiphase mixed methods study to develop and implement a Web-based decision tool that is customized to meet the needs of women with chronic medical conditions in primary care settings. Study findings will promote contraceptive counseling via shared decision making and reflect evidence-based guidelines for contraceptive selection. Trial Registration ClinicalTrials.gov NCT03153644; https://clinicaltrials.gov/ct2/show/NCT03153644 (Archived by WebCite at http://www.webcitation.org/6yUkA5lK8) PMID:29669707

  8. Desktop microsimulation: a tool to improve efficiency in the medical office practice.

    PubMed

    Montgomery, James B; Linville, Beth A; Slonim, Anthony D

    2013-01-01

    Because the economic crisis in the United States continues to have an impact on healthcare organizations, industry leaders must optimize their decision making. Discrete-event computer simulation is a quality tool with a demonstrated track record of improving the precision of analysis for process redesign. However, the use of simulation to consolidate practices and design efficiencies into an unfinished medical office building was a unique task. A discrete-event computer simulation package was used to model the operations and forecast future results for four orthopedic surgery practices. The scenarios were created to allow an evaluation of the impact of process change on the output variables of exam room utilization, patient queue size, and staff utilization. The model helped with decisions regarding space allocation and efficient exam room use by demonstrating the impact of process changes in patient queues at check-in/out, x-ray, and cast room locations when compared to the status quo model. The analysis impacted decisions on facility layout, patient flow, and staff functions in this newly consolidated practice. Simulation was found to be a useful tool for process redesign and decision making even prior to building occupancy. © 2011 National Association for Healthcare Quality.

  9. A streamlined sustainability assessment tool for improved decision making in the urban water industry.

    PubMed

    Schulz, Matthias; Short, Michael D; Peters, Gregory M

    2012-01-01

    Water supply is a key consideration in sustainable urban planning. Ideally, detailed quantitative sustainability assessments are undertaken during the planning stage to inform the decision-making process. In reality, however, the significant time and cost associated with undertaking such detailed environmental and economic assessments is often cited as a barrier to wider implementation of these key decision support tools, particularly for decisions made at the local or regional government level. In an attempt to overcome this barrier of complexity, 4 water service providers in Melbourne, Australia, funded the development of a publicly available streamlined Environmental Sustainability Assessment Tool, which is aimed at a wide range of decision makers to assist them in broadening the type and number of water servicing options that can be considered for greenfield or backlog developments. The Environmental Sustainability Assessment Tool consists of a simple user interface and draws on life cycle inventory data to allow for rapid estimation of the environmental and economic performance of different water servicing scenarios. Scenario options can then be further prioritized by means of an interactive multicriteria analysis. The intent of this article is to identify the key issues to be considered in a streamlined sustainability assessment tool for the urban water industry, and to demonstrate the feasibility of generating accurate life cycle assessments and life cycle costings, using such a tool. We use a real-life case study example consisting of 3 separate scenarios for a planned urban development to show that this kind of tool can emulate life cycle assessments and life cycle costings outcomes obtained through more detailed studies. This simplified approach is aimed at supporting "sustainability thinking" early in the decision-making process, thereby encouraging more sustainable water and sewerage infrastructure solutions. Copyright © 2011 SETAC.

  10. Patient, surgeon, and healthcare purchaser views on the use of decision and communication aids in orthopaedic surgery: a mixed methods study.

    PubMed

    Bozic, Kevin J; Chenok, Kate Eresian; Schindel, Jennifer; Chan, Vanessa; Huddleston, James I; Braddock, Clarence; Belkora, Jeffrey

    2014-08-31

    Despite evidence that decision and communication aids are effective for enhancing the quality of preference-sensitive decisions, their adoption in the field of orthopaedic surgery has been limited. The purpose of this mixed-methods study was to evaluate the perceived value of decision and communication aids among different healthcare stakeholders. Patients with hip or knee arthritis, orthopaedic surgeons who perform hip and knee replacement procedures, and a group of large, self-insured employers (healthcare purchasers) were surveyed regarding their views on the value of decision and communication aids in orthopaedics. Patients with hip or knee arthritis who participated in a randomized controlled trial involving decision and communication aids were asked to complete an online survey about what was most and least beneficial about each of the tools they used, the ideal mode of administration of these tools and services, and their interest in receiving comparable materials and services in the future. A subset of these patients were invited to participate in a telephone interview, where there were asked to rank and attribute a monetary value to the interventions. These interviews were analyzed using a qualitative and mixed methods analysis software. Members of the American Hip and Knee Surgeons (AAHKS) were surveyed on their perceptions and usage of decision and communication aids in orthopaedic practice. Healthcare purchasers were interviewed about their perspectives on patient-oriented decision support. All stakeholders saw value in decision and communication aids, with the major barrier to implementation being cost. Both patients and surgeons would be willing to bear at least part of the cost of implementing these tools, while employers felt health plans should be responsible for shouldering the costs. Decision and communication aids can be effective tools for incorporating patients preferences and values into preference-sensitive decisions in orthopaedics. Future efforts should be aimed at assessing strategies for efficient implementation of these tools into widespread orthopaedic practice.

  11. Next generation data systems and knowledge products to support agricultural producers and science-based policy decision making.

    PubMed

    Capalbo, Susan M; Antle, John M; Seavert, Clark

    2017-07-01

    Research on next generation agricultural systems models shows that the most important current limitation is data, both for on-farm decision support and for research investment and policy decision making. One of the greatest data challenges is to obtain reliable data on farm management decision making, both for current conditions and under scenarios of changed bio-physical and socio-economic conditions. This paper presents a framework for the use of farm-level and landscape-scale models and data to provide analysis that could be used in NextGen knowledge products, such as mobile applications or personal computer data analysis and visualization software. We describe two analytical tools - AgBiz Logic and TOA-MD - that demonstrate the current capability of farmlevel and landscape-scale models. The use of these tools is explored with a case study of an oilseed crop, Camelina sativa , which could be used to produce jet aviation fuel. We conclude with a discussion of innovations needed to facilitate the use of farm and policy-level models to generate data and analysis for improved knowledge products.

  12. Development of the Expert System Domain Advisor and Analysis Tool

    DTIC Science & Technology

    1991-09-01

    analysis. Typical of the current methods in use at this time is the " tarot metric". This method defines a decision rule whose output is whether to go...B - TAROT METRIC B. ::TTRODUCTION The system chart of ESEM, Figure 1, shows the following three risk-based decision points: i. At prolect initiation...34 decisions. B-I 201 PRELIMINARY T" B-I. Evaluais Factan for ES Deyelopsineg FACTORS POSSIBLE VALUE RATINGS TAROT metric (overall suitability) Poor, Fair

  13. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations.

    PubMed

    Dotson, G Scott; Hudson, Naomi L; Maier, Andrew

    2015-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management.

  14. A decision support framework for characterizing and managing dermal exposures to chemicals during Emergency Management and Operations

    PubMed Central

    Dotson, G. Scott; Hudson, Naomi L.; Maier, Andrew

    2016-01-01

    Emergency Management and Operations (EMO) personnel are in need of resources and tools to assist in understanding the health risks associated with dermal exposures during chemical incidents. This article reviews available resources and presents a conceptual framework for a decision support system (DSS) that assists in characterizing and managing risk during chemical emergencies involving dermal exposures. The framework merges principles of three decision-making techniques: 1) scenario planning, 2) risk analysis, and 3) multicriteria decision analysis (MCDA). This DSS facilitates dynamic decision making during each of the distinct life cycle phases of an emergency incident (ie, preparedness, response, or recovery) and identifies EMO needs. A checklist tool provides key questions intended to guide users through the complexities of conducting a dermal risk assessment. The questions define the scope of the framework for resource identification and application to support decision-making needs. The framework consists of three primary modules: 1) resource compilation, 2) prioritization, and 3) decision. The modules systematically identify, organize, and rank relevant information resources relating to the hazards of dermal exposures to chemicals and risk management strategies. Each module is subdivided into critical elements designed to further delineate the resources based on relevant incident phase and type of information. The DSS framework provides a much needed structure based on contemporary decision analysis principles for 1) documenting key questions for EMO problem formulation and 2) a method for systematically organizing, screening, and prioritizing information resources on dermal hazards, exposures, risk characterization, and management. PMID:26312660

  15. Advanced Productivity Analysis Methods for Air Traffic Control Operations

    DTIC Science & Technology

    1976-12-01

    Routine Work ............................... 37 4.2.2. Surveillance Work .......................... 40 4.2.3. Conflict Prcessing Work ................... 41...crossing and overtake conflicts) includes potential- conflict recognition, assessment, and resolution decision making and A/N voice communications...makers to utilize £ .quantitative and dynamic analysis as a tool for decision - making. 1.1.3 Types of Simulation Models Although there are many ways to

  16. The Rank Hypothesis and Lexical Decision: A Reply to Adelman and Brown (2008)

    ERIC Educational Resources Information Center

    Murray, Wayne S.; Forster, Kenneth I.

    2008-01-01

    J. S. Adelman and G. D. A. Brown (2008) provided an extensive analysis of the form of word frequency and contextual diversity effects on lexical decision time. In this reply, the current authors suggest that their analysis provides a valuable tool for the evaluation of models of lexical access and that the results they report are broadly…

  17. Recent advances in applying decision science to managing national forests

    USGS Publications Warehouse

    Marcot, Bruce G.; Thompson, Matthew P.; Runge, Michael C.; Thompson, Frank R.; McNulty, Steven; Cleaves, David; Tomosy, Monica; Fisher, Larry A.; Andrew, Bliss

    2012-01-01

    Management of federal public forests to meet sustainability goals and multiple use regulations is an immense challenge. To succeed, we suggest use of formal decision science procedures and tools in the context of structured decision making (SDM). SDM entails four stages: problem structuring (framing the problem and defining objectives and evaluation criteria), problem analysis (defining alternatives, evaluating likely consequences, identifying key uncertainties, and analyzing tradeoffs), decision point (identifying the preferred alternative), and implementation and monitoring the preferred alternative with adaptive management feedbacks. We list a wide array of models, techniques, and tools available for each stage, and provide three case studies of their selected use in National Forest land management and project plans. Successful use of SDM involves participation by decision-makers, analysts, scientists, and stakeholders. We suggest specific areas for training and instituting SDM to foster transparency, rigor, clarity, and inclusiveness in formal decision processes regarding management of national forests.

  18. Utilization of multiple-criteria decision analysis (MCDA) to support healthcare decision-making FIFARMA, 2016

    PubMed Central

    Drake, Julia I.; de Hart, Juan Carlos Trujillo; Monleón, Clara; Toro, Walter; Valentim, Joice

    2017-01-01

    ABSTRACT Background and objectives:   MCDA is a decision-making tool with increasing use in the healthcare sector, including HTA (Health Technology Assessment). By applying multiple criteria, including innovation, in a comprehensive, structured and explicit manner, MCDA fosters a transparent, participative, consistent decision-making process taking into consideration values of all stakeholders. This paper by FIFARMA (Latin American Federation of Pharmaceutical Industry) proposes the deliberative (partial) MCDA as a more pragmatic, agile approach, especially when newly implemented. Methods: Literature review including real-world examples of effective MCDA implementation in healthcare decision making in both the public and private sector worldwide and in LA. Results and conclusion: It is the view of FIFARMA that MCDA should strongly be considered as a tool to support HTA and broader healthcare decision making such as the contracts and tenders process in order to foster transparency, fairness, and collaboration amongst stakeholders. PMID:29081919

  19. Use of PRA in Shuttle Decision Making Process

    NASA Technical Reports Server (NTRS)

    Boyer, Roger L.; Hamlin, Teri L.

    2010-01-01

    How do you use PRA to support an operating program? This presentation will explore how the Shuttle Program Management has used the Shuttle PRA in its decision making process. It will reveal how the PRA has evolved from a tool used to evaluate Shuttle upgrades like Electric Auxiliary Power Unit (EAPU) to a tool that supports Flight Readiness Reviews (FRR) and real-time flight decisions. Specific examples of Shuttle Program decisions that have used the Shuttle PRA as input will be provided including how it was used in the Hubble Space Telescope (HST) manifest decision. It will discuss the importance of providing management with a clear presentation of the analysis, applicable assumptions and limitations, along with estimates of the uncertainty. This presentation will show how the use of PRA by the Shuttle Program has evolved overtime and how it has been used in the decision making process providing specific examples.

  20. SMARTE: HELPING COMMUNITIES OVERCOME OBSTACLES TO REVITALIZATION (04/23/07)

    EPA Science Inventory

    Sustainable Management Approaches and Revitalization Tools - electronic (SMARTe), is an open-source, web-based, decision support system for developing and evaluating future reuse scenarios for potentially contaminated land. SMARTe contains information and analysis tools for all a...

  1. Development of a decision support system for analysis and solutions of prolonged standing in the workplace.

    PubMed

    Halim, Isa; Arep, Hambali; Kamat, Seri Rahayu; Abdullah, Rohana; Omar, Abdul Rahman; Ismail, Ahmad Rasdan

    2014-06-01

    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. The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. 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. 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.

  2. 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

  3. Warfighter Integrated Physical Ergonomics Tool Development: Needs Analysis and State of the Art Review

    DTIC Science & Technology

    2011-03-01

    Humansystems® Warfighter Integrated Physical Ergonomics Tool Development Page 14 e) Forces: Griffon seat design assessments include questions of vibration...the suitability of alternative designs . Humansystems® Warfighter Integrated Physical Ergonomics Tool Development Page 5 e) Performance Measures...configurations to assess Humansystems® Warfighter Integrated Physical Ergonomics Tool Development Page 8 design and acquisition decisions, and more

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

    PubMed

    Lenz, Matthias; Kasper, Jürgen; Mühlhauser, Ingrid

    2009-10-19

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

  5. Impact of Educational and Patient Decision Aids on Decisional Conflict Associated with Total Knee Arthroplasty

    PubMed Central

    de Achaval, Sofia; Fraenkel, Liana; Volk, Robert J.; Cox, Vanessa; Suarez-Almazor, Maria E.

    2012-01-01

    Our objective was to examine the impact of a videobooklet patient decision aid supplemented by an interactive values clarification exercise on decisional conflict in patients with knee osteoarthritis (OA) considering total knee arthroplasy. 208 patients participated in the study (mean age 63 years; 68% female; 66% White). Participants were randomized to 1 of 3 groups: (1) Educational booklet on OA management (control); (2) Patient decision aid (videobooklet) on OA management; and (3) Patient decision aid (videobooklet) + adaptive conjoint analysis ACA tool. The ACA tool enables patients to consider competing attributes (i.e. specific risks/benefits) by asking them to rate a series of paired-comparisons. The primary outcome was the decisional conflict scale ranging from 0 to 100. Differences between groups were analyzed using analysis of variance (ANOVA) and Tukey's honestly significant difference tests. Overall, decisional conflict decreased significantly in all groups (p<0.05). The largest reduction in decisional conflict was observed for participants in the videobooklet decision aid group (21 points). Statistically significant differences in pre vs. post-intervention total scores favored the videobooklet group compared to the control group (21 vs. 10) and to the videobooklet plus ACA group (21 vs. 14; p<0.001). Changes in the decisional conflict score for the control compared to the videobooklet decision aid + ACA group were not significantly different. In our study, an audiovisual patient decision aid decreased decisional conflict more than printed material alone, or than the addition of a more complex computer-based ACA tool requiring more intense cognitive involvement and explicit value choices. PMID:21954198

  6. Traffic analysis toolbox volume XI : weather and traffic analysis, modeling and simulation.

    DOT National Transportation Integrated Search

    2010-12-01

    This document presents a weather module for the traffic analysis tools program. It provides traffic engineers, transportation modelers and decisions makers with a guide that can incorporate weather impacts into transportation system analysis and mode...

  7. Demonstration of a modelling-based multi-criteria decision analysis procedure for prioritisation of occupational risks from manufactured nanomaterials.

    PubMed

    Hristozov, Danail; Zabeo, Alex; Alstrup Jensen, Keld; Gottardo, Stefania; Isigonis, Panagiotis; Maccalman, Laura; Critto, Andrea; Marcomini, Antonio

    2016-11-01

    Several tools to facilitate the risk assessment and management of manufactured nanomaterials (MN) have been developed. Most of them require input data on physicochemical properties, toxicity and scenario-specific exposure information. However, such data are yet not readily available, and tools that can handle data gaps in a structured way to ensure transparent risk analysis for industrial and regulatory decision making are needed. This paper proposes such a quantitative risk prioritisation tool, based on a multi-criteria decision analysis algorithm, which combines advanced exposure and dose-response modelling to calculate margins of exposure (MoE) for a number of MN in order to rank their occupational risks. We demonstrated the tool in a number of workplace exposure scenarios (ES) involving the production and handling of nanoscale titanium dioxide, zinc oxide (ZnO), silver and multi-walled carbon nanotubes. The results of this application demonstrated that bag/bin filling, manual un/loading and dumping of large amounts of dry powders led to high emissions, which resulted in high risk associated with these ES. The ZnO MN revealed considerable hazard potential in vivo, which significantly influenced the risk prioritisation results. In order to study how variations in the input data affect our results, we performed probabilistic Monte Carlo sensitivity/uncertainty analysis, which demonstrated that the performance of the proposed model is stable against changes in the exposure and hazard input variables.

  8. Spatially explicit multi-criteria decision analysis for managing vector-borne diseases

    PubMed Central

    2011-01-01

    The complex epidemiology of vector-borne diseases creates significant challenges in the design and delivery of prevention and control strategies, especially in light of rapid social and environmental changes. Spatial models for predicting disease risk based on environmental factors such as climate and landscape have been developed for a number of important vector-borne diseases. The resulting risk maps have proven value for highlighting areas for targeting public health programs. However, these methods generally only offer technical information on the spatial distribution of disease risk itself, which may be incomplete for making decisions in a complex situation. In prioritizing surveillance and intervention strategies, decision-makers often also need to consider spatially explicit information on other important dimensions, such as the regional specificity of public acceptance, population vulnerability, resource availability, intervention effectiveness, and land use. There is a need for a unified strategy for supporting public health decision making that integrates available data for assessing spatially explicit disease risk, with other criteria, to implement effective prevention and control strategies. Multi-criteria decision analysis (MCDA) is a decision support tool that allows for the consideration of diverse quantitative and qualitative criteria using both data-driven and qualitative indicators for evaluating alternative strategies with transparency and stakeholder participation. Here we propose a MCDA-based approach to the development of geospatial models and spatially explicit decision support tools for the management of vector-borne diseases. We describe the conceptual framework that MCDA offers as well as technical considerations, approaches to implementation and expected outcomes. We conclude that MCDA is a powerful tool that offers tremendous potential for use in public health decision-making in general and vector-borne disease management in particular. PMID:22206355

  9. Rapid Accurate Identification of Tuberculous Meningitis Among South African Children Using a Novel Clinical Decision Tool.

    PubMed

    Goenka, Anu; Jeena, Prakash M; Mlisana, Koleka; Solomon, Tom; Spicer, Kevin; Stephenson, Rebecca; Verma, Arpana; Dhada, Barnesh; Griffiths, Michael J

    2018-03-01

    Early diagnosis of tuberculous meningitis (TBM) is crucial to achieve optimum outcomes. There is no effective rapid diagnostic test for use in children. We aimed to develop a clinical decision tool to facilitate the early diagnosis of childhood TBM. Retrospective case-control study was performed across 7 hospitals in KwaZulu-Natal, South Africa (2010-2014). We identified the variables most predictive of microbiologically confirmed TBM in children (3 months to 15 years) by univariate analysis. These variables were modelled into a clinical decision tool and performance tested on an independent sample group. Of 865 children with suspected TBM, 3% (25) were identified with microbiologically confirmed TBM. Clinical information was retrieved for 22 microbiologically confirmed cases of TBM and compared with 66 controls matched for age, ethnicity, sex and geographical origin. The 9 most predictive variables among the confirmed cases were used to develop a clinical decision tool (CHILD TB LP): altered Consciousness; caregiver HIV infected; Illness length >7 days; Lethargy; focal neurologic Deficit; failure to Thrive; Blood/serum sodium <132 mmol/L; CSF >10 Lymphocytes ×10/L; CSF Protein >0.65 g/L. This tool successfully classified an independent sample of 7 cases and 21 controls with a sensitivity of 100% and specificity of 90%. The CHILD TB LP decision tool accurately classified microbiologically confirmed TBM. We propose that CHILD TB LP is prospectively evaluated as a novel rapid diagnostic tool for use in the initial evaluation of children with suspected neurologic infection presenting to hospitals in similar settings.

  10. Naturalistic Decision Making for Power System Operators

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Greitzer, Frank L.; Podmore, Robin; Robinson, Marck

    2010-02-01

    Motivation – Investigations of large-scale outages in the North American interconnected electric system often attribute the causes to three T’s: Trees, Training and Tools. To document and understand the mental processes used by expert operators when making critical decisions, a naturalistic decision making (NDM) model was developed. Transcripts of conversations were analyzed to reveal and assess NDM-based performance criteria. Findings/Design – An item analysis indicated that the operators’ Situation Awareness Levels, mental models, and mental simulations can be mapped at different points in the training scenario. This may identify improved training methods or analytical/ visualization tools. Originality/Value – This studymore » applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message – The NDM approach provides a viable framework for systematic training management to accelerate learning in simulator-based training scenarios for power system operators and teams.« less

  11. Effectiveness of a Case-Based Computer Program on Students' Ethical Decision Making.

    PubMed

    Park, Eun-Jun; Park, Mihyun

    2015-11-01

    The aim of this study was to test the effectiveness of a case-based computer program, using an integrative ethical decision-making model, on the ethical decision-making competency of nursing students in South Korea. This study used a pre- and posttest comparison design. Students in the intervention group used a computer program for case analysis assignments, whereas students in the standard group used a traditional paper assignment for case analysis. The findings showed that using the case-based computer program as a complementary tool for the ethics courses offered at the university enhanced students' ethical preparedness and satisfaction with the course. On the basis of the findings, it is recommended that nurse educators use a case-based computer program as a complementary self-study tool in ethics courses to supplement student learning without an increase in course hours, particularly in terms of analyzing ethics cases with dilemma scenarios and exercising ethical decision making. Copyright 2015, SLACK Incorporated.

  12. Systems analysis - a new paradigm and decision support tools for the water framework directive

    NASA Astrophysics Data System (ADS)

    Bruen, M.

    2007-06-01

    In the early days of Systems Analysis the focus was on providing tools for optimisation, modelling and simulation for use by experts. Now there is a recognition of the need to develop and disseminate tools to assist in making decisions, negotiating compromises and communicating preferences that can easily be used by stakeholders without the need for specialist training. The Water Framework Directive (WFD) requires public participation and thus provides a strong incentive for progress in this direction. This paper places the new paradigm in the context of the classical one and discusses some of the new approaches which can be used in the implementation of the WFD. These include multi-criteria decision support methods suitable for environmental problems, adaptive management, cognitive mapping, social learning and cooperative design and group decision-making. Concordance methods (such as ELECTRE) and the Analytical Hierarchy Process (AHP) are identified as multi-criteria methods that can be readily integrated into Decision Support Systems (DSS) that deal with complex environmental issues with very many criteria, some of which are qualitative. The expanding use of the new paradigm provides an opportunity to observe and learn from the interaction of stakeholders with the new technology and to assess its effectiveness. This is best done by trained sociologists fully integrated into the processes. The WINCOMS research project is an example applied to the implementation of the WFD in Ireland.

  13. Strategic Analysis Overview

    NASA Technical Reports Server (NTRS)

    Cirillo, William M.; Earle, Kevin D.; Goodliff, Kandyce E.; Reeves, J. D.; Stromgren, Chel; Andraschko, Mark R.; Merrill, R. Gabe

    2008-01-01

    NASA s Constellation Program employs a strategic analysis methodology in providing an integrated analysis capability of Lunar exploration scenarios and to support strategic decision-making regarding those scenarios. The strategic analysis methodology integrates the assessment of the major contributors to strategic objective satisfaction performance, affordability, and risk and captures the linkages and feedbacks between all three components. Strategic analysis supports strategic decision making by senior management through comparable analysis of alternative strategies, provision of a consistent set of high level value metrics, and the enabling of cost-benefit analysis. The tools developed to implement the strategic analysis methodology are not element design and sizing tools. Rather, these models evaluate strategic performance using predefined elements, imported into a library from expert-driven design/sizing tools or expert analysis. Specific components of the strategic analysis tool set include scenario definition, requirements generation, mission manifesting, scenario lifecycle costing, crew time analysis, objective satisfaction benefit, risk analysis, and probabilistic evaluation. Results from all components of strategic analysis are evaluated a set of pre-defined figures of merit (FOMs). These FOMs capture the high-level strategic characteristics of all scenarios and facilitate direct comparison of options. The strategic analysis methodology that is described in this paper has previously been applied to the Space Shuttle and International Space Station Programs and is now being used to support the development of the baseline Constellation Program lunar architecture. This paper will present an overview of the strategic analysis methodology and will present sample results from the application of the strategic analysis methodology to the Constellation Program lunar architecture.

  14. Transmission Planning Analysis Tool

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    2015-06-23

    Developed to solve specific problem: Assist transmission planning for regional transfers in interconnected power systems. This work was originated in a study for the U.S. Department of State, to recommend transmission reinforcements for the Central American regional system that interconnects 6 countries. Transmission planning analysis is currently performed by engineers with domainspecific and systemspecific knowledge without a unique methodology. The software codes of this disclosure assists engineers by defining systematic analysis procedures to help identify weak points and make decisions on transmission planning of regional interconnected power systems. Transmission Planning Analysis Tool groups PSS/E results of multiple AC contingency analysismore » and voltage stability analysis and QV analysis of many scenarios of study and arrange them in a systematic way to aid power system planning engineers or transmission operators in effective decision]making process or in the off]line study environment.« less

  15. Evaluating the Effectiveness of Web-based Climate Resilience Decision Support Tools: Insights from Coastal New Jersey

    NASA Astrophysics Data System (ADS)

    Brady, M.; Lathrop, R.; Auermuller, L. M.; Leichenko, R.

    2016-12-01

    Despite the recent surge of Web-based decision support tools designed to promote resiliency in U.S. coastal communities, to-date there has been no systematic study of their effectiveness. This study demonstrates a method to evaluate important aspects of effectiveness of four Web map tools designed to promote consideration of climate risk information in local decision-making and planning used in coastal New Jersey. In summer 2015, the research team conducted in-depth phone interviews with users of one regulatory and three non-regulatory Web map tools using a semi-structured questionnaire. The interview and analysis design drew from a combination of effectiveness evaluation approaches developed in software and information usability, program evaluation, and management information system (MIS) research. Effectiveness assessment results were further analyzed and discussed in terms of conceptual hierarchy of system objectives defined by respective tool developer and user organizations represented in the study. Insights from the interviews suggest that users rely on Web tools as a supplement to desktop and analog map sources because they provide relevant and up-to-date information in a highly accessible and mobile format. The users also reported relying on multiple information sources and comparison between digital and analog sources for decision support. However, with respect to this decision support benefit, users were constrained by accessibility factors such as lack of awareness and training with some tools, lack of salient information such as planning time horizons associated with future flood scenarios, and environmental factors such as mandates restricting some users to regulatory tools. Perceptions of Web tool credibility seem favorable overall, but factors including system design imperfections and inconsistencies in data and information across platforms limited trust, highlighting a need for better coordination between tools. Contributions of the study include user feedback on web-tool system designs consistent with collaborative methods for enhancing usability and a systematic look at effectiveness that includes both user perspectives and consideration of developer and organizational objectives.

  16. Using Cognitive Work Analysis to Fit Decision Support Tools to Nurse Managers’ Work Flow

    PubMed Central

    Brewer, Barbara B.; Logue, Melanie D.; Gephart, Sheila; Verran, Joyce A.

    2011-01-01

    Purpose To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager’s work domain. Methods Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in 3 Arizona hospitals. The WDA described the nurse manager’s environment in terms of the constraints it imposes on the nurse manager’s ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. Results The results highlight the competing priorities, and external and internal constraints that today’s nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering “what if” questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogenous sample and the reliance on interview data targeting safety and quality. PMID:21862397

  17. Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow.

    PubMed

    Effken, Judith A; Brewer, Barbara B; Logue, Melanie D; Gephart, Sheila M; Verran, Joyce A

    2011-10-01

    To better understand the environmental constraints on nurse managers that impact their need for and use of decision support tools, we conducted a Cognitive Work Analysis (CWA). A complete CWA includes system analyses at five levels: work domain, decision-making procedures, decision-making strategies, social organization/collaboration, and worker skill level. Here we describe the results of the Work Domain Analysis (WDA) portion in detail then integrate the WDA with other portions of the CWA, reported previously, to generate a more complete picture of the nurse manager's work domain. Data for the WDA were obtained from semi-structured interviews with nurse managers, division directors, CNOs, and other managers (n = 20) on 10 patient care units in three Arizona hospitals. The WDA described the nurse manager's environment in terms of the constraints it imposes on the nurse manager's ability to achieve targeted outcomes through organizational goals and priorities, functions, processes, as well as work objects and resources (e.g., people, equipment, technology, and data). Constraints were identified and summarized through qualitative thematic analysis. The results highlight the competing priorities, and external and internal constraints that today's nurse managers must satisfy as they try to improve quality and safety outcomes on their units. Nurse managers receive a great deal of data, much in electronic format. Although dashboards were perceived as helpful because they integrated some data elements, no decision support tools were available to help nurse managers with planning or answering "what if" questions. The results suggest both the need for additional decision support to manage the growing complexity of the environment, and the constraints the environment places on the design of that technology if it is to be effective. Limitations of the study include the small homogeneous sample and the reliance on interview data targeting safety and quality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education

    PubMed Central

    PHELPS, CHARLES; RAPPUOLI, RINO; LEVIN, SCOTT; SHORTLIFFE, EDWARD; COLWELL, RITA

    2016-01-01

    Policy Points: Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning.Public health agencies’ current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost‐effectiveness.As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost‐effectiveness analyses widely recommended and used for public health planning.Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Context Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost‐effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Methods Our work employed a multicriteria systems analysis approach—specifically, multiattribute utility theory—to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost‐effectiveness analysis approach. Findings (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost‐effectiveness analysis. (2) More sophisticated systems‐level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer. Conclusions The teaching of strategic planning in public health must be expanded in order to fill a void in the profession's planning capabilities. Public health training should actively incorporate model building, promote the interactive use of software tools, and explore planning approaches that transcend restrictive assumptions of cost‐effectiveness analysis. The Strategic Multi‐Attribute Ranking Tool for Vaccines (SMART Vaccines), which was recently developed by the Institute of Medicine and the National Academy of Engineering to help prioritize new vaccine development, is a working example of systems analysis as a basis for decision support. PMID:26994711

  19. Strategic Planning in Population Health and Public Health Practice: A Call to Action for Higher Education.

    PubMed

    Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Levin, Scott; Shortliffe, Edward; Colwell, Rita

    2016-03-01

    Scarce resources, especially in population health and public health practice, underlie the importance of strategic planning. Public health agencies' current planning and priority setting efforts are often narrow, at times opaque, and focused on single metrics such as cost-effectiveness. As demonstrated by SMART Vaccines, a decision support software system developed by the Institute of Medicine and the National Academy of Engineering, new approaches to strategic planning allow the formal incorporation of multiple stakeholder views and multicriteria decision making that surpass even those sophisticated cost-effectiveness analyses widely recommended and used for public health planning. Institutions of higher education can and should respond by building on modern strategic planning tools as they teach their students how to improve population health and public health practice. Strategic planning in population health and public health practice often uses single indicators of success or, when using multiple indicators, provides no mechanism for coherently combining the assessments. Cost-effectiveness analysis, the most complex strategic planning tool commonly applied in public health, uses only a single metric to evaluate programmatic choices, even though other factors often influence actual decisions. Our work employed a multicriteria systems analysis approach--specifically, multiattribute utility theory--to assist in strategic planning and priority setting in a particular area of health care (vaccines), thereby moving beyond the traditional cost-effectiveness analysis approach. (1) Multicriteria systems analysis provides more flexibility, transparency, and clarity in decision support for public health issues compared with cost-effectiveness analysis. (2) More sophisticated systems-level analyses will become increasingly important to public health as disease burdens increase and the resources to deal with them become scarcer. The teaching of strategic planning in public health must be expanded in order to fill a void in the profession's planning capabilities. Public health training should actively incorporate model building, promote the interactive use of software tools, and explore planning approaches that transcend restrictive assumptions of cost-effectiveness analysis. The Strategic Multi-Attribute Ranking Tool for Vaccines (SMART Vaccines), which was recently developed by the Institute of Medicine and the National Academy of Engineering to help prioritize new vaccine development, is a working example of systems analysis as a basis for decision support. © 2016 Milbank Memorial Fund.

  20. Data for Renewable Energy Planning, Policy, and Investment

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cox, Sarah L

    Reliable, robust, and validated data are critical for informed planning, policy development, and investment in the clean energy sector. The Renewable Energy (RE) Explorer was developed to support data-driven renewable energy analysis that can inform key renewable energy decisions globally. This document presents the types of geospatial and other data at the core of renewable energy analysis and decision making. Individual data sets used to inform decisions vary in relation to spatial and temporal resolution, quality, and overall usefulness. From Data to Decisions, a complementary geospatial data and analysis decision guide, provides an in-depth view of these and other considerationsmore » to enable data-driven planning, policymaking, and investment. Data support a wide variety of renewable energy analyses and decisions, including technical and economic potential assessment, renewable energy zone analysis, grid integration, risk and resiliency identification, electrification, and distributed solar photovoltaic potential. This fact sheet provides information on the types of data that are important for renewable energy decision making using the RE Data Explorer or similar types of geospatial analysis tools.« less

  1. Ranking of Business Process Simulation Software Tools with DEX/QQ Hierarchical Decision Model

    PubMed Central

    2016-01-01

    The omnipresent need for optimisation requires constant improvements of companies’ business processes (BPs). Minimising the risk of inappropriate BP being implemented is usually performed by simulating the newly developed BP under various initial conditions and “what-if” scenarios. An effectual business process simulations software (BPSS) is a prerequisite for accurate analysis of an BP. Characterisation of an BPSS tool is a challenging task due to the complex selection criteria that includes quality of visual aspects, simulation capabilities, statistical facilities, quality reporting etc. Under such circumstances, making an optimal decision is challenging. Therefore, various decision support models are employed aiding the BPSS tool selection. The currently established decision support models are either proprietary or comprise only a limited subset of criteria, which affects their accuracy. Addressing this issue, this paper proposes a new hierarchical decision support model for ranking of BPSS based on their technical characteristics by employing DEX and qualitative to quantitative (QQ) methodology. Consequently, the decision expert feeds the required information in a systematic and user friendly manner. There are three significant contributions of the proposed approach. Firstly, the proposed hierarchical model is easily extendible for adding new criteria in the hierarchical structure. Secondly, a fully operational decision support system (DSS) tool that implements the proposed hierarchical model is presented. Finally, the effectiveness of the proposed hierarchical model is assessed by comparing the resulting rankings of BPSS with respect to currently available results. PMID:26871694

  2. How to use multi-criteria decision analysis methods for reimbursement decision-making in healthcare: a step-by-step guide.

    PubMed

    Diaby, Vakaramoko; Goeree, Ron

    2014-02-01

    In recent years, the quest for more comprehensiveness, structure and transparency in reimbursement decision-making in healthcare has prompted the research into alternative decision-making frameworks. In this environment, multi-criteria decision analysis (MCDA) is arising as a valuable tool to support healthcare decision-making. In this paper, we present the main MCDA decision support methods (elementary methods, value-based measurement models, goal programming models and outranking models) using a case study approach. For each family of methods, an example of how an MCDA model would operate in a real decision-making context is presented from a critical perspective, highlighting the parameters setting, the selection of the appropriate evaluation model as well as the role of sensitivity and robustness analyses. This study aims to provide a step-by-step guide on how to use MCDA methods for reimbursement decision-making in healthcare.

  3. Clinical utility of gene expression profiling data for clinical decision-making regarding adjuvant therapy in early stage, node-negative breast cancer: a case report.

    PubMed

    Schuster, Steven R; Pockaj, Barbara A; Bothe, Mary R; David, Paru S; Northfelt, Donald W

    2012-09-10

    Breast cancer is the most common malignancy among women in the United States with the second highest incidence of cancer-related death following lung cancer. The decision-making process regarding adjuvant therapy is a time intensive dialogue between the patient and her oncologist. There are multiple tools that help individualize the treatment options for a patient. Population-based analysis with Adjuvant! Online and genomic profiling with Oncotype DX are two commonly used tools in patients with early stage, node-negative breast cancer. This case report illustrates a situation in which the population-based prognostic and predictive information differed dramatically from that obtained from genomic profiling and affected the patient's decision. In light of this case, we discuss the benefits and limitations of these tools.

  4. The second iteration of the Systems Prioritization Method: A systems prioritization and decision-aiding tool for the Waste Isolation Pilot Plant: Volume 2, Summary of technical input and model implementation

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Prindle, N.H.; Mendenhall, F.T.; Trauth, K.

    1996-05-01

    The Systems Prioritization Method (SPM) is a decision-aiding tool developed by Sandia National Laboratories (SNL). SPM provides an analytical basis for supporting programmatic decisions for the Waste Isolation Pilot Plant (WIPP) to meet selected portions of the applicable US EPA long-term performance regulations. The first iteration of SPM (SPM-1), the prototype for SPM< was completed in 1994. It served as a benchmark and a test bed for developing the tools needed for the second iteration of SPM (SPM-2). SPM-2, completed in 1995, is intended for programmatic decision making. This is Volume II of the three-volume final report of the secondmore » iteration of the SPM. It describes the technical input and model implementation for SPM-2, and presents the SPM-2 technical baseline and the activities, activity outcomes, outcome probabilities, and the input parameters for SPM-2 analysis.« less

  5. A Web-Based Decision Tool to Improve Contraceptive Counseling for Women With Chronic Medical Conditions: Protocol For a Mixed Methods Implementation Study.

    PubMed

    Wu, Justine P; Damschroder, Laura J; Fetters, Michael D; Zikmund-Fisher, Brian J; Crabtree, Benjamin F; Hudson, Shawna V; Ruffin, Mack T; Fucinari, Juliana; Kang, Minji; Taichman, L Susan; Creswell, John W

    2018-04-18

    Women with chronic medical conditions, such as diabetes and hypertension, have a higher risk of pregnancy-related complications compared with women without medical conditions and should be offered contraception if desired. Although evidence based guidelines for contraceptive selection in the presence of medical conditions are available via the United States Medical Eligibility Criteria (US MEC), these guidelines are underutilized. Research also supports the use of decision tools to promote shared decision making between patients and providers during contraceptive counseling. The overall goal of the MiHealth, MiChoice project is to design and implement a theory-driven, Web-based tool that incorporates the US MEC (provider-level intervention) within the vehicle of a contraceptive decision tool for women with chronic medical conditions (patient-level intervention) in community-based primary care settings (practice-level intervention). This will be a 3-phase study that includes a predesign phase, a design phase, and a testing phase in a randomized controlled trial. This study protocol describes phase 1 and aim 1, which is to determine patient-, provider-, and practice-level factors that are relevant to the design and implementation of the contraceptive decision tool. This is a mixed methods implementation study. To customize the delivery of the US MEC in the decision tool, we selected high-priority constructs from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework to drive data collection and analysis at the practice and provider level, respectively. A conceptual model that incorporates constructs from the transtheoretical model and the health beliefs model undergirds patient-level data collection and analysis and will inform customization of the decision tool for this population. We will recruit 6 community-based primary care practices and conduct quantitative surveys and semistructured qualitative interviews with women who have chronic medical conditions, their primary care providers (PCPs), and clinic staff, as well as field observations of practice activities. Quantitative survey data will be summarized with simple descriptive statistics and relationships between participant characteristics and contraceptive recommendations (for PCPs), and current contraceptive use (for patients) will be examined using Fisher exact test. We will conduct thematic analysis of qualitative data from interviews and field observations. The integration of data will occur by comparing, contrasting, and synthesizing qualitative and quantitative findings to inform the future development and implementation of the intervention. We are currently enrolling practices and anticipate study completion in 15 months. This protocol describes the first phase of a multiphase mixed methods study to develop and implement a Web-based decision tool that is customized to meet the needs of women with chronic medical conditions in primary care settings. Study findings will promote contraceptive counseling via shared decision making and reflect evidence-based guidelines for contraceptive selection. ClinicalTrials.gov NCT03153644; https://clinicaltrials.gov/ct2/show/NCT03153644 (Archived by WebCite at http://www.webcitation.org/6yUkA5lK8). ©Justine P Wu, Laura J Damschroder, Michael D Fetters, Brian J Zikmund-Fisher, Benjamin F Crabtree, Shawna V Hudson, Mack T Ruffin IV, Juliana Fucinari, Minji Kang, L Susan Taichman, John W Creswell. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.04.2018.

  6. Decision-making tools in prostate cancer: from risk grouping to nomograms.

    PubMed

    Fontanella, Paolo; Benecchi, Luigi; Grasso, Angelica; Patel, Vipul; Albala, David; Abbou, Claude; Porpiglia, Francesco; Sandri, Marco; Rocco, Bernardo; Bianchi, Giampaolo

    2017-12-01

    Prostate cancer (PCa) is the most common solid neoplasm and the second leading cause of cancer death in men. After the Partin tables were developed, a number of predictive and prognostic tools became available for risk stratification. These tools have allowed the urologist to better characterize this disease and lead to more confident treatment decisions for patients. The purpose of this study is to critically review the decision-making tools currently available to the urologist, from the moment when PCa is first diagnosed until patients experience metastatic progression and death. A systematic and critical analysis through Medline, EMBASE, Scopus and Web of Science databases was carried out in February 2016 as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The search was conducted using the following key words: "prostate cancer," "prediction tools," "nomograms." Seventy-two studies were identified in the literature search. We summarized the results into six sections: Tools for prediction of life expectancy (before treatment), Tools for prediction of pathological stage (before treatment), Tools for prediction of survival and cancer-specific mortality (before/after treatment), Tools for prediction of biochemical recurrence (before/after treatment), Tools for prediction of metastatic progression (after treatment) and in the last section biomarkers and genomics. The management of PCa patients requires a tailored approach to deliver a truly personalized treatment. The currently available tools are of great help in helping the urologist in the decision-making process. These tests perform very well in high-grade and low-grade disease, while for intermediate-grade disease further research is needed. Newly discovered markers, genomic tests, and advances in imaging acquisition through mpMRI will help in instilling confidence that the appropriate treatments are being offered to patients with prostate cancer.

  7. Risk-Based Prioritization of Research for Aviation Security Using Logic-Evolved Decision Analysis

    NASA Technical Reports Server (NTRS)

    Eisenhawer, S. W.; Bott, T. F.; Sorokach, M. R.; Jones, F. P.; Foggia, J. R.

    2004-01-01

    The National Aeronautics and Space Administration is developing advanced technologies to reduce terrorist risk for the air transportation system. Decision support tools are needed to help allocate assets to the most promising research. An approach to rank ordering technologies (using logic-evolved decision analysis), with risk reduction as the metric, is presented. The development of a spanning set of scenarios using a logic-gate tree is described. Baseline risk for these scenarios is evaluated with an approximate reasoning model. Illustrative risk and risk reduction results are presented.

  8. Clarity versus complexity: land-use modeling as a practical tool for decision-makers

    USGS Publications Warehouse

    Sohl, Terry L.; Claggett, Peter

    2013-01-01

    The last decade has seen a remarkable increase in the number of modeling tools available to examine future land-use and land-cover (LULC) change. Integrated modeling frameworks, agent-based models, cellular automata approaches, and other modeling techniques have substantially improved the representation of complex LULC systems, with each method using a different strategy to address complexity. However, despite the development of new and better modeling tools, the use of these tools is limited for actual planning, decision-making, or policy-making purposes. LULC modelers have become very adept at creating tools for modeling LULC change, but complicated models and lack of transparency limit their utility for decision-makers. The complicated nature of many LULC models also makes it impractical or even impossible to perform a rigorous analysis of modeling uncertainty. This paper provides a review of land-cover modeling approaches and the issues causes by the complicated nature of models, and provides suggestions to facilitate the increased use of LULC models by decision-makers and other stakeholders. The utility of LULC models themselves can be improved by 1) providing model code and documentation, 2) through the use of scenario frameworks to frame overall uncertainties, 3) improving methods for generalizing key LULC processes most important to stakeholders, and 4) adopting more rigorous standards for validating models and quantifying uncertainty. Communication with decision-makers and other stakeholders can be improved by increasing stakeholder participation in all stages of the modeling process, increasing the transparency of model structure and uncertainties, and developing user-friendly decision-support systems to bridge the link between LULC science and policy. By considering these options, LULC science will be better positioned to support decision-makers and increase real-world application of LULC modeling results.

  9. The IDEA Assessment Tool: Assessing the Reporting, Diagnostic Reasoning, and Decision-Making Skills Demonstrated in Medical Students' Hospital Admission Notes.

    PubMed

    Baker, Elizabeth A; Ledford, Cynthia H; Fogg, Louis; Way, David P; Park, Yoon Soo

    2015-01-01

    Construct: Clinical skills are used in the care of patients, including reporting, diagnostic reasoning, and decision-making skills. Written comprehensive new patient admission notes (H&Ps) are a ubiquitous part of student education but are underutilized in the assessment of clinical skills. The interpretive summary, differential diagnosis, explanation of reasoning, and alternatives (IDEA) assessment tool was developed to assess students' clinical skills using written comprehensive new patient admission notes. The validity evidence for assessment of clinical skills using clinical documentation following authentic patient encounters has not been well documented. Diagnostic justification tools and postencounter notes are described in the literature (1,2) but are based on standardized patient encounters. To our knowledge, the IDEA assessment tool is the first published tool that uses medical students' H&Ps to rate students' clinical skills. The IDEA assessment tool is a 15-item instrument that asks evaluators to rate students' reporting, diagnostic reasoning, and decision-making skills based on medical students' new patient admission notes. This study presents validity evidence in support of the IDEA assessment tool using Messick's unified framework, including content (theoretical framework), response process (interrater reliability), internal structure (factor analysis and internal-consistency reliability), and relationship to other variables. Validity evidence is based on results from four studies conducted between 2010 and 2013. First, the factor analysis (2010, n = 216) yielded a three-factor solution, measuring patient story, IDEA, and completeness, with reliabilities of .79, .88, and .79, respectively. Second, an initial interrater reliability study (2010) involving two raters demonstrated fair to moderate consensus (κ = .21-.56, ρ =.42-.79). Third, a second interrater reliability study (2011) with 22 trained raters also demonstrated fair to moderate agreement (intraclass correlations [ICCs] = .29-.67). There was moderate reliability for all three skill domains, including reporting skills (ICC = .53), diagnostic reasoning skills (ICC = .64), and decision-making skills (ICC = .63). Fourth, there was a significant correlation between IDEA rating scores (2010-2013) and final Internal Medicine clerkship grades (r = .24), 95% confidence interval (CI) [.15, .33]. The IDEA assessment tool is a novel tool with validity evidence to support its use in the assessment of students' reporting, diagnostic reasoning, and decision-making skills. The moderate reliability achieved supports formative or lower stakes summative uses rather than high-stakes summative judgments.

  10. Second NASA Technical Interchange Meeting (TIM): Advanced Technology Lifecycle Analysis System (ATLAS) Technology Tool Box (TTB)

    NASA Technical Reports Server (NTRS)

    ONeil, D. A.; Mankins, J. C.; Christensen, C. B.; Gresham, E. C.

    2005-01-01

    The Advanced Technology Lifecycle Analysis System (ATLAS), a spreadsheet analysis tool suite, applies parametric equations for sizing and lifecycle cost estimation. Performance, operation, and programmatic data used by the equations come from a Technology Tool Box (TTB) database. In this second TTB Technical Interchange Meeting (TIM), technologists, system model developers, and architecture analysts discussed methods for modeling technology decisions in spreadsheet models, identified specific technology parameters, and defined detailed development requirements. This Conference Publication captures the consensus of the discussions and provides narrative explanations of the tool suite, the database, and applications of ATLAS within NASA s changing environment.

  11. Group decision-making techniques for natural resource management applications

    USGS Publications Warehouse

    Coughlan, Beth A.K.; Armour, Carl L.

    1992-01-01

    This report is an introduction to decision analysis and problem-solving techniques for professionals in natural resource management. Although these managers are often called upon to make complex decisions, their training in the natural sciences seldom provides exposure to the decision-making tools developed in management science. Our purpose is to being to fill this gap. We present a general analysis of the pitfalls of group problem solving, and suggestions for improved interactions followed by the specific techniques. Selected techniques are illustrated. The material is easy to understand and apply without previous training or excessive study and is applicable to natural resource management issues.

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

    PubMed

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

    2013-09-25

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

  13. The Value of Information in Decision-Analytic Modeling for Malaria Vector Control in East Africa.

    PubMed

    Kim, Dohyeong; Brown, Zachary; Anderson, Richard; Mutero, Clifford; Miranda, Marie Lynn; Wiener, Jonathan; Kramer, Randall

    2017-02-01

    Decision analysis tools and mathematical modeling are increasingly emphasized in malaria control programs worldwide to improve resource allocation and address ongoing challenges with sustainability. However, such tools require substantial scientific evidence, which is costly to acquire. The value of information (VOI) has been proposed as a metric for gauging the value of reduced model uncertainty. We apply this concept to an evidenced-based Malaria Decision Analysis Support Tool (MDAST) designed for application in East Africa. In developing MDAST, substantial gaps in the scientific evidence base were identified regarding insecticide resistance in malaria vector control and the effectiveness of alternative mosquito control approaches, including larviciding. We identify four entomological parameters in the model (two for insecticide resistance and two for larviciding) that involve high levels of uncertainty and to which outputs in MDAST are sensitive. We estimate and compare a VOI for combinations of these parameters in evaluating three policy alternatives relative to a status quo policy. We find having perfect information on the uncertain parameters could improve program net benefits by up to 5-21%, with the highest VOI associated with jointly eliminating uncertainty about reproductive speed of malaria-transmitting mosquitoes and initial efficacy of larviciding at reducing the emergence of new adult mosquitoes. Future research on parameter uncertainty in decision analysis of malaria control policy should investigate the VOI with respect to other aspects of malaria transmission (such as antimalarial resistance), the costs of reducing uncertainty in these parameters, and the extent to which imperfect information about these parameters can improve payoffs. © 2016 Society for Risk Analysis.

  14. Demonstrating Success: Web Analytics and Continuous Improvement

    ERIC Educational Resources Information Center

    Loftus, Wayne

    2012-01-01

    As free and low-cost Web analytics tools become more sophisticated, libraries' approach to user analysis can become more nuanced and precise. Tracking appropriate metrics with a well-formulated analytics program can inform design decisions, demonstrate the degree to which those decisions have succeeded, and thereby inform the next iteration in the…

  15. Web Tutorials on Systems Thinking Using the Driver-Pressure-State-Impact-Response (DPSIR) Framework

    EPA Science Inventory

    This set of tutorials provides an overview of incorporating systems thinking into decision-making, an introduction to the DPSIR framework as one approach that can assist in the decision analysis process, and an overview of DPSIR tools, including concept mapping and keyword lists,...

  16. Triple Value System Dynamics Modeling to Help Stakeholders Engage with Food-Energy-Water Problems

    EPA Science Inventory

    Triple Value (3V) Community scoping projects and Triple Value Simulation (3VS) models help decision makers and stakeholders apply systems-analysis methodology to complex problems related to food production, water quality, and energy use. 3VS models are decision support tools that...

  17. Minimising farm crop protection pressure supported by the multiple functionalities of the DISCUSS indicator set.

    PubMed

    Wustenberghs, Hilde; Fevery, Davina; Lauwers, Ludwig; Marchand, Fleur; Spanoghe, Pieter

    2018-03-15

    Sustainable crop protection (SCP) has many facets. Farmers may therefore perceive transition to SCP as very complex. The Dual Indicator Set for Crop Protection Sustainability (DISCUSS) can handle this complexity. To provide targeted support throughout the transition to SCP, complexity capture must be synchronised with the time course of on-farm decision-making. Tool use must be tuned to farmer awareness and appropriate level of data in consecutive stages. This paper thus explores the potential functionalities of DISCUSS in relation to both complexity and time. Results from apple and potato crop protection show three potential functions: DISCUSS can be used as (1) a simulation tool for communication and decision support, (2) an assessment and monitoring tool, and (3) a discussion support tool for farmer groups. Analysis of these functionalities using a framework for guiding on-farm sustainability assessment and strategic decision-making shows how each functionality can support the consecutive steps of transition to SCP, i.e. using the right tool functionality at the right time. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Spiral Bevel Gear Damage Detection Using Decision Fusion Analysis

    NASA Technical Reports Server (NTRS)

    Dempsey, Paula J.; Handschuh, Robert F.; Afjeh, Abdollah A.

    2002-01-01

    A diagnostic tool for detecting damage to spiral bevel gears was developed. Two different monitoring technologies, oil debris analysis and vibration, were integrated using data fusion into a health monitoring system for detecting surface fatigue pitting damage on gears. This integrated system showed improved detection and decision-making capabilities as compared to using individual monitoring technologies. This diagnostic tool was evaluated by collecting vibration and oil debris data from fatigue tests performed in the NASA Glenn Spiral Bevel Gear Fatigue Rigs. Data was collected during experiments performed in this test rig when pitting damage occurred. Results show that combining the vibration and oil debris measurement technologies improves the detection of pitting damage on spiral bevel gears.

  19. Analysis And Assistant Planning System Ofregional Agricultural Economic Inform

    NASA Astrophysics Data System (ADS)

    Han, Jie; Zhang, Junfeng

    For the common problems existed in regional development and planning, we try to design a decision support system for assisting regional agricultural development and alignment as a decision-making tool for local government and decision maker. The analysis methods of forecast, comparative advantage, liner programming and statistical analysis are adopted. According to comparative advantage theory, the regional advantage can be determined by calculating and comparing yield advantage index (YAI), Scale advantage index (SAI), Complicated advantage index (CAI). Combining with GIS, agricultural data are presented as a form of graph such as area, bar and pie to uncover the principle and trend for decision-making which can't be found in data table. This system provides assistant decisions for agricultural structure adjustment, agro-forestry development and planning, and can be integrated to information technologies such as RS, AI and so on.

  20. Applying analysis tools in planning for operations : case study #3 -- using archived data as a tool for operations planning

    DOT National Transportation Integrated Search

    2009-09-01

    More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

  1. Spatial Approaches for Ecological Screening and Exposure Assessment of Chemicals and Radionclides

    EPA Science Inventory

    This presentation details a tool, SADA, available for use in environmental assessments of chemicals that can also be used for radiological assessments of the environment. Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates tools from e...

  2. Cognitive mapping tools: review and risk management needs.

    PubMed

    Wood, Matthew D; Bostrom, Ann; Bridges, Todd; Linkov, Igor

    2012-08-01

    Risk managers are increasingly interested in incorporating stakeholder beliefs and other human factors into the planning process. Effective risk assessment and management requires understanding perceptions and beliefs of involved stakeholders, and how these beliefs give rise to actions that influence risk management decisions. Formal analyses of risk manager and stakeholder cognitions represent an important first step. Techniques for diagramming stakeholder mental models provide one tool for risk managers to better understand stakeholder beliefs and perceptions concerning risk, and to leverage this new understanding in developing risk management strategies. This article reviews three methodologies for assessing and diagramming stakeholder mental models--decision-analysis-based mental modeling, concept mapping, and semantic web analysis--and assesses them with regard to their ability to address risk manager needs. © 2012 Society for Risk Analysis.

  3. A Comparative Analysis of Life-Cycle Assessment Tools for ...

    EPA Pesticide Factsheets

    We identified and evaluated five life-cycle assessment tools that community decision makers can use to assess the environmental and economic impacts of end-of-life (EOL) materials management options. The tools evaluated in this report are waste reduction mode (WARM), municipal solid waste-decision support tool (MSW-DST), solid waste optimization life-cycle framework (SWOLF), environmental assessment system for environmental technologies (EASETECH), and waste and resources assessment for the environment (WRATE). WARM, MSW-DST, and SWOLF were developed for US-specific materials management strategies, while WRATE and EASETECH were developed for European-specific conditions. All of the tools (with the exception of WARM) allow specification of a wide variety of parameters (e.g., materials composition and energy mix) to a varying degree, thus allowing users to model specific EOL materials management methods even outside the geographical domain they are originally intended for. The flexibility to accept user-specified input for a large number of parameters increases the level of complexity and the skill set needed for using these tools. The tools were evaluated and compared based on a series of criteria, including general tool features, the scope of the analysis (e.g., materials and processes included), and the impact categories analyzed (e.g., climate change, acidification). A series of scenarios representing materials management problems currently relevant to c

  4. Retention payoff-based cost per day open regression equations: Application in a user-friendly decision support tool for investment analysis of automated estrus detection technologies.

    PubMed

    Dolecheck, K A; Heersche, G; Bewley, J M

    2016-12-01

    Assessing the economic implications of investing in automated estrus detection (AED) technologies can be overwhelming for dairy producers. The objectives of this study were to develop new regression equations for estimating the cost per day open (DO) and to apply the results to create a user-friendly, partial budget, decision support tool for investment analysis of AED technologies. In the resulting decision support tool, the end user can adjust herd-specific inputs regarding general management, current reproductive management strategies, and the proposed AED system. Outputs include expected DO, reproductive cull rate, net present value, and payback period for the proposed AED system. Utility of the decision support tool was demonstrated with an example dairy herd created using data from DairyMetrics (Dairy Records Management Systems, Raleigh, NC), Food and Agricultural Policy Research Institute (Columbia, MO), and published literature. Resulting herd size, rolling herd average milk production, milk price, and feed cost were 323 cows, 10,758kg, $0.41/kg, and $0.20/kg of dry matter, respectively. Automated estrus detection technologies with 2 levels of initial system cost (low: $5,000 vs. high: $10,000), tag price (low: $50 vs. high: $100), and estrus detection rate (low: 60% vs. high: 80%) were compared over a 7-yr investment period. Four scenarios were considered in a demonstration of the investment analysis tool: (1) a herd using 100% visual observation for estrus detection before adopting 100% AED, (2) a herd using 100% visual observation before adopting 75% AED and 25% visual observation, (3) a herd using 100% timed artificial insemination (TAI) before adopting 100% AED, and (4) a herd using 100% TAI before adopting 75% AED and 25% TAI. Net present value in scenarios 1 and 2 was always positive, indicating a positive investment situation. Net present value in scenarios 3 and 4 was always positive in combinations using a $50 tag price, and in scenario 4, the $5,000, $100, and 80% combination. Overall, the payback period ranged from 1.6 yr to greater than 10 yr. Investment analysis demonstration results were highly dependent on assumptions, especially AED system initial investment and labor costs. Dairy producers can use herd-specific inputs with the cost per day open regression equations and the decision support tool to estimate individual herd results. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  5. Practical thoughts on cost-benefit analysis and health services.

    PubMed

    Burchell, A; Weeden, R

    1982-08-01

    Cost-benefit analysis is fast becoming--if it is not already--an essential tool in decision making. It is, however, a complex subject, and one in which few doctors have been trained. This paper offers practical thoughts on the art of cost-benefit analysis, and is written for clinicians and other medical specialists who, though inexpert in the techniques of accountancy, nevertheless wish to carry out their own simple analyses in a manner that will enable them, and others, to take effective decisions.

  6. Analysis for Non-Traditional Security Challenges: Methods and Tools

    DTIC Science & Technology

    2006-11-20

    PMESII Modeling Challenges modeling or where data is not available to support the model, would aid decision Domain is large, nebulous, complex, and...traditional challenges . This includes enlisting the aid of the inter-agency and alliance/coalition communities. Second, we need to realize this...20 November 2006 MILITARY OPERATIONS RESEARCH SOCIETY MIFh MORS Workshop Analysis for Non-Traditional Security Challenges : Methods and Tools 21-23

  7. 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 delivers map data products including deformation modeling results (slope change and strain magnitude) and aftershock forecasts, with remote sensing change detection results under development. These products are event triggered (from the USGS earthquake feed) and will be posted to event feeds on the E-DECIDER webpage and accessible via the mobile interface and UICDS. E-DECIDER also features a KML service that provides infrastructure information from the FEMA HAZUS database through UICDS and the mobile interface. The back-end GIS service architecture and front-end gateway components form a decision support system that is designed for ease-of-use and extensibility for end-users.

  8. Analyzing stakeholder preferences for managing elk and bison at the National Elk Refuge and Grand Teton National Park: An example of the disparate stakeholder management approach

    USGS Publications Warehouse

    Koontz, Lynne; Hoag, Dana L.

    2005-01-01

    Many programs and tools have been developed by different disciplines to facilitate group negotiation and decision making. Three examples are relevant here. First, decision analysis models such as the Analytical Hierarchy Process (AHP) are commonly used to prioritize the goals and objectives of stakeholders’ preferences for resource planning by formally structuring conflicts and assisting decision makers in developing a compromised solution (Forman, 1998). Second, institutional models such as the Legal Institutional Analysis Model (LIAM) have been used to describe the organizational rules of behavior and the institutional boundaries constraining management decisions (Lamb and others, 1998). Finally, public choice models have been used to predict the potential success of rent-seeking activity (spending additional time and money to exert political pressure) to change the political rules (Becker, 1983). While these tools have been successful at addressing various pieces of the natural resource decision making process, their use in isolation is not enough to fully depict the complexities of the physical and biological systems with the rules and constraints of the underlying economic and political systems. An approach is needed that combines natural sciences, economics, and politics.

  9. 78 FR 69839 - Building Technologies Office Prioritization Tool

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-21

    ... innovative and cost-effective energy saving solutions: Supporting research and development of high impact... Description The tool was designed to inform programmatic decision-making and facilitate the setting of... quantitative analysis to assure only the highest impact measures are the focus of further effort. The approach...

  10. WATERSHED HEALTH ASSESSMENT TOOLS-INVESTIGATING FISHERIES (WHAT-IF): A MODELING TOOLKIT FOR WATERSHED AND FISHERIES MANAGEMENT

    EPA Science Inventory

    The Watershed Health Assessment Tools-Investigating Fisheries (WHAT-IF) is a decision-analysis modeling toolkit for personal computers that supports watershed and fisheries management. The WHAT-IF toolkit includes a relational database, help-system functions and documentation, a...

  11. Design and evaluation of a web-based decision support tool for district-level disease surveillance in a low-resource setting

    PubMed Central

    Pore, Meenal; Sengeh, David M.; Mugambi, Purity; Purswani, Nuri V.; Sesay, Tom; Arnold, Anna Lena; Tran, Anh-Minh A.; Myers, Ralph

    2017-01-01

    During the 2014 West African Ebola Virus outbreak it became apparent that the initial response to the outbreak was hampered by limitations in the collection, aggregation, analysis and use of data for intervention planning. As part of the post-Ebola recovery phase, IBM Research Africa partnered with the Port Loko District Health Management Team (DHMT) in Sierra Leone and GOAL Global, to design, implement and deploy a web-based decision support tool for district-level disease surveillance. This paper discusses the design process and the functionality of the first version of the system. The paper presents evaluation results prior to a pilot deployment and identifies features for future iterations. A qualitative assessment of the tool prior to pilot deployment indicates that it improves the timeliness and ease of using data for making decisions at the DHMT level. PMID:29854209

  12. Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review.

    PubMed

    Austin, C Adrian; Mohottige, Dinushika; Sudore, Rebecca L; Smith, Alexander K; Hanson, Laura C

    2015-07-01

    Serious illness impairs function and threatens survival. Patients facing serious illness value shared decision making, yet few decision aids address the needs of this population. To perform a systematic review of evidence about decision aids and other exportable tools that promote shared decision making in serious illness, thereby (1) identifying tools relevant to the treatment decisions of seriously ill patients and their caregivers, (2) evaluating the quality of evidence for these tools, and (3) summarizing their effect on outcomes and accessibility for clinicians. We searched PubMed, CINAHL, and PsychInfo from January 1, 1995, through October 31, 2014, and identified additional studies from reference lists and other systematic reviews. Clinical trials with random or nonrandom controls were included if they tested print, video, or web-based tools for advance care planning (ACP) or decision aids for serious illness. We extracted data on the study population, design, results, and risk for bias using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Each tool was evaluated for its effect on patient outcomes and accessibility. Seventeen randomized clinical trials tested decision tools in serious illness. Nearly all the trials were of moderate or high quality and showed that decision tools improve patient knowledge and awareness of treatment choices. The available tools address ACP, palliative care and goals of care communication, feeding options in dementia, lung transplant in cystic fibrosis, and truth telling in terminal cancer. Five randomized clinical trials provided further evidence that decision tools improve ACP documentation, clinical decisions, and treatment received. Clinicians can access and use evidence-based tools to engage seriously ill patients in shared decision making. This field of research is in an early stage; future research is needed to develop novel decision aids for other serious diagnoses and key decisions. Health care delivery organizations should prioritize the use of currently available tools that are evidence based and effective.

  13. Multi-criteria decision analysis of breast cancer control in low- and middle- income countries: development of a rating tool for policy makers.

    PubMed

    Venhorst, Kristie; Zelle, Sten G; Tromp, Noor; Lauer, Jeremy A

    2014-01-01

    The objective of this study was to develop a rating tool for policy makers to prioritize breast cancer interventions in low- and middle- income countries (LMICs), based on a simple multi-criteria decision analysis (MCDA) approach. The definition and identification of criteria play a key role in MCDA, and our rating tool could be used as part of a broader priority setting exercise in a local setting. This tool may contribute to a more transparent priority-setting process and fairer decision-making in future breast cancer policy development. First, an expert panel (n = 5) discussed key considerations for tool development. A literature review followed to inventory all relevant criteria and construct an initial set of criteria. A Delphi study was then performed and questionnaires used to discuss a final list of criteria with clear definitions and potential scoring scales. For this Delphi study, multiple breast cancer policy and priority-setting experts from different LMICs were selected and invited by the World Health Organization. Fifteen international experts participated in all three Delphi rounds to assess and evaluate each criterion. This study resulted in a preliminary rating tool for assessing breast cancer interventions in LMICs. The tool consists of 10 carefully crafted criteria (effectiveness, quality of the evidence, magnitude of individual health impact, acceptability, cost-effectiveness, technical complexity, affordability, safety, geographical coverage, and accessibility), with clear definitions and potential scoring scales. This study describes the development of a rating tool to assess breast cancer interventions in LMICs. Our tool can offer supporting knowledge for the use or development of rating tools as part of a broader (MCDA based) priority setting exercise in local settings. Further steps for improving the tool are proposed and should lead to its useful adoption in LMICs.

  14. Interfacing Computer Aided Parallelization and Performance Analysis

    NASA Technical Reports Server (NTRS)

    Jost, Gabriele; Jin, Haoqiang; Labarta, Jesus; Gimenez, Judit; Biegel, Bryan A. (Technical Monitor)

    2003-01-01

    When porting sequential applications to parallel computer architectures, the program developer will typically go through several cycles of source code optimization and performance analysis. We have started a project to develop an environment where the user can jointly navigate through program structure and performance data information in order to make efficient optimization decisions. In a prototype implementation we have interfaced the CAPO computer aided parallelization tool with the Paraver performance analysis tool. We describe both tools and their interface and give an example for how the interface helps within the program development cycle of a benchmark code.

  15. Structured decision making: Chapter 5

    USGS Publications Warehouse

    Runge, Michael C.; Grand, James B.; Mitchell, Michael S.; Krausman, Paul R.; Cain, James W. III

    2013-01-01

    Wildlife management is a decision-focused discipline. It needs to integrate traditional wildlife science and social science to identify actions that are most likely to achieve the array of desires society has surrounding wildlife populations. Decision science, a vast field with roots in economics, operations research, and psychology, offers a rich set of tools to help wildlife managers frame, decompose, analyze, and synthesize their decisions. The nature of wildlife management as a decision science has been recognized since the inception of the field, but formal methods of decision analysis have been underused. There is tremendous potential for wildlife management to grow further through the use of formal decision analysis. First, the wildlife science and human dimensions of wildlife disciplines can be readily integrated. Second, decisions can become more efficient. Third, decisions makers can communicate more clearly with stakeholders and the public. Fourth, good, intuitive wildlife managers, by explicitly examining how they make decisions, can translate their art into a science that is readily used by the next generation.

  16. Decision support for evidence-based integration of disease control: A proof of concept for malaria and schistosomiasis

    PubMed Central

    Graeden, Ellie; Kerr, Justin; Sorrell, Erin M.; Katz, Rebecca

    2018-01-01

    Managing infectious disease requires rapid and effective response to support decision making. The decisions are complex and require understanding of the diseases, disease intervention and control measures, and the disease-relevant characteristics of the local community. Though disease modeling frameworks have been developed to address these questions, the complexity of current models presents a significant barrier to community-level decision makers in using the outputs of the most scientifically robust methods to support pragmatic decisions about implementing a public health response effort, even for endemic diseases with which they are already familiar. Here, we describe the development of an application available on the internet, including from mobile devices, with a simple user interface, to support on-the-ground decision-making for integrating disease control programs, given local conditions and practical constraints. The model upon which the tool is built provides predictive analysis for the effectiveness of integration of schistosomiasis and malaria control, two diseases with extensive geographical and epidemiological overlap, and which result in significant morbidity and mortality in affected regions. Working with data from countries across sub-Saharan Africa and the Middle East, we present a proof-of-principle method and corresponding prototype tool to provide guidance on how to optimize integration of vertical disease control programs. This method and tool demonstrate significant progress in effectively translating the best available scientific models to support practical decision making on the ground with the potential to significantly increase the efficacy and cost-effectiveness of disease control. Author summary Designing and implementing effective programs for infectious disease control requires complex decision-making, informed by an understanding of the diseases, the types of disease interventions and control measures available, and the disease-relevant characteristics of the local community. Though disease modeling frameworks have been developed to address these questions and support decision-making, the complexity of current models presents a significant barrier to on-the-ground end users. The picture is further complicated when considering approaches for integration of different disease control programs, where co-infection dynamics, treatment interactions, and other variables must also be taken into account. Here, we describe the development of an application available on the internet with a simple user interface, to support on-the-ground decision-making for integrating disease control, given local conditions and practical constraints. The model upon which the tool is built provides predictive analysis for the effectiveness of integration of schistosomiasis and malaria control, two diseases with extensive geographical and epidemiological overlap. This proof-of-concept method and tool demonstrate significant progress in effectively translating the best available scientific models to support pragmatic decision-making on the ground, with the potential to significantly increase the impact and cost-effectiveness of disease control. PMID:29649260

  17. Visual Analysis of Air Traffic Data

    NASA Technical Reports Server (NTRS)

    Albrecht, George Hans; Pang, Alex

    2012-01-01

    In this paper, we present visual analysis tools to help study the impact of policy changes on air traffic congestion. The tools support visualization of time-varying air traffic density over an area of interest using different time granularity. We use this visual analysis platform to investigate how changing the aircraft separation volume can reduce congestion while maintaining key safety requirements. The same platform can also be used as a decision aid for processing requests for unmanned aerial vehicle operations.

  18. Decision Making and Priority Setting: The Evolving Path Towards Universal Health Coverage.

    PubMed

    Paolucci, Francesco; Redekop, Ken; Fouda, Ayman; Fiorentini, Gianluca

    2017-12-01

    Health technology assessment (HTA) is widely viewed as an essential component in good universal health coverage (UHC) decision-making in any country. Various HTA tools and metrics have been developed and refined over the years, including systematic literature reviews (Cochrane), economic modelling, and cost-effectiveness ratios and acceptability curves. However, while the cost-effectiveness ratio is faithfully reported in most full economic evaluations, it is viewed by many as an insufficient basis for reimbursement decisions. Emotional debates about the reimbursement of cancer drugs, orphan drugs, and end-of-life treatments have revealed fundamental disagreements about what should and should not be considered in reimbursement decisions. Part of this disagreement seems related to the equity-efficiency tradeoff, which reflects fundamental differences in priorities. All in all, it is clear that countries aiming to improve UHC policies will have to go beyond the capacity building needed to utilize the available HTA toolbox. Multi-criteria decision analysis (MCDA) offers a more comprehensive tool for reimbursement decisions where different weights of different factors/attributes can give policymakers important insights to consider. Sooner or later, every country will have to develop their own way to carefully combine the results of those tools with their own priorities. In the end, all policymaking is based on a mix of facts and values.

  19. Managerial Analysis and Decision Support: A Guidebook and Case Studies

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers (NJ3), 2004

    2004-01-01

    Developed and edited by the National Association of College and University Business Officers' (NACUBO's) Accounting Principles Council, this guidebook, written by highly experienced, seasoned college and university leaders, is designed to help readers make sense of today's world and provide the right tools to make the right decisions. The book,…

  20. Multiple Criteria Evaluation of Quality and Optimisation of e-Learning System Components

    ERIC Educational Resources Information Center

    Kurilovas, Eugenijus; Dagiene, Valentina

    2010-01-01

    The main research object of the paper is investigation and proposal of the comprehensive Learning Object Repositories (LORs) quality evaluation tool suitable for their multiple criteria decision analysis, evaluation and optimisation. Both LORs "internal quality" and "quality in use" evaluation (decision making) criteria are analysed in the paper.…

  1. Development and Technical Characteristics of a Team Decision-Making Assessment Tool: Decision Observation, Recording, and Analysis (DORA)

    ERIC Educational Resources Information Center

    Algozzine, Bob; Newton, J. Stephen; Horner, Robert H.; Todd, Anne W.; Algozzine, Kate

    2012-01-01

    Problem solving is fundamental to psychoeducational assessment practices and generally grounded in activities related to identifying problems, developing and refining hypotheses, generating solutions, developing and implementing actions, and evaluating outcomes. While the process is central to response-to-intervention practices as well, little…

  2. Analysis of Wastewater and Water System Renewal Decision-Making Tools and Approaches

    EPA Science Inventory

    In regards to the development of software for decision support for pipeline renewal, most of the attention to date has been paid to the development of asset management models which help an owner decide on which portions of a system to prioritize for needed actions. There has not ...

  3. Inexpensive Tools To Quantify And Map Vegetative Cover For Large-Scale Research Or Management Decisions.

    USDA-ARS?s Scientific Manuscript database

    Vegetative cover can be quantified quickly and consistently and often at lower cost with image analysis of color digital images than with visual assessments. Image-based mapping of vegetative cover for large-scale research and management decisions can now be considered with the accuracy of these met...

  4. An Analysis of the EPA Report on Pipeline Renewal Decision Making Tools and Approaches

    EPA Science Inventory

    Few DSS are commercially available for technology selection as most utilities make decisions based on in-house and consultant expertise (Matthews et al., 2011). This review presents some of the models proposed over the past 15 years for selecting technologies in the U.S. and wor...

  5. Critical review of decision support tools for sustainability assessment of site remediation options.

    PubMed

    Huysegoms, Lies; Cappuyns, Valérie

    2017-07-01

    In Europe alone, there are more than 2,5 million potentially contaminated sites of which 14% are expected to require remediation. Contaminated soil and groundwater can cause damage to human health as well as to valuable ecosystems. Globally more attention has been paid to this problem of soil contamination in the past decades. For example, more than 58 000 sites have been remediated in Europe between 2006 and 2011. Together with this increase in remediation projects there has been a surge in the development of new remediation technologies and decision support tools to be able to match every site and its specific characteristics to the best possible remediation alternative. In the past years the development of decision support tools (DST) has evolved in a more sustainable direction. Several DSTs added the claim not only to denote effective or technologically and economically feasible remediation alternatives but also to point out the more or most sustainable remediation alternatives. These trends in the evaluation of site remediation options left users with a confusing clew of possibly applicable tools to assist them in decision making for contaminated site remediation. This review provides a structured overview on the extent decision support tools for contaminated site remediation, that claim to assist in choosing the most sustainable remediation alternative, actually include the different elements of sustainability proposed in our assessment framework. The review contains an in-depth analysis of thirteen tools specifically developed to assess the sustainability of site remediation alternatives. This analysis is based on six criteria derived from the definition of sustainable development of the Brundtland report. The six criteria were concretized by using the three pillars of sustainability, applied to site remediation according to the SuRF-UK framework, two criteria derived from Life Cycle Assessment and Cost-Benefit Analysis, and an 'User friendly' criterion. These elements come together in a framework, drafted for this study, containing six criteria covering the environmental, economic, social, time, uncertainty aspects and user friendliness of a sustainable site remediation. The main remarks uncovered by this review are the imbalance of used indicators still expressing a strong preference for the environmental aspect at the expense of the economic and social aspects of sustainability, the lack of consistency in the terminology used within the field and the failure in adapting released tools to recent legislation or scientific advancements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Benchmarking of Decision-Support Tools Used for Tiered Sustainable Remediation Appraisal.

    PubMed

    Smith, Jonathan W N; Kerrison, Gavin

    2013-01-01

    Sustainable remediation comprises soil and groundwater risk-management actions that are selected, designed, and operated to maximize net environmental, social, and economic benefit (while assuring protection of human health and safety). This paper describes a benchmarking exercise to comparatively assess potential differences in environmental management decision making resulting from application of different sustainability appraisal tools ranging from simple (qualitative) to more quantitative (multi-criteria and fully monetized cost-benefit analysis), as outlined in the SuRF-UK framework. The appraisal tools were used to rank remedial options for risk management of a subsurface petroleum release that occurred at a petrol filling station in central England. The remediation options were benchmarked using a consistent set of soil and groundwater data for each tier of sustainability appraisal. The ranking of remedial options was very similar in all three tiers, and an environmental management decision to select the most sustainable options at tier 1 would have been the same decision at tiers 2 and 3. The exercise showed that, for relatively simple remediation projects, a simple sustainability appraisal led to the same remediation option selection as more complex appraisal, and can be used to reliably inform environmental management decisions on other relatively simple land contamination projects.

  7. Promoting informed choice: evaluating a decision-making tool for family planning clients and providers in Mexico.

    PubMed

    Kim, Young Mi; Kols, Adrienne; Martin, Antonieta; Silva, David; Rinehart, Ward; Prammawat, Sarah; Johnson, Sarah; Church, Kathryn

    2005-12-01

    The World Health Organization (WHO) has developed a decision-making tool to be used by providers and clients during family planning visits to improve the quality of services. It is important to examine the tool's usability and its impact on counseling and decision-making processes during family planning consultations. Thirteen providers in Mexico City were videotaped with family planning clients three months before and one month after attending a training session on the WHO decision-making tool. The videotapes were coded for client-provider communication and eye contact, and decision-making behaviors were rated. In-depth interviews and focus group discussions explored clients' and providers' opinions of the tool. After providers began using the decision-making tool, they gave clients more information on family planning, tailored that information more closely to clients' situations and more often discussed HIV/AIDS prevention, dual protection and condom use. Client involvement in the decision-making process and client active communication increased, contributing to a shift from provider-dominated to shared decision making. Clients reported that the tool helped them understand the provider's explanations and made them feel more comfortable talking and asking questions during consultations. After one month of practice with the decision-making tool, most providers felt comfortable with it and found it useful; however, they recommended some changes to the tool to help engage clients in the decision-making process. The decision-making tool was useful both as a job aid for providers and as a decision aid for clients.

  8. 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

  9. Asking the Right Questions: Techniques for Collaboration and School Change. 2nd Edition.

    ERIC Educational Resources Information Center

    Holcomb, Edie L.

    This work provides school change leaders with tools, techniques, tips, examples, illustrations, and stories about promoting school change. Tools provided include histograms, surveys, run charts, weighted voting, force-field analysis, decision matrices, and many others. Chapter 1, "Introduction," applies a matrix for asking questions…

  10. Bringing values and deliberation to science communication.

    PubMed

    Dietz, Thomas

    2013-08-20

    Decisions always involve both facts and values, whereas most science communication focuses only on facts. If science communication is intended to inform decisions, it must be competent with regard to both facts and values. Public participation inevitably involves both facts and values. Research on public participation suggests that linking scientific analysis to public deliberation in an iterative process can help decision making deal effectively with both facts and values. Thus, linked analysis and deliberation can be an effective tool for science communication. However, challenges remain in conducting such process at the national and global scales, in enhancing trust, and in reconciling diverse values.

  11. Multi-criteria decision analysis for health technology assessment in Canada: insights from an expert panel discussion.

    PubMed

    Diaby, Vakaramoko; Goeree, Ron; Hoch, Jeffrey; Siebert, Uwe

    2015-02-01

    Multi-criteria decision analysis (MCDA), a decision-making tool, has received increasing attention in recent years, notably in the healthcare field. For Canada, it is unclear whether and how MCDA should be incorporated into the existing health technology assessment (HTA) decision-making process. To facilitate debate on improving HTA decision-making in Canada, a workshop was held in conjunction with the 8th World Congress on Health Economics of the International Health Economics Association in Toronto, Canada in July 2011. The objective of the workshop was to discuss the potential benefits and challenges related to the use of MCDA for HTA decision-making in Canada. This paper summarizes and discusses the recommendations of an expert panel convened at the workshop to discuss opportunities and concerns with reference to the implementation of MCDA in Canada.

  12. Postoptimality Analysis in the Selection of Technology Portfolios

    NASA Technical Reports Server (NTRS)

    Adumitroaie, Virgil; Shelton, Kacie; Elfes, Alberto; Weisbin, Charles R.

    2006-01-01

    This slide presentation reviews a process of postoptimally analysing the selection of technology portfolios. The rationale for the analysis stems from the need for consistent, transparent and auditable decision making processes and tools. The methodology is used to assure that project investments are selected through an optimization of net mission value. The main intent of the analysis is to gauge the degree of confidence in the optimal solution and to provide the decision maker with an array of viable selection alternatives which take into account input uncertainties and possibly satisfy non-technical constraints. A few examples of the analysis are reviewed. The goal of the postoptimality study is to enhance and improve the decision-making process by providing additional qualifications and substitutes to the optimal solution.

  13. Traffic analysis toolbox volume IX : work zone modeling and simulation, a guide for analysts

    DOT National Transportation Integrated Search

    2009-03-01

    This document is the second volume in the FHWA Traffic Analysis Toolbox: Work Zone Analysis series. Whereas the first volume provides guidance to decision-makers at agencies and jurisdictions considering the role of analytical tools in work zone plan...

  14. Survey of Human Systems Integration (HSI) Tools for USCG Acquisitions

    DTIC Science & Technology

    2009-04-01

    an IMPRINT HPM. IMPRINT uses task network modeling to represent human performance. As the name implies, task networks use a flowchart type format...tools; and built-in tutoring support for beginners . A perceptual/motor layer extending ACT-R’s theory of cognition to perception and action is also...chisystems.com B.8 Information and Functional Flow Analysis Description In information flow analysis, a flowchart of the information and decisions

  15. Graphical Contingency Analysis for the Nation's Electric Grid

    ScienceCinema

    Zhenyu (Henry) Huang

    2017-12-09

    PNNL has developed a new tool to manage the electric grid more effectively, helping prevent blackouts and brownouts--and possibly avoiding millions of dollars in fines for system violations. The Graphical Contingency Analysis tool monitors grid performance, shows prioritized lists of problems, provides visualizations of potential consequences, and helps operators identify the most effective courses of action. This technology yields faster, better decisions and a more stable and reliable power grid.

  16. Decision support tool for diagnosing the source of variation

    NASA Astrophysics Data System (ADS)

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

    2017-08-01

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

  17. Lakeside: Merging Urban Design with Scientific Analysis

    ScienceCinema

    Guzowski, Leah; Catlett, Charlie; Woodbury, Ed

    2018-01-16

    Researchers at the U.S. Department of Energy's Argonne National Laboratory and the University of Chicago are developing tools that merge urban design with scientific analysis to improve the decision-making process associated with large-scale urban developments. One such tool, called LakeSim, has been prototyped with an initial focus on consumer-driven energy and transportation demand, through a partnership with the Chicago-based architectural and engineering design firm Skidmore, Owings & Merrill, Clean Energy Trust and developer McCaffery Interests. LakeSim began with the need to answer practical questions about urban design and planning, requiring a better understanding about the long-term impact of design decisions on energy and transportation demand for a 600-acre development project on Chicago's South Side - the Chicago Lakeside Development project.

  18. Depth of manual dismantling analysis: A cost–benefit approach

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Achillas, Ch., E-mail: c.achillas@ihu.edu.gr; Aidonis, D.; Vlachokostas, Ch.

    Highlights: ► A mathematical modeling tool for OEMs. ► The tool can be used by OEMs, recyclers of electr(on)ic equipment or WEEE management systems’ regulators. ► The tool makes use of cost–benefit analysis in order to determine the optimal depth of product disassembly. ► The reusable materials and the quantity of metals and plastics recycled can be quantified in an easy-to-comprehend manner. - Abstract: This paper presents a decision support tool for manufacturers and recyclers towards end-of-life strategies for waste electrical and electronic equipment. A mathematical formulation based on the cost benefit analysis concept is herein analytically described in ordermore » to determine the parts and/or components of an obsolete product that should be either non-destructively recovered for reuse or be recycled. The framework optimally determines the depth of disassembly for a given product, taking into account economic considerations. On this basis, it embeds all relevant cost elements to be included in the decision-making process, such as recovered materials and (depreciated) parts/components, labor costs, energy consumption, equipment depreciation, quality control and warehousing. This tool can be part of the strategic decision-making process in order to maximize profitability or minimize end-of-life management costs. A case study to demonstrate the models’ applicability is presented for a typical electronic product in terms of structure and material composition. Taking into account the market values of the pilot product’s components, the manual disassembly is proven profitable with the marginal revenues from recovered reusable materials to be estimated at 2.93–23.06 €, depending on the level of disassembly.« less

  19. The challenge of predicting problematic chemicals using a decision analysis tool: Triclosan as a case study.

    PubMed

    Perez, Angela L; Gauthier, Alison M; Ferracini, Tyler; Cowan, Dallas M; Kingsbury, Tony; Panko, Julie

    2017-01-01

    Manufacturers lack a reliable means for determining whether a chemical will be targeted for deselection from their supply chain. In this analysis, 3 methods for determining whether a specific chemical (triclosan) would meet the criteria necessary for being targeted for deselection are presented. The methods included a list-based approach, use of a commercially available chemical assessment software tool run in 2 modes, and a public interest evaluation. Our results indicated that triclosan was included on only 6 of the lists reviewed, none of which were particularly influential in chemical selection decisions. The results from the chemical assessment tool evaluations indicated that human and ecological toxicity for triclosan is low and received scores indicating that the chemical would be considered of low concern. However, triclosan's peak public interest tracked several years in advance of increased regulatory scrutiny of this chemical suggesting that public pressure may have been influential in deselection decisions. Key data gaps and toxicity endpoints not yet regulated such as endocrine disruption potential or phototoxicity, but that are important to estimate the trajectory for deselection of a chemical, are discussed. Integr Environ Assess Manag 2017;13:198-207. © 2016 SETAC. © 2016 SETAC.

  20. Modern data-driven decision support systems: the role of computing with words and computational linguistics

    NASA Astrophysics Data System (ADS)

    Kacprzyk, Janusz; Zadrożny, Sławomir

    2010-05-01

    We present how the conceptually and numerically simple concept of a fuzzy linguistic database summary can be a very powerful tool for gaining much insight into the very essence of data. The use of linguistic summaries provides tools for the verbalisation of data analysis (mining) results which, in addition to the more commonly used visualisation, e.g. via a graphical user interface, can contribute to an increased human consistency and ease of use, notably for supporting decision makers via the data-driven decision support system paradigm. Two new relevant aspects of the analysis are also outlined which were first initiated by the authors. First, following Kacprzyk and Zadrożny, it is further considered how linguistic data summarisation is closely related to some types of solutions used in natural language generation (NLG). This can make it possible to use more and more effective and efficient tools and techniques developed in NLG. Second, similar remarks are given on relations to systemic functional linguistics. Moreover, following Kacprzyk and Zadrożny, comments are given on an extremely relevant aspect of scalability of linguistic summarisation of data, using a new concept of a conceptual scalability.

  1. Using Decision Analysis to Improve Malaria Control Policy Making

    PubMed Central

    Kramer, Randall; Dickinson, Katherine L.; Anderson, Richard M.; Fowler, Vance G.; Miranda, Marie Lynn; Mutero, Clifford M.; Saterson, Kathryn A.; Wiener, Jonathan B.

    2013-01-01

    Malaria and other vector-borne diseases represent a significant and growing burden in many tropical countries. Successfully addressing these threats will require policies that expand access to and use of existing control methods, such as insecticide-treated bed nets and artemesinin combination therapies for malaria, while weighing the costs and benefits of alternative approaches over time. This paper argues that decision analysis provides a valuable framework for formulating such policies and combating the emergence and re-emergence of malaria and other diseases. We outline five challenges that policy makers and practitioners face in the struggle against malaria, and demonstrate how decision analysis can help to address and overcome these challenges. A prototype decision analysis framework for malaria control in Tanzania is presented, highlighting the key components that a decision support tool should include. Developing and applying such a framework can promote stronger and more effective linkages between research and policy, ultimately helping to reduce the burden of malaria and other vector-borne diseases. PMID:19356821

  2. A framework for sensitivity analysis of decision trees.

    PubMed

    Kamiński, Bogumił; Jakubczyk, Michał; Szufel, Przemysław

    2018-01-01

    In the paper, we consider sequential decision problems with uncertainty, represented as decision trees. Sensitivity analysis is always a crucial element of decision making and in decision trees it often focuses on probabilities. In the stochastic model considered, the user often has only limited information about the true values of probabilities. We develop a framework for performing sensitivity analysis of optimal strategies accounting for this distributional uncertainty. We design this robust optimization approach in an intuitive and not overly technical way, to make it simple to apply in daily managerial practice. The proposed framework allows for (1) analysis of the stability of the expected-value-maximizing strategy and (2) identification of strategies which are robust with respect to pessimistic/optimistic/mode-favoring perturbations of probabilities. We verify the properties of our approach in two cases: (a) probabilities in a tree are the primitives of the model and can be modified independently; (b) probabilities in a tree reflect some underlying, structural probabilities, and are interrelated. We provide a free software tool implementing the methods described.

  3. The development and validation of the clinicians' awareness towards cognitive errors (CATChES) in clinical decision making questionnaire tool.

    PubMed

    Chew, Keng Sheng; Kueh, Yee Cheng; Abdul Aziz, Adlihafizi

    2017-03-21

    Despite their importance on diagnostic accuracy, there is a paucity of literature on questionnaire tools to assess clinicians' awareness toward cognitive errors. A validation study was conducted to develop a questionnaire tool to evaluate the Clinician's Awareness Towards Cognitive Errors (CATChES) in clinical decision making. This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors. Content validation for both parts was first determined followed by construct validation for Part A. Construct validation for Part B was not determined as the responses were set in a dichotomous format. For content validation, all items in both Part A and Part B were rated as "excellent" in terms of their relevance in clinical settings. For construct validation using exploratory factor analysis (EFA) for Part A, a two-factor model with total variance extraction of 60% was determined. Two items were deleted. Then, the EFA was repeated showing that all factor loadings are above the cut-off value of >0.5. The Cronbach's alpha for both factors are above 0.6. The CATChES questionnaire tool is a valid questionnaire tool aimed to evaluate the awareness among clinicians toward cognitive errors in clinical decision making.

  4. ISHM Decision Analysis Tool: Operations Concept

    NASA Technical Reports Server (NTRS)

    2006-01-01

    The state-of-the-practice Shuttle caution and warning system warns the crew of conditions that may create a hazard to orbiter operations and/or crew. Depending on the severity of the alarm, the crew is alerted with a combination of sirens, tones, annunciator lights, or fault messages. The combination of anomalies (and hence alarms) indicates the problem. Even with much training, determining what problem a particular combination represents is not trivial. In many situations, an automated diagnosis system can help the crew more easily determine an underlying root cause. Due to limitations of diagnosis systems,however, it is not always possible to explain a set of alarms with a single root cause. Rather, the system generates a set of hypotheses that the crew can select from. The ISHM Decision Analysis Tool (IDAT) assists with this task. It presents the crew relevant information that could help them resolve the ambiguity of multiple root causes and determine a method for mitigating the problem. IDAT follows graphical user interface design guidelines and incorporates a decision analysis system. I describe both of these aspects.

  5. Structured decision making for managing pneumonia epizootics in bighorn sheep

    USGS Publications Warehouse

    Sells, Sarah N.; Mitchell, Michael S.; Edwards, Victoria L.; Gude, Justin A.; Anderson, Neil J.

    2016-01-01

    Good decision-making is essential to conserving wildlife populations. Although there may be multiple ways to address a problem, perfect solutions rarely exist. Managers are therefore tasked with identifying decisions that will best achieve desired outcomes. Structured decision making (SDM) is a method of decision analysis used to identify the most effective, efficient, and realistic decisions while accounting for values and priorities of the decision maker. The stepwise process includes identifying the management problem, defining objectives for solving the problem, developing alternative approaches to achieve the objectives, and formally evaluating which alternative is most likely to accomplish the objectives. The SDM process can be more effective than informal decision-making because it provides a transparent way to quantitatively evaluate decisions for addressing multiple management objectives while incorporating science, uncertainty, and risk tolerance. To illustrate the application of this process to a management need, we present an SDM-based decision tool developed to identify optimal decisions for proactively managing risk of pneumonia epizootics in bighorn sheep (Ovis canadensis) in Montana. Pneumonia epizootics are a major challenge for managers due to long-term impacts to herds, epistemic uncertainty in timing and location of future epizootics, and consequent difficulty knowing how or when to manage risk. The decision tool facilitates analysis of alternative decisions for how to manage herds based on predictions from a risk model, herd-specific objectives, and predicted costs and benefits of each alternative. Decision analyses for 2 example herds revealed that meeting management objectives necessitates specific approaches unique to each herd. The analyses showed how and under what circumstances the alternatives are optimal compared to other approaches and current management. Managers can be confident that these decisions are effective, efficient, and realistic because they explicitly account for important considerations managers implicitly weigh when making decisions, including competing management objectives, uncertainty in potential outcomes, and risk tolerance.

  6. Analysis of a Decision Support System for CASE Tool Selection and the Specification of an Ada to SQL Abstract Interface

    DTIC Science & Technology

    1991-12-01

    34 foreign keys" ,which are keys inherited from conlected entities, the keys would already be defined in the connected entity’s domain primiti le definition...defined for the rootnode re!ationship because all attributes are foreign keys and they are already defined in the connected entities domain primitive...can exchange data with other tools including other tools in the tool vendor’s tool 99 Upper CASE Tool Charactcrizcs set. The important attributes are

  7. Clinical Decision Support Reduces Overuse of Red Blood Cell Transfusions: Interrupted Time Series Analysis.

    PubMed

    Kassakian, Steven Z; Yackel, Thomas R; Deloughery, Thomas; Dorr, David A

    2016-06-01

    Red blood cell transfusion is the most common procedure in hospitalized patients in the US. Growing evidence suggests that a sizeable percentage of these transfusions are inappropriate, putting patients at significant risk and increasing costs to the health care system. We performed a retrospective quasi-experimental study from November 2008 until November 2014 in a 576-bed tertiary care hospital. The intervention consisted of an interruptive clinical decision support alert shown to a provider when a red blood cell transfusion was ordered in a patient whose most recent hematocrit was ≥21%. We used interrupted time series analysis to determine whether our primary outcome of interest, rate of red blood cell transfusion in patients with hematocrit ≥21% per 100 patient (pt) days, was reduced by the implementation of the clinical decision support tool. The rate of platelet transfusions was used as a nonequivalent dependent control variable. A total of 143,000 hospital admissions were included in our analysis. Red blood cell transfusions decreased from 9.4 to 7.8 per 100 pt days after the clinical decision support intervention was implemented. Interrupted time series analysis showed that significant decline of 0.05 (95% confidence interval [CI], 0.03-0.07; P < .001) units of red blood cells transfused per 100 pt days per month was already underway in the preintervention period. This trend accelerated to 0.1 (95% CI, 0.09-0.12; P < .001) units of red blood cells transfused per 100 pt days per month following the implementation of the clinical decision support tool. There was no statistical change in the rate of platelet transfusion resulting from the intervention. The implementation of an evidence-based clinical decision support tool was associated with a significant decline in the overuse of red blood cell transfusion. We believe this intervention could be easily replicated in other hospitals using commercial electronic health records and a similar reduction in overuse of red blood cell transfusions achieved. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Multi Criteria Evaluation Module for RiskChanges Spatial Decision Support System

    NASA Astrophysics Data System (ADS)

    Olyazadeh, Roya; Jaboyedoff, Michel; van Westen, Cees; Bakker, Wim

    2015-04-01

    Multi-Criteria Evaluation (MCE) module is one of the five modules of RiskChanges spatial decision support system. RiskChanges web-based platform aims to analyze changes in hydro-meteorological risk and provides tools for selecting the best risk reduction alternative. It is developed under CHANGES framework (changes-itn.eu) and INCREO project (increo-fp7.eu). MCE tool helps decision makers and spatial planners to evaluate, sort and rank the decision alternatives. The users can choose among different indicators that are defined within the system using Risk and Cost Benefit analysis results besides they can add their own indicators. Subsequently the system standardizes and prioritizes them. Finally, the best decision alternative is selected by using the weighted sum model (WSM). The Application of this work is to facilitate the effect of MCE for analyzing changing risk over the time under different scenarios and future years by adopting a group decision making into practice and comparing the results by numeric and graphical view within the system. We believe that this study helps decision-makers to achieve the best solution by expressing their preferences for strategies under future scenarios. Keywords: Multi-Criteria Evaluation, Spatial Decision Support System, Weighted Sum Model, Natural Hazard Risk Management

  9. Overview of EPA tools for supporting local-, state- and regional-level decision makers addressing energy and environmental issues: NYC MARKAL Energy Systems Model and Municipal Solid Waste Decision Support Tool

    EPA Science Inventory

    A workshop will be conducted to demonstrate and focus on two decision support tools developed at EPA/ORD: 1. Community-scale MARKAL model: an energy-water technology evaluation tool and 2. Municipal Solid Waste Decision Support Tool (MSW DST). The Workshop will be part of Southea...

  10. Views of general practitioners on the use of STOPP&START in primary care: a qualitative study.

    PubMed

    Dalleur, O; Feron, J-M; Spinewine, A

    2014-08-01

    STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment) criteria aim at detecting potentially inappropriate prescribing in older people. The objective was to explore general practitioners' (GPs) perceptions regarding the use of the STOPP&START tool in their practice. We conducted three focus groups which were conveniently sampled. Vignettes with clinical cases were provided for discussion as well as a full version of the STOPP&START tool. Knowledge, strengths and weaknesses of the tool and its implementation were discussed. Two researchers independently performed content analysis, classifying quotes and creating new categories for emerging themes. Discussions highlighted incentives (e.g. systematic procedure for medication review) and barriers (e.g. time-consuming application) influencing the use of STOPP&START in primary care. Usefulness, comprehensiveness, and relevance of the tool were also questioned. Another important category emerging from the content analysis was the projected use of the tool. The GPs imagined key elements for the implementation in daily practice: computerized clinical decision support system, education, and multidisciplinary collaborations, especially at care transitions and in nursing homes. Despite variables views on the usefulness, comprehensiveness, and relevance of STOPP&START, GPs suggest the implementation of this tool in primary care within computerized clinical decision support systems, through education, and used as part of multidisciplinary collaborations.

  11. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shahidehpour, Mohammad

    Integrating 20% or more wind energy into the system and transmitting large sums of wind energy over long distances will require a decision making capability that can handle very large scale power systems with tens of thousands of buses and lines. There is a need to explore innovative analytical and implementation solutions for continuing reliable operations with the most economical integration of additional wind energy in power systems. A number of wind integration solution paths involve the adoption of new operating policies, dynamic scheduling of wind power across interties, pooling integration services, and adopting new transmission scheduling practices. Such practicesmore » can be examined by the decision tool developed by this project. This project developed a very efficient decision tool called Wind INtegration Simulator (WINS) and applied WINS to facilitate wind energy integration studies. WINS focused on augmenting the existing power utility capabilities to support collaborative planning, analysis, and wind integration project implementations. WINS also had the capability of simulating energy storage facilities so that feasibility studies of integrated wind energy system applications can be performed for systems with high wind energy penetrations. The development of WINS represents a major expansion of a very efficient decision tool called POwer Market Simulator (POMS), which was developed by IIT and has been used extensively for power system studies for decades. Specifically, WINS provides the following superiorities; (1) An integrated framework is included in WINS for the comprehensive modeling of DC transmission configurations, including mono-pole, bi-pole, tri-pole, back-to-back, and multi-terminal connection, as well as AC/DC converter models including current source converters (CSC) and voltage source converters (VSC); (2) An existing shortcoming of traditional decision tools for wind integration is the limited availability of user interface, i.e., decision results are often text-based demonstrations. WINS includes a powerful visualization tool and user interface capability for transmission analyses, planning, and assessment, which will be of great interest to power market participants, power system planners and operators, and state and federal regulatory entities; and (3) WINS can handle extended transmission models for wind integration studies. WINS models include limitations on transmission flow as well as bus voltage for analyzing power system states. The existing decision tools often consider transmission flow constraints (dc power flow) alone which could result in the over-utilization of existing resources when analyzing wind integration. WINS can be used to assist power market participants including transmission companies, independent system operators, power system operators in vertically integrated utilities, wind energy developers, and regulatory agencies to analyze economics, security, and reliability of various options for wind integration including transmission upgrades and the planning of new transmission facilities. WINS can also be used by industry for the offline training of reliability and operation personnel when analyzing wind integration uncertainties, identifying critical spots in power system operation, analyzing power system vulnerabilities, and providing credible decisions for examining operation and planning options for wind integration. Researches in this project on wind integration included (1) Development of WINS; (2) Transmission Congestion Analysis in the Eastern Interconnection; (3) Analysis of 2030 Large-Scale Wind Energy Integration in the Eastern Interconnection; (4) Large-scale Analysis of 2018 Wind Energy Integration in the Eastern U.S. Interconnection. The research resulted in 33 papers, 9 presentations, 9 PhD degrees, 4 MS degrees, and 7 awards. The education activities in this project on wind energy included (1) Wind Energy Training Facility Development; (2) Wind Energy Course Development.« less

  12. 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.

  13. TOOLS FOR COMPARATIVE ANALYSIS OF ALTERNATIVES: COMPETING OR COMPLEMENTARY PERSPECTIVES?

    EPA Science Inventory

    A third generation of environmental policymaking and risk management will increasingly impose environmental measures, which may give rise to analyzing countervailing risks. Therefore, a comprehensive analysis of these risks associated with the decision alternatives at hand will e...

  14. Environmental risk assessment of chemicals and nanomaterials--The best foundation for regulatory decision-making?

    PubMed

    Syberg, Kristian; Hansen, Steffen Foss

    2016-01-15

    Environmental risk assessment (ERA) is often considered as the most transparent, objective and reliable decision-making tool for informing the risk management of chemicals and nanomaterials. ERAs are based on the assumption that it is possible to provide accurate estimates of hazard and exposure and, subsequently, to quantify risk. In this paper we argue that since the quantification of risk is dominated by uncertainties, ERAs do not provide a transparent or an objective foundation for decision-making and they should therefore not be considered as a "holy grail" for informing risk management. We build this thesis on the analysis of two case studies (of nonylphenol and nanomaterials) as well as a historical analysis in which we address the scientific foundation for ERAs. The analyses show that ERAs do not properly address all aspects of actual risk, such as the mixture effect and the environmentally realistic risk from nanomaterials. Uncertainties have been recognised for decades, and assessment factors are used to compensate for the lack of realism in ERAs. The assessment factors' values were pragmatically determined, thus lowering the scientific accuracy of the ERAs. Furthermore, the default choice of standard assay for assessing a hazard might not always be the most biologically relevant, so we therefore argue that an ERA should be viewed as a pragmatic decision-making tool among several, and it should not have a special status for informing risk management. In relation to other relevant decision-making tools we discuss the use of chemical alternative assessments (CAAs) and the precautionary principle. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Case Study Application of Determining End of Physical Life Using Survival Analysis (WERF Report INFR2R11b)

    EPA Science Inventory

    Abstract: This case study application provides discussion on a selected application of advanced concepts, included in the End of Asset Life Reinvestment decision-making process tool, using Milwaukee Metropolitan Sewer District (MMSD) pump and motor data sets. The tool provides s...

  16. Development and Validation of the Controller Acceptance Rating Scale (CARS): Results of Empirical Research

    NASA Technical Reports Server (NTRS)

    Lee, Katharine K.; Kerns, Karol; Bone, Randall

    2001-01-01

    The measurement of operational acceptability is important for the development, implementation, and evolution of air traffic management decision support tools. The Controller Acceptance Rating Scale was developed at NASA Ames Research Center for the development and evaluation of the Passive Final Approach Spacing Tool. CARS was modeled after a well-known pilot evaluation rating instrument, the Cooper-Harper Scale, and has since been used in the evaluation of the User Request Evaluation Tool, developed by MITRE's Center for Advanced Aviation System Development. In this paper, we provide a discussion of the development of CARS and an analysis of the empirical data collected with CARS to examine construct validity. Results of intraclass correlations indicated statistically significant reliability for the CARS. From the subjective workload data that were collected in conjunction with the CARS, it appears that the expected set of workload attributes was correlated with the CARS. As expected, the analysis also showed that CARS was a sensitive indicator of the impact of decision support tools on controller operations. Suggestions for future CARS development and its improvement are also provided.

  17. Influence of export control policy on the competitiveness of machine tool producing organizations

    NASA Astrophysics Data System (ADS)

    Ahrstrom, Jeffrey D.

    The possible influence of export control policies on producers of export controlled machine tools is examined in this quantitative study. International market competitiveness theories hold that market controlling policies such as export control regulations may influence an organization's ability to compete (Burris, 2010). Differences in domestic application of export control policy on machine tool exports may impose throttling effects on the competitiveness of participating firms (Freedenberg, 2010). Commodity shipments from Japan, Germany, and the United States to the Russian market will be examined using descriptive statistics; gravity modeling of these specific markets provides a foundation for comparison to actual shipment data; and industry participant responses to a user developed survey will provide additional data for analysis using a Kruskal-Wallis one-way analysis of variance. There is scarce academic research data on the topic of export control effects within the machine tool industry. Research results may be of interest to industry leadership in market participation decisions, advocacy arguments, and strategic planning. Industry advocates and export policy decision makers could find data of interest in supporting positions for or against modifications of export control policies.

  18. Midlevel Maternity Providers' Preferences of a Childbirth Monitoring Tool in Low-Income Health Units in Uganda.

    PubMed

    Balikuddembe, Michael S; Wakholi, Peter K; Tumwesigye, Nazarius M; Tylleskär, Thorkild

    2018-01-01

    A third of women in childbirth are inadequately monitored, partly due to the tools used. Some stakeholders assert that the current labour monitoring tools are not efficient and need improvement to become more relevant to childbirth attendants. The study objective was to explore the expectations of maternity service providers for a mobile childbirth monitoring tool in maternity facilities in a low-income country like Uganda. Semi-structured interviews of purposively selected midwives and doctors in rural-urban childbirth facilities in Uganda were conducted before thematic data analysis. The childbirth providers expected a tool that enabled fast and secure childbirth record storage and sharing. They desired a tool that would automatically and conveniently register patient clinical findings, and actively provide interactive clinical decision support on a busy ward. The tool ought to support agreed upon standards for good pregnancy outcomes but also adaptable to the patient and their difficult working conditions. The tool functionality should include clinical data management and real-time decision support to the midwives, while the non-functional attributes include versatility and security.

  19. The application of data mining techniques to oral cancer prognosis.

    PubMed

    Tseng, Wan-Ting; Chiang, Wei-Fan; Liu, Shyun-Yeu; Roan, Jinsheng; Lin, Chun-Nan

    2015-05-01

    This study adopted an integrated procedure that combines the clustering and classification features of data mining technology to determine the differences between the symptoms shown in past cases where patients died from or survived oral cancer. Two data mining tools, namely decision tree and artificial neural network, were used to analyze the historical cases of oral cancer, and their performance was compared with that of logistic regression, the popular statistical analysis tool. Both decision tree and artificial neural network models showed superiority to the traditional statistical model. However, as to clinician, the trees created by the decision tree models are relatively easier to interpret compared to that of the artificial neural network models. Cluster analysis also discovers that those stage 4 patients whose also possess the following four characteristics are having an extremely low survival rate: pN is N2b, level of RLNM is level I-III, AJCC-T is T4, and cells mutate situation (G) is moderate.

  20. Promotion Assistance Tool for Mobile Phone Users

    NASA Astrophysics Data System (ADS)

    Intraprasert, P.; Jatikul, N.; Chantrapornchai, C.

    In this paper, we propose an application tool to help analyze the usage of a mobile phone for a typical user. From the past usage, the tool can analyze the promotion that is suitable for the user which may save the total expense. The application consists of both client and server side. On the server side, the information for each promotion package for a phone operator is stored as well as the usage database for each client. The client side is a user interface for both phone operators and users to enter their information. The analysis engine are based on KNN, ANN, decision tree and Naïve Bayes models. For comparison, it is shown that KNN and decision outperforms the others.

  1. The BCD of response time analysis in experimental economics.

    PubMed

    Spiliopoulos, Leonidas; Ortmann, Andreas

    2018-01-01

    For decisions in the wild, time is of the essence. Available decision time is often cut short through natural or artificial constraints, or is impinged upon by the opportunity cost of time. Experimental economists have only recently begun to conduct experiments with time constraints and to analyze response time (RT) data, in contrast to experimental psychologists. RT analysis has proven valuable for the identification of individual and strategic decision processes including identification of social preferences in the latter case, model comparison/selection, and the investigation of heuristics that combine speed and performance by exploiting environmental regularities. Here we focus on the benefits, challenges, and desiderata of RT analysis in strategic decision making. We argue that unlocking the potential of RT analysis requires the adoption of process-based models instead of outcome-based models, and discuss how RT in the wild can be captured by time-constrained experiments in the lab. We conclude that RT analysis holds considerable potential for experimental economics, deserves greater attention as a methodological tool, and promises important insights on strategic decision making in naturally occurring environments.

  2. Translating Cholesterol Guidelines Into Primary Care Practice: A Multimodal Cluster Randomized Trial

    PubMed Central

    Eaton, Charles B.; Parker, Donna R.; Borkan, Jeffrey; McMurray, Jerome; Roberts, Mary B.; Lu, Bing; Goldman, Roberta; Ahern, David K.

    2011-01-01

    PURPOSE We wanted to determine whether an intervention based on patient activation and a physician decision support tool was more effective than usual care for improving adherence to National Cholesterol Education Program guidelines. METHODS A 1-year cluster randomized controlled trial was performed using 30 primary care practices (4,105 patients) in southeastern New England. The main outcome was the percentage of patients screened for hyperlipidemia and treated to their low-density lipoprotein (LDL) and non–high-density lipoprotein (HDL) cholesterol goals. RESULTS After 1 year of intervention, both randomized practice groups improved screening (89% screened), and 74% of patients in both groups were at their LDL and non-HDL cholesterol goals (P <.001). Using intent-to-treat analysis, we found no statistically significant differences between practice groups in screening or percentage of patients who achieved LDL and non-HDL cholesterol goals. Post hoc analysis showed practices who made high use of the patient activation kiosk were more likely to have patients screened (odds ratio [OR] = 2.54; 95% confidence interval [CI], 1.97–3.27) compared with those who made infrequent or no use. Additionally, physicians who made high use of decision support tools were more likely to have their patients at their LDL cholesterol goals (OR = 1.27; 95% CI, 1.07–1.50) and non-HDL goals (OR = 1.23; 95% CI, 1.04–1.46) than low-use or no-use physicians. CONCLUSION This study showed null results with the intent-to-treat analysis regarding the benefits of a patient activation and a decision support tool in improving cholesterol management in primary care practices. Post hoc analysis showed a potential benefit in practices that used the e-health tools more frequently in screening and management of dyslipidemia. Further research on how to incorporate and increase adoption of user-friendly, patient-centered e-health tools to improve screening and management of chronic diseases and their risk factors is warranted. PMID:22084264

  3. Integrating evidence and individual preferences using a web-based multi-criteria decision analytic tool: an application to prostate cancer screening.

    PubMed

    Cunich, Michelle; Salkeld, Glenn; Dowie, Jack; Henderson, Joan; Bayram, Clare; Britt, Helena; Howard, Kirsten

    2011-01-01

    Annalisa© (AL) is a web-based decision-support template grounded in multi-criteria decision analysis (MCDA). It uses a simple expected value algorithm to calculate a score for each option by taking into account the individual's preferences for different criteria (as importance weights) and the evidence of the performance of each option on each criterion. Given the uncertainty surrounding the trade offs between benefits and harms for prostate cancer screening, this topic was chosen as the vehicle to introduce this new decision-support template. The aim of the study was to introduce a new decision-support template, AL, and to develop and pilot a decision-support tool for prostate cancer screening using it. A decision-support tool for prostate cancer screening (ALProst) was implemented in the AL template. ALProst incorporated evidence on both the benefits and the potential harms of prostate cancer screening (the 'attributes') from published randomized controlled trials (RCTs). Individual weights for each attribute were elicited during interviews. By combining the individual's preferences and the evidence, the best option for the user was identified on the basis of quantified scores. A convenience sample of computer-proficient primary-care physicians (general practitioners [GPs] in Australia) from the Sydney Metropolitan area (Australia) were invited to complete a face-to-face interview involving the decision-support tool. Preference for undergoing prostate-specific antigen testing for prostate cancer, both personally and for their patients, was sought prior to seeing the tool. After gaining hands-on experience with using the tool, GPs were asked to comment on the merits of the template and the tool. Preference for presenting the benefits of prostate cancer screening as the relative or absolute risk reduction in prostate cancer-specific mortality was also sought. Of 60 GPs approached, ten (six men and four women) completed an interview (16.7% response rate). Most GPs agreed/strongly agreed with positive statements about the ease with which they could use AL (seven GPs), and understand the information in, and format of, AL (nine and eight, respectively). Eight agreed/strongly agreed that ALProst would be a useful tool for discussing prostate cancer screening with their patients. GPs were also asked to nominate difficult clinical decisions that they, and their patients, have had to make; responses included cancer screening (including prostate cancer); treating patients with multiple illnesses/diseases; managing multiple cardiovascular disease risk factors; and managing patients who are receiving multiple medications. The common element was the need to consider multiple factors in making these complex decisions. AL is distinguishable from most other decision-support templates available today by its underlying conceptual framework, MCDA, and its power to combine individual preferences with evidence to derive the best option for the user quantitatively. It therefore becomes potentially useful for all decisions at all levels in the healthcare system. Moreover, it will provide a universal graphic 'language' that can overcome the burden to patients of encountering a plethora of widely varying decision aids for different conditions during their lifetime.

  4. FDT 2.0: Improving scalability of the fuzzy decision tree induction tool - integrating database storage.

    PubMed

    Durham, Erin-Elizabeth A; Yu, Xiaxia; Harrison, Robert W

    2014-12-01

    Effective machine-learning handles large datasets efficiently. One key feature of handling large data is the use of databases such as MySQL. The freeware fuzzy decision tree induction tool, FDT, is a scalable supervised-classification software tool implementing fuzzy decision trees. It is based on an optimized fuzzy ID3 (FID3) algorithm. FDT 2.0 improves upon FDT 1.0 by bridging the gap between data science and data engineering: it combines a robust decisioning tool with data retention for future decisions, so that the tool does not need to be recalibrated from scratch every time a new decision is required. In this paper we briefly review the analytical capabilities of the freeware FDT tool and its major features and functionalities; examples of large biological datasets from HIV, microRNAs and sRNAs are included. This work shows how to integrate fuzzy decision algorithms with modern database technology. In addition, we show that integrating the fuzzy decision tree induction tool with database storage allows for optimal user satisfaction in today's Data Analytics world.

  5. Development and field testing of a decision support tool to facilitate shared decision making in contraceptive counseling.

    PubMed

    Dehlendorf, Christine; Fitzpatrick, Judith; Steinauer, Jody; Swiader, Lawrence; Grumbach, Kevin; Hall, Cara; Kuppermann, Miriam

    2017-07-01

    We developed and formatively evaluated a tablet-based decision support tool for use by women prior to a contraceptive counseling visit to help them engage in shared decision making regarding method selection. Drawing upon formative work around women's preferences for contraceptive counseling and conceptual understanding of health care decision making, we iteratively developed a storyboard and then digital prototypes, based on best practices for decision support tool development. Pilot testing using both quantitative and qualitative data and cognitive testing was conducted. We obtained feedback from patient and provider advisory groups throughout the development process. Ninety-six percent of women who used the tool in pilot testing reported that it helped them choose a method, and qualitative interviews indicated acceptability of the tool's content and presentation. Compared to the control group, women who used the tool demonstrated trends toward increased likelihood of complete satisfaction with their method. Participant responses to cognitive testing were used in tool refinement. Our decision support tool appears acceptable to women in the family planning setting. Formative evaluation of the tool supports its utility among patients making contraceptive decisions, which can be further evaluated in a randomized controlled trial. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Bringing values and deliberation to science communication

    PubMed Central

    Dietz, Thomas

    2013-01-01

    Decisions always involve both facts and values, whereas most science communication focuses only on facts. If science communication is intended to inform decisions, it must be competent with regard to both facts and values. Public participation inevitably involves both facts and values. Research on public participation suggests that linking scientific analysis to public deliberation in an iterative process can help decision making deal effectively with both facts and values. Thus, linked analysis and deliberation can be an effective tool for science communication. However, challenges remain in conducting such process at the national and global scales, in enhancing trust, and in reconciling diverse values. PMID:23940350

  7. Decision technology.

    PubMed

    Edwards, W; Fasolo, B

    2001-01-01

    This review is about decision technology-the rules and tools that help us make wiser decisions. First, we review the three rules that are at the heart of most traditional decision technology-multi-attribute utility, Bayes' theorem, and subjective expected utility maximization. Since the inception of decision research, these rules have prescribed how we should infer values and probabilities and how we should combine them to make better decisions. We suggest how to make best use of all three rules in a comprehensive 19-step model. The remainder of the review explores recently developed tools of decision technology. It examines the characteristics and problems of decision-facilitating sites on the World Wide Web. Such sites now provide anyone who can use a personal computer with access to very sophisticated decision-aiding tools structured mainly to facilitate consumer decision making. It seems likely that the Web will be the mode by means of which decision tools will be distributed to lay users. But methods for doing such apparently simple things as winnowing 3000 options down to a more reasonable number, like 10, contain traps for unwary decision technologists. The review briefly examines Bayes nets and influence diagrams-judgment and decision-making tools that are available as computer programs. It very briefly summarizes the state of the art of eliciting probabilities from experts. It concludes that decision tools will be as important in the 21st century as spreadsheets were in the 20th.

  8. Present-value analysis: A systems approach to public decisionmaking for cost effectiveness

    NASA Technical Reports Server (NTRS)

    Herbert, T. T.

    1971-01-01

    Decision makers within Governmental agencies and Congress must evaluate competing (and sometimes conflicting) proposals which seek funding and implementation. Present value analysis can be an effective decision making tool by enabling the formal evaluation of the effects of competing proposals on efficient national resource utilization. A project's costs are not only its direct disbursements, but its social costs as well. How much does it cost to have those funds diverted from their use and economic benefit by the private sector to the public project? Comparisons of competing projects' social costs allow decision makers to expand their decision bases by quantifying the projects' impacts upon the economy and the efficient utilization of the country's limited national resources. A conceptual model is established for the choosing of the appropriate discount rate to be used in evaluation decisions through the technique.

  9. The effectiveness of tools used to evaluate successful critical decision making skills for applicants to healthcare graduate educational programs: a systematic review.

    PubMed

    Benham, Brian; Hawley, Diane

    2015-05-15

    Students leave healthcare academic programs for a variety of reasons. When they attrite, it is disappointing for the student as well as their faculty. Advanced practice nursing and other healthcare professions require not only extensive academic preparation, but also the ability to critically evaluate patient care situations. The ability to critically evaluate a situation is not innate. Critical decision making skills are high level skills that are difficult to assess. For the purpose of this review, critical decision making and critical thinking skills refer to the same constructs and will be referred to globally as critical decision making skills. The objective of this review was to identify the effectiveness of tools used to evaluate critical decision making skills for applicants to healthcare graduate educational programs. Adult (18 years of age or older) applicants, students enrolled and/or recent graduates (within one year from completion) of healthcare graduate educational programs. Types of interventions: This review considered studies that evaluated the utilization of unique tools as well as standard tools, such as the Graduate Record Exam or grade point average, to evaluate critical decision making skills in graduate healthcare program applicants. Types of studies: Experimental and non-experimental studies were considered for inclusion. Types of outcomes: Successful quantitative evaluations based on specific field of study standards. The search strategy aimed to find both published and unpublished studies. Studies published in English after 1969 were considered for inclusion in this review. Databases that included both published and unpublished (grey) literature were searched. Additionally, reference lists from all articles retrieved were examined for articles for inclusion. Selected papers were assessed by two independent reviewers using standardized critical appraisal instruments from Joanna Briggs Institute. Any disagreement between reviewers was resolved through discussion or with a third reviewer. Data was extracted independently by each reviewer from papers included in the review using a Microsoft Excel spreadsheet. Included data included study type, 'r' values, number of subjects and reported 'p' values. These were indexed by author, year and study title. The meta-analysis was performed using the method for effect size analysis from Hunter and Schmidt. The syntax for equations was transposed into a Microsoft Excel spreadsheet for data entry, analysis and graph creation. No articles or paper addressing unique tools for ascertaining critical decision making skills met the inclusion criteria. Standard tools, which were represented in the literature, assess critical decision making skills via prediction of academic and clinical success, which indicates the presence of critical decision making skills in graduate healthcare students. A total of 16 studies addressing standard tools were included in this review. All were retrospective case series studies. The date range for the included studies was 1970 to 2009. The strongest relationship was undergraduate grade point average's correlation to graduate grade point average (small effect size with an 'r' value of 0.27, credibility interval of 0.18-0.37). The second strongest relationship was between Graduate Record Examination’s verbal section and graduate grade point average (small effect size with an r value of 0.24, CrI of 0.11-0.37). An applicant’s undergraduate GPA has the strongest correlation with graduate healthcare program success of the indicators analyzed (r = 0.27, small effect size). The next best predictor of graduate healthcare program success was the GRE Verbal score (r = 0.24, small effect size). However, all of the variables carried positive correlations with graduate success, just of lesser effect size strength. This review supports the continued use of traditional indicators of graduate school potential in the undergraduate grade point average and the various sections of the Graduate Record Examination for the selection of graduate healthcare applicants. Primary studies should be funded and performed to assess the use of unique tools in assessing critical thinking in graduate healthcare students. The Joanna Briggs Institute.

  10. An Analysis of the Plumbing Occupation.

    ERIC Educational Resources Information Center

    Carlton, Earnest L.; Hollar, Charles E.

    The occupational analysis contains a brief job description, presenting for the occupation of plumbing 12 detailed task statements which specify job duties (tools, equipment, materials, objects acted upon, performance knowledge, safety considerations/hazards, decisions, cues, and errors) and learning skills (science, mathematics/number systems, and…

  11. Analysis of the Medical Assisting Occupation.

    ERIC Educational Resources Information Center

    Keir, Lucille; And Others

    The occupational analysis contains a brief job description, presenting for the occupation of medical assistant 113 detailed task statements which specify job duties (tools, equipment, materials, objects acted upon, performance knowledge, safety consideration/hazards, decisions, cues, and errors) and learning skills (science, mathematics/number…

  12. Rapid Benefit Indicators (RBI) Spatial Analysis Toolset - Manual

    EPA Science Inventory

    The Rapid Benefit Indicators (RBI) approach consists of five steps and is outlined in Assessing the Benefits of Wetland Restoration - A Rapid Benefits Indicators Approach for Decision Makers. This spatial analysis tool is intended to be used to analyze existing spatial informatio...

  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. A peer review process as part of the implementation of clinical pathways in radiation oncology: Does it improve compliance?

    PubMed

    Gebhardt, Brian J; Heron, Dwight E; Beriwal, Sushil

    Clinical pathways are patient management plans that standardize evidence-based practices to ensure high-quality and cost-effective medical care. Implementation of a pathway is a collaborative process in our network, requiring the active involvement of physicians. This approach promotes acceptance of pathway recommendations, although a peer review process is necessary to ensure compliance and to capture and approve off-pathway selections. We investigated the peer review process and factors associated with time to completion of peer review. Our cancer center implemented radiation oncology pathways for every disease site throughout a large, integrated network. Recommendations are written based upon national guidelines, published literature, and institutional experience with evidence evaluated hierarchically in order of efficacy, toxicity, and then cost. Physicians enter decisions into an online, menu-driven decision support tool that integrates with medical records. Data were collected from the support tool and included the rate of on- and off-pathway selections, peer review decisions performed by disease site directors, and time to complete peer review. A total of 6965 treatment decisions were entered in 2015, and 605 (8.7%) were made off-pathway and were subject to peer review. The median time to peer review decision was 2 days (interquartile range, 0.2-6.8). Factors associated with time to peer review decision >48 hours on univariate analysis include disease site (P < .0001) with a trend toward significance (P = .066) for radiation therapy modality. There was no difference between recurrent and non-recurrent disease (P = .267). Multivariable analysis revealed disease site was associated with time to peer review (P < .001), with lymphoma and skin/sarcoma most strongly influencing decision time >48 hours. Clinical pathways are an integral tool for standardizing evidence-based care throughout our large, integrated network, with 91.3% of all treatment decisions being made as per pathway. The peer review process was feasible, with <1% selections ultimately rejected, suggesting that awareness of peer review of treatment decisions encourages compliance with clinical pathway recommendations. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  15. Incorporating Guideline Adherence and Practice Implementation Issues into the Design of Decision Support for Beta-Blocker Titration for Heart Failure.

    PubMed

    Smith, Michael W; Brown, Charnetta; Virani, Salim S; Weir, Charlene R; Petersen, Laura A; Kelly, Natalie; Akeroyd, Julia; Garvin, Jennifer H

    2018-04-01

     The recognition of and response to undertreatment of heart failure (HF) patients can be complicated. A clinical reminder can facilitate use of guideline-concordant β-blocker titration for HF patients with depressed ejection fraction. However, the design must consider the cognitive demands on the providers and the context of the work.  This study's purpose is to develop requirements for a clinical decision support tool (a clinical reminder) by analyzing the cognitive demands of the task along with the factors in the Cabana framework of physician adherence to guidelines, the health information technology (HIT) sociotechnical framework, and the Promoting Action on Research Implementation in Health Services (PARIHS) framework of health services implementation. It utilizes a tool that extracts information from medical records (including ejection fraction in free text reports) to identify qualifying patients at risk of undertreatment.  We conducted interviews with 17 primary care providers, 5 PharmDs, and 5 Registered Nurses across three Veterans Health Administration outpatient clinics. The interviews were based on cognitive task analysis (CTA) methods and enhanced through the inclusion of the Cabana, HIT sociotechnical, and PARIHS frameworks. The analysis of the interview data led to the development of requirements and a prototype design for a clinical reminder. We conducted a small pilot usability assessment of the clinical reminder using realistic clinical scenarios.  We identified organizational challenges (such as time pressures and underuse of pharmacists), knowledge issues regarding the guideline, and information needs regarding patient history and treatment status. We based the design of the clinical reminder on how to best address these challenges. The usability assessment indicated the tool could help the decision and titration processes.  Through the use of CTA methods enhanced with adherence, sociotechnical, and implementation frameworks, we designed a decision support tool that considers important challenges in the decision and execution of β-blocker titration for qualifying HF patients at risk of undertreatment. Schattauer GmbH Stuttgart.

  16. Case Study Application Of Determining End Of Asset Physical Life Using Survival Analysis:(WERF Report INFR2R11a)

    EPA Science Inventory

    Abstract:This case study application provides discussion on a selected application of advanced concepts, included in the End of Asset Life Reinvestment decision-making process tool, using a utility practitioner’s data set. The tool provides step-by-step process guidance to the as...

  17. A synthesis of postfire road treatments for BAER teams: methods, treatment effectiveness, and decisionmaking tools for rehabilitation

    Treesearch

    Randy B. Foltz; Peter R. Robichaud; Hakjun Rhee

    2008-01-01

    We synthesized post-fire road treatment information to assist BAER specialists in making road rehabilitation decisions. We developed a questionnaire; conducted 30 interviews of BAER team engineers and hydrologists; acquired and analyzed gray literature and other relevant publications; and reviewed road rehabilitation procedures and analysis tools. Post-fire road...

  18. A Business Analytics Software Tool for Monitoring and Predicting Radiology Throughput Performance.

    PubMed

    Jones, Stephen; Cournane, Seán; Sheehy, Niall; Hederman, Lucy

    2016-12-01

    Business analytics (BA) is increasingly being utilised by radiology departments to analyse and present data. It encompasses statistical analysis, forecasting and predictive modelling and is used as an umbrella term for decision support and business intelligence systems. The primary aim of this study was to determine whether utilising BA technologies could contribute towards improved decision support and resource management within radiology departments. A set of information technology requirements were identified with key stakeholders, and a prototype BA software tool was designed, developed and implemented. A qualitative evaluation of the tool was carried out through a series of semi-structured interviews with key stakeholders. Feedback was collated, and emergent themes were identified. The results indicated that BA software applications can provide visibility of radiology performance data across all time horizons. The study demonstrated that the tool could potentially assist with improving operational efficiencies and management of radiology resources.

  19. Tools of the Future: How Decision Tree Analysis Will Impact Mission Planning

    NASA Technical Reports Server (NTRS)

    Otterstatter, Matthew R.

    2005-01-01

    The universe is infinitely complex; however, the human mind has a finite capacity. The multitude of possible variables, metrics, and procedures in mission planning are far too many to address exhaustively. This is unfortunate because, in general, considering more possibilities leads to more accurate and more powerful results. To compensate, we can get more insightful results by employing our greatest tool, the computer. The power of the computer will be utilized through a technology that considers every possibility, decision tree analysis. Although decision trees have been used in many other fields, this is innovative for space mission planning. Because this is a new strategy, no existing software is able to completely accommodate all of the requirements. This was determined through extensive research and testing of current technologies. It was necessary to create original software, for which a short-term model was finished this summer. The model was built into Microsoft Excel to take advantage of the familiar graphical interface for user input, computation, and viewing output. Macros were written to automate the process of tree construction, optimization, and presentation. The results are useful and promising. If this tool is successfully implemented in mission planning, our reliance on old-fashioned heuristics, an error-prone shortcut for handling complexity, will be reduced. The computer algorithms involved in decision trees will revolutionize mission planning. The planning will be faster and smarter, leading to optimized missions with the potential for more valuable data.

  20. Analysis of complex decisionmaking processes. [with application to jet engine development

    NASA Technical Reports Server (NTRS)

    Hill, J. D.; Ollila, R. G.

    1978-01-01

    The analysis of corporate decisionmaking processes related to major system developments is unusually difficult because of the number of decisionmakers involved in the process and the long development cycle. A method for analyzing such decision processes is developed and illustrated through its application to the analysis of the commercial jet engine development process. The method uses interaction matrices as the key tool for structuring the problem, recording data, and analyzing the data to establish the rank order of the major factors affecting development decisions. In the example, the use of interaction matrices permitted analysts to collect and analyze approximately 50 factors that influenced decisions during the four phases of the development cycle, and to determine the key influencers of decisions at each development phase. The results of this study indicate that the cost of new technology installed on an aircraft is the prime concern of the engine manufacturer.

  1. NEW APPROACHES IN RISK ANALYSIS OF ENVIRONMENTAL STRESSORS TO HUMAN AND ECOLOGICAL SYSTEMS

    EPA Science Inventory

    We explore the application of novel techniques for improving and integrating risk analysis of environmental stressors to human and ecological systems. Environmental protection decisions are guided by risk assessments serving as tools to develop regulatory policy and other relate...

  2. Using an ecosystem service decision support tool to support ridge to reef management: An example of sediment reduction in west Maui, Hawaii

    NASA Astrophysics Data System (ADS)

    Falinski, K. A.; Oleson, K.; Htun, H.; Kappel, C.; Lecky, J.; Rowe, C.; Selkoe, K.; White, C.

    2016-12-01

    Faced with anthropogenic stressors and declining coral reef states, managers concerned with restoration and resilience of coral reefs are increasingly recognizing the need to take a ridge-to-reef, ecosystem-based approach. An ecosystem services framing can help managers move towards these goals, helping to illustrate trade-offs and opportunities of management actions in terms of their impacts on society. We describe a research program building a spatial ecosystem services-based decision-support tool, and being applied to guide ridge-to-reef management in a NOAA priority site in West Maui. We use multiple modeling methods to link biophysical processes to ecosystem services and their spatial flows and social values in an integrating platform. Modeled services include water availability, sediment retention, nutrient retention and carbon sequestration on land. A coral reef ecosystem service model is under development to capture the linkages between terrestrial and coastal ecosystem services. Valuation studies are underway to quantify the implications for human well-being. The tool integrates techniques from decision science to facilitate decision making. We use the sediment retention model to illustrate the types of analyses the tool can support. The case study explores the tradeoffs between road rehabilitation costs and sediment export avoided. We couple the sediment and cost models with trade-off analysis to identify optimal distributed solutions that are most cost-effective in reducing erosion, and then use those models to estimate sediment exposure to coral reefs. We find that cooperation between land owners reveals opportunities for maximizing the benefits of fixing roads and minimizes costs. This research forms the building blocks of an ecosystem service decision support tool that we intend to continue to test and apply in other Pacific Island settings.

  3. Applications of Formal Methods to Specification and Safety of Avionics Software

    NASA Technical Reports Server (NTRS)

    Hoover, D. N.; Guaspari, David; Humenn, Polar

    1996-01-01

    This report treats several topics in applications of formal methods to avionics software development. Most of these topics concern decision tables, an orderly, easy-to-understand format for formally specifying complex choices among alternative courses of action. The topics relating to decision tables include: generalizations fo decision tables that are more concise and support the use of decision tables in a refinement-based formal software development process; a formalism for systems of decision tables with behaviors; an exposition of Parnas tables for users of decision tables; and test coverage criteria and decision tables. We outline features of a revised version of ORA's decision table tool, Tablewise, which will support many of the new ideas described in this report. We also survey formal safety analysis of specifications and software.

  4. Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool.

    PubMed

    Streufert, Ben; Reed, Shelby D; Orlando, Lori A; Taylor, Dean C; Huber, Joel C; Mather, Richard C

    2017-03-01

    Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown. To test a novel shared decision-making tool after sustained FTASD. Specifically measured were the following: (1) importance of aspects of operative versus nonoperative treatment, (2) respondents' agreement with results generated by the tool, (3) willingness to share these results with physicians, and (4) association of results with choice of treatment after FTASD. Cross-sectional study; Level of evidence, 3. A tool was designed and tested using members of Amazon Mechanical Turk, an online panel. The tool included an adaptive conjoint analysis exercise, a method to understand individuals' perceived importance of the following attributes of treatment: (1) chance of recurrent dislocation, (2) cost, (3) short-term limits on shoulder motion, (4) limits on participation in high-risk activities, and (5) duration of physical therapy. Respondents then chose between operative and nonoperative treatment for hypothetical shoulder dislocation. Overall, 374 of 501 (75%) respondents met the inclusion criteria, of which most were young, active males; one-third reported prior dislocation. From the conjoint analysis, the importance of recurrent dislocation and cost of treatment were the most important attributes. A substantial majority agreed with the tool's ability to generate representative preferences and indicated that they would share these preferences with their physician. Importance of recurrence proved significantly predictive of respondents' treatment choices, independent of sex or age; however, activity level was important to previous dislocators. A total of 125 (55%) males and 33 (23%) females chose surgery after FTASD, as did 37% of previous dislocators compared with 45% of nondislocators. When given thorough information about the risks and benefits, respondents had strong preferences for operative treatment after an FTASD. Respondents agreed with the survey results and wanted to share the information with providers. Recurrence was the most important attribute and played a role in decisions about treatment.

  5. The information value of early career productivity in mathematics: a ROC analysis of prediction errors in bibliometricly informed decision making.

    PubMed

    Lindahl, Jonas; Danell, Rickard

    The aim of this study was to provide a framework to evaluate bibliometric indicators as decision support tools from a decision making perspective and to examine the information value of early career publication rate as a predictor of future productivity. We used ROC analysis to evaluate a bibliometric indicator as a tool for binary decision making. The dataset consisted of 451 early career researchers in the mathematical sub-field of number theory. We investigated the effect of three different definitions of top performance groups-top 10, top 25, and top 50 %; the consequences of using different thresholds in the prediction models; and the added prediction value of information on early career research collaboration and publications in prestige journals. We conclude that early career performance productivity has an information value in all tested decision scenarios, but future performance is more predictable if the definition of a high performance group is more exclusive. Estimated optimal decision thresholds using the Youden index indicated that the top 10 % decision scenario should use 7 articles, the top 25 % scenario should use 7 articles, and the top 50 % should use 5 articles to minimize prediction errors. A comparative analysis between the decision thresholds provided by the Youden index which take consequences into consideration and a method commonly used in evaluative bibliometrics which do not take consequences into consideration when determining decision thresholds, indicated that differences are trivial for the top 25 and the 50 % groups. However, a statistically significant difference between the methods was found for the top 10 % group. Information on early career collaboration and publication strategies did not add any prediction value to the bibliometric indicator publication rate in any of the models. The key contributions of this research is the focus on consequences in terms of prediction errors and the notion of transforming uncertainty into risk when we are choosing decision thresholds in bibliometricly informed decision making. The significance of our results are discussed from the point of view of a science policy and management.

  6. A Decision Analysis Tool for Climate Impacts, Adaptations, and Vulnerabilities

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Omitaomu, Olufemi A; Parish, Esther S; Nugent, Philip J

    Climate change related extreme events (such as flooding, storms, and drought) are already impacting millions of people globally at a cost of billions of dollars annually. Hence, there are urgent needs for urban areas to develop adaptation strategies that will alleviate the impacts of these extreme events. However, lack of appropriate decision support tools that match local applications is limiting local planning efforts. In this paper, we present a quantitative analysis and optimization system with customized decision support modules built on geographic information system (GIS) platform to bridge this gap. This platform is called Urban Climate Adaptation Tool (Urban-CAT). Formore » all Urban-CAT models, we divide a city into a grid with tens of thousands of cells; then compute a list of metrics for each cell from the GIS data. These metrics are used as independent variables to predict climate impacts, compute vulnerability score, and evaluate adaptation options. Overall, the Urban-CAT system has three layers: data layer (that contains spatial data, socio-economic and environmental data, and analytic data), middle layer (that handles data processing, model management, and GIS operation), and application layer (that provides climate impacts forecast, adaptation optimization, and site evaluation). The Urban-CAT platform can guide city and county governments in identifying and planning for effective climate change adaptation strategies.« less

  7. Prioritizing Health: A Systematic Approach to Scoping Determinants in Health Impact Assessment.

    PubMed

    McCallum, Lindsay C; Ollson, Christopher A; Stefanovic, Ingrid L

    2016-01-01

    The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of health impact assessment (HIA), the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical) for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted, including both primary and gray literature. A total of 10 HIA scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors, such as impact, public concern, and data availability, to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  8. Building Training Curricula for Accelerating the Use of NOAA Climate Products and Tools

    NASA Astrophysics Data System (ADS)

    Timofeyeva-Livezey, M. M.; Meyers, J. C.; Stevermer, A.; Abshire, W. E.; Beller-Simms, N.; Herring, D.

    2016-12-01

    The National Oceanic and Atmospheric Administration (NOAA) plays a leading role in U.S. intergovernmental efforts on the Climate Data Initiative and the Climate Resilience Toolkit (CRT). CRT (http://toolkit.climate.gov/) is a valuable resource that provides tools, information, and subject matter expertise to decision makers in various sectors, such as agriculture, water resources and transportation, to help them build resilience to our changing climate. In order to make best use of the toolkit and all the resources within it, a training component is critical. The training section helps building users' understanding of the data, science, and impacts of climate variability and change. CRT identifies five steps in building resilience that includes use of appropriate tools to support decision makers depending on their needs. One tool that can be potentially integrated into CRT is NOAA's Local Climate Analysis Tool (LCAT), which provides access to trusted NOAA data and scientifically-sound analysis techniques for doing regional and local climate studies on climate variability and climate change. However, in order for LCAT to be used effectively, we have found an iterative learning approach using specific examples to train users. For example, for LCAT application in analysis of water resources, we use existing CRT case studies for Arizona and Florida water supply users. The Florida example demonstrates primary sensitivity to climate variability impacts, whereas the Arizona example takes into account longer- term climate change. The types of analyses included in LCAT are time series analysis of local climate and the estimated rate of change in the local climate. It also provides a composite analysis to evaluate the relationship between local climate and climate variability events such as El Niño Southern Oscillation, the Pacific North American Index, and other modes of climate variability. This paper will describe the development of a training module for use of LCAT and its integration into CRT. An iterative approach was used that incorporates specific examples of decision making while working with subject matter experts within the water supply community. The recommended strategy is to use a "stepping stone" learning structure to build users knowledge of best practices for use of LCAT.

  9. Fire behavior modeling-a decision tool

    Treesearch

    Jack Cohen; Bill Bradshaw

    1986-01-01

    The usefulness of an analytical model as a fire management decision tool is determined by the correspondence of its descriptive capability to the specific decision context. Fire managers must determine the usefulness of fire models as a decision tool when applied to varied situations. Because the wildland fire phenomenon is complex, analytical fire spread models will...

  10. Decision analysis applied to the purchase of frozen premixed intravenous admixtures.

    PubMed

    Witte, K W; Eck, T A; Vogel, D P

    1985-04-01

    A structured decision-analysis model was used to evaluate frozen premixed cefazolin admixtures. Decision analysis is a process of stating the desired outcome, establishing and weighting evaluation criteria, identifying options for reaching the outcome, evaluating and numerically ranking each option for each criterion, multiplying the ranking by the weight for each criterion, and calculating total points for each option. It was used to compare objectively frozen premixed cefazolin admixtures with batch reconstitution from vials and reconstitution of lyophilized, ready-to-mix containers. In this institution the model numerically demonstrated a distinct preference for the premixed frozen admixture over these other alternatives. A comparison of these results with the total cost impact of each option resulted in a decision to purchase the frozen premixed solution. The advantages of the frozen premixed solution that contributed most to this decision were decreased waste and personnel time. The latter was especially important since it allowed for the reallocation of personnel resources to other potentially cost-reducing clinical functions. Decision analysis proved to be an effective tool for formalizing the process of selecting among various alternatives to reach a desired outcome in this hospital pharmacy.

  11. Multicriteria decision analysis in ranking of analytical procedures for aldrin determination in water.

    PubMed

    Tobiszewski, Marek; Orłowski, Aleksander

    2015-03-27

    The study presents the possibility of multi-criteria decision analysis (MCDA) application when choosing analytical procedures with low environmental impact. A type of MCDA, Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE), was chosen as versatile tool that meets all the analytical chemists--decision makers requirements. Twenty five analytical procedures for aldrin determination in water samples (as an example) were selected as input alternatives to MCDA analysis. Nine different criteria describing the alternatives were chosen from different groups--metrological, economical and the most importantly--environmental impact. The weights for each criterion were obtained from questionnaires that were sent to experts, giving three different scenarios for MCDA results. The results of analysis show that PROMETHEE is very promising tool to choose the analytical procedure with respect to its greenness. The rankings for all three scenarios placed solid phase microextraction and liquid phase microextraction--based procedures high, while liquid-liquid extraction, solid phase extraction and stir bar sorptive extraction--based procedures were placed low in the ranking. The results show that although some of the experts do not intentionally choose green analytical chemistry procedures, their MCDA choice is in accordance with green chemistry principles. The PROMETHEE ranking results were compared with more widely accepted green analytical chemistry tools--NEMI and Eco-Scale. As PROMETHEE involved more different factors than NEMI, the assessment results were only weakly correlated. Oppositely, the results of Eco-Scale assessment were well-correlated as both methodologies involved similar criteria of assessment. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. An Analysis of the Waste Water Treatment Operator Occupation.

    ERIC Educational Resources Information Center

    Clark, Anthony B.; And Others

    The occupational analysis contains a brief job description for the waste water treatment occupations of operator and maintenance mechanic and 13 detailed task statements which specify job duties (tools, equipment, materials, objects acted upon, performance knowledge, safety considerations/hazards, decisions, cues, and errors) and learning skills…

  13. Science Operations Management

    NASA Astrophysics Data System (ADS)

    Squibb, Gael F.

    1984-10-01

    The operation teams for the Infrared Astronomical Satellite (IRAS) included scientists from the IRAS International Science Team. The scientific decisions on an hour-to-hour basis, as well as the long-term strategic decisions, were made by science team members. The IRAS scientists were involved in the analysis of the instrument performance, the analysis of the quality of the data, the decision to reacquire data that was contaminated by radiation effects, the strategy for acquiring the survey data, and the process for using the telescope for additional observations, as well as the processing decisions required to ensure the publication of the final scientific products by end of flight operations plus one year. Early in the project, two science team members were selected to be responsible for the scientific operational decisions. One, located at the operations control center in England, was responsible for the scientific aspects of the satellite operations; the other, located at the scientific processing center in Pasadena, was responsible for the scientific aspects of the processing. These science team members were then responsible for approving the design and test of the tools to support their responsibilities and then, after launch, for using these tools in making their decisions. The ability of the project to generate the final science data products one year after the end of flight operations is due in a large measure to the active participation of the science team members in the operations. This paper presents a summary of the operational experiences gained from this scientific involvement.

  14. Teacher Evaluation and the 'Hand of History.'

    ERIC Educational Resources Information Center

    Wood, Carolyn J.; Pohland, Paul A.

    1983-01-01

    Analysis of teacher evaluation instruments from 65 New Mexico school districts, concurring with nationwide studies, suggests that teacher evaluation is meant more as a tool for administrative decisions than for improving teaching. (JW)

  15. Benefit-Cost Analysis as a Teaching Tool.

    ERIC Educational Resources Information Center

    Dowd, Richard F.

    1980-01-01

    Demonstrates how benefit-cost and present-value analyses can be used to assess the potential social benefits of government projects and to illustrate how interest rates affect decision-making in government and business. (AYC)

  16. Applying analysis tools in planning for operations

    DOT National Transportation Integrated Search

    2009-09-01

    More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

  17. Transmission Bearing Damage Detection Using Decision Fusion Analysis

    NASA Technical Reports Server (NTRS)

    Dempsey, Paula J.; Lewicki, David G.; Decker, Harry J.

    2004-01-01

    A diagnostic tool was developed for detecting fatigue damage to rolling element bearings in an OH-58 main rotor transmission. Two different monitoring technologies, oil debris analysis and vibration, were integrated using data fusion into a health monitoring system for detecting bearing surface fatigue pitting damage. This integrated system showed improved detection and decision-making capabilities as compared to using individual monitoring technologies. This diagnostic tool was evaluated by collecting vibration and oil debris data from tests performed in the NASA Glenn 500 hp Helicopter Transmission Test Stand. Data was collected during experiments performed in this test rig when two unanticipated bearing failures occurred. Results show that combining the vibration and oil debris measurement technologies improves the detection of pitting damage on spiral bevel gears duplex ball bearings and spiral bevel pinion triplex ball bearings in a main rotor transmission.

  18. [Health Impact Assessment: opportunity for participative decision-making or persuasive tool for decisions already taken?].

    PubMed

    Sturloni, Giancarlo

    2016-01-01

    The Health Impact Assessment (HIA) has already been tested in dozens of nations, including Italy, and the reflection is now mature enough to allow a first evaluation of its effective capacity to offer an inclusive tool for prevention. The analysis focuses in particular on the HIA ability to address, through a participatory approach, one of its founding values: the democratic nature of decisions with an impact on public health. In most cases, the experiments carried out so far seem to be disappointing: the participation is often absent or performed in a rhetorical form. Sometimes the HIA has even been used in an instrumental way to justify decisions already taken, with the only result to further erode the credibility of experts and institutions. In this work, however, the author will try to show how, on the contrary, a greater involvement in the evaluation and decision-making processes could improve the effectiveness of HIA in terms of prevention, while at the same time promoting a relationship of trust between experts, institutions, and citizens on which to establish an ecologically and socially sustainable development.

  19. Developpement energetique par modelisation et intelligence territoriale: Un outil de prise de decision participative pour le developpement durable des projets eoliens

    NASA Astrophysics Data System (ADS)

    Vazquez Rascon, Maria de Lourdes

    This thesis focuses on the implementation of a participatory and transparent decision making tool about the wind farm projects. This tool is based on an (argumentative) framework that reflects the stakeholder's values systems involved in these projects and it employs two multicriteria methods: the multicriteria decision aide and the participatory geographical information systems, making it possible to represent this value systems by criteria and indicators to be evaluated. The stakeholder's values systems will allow the inclusion of environmental, economic and social-cultural aspects of wind energy projects and, thus, a sustainable development wind projects vision. This vision will be analyzed using the 16 sustainable principles included in the Quebec's Sustainable Development Act. Four specific objectives have been instrumented to favor a logical completion work, and to ensure the development of a successfultool : designing a methodology to couple the MCDA and participatory GIS, testing the developed methodology by a case study, making a robustness analysis to address strategic issues and analyzing the strengths, weaknesses, opportunities and threads of the developed methodology. Achieving the first goal allowed us to obtain a decision-making tool called Territorial Intelligence Modeling for Energy Development (TIMED approach). The TIMED approach is visually represented by a figure expressing the idea of a co-construction decision and where ail stakeholders are the focus of this methodology. TIMED is composed of four modules: Multi-Criteria decision analysis, participatory geographic Information systems, active involvement of the stakeholders and scientific knowledge/local knowledge. The integration of these four modules allows for the analysis of different implementation scenarios of wind turbines in order to choose the best one based on a participatory and transparent decision-making process that takes into account stakeholders' concerns. The second objective enabled the testing of TIMED in an ex-post experience of a wind farm in operation since 2006. In this test, II people participated representing four stakeholder' categories: the private sector, the public sector, experts and civil society. This test allowed us to analyze the current situation in which wind projects are currently developed in Quebec. The concerns of some stakeholders regarding situations that are not considered in the current context were explored through a third goal. This third objective allowed us to make simulations taking into account the assumptions of strategic levels. Examples of the strategic level are the communication tools used to approach the host community and the park property type. Finally, the fourth objective, a SWOT analysis with the participation of eight experts, allowed us to verify the extent to which TIMED approach succeeded in constructing four fields for participatory decision-making: physical, intellectual, emotional and procedural. From these facts, 116 strengths, 28 weaknesses, 32 constraints and 54 opportunities were identified. Contributions, applications, limitations and extensions of this research are based on giving a participatory decision-making methodology taking into account socio-cultural, environmental and economic variables; making reflection sessions on a wind farm in operation; acquiring MCDA knowledge for participants involved in testing the proposed methodology; taking into account the physical, intellectual, emotional and procedural spaces to al1iculate a participatory decision; using the proposed methodology in renewable energy sources other than wind; the need to an interdisciplinary team for the methodology application; access to quality data; access to information technologies; the right to public participation; the neutrality of experts; the relationships between experts and non-experts; cultural constraints; improvement of designed indicators; the implementation of a Web platform for participatory decision-making and writing a manual on the use of the developed methodology. Keywords: wind farm, multicriteria decision, geographic information systems, TIMED approach, sustainable wind energy projects development, renewable energy, social participation, robustness concern, SWOT analysis.

  20. Use of cloud computing technology in natural hazard assessment and emergency management

    NASA Astrophysics Data System (ADS)

    Webley, P. W.; Dehn, J.

    2015-12-01

    During a natural hazard event, the most up-to-date data needs to be in the hands of those on the front line. Decision support system tools can be developed to provide access to pre-made outputs to quickly assess the hazard and potential risk. However, with the ever growing availability of new satellite data as well as ground and airborne data generated in real-time there is a need to analyze the large volumes of data in an easy-to-access and effective environment. With the growth in the use of cloud computing, where the analysis and visualization system can grow with the needs of the user, then these facilities can used to provide this real-time analysis. Think of a central command center uploading the data to the cloud compute system and then those researchers in-the-field connecting to a web-based tool to view the newly acquired data. New data can be added by any user and then viewed instantly by anyone else in the organization through the cloud computing interface. This provides the ideal tool for collaborative data analysis, hazard assessment and decision making. We present the rationale for developing a cloud computing systems and illustrate how this tool can be developed for use in real-time environments. Users would have access to an interactive online image analysis tool without the need for specific remote sensing software on their local system therefore increasing their understanding of the ongoing hazard and mitigate its impact on the surrounding region.

  1. An integrated modeling approach to support management decisions of coupled groundwater-agricultural systems under multiple uncertainties

    NASA Astrophysics Data System (ADS)

    Hagos Subagadis, Yohannes; Schütze, Niels; Grundmann, Jens

    2015-04-01

    The planning and implementation of effective water resources management strategies need an assessment of multiple (physical, environmental, and socio-economic) issues, and often requires new research in which knowledge of diverse disciplines are combined in a unified methodological and operational frameworks. Such integrative research to link different knowledge domains faces several practical challenges. Such complexities are further compounded by multiple actors frequently with conflicting interests and multiple uncertainties about the consequences of potential management decisions. A fuzzy-stochastic multiple criteria decision analysis tool was developed in this study to systematically quantify both probabilistic and fuzzy uncertainties associated with complex hydrosystems management. It integrated physical process-based models, fuzzy logic, expert involvement and stochastic simulation within a general framework. Subsequently, the proposed new approach is applied to a water-scarce coastal arid region water management problem in northern Oman, where saltwater intrusion into a coastal aquifer due to excessive groundwater extraction for irrigated agriculture has affected the aquifer sustainability, endangering associated socio-economic conditions as well as traditional social structure. Results from the developed method have provided key decision alternatives which can serve as a platform for negotiation and further exploration. In addition, this approach has enabled to systematically quantify both probabilistic and fuzzy uncertainties associated with the decision problem. Sensitivity analysis applied within the developed tool has shown that the decision makers' risk aversion and risk taking attitude may yield in different ranking of decision alternatives. The developed approach can be applied to address the complexities and uncertainties inherent in water resources systems to support management decisions, while serving as a platform for stakeholder participation.

  2. Bioenergy Knowledge Discovery Framework Fact Sheet

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    None

    The Bioenergy Knowledge Discovery Framework (KDF) supports the development of a sustainable bioenergy industry by providing access to a variety of data sets, publications, and collaboration and mapping tools that support bioenergy research, analysis, and decision making. In the KDF, users can search for information, contribute data, and use the tools and map interface to synthesize, analyze, and visualize information in a spatially integrated manner.

  3. Complexity Science: A Mechanism for Strategic Foresight and Resiliency in National Security Decision-Making.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ackermann, Mark R.; Hayden, Nancy Kay; Backus, George A.

    Most national policy decisions are complex with a variety of stakeholders, disparate interests and the potential for unintended consequences. While a number of analytical tools exist to help decision makers sort through the mountains of data and myriad of options, decision support teams are increasingly turning to complexity science for improved analysis and better insight into the potential impact of policy decisions. While complexity science has great potential, it has only proven useful in limited case s and when properly applied. In advance of more widespread use, a national - level effort to refine complexity science and more rigorously establishmore » its technical underpinnings is recommended.« less

  4. Impact of electronic clinical decision support on adherence to guideline-recommended treatment for hyperlipidaemia, atrial fibrillation and heart failure: protocol for a cluster randomised trial

    PubMed Central

    Kessler, Maya Elizabeth; Cook, David A; Kor, Daryl Jon; McKie, Paul M; Pencille, Laurie J; Scheitel, Marianne R; Chaudhry, Rajeev

    2017-01-01

    Introduction Clinical practice guidelines facilitate optimal clinical practice. Point of care access, interpretation and application of such guidelines, however, is inconsistent. Informatics-based tools may help clinicians apply guidelines more consistently. We have developed a novel clinical decision support tool that presents guideline-relevant information and actionable items to clinicians at the point of care. We aim to test whether this tool improves the management of hyperlipidaemia, atrial fibrillation and heart failure by primary care clinicians. Methods/analysis Clinician care teams were cluster randomised to receive access to the clinical decision support tool or passive access to institutional guidelines on 16 May 2016. The trial began on 1 June 2016 when access to the tool was granted to the intervention clinicians. The trial will be run for 6 months to ensure a sufficient number of patient encounters to achieve 80% power to detect a twofold increase in the primary outcome at the 0.05 level of significance. The primary outcome measure will be the percentage of guideline-based recommendations acted on by clinicians for hyperlipidaemia, atrial fibrillation and heart failure. We hypothesise care teams with access to the clinical decision support tool will act on recommendations at a higher rate than care teams in the standard of care arm. Ethics and dissemination The Mayo Clinic Institutional Review Board approved all study procedures. Informed consent was obtained from clinicians. A waiver of informed consent and of Health Insurance Portability and Accountability Act (HIPAA) authorisation for patients managed by clinicians in the study was granted. In addition to publication, results will be disseminated via meetings and newsletters. Trial registration number NCT02742545. PMID:29208620

  5. Intelligent Model Management in a Forest Ecosystem Management Decision Support System

    Treesearch

    Donald Nute; Walter D. Potter; Frederick Maier; Jin Wang; Mark Twery; H. Michael Rauscher; Peter Knopp; Scott Thomasma; Mayukh Dass; Hajime Uchiyama

    2002-01-01

    Decision making for forest ecosystem management can include the use of a wide variety of modeling tools. These tools include vegetation growth models, wildlife models, silvicultural models, GIS, and visualization tools. NED-2 is a robust, intelligent, goal-driven decision support system that integrates tools in each of these categories. NED-2 uses a blackboard...

  6. Transportation Big Data: Unbiased Analysis and Tools to Inform Sustainable Transportation Decisions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Today, transportation operation and energy systems data are generated at an unprecedented scale. The U.S. Department of Energy's National Renewable Energy Laboratory (NREL) is the go-to source for expertise in providing data and analysis to inform industry and government transportation decision making. The lab's teams of data experts and engineers are mining and analyzing large sets of complex data -- or 'big data' -- to develop solutions that support the research, development, and deployment of market-ready technologies that reduce fuel consumption and greenhouse gas emissions.

  7. 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.

  8. eSACP - a new Nordic initiative towards developing statistical climate services

    NASA Astrophysics Data System (ADS)

    Thorarinsdottir, Thordis; Thejll, Peter; Drews, Martin; Guttorp, Peter; Venälainen, Ari; Uotila, Petteri; Benestad, Rasmus; Mesquita, Michel d. S.; Madsen, Henrik; Fox Maule, Cathrine

    2015-04-01

    The Nordic research council NordForsk has recently announced its support for a new 3-year research initiative on "statistical analysis of climate projections" (eSACP). eSACP will focus on developing e-science tools and services based on statistical analysis of climate projections for the purpose of helping decision-makers and planners in the face of expected future challenges in regional climate change. The motivation behind the project is the growing recognition in our society that forecasts of future climate change is associated with various sources of uncertainty, and that any long-term planning and decision-making dependent on a changing climate must account for this. At the same time there is an obvious gap between scientists from different fields and between practitioners in terms of understanding how climate information relates to different parts of the "uncertainty cascade". In eSACP we will develop generic e-science tools and statistical climate services to facilitate the use of climate projections by decision-makers and scientists from all fields for climate impact analyses and for the development of robust adaptation strategies, which properly (in a statistical sense) account for the inherent uncertainty. The new tool will be publically available and include functionality to utilize the extensive and dynamically growing repositories of data and use state-of-the-art statistical techniques to quantify the uncertainty and innovative approaches to visualize the results. Such a tool will not only be valuable for future assessments and underpin the development of dedicated climate services, but will also assist the scientific community in making more clearly its case on the consequences of our changing climate to policy makers and the general public. The eSACP project is led by Thordis Thorarinsdottir, Norwegian Computing Center, and also includes the Finnish Meteorological Institute, the Norwegian Meteorological Institute, the Technical University of Denmark and the Bjerknes Centre for Climate Research, Norway. This poster will present details of focus areas in the project and show some examples of the expected analysis tools.

  9. GIS and Time-Series Integration in the Kennedy Space Center Environmental Information System

    NASA Technical Reports Server (NTRS)

    Hinkle, Ross; Costa, Joao Ribeiro da; Engel, Bernard

    1996-01-01

    NASA started the Ecological Program 14 years ago to collect environmental data which can be used in making environmental management decisions. The EP team created the Mapping Analysis and Planning System (MAPS) to store all the data, including the appropriate tools for data analysis and exploration.

  10. The Strength of Ethical Matrixes as a Tool for Normative Analysis Related to Technological Choices: The Case of Geological Disposal for Radioactive Waste.

    PubMed

    Kermisch, Céline; Depaus, Christophe

    2018-02-01

    The ethical matrix is a participatory tool designed to structure ethical reflection about the design, the introduction, the development or the use of technologies. Its collective implementation, in the context of participatory decision-making, has shown its potential usefulness. On the contrary, its implementation by a single researcher has not been thoroughly analyzed. The aim of this paper is precisely to assess the strength of ethical matrixes implemented by a single researcher as a tool for conceptual normative analysis related to technological choices. Therefore, the ethical matrix framework is applied to the management of high-level radioactive waste, more specifically to retrievable and non-retrievable geological disposal. The results of this analysis show that the usefulness of ethical matrixes is twofold and that they provide a valuable input for further decision-making. Indeed, by using ethical matrixes, implicit ethically relevant issues were revealed-namely issues of equity associated with health impacts and differences between close and remote future generations regarding ethical impacts. Moreover, the ethical matrix framework was helpful in synthesizing and comparing systematically the ethical impacts of the technologies under scrutiny, and hence in highlighting the potential ethical conflicts.

  11. Guidelines for appropriate care: the importance of empirical normative analysis.

    PubMed

    Berg, M; Meulen, R T; van den Burg, M

    2001-01-01

    The Royal Dutch Medical Association recently completed a research project aimed at investigating how guidelines for 'appropriate medical care' should be construed. The project took as a starting point that explicit attention should be given to ethical and political considerations in addition to data about costs and effectiveness. In the project, two research groups set out to design guidelines and cost-effectiveness analyses (CEAs) for two circumscribed medical areas (angina pectoris and major depression). Our third group was responsible for the normative analysis. We undertook an explorative, qualitative pilot study of the normative considerations that played a role in constructing the guidelines and CEAs, and simultaneously interviewed specialists about the normative considerations that guided their diagnostic and treatment decisions. Explicating normative considerations, we argue, is important democratically: the issues at stake should not be left to decision analysts and guideline developers to decide. Moreover, it is a necessary condition for a successful implementation of such tools: those who draw upon these tools will only accept them when they can recognize themselves in the considerations implied. Empirical normative analysis, we argue, is a crucial tool in developing guidelines for appropriate medical care.

  12. What's the point? The contribution of a sustainability view in contaminated site remediation.

    PubMed

    Anderson, Robert; Norrman, Jenny; Back, Pär-Erik; Söderqvist, Tore; Rosén, Lars

    2018-07-15

    Decision support tools (DST) are often used in remediation projects to aid in the complex decision on how best to remediate a contaminated site. In recent years, the sustainable remediation concept has brought increased attention to the often-overlooked contradictory effects of site remediation, with a number of sustainability assessment tools now available. The aim of the present study is twofold: (1) to demonstrate how and when different assessment views affect the decision support outcome on remediation alternatives in a DST, and (2) to demonstrate the contribution of a full sustainability assessment. The SCORE tool was used in the analysis; it is based on a holistic multi-criteria decision analysis (MCDA) approach, assessing sustainability in three dimensions: environmental, social, and economic. Four assessment scenarios, compared to a full sustainability assessment, were considered to reflect different possible assessment views; considering public and private problem owner perspectives, as well as green and traditional assessment scopes. Four real case study sites in Sweden were analyzed. The results show that the decision support outcome from a full sustainability assessment most often differs to that of other assessment views, and results in remediation alternatives which balance trade-offs in most of the scenarios. In relation to the public perspective and traditional scope, which is seen to lead to the most extensive and expensive remediation alternatives, the trade-off is related to less contaminant removal in favour of reduced negative secondary effects such as emissions and waste disposal. Compared to the private perspective, associated with the lowest cost alternatives, the trade-off is higher costs, but more positive environmental and social effects. Generally, both the green and traditional assessment scopes miss out on relevant social and local environmental secondary effects which may ultimately be very important for the actual decision in a remediation project. Copyright © 2018 Elsevier B.V. All rights reserved.

  13. Accelerated bridge construction (ABC) decision making and economic modeling tool.

    DOT National Transportation Integrated Search

    2011-12-01

    In this FHWA-sponsored pool funded study, a set of decision making tools, based on the Analytic Hierarchy Process (AHP) was developed. This tool set is prepared for transportation specialists and decision-makers to determine if ABC is more effective ...

  14. Advanced Technology Lifecycle Analysis System (ATLAS) Technology Tool Box (TTB)

    NASA Technical Reports Server (NTRS)

    Doyle, Monica; ONeil, Daniel A.; Christensen, Carissa B.

    2005-01-01

    The Advanced Technology Lifecycle Analysis System (ATLAS) is a decision support tool designed to aid program managers and strategic planners in determining how to invest technology research and development dollars. It is an Excel-based modeling package that allows a user to build complex space architectures and evaluate the impact of various technology choices. ATLAS contains system models, cost and operations models, a campaign timeline and a centralized technology database. Technology data for all system models is drawn from a common database, the ATLAS Technology Tool Box (TTB). The TTB provides a comprehensive, architecture-independent technology database that is keyed to current and future timeframes.

  15. Practical example of game theory application for production route selection

    NASA Astrophysics Data System (ADS)

    Olender, M.; Krenczyk, D.

    2017-08-01

    The opportunity which opens before manufacturers on the dynamic market, especially before those from the sector of the small and medium-sized enterprises, is associated with the use of the virtual organizations concept. The planning stage of such organizations could be based on supporting decision-making tasks using the tools and formalisms taken from the game theory. In the paper the model of the virtual manufacturing network, along with the practical example of decision-making situation as two person game and the decision strategies with an analysis of calculation results are presented.

  16. Network meta-analysis: an introduction for pharmacists.

    PubMed

    Xu, Yina; Amiche, Mohamed Amine; Tadrous, Mina

    2018-05-21

    Network meta-analysis is a new tool used to summarize and compare studies for multiple interventions, irrespective of whether these interventions have been directly evaluated against each other. Network meta-analysis is quickly becoming the standard in conducting therapeutic reviews and clinical guideline development. However, little guidance is available to help pharmacists review network meta-analysis studies in their practice. Major institutions such as the Cochrane Collaboration, Agency for Healthcare Research and Quality, Canadian Agency for Drugs and Technologies in Health, and National Institute for Health and Care Excellence Decision Support Unit have endorsed utilizing network meta-analysis to establish therapeutic evidence and inform decision making. Our objective is to introduce this novel technique to pharmacy practitioners, and highlight key assumptions behind network meta-analysis studies.

  17. 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 consideration by journal editors to aid them in filtering papers that use the term, “decision support”.

  18. Exposure Models for the Prior Distribution in Bayesian Decision Analysis for Occupational Hygiene Decision Making

    PubMed Central

    Lee, Eun Gyung; Kim, Seung Won; Feigley, Charles E.; Harper, Martin

    2015-01-01

    This study introduces two semi-quantitative methods, Structured Subjective Assessment (SSA) and Control of Substances Hazardous to Health (COSHH) Essentials, in conjunction with two-dimensional Monte Carlo simulations for determining prior probabilities. Prior distribution using expert judgment was included for comparison. Practical applications of the proposed methods were demonstrated using personal exposure measurements of isoamyl acetate in an electronics manufacturing facility and of isopropanol in a printing shop. Applicability of these methods in real workplaces was discussed based on the advantages and disadvantages of each method. Although these methods could not be completely independent of expert judgments, this study demonstrated a methodological improvement in the estimation of the prior distribution for the Bayesian decision analysis tool. The proposed methods provide a logical basis for the decision process by considering determinants of worker exposure. PMID:23252451

  19. Choices, choices: the application of multi-criteria decision analysis to a food safety decision-making problem.

    PubMed

    Fazil, A; Rajic, A; Sanchez, J; McEwen, S

    2008-11-01

    In the food safety arena, the decision-making process can be especially difficult. Decision makers are often faced with social and fiscal pressures when attempting to identify an appropriate balance among several choices. Concurrently, policy and decision makers in microbial food safety are under increasing pressure to demonstrate that their policies and decisions are made using transparent and accountable processes. In this article, we present a multi-criteria decision analysis approach that can be used to address the problem of trying to select a food safety intervention while balancing various criteria. Criteria that are important when selecting an intervention were determined, as a result of an expert consultation, to include effectiveness, cost, weight of evidence, and practicality associated with the interventions. The multi-criteria decision analysis approach we present is able to consider these criteria and arrive at a ranking of interventions. It can also provide a clear justification for the ranking as well as demonstrate to stakeholders, through a scenario analysis approach, how to potentially converge toward common ground. While this article focuses on the problem of selecting food safety interventions, the range of applications in the food safety arena is truly diverse and can be a significant tool in assisting decisions that need to be coherent, transparent, and justifiable. Most importantly, it is a significant contributor when there is a need to strike a fine balance between various potentially competing alternatives and/or stakeholder groups.

  20. Choosing Mars-Time: Analysis of the Mars Exploration Rover Experience

    NASA Technical Reports Server (NTRS)

    Bass, Deborah S.; Wales,Roxana C.; Shalin, Valerie L.

    2004-01-01

    This paper focuses on the Mars Exploration Rover (MER) mission decision to work on Mars Time and the implications of that decision on the tactical surface operations process as personnel planned activities and created a new command load for work on each Martian sol. The paper also looks at tools that supported the complexities of Mars Time work, and makes some comparisons between Earth and Mars time scheduling.

  1. A Web-Based Treatment Decision Support Tool for Patients With Advanced Knee Arthritis: Evaluation of User Interface and Content Design

    PubMed Central

    Zheng, Hua; Rosal, Milagros C; Li, Wenjun; Borg, Amy; Yang, Wenyun; Ayers, David C

    2018-01-01

    Background Data-driven surgical decisions will ensure proper use and timing of surgical care. We developed a Web-based patient-centered treatment decision and assessment tool to guide treatment decisions among patients with advanced knee osteoarthritis who are considering total knee replacement surgery. Objective The aim of this study was to examine user experience and acceptance of the Web-based treatment decision support tool among older adults. Methods User-centered formative and summative evaluations were conducted for the tool. A sample of 28 patients who were considering total knee replacement participated in the study. Participants’ responses to the user interface design, the clarity of information, as well as usefulness, satisfaction, and acceptance of the tool were collected through qualitative (ie, individual patient interviews) and quantitative (ie, standardized Computer System Usability Questionnaire) methods. Results Participants were older adults with a mean age of 63 (SD 11) years. Three-quarters of them had no technical questions using the tool. User interface design recommendations included larger fonts, bigger buttons, less colors, simpler navigation without extra “next page” click, less mouse movement, and clearer illustrations with simple graphs. Color-coded bar charts and outcome-specific graphs with positive action were easiest for them to understand the outcomes data. Questionnaire data revealed high satisfaction with the tool usefulness and interface quality, and also showed ease of use of the tool, regardless of age or educational status. Conclusions We evaluated the usability of a patient-centered decision support tool designed for advanced knee arthritis patients to facilitate their knee osteoarthritis treatment decision making. The lessons learned can inform other decision support tools to improve interface and content design for older patients’ use. PMID:29712620

  2. Knowledge to Action - Understanding Natural Hazards-Induced Power Outage Scenarios for Actionable Disaster Responses

    NASA Astrophysics Data System (ADS)

    Kar, B.; Robinson, C.; Koch, D. B.; Omitaomu, O.

    2017-12-01

    The Sendai Framework for Disaster Risk Reduction 2015-2030 identified the following four priorities to prevent and reduce disaster risks: i) understanding disaster risk; ii) strengthening governance to manage disaster risk; iii) investing in disaster risk reduction for resilience and; iv) enhancing disaster preparedness for effective response, and to "Build Back Better" in recovery, rehabilitation and reconstruction. While forecasting and decision making tools are in place to predict and understand future impacts of natural hazards, the knowledge to action approach that currently exists fails to provide updated information needed by decision makers to undertake response and recovery efforts following a hazard event. For instance, during a tropical storm event advisories are released every two to three hours, but manual analysis of geospatial data to determine potential impacts of the event tends to be time-consuming and a post-event process. Researchers at Oak Ridge National Laboratory have developed a Spatial Decision Support System that enables real-time analysis of storm impact based on updated advisory. A prototype of the tool that focuses on determining projected power outage areas and projected duration of outages demonstrates the feasibility of integrating science with decision making for emergency management personnel to act in real time to protect communities and reduce risk.

  3. DOE Office of Scientific and Technical Information (OSTI.GOV)

    O'Malley, Daniel; Vesselinov, Velimir V.

    MADSpython (Model analysis and decision support tools in Python) is a code in Python that streamlines the process of using data and models for analysis and decision support using the code MADS. MADS is open-source code developed at LANL and written in C/C++ (MADS; http://mads.lanl.gov; LA-CC-11-035). MADS can work with external models of arbitrary complexity as well as built-in models of flow and transport in porous media. The Python scripts in MADSpython facilitate the generation of input and output file needed by MADS as wells as the external simulators which include FEHM and PFLOTRAN. MADSpython enables a number of data-more » and model-based analyses including model calibration, sensitivity analysis, uncertainty quantification, and decision analysis. MADSpython will be released under GPL V3 license. MADSpython will be distributed as a Git repo at gitlab.com and github.com. MADSpython manual and documentation will be posted at http://madspy.lanl.gov.« less

  4. Clean birth kits to improve birth practices: development and testing of a country level decision support tool.

    PubMed

    Hundley, Vanora A; Avan, Bilal I; Ahmed, Haris; Graham, Wendy J

    2012-12-19

    Clean birth practices can prevent sepsis, one of the leading causes of both maternal and newborn mortality. Evidence suggests that clean birth kits (CBKs), as part of package that includes education, are associated with a reduction in newborn mortality, omphalitis, and puerperal sepsis. However, questions remain about how best to approach the introduction of CBKs in country. We set out to develop a practical decision support tool for programme managers of public health systems who are considering the potential role of CBKs in their strategy for care at birth. Development and testing of the decision support tool was a three-stage process involving an international expert group and country level testing. Stage 1, the development of the tool was undertaken by the Birth Kit Working Group and involved a review of the evidence, a consensus meeting, drafting of the proposed tool and expert review. In Stage 2 the tool was tested with users through interviews (9) and a focus group, with federal and provincial level decision makers in Pakistan. In Stage 3 the findings from the country level testing were reviewed by the expert group. The decision support tool comprised three separate algorithms to guide the policy maker or programme manager through the specific steps required in making the country level decision about whether to use CBKs. The algorithms were supported by a series of questions (that could be administered by interview, focus group or questionnaire) to help the decision maker identify the information needed. The country level testing revealed that the decision support tool was easy to follow and helpful in making decisions about the potential role of CBKs. Minor modifications were made and the final algorithms are presented. Testing of the tool with users in Pakistan suggests that the tool facilitates discussion and aids decision making. However, testing in other countries is needed to determine whether these results can be replicated and to identify how the tool can be adapted to meet country specific needs.

  5. Mainstreaming Climate Change: Recent and Ongoing Efforts to Understand, Improve, and Expand Consideration of Climate Change in Federal Water Resources Planning

    NASA Astrophysics Data System (ADS)

    Ferguson, I. M.; McGuire, M.; Broman, D.; Gangopadhyay, S.

    2017-12-01

    The Bureau of Reclamation is a Federal agency tasked with developing and managing water supply and hydropower projects in the Western U.S. Climate and hydrologic variability and change significantly impact management actions and outcomes across Reclamation's programs and initiatives, including water resource planning and operations, infrastructure design and maintenance, hydropower generation, and ecosystem restoration, among others. Planning, design, and implementation of these programs therefore requires consideration of future climate and hydrologic conditions will impact program objectives. Over the past decade, Reclamation and other Federal agencies have adopted new guidelines, directives, and mandates that require consideration of climate change in water resources planning and decision making. Meanwhile, the scientific community has developed a large number of climate projections, along with an array of models, methods, and tools to facilitate consideration of climate projections in planning and decision making. However, water resources engineers, planners, and decision makers continue to face challenges regarding how best to use the available data and tools to support major decisions, including decisions regarding infrastructure investments and long-term operating criteria. This presentation will discuss recent and ongoing research towards understanding, improving, and expanding consideration of climate projections and related uncertainties in Federal water resources planning and decision making. These research efforts address a variety of challenges, including: How to choose between available climate projection datasets and related methods, models, and tools—many of which are considered experimental or research tools? How to select an appropriate decision framework when design or operating alternatives may differ between climate scenarios? How to effectively communicate results of a climate impacts analysis to decision makers? And, how to improve robustness and resilience of water resources systems in the face of significant uncertainty? Discussion will focus on the intersection between technical challenges and decision making paradigms and the need for improved scientist-decision maker engagement through the lens of this Federal water management agency.

  6. A Review and Analysis of Remote Sensing Capability for Air Quality Measurements as a Potential Decision Support Tool Conducted by the NASA DEVELOP Program

    NASA Technical Reports Server (NTRS)

    Ross, A.; Richards, A.; Keith, K.; Frew, C.; Boseck, J.; Sutton, S.; Watts, C.; Rickman, D.

    2007-01-01

    This project focused on a comprehensive utilization of air quality model products as decision support tools (DST) needed for public health applications. A review of past and future air quality measurement methods and their uncertainty, along with the relationship of air quality to national and global public health, is vital. This project described current and future NASA satellite remote sensing and ground sensing capabilities and the potential for using these sensors to enhance the prediction, prevention, and control of public health effects that result from poor air quality. The qualitative uncertainty of current satellite remotely sensed air quality, the ground-based remotely sensed air quality, the air quality/public health model, and the decision making process is evaluated in this study. Current peer-reviewed literature suggests that remotely sensed air quality parameters correlate well with ground-based sensor data. A satellite remote-sensed and ground-sensed data complement is needed to enhance the models/tools used by policy makers for the protection of national and global public health communities

  7. FRAMEWORK FOR RESPONSIBLE DECISION-MAKING (FRED): A TOOL FOR ENVIRONMENTALLY PREFERABLE PRODUCTS

    EPA Science Inventory

    In support of the Environmentally Preferable Purchasing Program of the USEPA, a decision-making tool based on life cycle assessment has been developed. This tool, the Framework for Responsible Environmental Decision-making or FRED, streamlines LCA by choosing a minimum list of im...

  8. 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...

  9. Decision tree analysis as a supplementary tool to enhance histomorphological differentiation when distinguishing human from non-human cranial bone in both burnt and unburnt states: A feasibility study.

    PubMed

    Simmons, T; Goodburn, B; Singhrao, S K

    2016-01-01

    This feasibility study was undertaken to describe and record the histological characteristics of burnt and unburnt cranial bone fragments from human and non-human bones. Reference series of fully mineralized, transverse sections of cranial bone, from all variables and specimen states, were prepared by manual cutting and semi-automated grinding and polishing methods. A photomicrograph catalogue reflecting differences in burnt and unburnt bone from human and non-humans was recorded and qualitative analysis was performed using an established classification system based on primary bone characteristics. The histomorphology associated with human and non-human samples was, for the main part, preserved following burning at high temperature. Clearly, fibro-lamellar complex tissue subtypes, such as plexiform or laminar primary bone, were only present in non-human bones. A decision tree analysis based on histological features provided a definitive identification key for distinguishing human from non-human bone, with an accuracy of 100%. The decision tree for samples where burning was unknown was 96% accurate, and multi-step classification to taxon was possible with 100% accuracy. The results of this feasibility study strongly suggest that histology remains a viable alternative technique if fragments of cranial bone require forensic examination in both burnt and unburnt states. The decision tree analysis may provide an additional but vital tool to enhance data interpretation. Further studies are needed to assess variation in histomorphology taking into account other cranial bones, ontogeny, species and burning conditions. © The Author(s) 2015.

  10. Renewable Energy Data Explorer User Guide

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Cox, Sarah L; Grue, Nicholas W; Tran, July

    This publication provides a user guide for the Renewable Energy Data Explorer and technical potential tool within the Explorer. The Renewable Energy Data Explorer is a dynamic, web-based geospatial analysis tool that facilitates renewable energy decision-making, investment, and deployment. It brings together renewable energy resource data and other modeled or measured geographic information system (GIS) layers, including land use, weather, environmental, population density, administrative, and grid data.

  11. Fair Use Education for the Twenty-First Century: A Comparative Study of Students' Use of an Interactive Tool to Guide Decision Making

    ERIC Educational Resources Information Center

    Greenhow, Christine; Walker, J. D.; Donnelly, Dan; Cohen, Brad

    2008-01-01

    Christine Greenhow, J. D. Walker, Dan Donnelly, and Brad Cohen describe the implementation and evaluation of the University of Minnesota's Fair Use Analysis (FUA) tool, an interactive online application intended to educate users and foster defensible fair use practice in accordance with copyright law by guiding users through a robust,…

  12. A qualitative analysis of implementing shared decision making in Child and Adolescent Mental Health Services in the United Kingdom: Stages and facilitators.

    PubMed

    Abrines-Jaume, Neus; Midgley, Nick; Hopkins, Katy; Hoffman, Jasmine; Martin, Kate; Law, Duncan; Wolpert, Miranda

    2016-01-01

    To explore the implementation of shared decision making (SDM) in Child and Adolescent Mental Health Services (CAMHS), and identify clinician-determined facilitators to SDM. Professionals from four UK CAMHS tried a range of tools to support SDM. They reflected on their experiences using plan-do-study-act log books. A total of 23 professionals completed 307 logs, which were transcribed and analysed using Framework Analysis in Atlas.Ti. Three states of implementation (apprehension, feeling clunky, and integration) and three aspects of clinician behavior or approach (effort, trust, and flexibility) were identified. Implementation of SDM in CAMHS requires key positive clinician behaviors, including preparedness to put in effort, trust in young people, and use of the approach flexibly. Implementation of SDM in CAMHS is effortful, and while tools may help support SDM, clinicians need to be allowed to use the tools flexibly to allow them to move from a state of apprehension through a sense of feeling "clunky" to integration in practice. © The Author(s) 2014.

  13. Allogeneic cell therapy bioprocess economics and optimization: downstream processing decisions.

    PubMed

    Hassan, Sally; Simaria, Ana S; Varadaraju, Hemanthram; Gupta, Siddharth; Warren, Kim; Farid, Suzanne S

    2015-01-01

    To develop a decisional tool to identify the most cost effective process flowsheets for allogeneic cell therapies across a range of production scales. A bioprocess economics and optimization tool was built to assess competing cell expansion and downstream processing (DSP) technologies. Tangential flow filtration was generally more cost-effective for the lower cells/lot achieved in planar technologies and fluidized bed centrifugation became the only feasible option for handling large bioreactor outputs. DSP bottlenecks were observed at large commercial lot sizes requiring multiple large bioreactors. The DSP contribution to the cost of goods/dose ranged between 20-55%, and 50-80% for planar and bioreactor flowsheets, respectively. This analysis can facilitate early decision-making during process development.

  14. Redefining risk research priorities for nanomaterials

    NASA Astrophysics Data System (ADS)

    Grieger, Khara D.; Baun, Anders; Owen, Richard

    2010-02-01

    Chemical-based risk assessment underpins the current approach to responsible development of nanomaterials (NM). It is now recognised, however, that this process may take decades, leaving decision makers with little support in the near term. Despite this, current and near future research efforts are largely directed at establishing (eco)toxicological and exposure data for NM, and comparatively little research has been undertaken on tools or approaches that may facilitate near-term decisions, some of which we briefly outline in this analysis. We propose a reprioritisation of NM risk research efforts to redress this imbalance, including the development of more adaptive risk governance frameworks, alternative/complementary tools to risk assessment, and health and environment surveillance.

  15. Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

    PubMed

    Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-04-09

    For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU. We searched multiple databases including MEDLINE, Embase, CINAHL, ERIC, and Cochrane from database inception until July 2014. Two reviewers independently screened articles, assessed eligibility, verified data extraction, and assessed risk of bias using the tool described by the Cochrane Collaboration and the Newcastle Ottawa Scale. Pooled estimates of effect (relative risk, standardized mean difference, or mean difference), were calculated where sufficient data existed. GRADE was used to evaluate the overall quality of evidence for each outcome. We screened 5785 abstracts and reviewed the full text of 424 articles, finding 168 eligible articles, including 19 studies in the ICU setting. The use of communication tools increased documentation of goals-of-care discussions (RR 3.47, 95% CI 1.55, 7.75, p = 0.020, very low-quality evidence), but did not have an effect on code status documentation (RR 1.03, 95% CI 0.96, 1.10, p = 0.540, low-quality evidence) or decisions to withdraw or withhold life-sustaining treatments (RR 0.98, 95% CI 0.89, 1.08, p = 0.70, low-quality evidence). The use of such tools was associated with a decrease in multiple measures of health care resource utilization, including duration of mechanical ventilation (MD -1.9 days, 95% CI -3.26, -0.54, p = 0.006, very low-quality evidence), length of ICU stay (MD -1.11 days, 95% CI -2.18, -0.03, p = 0.04, very low-quality evidence), and health care costs (SMD -0.32, 95% CI -0.5, -0.15, p < 0.001, very low-quality evidence). Structured communication tools may improve documentation of EOL decision making and may result in lower resource use. The supporting evidence is low to very low in quality. Further high-quality randomized studies of simple communication interventions are needed to determine whether structured, rather than ad hoc, approaches to end-of-life decision-making improve patient-level, family-level, and system-level outcomes. PROSPERO CRD42014012913.

  16. Visual Analysis as a design and decision-making tool in the development of a quarry

    Treesearch

    Randall Boyd Fitzgerald

    1979-01-01

    In order to obtain local and state government approvals, an environmental impact analysis of the mining and reclamation of a proposed hard rock quarry was required. High visibility of the proposed mining area from the adjacent community required a visual impact analysis in the planning and design of the project. The Visual Analysis defined design criteria for the...

  17. SMARTE TUTORIAL CD

    EPA Science Inventory

    SMARTe is a web-based decision support tool intended to help revitalization practitioners find information, perform data analysis, communicate, and evaluate future reuse options for a site or area. A tutorial was developed to help users navigate SMARTe. This tutorial is approxima...

  18. 2010 Comprehensive Economic Development Strategy "Vision Hampton Roads"

    DOT National Transportation Integrated Search

    2010-02-19

    The strategy is an economic development planning tool intended to aid : local governments in decision-making. The document provides an analysis : of regional and local economic conditions within the Hampton Roads : region, defined as including the te...

  19. DIY Solar Market Analysis STAT Webinars | State, Local, and Tribal

    Science.gov Websites

    do they help policymakers? Solar Resource and Technical Potential: Finding, using, and making maps for decision makers PVWatts: New tips and tricks for the latest update Community Solar Scenario Tool

  20. Impact of socioeconomic factors on informed decision making and treatment choice in patients with hip and knee OA.

    PubMed

    Youm, Jiwon; Chan, Vanessa; Belkora, Jeffrey; Bozic, Kevin J

    2015-02-01

    It is unclear how socioeconomic (SES) status influences the effectiveness of shared decision making (SDM) tools. The purpose of this study was to assess the impact of SES on the utility of SDM tools among patients with hip and knee osteoarthritis (OA). We performed a secondary analysis of data from a randomized controlled trial of 123 patients with hip or knee OA. Higher education and higher income were independently associated with higher knowledge survey scores. Patients with private insurance were 2.7 times more likely than patients with Medicare to arrive at a decision after the initial office visit. Higher education was associated with lower odds of choosing surgery, even after adjusting for knowledge. Patient knowledge of their medical condition and treatment options varies with SES. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. "ATLAS" Advanced Technology Life-cycle Analysis System

    NASA Technical Reports Server (NTRS)

    Lollar, Louis F.; Mankins, John C.; ONeil, Daniel A.

    2004-01-01

    Making good decisions concerning research and development portfolios-and concerning the best systems concepts to pursue - as early as possible in the life cycle of advanced technologies is a key goal of R&D management This goal depends upon the effective integration of information from a wide variety of sources as well as focused, high-level analyses intended to inform such decisions Life-cycle Analysis System (ATLAS) methodology and tool kit. ATLAS encompasses a wide range of methods and tools. A key foundation for ATLAS is the NASA-created Technology Readiness. The toolkit is largely spreadsheet based (as of August 2003). This product is being funded by the Human and Robotics The presentation provides a summary of the Advanced Technology Level (TRL) systems Technology Program Office, Office of Exploration Systems, NASA Headquarters, Washington D.C. and is being integrated by Dan O Neil of the Advanced Projects Office, NASA/MSFC, Huntsville, AL

  2. Embedded CLIPS for SDI BM/C3 simulation and analysis

    NASA Technical Reports Server (NTRS)

    Gossage, Brett; Nanney, Van

    1990-01-01

    Nichols Research Corporation is developing the BM/C3 Requirements Analysis Tool (BRAT) for the U.S. Army Strategic Defense Command. BRAT uses embedded CLIPS/Ada to model the decision making processes used by the human commander of a defense system. Embedding CLlPS/Ada in BRAT allows the user to explore the role of the human in Command and Control (C2) and the use of expert systems for automated C2. BRAT models assert facts about the current state of the system, the simulated scenario, and threat information into CLIPS/Ada. A user-defined rule set describes the decision criteria for the commander. We have extended CLIPS/Ada with user-defined functions that allow the firing of a rule to invoke a system action such as weapons release or a change in strategy. The use of embedded CLIPS/Ada will provide a powerful modeling tool for our customer at minimal cost.

  3. Development and Exploration of a Regional Stormwater BMP Performance Database to Parameterize an Integrated Decision Support Tool (i-DST)

    NASA Astrophysics Data System (ADS)

    Bell, C.; Li, Y.; Lopez, E.; Hogue, T. S.

    2017-12-01

    Decision support tools that quantitatively estimate the cost and performance of infrastructure alternatives are valuable for urban planners. Such a tool is needed to aid in planning stormwater projects to meet diverse goals such as the regulation of stormwater runoff and its pollutants, minimization of economic costs, and maximization of environmental and social benefits in the communities served by the infrastructure. This work gives a brief overview of an integrated decision support tool, called i-DST, that is currently being developed to serve this need. This presentation focuses on the development of a default database for the i-DST that parameterizes water quality treatment efficiency of stormwater best management practices (BMPs) by region. Parameterizing the i-DST by region will allow the tool to perform accurate simulations in all parts of the United States. A national dataset of BMP performance is analyzed to determine which of a series of candidate regionalizations explains the most variance in the national dataset. The data used in the regionalization analysis comes from the International Stormwater BMP Database and data gleaned from an ongoing systematic review of peer-reviewed and gray literature. In addition to identifying a regionalization scheme for water quality performance parameters in the i-DST, our review process will also provide example methods and protocols for systematic reviews in the field of Earth Science.

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

    PubMed

    Staszewska, Anna; Zaki, Pearl; Lee, Joon

    2017-10-06

    Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious illness. ©Anna Staszewska, Pearl Zaki, Joon Lee. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 06.10.2017.

  5. quantGenius: implementation of a decision support system for qPCR-based gene quantification.

    PubMed

    Baebler, Špela; Svalina, Miha; Petek, Marko; Stare, Katja; Rotter, Ana; Pompe-Novak, Maruša; Gruden, Kristina

    2017-05-25

    Quantitative molecular biology remains a challenge for researchers due to inconsistent approaches for control of errors in the final results. Due to several factors that can influence the final result, quantitative analysis and interpretation of qPCR data are still not trivial. Together with the development of high-throughput qPCR platforms, there is a need for a tool allowing for robust, reliable and fast nucleic acid quantification. We have developed "quantGenius" ( http://quantgenius.nib.si ), an open-access web application for a reliable qPCR-based quantification of nucleic acids. The quantGenius workflow interactively guides the user through data import, quality control (QC) and calculation steps. The input is machine- and chemistry-independent. Quantification is performed using the standard curve approach, with normalization to one or several reference genes. The special feature of the application is the implementation of user-guided QC-based decision support system, based on qPCR standards, that takes into account pipetting errors, assay amplification efficiencies, limits of detection and quantification of the assays as well as the control of PCR inhibition in individual samples. The intermediate calculations and final results are exportable in a data matrix suitable for further statistical analysis or visualization. We additionally compare the most important features of quantGenius with similar advanced software tools and illustrate the importance of proper QC system in the analysis of qPCR data in two use cases. To our knowledge, quantGenius is the only qPCR data analysis tool that integrates QC-based decision support and will help scientists to obtain reliable results which are the basis for biologically meaningful data interpretation.

  6. Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis.

    PubMed

    Oczkowski, Simon J; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-01-01

    Patients with serious illness, and their families, state that better communication and decision-making with healthcare providers is a high priority to improve the quality of end-of-life care. Numerous communication tools to assist patients, family members, and clinicians in end-of-life decision-making have been published, but their effectiveness remains unclear. To determine, amongst adults in ambulatory care settings, the effect of structured communication tools for end-of-life decision-making on completion of advance care planning. We searched for relevant randomized controlled trials (RCTs) or non-randomized intervention studies in MEDLINE, EMBASE, CINAHL, ERIC, and the Cochrane Database of Randomized Controlled Trials from database inception until July 2014. Two reviewers independently screened articles for eligibility, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each of the primary and secondary outcomes. Sixty-seven studies, including 46 RCTs, were found. The majority evaluated communication tools in older patients (age >50) with no specific medical condition, but many specifically evaluated populations with cancer, lung, heart, neurologic, or renal disease. Most studies compared the use of communication tools against usual care, but several compared the tools to less-intensive advance care planning tools. The use of structured communication tools increased: the frequency of advance care planning discussions/discussions about advance directives (RR 2.31, 95% CI 1.25-4.26, p = 0.007, low quality evidence) and the completion of advance directives (ADs) (RR 1.92, 95% CI 1.43-2.59, p<0.001, low quality evidence); concordance between AD preferences and subsequent medical orders for use or non-use of life supporting treatment (RR 1.19, 95% CI 1.01-1.39, p = 0.028, very low quality evidence, 1 observational study); and concordance between the care desired and care received by patients (RR 1.17, 95% CI 1.05-1.30, p = 0.004, low quality evidence, 2 RCTs). The use of structured communication tools may increase the frequency of discussions about and completion of advance directives, and concordance between the care desired and the care received by patients. The use of structured communication tools rather than an ad-hoc approach to end-of-life decision-making should be considered, and the selection and implementation of such tools should be tailored to address local needs and context. PROSPERO CRD42014012913.

  7. Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis

    PubMed Central

    Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J.

    2016-01-01

    Background Patients with serious illness, and their families, state that better communication and decision-making with healthcare providers is a high priority to improve the quality of end-of-life care. Numerous communication tools to assist patients, family members, and clinicians in end-of-life decision-making have been published, but their effectiveness remains unclear. Objectives To determine, amongst adults in ambulatory care settings, the effect of structured communication tools for end-of-life decision-making on completion of advance care planning. Methods We searched for relevant randomized controlled trials (RCTs) or non-randomized intervention studies in MEDLINE, EMBASE, CINAHL, ERIC, and the Cochrane Database of Randomized Controlled Trials from database inception until July 2014. Two reviewers independently screened articles for eligibility, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each of the primary and secondary outcomes. Results Sixty-seven studies, including 46 RCTs, were found. The majority evaluated communication tools in older patients (age >50) with no specific medical condition, but many specifically evaluated populations with cancer, lung, heart, neurologic, or renal disease. Most studies compared the use of communication tools against usual care, but several compared the tools to less-intensive advance care planning tools. The use of structured communication tools increased: the frequency of advance care planning discussions/discussions about advance directives (RR 2.31, 95% CI 1.25–4.26, p = 0.007, low quality evidence) and the completion of advance directives (ADs) (RR 1.92, 95% CI 1.43–2.59, p<0.001, low quality evidence); concordance between AD preferences and subsequent medical orders for use or non-use of life supporting treatment (RR 1.19, 95% CI 1.01–1.39, p = 0.028, very low quality evidence, 1 observational study); and concordance between the care desired and care received by patients (RR 1.17, 95% CI 1.05–1.30, p = 0.004, low quality evidence, 2 RCTs). Conclusions The use of structured communication tools may increase the frequency of discussions about and completion of advance directives, and concordance between the care desired and the care received by patients. The use of structured communication tools rather than an ad-hoc approach to end-of-life decision-making should be considered, and the selection and implementation of such tools should be tailored to address local needs and context. Registration PROSPERO CRD42014012913 PMID:27119571

  8. The role of risk-based prioritization in total quality management

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bennett, C.T.

    1994-10-01

    The climate in which government managers must make decisions grows more complex and uncertain. All stakeholders - the public, industry, and Congress - are demanding greater consciousness, responsibility, and accountability of programs and their budgets. Yet, managerial decisions have become multifaceted, involve greater risk, and operate over much longer time periods. Over the last four or five decades, as policy analysis and decisions became more complex, scientists from psychology, operations research, systems science, and economics have developed a more or less coherent process called decision analysis to aid program management. The process of decision analysis - a systems theoretic approachmore » - provides the backdrop for this paper. The Laboratory Integrated Prioritization System (LIPS) has been developed as a systems analytic and risk-based prioritization tool to aid the management of the Tri-Labs` (Lawrence Livermore, Los Alamos, and Sandia) operating resources. Preliminary analyses of the effects of LIPS has confirmed the practical benefits of decision and systems sciences - the systematic, quantitative reduction in uncertainty. To date, the use of LIPS - and, hence, its value - has been restricted to resource allocation within the Tri-Labs` operations budgets. This report extends the role of risk-based prioritization to the support of DOE Total Quality Management (TQM) programs. Furthermore, this paper will argue for the requirement to institutionalize an evolutionary, decision theoretic approach to the policy analysis of the Department of Energy`s Program Budget.« less

  9. Seismic slope-performance analysis: from hazard map to decision support system

    USGS Publications Warehouse

    Miles, Scott B.; Keefer, David K.; Ho, Carlton L.

    1999-01-01

    In response to the growing recognition of engineers and decision-makers of the regional effects of earthquake-induced landslides, this paper presents a general approach to conducting seismic landslide zonation, based on the popular Newmark's sliding block analogy for modeling coherent landslides. Four existing models based on the sliding block analogy are compared. The comparison shows that the models forecast notably different levels of slope performance. Considering this discrepancy along with the limitations of static maps as a decision tool, a spatial decision support system (SDSS) for seismic landslide analysis is proposed, which will support investigations over multiple scales for any number of earthquake scenarios and input conditions. Most importantly, the SDSS will allow use of any seismic landslide analysis model and zonation approach. Developments associated with the SDSS will produce an object-oriented model for encapsulating spatial data, an object-oriented specification to allow construction of models using modular objects, and a direct-manipulation, dynamic user-interface that adapts to the particular seismic landslide model configuration.

  10. Investigation on Effect of Material Hardness in High Speed CNC End Milling Process.

    PubMed

    Dhandapani, N V; Thangarasu, V S; Sureshkannan, G

    2015-01-01

    This research paper analyzes the effects of material properties on surface roughness, material removal rate, and tool wear on high speed CNC end milling process with various ferrous and nonferrous materials. The challenge of material specific decision on the process parameters of spindle speed, feed rate, depth of cut, coolant flow rate, cutting tool material, and type of coating for the cutting tool for required quality and quantity of production is addressed. Generally, decision made by the operator on floor is based on suggested values of the tool manufacturer or by trial and error method. This paper describes effect of various parameters on the surface roughness characteristics of the precision machining part. The prediction method suggested is based on various experimental analysis of parameters in different compositions of input conditions which would benefit the industry on standardization of high speed CNC end milling processes. The results show a basis for selection of parameters to get better results of surface roughness values as predicted by the case study results.

  11. Investigation on Effect of Material Hardness in High Speed CNC End Milling Process

    PubMed Central

    Dhandapani, N. V.; Thangarasu, V. S.; Sureshkannan, G.

    2015-01-01

    This research paper analyzes the effects of material properties on surface roughness, material removal rate, and tool wear on high speed CNC end milling process with various ferrous and nonferrous materials. The challenge of material specific decision on the process parameters of spindle speed, feed rate, depth of cut, coolant flow rate, cutting tool material, and type of coating for the cutting tool for required quality and quantity of production is addressed. Generally, decision made by the operator on floor is based on suggested values of the tool manufacturer or by trial and error method. This paper describes effect of various parameters on the surface roughness characteristics of the precision machining part. The prediction method suggested is based on various experimental analysis of parameters in different compositions of input conditions which would benefit the industry on standardization of high speed CNC end milling processes. The results show a basis for selection of parameters to get better results of surface roughness values as predicted by the case study results. PMID:26881267

  12. Non-Simultaneous Relative Importance-Performance Analysis: Meta-Results from 80 College Choice Surveys with 55,276 Respondents.

    ERIC Educational Resources Information Center

    Chapman, Randall G.

    1993-01-01

    A study investigated the utility of importance-performance analysis, a marketing tool for assessing marketing position and performance, in learning how college applicants perceive their chosen college in comparison with others. Findings reflect the complexity of student decisions and suggest the "average" college performs above average…

  13. A Biologically Informed Framework for the Analysis of the PPAR Signaling Pathway using a Bayesian Network

    EPA Science Inventory

    The US EPA’s ToxCastTM program seeks to combine advances in high-throughput screening technology with methodologies from statistics and computer science to develop high-throughput decision support tools for assessing chemical hazard and risk. To develop new methods of analysis of...

  14. Can You Fathom This? Connecting Data Analysis, Algebra, and Geometry with Probability Simulation

    ERIC Educational Resources Information Center

    Edwards, Michael Todd; Phelps, Steve

    2008-01-01

    Data analysis plays a prominent role in various facets of modern life: Schools evaluate and revise programs on the basis of test scores; policymakers make decisions on the basis of information gleaned from polling data; supermarkets stock shelves on the basis of data collected at checkout lanes. Data analysis provides teachers with new tools and…

  15. Financial Analysis: A Review of the Methods and Their Application to Employee Training. Training and Development Research Center Project Number Nine.

    ERIC Educational Resources Information Center

    Mosier, Nancy R.

    Financial analysis techniques are tools that help managers make sound financial decisions that contribute to general corporate objectives. A literature review reveals that the most commonly used financial analysis techniques are payback time, average rate of return, present value or present worth, and internal rate of return. Despite the success…

  16. Multi-criteria decision making--an approach to setting priorities in health care.

    PubMed

    Nobre, F F; Trotta, L T; Gomes, L F

    1999-12-15

    The objective of this paper is to present a multi-criteria decision making (MCDM) approach to support public health decision making that takes into consideration the fuzziness of the decision goals and the behavioural aspect of the decision maker. The approach is used to analyse the process of health technology procurement in a University Hospital in Rio de Janeiro, Brazil. The method, known as TODIM, relies on evaluating alternatives with a set of decision criteria assessed using an ordinal scale. Fuzziness in generating criteria scores and weights or conflicts caused by dealing with different viewpoints of a group of decision makers (DMs) are solved using fuzzy set aggregation rules. The results suggested that MCDM models, incorporating fuzzy set approaches, should form a set of tools for public health decision making analysis, particularly when there are polarized opinions and conflicting objectives from the DM group. Copyright 1999 John Wiley & Sons, Ltd.

  17. Multi-criteria analysis for PM10 planning

    NASA Astrophysics Data System (ADS)

    Pisoni, Enrico; Carnevale, Claudio; Volta, Marialuisa

    To implement sound air quality policies, Regulatory Agencies require tools to evaluate outcomes and costs associated to different emission reduction strategies. These tools are even more useful when considering atmospheric PM10 concentrations due to the complex nonlinear processes that affect production and accumulation of the secondary fraction of this pollutant. The approaches presented in the literature (Integrated Assessment Modeling) are mainly cost-benefit and cost-effective analysis. In this work, the formulation of a multi-objective problem to control particulate matter is proposed. The methodology defines: (a) the control objectives (the air quality indicator and the emission reduction cost functions); (b) the decision variables (precursor emission reductions); (c) the problem constraints (maximum feasible technology reductions). The cause-effect relations between air quality indicators and decision variables are identified tuning nonlinear source-receptor models. The multi-objective problem solution provides to the decision maker a set of not-dominated scenarios representing the efficient trade-off between the air quality benefit and the internal costs (emission reduction technology costs). The methodology has been implemented for Northern Italy, often affected by high long-term exposure to PM10. The source-receptor models used in the multi-objective analysis are identified processing long-term simulations of GAMES multiphase modeling system, performed in the framework of CAFE-Citydelta project.

  18. Maximizing the U.S. Army’s Future Contribution to Global Security Using the Capability Portfolio Analysis Tool (CPAT)

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Davis, Scott J.; Edwards, Shatiel B.; Teper, Gerald E.

    We report that recent budget reductions have posed tremendous challenges to the U.S. Army in managing its portfolio of ground combat systems (tanks and other fighting vehicles), thus placing many important programs at risk. To address these challenges, the Army and a supporting team developed and applied the Capability Portfolio Analysis Tool (CPAT) to optimally invest in ground combat modernization over the next 25–35 years. CPAT provides the Army with the analytical rigor needed to help senior Army decision makers allocate scarce modernization dollars to protect soldiers and maintain capability overmatch. CPAT delivers unparalleled insight into multiple-decade modernization planning usingmore » a novel multiphase mixed-integer linear programming technique and illustrates a cultural shift toward analytics in the Army’s acquisition thinking and processes. CPAT analysis helped shape decisions to continue modernization of the $10 billion Stryker family of vehicles (originally slated for cancellation) and to strategically reallocate over $20 billion to existing modernization programs by not pursuing the Ground Combat Vehicle program as originally envisioned. Ultimately, more than 40 studies have been completed using CPAT, applying operations research methods to optimally prioritize billions of taxpayer dollars and allowing Army acquisition executives to base investment decisions on analytically rigorous evaluations of portfolio trade-offs.« less

  19. Maximizing the U.S. Army’s Future Contribution to Global Security Using the Capability Portfolio Analysis Tool (CPAT)

    DOE PAGES

    Davis, Scott J.; Edwards, Shatiel B.; Teper, Gerald E.; ...

    2016-02-01

    We report that recent budget reductions have posed tremendous challenges to the U.S. Army in managing its portfolio of ground combat systems (tanks and other fighting vehicles), thus placing many important programs at risk. To address these challenges, the Army and a supporting team developed and applied the Capability Portfolio Analysis Tool (CPAT) to optimally invest in ground combat modernization over the next 25–35 years. CPAT provides the Army with the analytical rigor needed to help senior Army decision makers allocate scarce modernization dollars to protect soldiers and maintain capability overmatch. CPAT delivers unparalleled insight into multiple-decade modernization planning usingmore » a novel multiphase mixed-integer linear programming technique and illustrates a cultural shift toward analytics in the Army’s acquisition thinking and processes. CPAT analysis helped shape decisions to continue modernization of the $10 billion Stryker family of vehicles (originally slated for cancellation) and to strategically reallocate over $20 billion to existing modernization programs by not pursuing the Ground Combat Vehicle program as originally envisioned. Ultimately, more than 40 studies have been completed using CPAT, applying operations research methods to optimally prioritize billions of taxpayer dollars and allowing Army acquisition executives to base investment decisions on analytically rigorous evaluations of portfolio trade-offs.« less

  20. Using the missed opportunity tool as an application of the Lives Saved Tool (LiST) for intervention prioritization.

    PubMed

    Tam, Yvonne; Pearson, Luwei

    2017-11-07

    The Missed Opportunity tool was developed as an application in the Lives Saved Tool (LiST) to allow users to quickly compare the relative impact of interventions. Global Financing Facility (GFF) investment cases have been identified as a potential application of the Missed Opportunity analyses in Democratic Republic of the Congo (DRC), Ethiopia, Kenya, and Tanzania, to use 'lives saved' as a normative factor to set priorities. The Missed Opportunity analysis draws on data and methods in LiST to project maternal, stillbirth, and child deaths averted based on changes in interventions' coverage. Coverage of each individual intervention in LiST was automated to be scaled up from current coverage to 90% in the next year, to simulate a scenario where almost every mother and child receive proven interventions that they need. The main outcome of the Missed Opportunity analysis is deaths averted due to each intervention. When reducing unmet need for contraception is included in the analysis, it ranks as the top missed opportunity across the four countries. When it is not included in the analysis, top interventions with the most total deaths averted are hospital-based interventions such as labor and delivery management in the CEmOC and BEmOC level, and full treatment and supportive care for premature babies, and for sepsis/pneumonia. The Missed Opportunity tool can be used to provide a quick, first look at missed opportunities in a country or geographic region, and help identify interventions for prioritization. While it is a useful advocate for evidence-based priority setting, decision makers need to consider other factors that influence decision making, and also discuss how to implement, deliver, and sustain programs to achieve high coverage.

  1. The relative meaning of absolute numbers: the case of pain intensity scores as decision support systems for pain management of patients with dementia.

    PubMed

    Lichtner, Valentina; Dowding, Dawn; Closs, S José

    2015-12-24

    Assessment and management of pain in patients with dementia is known to be challenging, due to patients' cognitive and/or communication difficulties. In the UK, pain in hospital is managed through regular assessments, with the use of pain intensity scores as triggers for action. The aim of this study was to understand current pain assessment practices, in order to later inform the development of a decision support tool designed to improve the management of pain for people with dementia in hospital. An exploratory study was conducted in four hospitals in the UK (11 wards), with observations of patients with dementia (n = 31), interviews of staff (n = 52) and patients' family members (n = 4) and documentary analysis. A thematic analysis was carried out, structured along dimensions of decision making. This paper focuses on the emergent themes related to the use of assessment tools and pain intensity scores. A variety of tools were used to record pain intensity, usually with numerical scales. None of the tools in actual use had been specifically designed for patients with cognitive impairment. With patients with more severe dementia, the patient's body language and other cues were studied to infer pain intensity and then a score entered on behalf of the patient. Information regarding the temporality of pain and changes in pain experience (rather than a score at a single point in time) seemed to be most useful to the assessment of pain. Given the inherent uncertainty of the meaning of pain scores for patients with dementia, numerical scales were used with caution. Numerical scores triggered action but their meaning was relative - to the patient, to the clinician, to the time of recording and to the purpose of documenting. There are implications for use of data and computerized decision support systems design. Decision support interventions should include personalized alerting cut-off scores for individual patients, display pain scores over time and integrate professional narratives, mitigating uncertainties around single pain scores for patients with dementia.

  2. Introduction of the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Costing Tool: a user-friendly spreadsheet program to estimate costs of providing patient-centered interventions.

    PubMed

    Reed, Shelby D; Li, Yanhong; Kamble, Shital; Polsky, Daniel; Graham, Felicia L; Bowers, Margaret T; Samsa, Gregory P; Paul, Sara; Schulman, Kevin A; Whellan, David J; Riegel, Barbara J

    2012-01-01

    Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations. Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers and health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study. The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions.

  3. Designing Tools for Supporting User Decision-Making in e-Commerce

    NASA Astrophysics Data System (ADS)

    Sutcliffe, Alistair; Al-Qaed, Faisal

    The paper describes a set of tools designed to support a variety of user decision-making strategies. The tools are complemented by an online advisor so they can be adapted to different domains and users can be guided to adopt appropriate tools for different choices in e-commerce, e.g. purchasing high-value products, exploring product fit to users’ needs, or selecting products which satisfy requirements. The tools range from simple recommenders to decision support by interactive querying and comparison matrices. They were evaluated in a scenario-based experiment which varied the users’ task and motivation, with and without an advisor agent. The results show the tools and advisor were effective in supporting users and agreed with the predictions of ADM (adaptive decision making) theory, on which the design of the tools was based.

  4. Risk Acceptance Personality Paradigm: How We View What We Don't Know We Don't Know

    NASA Technical Reports Server (NTRS)

    Massie, Michael J.; Morris, A. Terry

    2011-01-01

    The purpose of integrated hazard analyses, probabilistic risk assessments, failure modes and effects analyses, fault trees and many other similar tools is to give managers of a program some idea of the risks associated with their program. All risk tools establish a set of undesired events and then try to evaluate the risk to the program by assessing the severity of the undesired event and the likelihood of that event occurring. Some tools provide qualitative results, some provide quantitative results and some do both. However, in the end the program manager and his/her team must decide which risks are acceptable and which are not. Even with a wide array of analysis tools available, risk acceptance is often a controversial and difficult decision making process. And yet, today's space exploration programs are moving toward more risk based design approaches. Thus, risk identification and good risk assessment is becoming even more vital to the engineering development process. This paper explores how known and unknown information influences risk-based decisions by looking at how the various parts of our personalities are affected by what they know and what they don't know. This paper then offers some criteria for consideration when making risk-based decisions.

  5. A study of diverse clinical decision support rule authoring environments and requirements for integration

    PubMed Central

    2012-01-01

    Background Efficient rule authoring tools are critical to allow clinical Knowledge Engineers (KEs), Software Engineers (SEs), and Subject Matter Experts (SMEs) to convert medical knowledge into machine executable clinical decision support rules. The goal of this analysis was to identify the critical success factors and challenges of a fully functioning Rule Authoring Environment (RAE) in order to define requirements for a scalable, comprehensive tool to manage enterprise level rules. Methods The authors evaluated RAEs in active use across Partners Healthcare, including enterprise wide, ambulatory only, and system specific tools, with a focus on rule editors for reminder and medication rules. We conducted meetings with users of these RAEs to discuss their general experience and perceived advantages and limitations of these tools. Results While the overall rule authoring process is similar across the 10 separate RAEs, the system capabilities and architecture vary widely. Most current RAEs limit the ability of the clinical decision support (CDS) interventions to be standardized, sharable, interoperable, and extensible. No existing system meets all requirements defined by knowledge management users. Conclusions A successful, scalable, integrated rule authoring environment will need to support a number of key requirements and functions in the areas of knowledge representation, metadata, terminology, authoring collaboration, user interface, integration with electronic health record (EHR) systems, testing, and reporting. PMID:23145874

  6. LEEDS Decision Tools for E-Craft

    DTIC Science & Technology

    2011-02-15

    currently valid 0MB control number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 15-Feb-2011 2. REPORT TYPE Final... RIT has received no feedback regarding which system monitoring would be most beneficial to MSB. TASKS 1. Decision support research Data/analysis...project, a Project Initiation Document (PID) was written by RIT and submitted to MSB for its approval. This document is attached in Appendix A. It

  7. Planning effectiveness may grow on fault trees.

    PubMed

    Chow, C W; Haddad, K; Mannino, B

    1991-10-01

    The first step of a strategic planning process--identifying and analyzing threats and opportunities--requires subjective judgments. By using an analytical tool known as a fault tree, healthcare administrators can reduce the unreliability of subjective decision making by creating a logical structure for problem solving and decision making. A case study of 11 healthcare administrators showed that an analysis technique called prospective hindsight can add to a fault tree's ability to improve a strategic planning process.

  8. An innovative approach to addressing childhood obesity: a knowledge-based infrastructure for supporting multi-stakeholder partnership decision-making in Quebec, Canada.

    PubMed

    Addy, Nii Antiaye; Shaban-Nejad, Arash; Buckeridge, David L; Dubé, Laurette

    2015-01-23

    Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a "portrait", which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity.

  9. An Innovative Approach to Addressing Childhood Obesity: A Knowledge-Based Infrastructure for Supporting Multi-Stakeholder Partnership Decision-Making in Quebec, Canada

    PubMed Central

    Addy, Nii Antiaye; Shaban-Nejad, Arash; Buckeridge, David L.; Dubé, Laurette

    2015-01-01

    Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a “portrait”, which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity. PMID:25625409

  10. National malaria vector control policy: an analysis of the decision to scale-up larviciding in Nigeria.

    PubMed

    Tesfazghi, Kemi; Hill, Jenny; Jones, Caroline; Ranson, Hilary; Worrall, Eve

    2016-02-01

    New vector control tools are needed to combat insecticide resistance and reduce malaria transmission. The World Health Organization (WHO) endorses larviciding as a supplementary vector control intervention using larvicides recommended by the WHO Pesticides Evaluation Scheme (WHOPES). The decision to scale-up larviciding in Nigeria provided an opportunity to investigate the factors influencing policy adoption and assess the role that actors and evidence play in the policymaking process, in order to draw lessons that help accelerate the uptake of new methods for vector control. A retrospective policy analysis was carried out using in-depth interviews with national level policy stakeholders to establish normative national vector control policy or strategy decision-making processes and compare these with the process that led to the decision to scale-up larviciding. The interviews were transcribed, then coded and analyzed using NVivo10. Data were coded according to pre-defined themes from an analytical policy framework developed a priori. Stakeholders reported that the larviciding decision-making process deviated from the normative vector control decision-making process. National malaria policy is normally strongly influenced by WHO recommendations, but the potential of larviciding to contribute to national economic development objectives through larvicide production in Nigeria was cited as a key factor shaping the decision. The larviciding decision involved a restricted range of policy actors, and notably excluded actors that usually play advisory, consultative and evidence generation roles. Powerful actors limited the access of some actors to the policy processes and content. This may have limited the influence of scientific evidence in this policy decision. This study demonstrates that national vector control policy change can be facilitated by linking malaria control objectives to wider socioeconomic considerations and through engaging powerful policy champions to drive policy change and thereby accelerate access to new vector control tools. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  11. SUSTAIN - A BMP Process and Placement Tool for Urban Watersheds (Poster)

    EPA Science Inventory

    To assist stormwater management professionals in planning for best management practices (BMPs) and low-impact developments (LIDs) implementation, USEPA is developing a decision support system, called the System for Urban Stormwater Treatment and Analysis INtegration (SUSTAIN). ...

  12. Soft System Analysis to Integrate Technology & Human in Controller Workstation

    DOT National Transportation Integrated Search

    2011-10-16

    Computer-based decision support tools (DST), : shared information, and other forms of automation : are increasingly being planned for use by controllers : and pilots to support Air Traffic Management (ATM) : and Air Traffic Control (ATC) in the Next ...

  13. A Decision Support Tool for Appropriate Glucose-Lowering Therapy in Patients with Type 2 Diabetes

    PubMed Central

    Benhamou, Pierre Yves; Charpentier, Guillaume; Consoli, Agostino; Diamant, Michaela; Gallwitz, Baptist; Khunti, Kamlesh; Mathieu, Chantal; Ridderstråle, Martin; Seufert, Jochen; Tack, Cees; Vilsbøll, Tina; Phan, Tra-Mi; Stoevelaar, Herman

    2015-01-01

    Abstract Background: Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed a patient-specific decision support tool based on a systematic analysis of expert opinion. Materials and Methods: Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND/UCLA Appropriateness Method) of treatment strategies for 930 clinical scenarios, which were permutations of clinical variables considered relevant to treatment choice. These included current treatment, hemoglobin A1c difference from individualized target, risk of hypoglycemia, body mass index, life expectancy, and comorbidities. Treatment options included addition of a second or third agent, drug switches, and replacement by monotherapies if the patient was metformin-intolerant. Treatment costs were not considered. Appropriateness (appropriate, inappropriate, uncertain) was based on the median score and expert agreement. The panel recommendations were embedded in an online decision support tool (DiaScope®; Novo Nordisk Health Care AG, Zürich, Switzerland). Results: Treatment appropriateness was associated with (combinations of) the patient variables mentioned above. As second-line agents, dipeptidyl peptidase-4 inhibitors were considered appropriate in all scenarios, followed by glucagon-like peptide-1 receptor agonists (50%), insulins (33%), and sulfonylureas (25%), but not pioglitazone (0%). Ratings of third-line combinations followed a similar pattern. Disagreement was highest for regimens including pioglitazone, sulfonylureas, or insulins and was partly due to differences in panelists' opinions and in drug availability and reimbursement across European countries (although costs were disregarded in the rating process). Conclusions: A novel decision support tool based on the ADA/EASD 2012 position statement and a systematic analysis of expert opinion has been developed to help healthcare professionals to individualize glucose-lowering therapy in daily clinical situations. PMID:25347226

  14. A decision support tool for appropriate glucose-lowering therapy in patients with type 2 diabetes.

    PubMed

    Ampudia-Blasco, F Javier; Benhamou, Pierre Yves; Charpentier, Guillaume; Consoli, Agostino; Diamant, Michaela; Gallwitz, Baptist; Khunti, Kamlesh; Mathieu, Chantal; Ridderstråle, Martin; Seufert, Jochen; Tack, Cees; Vilsbøll, Tina; Phan, Tra-Mi; Stoevelaar, Herman

    2015-03-01

    Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed a patient-specific decision support tool based on a systematic analysis of expert opinion. Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND/UCLA Appropriateness Method) of treatment strategies for 930 clinical scenarios, which were permutations of clinical variables considered relevant to treatment choice. These included current treatment, hemoglobin A1c difference from individualized target, risk of hypoglycemia, body mass index, life expectancy, and comorbidities. Treatment options included addition of a second or third agent, drug switches, and replacement by monotherapies if the patient was metformin-intolerant. Treatment costs were not considered. Appropriateness (appropriate, inappropriate, uncertain) was based on the median score and expert agreement. The panel recommendations were embedded in an online decision support tool (DiaScope(®); Novo Nordisk Health Care AG, Zürich, Switzerland). Treatment appropriateness was associated with (combinations of) the patient variables mentioned above. As second-line agents, dipeptidyl peptidase-4 inhibitors were considered appropriate in all scenarios, followed by glucagon-like peptide-1 receptor agonists (50%), insulins (33%), and sulfonylureas (25%), but not pioglitazone (0%). Ratings of third-line combinations followed a similar pattern. Disagreement was highest for regimens including pioglitazone, sulfonylureas, or insulins and was partly due to differences in panelists' opinions and in drug availability and reimbursement across European countries (although costs were disregarded in the rating process). A novel decision support tool based on the ADA/EASD 2012 position statement and a systematic analysis of expert opinion has been developed to help healthcare professionals to individualize glucose-lowering therapy in daily clinical situations.

  15. Development of an evidence-based decision pathway for vestibular schwannoma treatment options.

    PubMed

    Linkov, Faina; Valappil, Benita; McAfee, Jacob; Goughnour, Sharon L; Hildrew, Douglas M; McCall, Andrew A; Linkov, Igor; Hirsch, Barry; Snyderman, Carl

    To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS). This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator. Previously diagnosed VS patients were recruited by clinical investigators at the University of Pittsburgh Medical Center (UPMC). Classical content analysis was used for focus group data analysis. Providers were recruited from practices within the UPMC system and were surveyed using Delphi methods. This information can provide a basis for multi-criteria decision analysis (MCDA) framework to develop a treatment decision support system for patients with VS. Eight themes were derived from these data (focus group + surveys): doctor/health care system, side effects, effectiveness of treatment, anxiety, mortality, family/other people, quality of life, and post-operative symptoms. These data, as well as feedback from physicians were utilized in building a multi-criteria decision model. The study illustrated steps involved in the development of a decision support model that integrates evidence-based data and patient values to select treatment alternatives. Studies focusing on the actual development of the decision support technology for this group of patients are needed, as decisions are highly multifactorial. Such tools have the potential to improve decision making for complex medical problems with alternate treatment pathways. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. An approach to decision-making with triangular fuzzy reciprocal preference relations and its application

    NASA Astrophysics Data System (ADS)

    Meng, Fanyong

    2018-02-01

    Triangular fuzzy reciprocal preference relations (TFRPRs) are powerful tools to denoting decision-makers' fuzzy judgments, which permit the decision-makers to apply triangular fuzzy ratio rather than real numbers to express their judgements. Consistency analysis is one of the most crucial issues in preference relations that can guarantee the reasonable ranking order. However, all previous consistency concepts cannot well address this type of preference relations. Based on the operational laws on triangular fuzzy numbers, this paper introduces an additive consistency concept for TFRPRs by using quasi TFRPRs, which can be seen as a natural extension of the crisp case. Using this consistency concept, models to judging the additive consistency of TFRPRs and to estimating missing values in complete TFRPRs are constructed. Then, an algorithm to decision-making with TFRPRs is developed. Finally, two numerical examples are offered to illustrate the application of the proposed procedure, and comparison analysis is performed.

  17. Quick Fix for Managing Risks

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Under a Phase II SBIR contract, Kennedy and Lumina Decision Systems, Inc., jointly developed the Schedule and Cost Risk Analysis Modeling (SCRAM) system, based on a version of Lumina's flagship software product, Analytica(R). Acclaimed as "the best single decision-analysis program yet produced" by MacWorld magazine, Analytica is a "visual" tool used in decision-making environments worldwide to build, revise, and present business models, minus the time-consuming difficulty commonly associated with spreadsheets. With Analytica as their platform, Kennedy and Lumina created the SCRAM system in response to NASA's need to identify the importance of major delays in Shuttle ground processing, a critical function in project management and process improvement. As part of the SCRAM development project, Lumina designed a version of Analytica called the Analytica Design Engine (ADE) that can be easily incorporated into larger software systems. ADE was commercialized and utilized in many other developments, including web-based decision support.

  18. Decision Processes and Determinants of Hospital Evacuation and Shelter-in-Place During Hurricane Sandy.

    PubMed

    McGinty, Meghan D; Burke, Thomas A; Resnick, Beth; Barnett, Daniel J; Smith, Katherine C; Rutkow, Lainie

    Evacuation and shelter-in-place decision making for hospitals is complex, and existing literature contains little information about how these decisions are made in practice. To describe decision-making processes and identify determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. Semistructured interviews were conducted from March 2014 to February 2015 with key informants who had authority and responsibility for evacuation and shelter-in-place decisions for hospitals during Hurricane Sandy in 2012. Interviews were recorded, transcribed, and thematically analyzed. Interviewees included hospital executives and state and local public health, emergency management, and emergency medical service officials from Delaware, Maryland, New Jersey, and New York. Interviewees identified decision processes and determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. We interviewed 42 individuals from 32 organizations. Decisions makers reported relying on their instincts rather than employing guides or tools to make evacuation and shelter-in-place decisions during Hurricane Sandy. Risk to patient health from evacuation, prior experience, cost, and ability to maintain continuity of operations were the most influential factors in decision making. Flooding and utility outages, which were predicted to or actually impacted continuity of operations, were the primary determinants of evacuation. Evacuation and shelter-in-place decision making for hospitals can be improved by ensuring hospital emergency plans address flooding and include explicit thresholds that, if exceeded, would trigger evacuation. Comparative risk assessments that inform decision making would be enhanced by improved collection, analysis, and communication of data on morbidity and mortality associated with evacuation versus sheltering-in-place of hospitals. In addition, administrators and public officials can improve their preparedness to make evacuation and shelter-in-place decisions by practicing the use of decision-making tools during training and exercises.

  19. Smart Grid as Multi-layer Interacting System for Complex Decision Makings

    NASA Astrophysics Data System (ADS)

    Bompard, Ettore; Han, Bei; Masera, Marcelo; Pons, Enrico

    This chapter presents an approach to the analysis of Smart Grids based on a multi-layer representation of their technical, cyber, social and decision-making aspects, as well as the related environmental constraints. In the Smart Grid paradigm, self-interested active customers (prosumers), system operators and market players interact among themselves making use of an extensive cyber infrastructure. In addition, policy decision makers define regulations, incentives and constraints to drive the behavior of the competing operators and prosumers, with the objective of ensuring the global desired performance (e.g. system stability, fair prices). For these reasons, the policy decision making is more complicated than in traditional power systems, and needs proper modeling and simulation tools for assessing "in vitro" and ex-ante the possible impacts of the decisions assumed. In this chapter, we consider the smart grids as multi-layered interacting complex systems. The intricacy of the framework, characterized by several interacting layers, cannot be captured by closed-form mathematical models. Therefore, a new approach using Multi Agent Simulation is described. With case studies we provide some indications about how to develop agent-based simulation tools presenting some preliminary examples.

  20. The politics of end-of-life decision-making: computerised decision-support tools, physicians' jurisdiction and morality.

    PubMed

    Jennings, Beth

    2006-04-01

    With the increasing corporate and governmental rationalisation of medical care, the mandate of efficiency has caused many to fear that concern for the individual patient will be replaced with impersonal, rule-governed allocation of medical resources. Largely ignored is the role of moral principles in medical decision-making. This analysis comes from an ethnographic study conducted from 1999-2001 in three US Intensive Care Units, two of which were using the computerised decision-support tool, APACHE III (Acute Physiological and Chronic Health Evaluation III), which notably predicts the probability that a patient will die. It was found that the use of APACHE presents a paradox regarding concern for the individual patient. To maintain jurisdiction over the care of patients, physicians share the data with the payers and regulators of care to prove they are using resources effectively and efficiently, yet they use the system in conjunction with moral principles to justify treating each patient as unique. Thus, concern for the individual patient is not lessened with the use of this system. However, physicians do not share the data with patients or surrogate decision-makers because they fear they will be viewed as more interested in profits than patients.

  1. Landfill Site Selection by AHP Based Multi-criteria Decision Making Tool: A Case Study in Kolkata, India

    NASA Astrophysics Data System (ADS)

    Majumdar, Ankush; Hazra, Tumpa; Dutta, Amit

    2017-09-01

    This work presents a Multi-criteria Decision Making (MCDM) tool to select a landfill site from three candidate sites proposed for Kolkata Municipal Corporation (KMC) area that complies with accessibility, receptor, environment, public acceptability, geological and economic criteria. Analytical Hierarchy Process has been used to solve the MCDM problem. Suitability of the three sites (viz. Natagachi, Gangajoara and Kharamba) as landfills as proposed by KMC has been checked by Landfill Site Sensitivity Index (LSSI) as well as Economic Viability Index (EVI). Land area availability for disposing huge quantity of Municipal Solid Waste for the design period has been checked. Analysis of the studied sites show that they are moderately suitable for landfill facility construction as both LSSI and EVI scores lay between 300 and 750. The proposed approach represents an effective MCDM tool for siting sanitary landfill in growing metropolitan cities of developing countries like India.

  2. Development of a Suite of Analytical Tools for Energy and Water Infrastructure Knowledge Discovery

    NASA Astrophysics Data System (ADS)

    Morton, A.; Piburn, J.; Stewart, R.; Chandola, V.

    2017-12-01

    Energy and water generation and delivery systems are inherently interconnected. With demand for energy growing, the energy sector is experiencing increasing competition for water. With increasing population and changing environmental, socioeconomic, and demographic scenarios, new technology and investment decisions must be made for optimized and sustainable energy-water resource management. This also requires novel scientific insights into the complex interdependencies of energy-water infrastructures across multiple space and time scales. To address this need, we've developed a suite of analytical tools to support an integrated data driven modeling, analysis, and visualization capability for understanding, designing, and developing efficient local and regional practices related to the energy-water nexus. This work reviews the analytical capabilities available along with a series of case studies designed to demonstrate the potential of these tools for illuminating energy-water nexus solutions and supporting strategic (federal) policy decisions.

  3. The Mission Planning Lab: A Visualization and Analysis Tool

    NASA Technical Reports Server (NTRS)

    Daugherty, Sarah C.; Cervantes, Benjamin W.

    2009-01-01

    Simulation and visualization are powerful decision making tools that are time-saving and cost-effective. Space missions pose testing and e valuation challenges that can be overcome through modeling, simulatio n, and visualization of mission parameters. The National Aeronautics and Space Administration?s (NASA) Wallops Flight Facility (WFF) capi talizes on the benefits of modeling, simulation, and visualization to ols through a project initiative called The Mission Planning Lab (MPL ).

  4. Computer Based Decision Support Tool for Helicopter Mission Planning in Disaster Relief and Military Operations (Outil informatique d’aide a la decision pour la planification des missions d’helicopteres dans des operations militaires et de secours en cas de catastrophe)

    DTIC Science & Technology

    2008-06-01

    capacity planning; • Electrical generation capacity planning; • Machine scheduling; • Freight scheduling; • Dairy farm expansion planning...Support Systems and Multi Criteria Decision Analysis Products A.2.11.2.2.1 ELECTRE IS ELECTRE IS is a generalization of ELECTRE I. It is a...criteria, ELECTRE IS supports the user in the process of selecting one alternative or a subset of alternatives. The method consists of two parts

  5. Data warehousing as a healthcare business solution.

    PubMed

    Scheese, R

    1998-02-01

    Because of the trend toward consolidation in the healthcare field, many organizations have massive amounts of data stored in various information systems organizationwide, but access to the data by end users may be difficult. Healthcare organizations are being pressured to provide managers easy access to the data needed for critical decision making. One solution many organizations are turning to is implementing decision-support data warehouses. A data warehouse instantly delivers information directly to end users, freeing healthcare information systems staff for strategic operations. If designed appropriately, data warehouses can be a cost-effective tool for business analysis and decision support.

  6. A Web-Based Treatment Decision Support Tool for Patients With Advanced Knee Arthritis: Evaluation of User Interface and Content Design.

    PubMed

    Zheng, Hua; Rosal, Milagros C; Li, Wenjun; Borg, Amy; Yang, Wenyun; Ayers, David C; Franklin, Patricia D

    2018-04-30

    Data-driven surgical decisions will ensure proper use and timing of surgical care. We developed a Web-based patient-centered treatment decision and assessment tool to guide treatment decisions among patients with advanced knee osteoarthritis who are considering total knee replacement surgery. The aim of this study was to examine user experience and acceptance of the Web-based treatment decision support tool among older adults. User-centered formative and summative evaluations were conducted for the tool. A sample of 28 patients who were considering total knee replacement participated in the study. Participants' responses to the user interface design, the clarity of information, as well as usefulness, satisfaction, and acceptance of the tool were collected through qualitative (ie, individual patient interviews) and quantitative (ie, standardized Computer System Usability Questionnaire) methods. Participants were older adults with a mean age of 63 (SD 11) years. Three-quarters of them had no technical questions using the tool. User interface design recommendations included larger fonts, bigger buttons, less colors, simpler navigation without extra "next page" click, less mouse movement, and clearer illustrations with simple graphs. Color-coded bar charts and outcome-specific graphs with positive action were easiest for them to understand the outcomes data. Questionnaire data revealed high satisfaction with the tool usefulness and interface quality, and also showed ease of use of the tool, regardless of age or educational status. We evaluated the usability of a patient-centered decision support tool designed for advanced knee arthritis patients to facilitate their knee osteoarthritis treatment decision making. The lessons learned can inform other decision support tools to improve interface and content design for older patients' use. ©Hua Zheng, Milagros C Rosal, Wenjun Li, Amy Borg, Wenyun Yang, David C Ayers, Patricia D Franklin. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 30.04.2018.

  7. Stakeholder perspectives on decision-analytic modeling frameworks to assess genetic services policy.

    PubMed

    Guzauskas, Gregory F; Garrison, Louis P; Stock, Jacquie; Au, Sylvia; Doyle, Debra Lochner; Veenstra, David L

    2013-01-01

    Genetic services policymakers and insurers often make coverage decisions in the absence of complete evidence of clinical utility and under budget constraints. We evaluated genetic services stakeholder opinions on the potential usefulness of decision-analytic modeling to inform coverage decisions, and asked them to identify genetic tests for decision-analytic modeling studies. We presented an overview of decision-analytic modeling to members of the Western States Genetic Services Collaborative Reimbursement Work Group and state Medicaid representatives and conducted directed content analysis and an anonymous survey to gauge their attitudes toward decision-analytic modeling. Participants also identified and prioritized genetic services for prospective decision-analytic evaluation. Participants expressed dissatisfaction with current processes for evaluating insurance coverage of genetic services. Some participants expressed uncertainty about their comprehension of decision-analytic modeling techniques. All stakeholders reported openness to using decision-analytic modeling for genetic services assessments. Participants were most interested in application of decision-analytic concepts to multiple-disorder testing platforms, such as next-generation sequencing and chromosomal microarray. Decision-analytic modeling approaches may provide a useful decision tool to genetic services stakeholders and Medicaid decision-makers.

  8. 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…

  9. 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.

  10. HNS-MS : Improving Member States preparedness to face an HNS pollution of the Marine System

    NASA Astrophysics Data System (ADS)

    Legrand, Sebastien; Le Floch, Stéphane; Aprin, Laurent; Parthenay, Valérie; Donnay, Eric; Parmentier, Koen; Ovidio, Fabrice; Schallier, Ronny; Poncet, Florence; Chataing, Sophie; Poupon, Emmanuelle; Hellouvry, Yann-Hervé

    2016-04-01

    When dealing with a HNS pollution incident, one of the priority requirements is the identification of the hazard and an assessment of the risk posed to the public and responder safety, the environment and socioeconomic assets upon which a state or coastal community depend. The primary factors which determine the safety, environmental and socioeconomic impact of the released substance(s) relate to their physico-chemical properties and fate in the environment. Until now, preparedness actions at various levels have primarily aimed at classifying the general environmental or public health hazard of an HNS, or at performing a risk analysis of HNS transported in European marine regions. Operational datasheets have been (MIDSIS-TROCS) or are being (MAR-CIS) developed collating detailed, substance-specific information for responders and covering information needs at the first stage of an incident. However, contrary to oil pollution preparedness and response tools, only few decision-support tools used by Member State authorities (Coastguard agencies or other) integrate 3D models that are able to simulate the drift, fate and behaviour of HNS spills in the marine environment. When they do, they usually consider simplified or steady-state environmental conditions. Moreover, the above-mentioned available HNS information is currently not sufficiently detailed or not suitably classified to be used as an input for an advanced HNS support decision tool. HNS-MS aims at developing a 'one-stop shop' integrated HNS decision-support tool that is able to predict the drift, behaviour and Fate of HNS spills under realistic environmental conditions and at providing key product information - drawing upon and in complement to existing studies and databases - to improve the understanding and evaluation of a HNS spill situation in the field and the environmental and safety-related issues at stake. The 3D HNS drift and fate model and decision-support tool will also be useful at the preparedness stage. The expected results will be an operational HNS decision-support tool (prototype) for the Bonn Agreement area that can also be viewed as a demonstrator tool for other European marine regions. The developed tool will have a similar operational level as OSERIT, the Belgian oil spill drift model. The HNS decision-support tool will integrate the following features: 1. A database containing the physico-chemical parameters needed to compute the behaviour in the marine environment of 100+ relevant HNS; 2. A database of environmental and socioeconomic HNS-sensitive features; 3. A three dimensional HNS spill drift and fate model able to simulate HNS behaviour in the marine environment (including floaters, sinkers, evaporators and dissolvers). 4. A user-friendly web-based interface allowing Coastguard stations to launch a HNS drift simulation and visualize post-processed results in support of an incident evaluation and decision-making process. In this contribution, we will present the methodology followed to develop these four features.

  11. Collaborative environmental planning in river management: An application of multicriteria decision analysis in the White River Watershed in Vermont

    USGS Publications Warehouse

    Hermans, C.; Erickson, J.; Noordewier, T.; Sheldon, A.; Kline, M.

    2007-01-01

    Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible. ?? 2006 Elsevier Ltd. All rights reserved.

  12. Collaborative environmental planning in river management: an application of multicriteria decision analysis in the White River Watershed in Vermont.

    PubMed

    Hermans, Caroline; Erickson, Jon; Noordewier, Tom; Sheldon, Amy; Kline, Mike

    2007-09-01

    Multicriteria decision analysis (MCDA) provides a well-established family of decision tools to aid stakeholder groups in arriving at collective decisions. MCDA can also function as a framework for the social learning process, serving as an educational aid in decision problems characterized by a high level of public participation. In this paper, the framework and results of a structured decision process using the outranking MCDA methodology preference ranking organization method of enrichment evaluation (PROMETHEE) are presented. PROMETHEE is used to frame multi-stakeholder discussions of river management alternatives for the Upper White River of Central Vermont, in the northeastern United States. Stakeholders met over 10 months to create a shared vision of an ideal river and its services to communities, develop a list of criteria by which to evaluate river management alternatives, and elicit preferences to rank and compare individual and group preferences. The MCDA procedure helped to frame a group process that made stakeholder preferences explicit and substantive discussions about long-term river management possible.

  13. Application of uncertainty and sensitivity analysis to the air quality SHERPA modelling tool

    NASA Astrophysics Data System (ADS)

    Pisoni, E.; Albrecht, D.; Mara, T. A.; Rosati, R.; Tarantola, S.; Thunis, P.

    2018-06-01

    Air quality has significantly improved in Europe over the past few decades. Nonetheless we still find high concentrations in measurements mainly in specific regions or cities. This dimensional shift, from EU-wide to hot-spot exceedances, calls for a novel approach to regional air quality management (to complement EU-wide existing policies). The SHERPA (Screening for High Emission Reduction Potentials on Air quality) modelling tool was developed in this context. It provides an additional tool to be used in support to regional/local decision makers responsible for the design of air quality plans. It is therefore important to evaluate the quality of the SHERPA model, and its behavior in the face of various kinds of uncertainty. Uncertainty and sensitivity analysis techniques can be used for this purpose. They both reveal the links between assumptions and forecasts, help in-model simplification and may highlight unexpected relationships between inputs and outputs. Thus, a policy steered SHERPA module - predicting air quality improvement linked to emission reduction scenarios - was evaluated by means of (1) uncertainty analysis (UA) to quantify uncertainty in the model output, and (2) by sensitivity analysis (SA) to identify the most influential input sources of this uncertainty. The results of this study provide relevant information about the key variables driving the SHERPA output uncertainty, and advise policy-makers and modellers where to place their efforts for an improved decision-making process.

  14. Tools and techniques for developing policies for complex and uncertain systems.

    PubMed

    Bankes, Steven C

    2002-05-14

    Agent-based models (ABM) are examples of complex adaptive systems, which can be characterized as those systems for which no model less complex than the system itself can accurately predict in detail how the system will behave at future times. Consequently, the standard tools of policy analysis, based as they are on devising policies that perform well on some best estimate model of the system, cannot be reliably used for ABM. This paper argues that policy analysis by using ABM requires an alternative approach to decision theory. The general characteristics of such an approach are described, and examples are provided of its application to policy analysis.

  15. Overcoming redundancies in bedside nursing assessments by validating a parsimonious meta-tool: findings from a methodological exercise study.

    PubMed

    Palese, Alvisa; Marini, Eva; Guarnier, Annamaria; Barelli, Paolo; Zambiasi, Paola; Allegrini, Elisabetta; Bazoli, Letizia; Casson, Paola; Marin, Meri; Padovan, Marisa; Picogna, Michele; Taddia, Patrizia; Chiari, Paolo; Salmaso, Daniele; Marognolli, Oliva; Canzan, Federica; Ambrosi, Elisa; Saiani, Luisa; Grassetti, Luca

    2016-10-01

    There is growing interest in validating tools aimed at supporting the clinical decision-making process and research. However, an increased bureaucratization of clinical practice and redundancies in the measures collected have been reported by clinicians. Redundancies in clinical assessments affect negatively both patients and nurses. To validate a meta-tool measuring the risks/problems currently estimated by multiple tools used in daily practice. A secondary analysis of a database was performed, using a cross-validation and a longitudinal study designs. In total, 1464 patients admitted to 12 medical units in 2012 were assessed at admission with the Brass, Barthel, Conley and Braden tools. Pertinent outcomes such as the occurrence of post-discharge need for resources and functional decline at discharge, as well as falls and pressure sores, were measured. Explorative factor analysis of each tool, inter-tool correlations and a conceptual evaluation of the redundant/similar items across tools were performed. Therefore, the validation of the meta-tool was performed through explorative factor analysis, confirmatory factor analysis and the structural equation model to establish the ability of the meta-tool to predict the outcomes estimated by the original tools. High correlations between the tools have emerged (from r 0.428 to 0.867) with a common variance from 18.3% to 75.1%. Through a conceptual evaluation and explorative factor analysis, the items were reduced from 42 to 20, and the three factors that emerged were confirmed by confirmatory factor analysis. According to the structural equation model results, two out of three emerged factors predicted the outcomes. From the initial 42 items, the meta-tool is composed of 20 items capable of predicting the outcomes as with the original tools. © 2016 John Wiley & Sons, Ltd.

  16. Using Galaxy to Perform Large-Scale Interactive Data Analyses

    PubMed Central

    Hillman-Jackson, Jennifer; Clements, Dave; Blankenberg, Daniel; Taylor, James; Nekrutenko, Anton

    2014-01-01

    Innovations in biomedical research technologies continue to provide experimental biologists with novel and increasingly large genomic and high-throughput data resources to be analyzed. As creating and obtaining data has become easier, the key decision faced by many researchers is a practical one: where and how should an analysis be performed? Datasets are large and analysis tool set-up and use is riddled with complexities outside of the scope of core research activities. The authors believe that Galaxy provides a powerful solution that simplifies data acquisition and analysis in an intuitive Web application, granting all researchers access to key informatics tools previously only available to computational specialists working in Unix-based environments. We will demonstrate through a series of biomedically relevant protocols how Galaxy specifically brings together (1) data retrieval from public and private sources, for example, UCSC's Eukaryote and Microbial Genome Browsers, (2) custom tools (wrapped Unix functions, format standardization/conversions, interval operations), and 3rd-party analysis tools. PMID:22700312

  17. Regulating outdoor advertisement boards; employing spatial decision support system to control urban visual pollution

    NASA Astrophysics Data System (ADS)

    Wakil, K.; Hussnain, MQ; Tahir, A.; Naeem, M. A.

    2016-06-01

    Unmanaged placement, size, location, structure and contents of outdoor advertisement boards have resulted in severe urban visual pollution and deterioration of the socio-physical living environment in urban centres of Pakistan. As per the regulatory instruments, the approval decision for a new advertisement installation is supposed to be based on the locational density of existing boards and their proximity or remoteness to certain land- uses. In cities, where regulatory tools for the control of advertisement boards exist, responsible authorities are handicapped in effective implementation due to the absence of geospatial analysis capacity. This study presents the development of a spatial decision support system (SDSS) for regularization of advertisement boards in terms of their location and placement. The knowledge module of the proposed SDSS is based on provisions and restrictions prescribed in regulatory documents. While the user interface allows visualization and scenario evaluation to understand if the new board will affect existing linear density on a particular road and if it violates any buffer restrictions around a particular land use. Technically the structure of the proposed SDSS is a web-based solution which includes open geospatial tools such as OpenGeo Suite, GeoExt, PostgreSQL, and PHP. It uses three key data sets including road network, locations of existing billboards and building parcels with land use information to perform the analysis. Locational suitability has been calculated using pairwise comparison through analytical hierarchy process (AHP) and weighted linear combination (WLC). Our results indicate that open geospatial tools can be helpful in developing an SDSS which can assist solving space related iterative decision challenges on outdoor advertisements. Employing such a system will result in effective implementation of regulations resulting in visual harmony and aesthetic improvement in urban communities.

  18. New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality. A Validation and Clinical Decision-Making Study.

    PubMed

    Ranzani, Otavio T; Prina, Elena; Menéndez, Rosario; Ceccato, Adrian; Cilloniz, Catia; Méndez, Raul; Gabarrus, Albert; Barbeta, Enric; Bassi, Gianluigi Li; Ferrer, Miquel; Torres, Antoni

    2017-11-15

    The Sepsis-3 Task Force updated the clinical criteria for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown. To perform a clinical decision-making analysis of Sepsis-3 in patients with community-acquired pneumonia. This was a cohort study including adult patients with community-acquired pneumonia from two Spanish university hospitals. SIRS, qSOFA, the Confusion, Respiratory Rate and Blood Pressure (CRB) score, modified SOFA (mSOFA), the Confusion, Urea, Respiratory Rate, Blood Pressure and Age (CURB-65) score, and Pneumonia Severity Index (PSI) were calculated with data from the emergency department. We used decision-curve analysis to evaluate the clinical usefulness of each score and the primary outcome was in-hospital mortality. Of 6,874 patients, 442 (6.4%) died in-hospital. SIRS presented the worst discrimination, followed by qSOFA, CRB, mSOFA, CURB-65, and PSI. Overall, overestimation of in-hospital mortality and miscalibration was more evident for qSOFA and mSOFA. SIRS had lower net benefit than qSOFA and CRB, significantly increasing the risk of over-treatment and being comparable with the "treat-all" strategy. PSI had higher net benefit than mSOFA and CURB-65 for mortality, whereas mSOFA seemed more applicable when considering mortality/intensive care unit admission. Sepsis-3 flowchart resulted in better identification of patients at high risk of mortality. qSOFA and CRB outperformed SIRS and presented better clinical usefulness as prompt tools for patients with community-acquired pneumonia in the emergency department. Among the tools for a comprehensive patient assessment, PSI had the best decision-aid tool profile.

  19. Analysis of Nursing Clinical Decision Support Requests and Strategic Plan in a Large Academic Health System.

    PubMed

    Whalen, Kimberly; Bavuso, Karen; Bouyer-Ferullo, Sharon; Goldsmith, Denise; Fairbanks, Amanda; Gesner, Emily; Lagor, Charles; Collins, Sarah

    2016-01-01

    To understand requests for nursing Clinical Decision Support (CDS) interventions at a large integrated health system undergoing vendor-based EHR implementation. In addition, to establish a process to guide both short-term implementation and long-term strategic goals to meet nursing CDS needs. We conducted an environmental scan to understand current state of nursing CDS over three months. The environmental scan consisted of a literature review and an analysis of CDS requests received from across our health system. We identified existing high priority CDS and paper-based tools used in nursing practice at our health system that guide decision-making. A total of 46 nursing CDS requests were received. Fifty-six percent (n=26) were specific to a clinical specialty; 22 percent (n=10) were focused on facilitating clinical consults in the inpatient setting. "Risk Assessments/Risk Reduction/Promotion of Healthy Habits" (n=23) was the most requested High Priority Category received for nursing CDS. A continuum of types of nursing CDS needs emerged using the Data-Information-Knowledge-Wisdom Conceptual Framework: 1) facilitating data capture, 2) meeting information needs, 3) guiding knowledge-based decision making, and 4) exposing analytics for wisdom-based clinical interpretation by the nurse. Identifying and prioritizing paper-based tools that can be modified into electronic CDS is a challenge. CDS strategy is an evolving process that relies on close collaboration and engagement with clinical sites for short-term implementation and should be incorporated into a long-term strategic plan that can be optimized and achieved overtime. The Data-Information-Knowledge-Wisdom Conceptual Framework in conjunction with the High Priority Categories established may be a useful tool to guide a strategic approach for meeting short-term nursing CDS needs and aligning with the organizational strategic plan.

  20. Life cycle costing as a decision making tool for technology acquisition in radio-diagnosis

    PubMed Central

    Chakravarty, Abhijit; Debnath, Jyotindu

    2014-01-01

    Background Life cycle costing analysis is an emerging conceptual tool to validate capital investment in healthcare. Methods A preliminary study was done to analyze the long-term cost impact of acquiring a new 3 T MRI system when compared to technological upgradation of the existing 1.5 T MRI system with a view to evolve a decision matrix for correct investment planning and technology management. Operating costing method was utilized to estimate cost per unit MRI scan, costing inputs were considered for the existing 1.5 T and the proposed 3 T machine. Cost for each expected year in the life span of both 1.5 T and 3 T MRI scan options were then discounted to its Net Present Value. Net Present Value thus calculated for both the alternative options of 1.5 T and 3 T MRI machine was charted along with various intangible but critical Figures of Merit (FOM) to create a decision matrix for capital investment planning. Result Considering all fixed and variable costs contributing towards assumed operation, unit cost per MRI procedure was found to be Rs. 4244.58 for the 1.5 T upgrade and Rs. 6059.37 for the new 3 T MRI machine. Life Cycle Cost Analysis of the proposed 1.5 T upgrade and new 3 T machine showed a Net Present Value of Rs. 42,148,587.80 and Rs. 27,587,842.38 respectively. Conclusion The utility of life cycle costing as a strategic decision making tool towards evaluating alternative options for capital investment planning in health care environment is reiterated. PMID:25609862

  1. A review of recent advances in risk analysis for wildfire management

    Treesearch

    Carol Miller; Alan A. Ager

    2012-01-01

    Risk analysis evolved out of the need to make decisions concerning highly stochastic events, and is well suited to analyze the timing, location and potential effects of wildfires. Over the past 10 years, the application of risk analysis to wildland fire management has seen steady growth with new risk-based analytical tools that support a wide range of fire and fuels...

  2. Ontology based decision system for breast cancer diagnosis

    NASA Astrophysics Data System (ADS)

    Trabelsi Ben Ameur, Soumaya; Cloppet, Florence; Wendling, Laurent; Sellami, Dorra

    2018-04-01

    In this paper, we focus on analysis and diagnosis of breast masses inspired by expert concepts and rules. Accordingly, a Bag of Words is built based on the ontology of breast cancer diagnosis, accurately described in the Breast Imaging Reporting and Data System. To fill the gap between low level knowledge and expert concepts, a semantic annotation is developed using a machine learning tool. Then, breast masses are classified into benign or malignant according to expert rules implicitly modeled with a set of classifiers (KNN, ANN, SVM and Decision Tree). This semantic context of analysis offers a frame where we can include external factors and other meta-knowledge such as patient risk factors as well as exploiting more than one modality. Based on MRI and DECEDM modalities, our developed system leads a recognition rate of 99.7% with Decision Tree where an improvement of 24.7 % is obtained owing to semantic analysis.

  3. Depth of manual dismantling analysis: a cost-benefit approach.

    PubMed

    Achillas, Ch; Aidonis, D; Vlachokostas, Ch; Karagiannidis, A; Moussiopoulos, N; Loulos, V

    2013-04-01

    This paper presents a decision support tool for manufacturers and recyclers towards end-of-life strategies for waste electrical and electronic equipment. A mathematical formulation based on the cost benefit analysis concept is herein analytically described in order to determine the parts and/or components of an obsolete product that should be either non-destructively recovered for reuse or be recycled. The framework optimally determines the depth of disassembly for a given product, taking into account economic considerations. On this basis, it embeds all relevant cost elements to be included in the decision-making process, such as recovered materials and (depreciated) parts/components, labor costs, energy consumption, equipment depreciation, quality control and warehousing. This tool can be part of the strategic decision-making process in order to maximize profitability or minimize end-of-life management costs. A case study to demonstrate the models' applicability is presented for a typical electronic product in terms of structure and material composition. Taking into account the market values of the pilot product's components, the manual disassembly is proven profitable with the marginal revenues from recovered reusable materials to be estimated at 2.93-23.06 €, depending on the level of disassembly. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. 2010 Comprehensive Economic Development Strategy "Vision Hampton Roads" : Executive Summary

    DOT National Transportation Integrated Search

    2010-02-19

    The strategy is an economic development planning tool intended to aid local governments in decision-making. The document provides an analysis of regional and local economic conditions within the Hampton Roads region, defined as including the ten (10)...

  5. Probability and Statistics in Sensor Performance Modeling

    DTIC Science & Technology

    2010-12-01

    language software program is called Environmental Awareness for Sensor and Emitter Employment. Some important numerical issues in the implementation...3 Statistical analysis for measuring sensor performance...complementary cumulative distribution function cdf cumulative distribution function DST decision-support tool EASEE Environmental Awareness of

  6. Structuring modeling and simulation analysis for evacuation planning and operations.

    DOT National Transportation Integrated Search

    2009-06-01

    This document is intended to provide guidance to decision-makers at agencies and jurisdictions considering the role of analytical tools in evacuation planning and operations. It is often unclear what kind of analytical approach may be of most value, ...

  7. Climate change, land slide risks and sustainable development, risk analysis and decision support process tool

    NASA Astrophysics Data System (ADS)

    Andersson-sköld, Y. B.; Tremblay, M.

    2011-12-01

    Climate change is in most parts of Sweden expected to result in increased precipitation and increased sea water levels causing flooding, erosion, slope instability and related secondary consequences. Landslide risks are expected to increase with climate change in large parts of Sweden due to increased annual precipitation, more intense precipitation and increased flows combined with dryer summers. In response to the potential climate related risks, and on the commission of the Ministry of Environment, the Swedish Geotechnical Institute (SGI) is at present performing a risk analysis project for the most prominent landslide risk area in Sweden: the Göta river valley. As part of this, a methodology for land slide ex-ante consequence analysis today, and in a future climate, has been developed and applied in the Göta river valley. Human life, settlements, industry, contaminated sites, infrastructure of national importance are invented and assessed important elements at risk. The goal of the consequence analysis is to produce a map of geographically distributed expected losses, which can be combined with a corresponding map displaying landslide probability to describe the risk (the combination of probability and consequence of a (negative) event). The risk analysis is GIS-aided in presenting and visualise the risk and using existing databases for quantification of the consequences represented by ex-ante estimated monetary losses. The results will be used on national, regional and as an indication of the risk on local level, to assess the need of measures to mitigate the risk. The costs and environmental and social impacts to mitigate the risk are expected to be very high but the costs and impacts of a severe landslide are expected to be even higher. Therefore, civil servants have pronounced a need of tools to assess both the vulnerability and a more holistic picture of impacts of climate change adaptation measures. At SGI a tool for the inclusion of sustainability aspects in the decision making process on adaptation measures has been developed and is currently being tested in municipalities including central Gothenburg, and smaller municipalities in Sweden and Norway. The tool is a matrix based decision support tool (MDST) aiming for encoring discussion among experts and stakeholders. The first steps in the decision process include identification, inventory and assessment of the potential impacts of climate change such as landslides (or other events or actions). These steps are also included in general technical/physical risk and vulnerability analyses such as the risk analysis of the Göta älv valley. The MDST also includes further subsequent steps of the risk management process, and the full sequence of the MDST includes risk identification, risk specification, risk assessment, identification of measures, impact analysis of measures including an assessment of environmental, social and economical costs and benefits, a weight process and visualisation of the result. Here the MDST with some examples from the methodology for the Göta river valley analysis and the risk mitigation analysis from Sweden and Norway will be presented.

  8. The Impact of Size and Specialisation on Universities' Department Performance: A DEA Analysis Applied to Austrian Universities

    ERIC Educational Resources Information Center

    Leitner, Karl-Heinz; Prikoszovits, Julia; Schaffhauser-Linzatti, Michaela; Stowasser, Rainer; Wagner, Karin

    2007-01-01

    This paper explores the performance efficiency of natural and technical science departments at Austrian universities using Data Envelopment Analysis (DEA). We present DEA as an alternative tool for benchmarking and ranking the assignment of decision-making units (organisations and organisational units). The method applies a multiple input and…

  9. Contribution of suppression difficulty and lessons learned in forecasting fire suppression operations productivity: A methodological approach

    Treesearch

    Francisco Rodríguez y Silva; Armando González-Cabán

    2016-01-01

    We propose an economic analysis using utility and productivity, and efficiency theories to provide fire managers a decision support tool to determine the most efficient fire management programs levels. By incorporating managers’ accumulated fire suppression experiences (capitalized experience) in the analysis we help fire managers...

  10. Exploring the Utility of Narrative Analysis in Diagnostic Decision Making: Picture-Bound Reference, Elaboration, and Fetal Alcohol Spectrum Disorders

    ERIC Educational Resources Information Center

    Thorne, John C.; Coggins, Truman E.; Olson, Heather Carmichael; Astley, Susan J.

    2007-01-01

    Purpose: To evaluate classification accuracy and clinical feasibility of a narrative analysis tool for identifying children with a fetal alcohol spectrum disorder (FASD). Method: Picture-elicited narratives generated by 16 age-matched pairs of school-aged children (FASD vs. typical development [TD]) were coded for semantic elaboration and…

  11. Policy Implications Analysis: A Methodological Advancement for Policy Research and Evaluation.

    ERIC Educational Resources Information Center

    Madey, Doren L.; Stenner, A. Jackson

    Policy Implications Analysis (PIA) is a tool designed to maximize the likelihood that an evaluation report will have an impact on decision-making. PIA was designed to help people planning and conducting evaluations tailor their information so that it has optimal potential for being used and acted upon. This paper describes the development and…

  12. Analytical framework and tool kit for SEA follow-up

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nilsson, Mans; Wiklund, Hans; Finnveden, Goeran

    2009-04-15

    Most Strategic Environmental Assessment (SEA) research and applications have so far neglected the ex post stages of the process, also called SEA follow-up. Tool kits and methodological frameworks for engaging effectively with SEA follow-up have been conspicuously missing. In particular, little has so far been learned from the much more mature evaluation literature although many aspects are similar. This paper provides an analytical framework and tool kit for SEA follow-up. It is based on insights and tools developed within programme evaluation and environmental systems analysis. It is also grounded in empirical studies into real planning and programming practices at themore » regional level, but should have relevance for SEA processes at all levels. The purpose of the framework is to promote a learning-oriented and integrated use of SEA follow-up in strategic decision making. It helps to identify appropriate tools and their use in the process, and to systematise the use of available data and knowledge across the planning organization and process. It distinguishes three stages in follow-up: scoping, analysis and learning, identifies the key functions and demonstrates the informational linkages to the strategic decision-making process. The associated tool kit includes specific analytical and deliberative tools. Many of these are applicable also ex ante, but are then used in a predictive mode rather than on the basis of real data. The analytical element of the framework is organized on the basis of programme theory and 'DPSIR' tools. The paper discusses three issues in the application of the framework: understanding the integration of organizations and knowledge; understanding planners' questions and analytical requirements; and understanding interests, incentives and reluctance to evaluate.« less

  13. Program management aid for redundancy selection and operational guidelines

    NASA Technical Reports Server (NTRS)

    Hodge, P. W.; Davis, W. L.; Frumkin, B.

    1972-01-01

    Although this criterion was developed specifically for use on the shuttle program, it has application to many other multi-missions programs (i.e. aircraft or mechanisms). The methodology employed is directly applicable even if the tools (nomographs and equations) are for mission peculiar cases. The redundancy selection criterion was developed to insure that both the design and operational cost impacts (life cycle costs) were considered in the selection of the quantity of operational redundancy. These tools were developed as aids in expediting the decision process and not intended as the automatic decision maker. This approach to redundancy selection is unique in that it enables a pseudo systems analysis to be performed on an equipment basis without waiting for all designs to be hardened.

  14. The Health Impact Assessment (HIA) Resource and Tool ...

    EPA Pesticide Factsheets

    Health Impact Assessment (HIA) is a relatively new and rapidly emerging field in the U.S. An inventory of available HIA resources and tools was conducted, with a primary focus on resources developed in the U.S. The resources and tools available to HIA practitioners in the conduct of their work were identified through multiple methods and compiled into a comprehensive list. The compilation includes tools and resources related to the HIA process itself and those that can be used to collect and analyze data, establish a baseline profile, assess potential health impacts, and establish benchmarks and indicators for monitoring and evaluation. These resources include literature and evidence bases, data and statistics, guidelines, benchmarks, decision and economic analysis tools, scientific models, methods, frameworks, indices, mapping, and various data collection tools. Understanding the data, tools, models, methods, and other resources available to perform HIAs will help to advance the HIA community of practice in the U.S., improve the quality and rigor of assessments upon which stakeholder and policy decisions are based, and potentially improve the overall effectiveness of HIA to promote healthy and sustainable communities. The Health Impact Assessment (HIA) Resource and Tool Compilation is a comprehensive list of resources and tools that can be utilized by HIA practitioners with all levels of HIA experience to guide them throughout the HIA process. The HIA Resource

  15. Usability Testing of a Complex Clinical Decision Support Tool in the Emergency Department: Lessons Learned.

    PubMed

    Press, Anne; McCullagh, Lauren; Khan, Sundas; Schachter, Andy; Pardo, Salvatore; McGinn, Thomas

    2015-09-10

    As the electronic health record (EHR) becomes the preferred documentation tool across medical practices, health care organizations are pushing for clinical decision support systems (CDSS) to help bring clinical decision support (CDS) tools to the forefront of patient-physician interactions. A CDSS is integrated into the EHR and allows physicians to easily utilize CDS tools. However, often CDSS are integrated into the EHR without an initial phase of usability testing, resulting in poor adoption rates. Usability testing is important because it evaluates a CDSS by testing it on actual users. This paper outlines the usability phase of a study, which will test the impact of integration of the Wells CDSS for pulmonary embolism (PE) diagnosis into a large urban emergency department, where workflow is often chaotic and high stakes decisions are frequently made. We hypothesize that conducting usability testing prior to integration of the Wells score into an emergency room EHR will result in increased adoption rates by physicians. The objective of the study was to conduct usability testing for the integration of the Wells clinical prediction rule into a tertiary care center's emergency department EHR. We conducted usability testing of a CDS tool in the emergency department EHR. The CDS tool consisted of the Wells rule for PE in the form of a calculator and was triggered off computed tomography (CT) orders or patients' chief complaint. The study was conducted at a tertiary hospital in Queens, New York. There were seven residents that were recruited and participated in two phases of usability testing. The usability testing employed a "think aloud" method and "near-live" clinical simulation, where care providers interacted with standardized patients enacting a clinical scenario. Both phases were audiotaped, video-taped, and had screen-capture software activated for onscreen recordings. Phase I: Data from the "think-aloud" phase of the study showed an overall positive outlook on the Wells tool in assessing a patient for a PE diagnosis. Subjects described the tool as "well-organized" and "better than clinical judgment". Changes were made to improve tool placement into the EHR to make it optimal for decision-making, auto-populating boxes, and minimizing click fatigue. Phase II: After incorporating the changes noted in Phase 1, the participants noted tool improvements. There was less toggling between screens, they had all the clinical information required to complete the tool, and were able to complete the patient visit efficiently. However, an optimal location for triggering the tool remained controversial. This study successfully combined "think-aloud" protocol analysis with "near-live" clinical simulations in a usability evaluation of a CDS tool that will be implemented into the emergency room environment. Both methods proved useful in the assessment of the CDS tool and allowed us to refine tool usability and workflow.

  16. Critical care physician cognitive task analysis: an exploratory study

    PubMed Central

    Fackler, James C; Watts, Charles; Grome, Anna; Miller, Thomas; Crandall, Beth; Pronovost, Peter

    2009-01-01

    Introduction For better or worse, the imposition of work-hour limitations on house-staff has imperiled continuity and/or improved decision-making. Regardless, the workflow of every physician team in every academic medical centre has been irrevocably altered. We explored the use of cognitive task analysis (CTA) techniques, most commonly used in other high-stress and time-sensitive environments, to analyse key cognitive activities in critical care medicine. The study objective was to assess the usefulness of CTA as an analytical tool in order that physician cognitive tasks may be understood and redistributed within the work-hour limited medical decision-making teams. Methods After approval from each Institutional Review Board, two intensive care units (ICUs) within major university teaching hospitals served as data collection sites for CTA observations and interviews of critical care providers. Results Five broad categories of cognitive activities were identified: pattern recognition; uncertainty management; strategic vs. tactical thinking; team coordination and maintenance of common ground; and creation and transfer of meaning through stories. Conclusions CTA within the framework of Naturalistic Decision Making is a useful tool to understand the critical care process of decision-making and communication. The separation of strategic and tactical thinking has implications for workflow redesign. Given the global push for work-hour limitations, such workflow redesign is occurring. Further work with CTA techniques will provide important insights toward rational, rather than random, workflow changes. PMID:19265517

  17. Critical care physician cognitive task analysis: an exploratory study.

    PubMed

    Fackler, James C; Watts, Charles; Grome, Anna; Miller, Thomas; Crandall, Beth; Pronovost, Peter

    2009-01-01

    For better or worse, the imposition of work-hour limitations on house-staff has imperiled continuity and/or improved decision-making. Regardless, the workflow of every physician team in every academic medical centre has been irrevocably altered. We explored the use of cognitive task analysis (CTA) techniques, most commonly used in other high-stress and time-sensitive environments, to analyse key cognitive activities in critical care medicine. The study objective was to assess the usefulness of CTA as an analytical tool in order that physician cognitive tasks may be understood and redistributed within the work-hour limited medical decision-making teams. After approval from each Institutional Review Board, two intensive care units (ICUs) within major university teaching hospitals served as data collection sites for CTA observations and interviews of critical care providers. Five broad categories of cognitive activities were identified: pattern recognition; uncertainty management; strategic vs. tactical thinking; team coordination and maintenance of common ground; and creation and transfer of meaning through stories. CTA within the framework of Naturalistic Decision Making is a useful tool to understand the critical care process of decision-making and communication. The separation of strategic and tactical thinking has implications for workflow redesign. Given the global push for work-hour limitations, such workflow redesign is occurring. Further work with CTA techniques will provide important insights toward rational, rather than random, workflow changes.

  18. Application of a web-based Decision Support System in risk management

    NASA Astrophysics Data System (ADS)

    Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

    2013-04-01

    Increasingly, risk information is widely available with the help of advanced technologies such as earth observation satellites, global positioning technologies, coupled with hazard modeling and analysis, and geographical information systems (GIS). Even though it exists, no effort will be put into action if it is not properly presented to the decision makers. These information need to be communicated clearly and show its usefulness so that people can make better informed decision. Therefore, communicating available risk information has become an important challenge and decision support systems have been one of the significant approaches which can help not only in presenting risk information to the decision makers but also in making efficient decisions while reducing human resources and time needed. In this study, the conceptual framework of an internet-based decision support system is presented to highlight its importance role in risk management framework and how it can be applied in case study areas chosen. The main purpose of the proposed system is to facilitate the available risk information in risk reduction by taking into account of the changes in climate, land use and socio-economic along with the risk scenarios. It allows the users to formulate, compare and select risk reduction scenarios (mainly for floods and landslides) through an enhanced participatory platform with diverse stakeholders' involvement in the decision making process. It is based on the three-tier (client-server) architecture which integrates web-GIS plus DSS functionalities together with cost benefit analysis and other supporting tools. Embedding web-GIS provides its end users to make better planning and informed decisions referenced to a geographical location, which is the one of the essential factors in disaster risk reduction programs. Different risk reduction measures of a specific area (local scale) will be evaluated using this web-GIS tool, available risk scenarios obtained from Probabilistic Risk Assessment (PRA) model and the knowledge collected from experts. The visualization of the risk reduction scenarios can also be shared among the users on the web to support the on-line participatory process. In addition, cost-benefit ratios of the different risk reduction scenarios can be prepared in order to serve as inputs for high-level decision makers. The most appropriate risk reduction scenarios will be chosen using Multi-Criteria Evaluation (MCE) method by weighting different parameters according to the preferences and criteria defined by the users. The role of public participation has been changing from one-way communication between authorities, experts, stakeholders and citizens towards more intensive two-way interaction. Involving the affected public and interest groups can enhance the level of legitimacy, transparency, and confidence in the decision making process. Due to its important part in decision making, online participatory tool is included in the DSS in order to allow the involved stakeholders interactively in risk reduction and be aware of the existing vulnerability conditions of the community. Moreover, it aims to achieve a more transparent and better informed decision-making process. The system is under in progress and the first tools implemented will be presented showing the wide possibilities of new web technologies which can have a great impact on the decision making process. It will be applied in four pilot areas in Europe: French Alps, North Eastern Italy, Romania and Poland. Nevertheless, the framework will be designed and implemented in a way to be applicable in any other regions.

  19. How can we make progress with decision support systems in landscape and river basin management? Lessons learned from a comparative analysis of four different decision support systems.

    PubMed

    Volk, Martin; Lautenbach, Sven; van Delden, Hedwig; Newham, Lachlan T H; Seppelt, Ralf

    2010-12-01

    This article analyses the benefits and shortcomings of the recently developed decision support systems (DSS) FLUMAGIS, Elbe-DSS, CatchMODS, and MedAction. The analysis elaborates on the following aspects: (i) application area/decision problem, (ii) stakeholder interaction/users involved, (iii) structure of DSS/model structure, (iv) usage of the DSS, and finally (v) most important shortcomings. On the basis of this analysis, we formulate four criteria that we consider essential for the successful use of DSS in landscape and river basin management. The criteria relate to (i) system quality, (ii) user support and user training, (iii) perceived usefulness and (iv) user satisfaction. We can show that the availability of tools and technologies for DSS in landscape and river basin management is good to excellent. However, our investigations indicate that several problems have to be tackled. First of all, data availability and homogenisation, uncertainty analysis and uncertainty propagation and problems with model integration require further attention. Furthermore, the appropriate and methodological stakeholder interaction and the definition of 'what end-users really need and want' have been documented as general shortcomings of all four examples of DSS. Thus, we propose an iterative development process that enables social learning of the different groups involved in the development process, because it is easier to design a DSS for a group of stakeholders who actively participate in an iterative process. We also identify two important lines of further development in DSS: the use of interactive visualization tools and the methodology of optimization to inform scenario elaboration and evaluate trade-offs among environmental measures and management alternatives.

  20. How Can We Make Progress with Decision Support Systems in Landscape and River Basin Management? Lessons Learned from a Comparative Analysis of Four Different Decision Support Systems

    NASA Astrophysics Data System (ADS)

    Volk, Martin; Lautenbach, Sven; van Delden, Hedwig; Newham, Lachlan T. H.; Seppelt, Ralf

    2010-12-01

    This article analyses the benefits and shortcomings of the recently developed decision support systems (DSS) FLUMAGIS, Elbe-DSS, CatchMODS, and MedAction. The analysis elaborates on the following aspects: (i) application area/decision problem, (ii) stakeholder interaction/users involved, (iii) structure of DSS/model structure, (iv) usage of the DSS, and finally (v) most important shortcomings. On the basis of this analysis, we formulate four criteria that we consider essential for the successful use of DSS in landscape and river basin management. The criteria relate to (i) system quality, (ii) user support and user training, (iii) perceived usefulness and (iv) user satisfaction. We can show that the availability of tools and technologies for DSS in landscape and river basin management is good to excellent. However, our investigations indicate that several problems have to be tackled. First of all, data availability and homogenisation, uncertainty analysis and uncertainty propagation and problems with model integration require further attention. Furthermore, the appropriate and methodological stakeholder interaction and the definition of `what end-users really need and want' have been documented as general shortcomings of all four examples of DSS. Thus, we propose an iterative development process that enables social learning of the different groups involved in the development process, because it is easier to design a DSS for a group of stakeholders who actively participate in an iterative process. We also identify two important lines of further development in DSS: the use of interactive visualization tools and the methodology of optimization to inform scenario elaboration and evaluate trade-offs among environmental measures and management alternatives.

  1. Multi-criteria decision making to support waste management: A critical review of current practices and methods.

    PubMed

    Goulart Coelho, Lineker M; Lange, Liséte C; Coelho, Hosmanny Mg

    2017-01-01

    Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.

  2. A modelling tool for policy analysis to support the design of efficient and effective policy responses for complex public health problems.

    PubMed

    Atkinson, Jo-An; Page, Andrew; Wells, Robert; Milat, Andrew; Wilson, Andrew

    2015-03-03

    In the design of public health policy, a broader understanding of risk factors for disease across the life course, and an increasing awareness of the social determinants of health, has led to the development of more comprehensive, cross-sectoral strategies to tackle complex problems. However, comprehensive strategies may not represent the most efficient or effective approach to reducing disease burden at the population level. Rather, they may act to spread finite resources less intensively over a greater number of programs and initiatives, diluting the potential impact of the investment. While analytic tools are available that use research evidence to help identify and prioritise disease risk factors for public health action, they are inadequate to support more targeted and effective policy responses for complex public health problems. This paper discusses the limitations of analytic tools that are commonly used to support evidence-informed policy decisions for complex problems. It proposes an alternative policy analysis tool which can integrate diverse evidence sources and provide a platform for virtual testing of policy alternatives in order to design solutions that are efficient, effective, and equitable. The case of suicide prevention in Australia is presented to demonstrate the limitations of current tools to adequately inform prevention policy and discusses the utility of the new policy analysis tool. In contrast to popular belief, a systems approach takes a step beyond comprehensive thinking and seeks to identify where best to target public health action and resources for optimal impact. It is concerned primarily with what can be reasonably left out of strategies for prevention and can be used to explore where disinvestment may occur without adversely affecting population health (or equity). Simulation modelling used for policy analysis offers promise in being able to better operationalise research evidence to support decision making for complex problems, improve targeting of public health policy, and offers a foundation for strengthening relationships between policy makers, stakeholders, and researchers.

  3. Development of processes allowing near real-time refinement and validation of triage tools during the early stage of an outbreak in readiness for surge: the FLU-CATs Study.

    PubMed

    Venkatesan, Sudhir; Myles, Puja R; McCann, Gerard; Kousoulis, Antonis A; Hashmi, Maimoona; Belatri, Rabah; Boyle, Emma; Barcroft, Alan; van Staa, Tjeerd Pieter; Kirkham, Jamie J; Nguyen Van Tam, Jonathan S; Williams, Timothy J; Semple, Malcolm G

    2015-10-01

    During pandemics of novel influenza and outbreaks of emerging infections, surge in health-care demand can exceed capacity to provide normal standards of care. In such exceptional circumstances, triage tools may aid decisions in identifying people who are most likely to benefit from higher levels of care. Rapid research during the early phase of an outbreak should allow refinement and validation of triage tools so that in the event of surge a valid tool is available. The overarching study aim is to conduct a prospective near real-time analysis of structured clinical assessments of influenza-like illness (ILI) using primary care electronic health records (EHRs) during a pandemic. This abstract summarises the preparatory work, infrastructure development, user testing and proof-of-concept study. (1) In preparation for conducting rapid research in the early phase of a future outbreak, to develop processes that allow near real-time analysis of general practitioner (GP) assessments of people presenting with ILI, management decisions and patient outcomes. (2) As proof of concept: conduct a pilot study evaluating the performance of the triage tools 'Community Assessment Tools' and 'Pandemic Medical Early Warning Score' to predict hospital admission and death in patients presenting with ILI to GPs during inter-pandemic winter seasons. Prospective near real-time analysis of structured clinical assessments and anonymised linkage to data from EHRs. User experience was evaluated by semistructured interviews with participating GPs. Thirty GPs in England, Wales and Scotland, participating in the Clinical Practice Research Datalink. All people presenting with ILI. None. Study outcome is proof of concept through demonstration of data capture and near real-time analysis. Primary patient outcomes were hospital admission within 24 hours and death (all causes) within 30 days of GP assessment. Secondary patient outcomes included GP decision to prescribe antibiotics and/or influenza-specific antiviral drugs and/or refer to hospital - if admitted, the need for higher levels of care and length of hospital stay. Linked anonymised data from a web-based structured clinical assessment and primary care EHRs. In the 24 months to April 2015, data from 704 adult and 159 child consultations by 30 GPs were captured. GPs referred 11 (1.6%) adults and six (3.8%) children to hospital. There were 13 (1.8%) deaths of adults and two (1.3%) of children. There were too few outcome events to draw any conclusions regarding the performance of the triage tools. GP interviews showed that although there were some difficulties with installation, the web-based data collection tool was quick and easy to use. Some GPs felt that a minimal monetary incentive would promote participation. We have developed processes that allow capture and near real-time automated analysis of GP's clinical assessments and management decisions of people presenting with ILI. We will develop processes to include other EHR systems, attempt linkage to data on influenza surveillance and maintain processes in readiness for a future outbreak. This study is registered as ISRCTN87130712 and UK Clinical Research Network 12827. The National Institute for Health Research Health Technology Assessment programme. MGS is supported by the UK NIHR Health Protection Research Unit in Emerging and Zoonotic Infections.

  4. Communicating risk of hereditary breast and ovarian cancer with an interactive decision support tool.

    PubMed

    Rupert, Douglas J; Squiers, Linda B; Renaud, Jeanette M; Whitehead, Nedra S; Osborn, Roger J; Furberg, Robert D; Squire, Claudia M; Tzeng, Janice P

    2013-08-01

    Women with hereditary breast and ovarian cancer syndrome (HBOC) face a higher risk of earlier, more aggressive cancer. Because of HBOC's rarity, screening is recommended only for women with strong cancer family histories. However, most patients do not have accurate history available and struggle to understand genetic concepts. Cancer in the Family, an online clinical decision support tool, calculated women's HBOC risk and promoted shared patient-provider decisions about screening. A pilot evaluation (n=9 providers, n=48 patients) assessed the tool's impact on knowledge, attitudes, and screening decisions. Patients used the tool before wellness exams and completed three surveys. Providers accessed the tool during exams, completed exam checklists, and completed four surveys. Patients entered complete family histories (67%), calculated personal risk (96%), and shared risk printouts with providers (65%). HBOC knowledge increased dramatically for patients and providers, and many patients (75%) perceived tool results as valid. The tool prompted patient-provider discussions about HBOC risk and cancer family history (88%). The tool was effective in increasing knowledge, collecting family history, and sparking patient-provider discussions about HBOC screening. Interactive tools can effectively communicate personalized risk and promote shared decisions, but they are not a substitute for patient-provider discussions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  5. An ArcGIS decision support tool for artificial reefs site selection (ArcGIS ARSS)

    NASA Astrophysics Data System (ADS)

    Stylianou, Stavros; Zodiatis, George

    2017-04-01

    Although the use and benefits of artificial reefs, both socio-economic and environmental, have been recognized with research and national development programmes worldwide their development is rarely subjected to a rigorous site selection process and the majority of the projects use the traditional (non-GIS) approach, based on trial and error mode. Recent studies have shown that the use of Geographic Information Systems, unlike to traditional methods, for the identification of suitable areas for artificial reefs siting seems to offer a number of distinct advantages minimizing possible errors, time and cost. A decision support tool (DSS) has been developed based on the existing knowledge, the multi-criteria decision analysis techniques and the GIS approach used in previous studies in order to help the stakeholders to identify the optimal locations for artificial reefs deployment on the basis of the physical, biological, oceanographic and socio-economic features of the sites. The tool provides to the users the ability to produce a final report with the results and suitability maps. The ArcGIS ARSS support tool runs within the existing ArcMap 10.2.x environment and for the development the VB .NET high level programming language has been used along with ArcObjects 10.2.x. Two local-scale case studies were conducted in order to test the application of the tool focusing on artificial reef siting. The results obtained from the case studies have shown that the tool can be successfully integrated within the site selection process in order to select objectively the optimal site for artificial reefs deployment.

  6. Detroit deicing decision support tool : description, operation, and simulation results

    DOT National Transportation Integrated Search

    2006-01-01

    The John A. Volpe National Transportation Systems Center, sponsored by the National Aeronautics and Space Administration, : developed a deicing decision support tool, for Detroit Metropolitan Wayne County Airport (DTW).1 The deicing decision support ...

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

    PubMed

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

    2017-02-23

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

  8. The analysis of rapidly developing fog at the Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    Wheeler, Mark M.; Atchison, Michael K.; Schumann, Robin; Taylor, Greg E.; Yersavich, Ann; Warburton, John D.

    1994-01-01

    This report documents fog precursors and fog climatology at Kennedy Space Center (KSC) Florida from 1986 to 1990. The major emphasis of this report focuses on rapidly developing fog events that would affect the less than 7-statute mile visibility rule for End-Of-Mission (EOM) Shuttle landing at KSC (Rule 4-64(A)). The Applied Meteorology Unit's (AMU's) work is to: develop a data base for study of fog associated weather conditions relating to violations of this landing constraint; develop forecast techniques or rules-of-thumb to determine whether or not current conditions are likely to result in an acceptable condition at landing; validate the forecast techniques; and transition techniques to operational use. As part of the analysis the fog events were categorized as either advection, pre-frontal or radiation. As a result of these analyses, the AMU developed a fog climatological data base, identified fog precursors and developed forecaster tools and decision trees. The fog climatological analysis indicates that during the fog season (October to April) there is a higher risk for a visibility violation at KSC during the early morning hours (0700 to 1200 UTC), while 95 percent of all fog events have dissipated by 1600 UTC. A high number of fog events are characterized by a westerly component to the surface wind at KSC (92 percent) and 83 percent of the fog events had fog develop west of KSC first (up to 2 hours). The AMU developed fog decision trees and forecaster tools that would help the forecaster identify fog precursors up to 12 hours in advance. Using the decision trees as process tools ensures the important meteorological data are not overlooked in the forecast process. With these tools and a better understanding of fog formation in the local KSC area, the Shuttle weather support forecaster should be able to give the Launch and Flight Directors a better KSC fog forecast with more confidence.

  9. Perspectives of adolescents on decision making about participation in a biobank study: a pilot study.

    PubMed

    Grootens-Wiegers, Petronella; Visser, Eline G; van Rossum, Annemarie M C; van Waardhuizen, Claudia N; de Wildt, Saskia N; Sweep, Boudewijn; van den Broek, Jos M; de Vries, Martine C

    2017-01-01

    To be able to truly involve adolescents in decision making about clinical research participation, we need more insight in the perspective of adolescents themselves. To this end, adolescents in an ongoing biobank study were consulted to test a tentative decision assessment tool. The perspectives of adolescents (n=8) concerning participation in decision making for research participation were explored in interviews with a tentative tool, which covered six topics: information material usage, understanding, disease perceptions, anxiety, decision-making process and role sharing. All adolescents unequivocally expressed the desire to be involved in decision making, but also wanted advice from their parents. The extent of the preferred role of adolescent versus parents varied between individuals. In decision making, adolescents relied on parents for information. More than half hardly used the information material. Adolescents in our study preferred a shared decision-making process. The extent of sharing varied between individuals. The decision assessment tool was a fruitful starting point to discuss adolescents' perspectives and may aid in tailoring the situation to the individual to achieve optimal participation practices. Consulting adolescents about their preferences concerning decision making using the tool will facilitate tailoring of the shared decision-making process and optimising the developing autonomy of minors.

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

    PubMed

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

    2013-09-01

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

  11. Audio‐video decision support for patients: the documentary genré as a basis for decision aids

    PubMed Central

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

    2011-01-01

    Abstract Objective  Decision support tools are increasingly using audio‐visual materials. However, disagreement exists about the use of audio‐visual materials as they may be subjective and biased. Methods  This is a literature review of the major texts for documentary film studies to extrapolate issues of objectivity and bias from film to decision support tools. Results  The key features of documentary films are that they attempt to portray real events and that the attempted reality is always filtered through the lens of the filmmaker. The same key features can be said of decision support tools that use audio‐visual materials. Three concerns arising from documentary film studies as they apply to the use of audio‐visual materials in decision support tools include whose perspective matters (stakeholder bias), how to choose among audio‐visual materials (selection bias) and how to ensure objectivity (editorial bias). Discussion  Decision science needs to start a debate about how audio‐visual materials are to be used in decision support tools. Simply because audio‐visual materials may be subjective and open to bias does not mean that we should not use them. Conclusion  Methods need to be found to ensure consensus around balance and editorial control, such that audio‐visual materials can be used. PMID:22032516

  12. Clinical decision support tools for osteoporosis disease management: a systematic review of randomized controlled trials.

    PubMed

    Kastner, Monika; Straus, Sharon E

    2008-12-01

    Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management.

  13. Development of an online, publicly accessible naive Bayesian decision support tool for mammographic mass lesions based on the American College of Radiology (ACR) BI-RADS lexicon.

    PubMed

    Benndorf, Matthias; Kotter, Elmar; Langer, Mathias; Herda, Christoph; Wu, Yirong; Burnside, Elizabeth S

    2015-06-01

    To develop and validate a decision support tool for mammographic mass lesions based on a standardized descriptor terminology (BI-RADS lexicon) to reduce variability of practice. We used separate training data (1,276 lesions, 138 malignant) and validation data (1,177 lesions, 175 malignant). We created naïve Bayes (NB) classifiers from the training data with tenfold cross-validation. Our "inclusive model" comprised BI-RADS categories, BI-RADS descriptors, and age as predictive variables; our "descriptor model" comprised BI-RADS descriptors and age. The resulting NB classifiers were applied to the validation data. We evaluated and compared classifier performance with ROC-analysis. In the training data, the inclusive model yields an AUC of 0.959; the descriptor model yields an AUC of 0.910 (P < 0.001). The inclusive model is superior to the clinical performance (BI-RADS categories alone, P < 0.001); the descriptor model performs similarly. When applied to the validation data, the inclusive model yields an AUC of 0.935; the descriptor model yields an AUC of 0.876 (P < 0.001). Again, the inclusive model is superior to the clinical performance (P < 0.001); the descriptor model performs similarly. We consider our classifier a step towards a more uniform interpretation of combinations of BI-RADS descriptors. We provide our classifier at www.ebm-radiology.com/nbmm/index.html . • We provide a decision support tool for mammographic masses at www.ebm-radiology.com/nbmm/index.html . • Our tool may reduce variability of practice in BI-RADS category assignment. • A formal analysis of BI-RADS descriptors may enhance radiologists' diagnostic performance.

  14. Decision Matrices: Tools to Enhance Middle School Engineering Instruction

    ERIC Educational Resources Information Center

    Gonczi, Amanda L.; Bergman, Brenda G.; Huntoon, Jackie; Allen, Robin; McIntyre, Barb; Turner, Sheri; Davis, Jen; Handler, Rob

    2017-01-01

    Decision matrices are valuable engineering tools. They allow engineers to objectively examine solution options. Decision matrices can be incorporated in K-12 classrooms to support authentic engineering instruction. In this article we provide examples of how decision matrices have been incorporated into 6th and 7th grade classrooms as part of an…

  15. Decision support methods for the environmental assessment of contamination at mining sites.

    PubMed

    Jordan, Gyozo; Abdaal, Ahmed

    2013-09-01

    Polluting mine accidents and widespread environmental contamination associated with historic mining in Europe and elsewhere has triggered the improvement of related environmental legislation and of the environmental assessment and management methods for the mining industry. Mining has some unique features such as natural background pollution associated with natural mineral deposits, industrial activities and contamination located in the three-dimensional sub-surface space, the problem of long-term remediation after mine closure, problem of secondary contaminated areas around mine sites and abandoned mines in historic regions like Europe. These mining-specific problems require special tools to address the complexity of the environmental problems of mining-related contamination. The objective of this paper is to review and evaluate some of the decision support methods that have been developed and applied to mining contamination. In this paper, only those methods that are both efficient decision support tools and provide a 'holistic' approach to the complex problem as well are considered. These tools are (1) landscape ecology, (2) industrial ecology, (3) landscape geochemistry, (4) geo-environmental models, (5) environmental impact assessment, (6) environmental risk assessment, (7) material flow analysis and (8) life cycle assessment. This unique inter-disciplinary study should enable both the researcher and the practitioner to obtain broad view on the state-of-the-art of decision support methods for the environmental assessment of contamination at mine sites. Documented examples and abundant references are also provided.

  16. Lifecycle analysis for automobiles: Uses and limitations

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gaines, L.; Stodolsky, F.

    There has been a recent trend toward the use of lifecycle analysis (LCA) as a decision-making tool for the automotive industry. However, the different practitioners` methods and assumptions vary widely, as do the interpretations put on the results. The lack of uniformity has been addressed by such groups as the Society of Environmental Toxicology and Chemistry (SETAC) and the International Organization for Standardization (ISO), but standardization of methodology assures neither meaningful results nor appropriate use of the results. This paper examines the types of analysis that are possible for automobiles, explains possible pitfalls to be avoided, and suggests ways thatmore » LCA can be used as part of a rational decision-making procedure. The key to performing a useful analysis is identification of the factors that will actually be used in making the decision. It makes no sense to analyze system energy use in detail if direct financial cost is to be the decision criterion. Criteria may depend on who is making the decision (consumer, producer, regulator). LCA can be used to track system performance for a variety of criteria, including emissions, energy use, and monetary costs, and these can have spatial and temporal distributions. Because optimization of one parameter is likely to worsen another, identification of trade-offs is an important function of LCA.« less

  17. The Healthcare Administrator's Associate: an experiment in distributed healthcare information systems.

    PubMed Central

    Fowler, J.; Martin, G.

    1997-01-01

    The Healthcare Administrator's Associate is a collection of portable tools designed to support analysis of data retrieved via the Internet from diverse distributed healthcare information systems by means of the InfoSleuth system of distributed software agents. Development of these tools is part of an effort to enhance access to diverse and geographically distributed healthcare data in order to improve the basis upon which administrative and clinical decisions are made. PMID:9357686

  18. Decision analysis framing study; in-valley drainage management strategies for the western San Joaquin Valley, California

    USGS Publications Warehouse

    Presser, Theresa S.; Jenni, Karen E.; Nieman, Timothy; Coleman, James

    2010-01-01

    Constraints on drainage management in the western San Joaquin Valley and implications of proposed approaches to management were recently evaluated by the U.S. Geological Survey (USGS). The USGS found that a significant amount of data for relevant technical issues was available and that a structured, analytical decision support tool could help optimize combinations of specific in-valley drainage management strategies, address uncertainties, and document underlying data analysis for future use. To follow-up on USGS's technical analysis and to help define a scientific basis for decisionmaking in implementing in-valley drainage management strategies, this report describes the first step (that is, a framing study) in a Decision Analysis process. In general, a Decision Analysis process includes four steps: (1) problem framing to establish the scope of the decision problem(s) and a set of fundamental objectives to evaluate potential solutions, (2) generation of strategies to address identified decision problem(s), (3) identification of uncertainties and their relationships, and (4) construction of a decision support model. Participation in such a systematic approach can help to promote consensus and to build a record of qualified supporting data for planning and implementation. In December 2008, a Decision Analysis framing study was initiated with a series of meetings designed to obtain preliminary input from key stakeholder groups on the scope of decisions relevant to drainage management that were of interest to them, and on the fundamental objectives each group considered relevant to those decisions. Two key findings of this framing study are: (1) participating stakeholders have many drainage management objectives in common; and (2) understanding the links between drainage management and water management is necessary both for sound science-based decisionmaking and for resolving stakeholder differences about the value of proposed drainage management solutions. Citing ongoing legal processes associated with drainage management in the western San Joaquin Valley, the U.S. Bureau of Reclamation (USBR) withdrew from the Decision Analysis process early in the proceedings. Without the involvement of the USBR, the USGS discontinued further development of this study.

  19. Enhancement of the FDOT's project level and network level bridge management analysis tools

    DOT National Transportation Integrated Search

    2011-02-01

    Over several years, the Florida Department of Transportation (FDOT) has been implementing the AASHTO Pontis Bridge Management System to support network-level and project-level decision making in the headquarters and district offices. Pontis is an int...

  20. Reviewing and Viewing.

    ERIC Educational Resources Information Center

    Clements, Douglas H., Ed.; And Others

    1988-01-01

    Presents reviews of three software packages. Includes "Cube Builder: A 3-D Geometry Tool," which allows students to build three-dimensional shapes; "Number Master," a multipurpose practice program for whole number computation; and "Safari Search: Problem Solving and Inference," which focuses on decision making in mathematical analysis. (PK)

  1. Guidance for Technology Decisions from Classroom Observation

    ERIC Educational Resources Information Center

    Bielefeldt, Talbot

    2012-01-01

    Correlational analysis of two years of classroom observation indicates relationships between technology use and various classroom characteristics, including teacher roles and instructional strategies. Three observers used the ISTE Classroom Observation Tool (ICOT) to record 144 observations of classrooms participating in a variety of educational…

  2. SMARTE 2007 TUTORIAL - JANUARY 2007 REVISION

    EPA Science Inventory

    SMARTe 2007 is a web-based decision support tool intended to help revitalization practitioners find information, perform data analysis, communicate, and evaluate future reuse options for a site or area. This tutorial CD was developed to help users navigate SMARTe 2007. It is appr...

  3. Integrated Analysis Tools for the NERRS System-Wide Monitoring Program Data

    EPA Science Inventory

    Standardized monitoring programs have vastly improved the quantity and quality of data that form the basis of environmental decision-making. One example is the NOAA-funded National Estuarine Research Reserve System (NERRS) System-wide Monitoring Program (SWMP) that was implement...

  4. Applying analysis tools in planning for operations : case study #1 -- operations strategy impact reference and deployment guidance

    DOT National Transportation Integrated Search

    2009-09-01

    More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

  5. Virtual Beach v2.2 User Guide

    EPA Science Inventory

    Virtual Beach version 2.2 (VB 2.2) is a decision support tool. It is designed to construct site-specific Multi-Linear Regression (MLR) models to predict pathogen indicator levels (or fecal indicator bacteria, FIB) at recreational beaches. MLR analysis has outperformed persisten...

  6. Tradespace Exploration for the Engineering of Resilient Systems

    DTIC Science & Technology

    2015-05-01

    world scenarios. The types of tools within the SAE set include visualization, decision analysis, and M&S, so it is difficult to categorize this toolset... overpopulated , or questionable. ERS Tradespace Workshop Create predictive models using multiple techniques (e.g., regression, Kriging, neural nets

  7. The Role of Documentation Quality in Anesthesia-Related Closed Claims: A Descriptive Qualitative Study.

    PubMed

    Wilbanks, Bryan A; Geisz-Everson, Marjorie; Boust, Rebecca R

    2016-09-01

    Clinical documentation is a critical tool in supporting care provided to patients. Sound documentation provides a picture of clinical events that can be used to improve patient care. However, many other uses for clinical documentation are equally important. Such documentation informs clinical decision support tools, creates a legal record of patient care, assists in financial reimbursement of services, and serves as a repository for secondary data analysis. Conversely, poor documentation can impair patient safety and increase malpractice risk exposure by reflecting poor or inaccurate information that ultimately may guide patient care decisions.Through an examination of anesthesia-related closed claims, a descriptive qualitative study emerged, which explored the antecedents and consequences of documentation quality in the claims reviewed. A secondary data analysis utilized a database generated by the American Association of Nurse Anesthetists Foundation closed claim review team. Four major themes emerged from the analysis. Themes 1, 2, and 4 primarily describe how poor documentation quality can have negative consequences for clinicians. The third theme primarily describes how poor documentation quality that can negatively affect patient safety.

  8. Portfolio Analysis Tool

    NASA Technical Reports Server (NTRS)

    Barth, Tim; Zapata, Edgar; Benjamin, Perakath; Graul, Mike; Jones, Doug

    2005-01-01

    Portfolio Analysis Tool (PAT) is a Web-based, client/server computer program that helps managers of multiple projects funded by different customers to make decisions regarding investments in those projects. PAT facilitates analysis on a macroscopic level, without distraction by parochial concerns or tactical details of individual projects, so that managers decisions can reflect the broad strategy of their organization. PAT is accessible via almost any Web-browser software. Experts in specific projects can contribute to a broad database that managers can use in analyzing the costs and benefits of all projects, but do not have access for modifying criteria for analyzing projects: access for modifying criteria is limited to managers according to levels of administrative privilege. PAT affords flexibility for modifying criteria for particular "focus areas" so as to enable standardization of criteria among similar projects, thereby making it possible to improve assessments without need to rewrite computer code or to rehire experts, and thereby further reducing the cost of maintaining and upgrading computer code. Information in the PAT database and results of PAT analyses can be incorporated into a variety of ready-made or customizable tabular or graphical displays.

  9. A proposal for the development of national certification standards for patient decision aids in the US.

    PubMed

    Elwyn, Glyn; Burstin, Helen; Barry, Michael J; Corry, Maureen P; Durand, Marie Anne; Lessler, Daniel; Saigal, Christopher

    2018-04-27

    Efforts to implement the use of patient decision aids to stimulate shared decision making are gaining prominence. Patient decision aids have been designed to help patients participate in making specific choices among health care options. Because these tools clearly influence decisions, poor quality, inaccurate or unbalanced presentations or misleading tools are a risk to patients. As payer interest in these tools increases, so does the risk that patients are harmed by the use of tools that are described as patient decision aids yet fail to meet established standards. To address this problem, the National Quality Forum (NQF) in the USA convened a multi-stakeholder expert panel in 2016 to propose national standards for a patient decision aid certification process. In 2017, NQF established an Action Team to foster shared decision making, and to call for a national certification process as one recommendation among others to stimulate improvement. A persistent barrier to the setup of a national patient decision aids certification process is the lack of a sustainable financial model to support the work. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

  10. Decision support frameworks and tools for conservation

    USGS Publications Warehouse

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

    2018-01-01

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

  11. Evaluation of an open source tool for indexing and searching enterprise radiology and pathology reports

    NASA Astrophysics Data System (ADS)

    Kim, Woojin; Boonn, William

    2010-03-01

    Data mining of existing radiology and pathology reports within an enterprise health system can be used for clinical decision support, research, education, as well as operational analyses. In our health system, the database of radiology and pathology reports exceeds 13 million entries combined. We are building a web-based tool to allow search and data analysis of these combined databases using freely available and open source tools. This presentation will compare performance of an open source full-text indexing tool to MySQL's full-text indexing and searching and describe implementation procedures to incorporate these capabilities into a radiology-pathology search engine.

  12. Efforts to Support Consumer Enrollment Decisions Using Total Cost Estimators: Lessons from the Affordable Care Act’s Marketplaces.

    PubMed

    Giovannelli, Justin; Curran, Emily

    2017-02-01

    Issue: Policymakers have sought to improve the shopping experience on the Affordable Care Act’s marketplaces by offering decision support tools that help consumers better understand and compare their health plan options. Cost estimators are one such tool. They are designed to provide consumers a personalized estimate of the total cost--premium, minus subsidy, plus cost-sharing--of their coverage options. Cost estimators were available in most states by the start of the fourth open enrollment period. Goal: To understand the experiences of marketplaces that offer a total cost estimator and the interests and concerns of policymakers from states that are not using them. Methods: Structured interviews with marketplace officials, consumer enrollment assisters, technology vendors, and subject matter experts; analysis of the total cost estimators available on the marketplaces as of October 2016. Key findings and conclusions: Informants strongly supported marketplace adoption of a total cost estimator. Marketplaces that offer an estimator faced a range of design choices and varied significantly in their approaches to resolving them. Interviews suggested a clear need for additional consumer testing and data analysis of tool usage and for sustained outreach to enrollment assisters to encourage greater use of the estimators.

  13. Economics of infection control surveillance technology: cost-effective or just cost?

    PubMed

    Furuno, Jon P; Schweizer, Marin L; McGregor, Jessina C; Perencevich, Eli N

    2008-04-01

    Previous studies have suggested that informatics tools, such as automated alert and decision support systems, may increase the efficiency and quality of infection control surveillance. However, little is known about the cost-effectiveness of these tools. We focus on 2 types of economic analyses that have utility in assessing infection control interventions (cost-effectiveness analysis and business-case analysis) and review the available literature on the economics of computerized infection control surveillance systems. Previous studies on the effectiveness of computerized infection control surveillance have been limited to assessments of whether these tools increase the sensitivity and specificity of surveillance over traditional methods. Furthermore, we identified only 2 studies that assessed the costs associated with computerized infection control surveillance. Thus, it remains unknown whether computerized infection control surveillance systems are cost-effective and whether use of these systems improves patient outcomes. The existing data are insufficient to allow for a summary conclusion on the cost-effectiveness of infection control surveillance technology. All future studies of computerized infection control surveillance systems should aim to collect outcomes and economic data to inform decision making and assist hospitals with completing business-cases analyses.

  14. THE CAUSAL ANALYSIS / DIAGNOSIS DECISION ...

    EPA Pesticide Factsheets

    CADDIS is an on-line decision support system that helps investigators in the regions, states and tribes find, access, organize, use and share information to produce causal evaluations in aquatic systems. It is based on the US EPA's Stressor Identification process which is a formal method for identifying causes of impairments in aquatic systems. CADDIS 2007 increases access to relevant information useful for causal analysis and provides methods and tools that practitioners can use to analyze their own data. The new Candidate Cause section provides overviews of commonly encountered causes of impairments to aquatic systems: metals, sediments, nutrients, flow alteration, temperature, ionic strength, and low dissolved oxygen. CADDIS includes new Conceptual Models that illustrate the relationships from sources to stressors to biological effects. An Interactive Conceptual Model for phosphorus links the diagram with supporting literature citations. The new Analyzing Data section helps practitioners analyze their data sets and interpret and use those results as evidence within the USEPA causal assessment process. Downloadable tools include a graphical user interface statistical package (CADStat), and programs for use with the freeware R statistical package, and a Microsoft Excel template. These tools can be used to quantify associations between causes and biological impairments using innovative methods such as species-sensitivity distributions, biological inferenc

  15. Understanding Pediatric Dentists' Dental Caries Management Treatment Decisions: A Conjoint Experiment.

    PubMed

    Kateeb, E T; Warren, J J; Gaeth, G J; Momany, E T; Damiano, P C

    2016-04-01

    When traditional ranking and rating surveys are used to assess dentists' treatment decisions, the patient's source of payment appears to be of little importance. Therefore, this study used the marketing research tool conjoint analysis to investigate the relative impact of source of payment along with the child's age and cooperativeness on pediatric dentists' willingness to use Atraumatic Restorative Treatment (ART) to restore posterior primary teeth. A conjoint survey was completed by 707 pediatric dentists. Three factors (age of the child, cooperativeness, type of insurance) were varied across 3 levels to create 9 patient scenarios. The relative weights that dentists placed on these factors in the restorative treatment decision process were determined by conjoint analysis. "Cooperativeness" (52%) was the most important factor, "age of the child" (26%) the second-most important factor, followed by "insurance status of the child" (22%). For the third factor, insurance, pediatric dentists were least willing to use ART with publicly insured children (-0.082), and this was significantly different from their willingness to use ART with uninsured children (0.010) but not significantly different than their willingness to use ART for children with private insurance (0.073). Unlike traditional ranking and rating tools, conjoint analysis found that the insurance status of the patient appeared to be an important factor in dentists' decisions about different restorative treatment options. When pediatric dentists were forced to make tradeoffs among different patients' factors, they were most willing to use ART technique with young, uncooperative patients when they had no insurance. Knowledge Transfer Statement : The present study suggests the feasibility of using techniques borrowed from marketing research, such as conjoint analysis, to understand dentists' restorative treatment decisions. Results of this study demonstrate pediatric dentists' willingness to use a particular restorative treatment option (Atraumatic Restorative Treatment in this application) when forced to make tradeoffs in a "conjoined," or holistic, context among different factors presented in real-life patient scenarios. A deeper understanding of dentists' treatment decisions is vital to develop valid practice guidelines and interventions that encourage the use of appropriate restorative treatment modalities.

  16. Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis.

    PubMed

    Wyatt, Kirk D; Branda, Megan E; Inselman, Jonathan W; Ting, Henry H; Hess, Erik P; Montori, Victor M; LeBlanc, Annie

    2014-09-02

    Gender differences in communication styles between clinicians and patients have been postulated to impact patient care, but the extent to which the gender dyad structure impacts outcomes in shared decision making remains unclear. Participant-level meta-analysis of 775 clinical encounters within 7 randomized trials where decision aids, shared decision making tools, were used at the point of care. Outcomes analysed include decisional conflict scale scores, satisfaction with the clinical encounter, concordance between stated decision and action taken, and degree of patient engagement by the clinician using the OPTION scale. An estimated minimal important difference was used to determine if nonsignificant results could be explained by low power. We did not find a statistically significant interaction between clinician/patient gender mix and arm for decisional conflict, satisfaction with the clinical encounter or patient engagement. A borderline significant interaction (p = 0.05) was observed for one outcome: concordance between stated decision and action taken, where encounters with female clinician/male patient showed increased concordance in the decision aid arm compared to control (8% more concordant encounters). All other gender dyads showed decreased concordance with decision aid use (6% fewer concordant encounters for same-gender, 16% fewer concordant encounters for male clinician/female patient). In this participant-level meta-analysis of 7 randomized trials, decision aids used at the point of care demonstrated comparable efficacy across gender dyads. Purported barriers to shared decision making based on gender were not detected when tested for a minimum detected difference. ClinicalTrials.gov NCT00888537, NCT01077037, NCT01029288, NCT00388050, NCT00578981, NCT00949611, NCT00217061.

  17. Usability and feasibility of a tablet-based Decision-Support and Integrated Record-keeping (DESIRE) tool in the nurse management of hypertension in rural western Kenya.

    PubMed

    Vedanthan, Rajesh; Blank, Evan; Tuikong, Nelly; Kamano, Jemima; Misoi, Lawrence; Tulienge, Deborah; Hutchinson, Claire; Ascheim, Deborah D; Kimaiyo, Sylvester; Fuster, Valentin; Were, Martin C

    2015-03-01

    Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Usability testing consisted of "think aloud" exercises and "mock patient encounters" with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Usability and Feasibility of a Tablet-Based Decision-Support and Integrated Record-Keeping (DESIRE) Tool in the Nurse Management of Hypertension in Rural Western Kenya

    PubMed Central

    Vedanthan, Rajesh; Blank, Evan; Tuikong, Nelly; Kamano, Jemima; Misoi, Lawrence; Tulienge, Deborah; Hutchinson, Claire; Ascheim, Deborah D.; Kimaiyo, Sylvester; Fuster, Valentin; Were, Martin C.

    2015-01-01

    Background Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. Objective To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Methods Usability testing consisted of “think aloud” exercises and “mock patient encounters” with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with nurses. Content analysis was performed using both deductive codes and significant inductive codes. Critical incidents were identified and ranked according to severity. A cause-of-error analysis was used to develop corresponding design change suggestions. Results Fifty-seven critical incidents were identified in usability testing, 21 of which were unique. The cause-of-error analysis yielded 23 design change suggestions. Feasibility themes included barriers to implementation along both human and technical axes, facilitators to implementation, provider issues, patient issues and feature requests. Conclusions This participatory, iterative human-centered design process revealed previously unaddressed usability and feasibility issues affecting the implementation of the DESIRE tool in western Kenya. In addition to well-known technical issues, we highlight the importance of human factors that can impact implementation of mHealth interventions. PMID:25612791

  19. Advancements in Risk-Informed Performance-Based Asset Management for Commercial Nuclear Power Plants

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Liming, James K.; Ravindra, Mayasandra K.

    2006-07-01

    Over the past several years, ABSG Consulting Inc. (ABS Consulting) and the South Texas Project Nuclear Operating Company (STPNOC) have developed a decision support process and associated software for risk-informed, performance-based asset management (RIPBAM) of nuclear power plant facilities. RIPBAM applies probabilistic risk assessment (PRA) tools and techniques in the realm of plant physical and financial asset management. The RIPBAM process applies a tiered set of models and supporting performance measures (or metrics) that can ultimately be applied to support decisions affecting the allocation and management of plant resources (e.g., funding, staffing, scheduling, etc.). In general, the ultimate goal ofmore » the RIPBAM process is to continually support decision-making to maximize a facility's net present value (NPV) and long-term profitability for its owners. While the initial applications of RIPBAM have been for nuclear power stations, the methodology can easily be adapted to other types of power station or complex facility decision-making support. RIPBAM can also be designed to focus on performance metrics other than NPV and profitability (e.g., mission reliability, operational availability, probability of mission success per dollar invested, etc.). Recent advancements in the RIPBAM process focus on expanding the scope of previous RIPBAM applications to include not only operations, maintenance, and safety issues, but also broader risk perception components affecting plant owner (stockholder), operator, and regulator biases. Conceptually, RIPBAM is a comprehensive risk-informed cash flow model for decision support. It originated as a tool to help manage plant refueling outage scheduling, and was later expanded to include the full spectrum of operations and maintenance decision support. However, it differs from conventional business modeling tools in that it employs a systems engineering approach with broadly based probabilistic analysis of organizational 'value streams'. The scope of value stream inclusion in the process can be established by the user, but in its broadest applications, RIPBAM can be used to address how risk perceptions of plant owners and regulators are impacted by plant performance. Plant staffs can expand and refine RIPBAM models scope via a phased program of activities over time. This paper shows how the multi-metric uncertainty analysis feature of RIPBAM can apply a wide spectrum of decision-influencing factors to support decisions designed to maximize the probability of achieving, maintaining, and improving upon plant goals and objectives. In this paper, the authors show how this approach can be extremely valuable to plant owners and operators in supporting plant value-impacting decision-making processes. (authors)« less

  20. The use of the Dutch Self-Sufficiency Matrix (SSM-D) to inform allocation decisions to public mental health care for homeless people.

    PubMed

    Lauriks, Steve; de Wit, Matty A S; Buster, Marcel C A; Fassaert, Thijs J L; van Wifferen, Ron; Klazinga, Niek S

    2014-10-01

    The current study set out to develop a decision support tool based on the Self-Sufficiency Matrix (Dutch version; SSM-D) for the clinical decision to allocate homeless people to the public mental health care system at the central access point of public mental health care in Amsterdam, The Netherlands. Logistic regression and receiver operating characteristic-curve analyses were used to model professional decisions and establish four decision categories based on SSM-D scores from half of the research population (Total n = 612). The model and decision categories were found to be accurate and reliable in predicting professional decisions in the second half of the population. Results indicate that the decision support tool based on the SSM-D is useful and feasible. The method to develop the SSM-D as a decision support tool could be applied to decision-making processes in other systems and services where the SSM-D has been implemented, to further increase the utility of the instrument.

  1. PICASSO: an end-to-end image simulation tool for space and airborne imaging systems

    NASA Astrophysics Data System (ADS)

    Cota, Steve A.; Bell, Jabin T.; Boucher, Richard H.; Dutton, Tracy E.; Florio, Chris J.; Franz, Geoffrey A.; Grycewicz, Thomas J.; Kalman, Linda S.; Keller, Robert A.; Lomheim, Terrence S.; Paulson, Diane B.; Willkinson, Timothy S.

    2008-08-01

    The design of any modern imaging system is the end result of many trade studies, each seeking to optimize image quality within real world constraints such as cost, schedule and overall risk. Image chain analysis - the prediction of image quality from fundamental design parameters - is an important part of this design process. At The Aerospace Corporation we have been using a variety of image chain analysis tools for many years, the Parameterized Image Chain Analysis & Simulation SOftware (PICASSO) among them. In this paper we describe our PICASSO tool, showing how, starting with a high quality input image and hypothetical design descriptions representative of the current state of the art in commercial imaging satellites, PICASSO can generate standard metrics of image quality in support of the decision processes of designers and program managers alike.

  2. PICASSO: an end-to-end image simulation tool for space and airborne imaging systems

    NASA Astrophysics Data System (ADS)

    Cota, Stephen A.; Bell, Jabin T.; Boucher, Richard H.; Dutton, Tracy E.; Florio, Christopher J.; Franz, Geoffrey A.; Grycewicz, Thomas J.; Kalman, Linda S.; Keller, Robert A.; Lomheim, Terrence S.; Paulson, Diane B.; Wilkinson, Timothy S.

    2010-06-01

    The design of any modern imaging system is the end result of many trade studies, each seeking to optimize image quality within real world constraints such as cost, schedule and overall risk. Image chain analysis - the prediction of image quality from fundamental design parameters - is an important part of this design process. At The Aerospace Corporation we have been using a variety of image chain analysis tools for many years, the Parameterized Image Chain Analysis & Simulation SOftware (PICASSO) among them. In this paper we describe our PICASSO tool, showing how, starting with a high quality input image and hypothetical design descriptions representative of the current state of the art in commercial imaging satellites, PICASSO can generate standard metrics of image quality in support of the decision processes of designers and program managers alike.

  3. Influence diagrams as oil spill decision science tools

    EPA Science Inventory

    Making inferences on risks to ecosystem services (ES) from ecological crises can be more reliably handled using decision science tools. Influence diagrams (IDs) are probabilistic networks that explicitly represent the decisions related to a problem and evidence of their influence...

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

    PubMed

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

    2017-06-01

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

  5. Diagnostic accuracy and receiver-operating characteristics curve analysis in surgical research and decision making.

    PubMed

    Søreide, Kjetil; Kørner, Hartwig; Søreide, Jon Arne

    2011-01-01

    In surgical research, the ability to correctly classify one type of condition or specific outcome from another is of great importance for variables influencing clinical decision making. Receiver-operating characteristic (ROC) curve analysis is a useful tool in assessing the diagnostic accuracy of any variable with a continuous spectrum of results. In order to rule a disease state in or out with a given test, the test results are usually binary, with arbitrarily chosen cut-offs for defining disease versus health, or for grading of disease severity. In the postgenomic era, the translation from bench-to-bedside of biomarkers in various tissues and body fluids requires appropriate tools for analysis. In contrast to predetermining a cut-off value to define disease, the advantages of applying ROC analysis include the ability to test diagnostic accuracy across the entire range of variable scores and test outcomes. In addition, ROC analysis can easily examine visual and statistical comparisons across tests or scores. ROC is also favored because it is thought to be independent from the prevalence of the condition under investigation. ROC analysis is used in various surgical settings and across disciplines, including cancer research, biomarker assessment, imaging evaluation, and assessment of risk scores.With appropriate use, ROC curves may help identify the most appropriate cutoff value for clinical and surgical decision making and avoid confounding effects seen with subjective ratings. ROC curve results should always be put in perspective, because a good classifier does not guarantee the expected clinical outcome. In this review, we discuss the fundamental roles, suggested presentation, potential biases, and interpretation of ROC analysis in surgical research.

  6. Invited review: Helping dairy farmers to improve economic performance utilizing data-driving decision support tools.

    PubMed

    Cabrera, V E

    2018-01-01

    The objective of this review paper is to describe the development and application of a suite of more than 40 computerized dairy farm decision support tools contained at the University of Wisconsin-Madison (UW) Dairy Management website http://DairyMGT.info. These data-driven decision support tools are aimed to help dairy farmers improve their decision-making, environmental stewardship and economic performance. Dairy farm systems are highly dynamic in which changing market conditions and prices, evolving policies and environmental restrictions together with every time more variable climate conditions determine performance. Dairy farm systems are also highly integrated with heavily interrelated components such as the dairy herd, soils, crops, weather and management. Under these premises, it is critical to evaluate a dairy farm following a dynamic integrated system approach. For this approach, it is crucial to use meaningful data records, which are every time more available. These data records should be used within decision support tools for optimal decision-making and economic performance. Decision support tools in the UW-Dairy Management website (http://DairyMGT.info) had been developed using combination and adaptation of multiple methods together with empirical techniques always with the primary goal for these tools to be: (1) highly user-friendly, (2) using the latest software and computer technologies, (3) farm and user specific, (4) grounded on the best scientific information available, (5) remaining relevant throughout time and (6) providing fast, concrete and simple answers to complex farmers' questions. DairyMGT.info is a translational innovative research website in various areas of dairy farm management that include nutrition, reproduction, calf and heifer management, replacement, price risk and environment. This paper discusses the development and application of 20 selected (http://DairyMGT.info) decision support tools.

  7. Biological Event Modeling for Response Planning

    NASA Astrophysics Data System (ADS)

    McGowan, Clement; Cecere, Fred; Darneille, Robert; Laverdure, Nate

    People worldwide continue to fear a naturally occurring or terrorist-initiated biological event. Responsible decision makers have begun to prepare for such a biological event, but critical policy and system questions remain: What are the best courses of action to prepare for and react to such an outbreak? Where resources should be stockpiled? How many hospital resources—doctors, nurses, intensive-care beds—will be required? Will quarantine be necessary? Decision analysis tools, particularly modeling and simulation, offer ways to address and help answer these questions.

  8. An Investigation of Human Performance Model Validation

    DTIC Science & Technology

    2005-03-01

    of design decisions, what the costs and benefits are for each of the stages of analysis options. On the ’benefits’ side, the manager needs to know...confidence. But we also want to know that we are not expending any more effort (and other costs ) than necessary to ensure that the right decision is...supported at each stage. Ultimately, we want to enable SBA managers to have confidence that they are selecting the right HPM tools and using them correctly in

  9. Clinical microbiology informatics.

    PubMed

    Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron

    2014-10-01

    The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  10. Clinical Microbiology Informatics

    PubMed Central

    Sintchenko, Vitali; Rauch, Carol A.; Pantanowitz, Liron

    2014-01-01

    SUMMARY The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future. PMID:25278581

  11. Compilation of Theses Abstracts

    DTIC Science & Technology

    2005-06-01

    allies; 2) institutes that focus on the integration of teaching and research in direct support of the four pillars of Joint Visions 2010 and 2020 and...in Performance Based Contracts ................. 7 An Analysis of the Marriage and Dependency Premium Among Active Duty Navy Personnel...Decision Support Tool MASTER OF BUSINESS ADMINISTRATION 8 AN ANALYSIS OF THE MARRIAGE AND DEPENDENCY PREMIUM AMONG ACTIVE DUTY NAVY

  12. A group decision-making tool for the application of membrane technologies in different water reuse scenarios.

    PubMed

    Sadr, S M K; Saroj, D P; Kouchaki, S; Ilemobade, A A; Ouki, S K

    2015-06-01

    A global challenge of increasing concern is diminishing fresh water resources. A growing practice in many communities to supplement diminishing fresh water availability has been the reuse of water. Novel methods of treating polluted waters, such as membrane assisted technologies, have recently been developed and successfully implemented in many places. Given the diversity of membrane assisted technologies available, the current challenge is how to select a reliable alternative among numerous technologies for appropriate water reuse. In this research, a fuzzy logic based multi-criteria, group decision making tool has been developed. This tool has been employed in the selection of appropriate membrane treatment technologies for several non-potable and potable reuse scenarios. Robust criteria, covering technical, environmental, economic and socio-cultural aspects, were selected, while 10 different membrane assisted technologies were assessed in the tool. The results show this approach capable of facilitating systematic and rigorous analysis in the comparison and selection of membrane assisted technologies for advanced wastewater treatment and reuse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Decision science and cervical cancer.

    PubMed

    Cantor, Scott B; Fahs, Marianne C; Mandelblatt, Jeanne S; Myers, Evan R; Sanders, Gillian D

    2003-11-01

    Mathematical modeling is an effective tool for guiding cervical cancer screening, diagnosis, and treatment decisions for patients and policymakers. This article describes the use of mathematical modeling as outlined in five presentations from the Decision Science and Cervical Cancer session of the Second International Conference on Cervical Cancer held at The University of Texas M. D. Anderson Cancer Center, April 11-14, 2002. The authors provide an overview of mathematical modeling, especially decision analysis and cost-effectiveness analysis, and examples of how it can be used for clinical decision making regarding the prevention, diagnosis, and treatment of cervical cancer. Included are applications as well as theory regarding decision science and cervical cancer. Mathematical modeling can answer such questions as the optimal frequency for screening, the optimal age to stop screening, and the optimal way to diagnose cervical cancer. Results from one mathematical model demonstrated that a vaccine against high-risk strains of human papillomavirus was a cost-effective use of resources, and discussion of another model demonstrated the importance of collecting direct non-health care costs and time costs for cost-effectiveness analysis. Research presented indicated that care must be taken when applying the results of population-wide, cost-effectiveness analyses to reduce health disparities. Mathematical modeling can encompass a variety of theoretical and applied issues regarding decision science and cervical cancer. The ultimate objective of using decision-analytic and cost-effectiveness models is to identify ways to improve women's health at an economically reasonable cost. Copyright 2003 American Cancer Society.

  14. Sea Level Rise Decision Support Tools for Adaptation Planning in Vulnerable Coastal Communities

    NASA Astrophysics Data System (ADS)

    Rozum, J. S.; Marcy, D.

    2015-12-01

    NOAA is involved in a myriad of climate related research and projects that help decision makers and the public understand climate science as well as climate change impacts. The NOAA Office for Coastal Management (OCM) provides data, tools, trainings and technical assistance to coastal resource managers. Beginning in 2011, NOAA OCM began developing a sea level rise and coastal flooding impacts viewer which provides nationally consistent data sets and analyses to help communities with coastal management goals such as: understanding and communicating coastal flood hazards, performing vulnerability assessments and increasing coastal resilience, and prioritizing actions for different inundation/flooding scenarios. The Viewer is available on NOAA's Digital Coast platform: (coast.noaa.gov/ditgitalcoast/tools/slr). In this presentation we will share the lessons learned from our work with coastal decision-makers on the role of coastal flood risk data and tools in helping to shape future land use decisions and policies. We will also focus on a recent effort in California to help users understand the similarities and differences of a growing array of sea level rise decision support tools. NOAA staff and other partners convened a workshop entitled, "Lifting the Fog: Bringing Clarity to Sea Level Rise and Shoreline Change Models and Tools," which was attended by tool develops, science translators and coastal managers with the goal to create a collaborative communication framework to help California coastal decision-makers navigate the range of available sea level rise planning tools, and to inform tool developers of future planning needs. A sea level rise tools comparison matrix will be demonstrated. This matrix was developed as part of this effort and has been expanded to many other states via a partnership with NOAA, Climate Central, and The Nature Conservancy.

  15. Development and evaluation of a comprehensive clinical decision support taxonomy: comparison of front-end tools in commercial and internally developed electronic health record systems

    PubMed Central

    Sittig, Dean F; Ash, Joan S; Feblowitz, Joshua; Meltzer, Seth; McMullen, Carmit; Guappone, Ken; Carpenter, Jim; Richardson, Joshua; Simonaitis, Linas; Evans, R Scott; Nichol, W Paul; Middleton, Blackford

    2011-01-01

    Background Clinical decision support (CDS) is a valuable tool for improving healthcare quality and lowering costs. However, there is no comprehensive taxonomy of types of CDS and there has been limited research on the availability of various CDS tools across current electronic health record (EHR) systems. Objective To develop and validate a taxonomy of front-end CDS tools and to assess support for these tools in major commercial and internally developed EHRs. Study design and methods We used a modified Delphi approach with a panel of 11 decision support experts to develop a taxonomy of 53 front-end CDS tools. Based on this taxonomy, a survey on CDS tools was sent to a purposive sample of commercial EHR vendors (n=9) and leading healthcare institutions with internally developed state-of-the-art EHRs (n=4). Results Responses were received from all healthcare institutions and 7 of 9 EHR vendors (response rate: 85%). All 53 types of CDS tools identified in the taxonomy were found in at least one surveyed EHR system, but only 8 functions were present in all EHRs. Medication dosing support and order facilitators were the most commonly available classes of decision support, while expert systems (eg, diagnostic decision support, ventilator management suggestions) were the least common. Conclusion We developed and validated a comprehensive taxonomy of front-end CDS tools. A subsequent survey of commercial EHR vendors and leading healthcare institutions revealed a small core set of common CDS tools, but identified significant variability in the remainder of clinical decision support content. PMID:21415065

  16. Monte Carlo simulation: Its status and future

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Murtha, J.A.

    1997-04-01

    Monte Carlo simulation is a statistics-based analysis tool that yields probability-vs.-value relationships for key parameters, including oil and gas reserves, capital exposure, and various economic yardsticks, such as net present value (NPV) and return on investment (ROI). Monte Carlo simulation is a part of risk analysis and is sometimes performed in conjunction with or as an alternative to decision [tree] analysis. The objectives are (1) to define Monte Carlo simulation in a more general context of risk and decision analysis; (2) to provide some specific applications, which can be interrelated; (3) to respond to some of the criticisms; (4) tomore » offer some cautions about abuses of the method and recommend how to avoid the pitfalls; and (5) to predict what the future has in store.« less

  17. Using Perilog to Explore "Decision Making at NASA"

    NASA Technical Reports Server (NTRS)

    McGreevy, Michael W.

    2005-01-01

    Perilog, a context intensive text mining system, is used as a discovery tool to explore topics and concerns in "Decision Making at NASA," chapter 6 of the Columbia Accident Investigation Board (CAIB) Report, Volume I. Two examples illustrate how Perilog can be used to discover highly significant safety-related information in the text without prior knowledge of the contents of the document. A third example illustrates how "if-then" statements found by Perilog can be used in logical analysis of decision making. In addition, in order to serve as a guide for future work, the technical details of preparing a PDF document for input to Perilog are included in an appendix.

  18. A GIS-based generic real-time risk assessment framework and decision tools for chemical spills in the river basin.

    PubMed

    Jiang, Jiping; Wang, Peng; Lung, Wu-seng; Guo, Liang; Li, Mei

    2012-08-15

    This paper presents a generic framework and decision tools of real-time risk assessment on Emergency Environmental Decision Support System for response to chemical spills in river basin. The generic "4-step-3-model" framework is able to delineate the warning area and the impact on vulnerable receptors considering four types of hazards referring to functional area, societal impact, and human health and ecology system. Decision tools including the stand-alone system and software components were implemented on GIS platform. A detailed case study on the Songhua River nitrobenzene spill illustrated the goodness of the framework and tool Spill first responders and decision makers of catchment management will benefit from the rich, visual and dynamic hazard information output from the software. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Pilot study of a point-of-use decision support tool for cancer clinical trials eligibility.

    PubMed

    Breitfeld, P P; Weisburd, M; Overhage, J M; Sledge, G; Tierney, W M

    1999-01-01

    Many adults with cancer are not enrolled in clinical trials because caregivers do not have the time to match the patient's clinical findings with varying eligibility criteria associated with multiple trials for which the patient might be eligible. The authors developed a point-of-use portable decision support tool (DS-TRIEL) to automate this matching process. The support tool consists of a hand-held computer with a programmable relational database. A two-level hierarchic decision framework was used for the identification of eligible subjects for two open breast cancer clinical trials. The hand-held computer also provides protocol consent forms and schemas to further help the busy oncologist. This decision support tool and the decision framework on which it is based could be used for multiple trials and different cancer sites.

  20. Pilot Study of a Point-of-use Decision Support Tool for Cancer Clinical Trials Eligibility

    PubMed Central

    Breitfeld, Philip P.; Weisburd, Marina; Overhage, J. Marc; Sledge, George; Tierney, William M.

    1999-01-01

    Many adults with cancer are not enrolled in clinical trials because caregivers do not have the time to match the patient's clinical findings with varying eligibility criteria associated with multiple trials for which the patient might be eligible. The authors developed a point-of-use portable decision support tool (DS-TRIEL) to automate this matching process. The support tool consists of a hand-held computer with a programmable relational database. A two-level hierarchic decision framework was used for the identification of eligible subjects for two open breast cancer clinical trials. The hand-held computer also provides protocol consent forms and schemas to further help the busy oncologist. This decision support tool and the decision framework on which it is based could be used for multiple trials and different cancer sites. PMID:10579605

  1. Concept mapping in a critical care orientation program: a pilot study to develop critical thinking and decision-making skills in novice nurses.

    PubMed

    Wahl, Stacy E; Thompson, Anita M

    2013-10-01

    Newly graduated registered nurses who were hired into a critical care intensive care unit showed a lack of critical thinking skills to inform their clinical decision-making abilities. This study evaluated the effectiveness of concept mapping as a teaching tool to improve critical thinking and clinical decision-making skills in novice nurses. A self-evaluation tool was administered before and after the learning intervention. The 25-item tool measured five key indicators of the development of critical thinking skills: problem recognition, clinical decision-making, prioritization, clinical implementation, and reflection. Statistically significant improvements were seen in 10 items encompassing all five indicators. Concept maps are an effective tool for educators to use in assisting novice nurses to develop their critical thinking and clinical decision-making skills. Copyright 2013, SLACK Incorporated.

  2. Applying analysis tools in planning for operations : case study #4 -- application of microsimulation in combination with travel demand models

    DOT National Transportation Integrated Search

    2009-09-01

    More and more, transportation system operators are seeing the benefits of strengthening links between planning and operations. A critical element in improving transportation decision-making and the effectiveness of transportation systems related to o...

  3. Hard Choices for Individual Situations.

    ERIC Educational Resources Information Center

    Landon, Bruce

    This paper focuses on faculty use of a decision-making process for complex situations. The analysis part of the process describes and compares course management software focusing on: technical specifications, instructional design values,tools and features, ease of use, and standards compliance. The extensive comparisons provide faculty with…

  4. The Role of the Atmosphere in the Provision of Ecosystem Services

    EPA Science Inventory

    Solving the environmental problems that we are facing today requires holistic approaches to analysis and decision making that include social and economic aspects. The concept of ecosystem services, defined as the benefits people obtain from ecosystems, is one potential tool to p...

  5. Applying analysis tools in planning for operations : case study #2 -- incorporating Highway Capacity Manual procedures into long-range transportation planning

    DOT National Transportation Integrated Search

    2009-09-01

    More and more, transportation system operators are seeing the benefi ts of strengthening links between : planning and operations. A critical element in improving transportation decision-making and the effectiveness : of transportation systems related...

  6. Tools to support GHG emissions reduction : a regional effort, part 1 - carbon footprint estimation and decision support.

    DOT National Transportation Integrated Search

    2010-09-01

    Tools are proposed for carbon footprint estimation of transportation construction projects and decision support : for construction firms that must make equipment choice and usage decisions that affect profits, project duration : and greenhouse gas em...

  7. Decision-making tool for applying adaptive traffic control systems : final report.

    DOT National Transportation Integrated Search

    2016-03-01

    Adaptive traffic signal control technologies have been increasingly deployed in real world situations. The objective of this project was to develop a decision-making tool to guide traffic engineers and decision-makers who must decide whether or not a...

  8. Discharge Chamber Primary Electron Modeling Activities in Three-Dimensions

    NASA Technical Reports Server (NTRS)

    Steuber, Thomas J.

    2004-01-01

    Designing discharge chambers for ion thrusters involves many geometric configuration decisions. Various decisions will impact discharge chamber performance with respect to propellant utilization efficiency, ion production costs, and grid lifetime. These hardware design decisions can benefit from the assistance of computational modeling. Computational modeling for discharge chambers has been limited to two-dimensional codes that leveraged symmetry for interpretation into three-dimensional analysis. This paper presents model development activities towards a three-dimensional discharge chamber simulation to aid discharge chamber design decisions. Specifically, of the many geometric configuration decisions toward attainment of a worthy discharge chamber, this paper focuses on addressing magnetic circuit considerations with a three-dimensional discharge chamber simulation as a tool. With this tool, candidate discharge chamber magnetic circuit designs can be analyzed computationally to gain insight into factors that may influence discharge chamber performance such as: primary electron loss width in magnetic cusps, cathode tip position with respect to the low magnetic field volume, definition of a low magnetic field region, and maintenance of a low magnetic field region across the grid span. Corroborating experimental data will be obtained from mockup hardware tests. Initially, simulated candidate magnetic circuit designs will resemble previous successful thruster designs. To provide opportunity to improve beyond previous performance benchmarks, off-design modifications will be simulated and experimentally tested.

  9. Archetypes for Organisational Safety

    NASA Technical Reports Server (NTRS)

    Marais, Karen; Leveson, Nancy G.

    2003-01-01

    We propose a framework using system dynamics to model the dynamic behavior of organizations in accident analysis. Most current accident analysis techniques are event-based and do not adequately capture the dynamic complexity and non-linear interactions that characterize accidents in complex systems. In this paper we propose a set of system safety archetypes that model common safety culture flaws in organizations, i.e., the dynamic behaviour of organizations that often leads to accidents. As accident analysis and investigation tools, the archetypes can be used to develop dynamic models that describe the systemic and organizational factors contributing to the accident. The archetypes help clarify why safety-related decisions do not always result in the desired behavior, and how independent decisions in different parts of the organization can combine to impact safety.

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

    PubMed

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

    2014-02-01

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

  11. Opportunities and Strategies to Incorporate Ecosystem Services Knowledge and Decision Support Tools into Planning and Decision Making in Hawai`i

    NASA Astrophysics Data System (ADS)

    Bremer, Leah L.; Delevaux, Jade M. S.; Leary, James J. K.; J. Cox, Linda; Oleson, Kirsten L. L.

    2015-04-01

    Incorporating ecosystem services into management decisions is a promising means to link conservation and human well-being. Nonetheless, planning and management in Hawai`i, a state with highly valued natural capital, has yet to broadly utilize an ecosystem service approach. We conducted a stakeholder assessment, based on semi-structured interviews, with terrestrial ( n = 26) and marine ( n = 27) natural resource managers across the State of Hawai`i to understand the current use of ecosystem services (ES) knowledge and decision support tools and whether, how, and under what contexts, further development would potentially be useful. We found that ES knowledge and tools customized to Hawai`i could be useful for communication and outreach, justifying management decisions, and spatial planning. Greater incorporation of this approach is clearly desired and has a strong potential to contribute to more sustainable decision making and planning in Hawai`i and other oceanic island systems. However, the unique biophysical, socio-economic, and cultural context of Hawai`i, and other island systems, will require substantial adaptation of existing ES tools. Based on our findings, we identified four key opportunities for the use of ES knowledge and tools in Hawai`i: (1) linking native forest protection to watershed health; (2) supporting sustainable agriculture; (3) facilitating ridge-to-reef management; and (4) supporting statewide terrestrial and marine spatial planning. Given the interest expressed by natural resource managers, we envision broad adoption of ES knowledge and decision support tools if knowledge and tools are tailored to the Hawaiian context and coupled with adequate outreach and training.

  12. Opportunities and strategies to incorporate ecosystem services knowledge and decision support tools into planning and decision making in Hawai'i.

    PubMed

    Bremer, Leah L; Delevaux, Jade M S; Leary, James J K; J Cox, Linda; Oleson, Kirsten L L

    2015-04-01

    Incorporating ecosystem services into management decisions is a promising means to link conservation and human well-being. Nonetheless, planning and management in Hawai'i, a state with highly valued natural capital, has yet to broadly utilize an ecosystem service approach. We conducted a stakeholder assessment, based on semi-structured interviews, with terrestrial (n = 26) and marine (n = 27) natural resource managers across the State of Hawai'i to understand the current use of ecosystem services (ES) knowledge and decision support tools and whether, how, and under what contexts, further development would potentially be useful. We found that ES knowledge and tools customized to Hawai'i could be useful for communication and outreach, justifying management decisions, and spatial planning. Greater incorporation of this approach is clearly desired and has a strong potential to contribute to more sustainable decision making and planning in Hawai'i and other oceanic island systems. However, the unique biophysical, socio-economic, and cultural context of Hawai'i, and other island systems, will require substantial adaptation of existing ES tools. Based on our findings, we identified four key opportunities for the use of ES knowledge and tools in Hawai'i: (1) linking native forest protection to watershed health; (2) supporting sustainable agriculture; (3) facilitating ridge-to-reef management; and (4) supporting statewide terrestrial and marine spatial planning. Given the interest expressed by natural resource managers, we envision broad adoption of ES knowledge and decision support tools if knowledge and tools are tailored to the Hawaiian context and coupled with adequate outreach and training.

  13. Watershed Management Optimization Support Tool v3

    EPA Science Inventory

    The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that facilitates integrated water management at the local or small watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed context that is, accou...

  14. [Shared medical decision making in gynaecology].

    PubMed

    This, P; Panel, P

    2010-02-01

    When two options or more can be chosen in medical care, the final decision implies two steps: facts analysis, and patient evaluation of preferences. Shared Medical Decision-Making is a rational conceptual frame that can be used in such cases. In this paper, we describe the concept, its practical modalities, and the questions raised by its use. In gynaecology, many medical situations involve "sensitive preferences choice": for example, contraceptive choice, menorrhagia treatment, and approach of menopause. Some tools from the "Shared Medical Decision Making" concept are useful to structure medical consultations, to convey information, and to reveal patients preferences. Decision aid are used in clinical research settings, but some of them may also be easily used in usual practice, and help physicians to improve both quality and traceability of the decisional process. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  15. C3I Analysis Tools for Development Planning. Volume 1

    DTIC Science & Technology

    1985-09-27

    otherwise as in any manner licensing the holder or any other person or conveying any rights or permission to manufacture, use, or sell any patented... PERSONAL AUTHOR(S) ».A. Vail, G.H. Weissman, J.G. Wohl TYPE OF REPORT ?inal 13b. TIME COVERED FROM SUPPLEMENTARY NOTATION Refer to ESD-TR-86...support for decisions about the relative value of acquisition programs. 5. The software tool developed on a personal computer demonstrates that

  16. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Pardo-Bosch, Francesc, E-mail: francesc.pardo@upc.edu; Political Science Department, University of California - Berkeley; Aguado, Antonio, E-mail: antonio.aguado@upc.edu

    Infrastructure construction, one of the biggest driving forces of the economy nowadays, requires a huge analysis and clear transparency to decide what projects have to be executed with the few resources available. With the aim to provide the public administrations a tool with which they can make their decisions easier, the Sustainability Index of Infrastructure Projects (SIIP) has been defined, with a multi-criteria decision system called MIVES, in order to classify non-uniform investments. This index evaluates, in two inseparable stages, the contribution to the sustainable development of each infrastructure project, analyzing its social, environmental and economic impact. The result ofmore » the SIIP allows to decide the order with which projects will be prioritized. The case of study developed proves the adaptability and utility of this tool for the ordinary budget management.« less

  17. Developing an Ecosystem Services Online Decision Support Tool to Assess the Impacts of Climate Change and Urban Growth in the Santa Cruz Watershed: Where We Live, Work, and Play

    USGS Publications Warehouse

    Norman, Laura; Tallent-Halsell, Nita; Labiosa, William; Weber, Matt; McCoy, Amy; Hirschboeck, Katie; Callegary, James; van Riper, Charles; Gray, Floyd

    2010-01-01

    Using respective strengths of the biological, physical, and social sciences, we are developing an online decision support tool, the Santa Cruz Watershed Ecosystem Portfolio Model (SCWEPM), to help promote the use of information relevant to water allocation and land management in a binational watershed along the U.S.-Mexico border. The SCWEPM will include an ES valuation system within a suite of linked regional driver-response models and will use a multicriteria scenario-evaluation framework that builds on GIS analysis and spatially-explicit models that characterize important ecological, economic, and societal endpoints and consequences that are sensitive to climate patterns, regional water budgets, and regional LULC change in the SCW.

  18. Benefits and limitations of using decision analytic tools to assess uncertainty and prioritize Landscape Conservation Cooperative information needs

    USGS Publications Warehouse

    Post van der Burg, Max; Cullinane Thomas, Catherine; Holcombe, Tracy R.; Nelson, Richard D.

    2016-01-01

    The Landscape Conservation Cooperatives (LCCs) are a network of partnerships throughout North America that are tasked with integrating science and management to support more effective delivery of conservation at a landscape scale. In order to achieve this integration, some LCCs have adopted the approach of providing their partners with better scientific information in an effort to facilitate more effective and coordinated conservation decisions. Taking this approach has led many LCCs to begin funding research to provide the information for improved decision making. To ensure that funding goes to research projects with the highest likelihood of leading to more integrated broad scale conservation, some LCCs have also developed approaches for prioritizing which information needs will be of most benefit to their partnerships. We describe two case studies in which decision analytic tools were used to quantitatively assess the relative importance of information for decisions made by partners in the Plains and Prairie Potholes LCC. The results of the case studies point toward a few valuable lessons in terms of using these tools with LCCs. Decision analytic tools tend to help shift focus away from research oriented discussions and toward discussions about how information is used in making better decisions. However, many technical experts do not have enough knowledge about decision making contexts to fully inform the latter type of discussion. When assessed in the right decision context, however, decision analyses can point out where uncertainties actually affect optimal decisions and where they do not. This helps technical experts understand that not all research is valuable in improving decision making. But perhaps most importantly, our results suggest that decision analytic tools may be more useful for LCCs as way of developing integrated objectives for coordinating partner decisions across the landscape, rather than simply ranking research priorities.

  19. Development of a personalized decision aid for breast cancer risk reduction and management.

    PubMed

    Ozanne, Elissa M; Howe, Rebecca; Omer, Zehra; Esserman, Laura J

    2014-01-14

    Breast cancer risk reduction has the potential to decrease the incidence of the disease, yet remains underused. We report on the development a web-based tool that provides automated risk assessment and personalized decision support designed for collaborative use between patients and clinicians. Under Institutional Review Board approval, we evaluated the decision tool through a patient focus group, usability testing, and provider interviews (including breast specialists, primary care physicians, genetic counselors). This included demonstrations and data collection at two scientific conferences (2009 International Shared Decision Making Conference, 2009 San Antonio Breast Cancer Symposium). Overall, the evaluations were favorable. The patient focus group evaluations and usability testing (N = 34) provided qualitative feedback about format and design; 88% of these participants found the tool useful and 94% found it easy to use. 91% of the providers (N = 23) indicated that they would use the tool in their clinical setting. BreastHealthDecisions.org represents a new approach to breast cancer prevention care and a framework for high quality preventive healthcare. The ability to integrate risk assessment and decision support in real time will allow for informed, value-driven, and patient-centered breast cancer prevention decisions. The tool is being further evaluated in the clinical setting.

  20. The Three Gorges Project: How sustainable?

    NASA Astrophysics Data System (ADS)

    Kepa Brian Morgan, Te Kipa; Sardelic, Daniel N.; Waretini, Amaria F.

    2012-08-01

    SummaryIn 1984 the Government of China approved the decision to construct the Three Gorges Dam Project, the largest project since the Great Wall. The project had many barriers to overcome, and the decision was made at a time when sustainability was a relatively unknown concept. The decision to construct the Three Gorges Project remains contentious today, especially since Deputy Director of the Three Gorges Project Construction Committee, Wang Xiaofeng, stated that "We absolutely cannot relax our guard against ecological and environmental security problems sparked by the Three Gorges Project" (Bristow, 2007; McCabe, 2007). The question therefore was posed: how sustainable is the Three Gorges Project? Conventional approaches to sustainability assessment tend to use monetary based assessment aligned to triple bottom line thinking. That is, projects are evaluated as trade-offs between economic, environmental and social costs and benefits. The question of sustainability is considered using such a traditional Cost-Benefit Analysis approach, as undertaken in 1988 by a CIPM-Yangtze Joint Venture, and the Mauri Model Decision Making Framework (MMDMF). The Mauri Model differs from other approaches in that sustainability performance indicators are considered independently from any particular stakeholder bias. Bias is then introduced subsequently as a sensitivity analysis on the raw results obtained. The MMDMF is unique in that it is based on the Māori concept of Mauri, the binding force between the physical and the spiritual attributes of something, or the capacity to support life in the air, soil, and water. This concept of Mauri is analogous to the Chinese concept of Qi, and there are many analogous concepts in other cultures. It is the universal relevance of Mauri that allows its use to assess sustainability. This research identified that the MMDMF was a strong complement to Cost-Benefit Analysis, which is not designed as a sustainability assessment tool in itself. The MMDMF does have relevance in identifying areas of conflict, and it can support the Cost-Benefit Analysis in assessing sustainability, as a Decision Support Tool. The research concluded that, based on both models, the Three Gorges Project as understood in 1988, and incorporating more recent sustainability analysis is contributing to enhanced sustainability.

  1. Component Provider’s and Tool Developer’s Handbook. Central Archive for Reusable Defense Software (CARDS)

    DTIC Science & Technology

    1994-03-25

    metrics [DISA93b]. " The Software Engineering Institute (SET) has developed a domain analysis process (Feature-Oriented Domain Analysis - FODA ) and is...and expresses the range of variability of these decisions. 3.2.2.3 Feature Oriented Domain Analysis Feature Oriented Domain Analysis ( FODA ) is a domain...documents created in this phase. From a purely profit-oriented business point of view, a company may develop its own analysis of a government or commercial

  2. Challenging the Academically Adrift: A New Decision-Making Tool to Help Improve Student Commitment to Academic Preparation

    ERIC Educational Resources Information Center

    Davis, Carolyn D.

    2013-01-01

    This paper describes research in progress concerning the development and use of a newly created tool, the Decision-Making Grid, which was designed to teach undergraduate management students to develop and use metacognitive regulation skills to improve decision-making by requiring students to construct improved decision-making models in a boundedly…

  3. Accounting for reasonableness: Exploring the personal internal framework affecting decisions about cancer drug funding.

    PubMed

    Sinclair, Shane; Hagen, Neil A; Chambers, Carole; Manns, Braden; Simon, Anita; Browman, George P

    2008-05-01

    Drug decision-makers are involved in developing and implementing policy, procedure and processes to support health resource allocation regarding drug treatment formularies. A variety of approaches to decision-making, including formal decision-making frameworks, have been developed to support transparent and fair priority setting. Recently, a decision tool, 'The 6-STEPPPs Tool', was developed to assist in making decisions about new cancer drugs within the public health care system. We conducted a qualitative study, utilizing focus groups and participant observation, in order to investigate the internal frameworks that supported and challenged individual participants as they applied this decision tool within a multi-stakeholder decision process. We discovered that health care resource allocation engaged not only the minds of decision-makers but profoundly called on the often conflicting values of the heart. Objective decision-making frameworks for new drug therapies need to consider the subjective internal frameworks of decision-makers that affect decisions. Understanding the very human, internal turmoil experienced by individuals involved in health care resource allocation, sheds additional insight into how to account for reasonableness and how to better support difficult decisions through transparent, values-based resource allocation policy, procedures and processes.

  4. Cost-effectiveness Analysis with Influence Diagrams.

    PubMed

    Arias, M; Díez, F J

    2015-01-01

    Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. To develop a method for CEA in problems involving several dozen variables. We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. IDs can perform CEA on large problems that cannot be analyzed with decision trees.

  5. Towards a Decision Support Tool for 3d Visualisation: Application to Selectivity Purpose of Single Object in a 3d City Scene

    NASA Astrophysics Data System (ADS)

    Neuville, R.; Pouliot, J.; Poux, F.; Hallot, P.; De Rudder, L.; Billen, R.

    2017-10-01

    This paper deals with the establishment of a comprehensive methodological framework that defines 3D visualisation rules and its application in a decision support tool. Whilst the use of 3D models grows in many application fields, their visualisation remains challenging from the point of view of mapping and rendering aspects to be applied to suitability support the decision making process. Indeed, there exists a great number of 3D visualisation techniques but as far as we know, a decision support tool that facilitates the production of an efficient 3D visualisation is still missing. This is why a comprehensive methodological framework is proposed in order to build decision tables for specific data, tasks and contexts. Based on the second-order logic formalism, we define a set of functions and propositions among and between two collections of entities: on one hand static retinal variables (hue, size, shape…) and 3D environment parameters (directional lighting, shadow, haze…) and on the other hand their effect(s) regarding specific visual tasks. It enables to define 3D visualisation rules according to four categories: consequence, compatibility, potential incompatibility and incompatibility. In this paper, the application of the methodological framework is demonstrated for an urban visualisation at high density considering a specific set of entities. On the basis of our analysis and the results of many studies conducted in the 3D semiotics, which refers to the study of symbols and how they relay information, the truth values of propositions are determined. 3D visualisation rules are then extracted for the considered context and set of entities and are presented into a decision table with a colour coding. Finally, the decision table is implemented into a plugin developed with three.js, a cross-browser JavaScript library. The plugin consists of a sidebar and warning windows that help the designer in the use of a set of static retinal variables and 3D environment parameters.

  6. SU-E-J-04: A Data-Driven, Response-Based, Multi-Criteria Decision Support System for Personalized Lung Radiation Treatment Planning

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Luo, Y; McShan, D; Schipper, M

    2014-06-01

    Purpose: To develop a decision support tool to predict a patient's potential overall survival (OS) and radiation induced toxicity (RIT) based on clinical factors and responses during the course of radiotherapy, and suggest appropriate radiation dose adjustments to improve therapeutic effect. Methods: Important relationships between a patient's basic information and their clinical features before and during the radiation treatment are identified from historical clinical data by using statistical learning and data mining approaches. During each treatment period, a data analysis (DA) module predicts radiotherapy features such as time to local progression (TTLP), time to distant metastases (TTDM), radiation toxicity tomore » different organs, etc., under possible future treatment plans based on patient specifics or responses. An information fusion (IF) module estimates intervals for a patient's OS and the probabilities of RIT from a treatment plan by integrating the outcomes of module DA. A decision making (DM) module calculates “satisfaction” with the predicted radiation outcome based on trade-offs between OS and RIT, and finds the best treatment plan for the next time period via multi-criteria optimization. Results: Using physical and biological data from 130 lung cancer patients as our test bed, we were able to train and implement the 3 modules of our decision support tool. Examples demonstrate how it can help predict a new patient's potential OS and RIT with different radiation dose plans along with how these combinations change with dose, thus presenting a range of satisfaction/utility for use in individualized decision support. Conclusion: Although the decision support tool is currently developed from a small patient sample size, it shows the potential for the improvement of each patient's satisfaction in personalized radiation therapy. The radiation treatment outcome prediction and decision making model needs to be evaluated with more patients and demonstrated for use in radiation treatments for other cancers. P01-CA59827;R01CA142840.« less

  7. Use of handheld computers in clinical practice: a systematic review.

    PubMed

    Mickan, Sharon; Atherton, Helen; Roberts, Nia Wyn; Heneghan, Carl; Tilson, Julie K

    2014-07-06

    Many healthcare professionals use smartphones and tablets to inform patient care. Contemporary research suggests that handheld computers may support aspects of clinical diagnosis and management. This systematic review was designed to synthesise high quality evidence to answer the question; Does healthcare professionals' use of handheld computers improve their access to information and support clinical decision making at the point of care? A detailed search was conducted using Cochrane, MEDLINE, EMBASE, PsycINFO, Science and Social Science Citation Indices since 2001. Interventions promoting healthcare professionals seeking information or making clinical decisions using handheld computers were included. Classroom learning and the use of laptop computers were excluded. Two authors independently selected studies, assessed quality using the Cochrane Risk of Bias tool and extracted data. High levels of data heterogeneity negated statistical synthesis. Instead, evidence for effectiveness was summarised narratively, according to each study's aim for assessing the impact of handheld computer use. We included seven randomised trials investigating medical or nursing staffs' use of Personal Digital Assistants. Effectiveness was demonstrated across three distinct functions that emerged from the data: accessing information for clinical knowledge, adherence to guidelines and diagnostic decision making. When healthcare professionals used handheld computers to access clinical information, their knowledge improved significantly more than peers who used paper resources. When clinical guideline recommendations were presented on handheld computers, clinicians made significantly safer prescribing decisions and adhered more closely to recommendations than peers using paper resources. Finally, healthcare professionals made significantly more appropriate diagnostic decisions using clinical decision making tools on handheld computers compared to colleagues who did not have access to these tools. For these clinical decisions, the numbers need to test/screen were all less than 11. Healthcare professionals' use of handheld computers may improve their information seeking, adherence to guidelines and clinical decision making. Handheld computers can provide real time access to and analysis of clinical information. The integration of clinical decision support systems within handheld computers offers clinicians the highest level of synthesised evidence at the point of care. Future research is needed to replicate these early results and to identify beneficial clinical outcomes.

  8. Use of handheld computers in clinical practice: a systematic review

    PubMed Central

    2014-01-01

    Background Many healthcare professionals use smartphones and tablets to inform patient care. Contemporary research suggests that handheld computers may support aspects of clinical diagnosis and management. This systematic review was designed to synthesise high quality evidence to answer the question; Does healthcare professionals’ use of handheld computers improve their access to information and support clinical decision making at the point of care? Methods A detailed search was conducted using Cochrane, MEDLINE, EMBASE, PsycINFO, Science and Social Science Citation Indices since 2001. Interventions promoting healthcare professionals seeking information or making clinical decisions using handheld computers were included. Classroom learning and the use of laptop computers were excluded. Two authors independently selected studies, assessed quality using the Cochrane Risk of Bias tool and extracted data. High levels of data heterogeneity negated statistical synthesis. Instead, evidence for effectiveness was summarised narratively, according to each study’s aim for assessing the impact of handheld computer use. Results We included seven randomised trials investigating medical or nursing staffs’ use of Personal Digital Assistants. Effectiveness was demonstrated across three distinct functions that emerged from the data: accessing information for clinical knowledge, adherence to guidelines and diagnostic decision making. When healthcare professionals used handheld computers to access clinical information, their knowledge improved significantly more than peers who used paper resources. When clinical guideline recommendations were presented on handheld computers, clinicians made significantly safer prescribing decisions and adhered more closely to recommendations than peers using paper resources. Finally, healthcare professionals made significantly more appropriate diagnostic decisions using clinical decision making tools on handheld computers compared to colleagues who did not have access to these tools. For these clinical decisions, the numbers need to test/screen were all less than 11. Conclusion Healthcare professionals’ use of handheld computers may improve their information seeking, adherence to guidelines and clinical decision making. Handheld computers can provide real time access to and analysis of clinical information. The integration of clinical decision support systems within handheld computers offers clinicians the highest level of synthesised evidence at the point of care. Future research is needed to replicate these early results and to identify beneficial clinical outcomes. PMID:24998515

  9. Application of Risk Assessment Tools in the Continuous Risk Management (CRM) Process

    NASA Technical Reports Server (NTRS)

    Ray, Paul S.

    2002-01-01

    Marshall Space Flight Center (MSFC) of the National Aeronautics and Space Administration (NASA) is currently implementing the Continuous Risk Management (CRM) Program developed by the Carnegie Mellon University and recommended by NASA as the Risk Management (RM) implementation approach. The four most frequently used risk assessment tools in the center are: (a) Failure Modes and Effects Analysis (FMEA), Hazard Analysis (HA), Fault Tree Analysis (FTA), and Probabilistic Risk Analysis (PRA). There are some guidelines for selecting the type of risk assessment tools during the project formulation phase of a project, but there is not enough guidance as to how to apply these tools in the Continuous Risk Management process (CRM). But the ways the safety and risk assessment tools are used make a significant difference in the effectiveness in the risk management function. Decisions regarding, what events are to be included in the analysis, to what level of details should the analysis be continued, make significant difference in the effectiveness of risk management program. Tools of risk analysis also depends on the phase of a project e.g. at the initial phase of a project, when not much data are available on hardware, standard FMEA cannot be applied; instead a functional FMEA may be appropriate. This study attempted to provide some directives to alleviate the difficulty in applying FTA, PRA, and FMEA in the CRM process. Hazard Analysis was not included in the scope of the study due to the short duration of the summer research project.

  10. Mining Marketing Data

    NASA Technical Reports Server (NTRS)

    2002-01-01

    MarketMiner(R) Products, a line of automated marketing analysis tools manufactured by MarketMiner, Inc., can benefit organizations that perform significant amounts of direct marketing. MarketMiner received a Small Business Innovation Research (SBIR) contract from NASA's Johnson Space Center to develop the software as a data modeling tool for space mission applications. The technology was then built into the company current products to provide decision support for business and marketing applications. With the tool, users gain valuable information about customers and prospects from existing data in order to increase sales and profitability. MarketMiner(R) is a registered trademark of MarketMiner, Inc.

  11. SMARTE: IMPROVING REVITALIZATION DECISIONS (BERLIN, GERMANY)

    EPA Science Inventory

    The U.S.-German Bilateral Working Group is developing Site-specific Management Approaches and Redevelopment Tools (SMART). In the U.S., the SMART compilation is housed in a web-based, decision support tool called SMARTe. All tools within SMARTe that are developed specifically for...

  12. Watershed Management Optimization Support Tool (WMOST) v3: User Guide

    EPA Science Inventory

    The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that facilitates integrated water management at the local or small watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed context that is, accou...

  13. Watershed Management Optimization Support Tool (WMOST) v3: Theoretical Documentation

    EPA Science Inventory

    The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that facilitates integrated water management at the local or small watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed context, accounting fo...

  14. Watershed Management Optimization Support Tool (WMOST) v2: Theoretical Documentation

    EPA Science Inventory

    The Watershed Management Optimization Support Tool (WMOST) is a decision support tool that evaluates the relative cost-effectiveness of management practices at the local or watershed scale. WMOST models the environmental effects and costs of management decisions in a watershed c...

  15. A decision support tool for landfill methane generation and gas collection.

    PubMed

    Emkes, Harriet; Coulon, Frédéric; Wagland, Stuart

    2015-09-01

    This study presents a decision support tool (DST) to enhance methane generation at individual landfill sites. To date there is no such tool available to provide landfill decision makers with clear and simplified information to evaluate biochemical processes within a landfill site, to assess performance of gas production and to identify potential remedies to any issues. The current lack in understanding stems from the complexity of the landfill waste degradation process. Two scoring sets for landfill gas production performance are calculated with the tool: (1) methane output score which measures the deviation of the actual methane output rate at each site which the prediction generated by the first order decay model LandGEM; and (2) landfill gas indicators' score, which measures the deviation of the landfill gas indicators from their ideal ranges for optimal methane generation conditions. Landfill gas indicators include moisture content, temperature, alkalinity, pH, BOD, COD, BOD/COD ratio, ammonia, chloride, iron and zinc. A total landfill gas indicator score is provided using multi-criteria analysis to calculate the sum of weighted scores for each indicator. The weights for each indicator are calculated using an analytical hierarchical process. The tool is tested against five real scenarios for landfill sites in UK with a range of good, average and poor landfill methane generation over a one year period (2012). An interpretation of the results is given for each scenario and recommendations are highlighted for methane output rate enhancement. Results demonstrate how the tool can help landfill managers and operators to enhance their understanding of methane generation at a site-specific level, track landfill methane generation over time, compare and rank sites, and identify problems areas within a landfill site. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. A Method for Comparative Analysis of Recovery Potential in Impaired Waters Restoration Planning

    EPA Science Inventory

    Common decision support tools and a growing body of knowledge about ecological recovery can help inform and guide large state and federal restoration programs affecting thousands of impaired waters. Under the federal Clean Water Act (CWA), waters not meeting state Water Quality ...

  17. Issues in NASA Program and Project Management:: A Collection of Papers on Aerospace Management Issues (Supplement 11)

    NASA Technical Reports Server (NTRS)

    Hoffman, Edward J. (Editor); Lawbaugh, William M. (Editor)

    1996-01-01

    Papers address the following topics: NASA's project management development process; Better decisions through structural analysis; NASA's commercial technology management system; Today's management techniques and tools; Program control in NASA - needs and opportunities; and Resources for NASA managers.

  18. Use of chemoinformatics tools- nuts and bolts; Challenges in their regulatory application

    EPA Science Inventory

    Cheminformatics spans a continuum of components from data storage to uncovering new insights that are useful for different decision making contexts. It covers the input, retrieval of data, the manipulation and integration of data through to the visualisation and analysis to trans...

  19. Community Near-Port Modeling System (C-PORT): Briefing for Environmental Defense Fund

    EPA Science Inventory

    What C-PORT is: Screening level tool for assessing port activities and exploring the range of potential impacts that changes to port operations might have on local air quality; Analysis of decision alternatives through mapping of the likely pattern of potential pollutant dispersi...

  20. Intimate partner violence, pregnancy and the decision for abortion.

    PubMed

    Williams, Gail B; Brackley, Margaret H

    2009-04-01

    Pregnant women whose lives are affected by intimate partner violence and unintended pregnancy are often faced with the decision for abortion. In this qualitative research, the authors explored women's experiences of unintended pregnancy and intimate partner violence (IPV) from the perspective of adult pregnant women seeking abortion. Women were assessed for intimate partner violence and study inclusion by means of two IPV screening tools. The authors collected data during one-to two-hour semi-structured interviews with eight pregnant women. At the completion of the interviews, all women were assessed for safety using an assessment of danger tool. Safety planning and referrals were provided for all women. Qualitative data collection and data analysis were guided by naturalistic inquiry to identify prevalent themes. Three major themes emerged from the data: (1) It Wasn't That Bad, (2) Then It Got Worse, and (3) If I Have the Baby He'll Come Back. Descriptive statistics were used to tabulate and describe the women's responses to the three tools.

  1. 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...

  2. A simple way to unify multicriteria decision analysis (MCDA) and stochastic multicriteria acceptability analysis (SMAA) using a Dirichlet distribution in benefit-risk assessment.

    PubMed

    Saint-Hilary, Gaelle; Cadour, Stephanie; Robert, Veronique; Gasparini, Mauro

    2017-05-01

    Quantitative methodologies have been proposed to support decision making in drug development and monitoring. In particular, multicriteria decision analysis (MCDA) and stochastic multicriteria acceptability analysis (SMAA) are useful tools to assess the benefit-risk ratio of medicines according to the performances of the treatments on several criteria, accounting for the preferences of the decision makers regarding the relative importance of these criteria. However, even in its probabilistic form, MCDA requires the exact elicitations of the weights of the criteria by the decision makers, which may be difficult to achieve in practice. SMAA allows for more flexibility and can be used with unknown or partially known preferences, but it is less popular due to its increased complexity and the high degree of uncertainty in its results. In this paper, we propose a simple model as a generalization of MCDA and SMAA, by applying a Dirichlet distribution to the weights of the criteria and by making its parameters vary. This unique model permits to fit both MCDA and SMAA, and allows for a more extended exploration of the benefit-risk assessment of treatments. The precision of its results depends on the precision parameter of the Dirichlet distribution, which could be naturally interpreted as the strength of confidence of the decision makers in their elicitation of preferences. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. An agent architecture for an integrated forest ecosystem management decision support system

    Treesearch

    Donald Nute; Walter D. Potter; Mayukh Dass; Astrid Glende; Frederick Maier; Hajime Uchiyama; Jin Wang; Mark Twery; Peter Knopp; Scott Thomasma; H. Michael Rauscher

    2003-01-01

    A wide variety of software tools are available to support decision in the management of forest ecosystems. These tools include databases, growth and yield models, wildlife models, silvicultural expert systems, financial models, geographical informations systems, and visualization tools. Typically, each of these tools has its own complex interface and data format. To...

  4. Decision support for risk prioritisation of environmental health hazards in a UK city.

    PubMed

    Woods, Mae; Crabbe, Helen; Close, Rebecca; Studden, Mike; Milojevic, Ai; Leonardi, Giovanni; Fletcher, Tony; Chalabi, Zaid

    2016-03-08

    There is increasing appreciation of the proportion of the health burden that is attributed to modifiable population exposure to environmental health hazards. To manage this avoidable burden in the United Kingdom (UK), government policies and interventions are implemented. In practice, this procedure is interdisciplinary in action and multi-dimensional in context. Here, we demonstrate how Multi Criteria Decision Analysis (MCDA) can be used as a decision support tool to facilitate priority setting for environmental public health interventions within local authorities. We combine modelling and expert elicitation to gather evidence on the impacts and ranking of interventions. To present the methodology, we consider a hypothetical scenario in a UK city. We use MCDA to evaluate and compare the impact of interventions to reduce the health burden associated with four environmental health hazards and rank them in terms of their overall performance across several criteria. For illustrative purposes, we focus on heavy goods vehicle controls to reduce outdoor air pollution, remediation to control levels of indoor radon, carbon monoxide and fitting alarms, and encouraging cycling to target the obesogenic environment. Regional data was included as model evidence to construct a ratings matrix for the city. When MCDA is performed with uniform weights, the intervention of heavy goods vehicle controls to reduce outdoor air pollution is ranked the highest. Cycling and the obesogenic environment is ranked second. We argue that a MCDA based approach provides a framework to guide environmental public health decision makers. This is demonstrated through an online interactive MCDA tool. We conclude that MCDA is a transparent tool that can be used to compare the impact of alternative interventions on a set of pre-defined criteria. In our illustrative example, we ranked the best intervention across the equally weighted selected criteria out of the four alternatives. Further work is needed to test the tool with decision makers and stakeholders.

  5. The changing nature of ICU charge nurses' decision making: from supervision of care delivery to unit resource management.

    PubMed

    Miller, Anne; Buerhaus, Peter I

    2013-01-01

    Recent findings that variations in nursing workload may affect inpatient outcomes now highlight nurse workload management and the need for an updated analysis of the role of the charge nurse (CN). Observational data for eight CNs, each at one of eight ICUs in a not-for-profit Level 1 Trauma Center, coded to capture interprofessional interactions, decision making, team coordination phases, and support tools. A researcher shadowed each participant for 12 hours. Each shift began and ended with a face-to-face handoff that included summaries of each patient's condition; the current bed census; anticipated admissions, discharges, and transfers; and the number of nurses available to work the current and coming two shifts. The researcher, using a notebook, recorded the substantive content of all work conversations initiated by or directed to the CN from physicians, staff nurses, allied health workers, other employees, and patients/families. The tools used to support conversations were collected as blank forms or computer screen prints and annotated to describe how they were used, when, and for what purpose. Statistically significant three-way interactions suggest that CNs' conversations with colleagues depend on the team coordination phase and the decision-making level, and that the support tools that CNs use when talking to colleagues depend on the decision-making level and the team coordination phase. The role of ICU CNs appears to be continuing to evolve, now encompassing unit resource management in addition to supervising care delivery. Effective support tools, together with education that would enhance communication and resource management skills, will be essential to CNs' ability to support unit resilience and adaptability in an increasingly complex environment.

  6. Clinical Decision Support Tools for Osteoporosis Disease Management: A Systematic Review of Randomized Controlled Trials

    PubMed Central

    Straus, Sharon E.

    2008-01-01

    BACKGROUND Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. OBJECTIVE To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. DATA SOURCES Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. REVIEW METHODS Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. RESULTS Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). CONCLUSION Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0812-9) contains supplementary material, which is available to authorized users. PMID:18836782

  7. Exploring model based engineering for large telescopes: getting started with descriptive models

    NASA Astrophysics Data System (ADS)

    Karban, R.; Zamparelli, M.; Bauvir, B.; Koehler, B.; Noethe, L.; Balestra, A.

    2008-07-01

    Large telescopes pose a continuous challenge to systems engineering due to their complexity in terms of requirements, operational modes, long duty lifetime, interfaces and number of components. A multitude of decisions must be taken throughout the life cycle of a new system, and a prime means of coping with complexity and uncertainty is using models as one decision aid. The potential of descriptive models based on the OMG Systems Modeling Language (OMG SysMLTM) is examined in different areas: building a comprehensive model serves as the basis for subsequent activities of soliciting and review for requirements, analysis and design alike. Furthermore a model is an effective communication instrument against misinterpretation pitfalls which are typical of cross disciplinary activities when using natural language only or free-format diagrams. Modeling the essential characteristics of the system, like interfaces, system structure and its behavior, are important system level issues which are addressed. Also shown is how to use a model as an analysis tool to describe the relationships among disturbances, opto-mechanical effects and control decisions and to refine the control use cases. Considerations on the scalability of the model structure and organization, its impact on the development process, the relation to document-centric structures, style and usage guidelines and the required tool chain are presented.

  8. A conceptual framework for economic optimization of single hazard surveillance in livestock production chains.

    PubMed

    Guo, Xuezhen; Claassen, G D H; Oude Lansink, A G J M; Saatkamp, H W

    2014-06-01

    Economic analysis of hazard surveillance in livestock production chains is essential for surveillance organizations (such as food safety authorities) when making scientifically based decisions on optimization of resource allocation. To enable this, quantitative decision support tools are required at two levels of analysis: (1) single-hazard surveillance system and (2) surveillance portfolio. This paper addresses the first level by presenting a conceptual approach for the economic analysis of single-hazard surveillance systems. The concept includes objective and subjective aspects of single-hazard surveillance system analysis: (1) a simulation part to derive an efficient set of surveillance setups based on the technical surveillance performance parameters (TSPPs) and the corresponding surveillance costs, i.e., objective analysis, and (2) a multi-criteria decision making model to evaluate the impacts of the hazard surveillance, i.e., subjective analysis. The conceptual approach was checked for (1) conceptual validity and (2) data validity. Issues regarding the practical use of the approach, particularly the data requirement, were discussed. We concluded that the conceptual approach is scientifically credible for economic analysis of single-hazard surveillance systems and that the practicability of the approach depends on data availability. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    PubMed

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

    2015-06-01

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

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

    PubMed

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

    2013-04-01

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

  11. 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...

  12. Prognostic and Prediction Tools in Bladder Cancer: A Comprehensive Review of the Literature.

    PubMed

    Kluth, Luis A; Black, Peter C; Bochner, Bernard H; Catto, James; Lerner, Seth P; Stenzl, Arnulf; Sylvester, Richard; Vickers, Andrew J; Xylinas, Evanguelos; Shariat, Shahrokh F

    2015-08-01

    This review focuses on risk assessment and prediction tools for bladder cancer (BCa). To review the current knowledge on risk assessment and prediction tools to enhance clinical decision making and counseling of patients with BCa. A literature search in English was performed using PubMed in July 2013. Relevant risk assessment and prediction tools for BCa were selected. More than 1600 publications were retrieved. Special attention was given to studies that investigated the clinical benefit of a prediction tool. Most prediction tools for BCa focus on the prediction of disease recurrence and progression in non-muscle-invasive bladder cancer or disease recurrence and survival after radical cystectomy. Although these tools are helpful, recent prediction tools aim to address a specific clinical problem, such as the prediction of organ-confined disease and lymph node metastasis to help identify patients who might benefit from neoadjuvant chemotherapy. Although a large number of prediction tools have been reported in recent years, many of them lack external validation. Few studies have investigated the clinical utility of any given model as measured by its ability to improve clinical decision making. There is a need for novel biomarkers to improve the accuracy and utility of prediction tools for BCa. Decision tools hold the promise of facilitating the shared decision process, potentially improving clinical outcomes for BCa patients. Prediction models need external validation and assessment of clinical utility before they can be incorporated into routine clinical care. We looked at models that aim to predict outcomes for patients with bladder cancer (BCa). We found a large number of prediction models that hold the promise of facilitating treatment decisions for patients with BCa. However, many models are missing confirmation in a different patient cohort, and only a few studies have tested the clinical utility of any given model as measured by its ability to improve clinical decision making. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  13. Developing Cost Accounting and Decision Support Software for Comprehensive Community-Based Support Systems: An Analysis of Needs, Interest, and Readiness in the Field.

    ERIC Educational Resources Information Center

    Harrington, Robert; Jenkins, Peter; Marzke, Carolyn; Cohen, Carol

    Prominent among the new models of social service delivery are organizations providing comprehensive, community-based supports and services (CCBSS) to children and their families. A needs analysis explored CCBSS sites' interest in and readiness to use a software tool designed to help them make more effective internal resource allocation decisions…

  14. The Mayaguez Incident: An Organizational Theory Analysis

    DTIC Science & Technology

    2006-09-01

    actors, and its effectiveness is obtained. Applying organizational theory to the Mayaguez incident demonstrates that decision processes at the executive...theories to take to battle, an organizational theory tool to use on the lessons learned may prove effective . Though it is not feasible in the heat of...AND SUBTITLE: The Mayaguez Incident: An Organizational Theory Analysis 6. AUTHORS Edward J. Lengel, Shelley A. Rodriguez, Michael D. Tyynismaa and

  15. Decision or no decision: how do patient-physician interactions end and what matters?

    PubMed

    Tai-Seale, Ming; Bramson, Rachel; Bao, Xiaoming

    2007-03-01

    A clearly stated clinical decision can induce a cognitive closure in patients and is an important investment in the end of patient-physician communications. Little is known about how often explicit decisions are made in primary care visits. To use an innovative videotape analysis approach to assess physicians' propensity to state decisions explicitly, and to examine the factors influencing decision patterns. We coded topics discussed in 395 videotapes of primary care visits, noting the number of instances and the length of discussions on each topic, and how discussions ended. A regression analysis tested the relationship between explicit decisions and visit factors such as the nature of topics under discussion, instances of discussion, the amount of time the patient spoke, and competing demands from other topics. About 77% of topics ended with explicit decisions. Patients spoke for an average of 58 seconds total per topic. Patients spoke more during topics that ended with an explicit decision, (67 seconds), compared with 36 seconds otherwise. The number of instances of a topic was associated with higher odds of having an explicit decision (OR = 1.73, p < 0.01). Increases in the number of topics discussed in visits (OR = 0.95, p < .05), and topics on lifestyle and habits (OR = 0.60, p < .01) were associated with lower odds of explicit decisions. Although discussions often ended with explicit decisions, there were variations related to the content and dynamics of interactions. We recommend strengthening patients' voice and developing clinical tools, e.g., an "exit prescription," to improving decision making.

  16. Forecasting municipal solid waste generation using prognostic tools and regression analysis.

    PubMed

    Ghinea, Cristina; Drăgoi, Elena Niculina; Comăniţă, Elena-Diana; Gavrilescu, Marius; Câmpean, Teofil; Curteanu, Silvia; Gavrilescu, Maria

    2016-11-01

    For an adequate planning of waste management systems the accurate forecast of waste generation is an essential step, since various factors can affect waste trends. The application of predictive and prognosis models are useful tools, as reliable support for decision making processes. In this paper some indicators such as: number of residents, population age, urban life expectancy, total municipal solid waste were used as input variables in prognostic models in order to predict the amount of solid waste fractions. We applied Waste Prognostic Tool, regression analysis and time series analysis to forecast municipal solid waste generation and composition by considering the Iasi Romania case study. Regression equations were determined for six solid waste fractions (paper, plastic, metal, glass, biodegradable and other waste). Accuracy Measures were calculated and the results showed that S-curve trend model is the most suitable for municipal solid waste (MSW) prediction. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. OPTIMIZING USABILITY OF AN ECONOMIC DECISION SUPPORT TOOL: PROTOTYPE OF THE EQUIPT TOOL.

    PubMed

    Cheung, Kei Long; Hiligsmann, Mickaël; Präger, Maximilian; Jones, Teresa; Józwiak-Hagymásy, Judit; Muñoz, Celia; Lester-George, Adam; Pokhrel, Subhash; López-Nicolás, Ángel; Trapero-Bertran, Marta; Evers, Silvia M A A; de Vries, Hein

    2018-01-01

    Economic decision-support tools can provide valuable information for tobacco control stakeholders, but their usability may impact the adoption of such tools. This study aims to illustrate a mixed-method usability evaluation of an economic decision-support tool for tobacco control, using the EQUIPT ROI tool prototype as a case study. A cross-sectional mixed methods design was used, including a heuristic evaluation, a thinking aloud approach, and a questionnaire testing and exploring the usability of the Return of Investment tool. A total of sixty-six users evaluated the tool (thinking aloud) and completed the questionnaire. For the heuristic evaluation, four experts evaluated the interface. In total twenty-one percent of the respondents perceived good usability. A total of 118 usability problems were identified, from which twenty-six problems were categorized as most severe, indicating high priority to fix them before implementation. Combining user-based and expert-based evaluation methods is recommended as these were shown to identify unique usability problems. The evaluation provides input to optimize usability of a decision-support tool, and may serve as a vantage point for other developers to conduct usability evaluations to refine similar tools before wide-scale implementation. Such studies could reduce implementation gaps by optimizing usability, enhancing in turn the research impact of such interventions.

  18. Quantitative Decision Making.

    ERIC Educational Resources Information Center

    Baldwin, Grover H.

    The use of quantitative decision making tools provides the decision maker with a range of alternatives among which to decide, permits acceptance and use of the optimal solution, and decreases risk. Training line administrators in the use of these tools can help school business officials obtain reliable information upon which to base district…

  19. Distance-Based and Distributed Learning: A Decision Tool for Education Leaders.

    ERIC Educational Resources Information Center

    McGraw, Tammy M.; Ross, John D.

    This decision tool presents a progression of data collection and decision-making strategies that can increase the effectiveness of distance-based or distributed learning instruction. A narrative and flow chart cover the following steps: (1) basic assumptions, including purpose of instruction, market scan, and financial resources; (2) needs…

  20. Economic Benefits of Predictive Models for Pest Control in Agricultural Crops

    USDA-ARS?s Scientific Manuscript database

    Various forms of crop models or decision making tools for managing crops have existed for many years. The potential advantage of all of these decision making tools is that more informed and economically improved crop management or decision making is accomplished. However, examination of some of thes...

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