Analysis of decision fusion algorithms in handling uncertainties for integrated health monitoring systems

NASA Astrophysics Data System (ADS)

Zein-Sabatto, Saleh; Mikhail, Maged; Bodruzzaman, Mohammad; DeSimio, Martin; Derriso, Mark; Behbahani, Alireza

2012-06-01

It has been widely accepted that data fusion and information fusion methods can improve the accuracy and robustness of decision-making in structural health monitoring systems. It is arguably true nonetheless, that decision-level is equally beneficial when applied to integrated health monitoring systems. Several decisions at low-levels of abstraction may be produced by different decision-makers; however, decision-level fusion is required at the final stage of the process to provide accurate assessment about the health of the monitored system as a whole. An example of such integrated systems with complex decision-making scenarios is the integrated health monitoring of aircraft. Thorough understanding of the characteristics of the decision-fusion methodologies is a crucial step for successful implementation of such decision-fusion systems. In this paper, we have presented the major information fusion methodologies reported in the literature, i.e., probabilistic, evidential, and artificial intelligent based methods. The theoretical basis and characteristics of these methodologies are explained and their performances are analyzed. Second, candidate methods from the above fusion methodologies, i.e., Bayesian, Dempster-Shafer, and fuzzy logic algorithms are selected and their applications are extended to decisions fusion. Finally, fusion algorithms are developed based on the selected fusion methods and their performance are tested on decisions generated from synthetic data and from experimental data. Also in this paper, a modeling methodology, i.e. cloud model, for generating synthetic decisions is presented and used. Using the cloud model, both types of uncertainties; randomness and fuzziness, involved in real decision-making are modeled. Synthetic decisions are generated with an unbiased process and varying interaction complexities among decisions to provide for fair performance comparison of the selected decision-fusion algorithms. For verification purposes, implementation results of the developed fusion algorithms on structural health monitoring data collected from experimental tests are reported in this paper.

Navigating the grounded theory terrain. Part 1.

PubMed

Hunter, Andrew; Murphy, Kathy; Grealish, Annmarie; Casey, Dympna; Keady, John

2011-01-01

The decision to use grounded theory is not an easy one and this article aims to illustrate and explore the methodological complexity and decision-making process. It explores the decision making of one researcher in the first two years of a grounded theory PhD study looking at the psychosocial training needs of nurses and healthcare assistants working with people with dementia in residential care. It aims to map out three different approaches to grounded theory: classic, Straussian and constructivist. In nursing research, grounded theory is often referred to but it is not always well understood. This confusion is due in part to the history of grounded theory methodology, which is one of development and divergent approaches. Common elements across grounded theory approaches are briefly outlined, along with the key differences of the divergent approaches. Methodological literature pertaining to the three chosen grounded theory approaches is considered and presented to illustrate the options and support the choice made. The process of deciding on classical grounded theory as the version best suited to this research is presented. The methodological and personal factors that directed the decision are outlined. The relative strengths of Straussian and constructivist grounded theories are reviewed. All three grounded theory approaches considered offer the researcher a structured, rigorous methodology, but researchers need to understand their choices and make those choices based on a range of methodological and personal factors. In the second article, the final methodological decision will be outlined and its research application described.

Got risk? risk-centric perspective for spacecraft technology decision-making

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Cornford, Steven L.; Moran, Kelly

2004-01-01

A risk-based decision-making methodology conceived and developed at JPL and NASA has been used to aid in decision making for spacecraft technology assessment, adoption, development and operation. It takes a risk-centric perspective, through which risks are used as a reasoning step to interpose between mission objectives and risk mitigation measures.

INTEGRATING DATA ANALYTICS AND SIMULATION METHODS TO SUPPORT MANUFACTURING DECISION MAKING

PubMed Central

Kibira, Deogratias; Hatim, Qais; Kumara, Soundar; Shao, Guodong

2017-01-01

Modern manufacturing systems are installed with smart devices such as sensors that monitor system performance and collect data to manage uncertainties in their operations. However, multiple parameters and variables affect system performance, making it impossible for a human to make informed decisions without systematic methodologies and tools. Further, the large volume and variety of streaming data collected is beyond simulation analysis alone. Simulation models are run with well-prepared data. Novel approaches, combining different methods, are needed to use this data for making guided decisions. This paper proposes a methodology whereby parameters that most affect system performance are extracted from the data using data analytics methods. These parameters are used to develop scenarios for simulation inputs; system optimizations are performed on simulation data outputs. A case study of a machine shop demonstrates the proposed methodology. This paper also reviews candidate standards for data collection, simulation, and systems interfaces. PMID:28690363

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.

DRUG EVALUATION AND DECISION MAKING IN CATALONIA: DEVELOPMENT AND VALIDATION OF A METHODOLOGICAL FRAMEWORK BASED ON MULTI-CRITERIA DECISION ANALYSIS (MCDA) FOR ORPHAN DRUGS.

PubMed

Gilabert-Perramon, Antoni; Torrent-Farnell, Josep; Catalan, Arancha; Prat, Alba; Fontanet, Manel; Puig-Peiró, Ruth; Merino-Montero, Sandra; Khoury, Hanane; Goetghebeur, Mireille M; Badia, Xavier

2017-01-01

The aim of this study was to adapt and assess the value of a Multi-Criteria Decision Analysis (MCDA) framework (EVIDEM) for the evaluation of Orphan drugs in Catalonia (Catalan Health Service). The standard evaluation and decision-making procedures of CatSalut were compared with the EVIDEM methodology and contents. The EVIDEM framework was adapted to the Catalan context, focusing on the evaluation of Orphan drugs (PASFTAC program), during a Workshop with sixteen PASFTAC members. The criteria weighting was done using two different techniques (nonhierarchical and hierarchical). Reliability was assessed by re-test. The EVIDEM framework and methodology was found useful and feasible for Orphan drugs evaluation and decision making in Catalonia. All the criteria considered for the development of the CatSalut Technical Reports and decision making were considered in the framework. Nevertheless, the framework could improve the reporting of some of these criteria (i.e., "unmet needs" or "nonmedical costs"). Some Contextual criteria were removed (i.e., "Mandate and scope of healthcare system", "Environmental impact") or adapted ("population priorities and access") for CatSalut purposes. Independently of the weighting technique considered, the most important evaluation criteria identified for orphan drugs were: "disease severity", "unmet needs" and "comparative effectiveness", while the "size of the population" had the lowest relevance for decision making. Test-retest analysis showed weight consistency among techniques, supporting reliability overtime. MCDA (EVIDEM framework) could be a useful tool to complement the current evaluation methods of CatSalut, contributing to standardization and pragmatism, providing a method to tackle ethical dilemmas and facilitating discussions related to decision making.

Modeling Operations Other Than War: Non-Combatants in Combat Modeling

DTIC Science & Technology

1994-09-01

supposition that non-combatants are an essential feature in OOTW. The model proposal includes a methodology for civilian unit decision making . The model...combatants are an essential feature in OOTW. The model proposal includes a methodology for civilian unit decision making . Thi- model also includes...numerical example demonstrated that the model appeared to perform in an acceptable manner, in that it produced output within a reasonable range. During the

Cognitive Task Analysis of Business Jet Pilots' Weather Flying Behaviors: Preliminary Results

NASA Technical Reports Server (NTRS)

Latorella, Kara; Pliske, Rebecca; Hutton, Robert; Chrenka, Jason

2001-01-01

This report presents preliminary findings from a cognitive task analysis (CTA) of business aviation piloting. Results describe challenging weather-related aviation decisions and the information and cues used to support these decisions. Further, these results demonstrate the role of expertise in business aviation decision-making in weather flying, and how weather information is acquired and assessed for reliability. The challenging weather scenarios and novice errors identified in the results provide the basis for experimental scenarios and dependent measures to be used in future flight simulation evaluations of candidate aviation weather information systems. Finally, we analyzed these preliminary results to recommend design and training interventions to improve business aviation decision-making with weather information. The primary objective of this report is to present these preliminary findings and to document the extended CTA methodology used to elicit and represent expert business aviator decision-making with weather information. These preliminary findings will be augmented with results from additional subjects using this methodology. A summary of the complete results, absent the detailed treatment of methodology provided in this report, will be documented in a separate publication.

[Ethical principles and approaches to health systems governance research: conceptual and methodological implications].

PubMed

Flores, Walter

2010-01-01

Governance refers to decision-making processes in which power relationships and actors and institutions' particular interests converge. Situations of consensus and conflict are inherent to such processes. Furthermore, decision-making happens within a framework of ethical principles, motivations and incentives which could be explicit or implicit. Health systems in most Latin-American and Caribbean countries take the principles of equity, solidarity, social participation and the right to health as their guiding principles; such principles must thus rule governance processes. However, this is not always the case and this is where the importance of investigating governance in health systems lies. Making advances in investigating governance involves conceptual and methodological implications. Clarifying and integrating normative and analytical approaches is relevant at conceptual level as both are necessary for an approach seeking to investigate and understand social phenomena's complexity. In relation to methodological level, there is a need to expand the range of variables, sources of information and indicators for studying decision-making aimed to greater equity, health citizenship and public policy efficiency.

Data collection and information presentation for optimal decision making by clinical managers--the Autocontrol Project.

PubMed Central

Grant, A. M.; Richard, Y.; Deland, E.; Després, N.; de Lorenzi, F.; Dagenais, A.; Buteau, M.

1997-01-01

The Autocontrol methodology has been developed in order to support the optimisation of decision-making and the use of resources in the context of a clinical unit. The theoretical basis relates to quality assurance and information systems and is influenced by management and cognitive research in the health domain. The methodology uses population rather than individual decision making and because of its dynamic feedback design promises to have rapid and profound effect on practice. Most importantly the health care professional is the principle user of the Autocontrol system. In this methodology we distinguish three types of evidence necessary for practice change: practice based or internal evidence, best evidence derived from the literature or external evidence concerning the practice in question, and process based evidence on how to optimise the process of practice change. The software used by the system is of the executive decision support type which facilitates interrogation of large databases. The Autocontrol system is designed to interrogate the data of the patient medical record however the latter often lacks data on concomitant resource use and this must be supplemented. This paper reviews the Autocontrol methodology and gives examples from current studies. PMID:9357733

Data collection and information presentation for optimal decision making by clinical managers--the Autocontrol Project.

PubMed

Grant, A M; Richard, Y; Deland, E; Després, N; de Lorenzi, F; Dagenais, A; Buteau, M

1997-01-01

The Autocontrol methodology has been developed in order to support the optimisation of decision-making and the use of resources in the context of a clinical unit. The theoretical basis relates to quality assurance and information systems and is influenced by management and cognitive research in the health domain. The methodology uses population rather than individual decision making and because of its dynamic feedback design promises to have rapid and profound effect on practice. Most importantly the health care professional is the principle user of the Autocontrol system. In this methodology we distinguish three types of evidence necessary for practice change: practice based or internal evidence, best evidence derived from the literature or external evidence concerning the practice in question, and process based evidence on how to optimise the process of practice change. The software used by the system is of the executive decision support type which facilitates interrogation of large databases. The Autocontrol system is designed to interrogate the data of the patient medical record however the latter often lacks data on concomitant resource use and this must be supplemented. This paper reviews the Autocontrol methodology and gives examples from current studies.

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention.

PubMed

Al-Hajj, Samar; Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-09-12

Background : Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods : Inspired by the Delphi method, we introduced a novel methodology-group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders' observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results : The GA methodology triggered the emergence of ' common g round ' among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders' verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusion s : Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ' common ground' among diverse stakeholders about health data and their implications.

Comprehensible knowledge model creation for cancer treatment decision making.

PubMed

Afzal, Muhammad; Hussain, Maqbool; Ali Khan, Wajahat; Ali, Taqdir; Lee, Sungyoung; Huh, Eui-Nam; Farooq Ahmad, Hafiz; Jamshed, Arif; Iqbal, Hassan; Irfan, Muhammad; Abbas Hydari, Manzar

2017-03-01

A wealth of clinical data exists in clinical documents in the form of electronic health records (EHRs). This data can be used for developing knowledge-based recommendation systems that can assist clinicians in clinical decision making and education. One of the big hurdles in developing such systems is the lack of automated mechanisms for knowledge acquisition to enable and educate clinicians in informed decision making. An automated knowledge acquisition methodology with a comprehensible knowledge model for cancer treatment (CKM-CT) is proposed. With the CKM-CT, clinical data are acquired automatically from documents. Quality of data is ensured by correcting errors and transforming various formats into a standard data format. Data preprocessing involves dimensionality reduction and missing value imputation. Predictive algorithm selection is performed on the basis of the ranking score of the weighted sum model. The knowledge builder prepares knowledge for knowledge-based services: clinical decisions and education support. Data is acquired from 13,788 head and neck cancer (HNC) documents for 3447 patients, including 1526 patients of the oral cavity site. In the data quality task, 160 staging values are corrected. In the preprocessing task, 20 attributes and 106 records are eliminated from the dataset. The Classification and Regression Trees (CRT) algorithm is selected and provides 69.0% classification accuracy in predicting HNC treatment plans, consisting of 11 decision paths that yield 11 decision rules. Our proposed methodology, CKM-CT, is helpful to find hidden knowledge in clinical documents. In CKM-CT, the prediction models are developed to assist and educate clinicians for informed decision making. The proposed methodology is generalizable to apply to data of other domains such as breast cancer with a similar objective to assist clinicians in decision making and education. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stochastic model for fatigue crack size and cost effective design decisions. [for aerospace structures

NASA Technical Reports Server (NTRS)

Hanagud, S.; Uppaluri, B.

1975-01-01

This paper describes a methodology for making cost effective fatigue design decisions. The methodology is based on a probabilistic model for the stochastic process of fatigue crack growth with time. The development of a particular model for the stochastic process is also discussed in the paper. The model is based on the assumption of continuous time and discrete space of crack lengths. Statistical decision theory and the developed probabilistic model are used to develop the procedure for making fatigue design decisions on the basis of minimum expected cost or risk function and reliability bounds. Selections of initial flaw size distribution, NDT, repair threshold crack lengths, and inspection intervals are discussed.

Testing the Intelligence of Unmanned Autonomous Systems

DTIC Science & Technology

2008-01-01

decisions without the operator. The term autonomous is also used interchangeably with intelligent, giving rise to the name unmanned autonomous system ( UAS ...For the purposes of this article, UAS describes an unmanned system that makes decisions based on gathered information. Because testers should not...make assumptions about the decision process within a UAS , there is a need for a methodology that completely tests this decision process without biasing

Methodological decisions and the evaluation of possible effects of different family structures on children: The new family structures survey (NFSS).

PubMed

Schumm, Walter R

2012-11-01

Every social science researcher must make a number of methodological decisions when planning and implementing research projects. Each such decision carries with it both advantages and limitations. The decisions faced and made by Regnerus (2012) are discussed here in the wider context of social science literature regarding same-sex parenting. Even though the apparent outcomes of Regnerus's study were unpopular, the methodological decisions he made in the design and implementation of the New Family Structures Survey were not uncommon among social scientists, including many progressive, gay and lesbian scholars. These decisions and the research they produced deserve considerable and continued discussion, but criticisms of the underlying ethics and professionalism are misplaced because nearly every methodological decision that was made has ample precedents in research published by many other credible and distinguished scholars. Copyright © 2012 Elsevier Inc. All rights reserved.

[Shared decision-making in mental health care: a role model from youth mental health care].

PubMed

Westermann, G M A; Maurer, J M G

2015-01-01

In the communication and interaction between doctor and patient in Western health care there has been a paradigm shift from the paternalistic approach to shared decision-making. To summarise the background situation, recent developments and the current level of shared decision-making in (youth) mental health care. We conducted a critical review of the literature relating to the methodology development, research and the use of counselling and decision-making in mental health care. The majority of patients, professionals and other stakeholders consider shared decision-making to be desirable and important for improving the quality and efficiency of care. Up till recently most research and studies have concentrated on helping patients to develop decision-making skills and on showing patients how and where to access information. At the moment more attention is being given to the development of skills and circumstances that will increase patients' interaction with care professionals and patients' emotional involvement in shared decision-making. In mental health for children and adolescents, more often than in adult mental health care, it has been customary to give more attention to these aspects of shared decision-making, particularly during counselling sessions that mark the transition from diagnosis to treatment. This emphasis has been apparent for a long time in textbooks, daily practice, methodology development and research in youth mental health care. Currently, a number of similar developments are taking place in adult mental health care. Although most health professionals support the policy of shared decision-making, the implementation of the policy in mental health care is still at an early stage. In practice, a number of obstacles still have to be surmounted. However, the experience gained with counselling and decision-making in (youth) mental health care may serve as an example to other sections of mental health care and play an important role in the further development of shared decision-making.

Cost-effectiveness analyses and their role in improving healthcare strategies.

PubMed

Rodriguez, Maria I; Caughey, Aaron B

2013-12-01

In this era of healthcare reform, attention is focused on increasing the quality of care and access to services, while simultaneously reducing the cost. Economic evaluations can play an important role in translating research to evidence-based practice and policy. Cost-effectiveness analysis (CEA) and its utility for clinical and policy decision making among U.S. obstetricians and gynecologists is reviewed. Three case examples demonstrating the value of this methodology in decision making are considered. A discussion of the methodologic principles of CEA, the advantages, and the limitations of the methodology are presented. CEA can play an important role in evidence-based decision making, with value for clinicians and policy makers alike. These studies are of particular interest in the field of obstetrics and gynecology, in which uncertainty from epidemiologic or clinical trials exists, or multiple perspectives need to be considered (maternal, neonatal, and societal). As with all research, it is essential that economic evaluations are conducted according to established methodologic standards. Interpretation and application of results should occur with a clear understanding of both the value and the limitations of economic evaluations.

Using TELOS for the planning of the information system audit

NASA Astrophysics Data System (ADS)

Drljaca, D. P.; Latinovic, B.

2018-01-01

This paper intent is to analyse different aspects of information system audit and to synthesise them into the feasibility study report in order to facilitate decision making and planning of information system audit process. The TELOS methodology provides a comprehensive and holistic review for making feasibility study in general. This paper examines the use of TELOS in the identification of possible factors that may influence the decision on implementing information system audit. The research question relates to TELOS provision of sufficient information to decision makers to plan an information system audit. It was found that the TELOS methodology can be successfully applied in the process of approving and planning of information system audit. The five aspects of the feasibility study, if performed objectively, can provide sufficient information to decision makers to commission an information system audit, and also contribute better planning of the audit. Using TELOS methodology can assure evidence-based and cost-effective decision-making process and facilitate planning of the audit. The paper proposes an original approach, not examined until now. It is usual to use TELOS for different purposes and when there is a need for conveying of the feasibility study, but not in the planning of the information system audit. This gives originality to the paper and opens further research questions about evaluation of the feasibility study and possible research on comparative and complementary methodologies.

Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy.

PubMed

Blumenthal-Barby, J S; Krieger, Heather

2015-05-01

The role of cognitive biases and heuristics in medical decision making is of growing interest. The purpose of this study was to determine whether studies on cognitive biases and heuristics in medical decision making are based on actual or hypothetical decisions and are conducted with populations that are representative of those who typically make the medical decision; to categorize the types of cognitive biases and heuristics found and whether they are found in patients or in medical personnel; and to critically review the studies based on standard methodological quality criteria. Data sources were original, peer-reviewed, empirical studies on cognitive biases and heuristics in medical decision making found in Ovid Medline, PsycINFO, and the CINAHL databases published in 1980-2013. Predefined exclusion criteria were used to identify 213 studies. During data extraction, information was collected on type of bias or heuristic studied, respondent population, decision type, study type (actual or hypothetical), study method, and study conclusion. Of the 213 studies analyzed, 164 (77%) were based on hypothetical vignettes, and 175 (82%) were conducted with representative populations. Nineteen types of cognitive biases and heuristics were found. Only 34% of studies (n = 73) investigated medical personnel, and 68% (n = 145) confirmed the presence of a bias or heuristic. Each methodological quality criterion was satisfied by more than 50% of the studies, except for sample size and validated instruments/questions. Limitations are that existing terms were used to inform search terms, and study inclusion criteria focused strictly on decision making. Most of the studies on biases and heuristics in medical decision making are based on hypothetical vignettes, raising concerns about applicability of these findings to actual decision making. Biases and heuristics have been underinvestigated in medical personnel compared with patients. © The Author(s) 2014.

A Methodology for Making Early Comparative Architecture Performance Evaluations

ERIC Educational Resources Information Center

Doyle, Gerald S.

2010-01-01

Complex and expensive systems' development suffers from a lack of method for making good system-architecture-selection decisions early in the development process. Failure to make a good system-architecture-selection decision increases the risk that a development effort will not meet cost, performance and schedule goals. This research provides a…

Methodological individualism in experimental games: not so easily dismissed.

PubMed

Krueger, Joachim I

2008-06-01

Orthodox game theory and social preference models cannot explain why people cooperate in many experimental games or how they manage to coordinate their choices. The theory of evidential decision making provides a solution, based on the idea that people tend to project their own choices onto others, whatever these choices might be. Evidential decision making preserves methodological individualism, and it works without recourse to social preferences. Rejecting methodological individualism, team reasoning is a thinly disguised resurgence of the group mind fallacy, and the experiments reported by Colman et al. [Colman, A. M., Pulford, B. D., & Rose, J. (this issue). Collective rationality in interactive decisions: Evidence for team reasoning. Acta Psychologica, doi:10.1016/j.actpsy.2007.08.003.] do not offer evidence that uniquely supports team reasoning.

Using Multimedia Questionnaires to Study Influences on the Decisions Mathematics Teachers Make in Instructional Situations

ERIC Educational Resources Information Center

Herbst, Patricio; Chazan, Daniel; Kosko, Karl W.; Dimmel, Justin; Erickson, Ander

2016-01-01

This paper describes instruments designed to use multimedia to study at scale the instructional decisions that mathematics teachers make as well as teachers' recognition of elements of the context of their work that might influence those decision. This methodological contribution shows how evidence of constructs like instructional norm and…

A systematic and critical review of the evolving methods and applications of value of information in academia and practice.

PubMed

Steuten, Lotte; van de Wetering, Gijs; Groothuis-Oudshoorn, Karin; Retèl, Valesca

2013-01-01

This article provides a systematic and critical review of the evolving methods and applications of value of information (VOI) in academia and practice and discusses where future research needs to be directed. Published VOI studies were identified by conducting a computerized search on Scopus and ISI Web of Science from 1980 until December 2011 using pre-specified search terms. Only full-text papers that outlined and discussed VOI methods for medical decision making, and studies that applied VOI and explicitly discussed the results with a view to informing healthcare decision makers, were included. The included papers were divided into methodological and applied papers, based on the aim of the study. A total of 118 papers were included of which 50 % (n = 59) are methodological. A rapidly accumulating literature base on VOI from 1999 onwards for methodological papers and from 2005 onwards for applied papers is observed. Expected value of sample information (EVSI) is the preferred method of VOI to inform decision making regarding specific future studies, but real-life applications of EVSI remain scarce. Methodological challenges to VOI are numerous and include the high computational demands, dealing with non-linear models and interdependency between parameters, estimations of effective time horizons and patient populations, and structural uncertainties. VOI analysis receives increasing attention in both the methodological and the applied literature bases, but challenges to applying VOI in real-life decision making remain. For many technical and methodological challenges to VOI analytic solutions have been proposed in the literature, including leaner methods for VOI. Further research should also focus on the needs of decision makers regarding VOI.

Use of the AHP methodology in system dynamics: Modelling and simulation for health technology assessments to determine the correct prosthesis choice for hernia diseases.

PubMed

Improta, Giovanni; Russo, Mario Alessandro; Triassi, Maria; Converso, Giuseppe; Murino, Teresa; Santillo, Liberatina Carmela

2018-05-01

Health technology assessments (HTAs) are often difficult to conduct because of the decisive procedures of the HTA algorithm, which are often complex and not easy to apply. Thus, their use is not always convenient or possible for the assessment of technical requests requiring a multidisciplinary approach. This paper aims to address this issue through a multi-criteria analysis focusing on the analytic hierarchy process (AHP). This methodology allows the decision maker to analyse and evaluate different alternatives and monitor their impact on different actors during the decision-making process. However, the multi-criteria analysis is implemented through a simulation model to overcome the limitations of the AHP methodology. Simulations help decision-makers to make an appropriate decision and avoid unnecessary and costly attempts. Finally, a decision problem regarding the evaluation of two health technologies, namely, the evaluation of two biological prostheses for incisional infected hernias, will be analysed to assess the effectiveness of the model. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Using the Networked Fire Chief for ego-depletion research: measuring dynamic decision-making effort and performance.

PubMed

Barber, Larissa K; Smit, Brandon W

2014-01-01

This study replicated ego-depletion predictions from the self-control literature in a computer simulation task that requires ongoing decision-making in relation to constantly changing environmental information: the Network Fire Chief (NFC). Ego-depletion led to decreased self-regulatory effort, but not performance, on the NFC task. These effects were also buffered by task enjoyment so that individuals who enjoyed the dynamic decision-making task did not experience ego-depletion effects. These findings confirm that past ego-depletion effects on decision-making are not limited to static or isolated decision-making tasks and can be extended to dynamic, naturalistic decision-making processes more common to naturalistic settings. Furthermore, the NFC simulation provides a methodological mechanism for independently measuring effort and performance when studying ego-depletion.

Analytical group decision making in natural resources: Methodology and application

USGS Publications Warehouse

Schmoldt, D.L.; Peterson, D.L.

2000-01-01

Group decision making is becoming increasingly important in natural resource management and associated scientific applications, because multiple values are treated coincidentally in time and space, multiple resource specialists are needed, and multiple stakeholders must be included in the decision process. Decades of social science research on decision making in groups have provided insights into the impediments to effective group processes and on techniques that can be applied in a group context. Nevertheless, little integration and few applications of these results have occurred in resource management decision processes, where formal groups are integral, either directly or indirectly. A group decision-making methodology is introduced as an effective approach for temporary, formal groups (e.g., workshops). It combines the following three components: (1) brainstorming to generate ideas; (2) the analytic hierarchy process to produce judgments, manage conflict, enable consensus, and plan for implementation; and (3) a discussion template (straw document). Resulting numerical assessments of alternative decision priorities can be analyzed statistically to indicate where group member agreement occurs and where priority values are significantly different. An application of this group process to fire research program development in a workshop setting indicates that the process helps focus group deliberations; mitigates groupthink, nondecision, and social loafing pitfalls; encourages individual interaction; identifies irrational judgments; and provides a large amount of useful quantitative information about group preferences. This approach can help facilitate scientific assessments and other decision-making processes in resource management.

Application of an integrated multi-criteria decision making AHP-TOPSIS methodology for ETL software selection.

PubMed

Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

2016-01-01

Actually, a set of ETL software (Extract, Transform and Load) is available to constitute a major investment market. Each ETL uses its own techniques for extracting, transforming and loading data into data warehouse, which makes the task of evaluating ETL software very difficult. However, choosing the right software of ETL is critical to the success or failure of any Business Intelligence project. As there are many impacting factors in the selection of ETL software, the same process is considered as a complex multi-criteria decision making (MCDM) problem. In this study, an application of decision-making methodology that employs the two well-known MCDM techniques, namely Analytic Hierarchy Process (AHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) methods is designed. In this respect, the aim of using AHP is to analyze the structure of the ETL software selection problem and obtain weights of the selected criteria. Then, TOPSIS technique is used to calculate the alternatives' ratings. An example is given to illustrate the proposed methodology. Finally, a software prototype for demonstrating both methods is implemented.

International Students Decision-Making Process

ERIC Educational Resources Information Center

Cubillo, Jose Maria; Sanchez, Joaquin; Cervino, Julio

2006-01-01

Purpose--The purpose of this paper is to propose a theoretical model that integrates the different groups of factors which influence the decision-making process of international students, analysing different dimensions of this process and explaining those factors which determine students' choice. Design/methodology/approach--A hypothetical model…

Methodological challenges of validating a clinical decision-making tool in the practice environment.

PubMed

Brennan, Caitlin W; Daly, Barbara J

2015-04-01

Validating a measurement tool intended for use in the practice environment poses challenges that may not be present when validating a tool intended solely for research purposes. The aim of this article is to describe the methodological challenges of validating a clinical decision-making tool, the Oncology Acuity Tool, which nurses use to make nurse assignment and staffing decisions prospectively each shift. Data were derived from a larger validation study, during which several methodological challenges arose. Revisions to the tool, including conducting iterative feedback cycles with end users, were necessary before the validation study was initiated. The "true" value of patient acuity is unknown, and thus, two approaches to inter-rater reliability assessment were used. Discordant perspectives existed between experts and end users. Balancing psychometric rigor with clinical relevance may be achieved through establishing research-practice partnerships, seeking active and continuous feedback with end users, and weighing traditional statistical rules of thumb with practical considerations. © The Author(s) 2014.

Dynamic Educational e-Content Selection Using Multiple Criteria in Web-Based Personalized Learning Environments.

ERIC Educational Resources Information Center

Manouselis, Nikos; Sampson, Demetrios

This paper focuses on the way a multi-criteria decision making methodology is applied in the case of agent-based selection of offered learning objects. The problem of selection is modeled as a decision making one, with the decision variables being the learner model and the learning objects' educational description. In this way, selection of…

Measurement and Modelling: Sequential Use of Analytical Techniques in a Study of Risk-Taking in Decision-Making by School Principals

ERIC Educational Resources Information Center

Trimmer, Karen

2016-01-01

This paper investigates reasoned risk-taking in decision-making by school principals using a methodology that combines sequential use of psychometric and traditional measurement techniques. Risk-taking is defined as when decisions are made that are not compliant with the regulatory framework, the primary governance mechanism for public schools in…

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.

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

Emerging Educational Institutional Decision-Making Matrix

ERIC Educational Resources Information Center

Ashford-Rowe, Kevin H.; Holt, Marnie

2011-01-01

The "emerging educational institutional decision-making matrix" is developed to allow educational institutions to adopt a rigorous and consistent methodology of determining which of the myriad of emerging educational technologies will be the most compelling for the institution, particularly ensuring that it is the educational or pedagogical but…

Bayesian outcome-based strategy classification.

PubMed

Lee, Michael D

2016-03-01

Hilbig and Moshagen (Psychonomic Bulletin & Review, 21, 1431-1443, 2014) recently developed a method for making inferences about the decision processes people use in multi-attribute forced choice tasks. Their paper makes a number of worthwhile theoretical and methodological contributions. Theoretically, they provide an insightful psychological motivation for a probabilistic extension of the widely-used "weighted additive" (WADD) model, and show how this model, as well as other important models like "take-the-best" (TTB), can and should be expressed in terms of meaningful priors. Methodologically, they develop an inference approach based on the Minimum Description Length (MDL) principles that balances both the goodness-of-fit and complexity of the decision models they consider. This paper aims to preserve these useful contributions, but provide a complementary Bayesian approach with some theoretical and methodological advantages. We develop a simple graphical model, implemented in JAGS, that allows for fully Bayesian inferences about which models people use to make decisions. To demonstrate the Bayesian approach, we apply it to the models and data considered by Hilbig and Moshagen (Psychonomic Bulletin & Review, 21, 1431-1443, 2014), showing how a prior predictive analysis of the models, and posterior inferences about which models people use and the parameter settings at which they use them, can contribute to our understanding of human decision making.

The Use of Research Evidence in Public Health Decision Making Processes: Systematic Review

PubMed Central

Orton, Lois; Lloyd-Williams, Ffion; Taylor-Robinson, David; O'Flaherty, Martin; Capewell, Simon

2011-01-01

Background The use of research evidence to underpin public health policy is strongly promoted. However, its implementation has not been straightforward. The objectives of this systematic review were to synthesise empirical evidence on the use of research evidence by public health decision makers in settings with universal health care systems. Methods To locate eligible studies, 13 bibliographic databases were screened, organisational websites were scanned, key informants were contacted and bibliographies of included studies were scrutinised. Two reviewers independently assessed studies for inclusion, extracted data and assessed methodological quality. Data were synthesised as a narrative review. Findings 18 studies were included: 15 qualitative studies, and three surveys. Their methodological quality was mixed. They were set in a range of country and decision making settings. Study participants included 1063 public health decision makers, 72 researchers, and 174 with overlapping roles. Decision making processes varied widely between settings, and were viewed differently by key players. A range of research evidence was accessed. However, there was no reliable evidence on the extent of its use. Its impact was often indirect, competing with other influences. Barriers to the use of research evidence included: decision makers' perceptions of research evidence; the gulf between researchers and decision makers; the culture of decision making; competing influences on decision making; and practical constraints. Suggested (but largely untested) ways of overcoming these barriers included: research targeted at the needs of decision makers; research clearly highlighting key messages; and capacity building. There was little evidence on the role of research evidence in decision making to reduce inequalities. Conclusions To more effectively implement research informed public health policy, action is required by decision makers and researchers to address the barriers identified in this systematic review. There is an urgent need for evidence to support the use of research evidence to inform public health decision making to reduce inequalities. PMID:21818262

Case Study Methodology: Flexibility, Rigour, and Ethical Considerations for the Scholarship of Teaching and Learning

ERIC Educational Resources Information Center

Pearson, Marion L.; Albon, Simon P.; Hubball, Harry

2015-01-01

Individuals and teams engaging in the scholarship of teaching and learning (SoTL) in multidisciplinary higher education settings must make decisions regarding choice of research methodology and methods. These decisions are guided by the research context and the goals of the inquiry. With reference to our own recent experiences investigating…

The Decisions of Elementary School Principals: A Test of Ideal Type Methodology.

ERIC Educational Resources Information Center

Greer, John T.

Interviews with 25 Georgia elementary school principals provided data that could be used to test an application of Max Weber's ideal type methodology to decision-making. Alfred Schuetz's model of the rational act, based on one of Weber's ideal types, was analyzed and translated into describable acts and behaviors. Interview procedures were…

Decision making in prioritization of required operational capabilities

NASA Astrophysics Data System (ADS)

Andreeva, P.; Karev, M.; Kovacheva, Ts.

2015-10-01

The paper describes an expert heuristic approach to prioritization of required operational capabilities in the field of defense. Based on expert assessment and by application of the method of Analytical Hierarchical Process, a methodology for their prioritization has been developed. It has been applied to practical simulation decision making games.

Data-based Decision-making: Teachers' Comprehension of Curriculum-based Measurement Progress-monitoring Graphs

ERIC Educational Resources Information Center

van den Bosch, Roxette M.; Espin, Christine A.; Chung, Siuman; Saab, Nadira

2017-01-01

Teachers have difficulty using data from Curriculum-based Measurement (CBM) progress graphs of students with learning difficulties for instructional decision-making. As a first step in unraveling those difficulties, we studied teachers' comprehension of CBM graphs. Using think-aloud methodology, we examined 23 teachers' ability to…

Engineering tradeoff problems viewed as multiple objective optimizations and the VODCA methodology

NASA Astrophysics Data System (ADS)

Morgan, T. W.; Thurgood, R. L.

1984-05-01

This paper summarizes a rational model for making engineering tradeoff decisions. The model is a hybrid from the fields of social welfare economics, communications, and operations research. A solution methodology (Vector Optimization Decision Convergence Algorithm - VODCA) firmly grounded in the economic model is developed both conceptually and mathematically. The primary objective for developing the VODCA methodology was to improve the process for extracting relative value information about the objectives from the appropriate decision makers. This objective was accomplished by employing data filtering techniques to increase the consistency of the relative value information and decrease the amount of information required. VODCA is applied to a simplified hypothetical tradeoff decision problem. Possible use of multiple objective analysis concepts and the VODCA methodology in product-line development and market research are discussed.

Adolescent Sexual Decision-Making: An Integrative Review.

PubMed

Hulton, Linda J.

2001-10-03

PURPOSE: The purpose of this integrative review was to summarize the present literature to identify factors associated with adolescent sexual decision-making. Thirty-eight salient research studies were selected as a basis of this review from the databases of Medline, CINAHL, and Psychinfo using the Cooper methodology. CONCLUSIONS: Two categories of decision-making were identified: 1) The research on factors related to the decisions that adolescents make to become sexually active or to abstain from sexual activity; 2) The research on factors related to contraceptive decision-making. The most consistent findings were that the factors of gender differences, cognitive development, perception of benefits, parental influences, social influences, and sexual knowledge were important variables in the decision-making processes of adolescents. IMPLICATIONS: Practice implications for nursing suggest that clinicians should assess adolescent sexual decision-making in greater detail and address the social and psychological context in which sexual experiences occur. Nurses must be aware of the differences between adolescent and adult decision-making processes and incorporate knowledge of growth and development into intervention strategies. Moreover, to the degree that adolescent sexual decision-making proves to be less than rational, interventions designed to improve competent sexual decision-making are needed.

A multicriteria-based methodology for site prioritisation in sediment management.

PubMed

Alvarez-Guerra, Manuel; Viguri, Javier R; Voulvoulis, Nikolaos

2009-08-01

Decision-making for sediment management is a complex task that incorporates the selections of areas for remediation and the assessment of options for any mitigation required. The application of Multicriteria Analysis (MCA) to rank different areas, according to their need for sediment management, provides a great opportunity for prioritisation, a first step in an integrated methodology that finally aims to assess and select suitable alternatives for managing the identified priority sites. This paper develops a methodology that starts with the delimitation of management units within areas of study, followed by the application of MCA methods that allows ranking of these management units, according to their need for remediation. This proposed process considers not only scientific evidence on sediment quality, but also other relevant aspects such as social and economic criteria associated with such decisions. This methodology is illustrated with its application to the case study area of the Bay of Santander, in northern Spain, highlighting some of the implications of utilising different MCA methods in the process. It also uses site-specific data to assess the subjectivity in the decision-making process, mainly reflected through the assignment of the criteria weights and uncertainties in the criteria scores. Analysis of the sensitivity of the results to these factors is used as a way to assess the stability and robustness of the ranking as a first step of the sediment management decision-making process.

Probabilistic Flood Maps to support decision-making: Mapping the Value of Information

NASA Astrophysics Data System (ADS)

Alfonso, L.; Mukolwe, M. M.; Di Baldassarre, G.

2016-02-01

Floods are one of the most frequent and disruptive natural hazards that affect man. Annually, significant flood damage is documented worldwide. Flood mapping is a common preimpact flood hazard mitigation measure, for which advanced methods and tools (such as flood inundation models) are used to estimate potential flood extent maps that are used in spatial planning. However, these tools are affected, largely to an unknown degree, by both epistemic and aleatory uncertainty. Over the past few years, advances in uncertainty analysis with respect to flood inundation modeling show that it is appropriate to adopt Probabilistic Flood Maps (PFM) to account for uncertainty. However, the following question arises; how can probabilistic flood hazard information be incorporated into spatial planning? Thus, a consistent framework to incorporate PFMs into the decision-making is required. In this paper, a novel methodology based on Decision-Making under Uncertainty theories, in particular Value of Information (VOI) is proposed. Specifically, the methodology entails the use of a PFM to generate a VOI map, which highlights floodplain locations where additional information is valuable with respect to available floodplain management actions and their potential consequences. The methodology is illustrated with a simplified example and also applied to a real case study in the South of France, where a VOI map is analyzed on the basis of historical land use change decisions over a period of 26 years. Results show that uncertain flood hazard information encapsulated in PFMs can aid decision-making in floodplain planning.

Bayesian design of decision rules for failure detection

NASA Technical Reports Server (NTRS)

Chow, E. Y.; Willsky, A. S.

1984-01-01

The formulation of the decision making process of a failure detection algorithm as a Bayes sequential decision problem provides a simple conceptualization of the decision rule design problem. As the optimal Bayes rule is not computable, a methodology that is based on the Bayesian approach and aimed at a reduced computational requirement is developed for designing suboptimal rules. A numerical algorithm is constructed to facilitate the design and performance evaluation of these suboptimal rules. The result of applying this design methodology to an example shows that this approach is potentially a useful one.

A Decision Making Methodology in Support of the Business Rules Lifecycle

NASA Technical Reports Server (NTRS)

Wild, Christopher; Rosca, Daniela

1998-01-01

The business rules that underlie an enterprise emerge as a new category of system requirements that represent decisions about how to run the business, and which are characterized by their business-orientation and their propensity for change. In this report, we introduce a decision making methodology which addresses several aspects of the business rules lifecycle: acquisition, deployment and evolution. We describe a meta-model for representing business rules in terms of an enterprise model, and also a decision support submodel for reasoning about and deriving the rules. The possibility for lifecycle automated assistance is demonstrated in terms of the automatic extraction of business rules from the decision structure. A system based on the metamodel has been implemented, including the extraction algorithm. This is the final report for Daniela Rosca's PhD fellowship. It describes the work we have done over the past year, current research and the list of publications associated with her thesis topic.

Problem solving using soft systems methodology.

PubMed

Land, L

This article outlines a method of problem solving which considers holistic solutions to complex problems. Soft systems methodology allows people involved in the problem situation to have control over the decision-making process.

College Students' Scientific Epistemological Views and Thinking Patterns in Socioscientific Decision Making

ERIC Educational Resources Information Center

Liu, Shiang-Yao; Lin, Chuan-Shun; Tsai, Chin-Chung

2011-01-01

This study aims to test the nature of the assumption that there are relationships between scientific epistemological views (SEVs) and reasoning processes in socioscientific decision making. A mixed methodology that combines both qualitative and quantitative approaches of data collection and analysis was adopted not only to verify the assumption…

Foundation Degree Students and Their Educational Decision-Making

ERIC Educational Resources Information Center

Greenbank, Paul

2009-01-01

Purpose: The purpose of this paper is to examine the decision-making process of students who decided to study for a foundation degree. Design/methodology/approach: The research involved interviewing 30 students who were on, or had recently completed, a business-related foundation degree. Findings: This study found that students were not adopting a…

An analytical procedure to assist decision-making in a government research organization

Treesearch

H. Dean Claxton; Giuseppe Rensi

1972-01-01

An analytical procedure to help management decision-making in planning government research is described. The objectives, activities, and restrictions of a government research organization are modeled in a consistent analytical framework. Theory and methodology is drawn from economics and mathe-matical programing. The major analytical aspects distinguishing research...

Working against Ourselves: Decision Making in a Small Rural School District

ERIC Educational Resources Information Center

Patterson, Jean A.; Koenigs, Andrew; Mohn, Gordon; Rasmussen, Cheryl

2006-01-01

Purpose: The purpose of this paper is to examine decision making and resource allocation in a small, rural district in a Midwestern state of the USA during a time of economic retrenchment. Design/methodology/approach: Qualitative case study methods were used, including focus groups and personal interviews with current and former district…

Teacher Participation in Decision Making and Its Impact on School and Teachers

ERIC Educational Resources Information Center

Sarafidou, Jasmin-Olga; Chatziioannidis, Georgios

2013-01-01

Purpose: The purpose of this paper is to examine teacher involvement in different domains of decision making in Greek primary schools and explore associations with school and teacher variables. Design/methodology/approach: A survey employing self-administered questionnaires, with a Likert-type scale assessing teachers' actual and desired…

Sustainability and Ethics as Decision-Making Paradigms in Engineering Curricula

ERIC Educational Resources Information Center

El-Zein, Abbas; Airey, David; Bowden, Peter; Clarkeburn, Henriikka

2008-01-01

Purpose: The aim of this paper is to explore the rationale for teaching sustainability and engineering ethics within a decision-making paradigm, and critically appraise ways of achieving related learning outcomes. Design/methodology/approach: The paper presents the experience of the School of Civil Engineering at the University of Sydney in…

Improving the Process of Career Decision Making: An Action Research Approach

ERIC Educational Resources Information Center

Greenbank, Paul

2011-01-01

Purpose: This study adopts an action research approach with the aim of improving the process of career decision making among undergraduates in a business school at a "new" university in the UK. Design/methodology/approach: The study utilised unfreezing techniques, multiple case studies in conjunction with the principle of analogical…

Neuroeconomics: cross-currents in research on decision-making.

PubMed

Sanfey, Alan G; Loewenstein, George; McClure, Samuel M; Cohen, Jonathan D

2006-03-01

Despite substantial advances, the question of how we make decisions and judgments continues to pose important challenges for scientific research. Historically, different disciplines have approached this problem using different techniques and assumptions, with few unifying efforts made. However, the field of neuroeconomics has recently emerged as an inter-disciplinary effort to bridge this gap. Research in neuroscience and psychology has begun to investigate neural bases of decision predictability and value, central parameters in the economic theory of expected utility. Economics, in turn, is being increasingly influenced by a multiple-systems approach to decision-making, a perspective strongly rooted in psychology and neuroscience. The integration of these disparate theoretical approaches and methodologies offers exciting potential for the construction of more accurate models of decision-making.

Authors' response: the primacy of conscious decision making.

PubMed

Shanks, David R; Newell, Ben R

2014-02-01

The target article sought to question the common belief that our decisions are often biased by unconscious influences. While many commentators offer additional support for this perspective, others question our theoretical assumptions, empirical evaluations, and methodological criteria. We rebut in particular the starting assumption that all decision making is unconscious, and that the onus should be on researchers to prove conscious influences. Further evidence is evaluated in relation to the core topics we reviewed (multiple-cue judgment, deliberation without attention, and decisions under uncertainty), as well as priming effects. We reiterate a key conclusion from the target article, namely, that it now seems to be generally accepted that awareness should be operationally defined as reportable knowledge, and that such knowledge can only be evaluated by careful and thorough probing. We call for future research to pay heed to the different ways in which awareness can intervene in decision making (as identified in our lens model analysis) and to employ suitable methodology in the assessment of awareness, including the requirements that awareness assessment must be reliable, relevant, immediate, and sensitive.

Decision-making in Swiss home-like childbirth: A grounded theory study.

PubMed

Meyer, Yvonne; Frank, Franziska; Schläppy Muntwyler, Franziska; Fleming, Valerie; Pehlke-Milde, Jessica

2017-12-01

Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth. To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions. The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births. The central phenomenon that arose from the data was "defining/redefining decision as a joint commitment to healthy childbirth". The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife's decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman's decision, making an informed decision or taking the necessary decision. To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Adapting to Uncertainty: Comparing Methodological Approaches to Climate Adaptation and Mitigation Policy

NASA Astrophysics Data System (ADS)

Huda, J.; Kauneckis, D. L.

2013-12-01

Climate change adaptation represents a number of unique policy-making challenges. Foremost among these is dealing with the range of future climate impacts to a wide scope of inter-related natural systems, their interaction with social and economic systems, and uncertainty resulting from the variety of downscaled climate model scenarios and climate science projections. These cascades of uncertainty have led to a number of new approaches as well as a reexamination of traditional methods for evaluating risk and uncertainty in policy-making. Policy makers are required to make decisions and formulate policy irrespective of the level of uncertainty involved and while a debate continues regarding the level of scientific certainty required in order to make a decision, incremental change in the climate policy continues at multiple governance levels. This project conducts a comparative analysis of the range of methodological approaches that are evolving to address uncertainty in climate change policy. It defines 'methodologies' to include a variety of quantitative and qualitative approaches involving both top-down and bottom-up policy processes that attempt to enable policymakers to synthesize climate information into the policy process. The analysis examines methodological approaches to decision-making in climate policy based on criteria such as sources of policy choice information, sectors to which the methodology has been applied, sources from which climate projections were derived, quantitative and qualitative methods used to deal with uncertainty, and the benefits and limitations of each. A typology is developed to better categorize the variety of approaches and methods, examine the scope of policy activities they are best suited for, and highlight areas for future research and development.

[Impact of shared-decision making on patient satisfaction].

PubMed

Suh, Won S; Lee, Chae Kyung

2010-01-01

The purpose of this research is to analyze the impact of shared-decision making on patient satisfaction. The study is significant since it focuses on developing appropriate methodologies and analyzing data to identify patient preferences, with the goals of optimizing treatment selection, and substantiating the relationship between such preferences and their impact on outcomes. A thorough literature review that developed the framework illustrating key dimensions of shared decision making was followed by a quantitative assessment and regression analysis of patient-perceived satisfaction, and the degree of shared-decision making. A positive association was evident between shared-decision making and patient satisfaction. The impact of shared decision making on patient satisfaction was greater than other variable including gender, education, and number of visits. Patients who participate in care-related decisions and who are given an explanation of their health problems are more likely to be satisfied with their care. It would benefit health care organizations to train their medical professionals in this communication method, and to include it in their practice guidelines.

Finding the numerical compensation in multiple criteria decision-making problems under fuzzy environment

NASA Astrophysics Data System (ADS)

Gupta, Mahima; Mohanty, B. K.

2017-04-01

In this paper, we have developed a methodology to derive the level of compensation numerically in multiple criteria decision-making (MCDM) problems under fuzzy environment. The degree of compensation is dependent on the tranquility and anxiety level experienced by the decision-maker while taking the decision. Higher tranquility leads to the higher realisation of the compensation whereas the increased level of anxiety reduces the amount of compensation in the decision process. This work determines the level of tranquility (or anxiety) using the concept of fuzzy sets and its various level sets. The concepts of indexing of fuzzy numbers, the risk barriers and the tranquility level of the decision-maker are used to derive his/her risk prone or risk averse attitude of decision-maker in each criterion. The aggregation of the risk levels in each criterion gives us the amount of compensation in the entire MCDM problem. Inclusion of the compensation leads us to model the MCDM problem as binary integer programming problem (BIP). The solution to BIP gives us the compensatory decision to MCDM. The proposed methodology is illustrated through a numerical example.

Policy Implications for Continuous Employment Decisions of High School Principals: An Alternative Methodological Approach for Using High-Stakes Testing Outcomes

ERIC Educational Resources Information Center

Young, I. Phillip; Fawcett, Paul

2013-01-01

Several teacher models exist for using high-stakes testing outcomes to make continuous employment decisions for principals. These models are reviewed, and specific flaws are noted if these models are retrofitted for principals. To address these flaws, a different methodology is proposed on the basis of actual field data. Specially addressed are…

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

DOE PAGES

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

2016-09-03

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

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

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

Domestic Abuse and Child Contact: Positioning Children in the Decision-Making Process

ERIC Educational Resources Information Center

Holt, Stephanie

2011-01-01

Drawing on a three-year Irish research study, this paper focuses on the decision-making process in child contact, specifically the assessment and management of risk of continuing abuse to young people previously exposed to domestic abuse. A mixed methodological approach involved the completion of survey questionnaires by 219 mothers and the…

An Examination of the Decision-Making Processes Used by Superintendents in Reducing School District Budgets

ERIC Educational Resources Information Center

Slaven, Lori A.

2014-01-01

Purpose: The purpose of this study was to determine the degree of importance of Harvey et al.'s (1997) 13 problem-solving strategies for making retrenchment decisions on school district budgets as perceived by California superintendents of medium-sized school districts. Methodology: The subjects in the present study were 86 superintendents of…

Decision Making behind the Use of Metacognitive Pedagogy within Education Methodology Coursework: An Exploratory Case Study

ERIC Educational Resources Information Center

Stokes, Andria Hilvitz

2011-01-01

Recent Department of Education Reports identify a need for changes in pre-service teacher education to help close the continuance of the achievement gap. The purpose of this qualitative study is to identify the professor decision making about metacognitive pedagogical theory within preparation of preservice education programs. The study included…

The Impact of Video Gaming on Decision-Making and Teamworking Skills

ERIC Educational Resources Information Center

Campus-Wide Information Systems, 2005

2005-01-01

Purpose: To discuss the considerable impact of video gaming on young players' decision-making and teamworking skills, and the belief that video games provide an invaluable "training camp" for business. Design/methodology/approach: An interview with John Beck, the author of the book Got Game: How a New Generation of Gamers Is Reshaping Business…

Making the Right Decisions: Leadership in 1-to-1 Computing in Education

ERIC Educational Resources Information Center

Towndrow, Phillip A.; Vallance, Michael

2013-01-01

Purpose: The purpose of this paper is to detail the necessity for more informed decision making and leadership in the implementation of 1-to-1 computing in education. Design/methodology/approach: The contexts of high-tech countries of Singapore and Japan are used as case studies to contextualize and support four evidence-based recommendations for…

The Decision-Making Processes of Early Childhood Teachers When Working with Children Experiencing Parental Separation and Divorce

ERIC Educational Resources Information Center

Mahony, L.; Lunn, J.; Petriwskyj, A.; Walsh, K.

2015-01-01

In this study, the pedagogical decision-making processes of 21 Australian early childhood teachers working with children experiencing parental separation and divorce were examined. Transcripts from interviews and a focus group with teachers were analysed using grounded theory methodology. The findings showed that as teachers interacted with young…

Processes and Factors Underlying Adolescent Males' Attitudes and Decision-Making in Relation to an Unplanned Pregnancy

ERIC Educational Resources Information Center

Condon, John T.; Corkindale, Carolyn J.; Russell, Alan; Quinlivan, Julie A.

2006-01-01

This research examined adolescent males' decision-making when confronted with a hypothetical unplanned pregnancy in a sexual partner. An innovative methodology, involving a computerized simulation game was utilized with 386 Australian males (mean age of 15 years). Data were gathered from responses made during the simulation, and questionnaires…

Using M and S to Improve Human Decision Making and Achieve Effective Problem Solving in an International Environment

NASA Technical Reports Server (NTRS)

Christie, Vanessa L.; Landess, David J.

2012-01-01

In the international arena, decision makers are often swayed away from fact-based analysis by their own individual cultural and political bias. Modeling and Simulation-based training can raise awareness of individual predisposition and improve the quality of decision making by focusing solely on fact vice perception. This improved decision making methodology will support the multinational collaborative efforts of military and civilian leaders to solve challenges more effectively. The intent of this experimental research is to create a framework that allows decision makers to "come to the table" with the latest and most significant facts necessary to determine an appropriate solution for any given contingency.

Spillover Effects of Loss of Control on Risky Decision-Making

PubMed Central

Beisswingert, Birgit M.; Zhang, Keshun; Goetz, Thomas; Fischbacher, Urs

2016-01-01

Decision making in risky situations is frequently required in our everyday lives and has been shown to be influenced by various factors, some of which are independent of the risk context. Based on previous findings and theories about the central role of perceptions of control and their impact on subsequent settings, spillover effects of subjective loss of control on risky decision-making are assumed. After developing an innovative experimental paradigm for inducing loss of control, its hypothesized effects on risky decision-making are investigated. Partially supporting the hypotheses, results demonstrated no increased levels of risk perceptions but decreased risk-taking behavior following experiences of loss of control. Thus, this study makes a methodological contribution by proposing a newly developed experimental paradigm facilitating further research on the effects of subjective loss of control, and additionally provides partial evidence for the spillover effects of loss of control experiences on risky decision-making. PMID:26930066

A decision model for planetary missions

NASA Technical Reports Server (NTRS)

Hazelrigg, G. A., Jr.; Brigadier, W. L.

1976-01-01

Many techniques developed for the solution of problems in economics and operations research are directly applicable to problems involving engineering trade-offs. This paper investigates the use of utility theory for decision making in planetary exploration space missions. A decision model is derived that accounts for the objectives of the mission - science - the cost of flying the mission and the risk of mission failure. A simulation methodology for obtaining the probability distribution of science value and costs as a function spacecraft and mission design is presented and an example application of the decision methodology is given for various potential alternatives in a comet Encke mission.

Solid Waste Management Planning--A Methodology

ERIC Educational Resources Information Center

Theisen, Hilary M.; And Others

1975-01-01

This article presents a twofold solid waste management plan consisting of a basic design methodology and a decision-making methodology. The former provides a framework for the developing plan while the latter builds flexibility into the design so that there is a model for use during the planning process. (MA)

Clinical decision rules, spinal pain classification and prediction of treatment outcome: A discussion of recent reports in the rehabilitation literature

PubMed Central

2012-01-01

Clinical decision rules are an increasingly common presence in the biomedical literature and represent one strategy of enhancing clinical-decision making with the goal of improving the efficiency and effectiveness of healthcare delivery. In the context of rehabilitation research, clinical decision rules have been predominantly aimed at classifying patients by predicting their treatment response to specific therapies. Traditionally, recommendations for developing clinical decision rules propose a multistep process (derivation, validation, impact analysis) using defined methodology. Research efforts aimed at developing a “diagnosis-based clinical decision rule” have departed from this convention. Recent publications in this line of research have used the modified terminology “diagnosis-based clinical decision guide.” Modifications to terminology and methodology surrounding clinical decision rules can make it more difficult for clinicians to recognize the level of evidence associated with a decision rule and understand how this evidence should be implemented to inform patient care. We provide a brief overview of clinical decision rule development in the context of the rehabilitation literature and two specific papers recently published in Chiropractic and Manual Therapies. PMID:22726639

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.

An exploration of clinical decision making in mental health triage.

PubMed

Sands, Natisha

2009-08-01

Mental health (MH) triage is a specialist area of clinical nursing practice that involves complex decision making. The discussion in this article draws on the findings of a Ph.D. study that involved a statewide investigation of the scope of MH triage nursing practice in Victoria, Australia. Although the original Ph.D. study investigated a number of core practices in MH triage, the focus of the discussion in this article is specifically on the findings related to clinical decision making in MH triage, which have not previously been published. The study employed an exploratory descriptive research design that used mixed data collection methods including a survey questionnaire (n = 139) and semistructured interviews (n = 21). The study findings related to decision making revealed a lack of empirically tested evidence-based decision-making frameworks currently in use to support MH triage nursing practice. MH triage clinicians in Australia rely heavily on clinical experience to underpin decision making and have little of knowledge of theoretical models for practice, such as methodologies for rating urgency. A key recommendation arising from the study is the need to develop evidence-based decision-making frameworks such as clinical guidelines to inform and support MH triage clinical decision making.

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention

PubMed Central

Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-01-01

Background: Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods: Inspired by the Delphi method, we introduced a novel methodology—group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders’ observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results: The GA methodology triggered the emergence of ‘common ground’ among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders’ verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusions: Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ‘common ground’ among diverse stakeholders about health data and their implications. PMID:28895928

Discovering Decision Knowledge from Web Log Portfolio for Managing Classroom Processes by Applying Decision Tree and Data Cube Technology.

ERIC Educational Resources Information Center

Chen, Gwo-Dong; Liu, Chen-Chung; Ou, Kuo-Liang; Liu, Baw-Jhiune

2000-01-01

Discusses the use of Web logs to record student behavior that can assist teachers in assessing performance and making curriculum decisions for distance learning students who are using Web-based learning systems. Adopts decision tree and data cube information processing methodologies for developing more effective pedagogical strategies. (LRW)

Designing a rapid response program to support evidence-informed decision-making in the Americas region: using the best available evidence and case studies.

PubMed

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Barreto, Jorge; Reveiz, Ludovic; Lavis, John N

2016-08-18

The objective of this work was to inform the design of a rapid response program to support evidence-informed decision-making in health policy and practice for the Americas region. Specifically, we focus on the following: (1) What are the best methodological approaches for rapid reviews of the research evidence? (2) What other strategies are needed to facilitate evidence-informed decision-making in health policy and practice? and (3) How best to operationalize a rapid response program? The evidence used to inform the design of a rapid response program included (i) two rapid reviews of methodological approaches for rapid reviews of the research evidence and strategies to facilitate evidence-informed decision-making, (ii) supplementary literature in relation to the "shortcuts" that could be considered to reduce the time needed to complete rapid reviews, (iii) four case studies, and (iv) supplementary literature to identify additional operational issues for the design of the program. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting them. Better reporting of rapid review methods is needed. The literature found in relation to shortcuts will be helpful in choosing shortcuts that maximize timeliness while minimizing the impact on quality. Evidence for other strategies that can be used concurrently to facilitate the uptake of research evidence, including evidence drawn from rapid reviews, is presented. Operational issues that need to be considered in designing a rapid response program include the implications of a "user-pays" model, the importance of recruiting staff with the right mix of skills and qualifications, and ensuring that the impact of the model on research use in decision-making is formally evaluated. When designing a new rapid response program, greater attention needs to be given to specifying the rapid review methods and reporting these in sufficient detail to allow a quality assessment. It will also be important to engage in other strategies to facilitate the uptake of the rapid reviews and to evaluate the chosen model in order to make refinements and add to the evidence base for evidence-informed decision-making.

Actual and Ideal Decision-Making Processes Utilized in Senior High Schools That Individualize Instruction. Technical Report No. 460.

ERIC Educational Resources Information Center

Watkins, Arthur Noel

The purpose of this study was to identify and describe the decision-making processes in senior high schools that were implementing programs of individualized schooling. Field methodology, including interviews, observations, and analysis of documents, was used to gather data in six senior high schools of varying size located throughout the country,…

Ethical Leadership in Education and Its Relation to Ethical Decision-Making: The Case of Arab School Leaders in Israel

ERIC Educational Resources Information Center

Arar, Khalid; Haj, Ibrahim; Abramovitz, Ruth; Oplatka, Izhar

2016-01-01

Purpose: The purpose of this paper is to investigate ethical leadership in the context of the Arab educational system in Israel. It questions the relations of ethical leadership dimensions with decision making as well as background characteristics of the educational leaders. Design/methodology/approach: Arab educational leaders (n=150) from…

Decision Making Regarding Access to Training and Development in Medium-Sized Enterprises: An Exploratory Study Using the Critical Incident Technique

ERIC Educational Resources Information Center

Coetzer, Alan; Redmond, Janice; Sharafizad, Jalleh

2012-01-01

Purpose: The purpose of this paper is to develop an understanding of factors that impinge on managerial decision-making processes regarding employee access to structured training and development (T&D) opportunities that are at least partially funded by the firm. Design/methodology/approach: Semi-structured interviews incorporating the Critical…

From 'Parent' to 'Expert': How Parents of Children with Autism Spectrum Disorder Make Decisions about Which Intervention Approaches to Access

ERIC Educational Resources Information Center

Edwards, Amelia G.; Brebner, Chris M.; McCormack, Paul F.; MacDougall, Colin J.

2018-01-01

Parents of children with Autism Spectrum Disorder are responsible for deciding which interventions to implement with their child. There is limited research examining parental decision-making with regards to intervention approaches. A constructivist grounded theory methodology was implemented in this study. Semi-structured interviews were…

Productivity Assessment and Improvement Measurement of Decision Making Units--An Application for Ranking Cities in Israel

ERIC Educational Resources Information Center

Hadad, Yossi; Keren, Baruch; Ben-Yair, Avner

2010-01-01

In this paper we will demonstrate how productivity and improvement rate of urban organizational units (called also Decision Making Units--DMUs) may be assessed when measured along several time periods. The assessment and subsequent ranking of cities is achieved by means of the Data Envelopment Analysis (DEA) methodology to determine DMU's…

Strategic Decision-Making Learning from Label Distributions: An Approach for Facial Age Estimation.

PubMed

Zhao, Wei; Wang, Han

2016-06-28

Nowadays, label distribution learning is among the state-of-the-art methodologies in facial age estimation. It takes the age of each facial image instance as a label distribution with a series of age labels rather than the single chronological age label that is commonly used. However, this methodology is deficient in its simple decision-making criterion: the final predicted age is only selected at the one with maximum description degree. In many cases, different age labels may have very similar description degrees. Consequently, blindly deciding the estimated age by virtue of the highest description degree would miss or neglect other valuable age labels that may contribute a lot to the final predicted age. In this paper, we propose a strategic decision-making label distribution learning algorithm (SDM-LDL) with a series of strategies specialized for different types of age label distribution. Experimental results from the most popular aging face database, FG-NET, show the superiority and validity of all the proposed strategic decision-making learning algorithms over the existing label distribution learning and other single-label learning algorithms for facial age estimation. The inner properties of SDM-LDL are further explored with more advantages.

Strategic Decision-Making Learning from Label Distributions: An Approach for Facial Age Estimation

PubMed Central

Zhao, Wei; Wang, Han

2016-01-01

Nowadays, label distribution learning is among the state-of-the-art methodologies in facial age estimation. It takes the age of each facial image instance as a label distribution with a series of age labels rather than the single chronological age label that is commonly used. However, this methodology is deficient in its simple decision-making criterion: the final predicted age is only selected at the one with maximum description degree. In many cases, different age labels may have very similar description degrees. Consequently, blindly deciding the estimated age by virtue of the highest description degree would miss or neglect other valuable age labels that may contribute a lot to the final predicted age. In this paper, we propose a strategic decision-making label distribution learning algorithm (SDM-LDL) with a series of strategies specialized for different types of age label distribution. Experimental results from the most popular aging face database, FG-NET, show the superiority and validity of all the proposed strategic decision-making learning algorithms over the existing label distribution learning and other single-label learning algorithms for facial age estimation. The inner properties of SDM-LDL are further explored with more advantages. PMID:27367691

When parsimony is not enough: Considering dual processes and dual levels of influence in sexual decision making

PubMed Central

Rendina, H. Jonathon

2015-01-01

The literature on sexual decision making that has been used to understand behaviors relevant to HIV and STI risk has relied primarily on cognitive antecedents of behavior. In contrast, several prominent models of decision making outside of the sexual behavior literature rely on dual process models, in which both affective and cognitive processing are considered important precursors to behavior. Moreover, much of the literature on sexual behavior utilizes individual-level traits and characteristics to predict aggregated sexual behavior, despite decision making itself being a situational or event-level process. This paper proposes a framework for understanding sexual decision making as the result of dual processes (affective and cognitive) operating at dual level of influence (individual and situational). Finally, the paper ends with a discussion of the conceptual and methodological benefits and challenges to its use and future directions for research. PMID:26168978

Multi-disciplinary decision making in general practice.

PubMed

Kirby, Ann; Murphy, Aileen; Bradley, Colin

2018-04-09

Purpose Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners' (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making. Design/methodology/approach A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions. Findings Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants. Originality/value For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.

A multicriteria decision making model for assessment and selection of an ERP in a logistics context

NASA Astrophysics Data System (ADS)

Pereira, Teresa; Ferreira, Fernanda A.

2017-07-01

The aim of this work is to apply a methodology of decision support based on a multicriteria decision analyses (MCDA) model that allows the assessment and selection of an Enterprise Resource Planning (ERP) in a Portuguese logistics company by Group Decision Maker (GDM). A Decision Support system (DSS) that implements a MCDA - Multicriteria Methodology for the Assessment and Selection of Information Systems / Information Technologies (MMASSI / IT) is used based on its features and facility to change and adapt the model to a given scope. Using this DSS it was obtained the information system that best suited to the decisional context, being this result evaluated through a sensitivity and robustness analysis.

Personalized Clinical Diagnosis in Data Bases for Treatment Support in Phthisiology.

PubMed

Lugovkina, T K; Skornyakov, S N; Golubev, D N; Egorov, E A; Medvinsky, I D

2016-01-01

The decision-making is a key event in the clinical practice. The program products with clinical decision support models in electronic data-base as well as with fixed decision moments of the real clinical practice and treatment results are very actual instruments for improving phthisiological practice and may be useful in the severe cases caused by the resistant strains of Mycobacterium tuberculosis. The methodology for gathering and structuring of useful information (critical clinical signals for decisions) is described. Additional coding of clinical diagnosis characteristics was implemented for numeric reflection of the personal situations. The created methodology for systematization and coding Clinical Events allowed to improve the clinical decision models for better clinical results.

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

Radojcic, Riko; Nowak, Matt; Nakamoto, Mark

The status of the development of a Design-for-Stress simulation flow that captures the stress effects in packaged 3D-stacked Si products like integrated circuits (ICs) using advanced via-middle Through Si Via technology is outlined. The next set of challenges required to proliferate the methodology and to deploy it for making and dispositioning real Si product decisions are described here. These include the adoption and support of a Process Design Kit (PDK) that includes the relevant material properties, the development of stress simulation methodologies that operate at higher levels of abstraction in a design flow, and the development and adoption of suitablemore » models required to make real product reliability decisions.« less

How can multi criteria decision analysis support value assessment of pharmaceuticals? - Findings from a systematic literature review.

PubMed

Kolasa, Katarzyna; Zah, Vladimir; Kowalczyk, Marta

2018-04-29

As budget constraints become more and more visible, there is growing recognition for greater transparency and greater stakeholders' engagement in the pharmaceuticals' pric-ing&reimbursement (P&R) decision making. New frameworks of drugs' value assessments are searched for. Among them, the multi-criteria decision analysis (MCDA) receives more and more attention. In 2014, ISPOR established Task Force to provide methodological recommendations for MCDA utilization in the health care decision making. Still, there is not so much knowledge about the real life experience with MCDA's adaptation to the P&R processes. Areas covered: A systematic literature review was performed to understand the rationale for MCDA adaptation, methodology used as well as its impact on P&R outcomes. Expert commentary: In total 102 hits were found through the search of databases, out of which 18 publications were selected. Although limited in scope, the review highlighted how MCDA can im-prove the decision making processes not only regarding pricing & reimbursement but also contribute to the the risk benefit assessment as well as optimization of treatment outcomes. Still none of re-viewed studies did report how MCDA results actually impacted the real life settings.

[Research Biomedical Ethics and Practical Wisdom].

PubMed

Vergara, Oscar

2015-01-01

As is well known, in the field of Biomedical Ethics some methodological proposals have been put forward. They try to provide some guidelines in order to take proper decisions. These methodologies are quite useful insofar as they supply reasons for action, but they are essentially insufficient. In fact, taking a good decision requires a special skill that goes beyond sheer technique, and this skill is traditionally called practical wisdom. Not in the usual and more outlying sense of sheer caution, but in the more central one of phronesis or prudentia. Although it is not a new notion, it usually appears blurred in biomedical decision-making theory, playing the wrong role, or in a marginal or indefinite way. From this postulate, we will try to make a double analysis. First, we will try to show the need for a proper understanding of the core role that phronesis plays in decision making. Second, we will try to get the original meaning of Aristotelian phronesis back. For reasons of space, in this paper the second question will be just partially addressed.

Beyond Self-Report: Emerging Methods for Capturing Individual Differences in Decision-Making Process

PubMed Central

Connors, Brenda L.; Rende, Richard; Colton, Timothy J.

2016-01-01

People vary in the way in which they approach decision-making, which impacts real-world behavior. There has been a surge of interest in moving beyond reliance on self-report measures to capture such individual differences. Particular emphasis has been placed on devising and applying a range of methodologies that include experimental, neuroscience, and observational paradigms. This paper provides a selective review of recent studies that illustrate the methods and yield of these approaches in terms of generating a deeper understanding of decision-making style and the notable differences that can be found across individuals. PMID:26973589

Systematic behavior research for understanding consumer decision making.

PubMed

Lin, Chin-Feng

2009-05-01

This study incorporates means-end chain (MEC) theory and dynamic programming for understanding the implications of consumer decision making. The conceptual framework of this study can help programmers design information systems for analyzing consumption behaviors. Such analyses will provide marketers with meaningful information for formulating marketing strategies. The main contributions of this article are as follows: (1) to enable researchers to obtain information for consumer cognitive hierarchies utilizing an information system, (2) to enhance the functions of traditional MEC methodology and provide an integrated method for analyzing consumption information, and (3) to construct an information system for analyzing consumer decision-making processes.

Beyond Self-Report: Emerging Methods for Capturing Individual Differences in Decision-Making Process.

PubMed

Connors, Brenda L; Rende, Richard; Colton, Timothy J

2016-01-01

People vary in the way in which they approach decision-making, which impacts real-world behavior. There has been a surge of interest in moving beyond reliance on self-report measures to capture such individual differences. Particular emphasis has been placed on devising and applying a range of methodologies that include experimental, neuroscience, and observational paradigms. This paper provides a selective review of recent studies that illustrate the methods and yield of these approaches in terms of generating a deeper understanding of decision-making style and the notable differences that can be found across individuals.

The impact of geographic information systems on emergency management decision making at the U.S. Department of Homeland Security

NASA Astrophysics Data System (ADS)

King, Steven Gray

Geographic information systems (GIS) reveal relationships and patterns from large quantities of diverse data in the form of maps and reports. The United States spends billions of dollars to use GIS to improve decisions made during responses to natural disasters and terrorist attacks, but precisely how GIS improves or impairs decision making is not known. This research examined how GIS affect decision making during natural disasters, and how GIS can be more effectively used to improve decision making for emergency management. Using a qualitative case study methodology, this research examined decision making at the U.S. Department of Homeland Security (DHS) during a large full-scale disaster exercise. This study indicates that GIS provided decision makers at DHS with an outstanding context for information that would otherwise be challenging to understand, especially through the integration of multiple data sources and dynamic three-dimensional interactive maps. Decision making was hampered by outdated information, a reliance on predictive models based on hypothetical data rather than actual event data, and a lack of understanding of the capabilities of GIS beyond cartography. Geospatial analysts, emergency managers, and other decision makers who use GIS should take specific steps to improve decision making based on GIS for disaster response and emergency management.

Evaluative methodology for prioritizing transportation energy conservation strategies

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

Pang, L.M.G.

An analytical methodology was developed for the purpose of prioritizing a set of transportation energy conservation (TEC) strategies within an urban environment. Steps involved in applying the methodology consist of 1) defining the goals, objectives and constraints of the given urban community, 2) identifying potential TEC strategies, 3) assessing the impact of the strategies, 4) applying the TEC evaluation model, and 5) utilizing a selection process to determine the optimal set of strategies for implementation. This research provides an overview of 21 TEC strategies, a quick-response technique for estimating energy savings, a multiattribute utility theory approach for assessing subjective impacts,more » and a computer program for making the strategy evaluations, all of which assist in expediting the execution of the entire methodology procedure. The critical element of the methodology is the strategy evaluation model which incorporates a number of desirable concepts including 1) a comprehensive accounting of all relevant impacts, 2) the application of multiobjective decision-making techniques, 3) an approach to assure compatibilty among quantitative and qualitative impact measures, 4) the inclusion of the decision maker's preferences in the evaluation procedure, and 5) the cost-effectiveness concept. Application of the methodolgy to Salt Lake City, Utah demonstrated its utility, ease of use and favorability by decision makers.« less

A quantitative flood risk analysis methodology for urban areas with integration of social research data

NASA Astrophysics Data System (ADS)

Escuder-Bueno, I.; Castillo-Rodríguez, J. T.; Zechner, S.; Jöbstl, C.; Perales-Momparler, S.; Petaccia, G.

2012-09-01

Risk analysis has become a top priority for authorities and stakeholders in many European countries, with the aim of reducing flooding risk, considering the population's needs and improving risk awareness. Within this context, two methodological pieces have been developed in the period 2009-2011 within the SUFRI project (Sustainable Strategies of Urban Flood Risk Management with non-structural measures to cope with the residual risk, 2nd ERA-Net CRUE Funding Initiative). First, the "SUFRI Methodology for pluvial and river flooding risk assessment in urban areas to inform decision-making" provides a comprehensive and quantitative tool for flood risk analysis. Second, the "Methodology for investigation of risk awareness of the population concerned" presents the basis to estimate current risk from a social perspective and identify tendencies in the way floods are understood by citizens. Outcomes of both methods are integrated in this paper with the aim of informing decision making on non-structural protection measures. The results of two case studies are shown to illustrate practical applications of this developed approach. The main advantage of applying the methodology herein presented consists in providing a quantitative estimation of flooding risk before and after investing in non-structural risk mitigation measures. It can be of great interest for decision makers as it provides rational and solid information.

Fuzzy approaches to supplier selection problem

NASA Astrophysics Data System (ADS)

Ozkok, Beyza Ahlatcioglu; Kocken, Hale Gonce

2013-09-01

Supplier selection problem is a multi-criteria decision making problem which includes both qualitative and quantitative factors. In the selection process many criteria may conflict with each other, therefore decision-making process becomes complicated. In this study, we handled the supplier selection problem under uncertainty. In this context; we used minimum criterion, arithmetic mean criterion, regret criterion, optimistic criterion, geometric mean and harmonic mean. The membership functions created with the help of the characteristics of used criteria, and we tried to provide consistent supplier selection decisions by using these memberships for evaluating alternative suppliers. During the analysis, no need to use expert opinion is a strong aspect of the methodology used in the decision-making.

People adopt optimal policies in simple decision-making, after practice and guidance.

PubMed

Evans, Nathan J; Brown, Scott D

2017-04-01

Organisms making repeated simple decisions are faced with a tradeoff between urgent and cautious strategies. While animals can adopt a statistically optimal policy for this tradeoff, findings about human decision-makers have been mixed. Some studies have shown that people can optimize this "speed-accuracy tradeoff", while others have identified a systematic bias towards excessive caution. These issues have driven theoretical development and spurred debate about the nature of human decision-making. We investigated a potential resolution to the debate, based on two factors that routinely differ between human and animal studies of decision-making: the effects of practice, and of longer-term feedback. Our study replicated the finding that most people, by default, are overly cautious. When given both practice and detailed feedback, people moved rapidly towards the optimal policy, with many participants reaching optimality with less than 1 h of practice. Our findings have theoretical implications for cognitive and neural models of simple decision-making, as well as methodological implications.

Improving the Career Decision-Making Behaviour of Working Class Students: Do Economic Barriers Stand in the Way?

ERIC Educational Resources Information Center

Greenbank, Paul; Hepworth, Sue

2008-01-01

Purpose: This paper aims to examine the extent to which economic factors influence the career decision-making process of working class students. Design/methodology/approach: The study involved an initial survey of 165 final-year students from a range of degree programmes. It was followed by in-depth interviews with 30 working class students.…

Human Information Behavior, Coping, and Decision-Making in the Context of a Personal Crisis: An Interpretative Phenomenological Analysis of the Voices of Birthmothers on Relinquishing a Child for Adoption

ERIC Educational Resources Information Center

Clemens, Rachael Annette

2017-01-01

This qualitative and interpretive inquiry explores the information behavior of birthmothers surrounding the processes of decision-making, coping, and living with the act of child relinquishment to adoption. An interpretative phenomenological analysis methodology is used to reveal the phenomenon as experienced by eight birthmothers, women who…

E Pluribus Analysis: Applying a Superforecasting Methodology to the Detection of Homegrown Violence

DTIC Science & Technology

2018-03-01

actor violence and a set of predefined decision-making protocols. This research included running four simulations using the Monte Carlo technique, which...actor violence and a set of predefined decision-making protocols. This research included running four simulations using the Monte Carlo technique...PREDICTING RANDOMNESS.............................................................24 1. Using a “ Runs Test” to Determine a Temporal Pattern in Lone

Structural Equation Models of Management and Decision-Making Styles with Job Satisfaction of Academic Staff in Malaysian Research University

ERIC Educational Resources Information Center

Amzat, Ismail Hussein; Idris, Datuk Abdul Rahman

2012-01-01

Purpose: The purpose of this paper is to discuss the effect of management and decision-making styles on the job satisfaction of academic staff in a Malaysian Research University. Design/methodology/approach: The sample consisted of 218 respondents. The instruments used in the study were the Teacher Job Satisfaction Questionnaire and the Decision…

Real-Time Optimal Flood Control Decision Making and Risk Propagation Under Multiple Uncertainties

NASA Astrophysics Data System (ADS)

Zhu, Feilin; Zhong, Ping-An; Sun, Yimeng; Yeh, William W.-G.

2017-12-01

Multiple uncertainties exist in the optimal flood control decision-making process, presenting risks involving flood control decisions. This paper defines the main steps in optimal flood control decision making that constitute the Forecast-Optimization-Decision Making (FODM) chain. We propose a framework for supporting optimal flood control decision making under multiple uncertainties and evaluate risk propagation along the FODM chain from a holistic perspective. To deal with uncertainties, we employ stochastic models at each link of the FODM chain. We generate synthetic ensemble flood forecasts via the martingale model of forecast evolution. We then establish a multiobjective stochastic programming with recourse model for optimal flood control operation. The Pareto front under uncertainty is derived via the constraint method coupled with a two-step process. We propose a novel SMAA-TOPSIS model for stochastic multicriteria decision making. Then we propose the risk assessment model, the risk of decision-making errors and rank uncertainty degree to quantify the risk propagation process along the FODM chain. We conduct numerical experiments to investigate the effects of flood forecast uncertainty on optimal flood control decision making and risk propagation. We apply the proposed methodology to a flood control system in the Daduhe River basin in China. The results indicate that the proposed method can provide valuable risk information in each link of the FODM chain and enable risk-informed decisions with higher reliability.

Adaptive Multi-scale PHM for Robotic Assembly Processes

PubMed Central

Choo, Benjamin Y.; Beling, Peter A.; LaViers, Amy E.; Marvel, Jeremy A.; Weiss, Brian A.

2017-01-01

Adaptive multiscale prognostics and health management (AM-PHM) is a methodology designed to support PHM in smart manufacturing systems. As a rule, PHM information is not used in high-level decision-making in manufacturing systems. AM-PHM leverages and integrates component-level PHM information with hierarchical relationships across the component, machine, work cell, and production line levels in a manufacturing system. The AM-PHM methodology enables the creation of actionable prognostic and diagnostic intelligence up and down the manufacturing process hierarchy. Decisions are made with the knowledge of the current and projected health state of the system at decision points along the nodes of the hierarchical structure. A description of the AM-PHM methodology with a simulated canonical robotic assembly process is presented. PMID:28664161

ANFIS multi criteria decision making for overseas construction projects: a methodology

NASA Astrophysics Data System (ADS)

Utama, W. P.; Chan, A. P. C.; Zulherman; Zahoor, H.; Gao, R.; Jumas, D. Y.

2018-02-01

A critical part when a company targeting a foreign market is how to make a better decision in connection with potential project selection. Since different attributes of information are often incomplete, imprecise and ill-defined in overseas projects selection, the process of decision making by relying on the experiences and intuition is a risky attitude. This paper aims to demonstrate a decision support method in deciding overseas construction projects (OCPs). An Adaptive Neuro-Fuzzy Inference System (ANFIS), the amalgamation of Neural Network and Fuzzy Theory, was used as decision support tool to decide to go or not go on OCPs. Root mean square error (RMSE) and coefficient of correlation (R) were employed to identify the ANFIS system indicating an optimum and efficient result. The optimum result was obtained from ANFIS network with two input membership functions, Gaussian membership function (gaussmf) and hybrid optimization method. The result shows that ANFIS may help the decision-making process for go/not go decision in OCPs.

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

PubMed Central

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

2013-01-01

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

Identification of the Criteria for Decision Making of Cut-Away Peatland Reuse

NASA Astrophysics Data System (ADS)

Padur, Kadi; Ilomets, Mati; Põder, Tõnis

2017-03-01

The total area of abandoned milled peatlands which need to be rehabilitated for sustainable land-use is nearly 10,000 ha in Estonia. According to the agreement between Estonia and the European Union, Estonia has to create suitable conditions for restoration of 2000 ha of abandoned cut-away peatlands by 2023. The decisions on rehabilitation of abandoned milled peatlands have so far relied on a limited knowledgebase with unestablished methodologies, thus the decision making process needs a significant improvement. This study aims to improve the methodology by identifying the criteria for optimal decision making to ensure sustainable land use planning after peat extraction. Therefore relevant environmental, social and economic restrictive and weighted comparison criteria, which assess reuse alternatives suitability for achieving the goal, is developed in cooperation with stakeholders. Restrictive criteria are arranged into a decision tree to help to determine the implementable reuse alternatives in various situations. Weighted comparison criteria are developed in cooperation with stakeholders to rank the reuse alternatives. The comparison criteria are organised hierarchically into a value tree. In the situation, where the selection of a suitable rehabilitation alternative for a specific milled peatland is going to be made, the weighted comparison criteria values need to be identified and the presented approach supports the optimal and transparent decision making. In addition to Estonian context the general results of the study could also be applied to a cut-away peatlands in other regions with need-based site-dependent modifications of criteria values and weights.

Identification of the Criteria for Decision Making of Cut-Away Peatland Reuse.

PubMed

Padur, Kadi; Ilomets, Mati; Põder, Tõnis

2017-03-01

The total area of abandoned milled peatlands which need to be rehabilitated for sustainable land-use is nearly 10,000 ha in Estonia. According to the agreement between Estonia and the European Union, Estonia has to create suitable conditions for restoration of 2000 ha of abandoned cut-away peatlands by 2023. The decisions on rehabilitation of abandoned milled peatlands have so far relied on a limited knowledgebase with unestablished methodologies, thus the decision making process needs a significant improvement. This study aims to improve the methodology by identifying the criteria for optimal decision making to ensure sustainable land use planning after peat extraction. Therefore relevant environmental, social and economic restrictive and weighted comparison criteria, which assess reuse alternatives suitability for achieving the goal, is developed in cooperation with stakeholders. Restrictive criteria are arranged into a decision tree to help to determine the implementable reuse alternatives in various situations. Weighted comparison criteria are developed in cooperation with stakeholders to rank the reuse alternatives. The comparison criteria are organised hierarchically into a value tree. In the situation, where the selection of a suitable rehabilitation alternative for a specific milled peatland is going to be made, the weighted comparison criteria values need to be identified and the presented approach supports the optimal and transparent decision making. In addition to Estonian context the general results of the study could also be applied to a cut-away peatlands in other regions with need-based site-dependent modifications of criteria values and weights.

Decision-Oriented Health Technology Assessment: One Step Forward in Supporting the Decision-Making Process in Hospitals.

PubMed

Ritrovato, Matteo; Faggiano, Francesco C; Tedesco, Giorgia; Derrico, Pietro

2015-06-01

This article outlines the Decision-Oriented Health Technology Assessment: a new implementation of the European network for Health Technology Assessment Core Model, integrating the multicriteria decision-making analysis by using the analytic hierarchy process to introduce a standardized methodological approach as a valued and shared tool to support health care decision making within a hospital. Following the Core Model as guidance (European network for Health Technology Assessment. HTA core model for medical and surgical interventions. Available from: http://www.eunethta.eu/outputs/hta-core-model-medical-and-surgical-interventions-10r. [Accessed May 27, 2014]), it is possible to apply the analytic hierarchy process to break down a problem into its constituent parts and identify priorities (i.e., assigning a weight to each part) in a hierarchical structure. Thus, it quantitatively compares the importance of multiple criteria in assessing health technologies and how the alternative technologies perform in satisfying these criteria. The verbal ratings are translated into a quantitative form by using the Saaty scale (Saaty TL. Decision making with the analytic hierarchy process. Int J Serv Sci 2008;1:83-98). An eigenvectors analysis is used for deriving the weights' systems (i.e., local and global weights' system) that reflect the importance assigned to the criteria and the priorities related to the performance of the alternative technologies. Compared with the Core Model, this methodological approach supplies a more timely as well as contextualized evidence for a specific technology, making it possible to obtain data that are more relevant and easier to interpret, and therefore more useful for decision makers to make investment choices with greater awareness. We reached the conclusion that although there may be scope for improvement, this implementation is a step forward toward the goal of building a "solid bridge" between the scientific evidence and the final decision maker's choice. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Patient-reported outcomes in randomised controlled trials of prostate cancer: methodological quality and impact on clinical decision making.

PubMed

Efficace, Fabio; Feuerstein, Michael; Fayers, Peter; Cafaro, Valentina; Eastham, James; Pusic, Andrea; Blazeby, Jane

2014-09-01

Patient-reported outcomes (PRO) data from randomised controlled trials (RCTs) are increasingly used to inform patient-centred care as well as clinical and health policy decisions. The main objective of this study was to investigate the methodological quality of PRO assessment in RCTs of prostate cancer (PCa) and to estimate the likely impact of these studies on clinical decision making. A systematic literature search of studies was undertaken on main electronic databases to retrieve articles published between January 2004 and March 2012. RCTs were evaluated on a predetermined extraction form, including (1) basic trial demographics and clinical and PRO characteristics; (2) level of PRO reporting based on the recently published recommendations by the International Society for Quality of Life Research; and (3) bias, assessed using the Cochrane Risk of Bias tool. Studies were systematically analysed to evaluate their relevance for supporting clinical decision making. Sixty-five RCTs enrolling a total of 22 071 patients were evaluated, with 31 (48%) in patients with nonmetastatic disease. When a PRO difference between treatments was found, it related in most cases to symptoms only (n=29, 58%). Although the extent of missing data was generally documented (72% of RCTs), few reported details on statistical handling of this data (18%) and reasons for dropout (35%). Improvements in key methodological aspects over time were found. Thirteen (20%) RCTs were judged as likely to be robust in informing clinical decision making. Higher-quality PRO studies were generally associated with those RCTs that had higher internal validity. Including PRO in RCTs of PCa patients is critical for better evaluating the treatment effectiveness of new therapeutic approaches. Marked improvements in PRO quality reporting over time were found, and it is estimated that at least one-fifth of PRO RCTs have provided sufficient details to allow health policy makers and physicians to make critical appraisals of results. In this report, we have investigated the methodological quality of PCa trials that have included a PRO assessment. We conclude that including PRO is critical to better evaluating the treatment effectiveness of new therapeutic approaches from the patient's perspective. Also, at least one-fifth of PRO RCTs in PCa have provided sufficient details to allow health policy makers and physicians to make a critical appraisal of results. Copyright © 2013. Published by Elsevier B.V.

Cost-Utility Analysis: Current Methodological Issues and Future Perspectives

PubMed Central

Nuijten, Mark J. C.; Dubois, Dominique J.

2011-01-01

The use of cost–effectiveness as final criterion in the reimbursement process for listing of new pharmaceuticals can be questioned from a scientific and policy point of view. There is a lack of consensus on main methodological issues and consequently we may question the appropriateness of the use of cost–effectiveness data in health care decision-making. Another concern is the appropriateness of the selection and use of an incremental cost–effectiveness threshold (Cost/QALY). In this review, we focus mainly on only some key methodological concerns relating to discounting, the utility concept, cost assessment, and modeling methodologies. Finally we will consider the relevance of some other important decision criteria, like social values and equity. PMID:21713127

An Analysis of Category Management of Service Contracts

DTIC Science & Technology

2017-12-01

management teams a way to make informed , data-driven decisions. Data-driven decisions derived from clustering not only align with Category...savings. Furthermore, this methodology provides a data-driven visualization to inform sound business decisions on potential Category Management ...Category Management initiatives. The Maptitude software will allow future research to collect data and develop visualizations to inform Category

Methodology for studying recreation choice behavior with emphasis on grounded inquiry

Treesearch

Kent B. Downing; Roger N. Clark

1985-01-01

This paper reports methodology for investigating recreation choice behavior using grounded, naturalistic research methods. How these techniques can be coordinated with other social research methods is described. Naturalistic methods are preferred over other approaches to uncover recreationists' decision making processes at work.

Simulation software: engineer processes before reengineering.

PubMed

Lepley, C J

2001-01-01

People make decisions all the time using intuition. But what happens when you are asked: "Are you sure your predictions are accurate? How much will a mistake cost? What are the risks associated with this change?" Once a new process is engineered, it is difficult to analyze what would have been different if other options had been chosen. Simulating a process can help senior clinical officers solve complex patient flow problems and avoid wasted efforts. Simulation software can give you the data you need to make decisions. The author introduces concepts, methodologies, and applications of computer aided simulation to illustrate their use in making decisions to improve workflow design.

Ensemble modelling and structured decision-making to support Emergency Disease Management.

PubMed

Webb, Colleen T; Ferrari, Matthew; Lindström, Tom; Carpenter, Tim; Dürr, Salome; Garner, Graeme; Jewell, Chris; Stevenson, Mark; Ward, Michael P; Werkman, Marleen; Backer, Jantien; Tildesley, Michael

2017-03-01

Epidemiological models in animal health are commonly used as decision-support tools to understand the impact of various control actions on infection spread in susceptible populations. Different models contain different assumptions and parameterizations, and policy decisions might be improved by considering outputs from multiple models. However, a transparent decision-support framework to integrate outputs from multiple models is nascent in epidemiology. Ensemble modelling and structured decision-making integrate the outputs of multiple models, compare policy actions and support policy decision-making. We briefly review the epidemiological application of ensemble modelling and structured decision-making and illustrate the potential of these methods using foot and mouth disease (FMD) models. In case study one, we apply structured decision-making to compare five possible control actions across three FMD models and show which control actions and outbreak costs are robustly supported and which are impacted by model uncertainty. In case study two, we develop a methodology for weighting the outputs of different models and show how different weighting schemes may impact the choice of control action. Using these case studies, we broadly illustrate the potential of ensemble modelling and structured decision-making in epidemiology to provide better information for decision-making and outline necessary development of these methods for their further application. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Clinical, information and business process modeling to promote development of safe and flexible software.

PubMed

Liaw, Siaw-Teng; Deveny, Elizabeth; Morrison, Iain; Lewis, Bryn

2006-09-01

Using a factorial vignette survey and modeling methodology, we developed clinical and information models - incorporating evidence base, key concepts, relevant terms, decision-making and workflow needed to practice safely and effectively - to guide the development of an integrated rule-based knowledge module to support prescribing decisions in asthma. We identified workflows, decision-making factors, factor use, and clinician information requirements. The Unified Modeling Language (UML) and public domain software and knowledge engineering tools (e.g. Protégé) were used, with the Australian GP Data Model as the starting point for expressing information needs. A Web Services service-oriented architecture approach was adopted within which to express functional needs, and clinical processes and workflows were expressed in the Business Process Execution Language (BPEL). This formal analysis and modeling methodology to define and capture the process and logic of prescribing best practice in a reference implementation is fundamental to tackling deficiencies in prescribing decision support software.

Investment decision making in the health care industry: the future.

PubMed Central

Long, H W

1979-01-01

The economic and political environment in which providers of health care will operate during the 1980s will continue to be increasingly restrictive. Any private-sector organization's long-run survival depends directly on the quality of its investment decisions, broadly defined. This decision making will require three major innovations if private sector health care providers are to survive: 1) traditional biases about the economics of not-for-profit entities must be abandoned; 2) standard data, procedures, and personnel from the accounting discipline must be supplemented with information, methodologies, and people from the discipline of corporate finance; and 3) economic and fiscal risk must be measured and incorporated into both investment decisions and interactions with external regulators. Practitioners can begin to implement these innovations immediately. Although substantial literature exists developing all these concepts generally and applying them to for-profit settings, the literature purporting to treat investment decision making for private-sector health care providers is, on average, replete with conceptual error, simplistic thinking, erroneous applications, and out-of-date methodologies. The literature is, in a word, horrid. Authors, both practitioner and academic, should stop writing terrible books and booklike periodicals for easy royalty dollars, and, instead, pursue sound applied research and disseminate their results in classrooms and in refereed journals. PMID:391771

Assessing Campus Climates for Lesbian, Gay, Bisexual and Transgender (LGBT) Students: Methodological and Political Issues

ERIC Educational Resources Information Center

Brown, Robert D.; Gortmaker, Valerie J.

2009-01-01

Methodological and political issues arise during the designing, conducting, and reporting of campus-climate studies for LGBT students. These issues interact; making a decision about a methodological issue (e.g., sample size) has an impact on a political issue (e.g., how well the findings will be received). Ten key questions that must be addressed…

The enactment stage of end-of-life decision-making for children.

PubMed

Sullivan, Jane Elizabeth; Gillam, Lynn Heather; Monagle, Paul Terence

2018-01-11

Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process. A qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed. Twenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child's condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people's actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention. Significance of results A novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular emotional and practical implications for parents. Greater understanding of this stage can improve clinician's support for parents as they care for their child.

Use of economic evaluation in decision making: evidence and recommendations for improvement.

PubMed

Simoens, Steven

2010-10-22

Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives. These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.

A Design Pattern for Decentralised Decision Making

PubMed Central

Valentini, Gabriele; Fernández-Oto, Cristian; Dorigo, Marco

2015-01-01

The engineering of large-scale decentralised systems requires sound methodologies to guarantee the attainment of the desired macroscopic system-level behaviour given the microscopic individual-level implementation. While a general-purpose methodology is currently out of reach, specific solutions can be given to broad classes of problems by means of well-conceived design patterns. We propose a design pattern for collective decision making grounded on experimental/theoretical studies of the nest-site selection behaviour observed in honeybee swarms (Apis mellifera). The way in which honeybee swarms arrive at consensus is fairly well-understood at the macroscopic level. We provide formal guidelines for the microscopic implementation of collective decisions to quantitatively match the macroscopic predictions. We discuss implementation strategies based on both homogeneous and heterogeneous multiagent systems, and we provide means to deal with spatial and topological factors that have a bearing on the micro-macro link. Finally, we exploit the design pattern in two case studies that showcase the viability of the approach. Besides engineering, such a design pattern can prove useful for a deeper understanding of decision making in natural systems thanks to the inclusion of individual heterogeneities and spatial factors, which are often disregarded in theoretical modelling. PMID:26496359

Value of Information and Prospect theory as tools to involve decision-makers in water-related design, operation and planning of water systems

NASA Astrophysics Data System (ADS)

Alfonso, Leonardo

2013-04-01

The role of decision-makers is to take the outputs from hydrological and hydraulic analyses and, in some extent, use them as inputs to make decisions that are related to planning, design and operation of water systems. However, the use of these technical analyses is frequently limited, since there are other non-hydrological issues that must be considered, that may end up in very different solutions than those envisaged by the purely technical ones. A possibility to account for the nature of the human decisions under uncertainty is by exploring the use of concepts from decision theory and behavioural economics, such as Value of Information and Prospect Theory and embed them into the methodologies we use in the hydrology practice. Three examples are presented to illustrate these multidisciplinary interactions. The first one, for monitoring network design, uses Value of Information within a methodology to locate water level stations in a complex canal of networks in the Netherlands. The second example, for operation, shows how the Value of Information concept can be used to formulate alternative methods to evaluate flood risk according to the set of options available for decision-making during a flood event. The third example, for planning, uses Prospect Theory concepts to understand how the "losses hurt more than gains feel good" effect can determine the final decision of urbanise or not a flood-prone area. It is demonstrated that decision theory and behavioural economic principles are promising to evaluate the complex decision-making process in water-related issues.

Age differences in decision making: a process methodology for examining strategic information processing.

PubMed

Johnson, M M

1990-03-01

This study explored the use of process tracing techniques in examining the decision-making processes of older and younger adults. Thirty-six college-age and thirty-six retirement-age participants decided which one of six cars they would purchase on the basis of computer-accessed data. They provided information search protocols. Results indicate that total time to reach a decision did not differ according to age. However, retirement-age participants used less information, spent more time viewing, and re-viewed fewer bits of information than college-age participants. Information search patterns differed markedly between age groups. Patterns of retirement-age adults indicated their use of noncompensatory decision rules which, according to decision-making literature (Payne, 1976), reduce cognitive processing demands. The patterns of the college-age adults indicated their use of compensatory decision rules, which have higher processing demands.

What are the best methodologies for rapid reviews of the research evidence for evidence-informed decision making in health policy and practice: a rapid review.

PubMed

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Barreto, Jorge; Reveiz, Ludovic; Lavis, John N

2016-11-25

Rapid reviews have the potential to overcome a key barrier to the use of research evidence in decision making, namely that of the lack of timely and relevant research. This rapid review of systematic reviews and primary studies sought to answer the question: What are the best methodologies to enable a rapid review of research evidence for evidence-informed decision making in health policy and practice? This rapid review utilised systematic review methods and was conducted according to a pre-defined protocol including clear inclusion criteria (PROSPERO registration: CRD42015015998). A comprehensive search strategy was used, including published and grey literature, written in English, French, Portuguese or Spanish, from 2004 onwards. Eleven databases and two websites were searched. Two review authors independently applied the eligibility criteria. Data extraction was done by one reviewer and checked by a second. The methodological quality of included studies was assessed independently by two reviewers. A narrative summary of the results is presented. Five systematic reviews and one randomised controlled trial (RCT) that investigated methodologies for rapid reviews met the inclusion criteria. None of the systematic reviews were of sufficient quality to allow firm conclusions to be made. Thus, the findings need to be treated with caution. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting rapid reviews. While a wide range of 'shortcuts' are used to make rapid reviews faster than a full systematic review, the included studies found little empirical evidence of their impact on the conclusions of either rapid or systematic reviews. There is some evidence from the included RCT (that had a low risk of bias) that rapid reviews may improve clarity and accessibility of research evidence for decision makers. Greater care needs to be taken in improving the transparency of the methods used in rapid review products. There is no evidence available to suggest that rapid reviews should not be done or that they are misleading in any way. We offer an improved definition of rapid reviews to guide future research as well as clearer guidance for policy and practice.

Value-Based Assessment of New Medical Technologies: Towards a Robust Methodological Framework for the Application of Multiple Criteria Decision Analysis in the Context of Health Technology Assessment.

PubMed

Angelis, Aris; Kanavos, Panos

2016-05-01

In recent years, multiple criteria decision analysis (MCDA) has emerged as a likely alternative to address shortcomings in health technology assessment (HTA) by offering a more holistic perspective to value assessment and acting as an alternative priority setting tool. In this paper, we argue that MCDA needs to subscribe to robust methodological processes related to the selection of objectives, criteria and attributes in order to be meaningful in the context of healthcare decision making and fulfil its role in value-based assessment (VBA). We propose a methodological process, based on multi-attribute value theory (MAVT) methods comprising five distinct phases, outline the stages involved in each phase and discuss their relevance in the HTA process. Importantly, criteria and attributes need to satisfy a set of desired properties, otherwise the outcome of the analysis can produce spurious results and misleading recommendations. Assuming the methodological process we propose is adhered to, the application of MCDA presents three very distinct advantages to decision makers in the context of HTA and VBA: first, it acts as an instrument for eliciting preferences on the performance of alternative options across a wider set of explicit criteria, leading to a more complete assessment of value; second, it allows the elicitation of preferences across the criteria themselves to reflect differences in their relative importance; and, third, the entire process of preference elicitation can be informed by direct stakeholder engagement, and can therefore reflect their own preferences. All features are fully transparent and facilitate decision making.

Facts and fiction of learning systems. [decision making intelligent control

NASA Technical Reports Server (NTRS)

Saridis, G. N.

1975-01-01

The methodology that will provide the updated precision for the hardware control and the advanced decision making and planning in the software control is called learning systems and intelligent control. It was developed theoretically as an alternative for the nonsystematic heuristic approaches of artificial intelligence experiments and the inflexible formulation of modern optimal control methods. Its basic concepts are discussed and some feasibility studies of some practical applications are presented.

Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM).

PubMed

Balneaves, Lynda G; Truant, Tracy L O; Kelly, Mary; Verhoef, Marja J; Davison, B Joyce

2007-08-01

The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies. Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process. The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together. Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.

Spatial planning using probabilistic flood maps

NASA Astrophysics Data System (ADS)

Alfonso, Leonardo; Mukolwe, Micah; Di Baldassarre, Giuliano

2015-04-01

Probabilistic flood maps account for uncertainty in flood inundation modelling and convey a degree of certainty in the outputs. Major sources of uncertainty include input data, topographic data, model structure, observation data and parametric uncertainty. Decision makers prefer less ambiguous information from modellers; this implies that uncertainty is suppressed to yield binary flood maps. Though, suppressing information may potentially lead to either surprise or misleading decisions. Inclusion of uncertain information in the decision making process is therefore desirable and transparent. To this end, we utilise the Prospect theory and information from a probabilistic flood map to evaluate potential decisions. Consequences related to the decisions were evaluated using flood risk analysis. Prospect theory explains how choices are made given options for which probabilities of occurrence are known and accounts for decision makers' characteristics such as loss aversion and risk seeking. Our results show that decision making is pronounced when there are high gains and loss, implying higher payoffs and penalties, therefore a higher gamble. Thus the methodology may be appropriately considered when making decisions based on uncertain information.

Decision Making Methodology to Mitigate Damage From Glacial Lake Outburst Floods From Imja Lake in Nepal

NASA Astrophysics Data System (ADS)

McKinney, D. C.; Cuellar, A. D.

2015-12-01

Climate change has accelerated glacial retreat in high altitude glaciated regions of Nepal leading to the growth and formation of glacier lakes. Glacial lake outburst floods (GLOF) are sudden events triggered by an earthquake, moraine failure or other shock that causes a sudden outflow of water. These floods are catastrophic because of their sudden onset, the difficulty predicting them, and enormous quantity of water and debris rapidly flooding downstream areas. Imja Lake in the Himalaya of Nepal has experienced accelerated growth since it first appeared in the 1960s. Communities threatened by a flood from Imja Lake have advocated for projects to adapt to the increasing threat of a GLOF. Nonetheless, discussions surrounding projects for Imja have not included a rigorous analysis of the potential consequences of a flood, probability of an event, or costs of mitigation projects in part because this information is unknown or uncertain. This work presents a demonstration of a decision making methodology developed to rationally analyze the risks posed by Imja Lake and the various adaptation projects proposed using available information. In this work the authors use decision analysis, data envelopement analysis (DEA), and sensitivity analysis to assess proposed adaptation measures that would mitigate damage in downstream communities from a GLOF. We use an existing hydrodynamic model of the at-risk area to determine how adaptation projects will affect downstream flooding and estimate fatalities using an empirical method developed for dam failures. The DEA methodology allows us to estimate the value of a statistical life implied by each project given the cost of the project and number of lives saved to determine which project is the most efficient. In contrast the decision analysis methodology requires fatalities to be assigned a cost but allows the inclusion of uncertainty in the decision making process. We compare the output of these two methodologies and determine the sensitivity of the conclusions to changes in uncertain input parameters including project cost, value of a statistical life, and time to a GLOF event.

Beyond Composite Scores and Cronbach's Alpha: Advancing Methodological Rigor in Recreation Research

ERIC Educational Resources Information Center

Gagnon, Ryan J.; Stone, Garrett A.; Garst, Barry A.

2017-01-01

Critically examining common statistical approaches and their strengths and weaknesses is an important step in advancing recreation and leisure sciences. To continue this critical examination and to inform methodological decision making, this study compared three approaches to determine how alternative approaches may result in contradictory…

Development of a requirements management system for technical decision - making processes in the geological disposal project

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

Hiroyoshi Ueda; Katsuhiko Ishiguro; Kazumi Kitayama

2007-07-01

NUMO (Nuclear Waste Management Organization of Japan) has a responsibility for implementing geological disposal of vitrified HLW (High-Level radioactive Waste) in the Japanese nuclear waste management programme. Its staged siting procedure was initiated in 2002 by an open call for volunteer sites. Careful management strategy and methodology for the technical decision-making at every milestone are required to prepare for the volunteer site application and the site investigation stages after that. The formal Requirement Management System (RMS) is planned to support the computerized implementation of the specific management methodology, termed the NUMO Structured Approach (NSA). This planned RMS will help formore » comprehensive management of the decision-making processes in the geological disposal project, change management towards the anticipated project deviations, efficient project driving such as well programmed R and D etc. and structured record-keeping regarding the past decisions, which leads to soundness of the project in terms of the long-term continuity. The system should have handling/management functions for the database including the decisions/requirements in the project in consideration, their associated information and the structures composed of them in every decision-making process. The information relating to the premises, boundary conditions and time plan of the project should also be prepared in the system. Effective user interface and efficient operation on the in-house network are necessary. As a living system for the long-term formal use, flexibility to updating is indispensable. In advance of the formal system development, two-year activity to develop the preliminary RMS was already started. The purpose of this preliminary system is to template the decision/requirement structure, prototype the decision making management and thus show the feasibility of the innovative RMS. The paper describes the current status of the development, focusing on the initial stage including work analysis/modeling and the system conceptualization. (authors)« less

What lies behind crop decisions?Coming to terms with revealing farmers' preferences

NASA Astrophysics Data System (ADS)

Gomez, C.; Gutierrez, C.; Pulido-Velazquez, M.; López Nicolás, A.

2016-12-01

The paper offers a fully-fledged applied revealed preference methodology to screen and represent farmers' choices as the solution of an optimal program involving trade-offs among the alternative welfare outcomes of crop decisions such as profits, income security and management easiness. The recursive two-stage method is proposed as an alternative to cope with the methodological problems inherent to common practice positive mathematical program methodologies (PMP). Differently from PMP, in the model proposed in this paper, the non-linear costs that are required for both calibration and smooth adjustment are not at odds with the assumptions of linear Leontief technologies and fixed crop prices and input costs. The method frees the model from ad-hoc assumptions about costs and then recovers the potential of economic analysis as a means to understand the rationale behind observed and forecasted farmers' decisions and then to enhance the potential of the model to support policy making in relevant domains such as agricultural policy, water management, risk management and climate change adaptation. After the introduction, where the methodological drawbacks and challenges are set up, section two presents the theoretical model, section three develops its empirical application and presents its implementation to a Spanish irrigation district and finally section four concludes and makes suggestions for further research.

Teacher Judgments of Students' Reading Abilities across a Continuum of Rating Methods and Achievement Measures

ERIC Educational Resources Information Center

Begeny, John C.; Krouse, Hailey E.; Brown, Kristina G.; Mann, Courtney M.

2011-01-01

Teacher judgments about students' academic abilities are important for instructional decision making and potential special education entitlement decisions. However, the small number of studies evaluating teachers' judgments are limited methodologically (e.g., sample size, procedural sophistication) and have yet to answer important questions…

How Do Raters Judge Spoken Vocabulary?

ERIC Educational Resources Information Center

Li, Hui

2016-01-01

The aim of the study was to investigate how raters come to their decisions when judging spoken vocabulary. Segmental rating was introduced to quantify raters' decision-making process. It is hoped that this simulated study brings fresh insight to future methodological considerations with spoken data. Twenty trainee raters assessed five Chinese…

Multiple Criteria Decision-Making Techniques in Higher Education

ERIC Educational Resources Information Center

Ho, William; Dey, Prasanta K.; Higson, Helen E.

2006-01-01

Purpose: The purpose of this paper is to review the literature which focuses on four major higher education decision problems. These are: resource allocation; performance measurement; budgeting; and scheduling. Design/methodology/approach: Related articles appearing in the international journals from 1996 to 2005 are gathered and analyzed so that…

Applying Generalizability Theory for Making Quantitative RTI Progress-Monitoring Decisions

ERIC Educational Resources Information Center

Fan, Chung-Hau; Hansmann, Paul R.

2015-01-01

Language in the Individuals With Disabilities Education Improvement Act (IDEIA) allows the use of response-to-intervention (RTI) methodology in the identification of specific learning disabilities. However, there is no consensus on decision rules using curriculum-based measurement of oral reading fluency (CBM-R) for defining responsiveness. The…

The quality of instruments to assess the process of shared decision making: A systematic review.

PubMed

Gärtner, Fania R; Bomhof-Roordink, Hanna; Smith, Ian P; Scholl, Isabelle; Stiggelbout, Anne M; Pieterse, Arwen H

2018-01-01

To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument's content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations.

Modeling Common-Sense Decisions in Artificial Intelligence

NASA Technical Reports Server (NTRS)

Zak, Michail

2010-01-01

A methodology has been conceived for efficient synthesis of dynamical models that simulate common-sense decision- making processes. This methodology is intended to contribute to the design of artificial-intelligence systems that could imitate human common-sense decision making or assist humans in making correct decisions in unanticipated circumstances. This methodology is a product of continuing research on mathematical models of the behaviors of single- and multi-agent systems known in biology, economics, and sociology, ranging from a single-cell organism at one extreme to the whole of human society at the other extreme. Earlier results of this research were reported in several prior NASA Tech Briefs articles, the three most recent and relevant being Characteristics of Dynamics of Intelligent Systems (NPO -21037), NASA Tech Briefs, Vol. 26, No. 12 (December 2002), page 48; Self-Supervised Dynamical Systems (NPO-30634), NASA Tech Briefs, Vol. 27, No. 3 (March 2003), page 72; and Complexity for Survival of Living Systems (NPO- 43302), NASA Tech Briefs, Vol. 33, No. 7 (July 2009), page 62. The methodology involves the concepts reported previously, albeit viewed from a different perspective. One of the main underlying ideas is to extend the application of physical first principles to the behaviors of living systems. Models of motor dynamics are used to simulate the observable behaviors of systems or objects of interest, and models of mental dynamics are used to represent the evolution of the corresponding knowledge bases. For a given system, the knowledge base is modeled in the form of probability distributions and the mental dynamics is represented by models of the evolution of the probability densities or, equivalently, models of flows of information. Autonomy is imparted to the decisionmaking process by feedback from mental to motor dynamics. This feedback replaces unavailable external information by information stored in the internal knowledge base. Representation of the dynamical models in a parameterized form reduces the task of common-sense-based decision making to a solution of the following hetero-associated-memory problem: store a set of m predetermined stochastic processes given by their probability distributions in such a way that when presented with an unexpected change in the form of an input out of the set of M inputs, the coupled motormental dynamics converges to the corresponding one of the m pre-assigned stochastic process, and a sample of this process represents the decision.

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

PubMed Central

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

2008-01-01

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

Translational cognition for decision support in critical care environments: a review.

PubMed

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

2008-06-01

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

Give Design a Chance: A Case for a Human Centered Approach to Operational Art

DTIC Science & Technology

2017-03-30

strategy development and operational art. This demands fuller integration of the Army Design Methodology (ADM) and the Military Decision Making Process...MDMP). This monograph proposes a way of thinking and planning that goes beyond current Army doctrinal methodologies to address the changing...between conceptual and detailed planning. 15. SUBJECT TERMS Design; Army Design Methodology (ADM); Human Centered; Strategy; Operational Art

Adaptive Multi-scale Prognostics and Health Management for Smart Manufacturing Systems

PubMed Central

Choo, Benjamin Y.; Adams, Stephen C.; Weiss, Brian A.; Marvel, Jeremy A.; Beling, Peter A.

2017-01-01

The Adaptive Multi-scale Prognostics and Health Management (AM-PHM) is a methodology designed to enable PHM in smart manufacturing systems. In application, PHM information is not yet fully utilized in higher-level decision-making in manufacturing systems. AM-PHM leverages and integrates lower-level PHM information such as from a machine or component with hierarchical relationships across the component, machine, work cell, and assembly line levels in a manufacturing system. The AM-PHM methodology enables the creation of actionable prognostic and diagnostic intelligence up and down the manufacturing process hierarchy. Decisions are then made with the knowledge of the current and projected health state of the system at decision points along the nodes of the hierarchical structure. To overcome the issue of exponential explosion of complexity associated with describing a large manufacturing system, the AM-PHM methodology takes a hierarchical Markov Decision Process (MDP) approach into describing the system and solving for an optimized policy. A description of the AM-PHM methodology is followed by a simulated industry-inspired example to demonstrate the effectiveness of AM-PHM. PMID:28736651

Scalable methodology for large scale building energy improvement: Relevance of calibration in model-based retrofit analysis

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

Heo, Yeonsook; Augenbroe, Godfried; Graziano, Diane

2015-05-01

The increasing interest in retrofitting of existing buildings is motivated by the need to make a major contribution to enhancing building energy efficiency and reducing energy consumption and CO2 emission by the built environment. This paper examines the relevance of calibration in model-based analysis to support decision-making for energy and carbon efficiency retrofits of individual buildings and portfolios of buildings. The authors formulate a set of real retrofit decision-making situations and evaluate the role of calibration by using a case study that compares predictions and decisions from an uncalibrated model with those of a calibrated model. The case study illustratesmore » both the mechanics and outcomes of a practical alternative to the expert- and time-intense application of dynamic energy simulation models for large-scale retrofit decision-making under uncertainty.« less

Building Capacity to Use Earth Observations in Decision Making: A Case Study of NASA's DEVELOP National Program Methods and Best Practices

NASA Astrophysics Data System (ADS)

Childs-Gleason, L. M.; Ross, K. W.; Crepps, G.; Miller, T. N.; Favors, J. E.; Rogers, L.; Allsbrook, K. N.; Bender, M. R.; Ruiz, M. L.

2015-12-01

NASA's DEVELOP National Program fosters an immersive research environment for dual capacity building. Through rapid feasibility Earth science projects, the future workforce and current decision makers are engaged in research projects to build skills and capabilities to use Earth observation in environmental management and policy making. DEVELOP conducts over 80 projects annually, successfully building skills through partnerships with over 150 organizations and providing over 350 opportunities for project participants each year. Filling a void between short-term training courses and long-term research projects, the DEVELOP model has been successful in supporting state, local, federal and international government organizations to adopt methodologies and enhance decision making processes. This presentation will highlight programmatic best practices, feedback from participants and partner organizations, and three sample case studies of successful adoption of methods in the decision making process.

Current Challenges in Health Economic Modeling of Cancer Therapies: A Research Inquiry

PubMed Central

Miller, Jeffrey D.; Foley, Kathleen A.; Russell, Mason W.

2014-01-01

Background The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology. Objectives We sought to explore some of the contentious issues associated with the development and use of oncology economic models as informative tools in current healthcare decision-making. Our objective was to draw attention to these complex pharmacoeconomic concerns and to promote discussion within the oncology and health economics research communities. Methods Using our combined expertise in health economics research and economic modeling, we structured our inquiry around the following 4 questions: (1) Are economic models adequately addressing questions relevant to oncology decision makers; (2) What are the methodologic limitations of oncology economic models; (3) What guidelines are followed for developing oncology economic models; and (4) Is the evolution of oncology economic modeling keeping pace with treatment innovation? Within the context of each of these questions, we discuss issues related to the technical limitations of oncology modeling, the availability of adequate data for developing models, and the problems with how modeling analyses and results are presented and interpreted. Discussion There is general acceptance that economic models are good, essential tools for decision-making, but the practice of oncology and its rapidly evolving technologies present unique challenges that make assessing and demonstrating value especially complex. There is wide latitude for improvement in oncology modeling methodologies and how model results are presented and interpreted. Conclusion Complex technical and data availability issues with oncology economic modeling pose serious concerns that need to be addressed. It is our hope that this article will provide a framework to guide future discourse on this important topic. PMID:24991399

Current challenges in health economic modeling of cancer therapies: a research inquiry.

PubMed

Miller, Jeffrey D; Foley, Kathleen A; Russell, Mason W

2014-05-01

The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology. We sought to explore some of the contentious issues associated with the development and use of oncology economic models as informative tools in current healthcare decision-making. Our objective was to draw attention to these complex pharmacoeconomic concerns and to promote discussion within the oncology and health economics research communities. Using our combined expertise in health economics research and economic modeling, we structured our inquiry around the following 4 questions: (1) Are economic models adequately addressing questions relevant to oncology decision makers; (2) What are the methodologic limitations of oncology economic models; (3) What guidelines are followed for developing oncology economic models; and (4) Is the evolution of oncology economic modeling keeping pace with treatment innovation? Within the context of each of these questions, we discuss issues related to the technical limitations of oncology modeling, the availability of adequate data for developing models, and the problems with how modeling analyses and results are presented and interpreted. There is general acceptance that economic models are good, essential tools for decision-making, but the practice of oncology and its rapidly evolving technologies present unique challenges that make assessing and demonstrating value especially complex. There is wide latitude for improvement in oncology modeling methodologies and how model results are presented and interpreted. Complex technical and data availability issues with oncology economic modeling pose serious concerns that need to be addressed. It is our hope that this article will provide a framework to guide future discourse on this important topic.

Linking data to decision-making: applying qualitative data analysis methods and software to identify mechanisms for using outcomes data.

PubMed

Patel, Vaishali N; Riley, Anne W

2007-10-01

A multiple case study was conducted to examine how staff in child out-of-home care programs used data from an Outcomes Management System (OMS) and other sources to inform decision-making. Data collection consisted of thirty-seven semi-structured interviews with clinicians, managers, and directors from two treatment foster care programs and two residential treatment centers, and individuals involved with developing the OMS; and observations of clinical and quality management meetings. Case study and grounded theory methodology guided analyses. The application of qualitative data analysis software is described. Results show that although staff rarely used data from the OMS, they did rely on other sources of systematically collected information to inform clinical, quality management, and program decisions. Analyses of how staff used these data suggest that improving the utility of OMS will involve encouraging staff to participate in data-based decision-making, and designing and implementing OMS in a manner that reflects how decision-making processes operate.

Reaching a Consensus: Terminology and Concepts Used in Coordination and Decision-Making Research.

PubMed

Pyritz, Lennart W; King, Andrew J; Sueur, Cédric; Fichtel, Claudia

2011-12-01

Research on coordination and decision-making in humans and nonhuman primates has increased considerably throughout the last decade. However, terminology has been used inconsistently, hampering the broader integration of results from different studies. In this short article, we provide a glossary containing the central terms of coordination and decision-making research. The glossary is based on previous definitions that have been critically revised and annotated by the participants of the symposium "Where next? Coordination and decision-making in primate groups" at the XXIIIth Congress of the International Primatological Society (IPS) in Kyoto, Japan. We discuss a number of conceptual and methodological issues and highlight consequences for their implementation. In summary, we recommend that future studies on coordination and decision-making in animal groups do not use the terms "combined decision" and "democratic/despotic decision-making." This will avoid ambiguity as well as anthropocentric connotations. Further, we demonstrate the importance of 1) taxon-specific definitions of coordination parameters (initiation, leadership, followership, termination), 2) differentiation between coordination research on individual-level process and group-level outcome, 3) analyses of collective action processes including initiation and termination, and 4) operationalization of successful group movements in the field to collect meaningful and comparable data across different species.

Essential methodological considerations when using grounded theory.

PubMed

Achora, Susan; Matua, Gerald Amandu

2016-07-01

To suggest important methodological considerations when using grounded theory. A research method widely used in nursing research is grounded theory, at the centre of which is theory construction. However, researchers still struggle with some of its methodological issues. Although grounded theory is widely used to study and explain issues in nursing practice, many researchers are still failing to adhere to its rigorous standards. Researchers should articulate the focus of their investigations - the substantive area of interest as well as the focal population. This should be followed by a succinct explanation of the strategies used to collect and analyse data, supported by clear coding processes. Finally, the resolution of the core issues, including the core category and related categories, should be explained to advance readers' understanding. Researchers should endeavour to understand the tenets of grounded theory. This enables 'neophytes' in particular to make methodological decisions that will improve their studies' rigour and fit with grounded theory. This paper complements the current dialogue on improving the understanding of grounded theory methodology in nursing research. The paper also suggests important procedural decisions researchers need to make to preserve their studies' scientific merit and fit with grounded theory.

Policy capturing as a method of quantifying the determinants of landscape preference

Treesearch

Dennis B. Propst

1979-01-01

Policy Capturing, a potential methodology for evaluating landscape preference, was described and tested. This methodology results in a mathematical model that theoretically represents the human decision-making process. Under experimental conditions, judges were asked to express their preferences for scenes of the Blue Ridge Parkway. An equation which "captures,...

Tough Teens: The Methodological Challenges of Interviewing Teenagers as Research Participants

ERIC Educational Resources Information Center

Bassett, Raewyn; Beagan, Brenda L.; Ristovski-Slijepcevic, Svetlana; Chapman, Gwen E.

2008-01-01

Encouraging a teenager to have a conversation in a semistructured research interview is fraught with difficulties. The authors discuss the methodological challenges encountered when interviewing adolescents of European Canadian, African Canadian, and Punjabi Canadian families who took part in the Family Food Decision-Making Study in two regions of…

Methodological Approaches in Conducting Overviews: Current State in HTA Agencies

ERIC Educational Resources Information Center

Pieper, Dawid; Antoine, Sunya-Lee; Morfeld, Jana-Carina; Mathes, Tim; Eikermann, Michaela

2014-01-01

Objectives: Overviews search for reviews rather than for primary studies. They might have the potential to support decision making within a shorter time frame by reducing production time. We aimed to summarize available instructions for authors intending to conduct overviews as well as the currently applied methodology of overviews in…

Reducing Subjectivity in Geothermal Exploration Decision Making (Presentation); NREL(National Renewable Energy Laboratory)

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

Akar, S.; Young, K.

Geothermal exploration projects have a significant amount of risk associated with uncertainties encountered in the discovery of the geothermal resource. Two of the largest challenges for increased geothermal deployment are 1) understanding when and how to proceed in an exploration program, and 2) when to walk away from a site. Current methodologies for exploration decision-making are formulatedby subjective expert opinion which can be incorrectly biased by expertise (e.g. geochemistry, geophysics), geographic location of focus, and the assumed conceptual model. The aim of this project is to develop a methodology for more objective geothermal exploration decision making at a given location,more » including go/no-go decision points to help developers and investors decide when to give up on alocation. In this scope, two different approaches are investigated: 1) value of information analysis (VOIA) which is used for evaluating and quantifying the value of a data before they are purchased, and 2) enthalpy-based exploration targeting based on reservoir size, temperature gradient estimates, and internal rate of return (IRR). The first approach, VOIA, aims to identify the value of aparticular data when making decisions with an uncertain outcome. This approach targets the pre-drilling phase of exploration. These estimated VOIs are highly affected by the size of the project and still have a high degree of subjectivity in assignment of probabilities. The second approach, exploration targeting, is focused on decision making during the drilling phase. It starts with a basicgeothermal project definition that includes target and minimum required production capacity and initial budgeting for exploration phases. Then, it uses average temperature gradient, reservoir temperature estimates, and production capacity to define targets and go/no-go limits. The decision analysis in this approach is based on achieving a minimum IRR at each phase of the project. This secondapproach was determined to be less subjective, since numerical inputs come from the collected data. And it helps to facilitate communication between project managers and exploration geologists in making objective go/no-go decisions throughout the different project phases.« less

Do neonatologists limit parental decision-making authority? A Canadian perspective.

PubMed

Albersheim, Susan G; Lavoie, Pascal M; Keidar, Yaron D

2010-12-01

According to the principles of family-centered care, fully informed parents and health care professionals are partners in the care of sick neonates. The aim of this study was to assess the attitudes of Canadian neonatologists towards the authority of parents to make life-and-death decisions for their babies. We interviewed 121 (74%) of the 164 practicing neonatologists in Canada (June 2004-March 2005), using scripted open-ended questions and common clinical scenarios. Data analysis employed interpretive description methodology. The main outcome measure was the intention of neonatologists to limit parental life-and-death decision-making authority, when they disagree with parental decisions. Neonatologists' self-rated respect for parental decision-making authority was 8/10. Most neonatologists thought that parents should be either primary decision-makers or part of the decision-making team. Fifty-six percent of neonatologists would limit parental decision-making authority if the parents' decision is not in the baby's "best interest". In response to common neonatal severe illness scenarios, up to 18% of neonatologists said they would limit parental decision-making, even if the chance of intact survival is very poor. For clinical scenarios with equally poor long-term outcomes, neonatologists were more likely to comply with parental wishes early in the life of a baby, particularly with documented brain injury. Canadian neonatologists espouse high regard for parental decision-making authority, but are prepared to limit parental authority if the parents' decision is not thought to be in the baby's best interest. Although neonatologists advise parents that treatment can be started at birth, and stopped later, this was only for early severe brain injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

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.

Fuzzy Integration of Support Vector Regression Models for Anticipatory Control of Complex Energy Systems

DOE PAGES

Alamaniotis, Miltiadis; Agarwal, Vivek

2014-04-01

Anticipatory control systems are a class of systems whose decisions are based on predictions for the future state of the system under monitoring. Anticipation denotes intelligence and is an inherent property of humans that make decisions by projecting in future. Likewise, artificially intelligent systems equipped with predictive functions may be utilized for anticipating future states of complex systems, and therefore facilitate automated control decisions. Anticipatory control of complex energy systems is paramount to their normal and safe operation. In this paper a new intelligent methodology integrating fuzzy inference with support vector regression is introduced. Our proposed methodology implements an anticipatorymore » system aiming at controlling energy systems in a robust way. Initially a set of support vector regressors is adopted for making predictions over critical system parameters. Furthermore, the predicted values are fed into a two stage fuzzy inference system that makes decisions regarding the state of the energy system. The inference system integrates the individual predictions into a single one at its first stage, and outputs a decision together with a certainty factor computed at its second stage. The certainty factor is an index of the significance of the decision. The proposed anticipatory control system is tested on a real world set of data obtained from a complex energy system, describing the degradation of a turbine. Results exhibit the robustness of the proposed system in controlling complex energy systems.« less

Assessment of New Approaches in Geothermal Exploration Decision Making: Preprint

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

Akar, S.; Young, K. R.

Geothermal exploration projects have significant amount of risk associated with uncertainties encountered in the discovery of the geothermal resource. Understanding when and how to proceed in an exploration program, and when to walk away from a site, are two of the largest challenges for increased geothermal deployment. Current methodologies for exploration decision making is left to subjective by subjective expert opinion which can be incorrectly biased by expertise (e.g. geochemistry, geophysics), geographic location of focus, and the assumed conceptual model. The aim of this project is to develop a methodology for more objective geothermal exploration decision making at a givenmore » location, including go-no-go decision points to help developers and investors decide when to give up on a location. In this scope, two different approaches are investigated: 1) value of information analysis (VOIA) which is used for evaluating and quantifying the value of a data before they are purchased, and 2) enthalpy-based exploration targeting based on reservoir size, temperature gradient estimates, and internal rate of return (IRR). The first approach, VOIA, aims to identify the value of a particular data when making decisions with an uncertain outcome. This approach targets the pre-drilling phase of exploration. These estimated VOIs are highly affected by the size of the project and still have a high degree of subjectivity in assignment of probabilities. The second approach, exploration targeting, is focused on decision making during the drilling phase. It starts with a basic geothermal project definition that includes target and minimum required production capacity and initial budgeting for exploration phases. Then, it uses average temperature gradient, reservoir temperature estimates, and production capacity to define targets and go/no-go limits. The decision analysis in this approach is based on achieving a minimum IRR at each phase of the project. This second approach was determined to be less subjective, since it requires less subjectivity in the input values.« less

A fuzzy stochastic framework for managing hydro-environmental and socio-economic interactions under uncertainty

NASA Astrophysics Data System (ADS)

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

2014-05-01

An amplified interconnectedness between a hydro-environmental and socio-economic system brings about profound challenges of water management decision making. In this contribution, we present a fuzzy stochastic approach to solve a set of decision making problems, which involve hydrologically, environmentally, and socio-economically motivated criteria subjected to uncertainty and ambiguity. The proposed methodological framework combines objective and subjective criteria in a decision making procedure for obtaining an acceptable ranking in water resources management alternatives under different type of uncertainty (subjective/objective) and heterogeneous information (quantitative/qualitative) simultaneously. The first step of the proposed approach involves evaluating the performance of alternatives with respect to different types of criteria. The ratings of alternatives with respect to objective and subjective criteria are evaluated by simulation-based optimization and fuzzy linguistic quantifiers, respectively. Subjective and objective uncertainties related to the input information are handled through linking fuzziness and randomness together. Fuzzy decision making helps entail the linguistic uncertainty and a Monte Carlo simulation process is used to map stochastic uncertainty. With this framework, the overall performance of each alternative is calculated using an Order Weighted Averaging (OWA) aggregation operator accounting for decision makers' experience and opinions. Finally, ranking is achieved by conducting pair-wise comparison of management alternatives. This has been done on the basis of the risk defined by the probability of obtaining an acceptable ranking and mean difference in total performance for the pair of management alternatives. The proposed methodology is tested in a real-world hydrosystem, to find effective and robust intervention strategies for the management of a coastal aquifer system affected by saltwater intrusion due to excessive groundwater extraction for irrigated agriculture and municipal use. The results show that the approach gives useful support for robust decision-making and is sensitive to the decision makers' degree of optimism.

Methodological Quality of Consensus Guidelines in Implant Dentistry.

PubMed

Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

2017-01-01

Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p < 0.05). Methodological improvement of consensus guidelines published in major implant dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions.

Methodological Quality of Consensus Guidelines in Implant Dentistry

PubMed Central

Faggion, Clovis Mariano; Apaza, Karol; Ariza-Fritas, Tania; Málaga, Lilian; Giannakopoulos, Nikolaos Nikitas; Alarcón, Marco Antonio

2017-01-01

Background Consensus guidelines are useful to improve clinical decision making. Therefore, the methodological evaluation of these guidelines is of paramount importance. Low quality information may guide to inadequate or harmful clinical decisions. Objective To evaluate the methodological quality of consensus guidelines published in implant dentistry using a validated methodological instrument. Methods The six implant dentistry journals with impact factors were scrutinised for consensus guidelines related to implant dentistry. Two assessors independently selected consensus guidelines, and four assessors independently evaluated their methodological quality using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Disagreements in the selection and evaluation of guidelines were resolved by consensus. First, the consensus guidelines were analysed alone. Then, systematic reviews conducted to support the guidelines were included in the analysis. Non-parametric statistics for dependent variables (Wilcoxon signed rank test) was used to compare both groups. Results Of 258 initially retrieved articles, 27 consensus guidelines were selected. Median scores in four domains (applicability, rigour of development, stakeholder involvement, and editorial independence), expressed as percentages of maximum possible domain scores, were below 50% (median, 26%, 30.70%, 41.70%, and 41.70%, respectively). The consensus guidelines and consensus guidelines + systematic reviews data sets could be compared for 19 guidelines, and the results showed significant improvements in all domain scores (p < 0.05). Conclusions Methodological improvement of consensus guidelines published in major implant dentistry journals is needed. The findings of the present study may help researchers to better develop consensus guidelines in implant dentistry, which will improve the quality and trust of information needed to make proper clinical decisions. PMID:28107405

Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions.

PubMed

Pollock, Michelle; Fernandes, Ricardo M; Hartling, Lisa

2017-03-23

Overviews of reviews (overviews) compile information from multiple systematic reviews (SRs) to provide a single synthesis of relevant evidence for decision-making. It is recommended that authors assess and report the methodological quality of SRs in overviews-for example, using A MeaSurement Tool to Assess systematic Reviews (AMSTAR). Currently, there is variation in whether and how overview authors assess and report SR quality, and limited guidance is available. Our objectives were to: examine methodological considerations involved in using AMSTAR to assess the quality of Cochrane and non-Cochrane SRs in overviews of healthcare interventions; identify challenges (and develop potential decision rules) when using AMSTAR in overviews; and examine the potential impact of considering methodological quality when making inclusion decisions in overviews. We selected seven overviews of healthcare interventions and included all SRs meeting each overview's inclusion criteria. For each SR, two reviewers independently conducted AMSTAR assessments with consensus and discussed challenges encountered. We also examined the correlation between AMSTAR assessments and SR results/conclusions. Ninety-five SRs were included (30 Cochrane, 65 non-Cochrane). Mean AMSTAR assessments (9.6/11 vs. 5.5/11; p < 0.001) and inter-rater reliability (AC1 statistic: 0.84 vs. 0.69; "almost perfect" vs. "substantial" using the Landis & Koch criteria) were higher for Cochrane compared to non-Cochrane SRs. Four challenges were identified when applying AMSTAR in overviews: the scope of the SRs and overviews often differed; SRs examining similar topics sometimes made different methodological decisions; reporting of non-Cochrane SRs was sometimes poor; and some non-Cochrane SRs included other SRs as well as primary studies. Decision rules were developed to address each challenge. We found no evidence that AMSTAR assessments were correlated with SR results/conclusions. Results indicate that the AMSTAR tool can be used successfully in overviews that include Cochrane and non-Cochrane SRs, though decision rules may be useful to circumvent common challenges. Findings support existing recommendations that quality assessments of SRs in overviews be conducted independently, in duplicate, with a process for consensus. Results also suggest that using methodological quality to guide inclusion decisions (e.g., to exclude poorly conducted and reported SRs) may not introduce bias into the overview process.

Bayesian methodology for the design and interpretation of clinical trials in critical care medicine: a primer for clinicians.

PubMed

Kalil, Andre C; Sun, Junfeng

2014-10-01

To review Bayesian methodology and its utility to clinical decision making and research in the critical care field. Clinical, epidemiological, and biostatistical studies on Bayesian methods in PubMed and Embase from their inception to December 2013. Bayesian methods have been extensively used by a wide range of scientific fields, including astronomy, engineering, chemistry, genetics, physics, geology, paleontology, climatology, cryptography, linguistics, ecology, and computational sciences. The application of medical knowledge in clinical research is analogous to the application of medical knowledge in clinical practice. Bedside physicians have to make most diagnostic and treatment decisions on critically ill patients every day without clear-cut evidence-based medicine (more subjective than objective evidence). Similarly, clinical researchers have to make most decisions about trial design with limited available data. Bayesian methodology allows both subjective and objective aspects of knowledge to be formally measured and transparently incorporated into the design, execution, and interpretation of clinical trials. In addition, various degrees of knowledge and several hypotheses can be tested at the same time in a single clinical trial without the risk of multiplicity. Notably, the Bayesian technology is naturally suited for the interpretation of clinical trial findings for the individualized care of critically ill patients and for the optimization of public health policies. We propose that the application of the versatile Bayesian methodology in conjunction with the conventional statistical methods is not only ripe for actual use in critical care clinical research but it is also a necessary step to maximize the performance of clinical trials and its translation to the practice of critical care medicine.

[Clinical reasoning in undergraduate nursing education: a scoping review].

PubMed

Menezes, Sáskia Sampaio Cipriano de; Corrêa, Consuelo Garcia; Silva, Rita de Cássia Gengo E; Cruz, Diná de Almeida Monteiro Lopes da

2015-12-01

This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decision-making process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

Comparing and using assessments of the value of information to clinical decision-making.

PubMed Central

Urquhart, C J; Hepworth, J B

1996-01-01

This paper discusses the Value project, which assessed the value to clinical decision-making of information supplied by National Health Service (NHS) library and information services. The project not only showed how health libraries in the United Kingdom help clinicians in decision-making but also provided quality assurance guidelines for these libraries to help make their information services more effective. The paper reviews methods and results used in previous studies of the value of health libraries, noting that methodological differences appear to affect the results. The paper also discusses aspects of user involvement, categories of clinical decision-making, the value of information to present and future clinical decisions, and the combination of quantitative and qualitative assessments of value, as applied to the Value project and the studies reviewed. The Value project also demonstrated that the value placed on information depends in part on the career stage of the physician. The paper outlines the structure of the quality assurance tool kit, which is based on the findings and methods used in the Value project. PMID:8913550

Factors influencing parental decision making about stimulant treatment for attention-deficit/hyperactivity disorder.

PubMed

Ahmed, Rana; McCaffery, Kirsten J; Aslani, Parisa

2013-04-01

Attention-deficit/hyperactivity disorder (ADHD) is a pediatric psychological condition commonly treated with stimulant medications. Negative media reports and stigmatizing societal attitudes surrounding the use of these medications make it difficult for parents of affected children to accept stimulant treatment, despite it being first line therapy. The purpose of this study was to identify factors that influence parental decision making regarding stimulant treatment for ADHD. A systematic review of the literature was conducted to identify studies: 1) that employed qualitative methodology, 2) that highlighted treatment decision(s) about stimulant medication, 3) in which the decision(s) were made by the parent of a child with an official ADHD diagnosis, and 4) that examined the factors affecting the decision(s) made. Individual factors influencing parental treatment decision making, and the major themes encompassing these factors, were identified and followed by a thematic analysis. Eleven studies reporting on the experiences of 335 parents of children with ADHD were included. Four major themes encompassing influences on parents' decisions were derived from the thematic analysis performed: confronting the diagnosis, external influences, apprehension regarding therapy, and experience with the healthcare system. The findings of this systematic review reveal that there are multiple factors that influence parents' decisions about stimulant therapy. This information can assist clinicians in enhancing information delivery to parents of children with ADHD, and help reduce parental ambivalence surrounding stimulant medication use. Future work needs to address parental concerns about stimulants, and increase their involvement in shared decision making with clinicians to empower them to make the most appropriate treatment decision for their child.

Multi-model Effort Highlights Progress, Future Needs in Renewable Energy

Science.gov Websites

January 9, 2018 Models of the U.S. electricity sector are relied upon by sector stakeholders and decision of VRE technologies. The report also documents differences in modeling methodologies and shows how long-term planning and decision-making, both for the respective agencies and for other electricity

Technology as an Instructional Tool: What We Are Learning. Research Bulletin #3.

ERIC Educational Resources Information Center

Minnesota Educational Computing Consortium, St. Paul.

The purpose of this research bulletin is to provide educational decision-makers with empirical data for making informed decisions relative to the integration of technology in schools. Ten expanded abstracts of research studies are included here, each with a background/problem statement, list of study goals, description of methodology, conclusion…

Assessment of Competence in Clinical Reasoning and Decision-Making under Uncertainty: The Script Concordance Test Method

ERIC Educational Resources Information Center

Ramaekers, Stephan; Kremer, Wim; Pilot, Albert; van Beukelen, Peter; van Keulen, Hanno

2010-01-01

Real-life, complex problems often require that decisions are made despite limited information or insufficient time to explore all relevant aspects. Incorporating authentic uncertainties into an assessment, however, poses problems in establishing results and analysing their methodological qualities. This study aims at developing a test on clinical…

75 FR 78678 - Proposed Methodology for Respondent Selection in Antidumping Proceedings; Request for Comment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-16

... evidence of shipment from a non-selected company before making its respondent-selection decision. However... administering authority at the time of selection, or (2) exporters and producers accounting for the largest... accompanying Issues and Decision Memorandum at Comment 1A. Therefore, to ensure the statistical validity of the...

The Impact of Principal Mentoring Programs on the Moral Judgment of School Principals

ERIC Educational Resources Information Center

Kiley, Wendi J.

2017-01-01

This research addresses moral decision making and the experience of public school principals. It also explores the possible influence mentoring has on principals' abilities to confront complex decisions when clear ethical choices do not exist. This study incorporates a survey methodology, exploring the relationship between principal mentoring…

Bi-Level Decision Making for Supporting Energy and Water Nexus

NASA Astrophysics Data System (ADS)

Zhang, X.; Vesselinov, V. V.

2016-12-01

The inseparable relationship between energy production and water resources has led to the emerging energy-water nexus concept, which provides a means for integrated management and decision making of these two critical resources. However, the energy-water nexus frequently involves decision makers with different and competing management objectives. Furthermore, there is a challenge that decision makers and stakeholders might be making decisions sequentially from a higher level to a lower level, instead of at the same decision level, whereby the objective of a decision maker at a higher level should be satisfied first. In this study, a bi-level decision model is advanced to handle such decision-making situations for managing the energy-water nexus. The work represents a unique contribution to developing an integrated decision-support framework/tool to quantify and analyze the tradeoffs between the two-level energy-water nexus decision makers. Here, plans for electricity generation, fuel supply, water supply, capacity expansion of the power plants and environmental impacts are optimized to provide effective decision support. The developed decision-support framework is implemented in Julia (a high-level, high-performance dynamic programming language for technical computing) and is a part of the MADS (Model Analyses & Decision Support) framework (http://mads.lanl.gov). To demonstrate the capabilities of the developed methodology, a series of analyses are performed for synthetic problems consistent with actual real-world energy-water nexus management problems.

Contribution of economic evaluation to decision making in early phases of product development: a methodological and empirical review.

PubMed

Hartz, Susanne; John, Jürgen

2008-01-01

Economic evaluation as an integral part of health technology assessment is today mostly applied to established technologies. Evaluating healthcare innovations in their early states of development has recently attracted attention. Although it offers several benefits, it also holds methodological challenges. The aim of our study was to investigate the possible contributions of economic evaluation to industry's decision making early in product development and to confront the results with the actual use of early data in economic assessments. We conducted a literature research to detect methodological contributions as well as economic evaluations that used data from early phases of product development. Economic analysis can be beneficially used in early phases of product development for various purposes including early market assessment, R&D portfolio management, and first estimations of pricing and reimbursement scenarios. Analytical tools available for these purposes have been identified. Numerous empirical works were detected, but most do not disclose any concrete decision context and could not be directly matched with the suggested applications. Industry can benefit from starting economic evaluation early in product development in several ways. Empirical evidence suggests that there is still potential left unused.

Development of a Model of Interprofessional Shared Clinical Decision Making in the ICU: A Mixed-Methods Study.

PubMed

DeKeyser Ganz, Freda; Engelberg, Ruth; Torres, Nicole; Curtis, Jared Randall

2016-04-01

To develop a model to describe ICU interprofessional shared clinical decision making and the factors associated with its implementation. Ethnographic (observations and interviews) and survey designs. Three ICUs (two in Israel and one in the United States). A convenience sample of nurses and physicians. None. Observations and interviews were analyzed using ethnographic and grounded theory methodologies. Questionnaires included a demographic information sheet and the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration. From observations and interviews, we developed a conceptual model of the process of shared clinical decision making that involves four stepped levels, proceeding from the lowest to the highest levels of collaboration: individual decision, information exchange, deliberation, and shared decision. This process is influenced by individual, dyadic, and system factors. Most decisions were made at the lower two levels. Levels of perceived collaboration were moderate with no statistically significant differences between physicians and nurses or between units. Both qualitative and quantitative data corroborated that physicians and nurses from all units were similarly and moderately satisfied with their level of collaboration and shared decision making. However, most ICU clinical decision making continues to take place independently, where there is some sharing of information but rarely are decisions made collectively. System factors, such as interdisciplinary rounds and unit culture, seem to have a strong impact on this process. This study provides a model for further study and improvement of interprofessional shared decision making.

A method for studying decision-making by guideline development groups.

PubMed

Gardner, Benjamin; Davidson, Rosemary; McAteer, John; Michie, Susan

2009-08-05

Multidisciplinary guideline development groups (GDGs) have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR) study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE) acute physical health GDG. This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making groups.

Patient-reported outcomes in randomised controlled trials of gynaecological cancers: investigating methodological quality and impact on clinical decision-making.

PubMed

Efficace, Fabio; Jacobs, Marc; Pusic, Andrea; Greimel, Elfriede; Piciocchi, Alfonso; Kieffer, Jacobien M; Gilbert, Alexandra; Fayers, Peter; Blazeby, Jane

2014-07-01

The aim for this study is to investigate the methodological quality and potential impact on clinical decision making of patient reported outcome (PRO) assessment in randomised controlled trials (RCTs) in the gynaecological cancer sites. A systematic review identified RCTs published between January 2004 and June 2012. Relevant studies were evaluated using a pre-determined extraction form which included: (1) Trial demographics and clinical and PRO characteristics; (2) level of PRO reporting and (3) bias, assessed using the Cochrane Risk of Bias tool. All studies were additionally analysed in relation to their relevance in supporting clinical decision making. Fifty RCTs enrolling 24,991 patients were identified. In eight RCTs (16%) a PRO was the primary end-point. Twenty-one studies (42%) were carried out in a multi-national context. Where statistically significant PRO differences between treatments were found, it related in most cases to both symptoms and domains other than symptoms (n=17, 57%). The majority of studies (n=42, 84%) did not mention the mode of administration nor the methods of collecting PRO data. Statistical approaches for dealing with missing data were only explicitly mentioned in nine RCTs (18%). Sixteen RCTs (32%) were considered to be of high-quality and thus able to inform clinical decision making. Higher-quality PRO studies were generally associated with RCTs that were at a low risk of bias. This study showed that RCTs with PROs were generally well designed and conducted. In a third the information was very informative to fully understand the pros and cons of PROs treatment decision-making. Copyright © 2014 Elsevier Ltd. All rights reserved.

To pass or to fail? Understanding the factors considered by faculty in the clinical evaluation of nursing students.

PubMed

DeBrew, Jacqueline Kayler; Lewallen, Lynne Porter

2014-04-01

Making the decision to pass or to fail a nursing student is difficult for nurse educators, yet one that all educators face at some point in time. To make this decision, nurse educators draw from their past experiences and personal reflections on the situation. Using the qualitative method of critical incident technique, the authors asked educators to describe a time when they had to make a decision about whether to pass or fail a student in the clinical setting. The findings describe student and faculty factors important in clinical evaluation decisions, demonstrate the benefits of reflective practice to nurse educators, and support the utility of critical incident technique not only as research methodology, but also as a technique for reflective practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

IS THE LINK BETWEEN HEALTH AND WEALTH CONSIDERED IN DECISION MAKING? RESULTS FROM A QUALITATIVE STUDY.

PubMed

Garau, Martina; Shah, Koonal Kirit; Sharma, Priya; Towse, Adrian

2015-01-01

The aim of this study was to explore whether wealth effects of health interventions, including productivity gains and savings in other sectors, are considered in resource allocations by health technology assessment (HTA) agencies and government departments. To analyze reasons for including, or not including, wealth effects. Semi-structured interviews with decision makers and academic experts in eight countries (Australia, France, Germany, Italy, Poland, South Korea, Sweden, and the United Kingdom). There is evidence suggesting that health interventions can produce economic gains for patients and national economies. However, we found that the link between health and wealth does not influence decision making in any country with the exception of Sweden. This is due to a combination of factors, including system fragmentation, methodological issues, and the economic recession forcing national governments to focus on short-term measures. In countries with established HTA processes and methods allowing, in principle, the inclusion of wider effects in exceptional cases or secondary analyses, it might be possible to overcome the methodological and practical barriers and see a more systematic consideration of wealth effect in decision making. This would be consistent with principles of efficient priority setting. Barriers for the consideration of wealth effects in government decision making are more fundamental, due to an enduring separation of budgets within the public sector and current financial pressures. However, governments should consider all relevant effects from public investments, including healthcare, even when benefits can only be captured in the medium- and long-term. This will ensure that resources are allocated where they bring the best returns.

On the Quality of Collective Decisions in Sociotechnical Systems: Transparency, Fairness, and Efficiency

NASA Astrophysics Data System (ADS)

Porello, Daniele

The aim of this paper is to propose a methodology for evaluating the quality of collective decisions in sociotechnical systems (STS). We propose using a foundational ontology for conceptualizing the complex hierarchy of information involved in decisions in STS (e.g., normative, conceptual, factual, perceptual). Moreover, we introduce the concept of transparency of decisions as a necessary condition in order to assess the quality of decision-making in STS. We further view transparency as an entitlement of the agent affected by the decision: i.e., the collective decision should be justified.

Pareto frontier analyses based decision making tool for transportation of hazardous waste.

PubMed

Das, Arup; Mazumder, T N; Gupta, A K

2012-08-15

Transportation of hazardous wastes through a region poses immense threat on the development along its road network. The risk to the population, exposed to such activities, has been documented in the past. However, a comprehensive framework for routing hazardous wastes has often been overlooked. A regional Hazardous Waste Management scheme should incorporate a comprehensive framework for hazardous waste transportation. This framework would incorporate the various stakeholders involved in decision making. Hence, a multi-objective approach is required to safeguard the interest of all the concerned stakeholders. The objective of this study is to design a methodology for routing of hazardous wastes between the generating units and the disposal facilities through a capacity constrained network. The proposed methodology uses posteriori method with multi-objective approach to find non-dominated solutions for the system consisting of multiple origins and destinations. A case study of transportation of hazardous wastes in Kolkata Metropolitan Area has also been provided to elucidate the methodology. Copyright © 2012 Elsevier B.V. All rights reserved.

A methodology for stochastic analysis of share prices as Markov chains with finite states.

PubMed

Mettle, Felix Okoe; Quaye, Enoch Nii Boi; Laryea, Ravenhill Adjetey

2014-01-01

Price volatilities make stock investments risky, leaving investors in critical position when uncertain decision is made. To improve investor evaluation confidence on exchange markets, while not using time series methodology, we specify equity price change as a stochastic process assumed to possess Markov dependency with respective state transition probabilities matrices following the identified state pace (i.e. decrease, stable or increase). We established that identified states communicate, and that the chains are aperiodic and ergodic thus possessing limiting distributions. We developed a methodology for determining expected mean return time for stock price increases and also establish criteria for improving investment decision based on highest transition probabilities, lowest mean return time and highest limiting distributions. We further developed an R algorithm for running the methodology introduced. The established methodology is applied to selected equities from Ghana Stock Exchange weekly trading data.

Computers and Management Structure: Some Empirical Findings Re-examined

ERIC Educational Resources Information Center

Robey, Daniel

1977-01-01

Studies that relate computerization to either centralization or decentralization of organizational decision making are reviewed. Four issues are addressed that relate to conceptual or methodological problems. (Author/MLF)

Methodological Issues in the Study of Air Force Organizational Structures,

DTIC Science & Technology

MOTIVATION, MORALE, PERFORMANCE(HUMAN), LEADERSHIP , SKILLS, MANAGEMENT PLANNING AND CONTROL, MODEL THEORY , SYMPOSIA...RESOURCE MANAGEMENT , *HUMAN RESOURCES, *MANPOWER UTILIZATION, *JOB ANALYSIS, *ORGANIZATIONS, STRUCTURES, PERSONNEL MANAGEMENT , DECISION MAKING

20 CFR 260.5 - Appeal from a reconsideration decision.

Code of Federal Regulations, 2010 CFR

2010-04-01

... motions, take testimony, and make all necessary investigations. (g) Evidence presented in support of... case preventing the use of these methodologies to conduct the hearing. (The information collection...

Cost-effectiveness modelling in diagnostic imaging: a stepwise approach.

PubMed

Sailer, Anna M; van Zwam, Wim H; Wildberger, Joachim E; Grutters, Janneke P C

2015-12-01

Diagnostic imaging (DI) is the fastest growing sector in medical expenditures and takes a central role in medical decision-making. The increasing number of various and new imaging technologies induces a growing demand for cost-effectiveness analysis (CEA) in imaging technology assessment. In this article we provide a comprehensive framework of direct and indirect effects that should be considered for CEA in DI, suitable for all imaging modalities. We describe and explain the methodology of decision analytic modelling in six steps aiming to transfer theory of CEA to clinical research by demonstrating key principles of CEA in a practical approach. We thereby provide radiologists with an introduction to the tools necessary to perform and interpret CEA as part of their research and clinical practice. • DI influences medical decision making, affecting both costs and health outcome. • This article provides a comprehensive framework for CEA in DI. • A six-step methodology for conducting and interpreting cost-effectiveness modelling is proposed.

The Reliability of Methodological Ratings for speechBITE Using the PEDro-P Scale

ERIC Educational Resources Information Center

Murray, Elizabeth; Power, Emma; Togher, Leanne; McCabe, Patricia; Munro, Natalie; Smith, Katherine

2013-01-01

Background: speechBITE (http://www.speechbite.com) is an online database established in order to help speech and language therapists gain faster access to relevant research that can used in clinical decision-making. In addition to containing more than 3000 journal references, the database also provides methodological ratings on the PEDro-P (an…

Toward a Collective Approach to Course Evaluation in Curriculum Development, A Contemporary Perspective

ERIC Educational Resources Information Center

Nyabero, Charles

2016-01-01

The purpose of this article was to explore on how course evaluation, decision making process, the methodology of evaluation and various roles of evaluation interact in the process of curriculum development. In the process of this exploration, the characteristics the types of evaluation, purposes of course evaluation, methodology of evaluation,…

The Ranking of Higher Education Institutions in Russia: Some Methodological Problems.

ERIC Educational Resources Information Center

Filinov, Nikolay B.; Ruchkina, Svetlana

2002-01-01

The ranking of higher education institutions in Russia is examined from two points of view: as a social phenomenon and as a multi-criteria decision-making problem. The first point of view introduces the idea of interested and involved parties; the second introduces certain principles on which a rational ranking methodology should be based.…

Evaluation of the Factors That Determine Quality in Higher Education: An Empirical Study

ERIC Educational Resources Information Center

Tsinidou, Maria; Gerogiannis, Vassilis; Fitsilis, Panos

2010-01-01

Purpose: The aim of this paper is to identify the quality determinants for education services provided by higher education institutions (HEIs) in Greece and to measure their relative importance from the students' points of view. Design/methodology/approach: A multi-criteria decision-making methodology was used for assessing the relative importance…

Extended Axiomatic Conjoint Measurement: A Solution to a Methodological Problem in Studying Fertility-Related Behaviors.

ERIC Educational Resources Information Center

Nickerson, Carol A.; McClelland, Gary H.

1988-01-01

A methodology is developed based on axiomatic conjoint measurement to accompany a fertility decision-making model. The usefulness of the model is then demonstrated via an application to a study of contraceptive choice (N=100 male and female family-planning clinic clients). Finally, the validity of the model is evaluated. (TJH)

Computer Network Operations Methodology

DTIC Science & Technology

2004-03-01

means of their computer information systems. Disrupt - This type of attack focuses on disrupting as “attackers might surreptitiously reprogram enemy...by reprogramming the computers that control distribution within the power grid. A disruption attack introduces disorder and inhibits the effective...between commanders. The use of methodologies is widespread and done subconsciously to assist individuals in decision making. The processes that

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm

PubMed Central

Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-01-01

Introduction: Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn’s theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. Methods: In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team’s four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn’s theory. Results: The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. Discussion: This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context. PMID:28435417

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm.

PubMed

Dogba, Maman Joyce; Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-07-19

Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn's theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team's four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn's theory. The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context.

An operational structured decision making framework for ...

EPA Pesticide Factsheets

Pressure to develop an operational framework for decision makers to employ the concepts of ecosystem goods and services for assessing changes to human well-being has been increasing since these concepts gained widespread notoriety after the Millennium Ecosystem Assessment Report. Many conceptual frameworks have been proposed, but most do not propose methodologies and tools to make this approach to decision making implementable. Building on common components of existing conceptual frameworks for ecosystem services and human well-being assessment we apply a structured decision making approach to develop a standardized operational framework and suggest tools and methods for completing each step. The structured decision making approach consists of six steps: 1) Clarify the Decision Context 2) Define Objectives and Evaluation Criteria 3) Develop Alternatives 4) Estimate Consequences 5) Evaluate Trade-Offs and Select and 6) Implement and Monitor. These six steps include the following activities, and suggested tools, when applied to ecosystem goods and services and human well-being conceptual frameworks: 1) Characterization of decision specific human beneficiaries using the Final Ecosystem Goods and Services (FEGS) approach and Classification System (FEGS-CS) 2) Determine beneficiaries’ relative priorities for human well-being domains in the Human Well-Being Index (HWBI) through stakeholder engagement and identify beneficiary-relevant metrics of FEGS using the Nat

Decision Dissonance: Evaluating an Approach to Measuring the Quality of Surgical Decision Making

PubMed Central

Fowler, Floyd J.; Gallagher, Patricia M.; Drake, Keith M.; Sepucha, Karen R.

2013-01-01

Background Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. Methods For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail survey of selected patients was carried out about one year after the procedures. Patients’ goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A Decision Dissonance Score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the Decision Dissonance Score was then assessed. Results When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. Conclusions Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality. PMID:23516764

Decision dissonance: evaluating an approach to measuring the quality of surgical decision making.

PubMed

Fowler, Floyd J; Gallagher, Patricia M; Drake, Keith M; Sepucha, Karen R

2013-03-01

Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail-survey of selected patients was carried out about one year after the procedures. Patients' goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A decision dissonance score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the decision dissonance score was then assessed. When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality.

Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback.

PubMed

Turner, Simon; D'Lima, Danielle; Hudson, Emma; Morris, Stephen; Sheringham, Jessica; Swart, Nick; Fulop, Naomi J

2017-12-04

A range of evidence informs decision-making on innovation in health care, including formal research findings, local data and professional opinion. However, cultural and organisational factors often prevent the translation of evidence for innovations into practice. In addition to the characteristics of evidence, it is known that processes at the individual level influence its impact on decision-making. Less is known about the ways in which processes at the professional, organisational and local system level shape evidence use and its role in decisions to adopt innovations. A systematic scoping review was used to review the health literature on innovations within acute and primary care and map processes at the professional, organisational and local system levels which influence how evidence informs decision-making on innovation. Stakeholder feedback on the themes identified was collected via focus groups to test and develop the findings. Following database and manual searches, 31 studies reporting primary qualitative data met the inclusion criteria: 24 were of sufficient methodological quality to be included in the thematic analysis. Evidence use in decision-making on innovation is influenced by multi-level processes (professional, organisational, local system) and interactions across these levels. Preferences for evidence vary by professional group and health service setting. Organisations can shape professional behaviour by requiring particular forms of evidence to inform decision-making. Pan-regional organisations shape innovation decision-making at lower levels. Political processes at all levels shape the selection and use of evidence in decision-making. The synthesis of results from primary qualitative studies found that evidence use in decision-making on innovation is influenced by processes at multiple levels. Interactions between different levels shape evidence use in decision-making (e.g. professional groups and organisations can use local systems to validate evidence and legitimise innovations, while local systems can tailor or frame evidence to influence activity at lower levels). Organisational leaders need to consider whether the environment in which decisions are made values diverse evidence and stakeholder perspectives. Further qualitative research on decision-making practices that highlights how and why different types of evidence come to count during decisions, and tracks the political aspects of decisions about innovation, is needed.

Communication nonaccommodation in family conversations about end-of-life health decisions.

PubMed

Scott, Allison M; Caughlin, John P

2015-01-01

Furthering our understanding of how communication can improve end-of-life decision making requires a shift in focus from whether people talk to how people talk about end-of-life health decisions. This study used communication accommodation theory to examine the extent to which communication nonaccommodation distinguished more from less successful end-of-life conversations among family members. We analyzed elicited conversations about end-of-life health decisions from 121 older parent/adult child dyads using outside ratings of communication over- and underaccommodation and self-reported conversational outcomes. Results of multilevel linear modeling revealed that outside ratings of underaccommodation predicted self-reported and partner-reported uncertainty, and ratings of overaccommodation predicted self-reported decision-making efficacy and change in concordance accuracy. We discuss the methodological, theoretical, and practical implications of these findings.

Cochlear Implant: the complexity involved in the decision making process by the family.

PubMed

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.

A qualitative metasynthesis: family involvement in decision making for people with dementia in residential aged care.

PubMed

Petriwskyj, Andrea; Gibson, Alexandra; Parker, Deborah; Banks, Susan; Andrews, Sharon; Robinson, Andrew

2014-06-01

Involving people in decisions about their care is good practice and ensures optimal outcomes. Despite considerable research, in practice family involvement in decision making can be challenging for both care staff and families. The aim of this review was to identify and appraise existing knowledge about family involvement in decision making for people with dementia living in residential aged care. The present Joanna Briggs Institute meta-synthesis considered studies that investigate involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this article presents the qualitative findings. A comprehensive search of studies was conducted in 15 electronic databases. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as relevant for this review; 16 were qualitative papers reporting on 15 studies. Two independent reviewers assessed the studies for methodological validity and extracted the data using the standardized Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The findings were synthesized using JBI-QARI. The findings related to the decisions encountered and made by family surrogates, family perceptions of, and preferences for, their role/s, factors regarding treatment decisions and the collaborative decision-making process, and outcomes for family decision makers. Results indicate varied and complex experiences and multiple factors influencing decision making. Communication and contacts between staff and families and the support available for families should be addressed, as well as the role of different stakeholders in decisions.

Failure detection system design methodology. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Chow, E. Y.

1980-01-01

The design of a failure detection and identification system consists of designing a robust residual generation process and a high performance decision making process. The design of these two processes are examined separately. Residual generation is based on analytical redundancy. Redundancy relations that are insensitive to modelling errors and noise effects are important for designing robust residual generation processes. The characterization of the concept of analytical redundancy in terms of a generalized parity space provides a framework in which a systematic approach to the determination of robust redundancy relations are developed. The Bayesian approach is adopted for the design of high performance decision processes. The FDI decision problem is formulated as a Bayes sequential decision problem. Since the optimal decision rule is incomputable, a methodology for designing suboptimal rules is proposed. A numerical algorithm is developed to facilitate the design and performance evaluation of suboptimal rules.

Automotive Marketing Methods and Practice

DOT National Transportation Integrated Search

1979-09-01

The report is a comprehensive examination of the current marketing practices, marketing methodologies, and decision-making processes utilized by the domestic automotive industry. The various marketing elements, such as products, consumer behavior, sa...

Modeling Common-Sense Decisions

NASA Astrophysics Data System (ADS)

Zak, Michail

This paper presents a methodology for efficient synthesis of dynamical model simulating a common-sense decision making process. The approach is based upon the extension of the physics' First Principles that includes behavior of living systems. The new architecture consists of motor dynamics simulating actual behavior of the object, and mental dynamics representing evolution of the corresponding knowledge-base and incorporating it in the form of information flows into the motor dynamics. The autonomy of the decision making process is achieved by a feedback from mental to motor dynamics. This feedback replaces unavailable external information by an internal knowledgebase stored in the mental model in the form of probability distributions.

The influence of patient portals on users' decision making is insufficiently investigated: A systematic methodological review.

PubMed

Fraccaro, Paolo; Vigo, Markel; Balatsoukas, Panagiotis; Buchan, Iain E; Peek, Niels; van der Veer, Sabine N

2018-03-01

Patient portals are considered valuable conduits for supporting patients' self-management. However, it is unknown why they often fail to impact on health care processes and outcomes. This may be due to a scarcity of robust studies focusing on the steps that are required to induce improvement: users need to effectively interact with the portal (step 1) in order to receive information (step 2), which might influence their decision-making (step 3). We aimed to explore this potential knowledge gap by investigating to what extent each step has been investigated for patient portals, and explore the methodological approaches used. We performed a systematic literature review using Coiera's information value chain as a guiding theoretical framework. We searched MEDLINE and Scopus by combining terms related to patient portals and evaluation methodologies. Two reviewers selected relevant papers through duplicate screening, and one extracted data from the included papers. We included 115 articles. The large majority (n = 104) evaluated aspects related to interaction with patient portals (step 1). Usage was most often assessed (n = 61), mainly by analysing system interaction data (n = 50), with most authors considering participants as active users if they logged in at least once. Overall usability (n = 57) was commonly assessed through non-validated questionnaires (n = 44). Step 2 (information received) was investigated in 58 studies, primarily by analysing interaction data to evaluate usage of specific system functionalities (n = 34). Eleven studies explicitly assessed the influence of patient portals on patients' and clinicians' decisions (step 3). Whereas interaction with patient portals has been extensively studied, their influence on users' decision-making remains under-investigated. Methodological approaches to evaluating usage and usability of portals showed room for improvement. To unlock the potential of patient portals, more (robust) research should focus on better understanding the complex process of how portals lead to improved health and care. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Making Just Tenure and Promotion Decisions Using the Objective Knowledge Growth Framework

ERIC Educational Resources Information Center

Chitpin, Stephanie

2015-01-01

Purpose: The purpose of this paper is to utilize the Objective Knowledge Growth Framework (OKGF) to promote a better understanding of the evaluating tenure and promotion processes. Design/Methodology/Approach: A scenario is created to illustrate the concept of using OKGF. Findings: The framework aims to support decision makers in identifying the…

Online Learning Era: Exploring the Most Decisive Determinants of MOOCs in Taiwanese Higher Education

ERIC Educational Resources Information Center

Hsieh, Ming-Yuan

2016-01-01

Because the development of Taiwanese Massive Open Online Course (MOOCs) websites is at this moment full of vitality, this research employs a series of analytical cross-measurements of Quality Function Deployment method of House of Quality (QFD-HOQ) model and Multiple Criteria Decision Making (MCDM) methodology to cross-evaluate the weighted…

The capacity of people with a 'mental disability' to make a health care decision.

PubMed

Wong, J G; Clare, C H; Holland, A J; Watson, P C; Gunn, M

2000-03-01

Based on the developing clinical and legal literature, and using the framework adopted in draft legislation, capacity to make a valid decision about a clinically required blood test was investigated in three groups of people with a 'mental disability' (i.e. mental illness (chronic schizophrenia), 'learning disability' ('mental retardation', or intellectual or developmental disability), or, dementia) and a fourth, comparison group. The three 'mental disability' groups (N = 20 in the 'learning disability' group, N = 21 in each of the other two groups) were recruited through the relevant local clinical services; and through a phlebotomy clinic for the 'general population' comparison group (N = 20). The decision-making task was progressively simplified by presenting the relevant information as separate elements and modifying the assessment of capacity so that responding became gradually less dependent on expressive verbal ability. Compared with the 'general population' group, capacity to make the particular decision was significantly more impaired in the 'learning disability' and 'dementia' groups. Importantly, however, it was not more impaired among the 'mental illness' group. All the groups benefited as the decision-making task was simplified, but at different stages. In each of the 'mental disability' groups, one participant benefited only when responding did not require any expensive verbal ability. Consistent with current views, capacity reflected an interaction between the decision-maker and the demands of the decision-making task. The findings have implications for the way in which decisions about health care interventions are sought from people with a 'mental disability'. The methodology may be extended to assess capacity to make other legally-significant decisions.

Decision support for redesigning wastewater treatment technologies.

PubMed

McConville, Jennifer R; Künzle, Rahel; Messmer, Ulrike; Udert, Kai M; Larsen, Tove A

2014-10-21

This paper offers a methodology for structuring the design space for innovative process engineering technology development. The methodology is exemplified in the evaluation of a wide variety of treatment technologies for source-separated domestic wastewater within the scope of the Reinvent the Toilet Challenge. It offers a methodology for narrowing down the decision-making field based on a strict interpretation of treatment objectives for undiluted urine and dry feces and macroenvironmental factors (STEEPLED analysis) which influence decision criteria. Such an evaluation identifies promising paths for technology development such as focusing on space-saving processes or the need for more innovation in low-cost, energy-efficient urine treatment methods. Critical macroenvironmental factors, such as housing density, transportation infrastructure, and climate conditions were found to affect technology decisions regarding reactor volume, weight of outputs, energy consumption, atmospheric emissions, investment cost, and net revenue. The analysis also identified a number of qualitative factors that should be carefully weighed when pursuing technology development; such as availability of O&M resources, health and safety goals, and other ethical issues. Use of this methodology allows for coevolution of innovative technology within context constraints; however, for full-scale technology choices in the field, only very mature technologies can be evaluated.

Simulation of California's Major Reservoirs Outflow Using Data Mining Technique

NASA Astrophysics Data System (ADS)

Yang, T.; Gao, X.; Sorooshian, S.

2014-12-01

The reservoir's outflow is controlled by reservoir operators, which is different from the upstream inflow. The outflow is more important than the reservoir's inflow for the downstream water users. In order to simulate the complicated reservoir operation and extract the outflow decision making patterns for California's 12 major reservoirs, we build a data-driven, computer-based ("artificial intelligent") reservoir decision making tool, using decision regression and classification tree approach. This is a well-developed statistical and graphical modeling methodology in the field of data mining. A shuffled cross validation approach is also employed to extract the outflow decision making patterns and rules based on the selected decision variables (inflow amount, precipitation, timing, water type year etc.). To show the accuracy of the model, a verification study is carried out comparing the model-generated outflow decisions ("artificial intelligent" decisions) with that made by reservoir operators (human decisions). The simulation results show that the machine-generated outflow decisions are very similar to the real reservoir operators' decisions. This conclusion is based on statistical evaluations using the Nash-Sutcliffe test. The proposed model is able to detect the most influential variables and their weights when the reservoir operators make an outflow decision. While the proposed approach was firstly applied and tested on California's 12 major reservoirs, the method is universally adaptable to other reservoir systems.

Optimization of the decision-making process for the selection of therapeutics to undergo clinical testing for spinal cord injury in the North American Clinical Trials Network.

PubMed

Guest, James; Harrop, James S; Aarabi, Bizhan; Grossman, Robert G; Fawcett, James W; Fehlings, Michael G; Tator, Charles H

2012-09-01

The North American Clinical Trials Network (NACTN) includes 9 clinical centers funded by the US Department of Defense and the Christopher Reeve Paralysis Foundation. Its purpose is to accelerate clinical testing of promising therapeutics in spinal cord injury (SCI) through the development of a robust interactive infrastructure. This structure includes key committees that serve to provide longitudinal guidance to the Network. These committees include the Executive, Data Management, and Neurological Outcome Assessments Committees, and the Therapeutic Selection Committee (TSC), which is the subject of this manuscript. The NACTN brings unique elements to the SCI field. The Network's stability is not restricted to a single clinical trial. Network members have diverse expertise and include experts in clinical care, clinical trial design and methodology, pharmacology, preclinical and clinical research, and advanced rehabilitation techniques. Frequent systematic communication is assigned a high value, as is democratic process, fairness and efficiency of decision making, and resource allocation. This article focuses on how decision making occurs within the TSC to rank alternative therapeutics according to 2 main variables: quality of the preclinical data set, and fit with the Network's aims and capabilities. This selection process is important because if the Network's resources are committed to a therapeutic, alternatives cannot be pursued. A proposed methodology includes a multicriteria decision analysis that uses a Multi-Attribute Global Inference of Quality matrix to quantify the process. To rank therapeutics, the TSC uses a series of consensus steps designed to reduce individual and group bias and limit subjectivity. Given the difficulties encountered by industry in completing clinical trials in SCI, stable collaborative not-for-profit consortia, such as the NACTN, may be essential to clinical progress in SCI. The evolution of the NACTN also offers substantial opportunity to refine decision making and group dynamics. Making the best possible decisions concerning therapeutics selection for trial testing is a cornerstone of the Network's function.

Socioeconomic Differences in Informed Decisions About Down Syndrome Screening: A Systematic Review and Research Agenda.

PubMed

Smith, Sian K; Sousa, Mariana S; Essink-Bot, Marie-Louise; Halliday, Jane; Peate, Michelle; Fransen, Mirjam

2016-08-01

Supporting pregnant women to make informed choices about Down syndrome screening is widely endorsed. We reviewed the literature on: (a) the association between socioeconomic position and informed choices and decision-making about Down syndrome screening, and (b) the possible mediating variables (e.g., health literacy, numeracy skills, behavioral and communication variables) that might explain the relationship. EMBASE, MEDLINE, PubMed, CINAHL, and PsycINFO were searched from January 1999 to September 2014. The methodological quality of studies was determined by predefined criteria regarding the research aims, study design, study population and setting, measurement tools, and statistical analysis. A total of 33 studies met the inclusion criteria. Women from lower socioeconomic groups experience greater difficulties making informed choices about Down syndrome screening compared to women from higher socioeconomic groups. Most studies focus on individual dimensions of informed decision-making rather than assessing elements in conjunction with one another. Few studies have explored why there are socioeconomic differences in women's ability to make informed screening decisions. Future work is needed to identify mediating variables in this pathway. Systematic evidence-based intervention development to improve communication, understanding, and decision-making about Down syndrome screening is needed to ensure that women have an equal opportunity to make an informed choice about screening regardless of their socioeconomic position.

What is adaptive about adaptive decision making? A parallel constraint satisfaction account.

PubMed

Glöckner, Andreas; Hilbig, Benjamin E; Jekel, Marc

2014-12-01

There is broad consensus that human cognition is adaptive. However, the vital question of how exactly this adaptivity is achieved has remained largely open. Herein, we contrast two frameworks which account for adaptive decision making, namely broad and general single-mechanism accounts vs. multi-strategy accounts. We propose and fully specify a single-mechanism model for decision making based on parallel constraint satisfaction processes (PCS-DM) and contrast it theoretically and empirically against a multi-strategy account. To achieve sufficiently sensitive tests, we rely on a multiple-measure methodology including choice, reaction time, and confidence data as well as eye-tracking. Results show that manipulating the environmental structure produces clear adaptive shifts in choice patterns - as both frameworks would predict. However, results on the process level (reaction time, confidence), in information acquisition (eye-tracking), and from cross-predicting choice consistently corroborate single-mechanisms accounts in general, and the proposed parallel constraint satisfaction model for decision making in particular. Copyright © 2014 Elsevier B.V. All rights reserved.

Is the relationship between pattern recall and decision-making influenced by anticipatory recall?

PubMed

Gorman, Adam D; Abernethy, Bruce; Farrow, Damian

2013-01-01

The present study compared traditional measures of pattern recall to measures of anticipatory recall and decision-making to examine the underlying mechanisms of expert pattern perception and to address methodological limitations in previous studies where anticipatory recall has generally been overlooked. Recall performance in expert and novice basketball players was measured by examining the spatial error in recalling player positions both for a target image (traditional recall) and at 40-ms increments following the target image (anticipatory recall). Decision-making performance was measured by comparing the participant's response to those identified by a panel of expert coaches. Anticipatory recall was observed in the recall task and was significantly more pronounced for the experts, suggesting that traditional methods of spatial recall analysis may not have provided a completely accurate determination of the full magnitude of the experts' superiority. Accounting for anticipatory recall also increased the relative contribution of recall skill to decision-making accuracy although the gains in explained variance were modest and of debatable functional significance.

Physiological utility theory and the neuroeconomics of choice

PubMed Central

Glimcher, Paul W.; Dorris, Michael C.; Bayer, Hannah M.

2006-01-01

Over the past half century economists have responded to the challenges of Allais [Econometrica (1953) 53], Ellsberg [Quart. J. Econ. (1961) 643] and others raised to neoclassicism either by bounding the reach of economic theory or by turning to descriptive approaches. While both of these strategies have been enormously fruitful, neither has provided a clear programmatic approach that aspires to a complete understanding of human decision making as did neoclassicism. There is, however, growing evidence that economists and neurobiologists are now beginning to reveal the physical mechanisms by which the human neuroarchitecture accomplishes decision making. Although in their infancy, these studies suggest both a single unified framework for understanding human decision making and a methodology for constraining the scope and structure of economic theory. Indeed, there is already evidence that these studies place mathematical constraints on existing economic models. This article reviews some of those constraints and suggests the outline of a neuroeconomic theory of decision. PMID:16845435

From data to evidence: evaluative methods in evidence-based medicine.

PubMed

Landry, M D; Sibbald, W J

2001-11-01

The amount of published information is increasing exponentially, and recent technologic advances have created systems whereby mass distribution of this information can occur at an infinite rate. This is particularly true in the broad field of medicine, as the absolute volume of data available to the practicing clinician is creating new challenges in the management of relevant information flow. Evidence-based medicine (EBM) is an information management and learning strategy that seeks to integrate clinical expertise with the best evidence available in order to make effective clinical decisions that will ultimately improve patient care. The systematic approach underlying EBM encourages the clinician to formulate specific and relevant questions, which are answered in an iterative manner through accessing the best available published evidence. The arguments against EBM stem from the idea that there are inherent weaknesses in research methodologies and that emphasis placed on published research may ignore clinical skills and individual patient needs. Despite these arguments, EBM is gaining momentum and is consistently used as a method of learning and improving health care delivery. However, if EBM is to be effective, the clinician needs to have a critical understanding of research methodology in order to judge the value and level of a particular data source. Without critical analysis of research methodology, there is an inherent risk of drawing incorrect conclusions that may affect clinical decision-making. Currently, there is a trend toward using secondary pre-appraised data rather than primary sources as best evidence. We review the qualitative and quantitative methodology commonly used in EBM and argue that it is necessary for the clinician to preferentially use primary rather than secondary sources in making clinically relevant decisions.

Understanding decision-making towards housework among women with upper limb repetitive strain injury.

PubMed

Cheung, Therma W C; Clemson, Lindy; O'Loughlin, Kate; Shuttleworth, Russell

2016-02-01

Among women with upper limb repetitive strain injury (RSI), occupational therapy interventions include education to facilitate ergonomic practices in housework. From a client-centred perspective, an understanding of women's decision-making about housework is needed to design effective occupational therapy programmes. This study addresses a gap in research in this area by exploring women's views about changing housework habits. The aim was to construct a conceptual representation to explain decision-making in housework by drawing on experiences of a sample of Singapore Chinese women with upper limb RSI from one hand therapy clinic. Based on a constructivist grounded theory methodology, data were collected through in-depth interviewing with 15 women. Interviews were audiotaped and transcribed. Data were analysed with line by line coding, focussed coding and axial coding with constant comparison throughout data collection. Decision-making in housework among these women involved three main themes: (i) emotional attachment to housework; (ii) cognitively informed decision; and (iii) emotionally influenced decision. Women with upper limb RSI had to make cognitive decisions for or against a change in housework to manage their condition. However, the women's cognitively informed decisions were shaped by their emotional attachment to housework. As such, they experienced strong emotional barriers to changing their housework practices even when they had cognitively accepted the necessity and possibility of making a change. Therapists need to be aware that counselling to address the emotional barriers experienced by women is important during ergonomic education. © 2016 Occupational Therapy Australia.

Integrating Ecosystem Services Into Health Impact Assessment

EPA Science Inventory

Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

The SIMRAND methodology - Simulation of Research and Development Projects

NASA Technical Reports Server (NTRS)

Miles, R. F., Jr.

1984-01-01

In research and development projects, a commonly occurring management decision is concerned with the optimum allocation of resources to achieve the project goals. Because of resource constraints, management has to make a decision regarding the set of proposed systems or tasks which should be undertaken. SIMRAND (Simulation of Research and Development Projects) is a methodology which was developed for aiding management in this decision. Attention is given to a problem description, aspects of model formulation, the reduction phase of the model solution, the simulation phase, and the evaluation phase. The implementation of the considered approach is illustrated with the aid of an example which involves a simplified network of the type used to determine the price of silicon solar cells.

Methodology to explore emergent behaviours of the interactions between water resources and ecosystem under a pluralistic approach

NASA Astrophysics Data System (ADS)

García-Santos, Glenda; Madruga de Brito, Mariana; Höllermann, Britta; Taft, Linda; Almoradie, Adrian; Evers, Mariele

2018-06-01

Understanding the interactions between water resources and its social dimensions is crucial for an effective and sustainable water management. The identification of sensitive control variables and feedback loops of a specific human-hydro-scape can enhance the knowledge about the potential factors and/or agents leading to the current water resources and ecosystems situation, which in turn supports the decision-making process of desirable futures. Our study presents the utility of a system dynamics modeling approach for water management and decision-making for the case of a forest ecosystem under risk of wildfires. We use the pluralistic water research concept to explore different scenarios and simulate the emergent behaviour of water interception and net precipitation after a wildfire in a forest ecosystem. Through a case study, we illustrate the applicability of this new methodology.

Toward a methodology for moral decision making in medicine.

PubMed

Kushner, T; Belliotti, R A; Buckner, D

1991-12-01

The failure of medical codes to provide adequate guidance for physicians' moral dilemmas points to the fact that some rules of analysis, informed by moral theory, are needed to assist in resolving perplexing ethical problems occurring with increasing frequency as medical technology advances. Initially, deontological and teleological theories appear more helpful, but criticisms can be lodged against both, and neither proves to be sufficient in itself. This paper suggests that to elude the limitations of previous approaches, a method of moral decision making must be developed incorporating both coherence methodology and some independently supported theoretical foundations. Wide Reflective Equilibrium is offered, and its process described along with a theory of the person which is used to animate the process. Steps are outlined to be used in the process, leading to the application of the method to an actual case.

Prioritizing sewer rehabilitation projects using AHP-PROMETHEE II ranking method.

PubMed

Kessili, Abdelhak; Benmamar, Saadia

2016-01-01

The aim of this paper is to develop a methodology for the prioritization of sewer rehabilitation projects for Algiers (Algeria) sewer networks to support the National Sanitation Office in its challenge to make decisions on prioritization of sewer rehabilitation projects. The methodology applies multiple-criteria decision making. The study includes 47 projects (collectors) and 12 criteria to evaluate them. These criteria represent the different issues considered in the prioritization of the projects, which are structural, hydraulic, environmental, financial, social and technical. The analytic hierarchy process (AHP) is used to determine weights of the criteria and the Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE II) method is used to obtain the final ranking of the projects. The model was verified using the sewer data of Algiers. The results have shown that the method can be used for prioritizing sewer rehabilitation projects.

Getting State Education Data Right: What We Can Learn from Tennessee

ERIC Educational Resources Information Center

Jones, Joseph; Southern, Kyle

2011-01-01

Federal education policy in recent years has encouraged state and local education agencies to embrace data use and analysis in decision-making, ranging from policy development and implementation to performance evaluation. The capacity of these agencies to make effective and methodologically sound use of collected data for these purposes remains an…

Use of Case Study Methods in Human Resource Management, Development, and Training Courses: Strategies and Techniques

ERIC Educational Resources Information Center

Maxwell, James R.; Gilberti, Anthony F.; Mupinga, Davison M.

2006-01-01

This paper will study some of the problems associated with case studies and make recommendations using standard and innovative methodologies effectively. Human resource management (HRM) and resource development cases provide context for analysis and decision-making designs in different industries. In most HRM development and training courses…

The Devil is in the Concepts: Lessons Learned from World War II Planning Staffs for Transitioning from Conceptual to Detailed Planning

DTIC Science & Technology

2017-05-25

the planning process. Current US Army doctrine links conceptual planning to the Army Design Methodology and detailed planning to the Military...Decision Making Process. By associating conceptual and detailed planning with doctrinal methodologies , it is easy to regard the transition as a set period...plans into detailed directives resulting in changes to the operational environment. 15. SUBJECT TERMS Design; Army Design Methodology ; Conceptual

How stakeholder roles, power, and negotiation impact natural resource policy: A political economy view

USGS Publications Warehouse

Caughlan, L.

2002-01-01

Natural resource management decisions are complicated by multiple property rights, management objectives, and stakeholders with varying degrees of influence over the decision making process. In order to make efficient decisions, managers must incorporate the opinions and values of the involved stakeholders as well as understand the complex institutional constraints and opportunities that influence the decision-making process. Often this type of information is not understood until after a decision has been made, which can result in wasted time and effort.The purpose of my dissertation was to show how institutional frameworks and stakeholder involvement influence the various phases of the resource management decision-making process in a public choice framework. The intent was to assist decision makers and stakeholders by developing a methodology for formally incorporating stakeholders'' objectives and influence into the resource management planning process and to predict the potential success of rent-seeking activity based on stakeholder preferences and level of influence. Concepts from decision analysis, institutional analysis, and public choice economics were used in designing this interdisciplinary framework. The framework was then applied to an actual case study concerning elk and bison management on the National Elk Refuge and Grand Teton National Park near Jackson, Wyoming. The framework allowed for the prediction of the level of support and conflict for all relevant policy decisions, and the identification of each stakeholder''s level of support or opposition for each management decision.

No Evidence of Association between Toxoplasma gondii Infection and Financial Risk Taking in Females

PubMed Central

Šebánková, Blanka; Flegr, Jaroslav; Nave, Gideon

2015-01-01

Background Past research linked Toxoplasma gondii (TG) infection in humans with neurological and mental disorders (e.g., schizophrenia, Alzheimer’s disease and attention disorders), irregularities of the dopaminergic and testosterone system, and increased likelihood of being involved in traffic accidents. Methodology/Principal Findings We test for an association between TG infection and financial decision-making (DM) using a case-control design in a sample of female Czech students (n = 79). We estimate each subject's risk attitude and loss aversion using an experimental economic task involving real monetary incentives. We find no significant evidence that either measure of decision-making is associated with TG infection. Conclusion We were unable to find evidence of an association between TG infection and financial decision-making in females. PMID:26401912

Influential factors on treatment decision making among patients with colorectal cancer: A scoping review.

PubMed

Cranley, Nicole M; Curbow, Barbara; George, Thomas J; Christie, Juliette

2017-09-01

In recent years, a greater emphasis has been placed on shared decision-making (SDM) techniques between providers and patients with the goal of helping patients make informed decisions about their care and subsequently to improve patient health outcomes. Previous research has shown variability in treatment decision-making among patients with colorectal cancer (CRC), and there is little comprehensive information available to help explain this variability. Thus, the purpose of this study was to evaluate the current state of the literature on factors that are influential in treatment decision-making among patients with CRC. A priori search terms using Boolean connectors were used to examine PubMed, PsycINFO, Web of Science, CINAHL, and MEDLINE for relevant studies. Eligibility criteria for inclusion in the study included patients with CRC and examination of influences on CRC treatment decision-making. All relevant data were extracted including, author, title and year, study methodology, and study results. Findings (n = 13) yielded influences in four areas: informational, patient treatment goals, patient role preferences, and relationship with provider. Quality of life and trust in physician were rated a high priority among patients when making decisions between different therapeutic options. Several studies found that patients wanted to be informed and involved but did not necessarily want to make autonomous treatment choices, with many preferring a more passive role. Providers who initiate a dialog to better understand their patients' treatment goals can establish rapport, increase patient understanding of treatment options, and help patients assume their desired role in their decision-making. Overall, there were a small number of studies that met all inclusion criteria with most used a cross-sectional design.

Approaches and Methodological As Well As Interpretative Issues in Quality of Life Research in Malaysia

PubMed Central

Hasanah, C. I.

2003-01-01

Quality of life measures are designed to enable patients’ perspectives on the impact of health and healthcare interventions on their lives to be assessed and taken into account in clinical decision-making and research. This paper discusses some approaches, methodological as well as interpretative issues of health related quality of life research. PMID:23386798

District Heating Systems Performance Analyses. Heat Energy Tariff

NASA Astrophysics Data System (ADS)

Ziemele, Jelena; Vigants, Girts; Vitolins, Valdis; Blumberga, Dagnija; Veidenbergs, Ivars

2014-12-01

The paper addresses an important element of the European energy sector: the evaluation of district heating (DH) system operations from the standpoint of increasing energy efficiency and increasing the use of renewable energy resources. This has been done by developing a new methodology for the evaluation of the heat tariff. The paper presents an algorithm of this methodology, which includes not only a data base and calculation equation systems, but also an integrated multi-criteria analysis module using MADM/MCDM (Multi-Attribute Decision Making / Multi-Criteria Decision Making) based on TOPSIS (Technique for Order Performance by Similarity to Ideal Solution). The results of the multi-criteria analysis are used to set the tariff benchmarks. The evaluation methodology has been tested for Latvian heat tariffs, and the obtained results show that only half of heating companies reach a benchmark value equal to 0.5 for the efficiency closeness to the ideal solution indicator. This means that the proposed evaluation methodology would not only allow companies to determine how they perform with regard to the proposed benchmark, but also to identify their need to restructure so that they may reach the level of a low-carbon business.

IFC BIM-Based Methodology for Semi-Automated Building Energy Performance Simulation

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

Bazjanac, Vladimir

2008-07-01

Building energy performance (BEP) simulation is still rarely used in building design, commissioning and operations. The process is too costly and too labor intensive, and it takes too long to deliver results. Its quantitative results are not reproducible due to arbitrary decisions and assumptions made in simulation model definition, and can be trusted only under special circumstances. A methodology to semi-automate BEP simulation preparation and execution makes this process much more effective. It incorporates principles of information science and aims to eliminate inappropriate human intervention that results in subjective and arbitrary decisions. This is achieved by automating every part ofmore » the BEP modeling and simulation process that can be automated, by relying on data from original sources, and by making any necessary data transformation rule-based and automated. This paper describes the new methodology and its relationship to IFC-based BIM and software interoperability. It identifies five steps that are critical to its implementation, and shows what part of the methodology can be applied today. The paper concludes with a discussion of application to simulation with EnergyPlus, and describes data transformation rules embedded in the new Geometry Simplification Tool (GST).« less

Common methodological flaws in economic evaluations.

PubMed

Drummond, Michael; Sculpher, Mark

2005-07-01

Economic evaluations are increasingly being used by those bodies such as government agencies and managed care groups that make decisions about the reimbursement of health technologies. However, several reviews of economic evaluations point to numerous deficiencies in the methodology of studies or the failure to follow published methodological guidelines. This article, written for healthcare decision-makers and other users of economic evaluations, outlines the common methodological flaws in studies, focussing on those issues that are likely to be most important when deciding on the reimbursement, or guidance for use, of health technologies. The main flaws discussed are: (i) omission of important costs or benefits; (ii) inappropriate selection of alternatives for comparison; (iii) problems in making indirect comparisons; (iv) inadequate representation of the effectiveness data; (v) inappropriate extrapolation beyond the period observed in clinical studies; (vi) excessive use of assumptions rather than data; (vii) inadequate characterization of uncertainty; (viii) problems in aggregation of results; (ix) reporting of average cost-effectiveness ratios; (x) lack of consideration of generalizability issues; and (xi) selective reporting of findings. In each case examples are given from the literature and guidance is offered on how to detect flaws in economic evaluations.

Decision-making regarding organ donation in Korean adults: A grounded-theory study.

PubMed

Yeun, Eun Ja; Kwon, Young Mi; Kim, Jung A

2015-06-01

The aim of this study was to identify the hidden patterns of behavior leading toward the decision to donate organs. Thirteen registrants at the Association for Organ Sharing in Korea were recruited. Data were collected using in-depth interview and the interview transcripts were analyzed using Glaserian grounded-theory methodology. The main problem of participants was "body attachment" and the core category (management process) was determined to be "pursuing life." The theme consisted of four phases, which were: "hesitating," "investigating," "releasing," and "re-discovering. " Therefore, to increase organ donations, it is important to find a strategy that will create positive attitudes about organ donation through education and public relations. These results explain and provide a deeper understanding of the main problem that Korean people have about organ donation and their management of decision-making processes. These findings can help care providers to facilitate the decision-making process and respond to public needs while taking into account the sociocultural context within which decisions are made. © 2014 Wiley Publishing Asia Pty Ltd.

Predefined three tier business intelligence architecture in healthcare enterprise.

PubMed

Wang, Meimei

2013-04-01

Business Intelligence (BI) has caused extensive concerns and widespread use in gathering, processing and analyzing data and providing enterprise users the methodology to make decisions. Different from traditional BI architecture, this paper proposes a new BI architecture, Top-Down Scalable BI architecture with defining mechanism for enterprise decision making solutions and aims at establishing a rapid, consistent, and scalable multiple applications on multiple platforms of BI mechanism. The two opposite information flows in our BI architecture offer the merits of having the high level of organizational prospects and making full use of the existing resources. We also introduced the avg-bed-waiting-time factor to evaluate hospital care capacity.

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

Fraile-Garcia, Esteban, E-mail: esteban.fraile@unirioja.es; Ferreiro-Cabello, Javier, E-mail: javier.ferreiro@unirioja.es; Qualiberica S.L.

The European Committee for Standardization (CEN) through its Technical Committee CEN/TC-350 is developing a series of standards for assessing the building sustainability, at both product and building levels. The practical application of the selection (decision making) of structural alternatives made by one-way slabs leads to an intermediate level between the product and the building. Thus the present study addresses this problem of decision making, following the CEN guidelines and incorporating relevant aspects of architectural design into residential construction. A life cycle assessment (LCA) is developed in order to obtain valid information for the decision making process (the LCA was developedmore » applying CML methodology although Ecoindicator99 was used in order to facilitate the comparison of the values); this information (the carbon footprint values) is contrasted with other databases and with the information from the Environmental Product Declaration (EPD) of one of the lightening materials (expanded polystyrene), in order to validate the results. Solutions of different column disposition and geometries are evaluated in the three pillars of sustainable construction on residential construction: social, economic and environmental. The quantitative analysis of the variables used in this study enables and facilitates an objective comparison in the design stage by a responsible technician; the application of the proposed methodology reduces the possible solutions to be evaluated by the expert to 12.22% of the options in the case of low values of the column index and to 26.67% for the highest values. - Highlights: • Methodology for selection of structural alternatives in buildings with one-way slabs • Adapted to CEN guidelines (CEN/TC-350) for assessing the building sustainability • LCA is developed in order to obtain valid information for the decision making process. • Results validated comparing carbon footprint, databases and Env. Product Declarations • The proposal reduces the solutions to be evaluated to between 12.22 and 26.67%.« less

The quality of instruments to assess the process of shared decision making: A systematic review

PubMed Central

Bomhof-Roordink, Hanna; Smith, Ian P.; Scholl, Isabelle; Stiggelbout, Anne M.; Pieterse, Arwen H.

2018-01-01

Objective To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. Methods In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. Results We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Conclusions Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument’s content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations. PMID:29447193

WHAT IS THE ROLE OF COMMUNITY PREFERENCE INFORMATION IN HEALTH TECHNOLOGY ASSESSMENT DECISION MAKING? A CASE STUDY OF COLORECTAL CANCER SCREENING.

PubMed

Wortley, Sally; Flitcroft, Kathy; Howard, Kirsten

2015-01-01

The aim of this study was to determine the role of community preference information from discrete choice studies of colorectal cancer (CRC) screening in health technology assessment (HTA) reports and subsequent policy decisions. We undertook a systematic review of discrete choice studies of CRC screening. Included studies were reviewed to assess the policy context of the research. For those studies that cited a recent or pending review of CRC screening, further searches were undertaken to determine the extent to which community preference information was incorporated into the HTA decision-making process. Eight discrete choice studies that evaluated preferences for CRC screening were identified. Four of these studies referred to a national or local review of CRC screening in three countries: Australia, Canada, and the Netherlands. Our review of subsequently released health policy documents showed that while consideration was given to community views on CRC, policy was not informed by discrete choice evidence. Preferences and values of patients are increasingly being considered "evidence" to be incorporated into HTA reports. Discrete choice methodology is a rigorous quantitative method for eliciting preferences and while as a methodology it is growing in profile, it would appear that the results of such research are not being systematically translated or integrated into HTA reports. A formalized approach is needed to incorporate preference literature into the HTA decision-making process.

[The ethical reflection approach in decision-making processes in health institutes].

PubMed

Gruat, Renaud

2015-12-01

Except in the specific case of end-of-life care, the law says nothing about the way in which health professionals must carry out ethical reflection regarding the treatment of their patients. A problem-solving methodology called the "ethical reflection approach" performed over several stages can be used. The decision-making process involves the whole team and draws on the ability of each caregiver to put forward a reasoned argument, in the interest of the patient. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Systems thinking, complexity and managerial decision-making: an analytical review.

PubMed

Cramp, D G; Carson, E R

2009-05-01

One feature that characterizes the organization and delivery of health care is its inherent complexity. All too often, with so much information and so many activities involved, it is difficult for decision-makers to determine in an objective fashion an appropriate course of action. It would appear that a holistic rather than a reductionist approach would be advantageous. The aim of this paper is to review how formal systems thinking can aid decision-making in complex situations. Consideration is given as to how the use of a number of systems modelling methodologies can help in gaining an understanding of a complex decision situation. This in turn can enhance the possibility of a decision being made in a more rational, explicit and transparent fashion. The arguments and approaches are illustrated using examples taken from the public health arena.

Cochlear Implant: the complexity involved in the decision making process by the family1

PubMed Central

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention. PMID:25029052

A Behavioural Approach to Understanding Semi-Subsistence Farmers' Technology Adoption Decisions: The Case of Improved Paddy-Prawn System in Indonesia

ERIC Educational Resources Information Center

Sambodo, Leonardo A. A. T.; Nuthall, Peter L.

2010-01-01

Purpose: This study traced the origins of subsistence Farmers' technology adoption attitudes and extracted the critical elements in their decision making systems. Design/Methodology/Approach: The analysis was structured using a model based on the Theory of Planned Behaviour (TPB). The role of a "bargaining process" was particularly…

Assessing the Usefulness of the Decision Framework for Identifying and Selecting Knowledge Management Projects

DTIC Science & Technology

2005-03-01

team-wide accountability and rewards Functional focus Group accountability and rewards Employee-owner interest conflicts Process focus Lack of...Collaborative and cross-functional work Incompatible IT Need to share Compartmentalization of functional groups Localized decision making Centralized...Steps are: • Step 1: Analyze Corporate Strategic Objectives Using SWOT (Strengths, Weaknesses, Opportunities, Threats) Methodology • Step 2

Role of scientific data in health decisions.

PubMed Central

Samuels, S W

1979-01-01

The distinction between reality and models or methodological assumptions is necessary for an understanding of the use of data--economic, technical or biological--in decision-making. The traditional modes of analysis used in decisions are discussed historically and analytically. Utilitarian-based concepts such as cost-benefit analysis and cannibalistic concepts such as "acceptable risk" are rejected on logical and moral grounds. Historical reality suggests the concept of socially necessary risk determined through the dialectic process in democracy. PMID:120251

Methodological variation in economic evaluations conducted in low- and middle-income countries: information for reference case development.

PubMed

Santatiwongchai, Benjarin; Chantarastapornchit, Varit; Wilkinson, Thomas; Thiboonboon, Kittiphong; Rattanavipapong, Waranya; Walker, Damian G; Chalkidou, Kalipso; Teerawattananon, Yot

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions.

Multi-criteria decision assessments using Subjective Logic: Methodology and the case of urban water strategies

NASA Astrophysics Data System (ADS)

Moglia, Magnus; Sharma, Ashok K.; Maheepala, Shiroma

2012-07-01

SummaryPlanning of regional and urban water resources, and in particular with Integrated Urban Water Management approaches, often considers inter-relationships between human uses of water, the health of the natural environment as well as the cost of various management strategies. Decision makers hence typically need to consider a combination of social, environmental and economic goals. The types of strategies employed can include water efficiency measures, water sensitive urban design, stormwater management, or catchment management. Therefore, decision makers need to choose between different scenarios and to evaluate them against a number of criteria. This type of problem has a discipline devoted to it, i.e. Multi-Criteria Decision Analysis, which has often been applied in water management contexts. This paper describes the application of Subjective Logic in a basic Bayesian Network to a Multi-Criteria Decision Analysis problem. By doing this, it outlines a novel methodology that explicitly incorporates uncertainty and information reliability. The application of the methodology to a known case study context allows for exploration. By making uncertainty and reliability of assessments explicit, it allows for assessing risks of various options, and this may help in alleviating cognitive biases and move towards a well formulated risk management policy.

Methodological quality of economic evaluations of new pharmaceuticals in The Netherlands.

PubMed

Hoomans, Ties; Severens, Johan L; van der Roer, Nicole; Delwel, Gepke O

2012-03-01

In the Netherlands, decisions about the reimbursement of new pharmaceuticals are based on cost effectiveness, as well as therapeutic value and budget impact. Since 1 January 2005, drug manufacturers are formally required to substantiate the cost effectiveness of drugs that have therapeutic added value in comparison with existing ones through pharmacoeconomic evaluations. Dutch guidelines for pharmacoeconomic research provide methods guidance, ensuring consistency in both the evidence and the decision-making process about drug reimbursement. This study reviewed the methodological quality of all 21 formally required pharmacoeconomic evaluations of new pharmaceuticals between 1 January 2005 and 1 October 2008, and verified whether these evaluations complied with pharmacoeconomic guidelines. Data on the quality of the pharmacoeconomic evaluations were extracted from the pharmacoeconomic reports published by the Dutch Health Care Insurance Board (CVZ). The Board's newsletters provided information on the advice to, and reimbursement decisions made by, the Dutch Minister of Health. All data extraction was carried out by two independent reviewers, and descriptive analyses were conducted. The methodological quality was sound in only 8 of the 21 pharmacoeconomic evaluations. In most cases, the perspective of analysis, the comparator drugs, and the reporting of both total and incremental costs and effects were correct. However, drug indication, form (i.e. cost utility/cost effectiveness) and time horizon of the evaluations were frequently flawed. Moreover, the costs and effects of the pharmaceuticals were not always analysed correctly, and modelling studies were often non-transparent. Twelve drugs were reimbursed, and nine were not. The compliance with pharmacoeconomic guidelines in economic evaluations of new pharmaceuticals can be improved. This would improve the methodological quality of the pharmacoeconomic evaluations and ensure consistency in the evidence and the decision-making process for drug reimbursement in the Netherlands.

Factors influencing cancer treatment decision-making by indigenous peoples: a systematic review.

PubMed

Tranberg, Rona; Alexander, Susan; Hatcher, Deborah; Mackey, Sandra; Shahid, Shaouli; Holden, Lynda; Kwok, Cannas

2016-02-01

We aim to systematically review studies that identify factors influencing cancer treatment decision-making among indigenous peoples. Following the outline suggested by the Preferred Reporting Items for Systematic Review and Meta-analysis, a rigorous systematic review and meta-synthesis were conducted of factors that influence cancer treatment decision-making by indigenous peoples. A total of 733 articles were retrieved from eight databases and a manual search. After screening the titles and abstracts, the full text of 26 articles were critically appraised, resulting in five articles that met inclusion criteria for the review. Because the five articles to be reviewed were qualitative studies, the Critical Appraisal Skills Program toolkit was used to evaluate the methodological quality. A thematic synthesis was employed to identify common themes across the studies. Multiple socio-economic and cultural factors were identified that all had the potential to influence cancer treatment decision-making by indigenous people. These factors were distilled into four themes: spiritual beliefs, cultural influences, communication and existing healthcare systems and structures. Although existing research identified multiple factors influencing decision-making, this review identified that quality studies in this domain are scarce. There is scope for further investigation, both into decision-making factors and into the subsequent design of culturally appropriate programmes and services that meet the needs of indigenous peoples. Copyright © 2015 John Wiley & Sons, Ltd.

The factors facilitating and inhibiting effective clinical decision-making in nursing: a qualitative study

PubMed Central

Hagbaghery, Mohsen Adib; Salsali, Mahvash; Ahmadi, Fazlolah

2004-01-01

Background Nurses' practice takes place in a context of ongoing advances in research and technology. The dynamic and uncertain nature of health care environment requires nurses to be competent decision-makers in order to respond to clients' needs. Recently, the public and the government have criticized Iranian nurses because of poor quality of patient care. However nurses' views and experiences on factors that affect their clinical function and clinical decision-making have rarely been studied. Methods Grounded theory methodology was used to analyze the participants' lived experiences and their viewpoints regarding the factors affecting their clinical function and clinical decision-making. Semi-structured interviews and participant observation methods were used to gather the data. Thirty-eight participants were interviewed and twelve sessions of observation were carried out. Constant comparative analysis method was used to analyze the data. Results Five main themes emerged from the data. From the participants' points of view, "feeling competent", "being self-confident", "organizational structure", "nursing education", and "being supported" were considered as important factors in effective clinical decision-making. Conclusion As participants in this research implied, being competent and self-confident are the most important personal factors influencing nurses clinical decision-making. Also external factors such as organizational structure, access to supportive resources and nursing education have strengthening or inhibiting effects on the nurses' decisions. Individual nurses, professional associations, schools of nursing, nurse educators, organizations that employ nurses and government all have responsibility for developing and finding strategies that facilitate nurses' effective clinical decision-making. They are responsible for identifying barriers and enhancing factors within the organizational structure that facilitate nurses' clinical decision-making. PMID:15068484

A survey of decision tree classifier methodology

NASA Technical Reports Server (NTRS)

Safavian, S. R.; Landgrebe, David

1991-01-01

Decision tree classifiers (DTCs) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps the most important feature of DTCs is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issues. After considering potential advantages of DTCs over single-state classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

A survey of decision tree classifier methodology

NASA Technical Reports Server (NTRS)

Safavian, S. Rasoul; Landgrebe, David

1990-01-01

Decision Tree Classifiers (DTC's) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps, the most important feature of DTC's is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issue. After considering potential advantages of DTC's over single stage classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

Environmental Risk Assessment of dredging processes - application to Marin harbour (NW Spain)

NASA Astrophysics Data System (ADS)

Gómez, A. G.; García Alba, J.; Puente, A.; Juanes, J. A.

2014-04-01

A methodological procedure to estimate the environmental risk of dredging operations in aquatic systems has been developed. Environmental risk estimations are based on numerical models results, which provide an appropriated spatio-temporal framework analysis to guarantee an effective decision-making process. The methodological procedure has been applied on a real dredging operation in the port of Marin (NW Spain). Results from Marin harbour confirmed the suitability of the developed methodology and the conceptual approaches as a comprehensive and practical management tool.

Feminist poststructuralism: a methodological paradigm for examining clinical decision-making.

PubMed

Arslanian-Engoren, Cynthia

2002-03-01

To present the philosophical framework of feminist poststructuralism, discuss its use as an innovative research approach and its implications for nursing knowledge development and practice. This perspective examines the construction of meaning, power relationships, and the importance of language as it affects contemporary healthcare decisions. It seeks to identify and expose biases that marginalize the healthcare needs of women and contribute to healthcare disparities for this population. Additionally, a feminist poststructuralist perspective seeks to develop new knowledge for understanding gender differences. A feminist poststructuralist perspective represents an alternative paradigm for studying the phenomenon of clinical decision-making. An empirical application example of a feminist poststructuralist perspective is provided. This exemplar investigated emergency department registered nurses' triage decisions for men and women with symptoms suggestive of coronary heart disease.

Evolution of Patient Decision-Making Regarding Medical Treatment of Rheumatoid Arthritis.

PubMed

Mathews, Alexandra L; Coleska, Adriana; Burns, Patricia B; Chung, Kevin C

2016-03-01

The migration of health care toward a consumer-driven system favors increased patient participation during the treatment decision-making process. Patient involvement in treatment decision discussions has been linked to increased treatment adherence and patient satisfaction. Previous studies have quantified decision-making styles of patients with rheumatoid arthritis (RA); however, none of them have considered the evolution of patient involvement after living with RA for many years. We conducted a qualitative study to determine the decision-making model used by long-term RA patients, and to describe the changes in their involvement over time. Twenty participants were recruited from the ongoing Silicone Arthroplasty in Rheumatoid Arthritis study. Semistructured interviews were conducted and data were analyzed using grounded theory methodology. Nineteen out of 20 participants recalled using the paternalistic decision-making (PDM) model immediately following their diagnosis. Fourteen of the 19 participants who initially used PDM evolved to shared decision-making (SDM). Participants attributed the change in involvement to the development of a trusting relationship with their physician, as well as to becoming educated about the disease. When initially diagnosed with RA, patients may let their physician decide on the best treatment course. However, over time patients may evolve to exercise a more collaborative role. Physicians should understand that even within SDM, each patient can demonstrate a varied amount of autonomy. It is up to the physician to have a discussion with each patient to determine his or her desired level of involvement. © 2016, American College of Rheumatology.

Graduate Career-Making and Business Start-Up: A Literature Review

ERIC Educational Resources Information Center

Nabi, Ghulam; Holden, Rick; Walmsley, Andreas

2006-01-01

Purpose: The purpose of this article is to provide a selective review of literature on the career-related decision-making processes in terms of the transition from student to business start-up, and the nature and influence of support and guidance. Design/methodology/approach: Primarily, a critical review of a range of recently published literature…

Making the Most of Obesity Research: Developing Research and Policy Objectives through Evidence Triangulation

ERIC Educational Resources Information Center

Oliver, Kathryn; Aicken, Catherine; Arai, Lisa

2013-01-01

Drawing lessons from research can help policy makers make better decisions. If a large and methodologically varied body of research exists, as with childhood obesity, this is challenging. We present new research and policy objectives for child obesity developed by triangulating user involvement data with a mapping study of interventions aimed at…

Humanitarian Interventions: Western Imperialism or a Responsibility to Protect?--An Analysis of the Humanitarian Interventions in Darfur

ERIC Educational Resources Information Center

Damboeck, Johanna

2012-01-01

Purpose: The aim of this article is to provide an analysis of the features that have shaped the state's decision-making process in the United Nations, with regard to the humanitarian intervention in Darfur from 2003 onwards. Design/methodology/approach: The methodological approach to the study is a review of political statement papers grounded in…

Comprehensive Genetic Characterization of Intraprostatic Chronic Inflammation and Prostate Cancer in African American Men

DTIC Science & Technology

2017-09-01

with new methodologies of intratumoral phylogenetic analyses, will yield pivotal information in elucidating the key genes involved evolution of PCa...combined with both clinical and experimental genetic data produced by this study may empower patients and doctors to make personalized treatment decisions...sequencing, paired with new methodologies of intratumoral phylogenetic analyses, will yield pivotal information in elucidating the key genes involved

Strategic Technology Investment Analysis: An Integrated System Approach

NASA Technical Reports Server (NTRS)

Adumitroaie, V.; Weisbin, C. R.

2010-01-01

Complex technology investment decisions within NASA are increasingly difficult to make such that the end results are satisfying the technical objectives and all the organizational constraints. Due to a restricted science budget environment and numerous required technology developments, the investment decisions need to take into account not only the functional impact on the program goals, but also development uncertainties and cost variations along with maintaining a healthy workforce. This paper describes an approach for optimizing and qualifying technology investment portfolios from the perspective of an integrated system model. The methodology encompasses multi-attribute decision theory elements and sensitivity analysis. The evaluation of the degree of robustness of the recommended portfolio provides the decision-maker with an array of viable selection alternatives, which take into account input uncertainties and possibly satisfy nontechnical constraints. The methodology is presented in the context of assessing capability development portfolios for NASA technology programs.

Applied Swarm-based medicine: collecting decision trees for patterns of algorithms analysis.

PubMed

Panje, Cédric M; Glatzer, Markus; von Rappard, Joscha; Rothermundt, Christian; Hundsberger, Thomas; Zumstein, Valentin; Plasswilm, Ludwig; Putora, Paul Martin

2017-08-16

The objective consensus methodology has recently been applied in consensus finding in several studies on medical decision-making among clinical experts or guidelines. The main advantages of this method are an automated analysis and comparison of treatment algorithms of the participating centers which can be performed anonymously. Based on the experience from completed consensus analyses, the main steps for the successful implementation of the objective consensus methodology were identified and discussed among the main investigators. The following steps for the successful collection and conversion of decision trees were identified and defined in detail: problem definition, population selection, draft input collection, tree conversion, criteria adaptation, problem re-evaluation, results distribution and refinement, tree finalisation, and analysis. This manuscript provides information on the main steps for successful collection of decision trees and summarizes important aspects at each point of the analysis.

A validated methodology for determination of laboratory instrument computer interface efficacy

NASA Astrophysics Data System (ADS)

1984-12-01

This report is intended to provide a methodology for determining when, and for which instruments, direct interfacing of laboratory instrument and laboratory computers is beneficial. This methodology has been developed to assist the Tri-Service Medical Information Systems Program Office in making future decisions regarding laboratory instrument interfaces. We have calculated the time savings required to reach a break-even point for a range of instrument interface prices and corresponding average annual costs. The break-even analyses used empirical data to estimate the number of data points run per day that are required to meet the break-even point. The results indicate, for example, that at a purchase price of $3,000, an instrument interface will be cost-effective if the instrument is utilized for at least 154 data points per day if operated in the continuous mode, or 216 points per day if operated in the discrete mode. Although this model can help to ensure that instrument interfaces are cost effective, additional information should be considered in making the interface decisions. A reduction in results transcription errors may be a major benefit of instrument interfacing.

Inter-rater reliability for movement pattern analysis (MPA): measuring patterning of behaviors versus discrete behavior counts as indicators of decision-making style

PubMed Central

Connors, Brenda L.; Rende, Richard; Colton, Timothy J.

2014-01-01

The unique yield of collecting observational data on human movement has received increasing attention in a number of domains, including the study of decision-making style. As such, interest has grown in the nuances of core methodological issues, including the best ways of assessing inter-rater reliability. In this paper we focus on one key topic – the distinction between establishing reliability for the patterning of behaviors as opposed to the computation of raw counts – and suggest that reliability for each be compared empirically rather than determined a priori. We illustrate by assessing inter-rater reliability for key outcome measures derived from movement pattern analysis (MPA), an observational methodology that records body movements as indicators of decision-making style with demonstrated predictive validity. While reliability ranged from moderate to good for raw counts of behaviors reflecting each of two Overall Factors generated within MPA (Assertion and Perspective), inter-rater reliability for patterning (proportional indicators of each factor) was significantly higher and excellent (ICC = 0.89). Furthermore, patterning, as compared to raw counts, provided better prediction of observable decision-making process assessed in the laboratory. These analyses support the utility of using an empirical approach to inform the consideration of measuring patterning versus discrete behavioral counts of behaviors when determining inter-rater reliability of observable behavior. They also speak to the substantial reliability that may be achieved via application of theoretically grounded observational systems such as MPA that reveal thinking and action motivations via visible movement patterns. PMID:24999336

Inter-rater reliability for movement pattern analysis (MPA): measuring patterning of behaviors versus discrete behavior counts as indicators of decision-making style.

PubMed

Connors, Brenda L; Rende, Richard; Colton, Timothy J

2014-01-01

The unique yield of collecting observational data on human movement has received increasing attention in a number of domains, including the study of decision-making style. As such, interest has grown in the nuances of core methodological issues, including the best ways of assessing inter-rater reliability. In this paper we focus on one key topic - the distinction between establishing reliability for the patterning of behaviors as opposed to the computation of raw counts - and suggest that reliability for each be compared empirically rather than determined a priori. We illustrate by assessing inter-rater reliability for key outcome measures derived from movement pattern analysis (MPA), an observational methodology that records body movements as indicators of decision-making style with demonstrated predictive validity. While reliability ranged from moderate to good for raw counts of behaviors reflecting each of two Overall Factors generated within MPA (Assertion and Perspective), inter-rater reliability for patterning (proportional indicators of each factor) was significantly higher and excellent (ICC = 0.89). Furthermore, patterning, as compared to raw counts, provided better prediction of observable decision-making process assessed in the laboratory. These analyses support the utility of using an empirical approach to inform the consideration of measuring patterning versus discrete behavioral counts of behaviors when determining inter-rater reliability of observable behavior. They also speak to the substantial reliability that may be achieved via application of theoretically grounded observational systems such as MPA that reveal thinking and action motivations via visible movement patterns.

Maximizing Health or Sufficient Capability in Economic Evaluation? A Methodological Experiment of Treatment for Drug Addiction.

PubMed

Goranitis, Ilias; Coast, Joanna; Day, Ed; Copello, Alex; Freemantle, Nick; Frew, Emma

2017-07-01

Conventional practice within the United Kingdom and beyond is to conduct economic evaluations with "health" as evaluative space and "health maximization" as the decision-making rule. However, there is increasing recognition that this evaluative framework may not always be appropriate, and this is particularly the case within public health and social care contexts. This article presents a methodological case study designed to explore the impact of changing the evaluative space within an economic evaluation from health to capability well-being and the decision-making rule from health maximization to the maximization of sufficient capability. Capability well-being is an evaluative space grounded on Amartya Sen's capability approach and assesses well-being based on individuals' ability to do and be the things they value in life. Sufficient capability is an egalitarian approach to decision making that aims to ensure everyone in society achieves a normatively sufficient level of capability well-being. The case study is treatment for drug addiction, and the cost-effectiveness of 2 psychological interventions relative to usual care is assessed using data from a pilot trial. Analyses are undertaken from a health care and a government perspective. For the purpose of the study, quality-adjusted life years (measured using the EQ-5D-5L) and years of full capability equivalent and years of sufficient capability equivalent (both measured using the ICECAP-A [ICEpop CAPability measure for Adults]) are estimated. The study concludes that different evaluative spaces and decision-making rules have the potential to offer opposing treatment recommendations. The implications for policy makers are discussed.

Evaluation of stormwater harvesting sites using multi criteria decision methodology

NASA Astrophysics Data System (ADS)

Inamdar, P. M.; Sharma, A. K.; Cook, Stephen; Perera, B. J. C.

2018-07-01

Selection of suitable urban stormwater harvesting sites and associated project planning are often complex due to spatial, temporal, economic, environmental and social factors, and related various other variables. This paper is aimed at developing a comprehensive methodology framework for evaluating of stormwater harvesting sites in urban areas using Multi Criteria Decision Analysis (MCDA). At the first phase, framework selects potential stormwater harvesting (SWH) sites using spatial characteristics in a GIS environment. In second phase, MCDA methodology is used for evaluating and ranking of SWH sites in multi-objective and multi-stakeholder environment. The paper briefly describes first phase of framework and focuses chiefly on the second phase of framework. The application of the methodology is also demonstrated over a case study comprising of the local government area, City of Melbourne (CoM), Australia for the benefit of wider water professionals engaged in this area. Nine performance measures (PMs) were identified to characterise the objectives and system performance related to the eight alternative SWH sites for the demonstration of the application of developed methodology. To reflect the stakeholder interests in the current study, four stakeholder participant groups were identified, namely, water authorities (WA), academics (AC), consultants (CS), and councils (CL). The decision analysis methodology broadly consisted of deriving PROMETHEE II rankings of eight alternative SWH sites in the CoM case study, under two distinct group decision making scenarios. The major innovation of this work is the development and application of comprehensive methodology framework that assists in the selection of potential sites for SWH, and facilitates the ranking in multi-objective and multi-stakeholder environment. It is expected that the proposed methodology will assist the water professionals and managers with better knowledge that will reduce the subjectivity in the selection and evaluation of SWH sites.

International lessons in new methods for grading and integrating cost effectiveness evidence into clinical practice guidelines.

PubMed

Antioch, Kathryn M; Drummond, Michael F; Niessen, Louis W; Vondeling, Hindrik

2017-01-01

Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor. New economic evaluation checklists, Multi-Criteria Decision Analyses (MCDA) and other decision criteria enable health economists to impact on decision making world-wide. We analyse the methodologies for integrating economic evidence into CPG agencies globally, including the Agency of Health Research and Quality (AHRQ) in the USA, National Health and Medical Research Council (NHMRC) and Australian political reforms. The Guidelines and Economists Network International (GENI) Board members from Australia, UK, Canada and Denmark presented the findings at the conference of the International Health Economists Association (IHEA) and we report conclusions and developments since. The Consolidated Guidelines for the Reporting of Economic Evaluations (CHEERS) 24 item check list can be used by AHRQ, NHMRC, other CPG and health organisations, in conjunction with the Drummond ten-point check list and a questionnaire that scores that checklist for grading studies, when assessing economic evidence. Cost-effectiveness Analysis (CEA) thresholds, opportunity cost and willingness-to-pay (WTP) are crucial issues for decision rules in CEA generally, including end-of-life therapies. Limitations of inter-rater reliability in checklists can be addressed by including more than one assessor to reach a consensus, especially when impacting on treatment decisions. We identify priority areas to generate economic evidence for CPGs by NHMRC, AHRQ, and other agencies. The evidence may cover demand for care issues such as involved time, logistics, innovation price, price sensitivity, substitutes and complements, WTP, absenteeism and presentism. Supply issues may include economies of scale, efficiency changes, and return on investment. Involved equity and efficiency measures may include cost-of-illness, disease burden, quality-of-life, budget impact, cost-effective ratios, net benefits and disparities in access and outcomes. Priority setting remains essential and trade-off decisions between policy criteria can be based on MCDA, both in evidence based clinical medicine and in health planning.

7 CFR 3430.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... financial assistance that provides support or stimulation to accomplish a public purpose. Awards may be..., curriculum development, instructional materials and equipment, and innovative teaching methodologies... knowledge and informal educational programs to people, enabling them to make practical decisions. Food and...

Green Remediation Best Management Practices: Overview of EPA's Methodology to Address the Environmental Footprint of Site Cleanup

EPA Pesticide Factsheets

Contaminated site cleanups involving complex activities may benefit from a detailed environmental footprint analysis to inform decision-making about application of suitable best management practices for greener cleanups.

[Methodology for construction of a panel of indicators for monitoring and evaluation of unified health system (SUS) management].

PubMed

Tamaki, Edson Mamoru; Tanaka, Oswaldo Yoshimi; Felisberto, Eronildo; Alves, Cinthia Kalyne de Almeida; Drumond Junior, Marcos; Bezerra, Luciana Caroline de Albuquerque; Calvo, Maria Cristina Marino; Miranda, Alcides Silva de

2012-04-01

This study sought to develop methodology for the construction of a Panel for the Monitoring and Evaluation of Management of the Unified Health System (SUS). The participative process used in addition to the systematization conducted made it possible to identify an effective strategy for building management tools in partnership with researchers, academic institutions and managers of the SUS. The final systematization of the Panel selected indicators for the management of the SUS in terms of Demand, Inputs, Processes, Outputs and Outcomes in order to provide a simple, versatile and useful tool for evaluation at any level of management and more transparent and easier communication with all stakeholders in decision-making. Taking the management of the SUS as the scope of these processes and practices in all normative aspects enabled dialog between systemic theories and those which consider the centrality of the social actor in the decision-making process.

Using Risk Assessment Methodologies to Meet Management Objectives

NASA Technical Reports Server (NTRS)

DeMott, D. L.

2015-01-01

Corporate and program objectives focus on desired performance and results. ?Management decisions that affect how to meet these objectives now involve a complex mix of: technology, safety issues, operations, process considerations, employee considerations, regulatory requirements, financial concerns and legal issues. ?Risk Assessments are a tool for decision makers to understand potential consequences and be in a position to reduce, mitigate or eliminate costly mistakes or catastrophic failures. Using a risk assessment methodology is only a starting point. ?A risk assessment program provides management with important input in the decision making process. ?A pro-active organization looks to the future to avoid problems, a reactive organization can be blindsided by risks that could have been avoided. ?You get out what you put in, how useful your program is will be up to the individual organization.

Ethical case deliberation and decision making.

PubMed

Gracia, Diego

2003-01-01

During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics.

Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders.

PubMed

Connors, Brenda L; Rende, Richard; Colton, Timothy J

2013-01-01

There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time-individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day.

Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders

PubMed Central

Connors, Brenda L.; Rende, Richard; Colton, Timothy J.

2013-01-01

There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time—individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day. PMID:24069012

A hierarchical-multiobjective framework for risk management

NASA Technical Reports Server (NTRS)

Haimes, Yacov Y.; Li, Duan

1991-01-01

A broad hierarchical-multiobjective framework is established and utilized to methodologically address the management of risk. United into the framework are the hierarchical character of decision-making, the multiple decision-makers at separate levels within the hierarchy, the multiobjective character of large-scale systems, the quantitative/empirical aspects, and the qualitative/normative/judgmental aspects. The methodological components essentially consist of hierarchical-multiobjective coordination, risk of extreme events, and impact analysis. Examples of applications of the framework are presented. It is concluded that complex and interrelated forces require an analysis of trade-offs between engineering analysis and societal preferences, as in the hierarchical-multiobjective framework, to successfully address inherent risk.

Methodological development for selection of significant predictors explaining fatal road accidents.

PubMed

Dadashova, Bahar; Arenas-Ramírez, Blanca; Mira-McWilliams, José; Aparicio-Izquierdo, Francisco

2016-05-01

Identification of the most relevant factors for explaining road accident occurrence is an important issue in road safety research, particularly for future decision-making processes in transport policy. However model selection for this particular purpose is still an ongoing research. In this paper we propose a methodological development for model selection which addresses both explanatory variable and adequate model selection issues. A variable selection procedure, TIM (two-input model) method is carried out by combining neural network design and statistical approaches. The error structure of the fitted model is assumed to follow an autoregressive process. All models are estimated using Markov Chain Monte Carlo method where the model parameters are assigned non-informative prior distributions. The final model is built using the results of the variable selection. For the application of the proposed methodology the number of fatal accidents in Spain during 2000-2011 was used. This indicator has experienced the maximum reduction internationally during the indicated years thus making it an interesting time series from a road safety policy perspective. Hence the identification of the variables that have affected this reduction is of particular interest for future decision making. The results of the variable selection process show that the selected variables are main subjects of road safety policy measures. Published by Elsevier Ltd.

Enhancing Fire Control Decision Making with the Patriot Cognitive Skills Trainer: Development and Validation

DTIC Science & Technology

2017-11-01

existing instruction. In addition, the methodology used to identify decision-triggers may be applied to other Army domains to develop instruction...ADDIE is an instructional design framework used as a descriptive guideline for building effective training and performance support tools. 3 In...and evaluate information, and create a solution—were Level Descriptive Terms Additional Examples Create Generating – hypothesizing Planning

A stochastic conflict resolution model for trading pollutant discharge permits in river systems.

PubMed

Niksokhan, Mohammad Hossein; Kerachian, Reza; Amin, Pedram

2009-07-01

This paper presents an efficient methodology for developing pollutant discharge permit trading in river systems considering the conflict of interests of involving decision-makers and the stakeholders. In this methodology, a trade-off curve between objectives is developed using a powerful and recently developed multi-objective genetic algorithm technique known as the Nondominated Sorting Genetic Algorithm-II (NSGA-II). The best non-dominated solution on the trade-off curve is defined using the Young conflict resolution theory, which considers the utility functions of decision makers and stakeholders of the system. These utility functions are related to the total treatment cost and a fuzzy risk of violating the water quality standards. The fuzzy risk is evaluated using the Monte Carlo analysis. Finally, an optimization model provides the trading discharge permit policies. The practical utility of the proposed methodology in decision-making is illustrated through a realistic example of the Zarjub River in the northern part of Iran.

To dialyse or delay: a qualitative study of older New Zealanders’ perceptions and experiences of decision-making, with stage 5 chronic kidney disease

PubMed Central

Lovell, Sarah; Walker, Robert J; Schollum, John B W; Marshall, Mark R; McNoe, Bronwen M; Derrett, Sarah

2017-01-01

Background Issues related to renal replacement therapy in elderly people with end stage kidney disease (ESKD) are complex. There is inadequate empirical data related to: decision-making by older populations, treatment experiences, implications of dialysis treatment and treatment modality on quality of life, and how these link to expectations of ageing. Study population Participants for this study were selected from a larger quantitative study of dialysis and predialysis patients aged 65 years or older recruited from three nephrology services across New Zealand. All participants had reached chronic kidney disease (CKD) stage 5 and had undergone dialysis education but had not started dialysis or recently started dialysis within the past 6 months. Methodology Serial qualitative interviews were undertaken to explore the decision-making processes and subsequent treatment experiences of patients with ESKD. Analytical approach: A framework method guided the iterative process of analysis. Decision-making codes were generated within NVivo software and then compared with the body of the interviews. Results Interviews were undertaken with 17 participants. We observed that decision-making was often a fluid process, rather than occurring at a single point in time, and was heavily influenced by perceptions of oneself as becoming old, social circumstances, life events and health status. Limitations This study focuses on participants' experiences of decision-making about treatment and does not include perspectives of their nephrologists or other members of the nephrology team. Conclusions Older patients often delay dialysis as an act of self-efficacy. They often do not commit to a dialysis decision following predialysis education. Delaying decision-making and initiating dialysis were common. This was not seen by participants as a final decision about therapy. Predialysis care and education should be different for older patients, who will delay decision-making until the time of facing obvious uraemic symptoms, threatening blood tests or paternalistic guidance from their nephrologist. Trial registration number Australasian Clinical Trials Registry ACTRN 12611000024943; results. PMID:28360253

Parents' involvement in the human papillomavirus vaccination decision for their sons.

PubMed

Perez, Samara; Restle, Hannah; Naz, Anila; Tatar, Ovidiu; Shapiro, Gilla K; Rosberger, Zeev

2017-12-01

Parents are critical to ensure sufficient human papillomavirus (HPV) vaccine coverage. No studies to date have examined how mothers and fathers perceive their own, their partners' and their sons' involvement in HPV vaccination decision-making process. An online survey methodology was used to collect data from a national sample of Canadian parents (33% fathers, 67% mothers, M age =44) who had a 9-16years old son (n=3117). Parent's perception of their self-involvement, partner-involvement and son's involvement in the decision to get their son the HPV vaccine were measured on a Likert scale and were classified as 'no involvement', 'moderate involvement' and 'high involvement'. Mothers and fathers both perceive that they themselves and their partners should be highly involved in their son's HPV vaccination decision. Son's involvement was reported as moderate and influenced by age. Significant gender differences were found for self and partner involvement, but the effect sizes were small. Mothers and fathers both perceive that they themselves and their partners should be significantly involved in their son's HPV vaccination decision. A dyad decision-making model involving both parents for HPV vaccine decision-making is suggested with a stronger recommendation for a triad decision-making model involving both parents as well as the child/adolescent. Gender stereotypes of females perceiving themselves as the sole decision-maker or fathers not wanting to be involved in their children's health decision were not supported. Copyright © 2017 Elsevier B.V. All rights reserved.

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

NASA Astrophysics Data System (ADS)

Armas, Iuliana; Gheorghe, Diana

2014-05-01

Nowadays, because of the ever increasing volume of information, policymakers are faced with decision making problems. Achieving an objective and suitable decision making may become a challenge. In such situations decision support systems (DSS) have been developed. DSS can assist in the decision making process, offering support on how a decision should be made, rather than what decision should be made (Simon, 1979). This in turn potentially involves a huge number of stakeholders and criteria. Regarding seismic risk, Bucharest City is highly vulnerable (Mandrescu et al., 2007). The aim of this study is to implement a spatial decision support system in order to secure a suitable shelter in case of an earthquake occurrence in the historical centre of Bucharest City. In case of a seismic risk, a shelter is essential for sheltering people who lost their homes or whose homes are in danger of collapsing while people at risk receive first aid in the post-disaster phase. For the present study, the SMCE Module for ILWIS 3.4 was used. The methodology included structuring the problem by creating a decision tree, standardizing and weighting of the criteria. The results showed that the most suitable buildings are Tania Hotel, Hanul lui Manuc, The National Bank of Romania, The Romanian Commercial Bank and The National History Museum.

A review of costing methodologies in critical care studies.

PubMed

Pines, Jesse M; Fager, Samuel S; Milzman, David P

2002-09-01

Clinical decision making in critical care has traditionally been based on clinical outcome measures such as mortality and morbidity. Over the past few decades, however, increasing competition in the health care marketplace has made it necessary to consider costs when making clinical and managerial decisions in critical care. Sophisticated costing methodologies have been developed to aid this decision-making process. We performed a narrative review of published costing studies in critical care during the past 6 years. A total of 282 articles were found, of which 68 met our search criteria. They involved a mean of 508 patients (range, 20-13,907). A total of 92.6% of the studies (63 of 68) used traditional cost analysis, whereas the remaining 7.4% (5 of 68) used cost-effectiveness analysis. None (0 of 68) used cost-benefit analysis or cost-utility analysis. A total of 36.7% (25 of 68) used hospital charges as a surrogate for actual costs. Of the 43 articles that actually counted costs, 37.2% (16 of 43) counted physician costs, 27.9% (12 of 43) counted facility costs, 34.9% (15 of 43) counted nursing costs, 9.3% (4 of 43) counted societal costs, and 90.7% (39 of 43) counted laboratory, equipment, and pharmacy costs. Our conclusion is that despite considerable progress in costing methodologies, critical care studies have not adequately implemented these techniques. Given the importance of financial implications in medicine, it would be prudent for critical care studies to use these more advanced techniques. Copyright 2002, Elsevier Science (USA). All rights reserved.

Knowledge based system and decision making methodologies in materials selection for aircraft cabin metallic structures

NASA Astrophysics Data System (ADS)

Adhikari, Pashupati Raj

Materials selection processes have been the most important aspects in product design and development. Knowledge-based system (KBS) and some of the methodologies used in the materials selection for the design of aircraft cabin metallic structures are discussed. Overall aircraft weight reduction means substantially less fuel consumption. Part of the solution to this problem is to find a way to reduce overall weight of metallic structures inside the cabin. Among various methodologies of materials selection using Multi Criterion Decision Making (MCDM) techniques, a few of them are demonstrated with examples and the results are compared with those obtained using Ashby's approach in materials selection. Pre-defined constraint values, mainly mechanical properties, are employed as relevant attributes in the process. Aluminum alloys with high strength-to-weight ratio have been second-to-none in most of the aircraft parts manufacturing. Magnesium alloys that are much lighter in weight as alternatives to the Al-alloys currently in use in the structures are tested using the methodologies and ranked results are compared. Each material attribute considered in the design are categorized as benefit and non-benefit attribute. Using Ashby's approach, material indices that are required to be maximized for an optimum performance are determined, and materials are ranked based on the average of consolidated indices ranking. Ranking results are compared for any disparity among the methodologies.

On multi-site damage identification using single-site training data

NASA Astrophysics Data System (ADS)

Barthorpe, R. J.; Manson, G.; Worden, K.

2017-11-01

This paper proposes a methodology for developing multi-site damage location systems for engineering structures that can be trained using single-site damaged state data only. The methodology involves training a sequence of binary classifiers based upon single-site damage data and combining the developed classifiers into a robust multi-class damage locator. In this way, the multi-site damage identification problem may be decomposed into a sequence of binary decisions. In this paper Support Vector Classifiers are adopted as the means of making these binary decisions. The proposed methodology represents an advancement on the state of the art in the field of multi-site damage identification which require either: (1) full damaged state data from single- and multi-site damage cases or (2) the development of a physics-based model to make multi-site model predictions. The potential benefit of the proposed methodology is that a significantly reduced number of recorded damage states may be required in order to train a multi-site damage locator without recourse to physics-based model predictions. In this paper it is first demonstrated that Support Vector Classification represents an appropriate approach to the multi-site damage location problem, with methods for combining binary classifiers discussed. Next, the proposed methodology is demonstrated and evaluated through application to a real engineering structure - a Piper Tomahawk trainer aircraft wing - with its performance compared to classifiers trained using the full damaged-state dataset.

Application of validity theory and methodology to patient-reported outcome measures (PROMs): building an argument for validity.

PubMed

Hawkins, Melanie; Elsworth, Gerald R; Osborne, Richard H

2018-07-01

Data from subjective patient-reported outcome measures (PROMs) are now being used in the health sector to make or support decisions about individuals, groups and populations. Contemporary validity theorists define validity not as a statistical property of the test but as the extent to which empirical evidence supports the interpretation of test scores for an intended use. However, validity testing theory and methodology are rarely evident in the PROM validation literature. Application of this theory and methodology would provide structure for comprehensive validation planning to support improved PROM development and sound arguments for the validity of PROM score interpretation and use in each new context. This paper proposes the application of contemporary validity theory and methodology to PROM validity testing. The validity testing principles will be applied to a hypothetical case study with a focus on the interpretation and use of scores from a translated PROM that measures health literacy (the Health Literacy Questionnaire or HLQ). Although robust psychometric properties of a PROM are a pre-condition to its use, a PROM's validity lies in the sound argument that a network of empirical evidence supports the intended interpretation and use of PROM scores for decision making in a particular context. The health sector is yet to apply contemporary theory and methodology to PROM development and validation. The theoretical and methodological processes in this paper are offered as an advancement of the theory and practice of PROM validity testing in the health sector.

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.

Near-Earth object hazardous impact: A Multi-Criteria Decision Making approach.

PubMed

Sánchez-Lozano, J M; Fernández-Martínez, M

2016-11-16

The impact of a near-Earth object (NEO) may release large amounts of energy and cause serious damage. Several NEO hazard studies conducted over the past few years provide forecasts, impact probabilities and assessment ratings, such as the Torino and Palermo scales. These high-risk NEO assessments involve several criteria, including impact energy, mass, and absolute magnitude. The main objective of this paper is to provide the first Multi-Criteria Decision Making (MCDM) approach to classify hazardous NEOs. Our approach applies a combination of two methods from a widely utilized decision making theory. Specifically, the Analytic Hierarchy Process (AHP) methodology is employed to determine the criteria weights, which influence the decision making, and the Technique for Order Performance by Similarity to Ideal Solution (TOPSIS) is used to obtain a ranking of alternatives (potentially hazardous NEOs). In addition, NEO datasets provided by the NASA Near-Earth Object Program are utilized. This approach allows the classification of NEOs by descending order of their TOPSIS ratio, a single quantity that contains all of the relevant information for each object.

U.S. EPA Authority to Use Cumulative Risk Assessments in Environmental Decision-Making

PubMed Central

Alves, Sarah; Tilghman, Joan; Rosenbaum, Arlene; Payne-Sturges, Devon C.

2012-01-01

Conventionally, in its decision-making, the U.S. EPA has evaluated the effects and risks associated with a single pollutant in a single exposure medium. In reality, people are exposed to mixtures of pollutants or to the same pollutant through a variety of media, including the air, water, and food. It is now more recognized than before that environmental exposure to pollutants occurs via multiple exposure routes and pathways, including inhalation, ingestion, and dermal absorption. Moreover, chemical, biologic, radiologic, physical, and psychologic stressors are all acknowledged as affecting human health. Although many EPA offices attempt to consider cumulative risk assessment and cumulative effects in various ways, there is no Agency-wide policy for considering these risks and the effects of exposure to these risks when making environmental decisions. This article examines how U.S. courts might assess EPA’s general authority and discretion to use cumulative risk assessment as the basis for developing data in support of environmental decision-making, and how courts might assess the validity of a cumulative risk assessment methodology itself. PMID:22829786

Burden of Disease Study and Priority Setting in Korea: an Ethical Perspective

PubMed Central

2016-01-01

When thinking about priority setting in access to healthcare resources, decision-making requires that cost-effectiveness is balanced against medical ethics. The burden of disease has emerged as an important approach to the assessment of health needs for political decision-making. However, the disability adjusted life years approach hides conceptual and methodological issues regarding the claims and value of disabled people. In this article, we discuss ethical issues that are raised as a consequence of the introduction of evidence-based health policy, such as economic evidence, in establishing resource allocation priorities. In terms of ethical values in health priority setting in Korea, there is no reliable rationale for the judgment used in decision-making as well as for setting separate and distinct priorities for different government bodies. An important question, therefore, is which ethical values guiding the practice of decision-making should be reconciled with the economic evidence found in Korean healthcare. The health technology assessment core model from the European network for Health Technology Assessment (EUnetHTA) project is a good example of incorporating ethical values into decision-making. We suggest that a fair distribution of scarce healthcare resources in South Korea can be achieved by considering the ethical aspects of healthcare. PMID:27775247

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

Decision making and senior management: the implementation of change projects covering clinical management in SUS hospitals.

PubMed

Pacheco, José Márcio da Cunha; Gomes, Romeu

2016-08-01

This paper analyses the decision making process for senior management in public hospitals that are a part of the National Health Service in Brazil (hereafter SUS) in relation to projects aimed at changing clinical management. The methodological design of this study is qualitative in nature taking a hermeneutics-dialectics perspective in terms of results. Hospital directors noted that clinical management projects changed the state of hospitals through: improving their organizations, mobilizing their staff in order to increase a sense of order and systemizing actions and available resources. Technical rationality was the principal basis used in the decision making process for managers. Due to the reality of many hospitals having fragmented organizations, this fact impeded the use of aspects related to rationality, such as economic and financial factors in the decision making process. The incremental model and general politics also play a role in this area. We concluded that the decision making process embraces a large array of factors including rational aspects such as the use of management techniques and the ability to analyze, interpret and summarize. It also incorporates subjective elements such as how to select values and dealing with people's working experiences. We recognized that management problems are wide in scope, ambiguous, complex and do not come with a lot of structure in practice.

Story-Making as Methodology: Disrupting Dominant Stories through Multimedia Storytelling.

PubMed

Rice, Carla; Mündel, Ingrid

2018-05-01

In this essay, we discuss multimedia story-making methodologies developed through Re•Vision: The Centre for Art and Social Justice that investigates the power of the arts, especially story, to positively influence decision makers in diverse sectors. Our story-making methodology brings together majority and minoritized creators to represent previously unattended experiences (e.g., around mind-body differences, queer sexuality, urban Indigenous identity, and Inuit cultural voice) with an aim to building understanding and shifting policies/practices that create barriers to social inclusion and justice. We analyze our ongoing efforts to rework our storytelling methodology, spotlighting acts of revising carried out by facilitators and researchers as they/we redefine methodological terms for each storytelling context, by researcher-storytellers as they/we rework material from our lives, and by receivers of the stories as we revise our assumptions about particular embodied histories and how they are defined within dominant cultural narratives and institutional structures. This methodology, we argue, contributes to the existing qualitative lexicon by providing innovative new approaches not only for chronicling marginalized/misrepresented experiences and critically researching selves, but also for scaffolding intersectional alliances and for imagining more just futures. © 2018 Canadian Sociological Association/La Société canadienne de sociologie.

How Can You Support RIDM/CRM/RM Through the Use of PRA

NASA Technical Reports Server (NTRS)

DoVemto. Tpmu

2011-01-01

Probabilistic Risk Assessment (PRA) is one of key Risk Informed Decision Making (RIDM) tools. It is a scenario-based methodology aimed at identifying and assessing Safety and Technical Performance risks in complex technological systems.

7 CFR 3430.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... resources of the organization to the project. Award means financial assistance that provides support or... equipment, and innovative teaching methodologies. Established and demonstrated capacity means that an..., enabling them to make practical decisions. Food and agricultural sciences means basic, applied, and...

[Promoting citizen participation in healthcare through PyDEsalud.com].

PubMed

Perestelo-Pérez, Lilisbeth; Pérez-Ramos, Jeanette; Abt-Sacks, Analía; Rivero-Santana, Amado; Serrano-Aguilar, Pedro

2013-01-01

This project supports the initiative promoted by the Spanish National Health System to provide informational materials, in printed or interactive format, to encourage public participation in decision making and healthcare. We present the newly created PyDEsalud.com, a web platform aimed at people with chronic diseases with a high socioeconomic impact, such as breast cancer, depression, and diabetes. This platform uses scientific methodology and contains three information service modules (Patients' experiences, Shared decision making, and Research needs), aimed at promoting health education for patients and families. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Uncertainty Representation and Interpretation in Model-Based Prognostics Algorithms Based on Kalman Filter Estimation

NASA Technical Reports Server (NTRS)

Galvan, Jose Ramon; Saxena, Abhinav; Goebel, Kai Frank

2012-01-01

This article discusses several aspects of uncertainty representation and management for model-based prognostics methodologies based on our experience with Kalman Filters when applied to prognostics for electronics components. In particular, it explores the implications of modeling remaining useful life prediction as a stochastic process, and how it relates to uncertainty representation, management and the role of prognostics in decision-making. A distinction between the interpretations of estimated remaining useful life probability density function is explained and a cautionary argument is provided against mixing interpretations for two while considering prognostics in making critical decisions.

Case-Based Learning as Pedagogy for Teaching Information Ethics Based on the Dervin Sense-Making Methodology

ERIC Educational Resources Information Center

Dow, Mirah J.; Boettcher, Carrie A.; Diego, Juana F.; Karch, Marziah E.; Todd-Diaz, Ashley; Woods, Kristine M.

2015-01-01

The purpose of this mixed methods study is to determine the effectiveness of case-based pedagogy in teaching basic principles of information ethics and ethical decision making. Study reports results of pre- and post-assessment completed by 49 library and information science (LIS) graduate students at a Midwestern university. Using Creswell's…

An integrated decision making approach for assessing healthcare waste treatment technologies from a multiple stakeholder.

PubMed

Shi, Hua; Liu, Hu-Chen; Li, Ping; Xu, Xue-Guo

2017-01-01

With increased worldwide awareness of environmental issues, healthcare waste (HCW) management has received much attention from both researchers and practitioners over the past decade. The task of selecting the optimum treatment technology for HCWs is a challenging decision making problem involving conflicting evaluation criteria and multiple stakeholders. In this paper, we develop an integrated decision making framework based on cloud model and MABAC method for evaluating and selecting the best HCW treatment technology from a multiple stakeholder perspective. The introduced framework deals with uncertain linguistic assessments of alternatives by using interval 2-tuple linguistic variables, determines decision makers' relative weights based on the uncertainty and divergence degrees of every decision maker, and obtains the ranking of all HCW disposal alternatives with the aid of an extended MABAC method. Finally, an empirical example from Shanghai, China, is provided to illustrate the feasibility and effectiveness of the proposed approach. Results indicate that the methodology being proposed is more suitable and effective to handle the HCW treatment technology selection problem under vague and uncertain information environment. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Boundaries of the autonomy of local health administration: innovation, creativity and evidence-based decision-making].

PubMed

Silva, Silvio Fernandes da; Souza, Nathan Mendes; Barreto, Jorge Otávio Maia

2014-11-01

The scope of this article was to identify the boundaries of the autonomy of local administration in the context of the federal pact in the Brazilian Unified Health System and the importance and potential for promoting innovation, creativity and evidence-based decision-making by local governments. The methodology used was to ask questions that favored dialogue with the specific literature to identify the influence of centrally-formulated policies in spaces of local autonomy and then to identify strategies to foster innovation, creativity and the systematic use of evidence-based research in health policy implementation. A gradual reduction in municipal decision-making autonomy was detected due to increased financial commitment of the municipalities resulting from responsibilities assumed, albeit with the possibility of reverting this trend in the more recent context. Some determinants and challenges for the dissemination of innovative practices were analyzed and some relevant national and international experiences in this respect were presented. The conclusion drawn is that it is possible to make local decision-making more effective provided that initiatives are consolidated to promote this culture and the formulation and implementation of evidence-based health policies.

[Basic principles and methodological considerations of health economic evaluations].

PubMed

Loza, Cesar; Castillo-Portilla, Manuel; Rojas, José Luis; Huayanay, Leandro

2011-01-01

Health Economics is an essential instrument for health management, and economic evaluations can be considered as tools assisting the decision-making process for the allocation of resources in health. Currently, economic evaluations are increasingly being used worldwide, thus encouraging evidence-based decision-making and seeking efficient and rational alternatives within the framework of health services activities. In this review, we present an overview and define the basic types of economic evaluations, with emphasis on complete Economic Evaluations (EE). In addition, we review key concepts regarding the perspectives from which EE can be conducted, the types of costs that can be considered, the time horizon, discounting, assessment of uncertainty and decision rules. Finally, we describe concepts about the extrapolation and spread of economic evaluations in health.

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.

KNOW ESSENTIALS: a tool for informed decisions in the absence of formal HTA systems.

PubMed

Mathew, Joseph L

2011-04-01

Most developing countries and resource-limited settings lack robust health technology assessment (HTA) systems. Because the development of locally relevant HTA is not immediately viable, and the extrapolation of external HTA is inappropriate, a new model for evaluating health technologies is required. The aim of this study was to describe the development and application of KNOW ESSENTIALS, a tool facilitating evidence-based decisions on health technologies by stakeholders in settings lacking formal HTA systems. Current HTA methodology was examined through literature search. Additional issues relevant to resource-limited settings, but not adequately addressed in current methodology, were identified through further literature search, appraisal of contextually relevant issues, discussion with healthcare professionals familiar with the local context, and personal experience. A set of thirteen elements important for evidence-based decisions was identified, selected and combined into a tool with the mnemonic KNOW ESSENTIALS. Detailed definitions for each element, coding for the elements, and a system to evaluate a given health technology using the tool were developed. Developing countries and resource-limited settings face several challenges to informed decision making. Models that are relevant and applicable in high-income countries are unlikely in such settings. KNOW ESSENTIALS is an alternative that facilitates evidence-based decision making by stakeholders without formal expertise in HTA. The tool could be particularly useful, as an interim measure, in healthcare systems that are developing HTA capacity. It could also be useful anywhere when rapid evidence-based decisions on health technologies are required.

Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making.

PubMed

Mathew, R; Davies, N; Manthorpe, J; Iliffe, S

2016-07-19

Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making

PubMed Central

Mathew, R; Davies, N; Manthorpe, J; Iliffe, S

2016-01-01

Objective Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. Design A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. Data sources A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. Results The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. Conclusions The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice. PMID:27436665

Engaging patients in health care decisions in the emergency department through shared decision-making: a systematic review.

PubMed

Flynn, Darren; Knoedler, Meghan A; Hess, Erik P; Murad, M Hassan; Erwin, Patricia J; Montori, Victor M; Thomson, Richard G

2012-08-01

Many decisions in the emergency department (ED) may benefit from patient involvement, even though this setting has been considered least conducive to shared decision-making (SDM). The objective was to conduct a systematic review to evaluate the approaches, methods, and tools used to engage patients or their surrogates in SDM in the ED. Five electronic databases were searched in conjunction with contacting content experts, reviewing selected bibliographies, and conducting citation searches using the Web of Knowledge database. Two reviewers independently selected eligible studies that addressed patient involvement and engagement in decision-making in the ED setting via the use of decision support interventions (DSIs), defined as decision aids or decision support designed to communicate probabilistic information on the risks and benefits of treatment options to patients as part of an SDM process. Eligible studies described and assessed at least one of the following outcomes: patient knowledge, experiences and perspectives on participating in treatment or management decisions, clinician or patient satisfaction, preference for involvement and/or degree of engagement in decision-making and treatment preferences, and clinical outcomes (e.g., rates of hospital admission/readmission, rates of medical or surgical interventions). Two reviewers extracted data on study characteristics, methodologic quality, and outcomes. The authors also assessed the extent to which SDM interventions adhered to good practice for the presentation of information on outcome probabilities (eight probability items from the International Patient Decision Aid Standards Instrument [IPDASi]) and had comprehensive development processes. Five studies met inclusion criteria and were synthesized using a narrative approach. Each study was of satisfactory methodologic quality and used a DSI to engage patients or their surrogates in decision-making in the ED across four domains: 1) management options for children with small lacerations; 2) options for rehydrating children presenting with vomiting or diarrhea or both; 3) risk of bacteremia (and associated complications), tests, and treatment options for febrile children; and 4) short-term risk of acute coronary syndrome (ACS) in adults with low-risk nontraumatic chest pain. Three studies had poor IPDASi probabilities and development process scores and lacked development informed by theory or involvement of clinicians and patients in development and usability testing. Overall, DSIs were associated with improvements in patients' knowledge and satisfaction with the explanation of their care, preferences for involvement, and engagement in decision-making and demonstrated utility for eliciting patients' preferences and values about management and treatment options. Two computerized DSIs (designed to predict risk of ACS in adults presenting to the ED with chest pain) were shown to reduce health care use without evidence of harm. None of the studies reported lack of feasibility of SDM in the ED. Early investigation of SDM in the ED suggests that patients may benefit from involvement in decision-making and offers no empirical evidence to suggest that SDM is not feasible. Future work is needed to develop and test additional SDM interventions in the ED and to identify contextual barriers and facilitators to implementation in practice. © 2012 by the Society for Academic Emergency Medicine.

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

PubMed Central

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

2013-01-01

Objective Shared decision making is inadequate in intensive care units (ICUs). Decision aids can improve decision making quality, though their role in an ICU setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation. Setting ICUs at three medical centers. Subjects 53 surrogate decision makers and 58 physicians. Design and interventions We developed the decision aid using defined methodological guidelines. After an iterative revision process, formative cognitive testing was performed among surrogate-physician dyads. Next, we compared the decision aid to usual care control in a prospective, before/after design study. Measurements and main results Primary outcomes were physician-surrogate discordance for expected patient survival, comprehension of relevant medical information, and the quality of communication. Compared to control, the intervention group had lower surrogate-physician discordance (7 [10] vs 43 [21]), greater comprehension (11.4 [0.7] vs 6.1 [3.7]), and improved quality of communication (8.7 [1.3] vs 8.4 [1.3]) (all p<0.05) post-intervention. Hospital costs were lower in the intervention group ($110,609 vs $178,618; p=0.044); mortality did not differ by group (38% vs 50%, p=0.95). 94% of surrogates and 100% of physicians reported that the decision aid was useful in decision making. Conclusion We developed a prolonged mechanical ventilation decision aid that is feasible, acceptable, and associated with both improved decision making quality and less resource utilization. Further evaluation using a randomized controlled trial design is needed to evaluate the decision aid's effect on long-term patient and surrogate outcomes. PMID:22635048

Moving data off the shelf and into action: an intervention to improve data-informed decision making in Côte d'Ivoire.

PubMed

Nutley, Tara; Gnassou, Léontine; Traore, Moussa; Bosso, Abitche Edwige; Mullen, Stephanie

2014-01-01

Improving a health system requires data, but too often they are unused or under-used by decision makers. Without interventions to improve the use of data in decision making, health systems cannot meet the needs of the populations they serve. In 2008, in Côte d'Ivoire, data were largely unused in health decision-making processes. To implement and evaluate an intervention to improve the use of data in decision making in Cote d'Ivoire. From 2008 to 2012, Cote d'Ivoire sought to improve the use of national health data through an intervention that broadens participation in and builds links between data collection and decision-making processes; identifies information needs; improves data quality; builds capacity to analyze, synthesize, and interpret data; and develops policies to support data use. To assess the results, a Performance of Routine Information System Management Assessment was conducted before and after the intervention using a combination of purposeful and random sampling. In 2008, the sample consisted of the central level, 12 districts, and 119 facilities, and in 2012, the sample consisted of the central level, 20 districts, and 190 health facilities. To assess data use, we developed dichotomous indicators: discussions of analysis findings, decisions taken based on the analysis, and decisions referred to upper management for action. We aggregated the indicators to generate a composite, continuous index of data use. From 2008 to 2012, the district data-use score increased from 40 to 70%; the facility score remained the same - 38%. The central score is not reported, because of a methodological difference in the two assessments. The intervention improved the use of data in decision making at the district level in Côte d'Ivoire. This study provides an example of, and guidance for, implementing a large-scale intervention to improve data-informed decision making.

Implementing CER: what will it take?

PubMed

Biskupiak, Joseph E; Dunn, Jeffrey D; Holtorf, Anke-Peggy

2012-06-01

Comparative effectiveness research (CER) is undeniably changing how drugs are developed, launched, priced, and reimbursed in the United States. But most organizations are still evaluating what CER can do for them and how and when they can utilize the data. A roundtable of stakeholders, including formulary decision makers, evaluated CER's possible effects on managed care organizations (MCOs) and what it may take to fully integrate CER into decision making. To examine the role of CER in current formulary decision making, compare CER to modeling, discuss ways CER may be used in the future, and describe CER funding sources. While decision makers from different types of organizations, such as pharmacy benefit management (PBM) companies and MCOs, may have varying definitions and expectations of CER, most thought leaders from a roundtable of stakeholders, including formulary decision makers, see value in CER's ability to enhance their formulary decision making. Formulary decision makers may be able to use CER to better inform their coverage decisions in areas such as benefit design, contracting, conditional reimbursement, pay for performance, and other alternative pricing arrangements. Real-world CER will require improvement in the health information technology infrastructure to better capture value-related information. The federal government is viewed as a key driver and funding source behind CER, especially for infrastructure and methods development, while industry will adapt the clinical development and create increasing CER evidence. CER then needs to be applied to determining value (or cost efficacy). It is expected that CER will continue to grow as a valuable component of formulary decision making. Future integration of CER into formulary decision making will require federal government and academic leadership, improvements in the health information technology infrastructure, ongoing funding, and improved and more consistent methodologies.

The Impact of Novel Assessment Methodologies in Toxicology on Green Chemistry and Chemical Alternatives.

PubMed

Rusyn, Ivan; Greene, Nigel

2018-02-01

The field of experimental toxicology is rapidly advancing by incorporating novel techniques and methods that provide a much more granular view into the mechanisms of potential adverse effects of chemical exposures on human health. The data from various in vitro assays and computational models are useful not only for increasing confidence in hazard and risk decisions, but also are enabling better, faster and cheaper assessment of a greater number of compounds, mixtures, and complex products. This is of special value to the field of green chemistry where design of new materials or alternative uses of existing ones is driven, at least in part, by considerations of safety. This article reviews the state of the science and decision-making in scenarios when little to no data may be available to draw conclusions about which choice in green chemistry is "safer." It is clear that there is no "one size fits all" solution and multiple data streams need to be weighed in making a decision. Moreover, the overall level of familiarity of the decision-makers and scientists alike with new assessment methodologies, their validity, value and limitations is evolving. Thus, while the "impact" of the new developments in toxicology on the field of green chemistry is great already, it is premature to conclude that the data from new assessment methodologies have been widely accepted yet. © The Author 2017. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Wildland fire management. Volume 1: Prevention methods and analysis. [systems engineering approach to California fire problems

NASA Technical Reports Server (NTRS)

Weissenberger, S. (Editor)

1973-01-01

A systems engineering approach is reported for the problem of reducing the number and severity of California's wildlife fires. Prevention methodologies are reviewed and cost benefit models are developed for making preignition decisions.

Uncertainty-based tradeoff analysis methodology for integrated transportation investment decision-making.

DOT National Transportation Integrated Search

2009-10-28

Transportation agencies strive to maintain their systems in good condition and also to provide : acceptable levels of service to users. However, funding is often inadequate to meet the needs : of system preservation and expansion, and thus performanc...

RISK ASSESSMENT AND EPIDEMIOLOGICAL INFORMATION FOR PATHOGENIC MICROORGANISMS APPLIED TO SOIL

EPA Science Inventory

There is increasing interest in the development of a microbial risk assessment methodology for regulatory and operational decision making. Initial interests in microbial risk assessments focused on drinking, recreational, and reclaimed water issues. More recently risk assessmen...

Research Methods in Education

ERIC Educational Resources Information Center

Check, Joseph; Schutt, Russell K.

2011-01-01

"Research Methods in Education" introduces research methods as an integrated set of techniques for investigating questions about the educational world. This lively, innovative text helps students connect technique and substance, appreciate the value of both qualitative and quantitative methodologies, and make ethical research decisions.…

Methodological Variation in Economic Evaluations Conducted in Low- and Middle-Income Countries: Information for Reference Case Development

PubMed Central

2015-01-01

Information generated from economic evaluation is increasingly being used to inform health resource allocation decisions globally, including in low- and middle- income countries. However, a crucial consideration for users of the information at a policy level, e.g. funding agencies, is whether the studies are comparable, provide sufficient detail to inform policy decision making, and incorporate inputs from data sources that are reliable and relevant to the context. This review was conducted to inform a methodological standardisation workstream at the Bill and Melinda Gates Foundation (BMGF) and assesses BMGF-funded cost-per-DALY economic evaluations in four programme areas (malaria, tuberculosis, HIV/AIDS and vaccines) in terms of variation in methodology, use of evidence, and quality of reporting. The findings suggest that there is room for improvement in the three areas of assessment, and support the case for the introduction of a standardised methodology or reference case by the BMGF. The findings are also instructive for all institutions that fund economic evaluations in LMICs and who have a desire to improve the ability of economic evaluations to inform resource allocation decisions. PMID:25950443

Support Tool in the Diagnosis of Major Depressive Disorder

NASA Astrophysics Data System (ADS)

Nunes, Luciano Comin; Pinheiro, Plácido Rogério; Pequeno, Tarcísio Cavalcante; Pinheiro, Mirian Calíope Dantas

Major Depressive Disorder have been responsible for millions of professionals temporary removal, and even permanent, from diverse fields of activities around the world, generating damage to social, financial, productive systems and social security, and especially damage to the image of the individual and his family that these disorders produce in individuals who are patients, characteristics that make them stigmatized and discriminated into their society, making difficult their return to the production system. The lack of early diagnosis has provided reactive and late measures, only when the professional suffering psychological disorder is already showing signs of incapacity for working and social relationships. This article aims to assist in the decision making to establish early diagnosis of these types of psychological disorders. It presents a proposal for a hybrid model composed of expert system structured methodologies for decision support (Multi-Criteria Decision Analysis - MCDA) and representations of knowledge structured in logical rules of production and probabilities (Artificial Intelligence - AI).

Software development to support decision making in the selection of nursing diagnoses and interventions for children and adolescents1

PubMed Central

Silva, Kenya de Lima; Évora, Yolanda Dora Martinez; Cintra, Camila Santana Justo

2015-01-01

Objective: to report the development of a software to support decision-making for the selection of nursing diagnoses and interventions for children and adolescents, based on the nomenclature of nursing diagnoses, outcomes and interventions of a university hospital in Paraiba. Method: a methodological applied study based on software engineering, as proposed by Pressman, developed in three cycles, namely: flow chart construction, development of the navigation interface, and construction of functional expressions and programming development. Result: the software consists of administrative and nursing process screens. The assessment is automatically selected according to age group, the nursing diagnoses are suggested by the system after information is inserted, and can be indicated by the nurse. The interventions for the chosen diagnosis are selected by structuring the care plan. Conclusion: the development of this tool used to document the nursing actions will contribute to decision-making and quality of care. PMID:26487144

Software development to support decision making in the selection of nursing diagnoses and interventions for children and adolescents.

PubMed

Silva, Kenya de Lima; Évora, Yolanda Dora Martinez; Cintra, Camila Santana Justo

2015-01-01

to report the development of a software to support decision-making for the selection of nursing diagnoses and interventions for children and adolescents, based on the nomenclature of nursing diagnoses, outcomes and interventions of a university hospital in Paraiba. a methodological applied study based on software engineering, as proposed by Pressman, developed in three cycles, namely: flow chart construction, development of the navigation interface, and construction of functional expressions and programming development. the software consists of administrative and nursing process screens. The assessment is automatically selected according to age group, the nursing diagnoses are suggested by the system after information is inserted, and can be indicated by the nurse. The interventions for the chosen diagnosis are selected by structuring the care plan. the development of this tool used to document the nursing actions will contribute to decision-making and quality of care.

Methodological standards and patient-centeredness in comparative effectiveness research: the PCORI perspective.

PubMed

2012-04-18

Rigorous methodological standards help to ensure that medical research produces information that is valid and generalizable, and are essential in patient-centered outcomes research (PCOR). Patient-centeredness refers to the extent to which the preferences, decision-making needs, and characteristics of patients are addressed, and is the key characteristic differentiating PCOR from comparative effectiveness research. The Patient Protection and Affordable Care Act signed into law in 2010 created the Patient-Centered Outcomes Research Institute (PCORI), which includes an independent, federally appointed Methodology Committee. The Methodology Committee is charged to develop methodological standards for PCOR. The 4 general areas identified by the committee in which standards will be developed are (1) prioritizing research questions, (2) using appropriate study designs and analyses, (3) incorporating patient perspectives throughout the research continuum, and (4) fostering efficient dissemination and implementation of results. A Congressionally mandated PCORI methodology report (to be issued in its first iteration in May 2012) will begin to provide standards in each of these areas, and will inform future PCORI funding announcements and review criteria. The work of the Methodology Committee is intended to enable generation of information that is relevant and trustworthy for patients, and to enable decisions that improve patient-centered outcomes.

Automated control of hierarchical systems using value-driven methods

NASA Technical Reports Server (NTRS)

Pugh, George E.; Burke, Thomas E.

1990-01-01

An introduction is given to the Value-driven methodology, which has been successfully applied to solve a variety of difficult decision, control, and optimization problems. Many real-world decision processes (e.g., those encountered in scheduling, allocation, and command and control) involve a hierarchy of complex planning considerations. For such problems it is virtually impossible to define a fixed set of rules that will operate satisfactorily over the full range of probable contingencies. Decision Science Applications' value-driven methodology offers a systematic way of automating the intuitive, common-sense approach used by human planners. The inherent responsiveness of value-driven systems to user-controlled priorities makes them particularly suitable for semi-automated applications in which the user must remain in command of the systems operation. Three examples of the practical application of the approach in the automation of hierarchical decision processes are discussed: the TAC Brawler air-to-air combat simulation is a four-level computerized hierarchy; the autonomous underwater vehicle mission planning system is a three-level control system; and the Space Station Freedom electrical power control and scheduling system is designed as a two-level hierarchy. The methodology is compared with rule-based systems and with other more widely-known optimization techniques.

Family involvement in decision making for people with dementia in residential aged care: a systematic review of quantitative literature.

PubMed

Petriwskyj, Andrea; Gibson, Alexandra; Parker, Deborah; Banks, Susan; Andrews, Sharon; Robinson, Andrew

2014-06-01

Ensuring older adults' involvement in their care is accepted as good practice and is vital, particularly for people with dementia, whose care and treatment needs change considerably over the course of the illness. However, involving family members in decision making on people's behalf is still practically difficult for staff and family. The aim of this review was to identify and appraise the existing quantitative evidence about family involvement in decision making for people with dementia living in residential aged care. The present Joanna Briggs Institute (JBI) metasynthesis assessed studies that investigated involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this paper presents the quantitative findings. A comprehensive search of 15 electronic databases was performed. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as being relevant; 10 were quantitative, with 1 mixed method study. Two independent reviewers assessed the studies for methodological validity and extracted the data using the JBI Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The findings were synthesized and presented in narrative form. The findings related to decisions encountered and made by family surrogates, variables associated with decisions, surrogates' perceptions of, and preferences for, their roles, as well as outcomes for people with dementia and their families. The results identified patterns within, and variables associated with, surrogate decision making, all of which highlight the complexity and variation regarding family involvement. Attention needs to be paid to supporting family members in decision making in collaboration with staff.

Characteristics and Methodological Quality of Meta-Analyses on Hypertension Treatments-A Cross-Sectional Study.

PubMed

Wu, Xin Yin; Du, Xin Jian; Ho, Robin S T; Lee, Clarence C Y; Yip, Benjamin H K; Wong, Martin C S; Wong, Samuel Y S; Chung, Vincent C H

2017-02-01

Methodological quality of meta-analyses on hypertension treatments can affect treatment decision-making. The authors conducted a cross-sectional study to investigate the methodological quality of meta-analyses on hypertension treatments. One hundred and fifty-eight meta-analyses were identified. Overall, methodological quality was unsatisfactory in the following aspects: comprehensive reporting of financial support (1.9%), provision of included and excluded lists of studies (22.8%), inclusion of grey literature (27.2%), and inclusion of protocols (32.9%). The 126 non-Cochrane meta-analyses had poor performance on almost all the methodological items. Non-Cochrane meta-analyses focused on nonpharmacologic treatments were more likely to consider scientific quality of included studies when making conclusions. The 32 Cochrane meta-analyses generally had good methodological quality except for comprehensive reporting of the sources of support. These results highlight the need for cautious interpretation of these meta-analyses, especially among physicians and policy makers when guidelines are formulated. Future meta-analyses should pay attention to improving these methodological aspects. ©2016 Wiley Periodicals, Inc.

Representing Heterogeneity in Structural Relationships Among Multiple Choice Variables Using a Latent Segmentation Approach

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

Garikapati, Venu; Astroza, Sebastian; Pendyala, Ram M.

Travel model systems often adopt a single decision structure that links several activity-travel choices together. The single decision structure is then used to predict activity-travel choices, with those downstream in the decision-making chain influenced by those upstream in the sequence. The adoption of a singular sequential causal structure to depict relationships among activity-travel choices in travel demand model systems ignores the possibility that some choices are made jointly as a bundle as well as the possible presence of structural heterogeneity in the population with respect to decision-making processes. As different segments in the population may adopt and follow different causalmore » decision-making mechanisms when making selected choices jointly, it would be of value to develop simultaneous equations model systems relating multiple endogenous choice variables that are able to identify population subgroups following alternative causal decision structures. Because the segments are not known a priori, they are considered latent and determined endogenously within a joint modeling framework proposed in this paper. The methodology is applied to a national mobility survey data set to identify population segments that follow different causal structures relating residential location choice, vehicle ownership, and car-share and mobility service usage. It is found that the model revealing three distinct latent segments best describes the data, confirming the efficacy of the modeling approach and the existence of structural heterogeneity in decision-making in the population. Future versions of activity-travel model systems should strive to incorporate such structural heterogeneity to better reflect varying decision processes across population subgroups.« less

Decision-making process related to treatment and management in Korean women with breast cancer: Finding the right individualized healthcare trajectory.

PubMed

Kim, Kkotbong; Yang, Jinhyang

2017-06-01

After being diagnosed with breast cancer, women must make a number of decisions about their treatment and management. When the decision-making process among breast cancer patients is ineffective, it results in harm to their health. Little is known about the decision-making process of breast cancer patients during the entire course of treatment and management. We investigated women with breast cancer to explore the decision-making processes related to treatment and management. Eleven women participated, all of whom were receiving treatment or management in Korea. The average participant age was 43.5years. For data collection and analysis, a grounded theory methodology was used. Through constant comparative analyses, a core category emerged that we referred to as "finding the right individualized healthcare trajectory." The decision-making process occurred in four phases: turmoil, exploration, balance, and control. The turmoil phase included weighing the credibility of information and lowering the anxiety level. The exploration phase included assessing the expertise/promptness of medical treatment and evaluating the effectiveness of follow-up management. The balance phase included performing analyses from multiple angles and rediscovering value as a human being. The control phase included constructing an individualized management system and following prescribed and other management options. It is important to provide patients with accurate information related to the treatment and management of breast cancer so that they can make effective decisions. Healthcare providers should engage with patients on issues related to their disease, understand the burden placed on patients because of issues related to their sex, and ensure that the patient has a sufficient support system. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for breast cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Towards a Transparent, Credible, Evidence-Based Decision-Making Process of New Drug Listing on the Hong Kong Hospital Authority Drug Formulary: Challenges and Suggestions.

PubMed

Wong, Carlos King Ho; Wu, Olivia; Cheung, Bernard M Y

2018-02-01

The aim of this article is to describe the process, evaluation criteria, and possible outcomes of decision-making for new drugs listed in the Hong Kong Hospital Authority Drug Formulary in comparison to the health technology assessment (HTA) policy overseas. Details of decision-making processes including the new drug listing submission, Drug Advisory Committee (DAC) meeting, and procedures prior to and following the meeting, were extracted from the official Hong Kong Hospital Authority drug formulary management website and manual. Publicly-available information related to the new drug decision-making process for five HTA agencies [the National Institute of Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC), the Australia Pharmaceutical Benefits Advisory Committee (PBAC), the Canadian Agency for Drugs and Technologies in Health (CADTH), and the New Zealand Pharmaceutical Management Agency (PHARMAC)] were reviewed and retrieved from official documents from public domains. The DAC is in charge of systemically and critically appraising new drugs before they are listed on the formulary, reviewing submitted applications, and making the decision to list the drug based on scientific evidence to which safety, efficacy, and cost-effectiveness are the primary considerations. When compared with other HTA agencies, transparency of the decision-making process of the DAC, the relevance of clinical and health economic evidence, and the lack of health economic and methodological input of submissions are the major challenges to the new-drug listing policy in Hong Kong. Despite these challenges, this review provides suggestions for the establishment of a more transparent, credible, and evidence-based decision-making process in the Hong Kong Hospital Authority Drug Formulary. Proposals for improvement in the listing of new drugs in the formulary should be a priority of healthcare reforms.

Expected p-values in light of an ROC curve analysis applied to optimal multiple testing procedures.

PubMed

Vexler, Albert; Yu, Jihnhee; Zhao, Yang; Hutson, Alan D; Gurevich, Gregory

2017-01-01

Many statistical studies report p-values for inferential purposes. In several scenarios, the stochastic aspect of p-values is neglected, which may contribute to drawing wrong conclusions in real data experiments. The stochastic nature of p-values makes their use to examine the performance of given testing procedures or associations between investigated factors to be difficult. We turn our focus on the modern statistical literature to address the expected p-value (EPV) as a measure of the performance of decision-making rules. During the course of our study, we prove that the EPV can be considered in the context of receiver operating characteristic (ROC) curve analysis, a well-established biostatistical methodology. The ROC-based framework provides a new and efficient methodology for investigating and constructing statistical decision-making procedures, including: (1) evaluation and visualization of properties of the testing mechanisms, considering, e.g. partial EPVs; (2) developing optimal tests via the minimization of EPVs; (3) creation of novel methods for optimally combining multiple test statistics. We demonstrate that the proposed EPV-based approach allows us to maximize the integrated power of testing algorithms with respect to various significance levels. In an application, we use the proposed method to construct the optimal test and analyze a myocardial infarction disease dataset. We outline the usefulness of the "EPV/ROC" technique for evaluating different decision-making procedures, their constructions and properties with an eye towards practical applications.

A time-responsive tool for informing policy making: rapid realist review.

PubMed

Saul, Jessie E; Willis, Cameron D; Bitz, Jennifer; Best, Allan

2013-09-05

A realist synthesis attempts to provide policy makers with a transferable theory that suggests a certain program is more or less likely to work in certain respects, for particular subjects, in specific kinds of situations. Yet realist reviews can require considerable and sustained investment over time, which does not always suit the time-sensitive demands of many policy decisions. 'Rapid Realist Review' methodology (RRR) has been developed as a tool for applying a realist approach to a knowledge synthesis process in order to produce a product that is useful to policy makers in responding to time-sensitive and/or emerging issues, while preserving the core elements of realist methodology. Using examples from completed RRRs, we describe key features of the RRR methodology, the resources required, and the strengths and limitations of the process. All aspects of an RRR are guided by both a local reference group, and a group of content experts. Involvement of knowledge users and external experts ensures both the usability of the review products, as well as their links to current practice. RRRs have proven useful in providing evidence for and making explicit what is known on a given topic, as well as articulating where knowledge gaps may exist. From the RRRs completed to date, findings broadly adhere to four (often overlapping) classifications: guiding rules for policy-making; knowledge quantification (i.e., the amount of literature available that identifies context, mechanisms, and outcomes for a given topic); understanding tensions/paradoxes in the evidence base; and, reinforcing or refuting beliefs and decisions taken. 'Traditional' realist reviews and RRRs have some key differences, which allow policy makers to apply each type of methodology strategically to maximize its utility within a particular local constellation of history, goals, resources, politics and environment. In particular, the RRR methodology is explicitly designed to engage knowledge users and review stakeholders to define the research questions, and to streamline the review process. In addition, results are presented with a focus on context-specific explanations for what works within a particular set of parameters rather than producing explanations that are potentially transferrable across contexts and populations. For policy makers faced with making difficult decisions in short time frames for which there is sufficient (if limited) published/research and practice-based evidence available, RRR provides a practical, outcomes-focused knowledge synthesis method.

The application of system dynamics modelling to environmental health decision-making and policy - a scoping review.

PubMed

Currie, Danielle J; Smith, Carl; Jagals, Paul

2018-03-27

Policy and decision-making processes are routinely challenged by the complex and dynamic nature of environmental health problems. System dynamics modelling has demonstrated considerable value across a number of different fields to help decision-makers understand and predict the dynamic behaviour of complex systems in support the development of effective policy actions. In this scoping review we investigate if, and in what contexts, system dynamics modelling is being used to inform policy or decision-making processes related to environmental health. Four electronic databases and the grey literature were systematically searched to identify studies that intersect the areas environmental health, system dynamics modelling, and decision-making. Studies identified in the initial screening were further screened for their contextual, methodological and application-related relevancy. Studies deemed 'relevant' or 'highly relevant' according to all three criteria were included in this review. Key themes related to the rationale, impact and limitation of using system dynamics in the context of environmental health decision-making and policy were analysed. We identified a limited number of relevant studies (n = 15), two-thirds of which were conducted between 2011 and 2016. The majority of applications occurred in non-health related sectors (n = 9) including transportation, public utilities, water, housing, food, agriculture, and urban and regional planning. Applications were primarily targeted at micro-level (local, community or grassroots) decision-making processes (n = 9), with macro-level (national or international) decision-making to a lesser degree. There was significant heterogeneity in the stated rationales for using system dynamics and the intended impact of the system dynamics model on decision-making processes. A series of user-related, technical and application-related limitations and challenges were identified. None of the reported limitations or challenges appeared unique to the application of system dynamics within the context of environmental health problems, but rather to the use of system dynamics in general. This review reveals that while system dynamics modelling is increasingly being used to inform decision-making related to environmental health, applications are currently limited. Greater application of system dynamics within this context is needed before its benefits and limitations can be fully understood.

What does the new breed of decision-making methodologies mean for choices and norms in hydrological science?

NASA Astrophysics Data System (ADS)

Wikman-Svahn, Per

2013-04-01

Hydrological sciences are increasingly utilized in decision-making contexts that need to manage deep uncertainty, changing conditions and very long-lead times and lifetimes. Traditional optimizing approaches become problematic in such situations. For example, optimizing approaches may underestimate the importance of low probability outcomes, or very uncertain outcomes. Alternative decision-making strategies are therefore increasingly used in hydrological applications, including "bottom-up/top-down", "context-first", "decision-scaling", "assess risk of policy", "robust", "resilient" or "flexible" approaches. These kinds of strategies are typically designed to handle very uncertain and diverse outcomes, and often start from the particular decision-making context, in contrast to more traditional "predict-then-act" or "science first" approaches. Contemporary research in philosophy of science stress the influence of value judgments and norms in scientific assessments. In particular, this literature points out that implicit anticipated applications often influence choices made in scientific assessments. Furthermore, this literature also emphasize that choices made at within scientific assessments have consequences for decision-making later on. One reason is that it is often difficult for decision-makers to see what choices are made and the implications of these choices. Another reason is that information that could be of use for decision-makers are lost at an early stage. For example, the choice to focus on central estimates and not providing assessments on more unlikely outcomes is a choice that has consequences for what outcomes are taken into account in the decision-making process. This paper develops this argument and then analyzes the implications of these new developments for hydrological science. One implication of the increasing use of the new breed of planning strategies is that a broader range of uncertainty in scientific assessments becomes desirable in order to fully benefit from the power of the new decision-making strategies. Another implication is that bayesian probability assessments become more important. Finally, advantages and risks involved in changing scientific assessments in order to anticipate the new decision-making strategies are discussed.

The Voice of the Patient Methodology: A Novel Mixed-Methods Approach to Identifying Treatment Goals for Men with Prostate Cancer.

PubMed

Saigal, Christopher S; Lambrechts, Sylvia I; Seenu Srinivasan, V; Dahan, Ely

2017-06-01

Many guidelines advocate the use of shared decision making for men with newly diagnosed prostate cancer. Decision aids can facilitate the process of shared decision making. Implicit in this approach is the idea that physicians understand which elements of treatment matter to patients. Little formal work exists to guide physicians or developers of decision aids in identifying these attributes. We use a mixed-methods technique adapted from marketing science, the 'Voice of the Patient', to describe and identify treatment elements of value for men with localized prostate cancer. We conducted semi-structured interviews with 30 men treated for prostate cancer in the urology clinic of the West Los Angeles Veteran Affairs Medical Center. We used a qualitative analysis to generate themes in patient narratives, and a quantitative approach, agglomerative hierarchical clustering, to identify attributes of treatment that were most relevant to patients making decisions about prostate cancer. We identified five 'traditional' prostate cancer treatment attributes: sexual dysfunction, bowel problems, urinary problems, lifespan, and others' opinions. We further identified two novel treatment attributes: a treatment's ability to validate a sense of proactivity and the need for an incision (separate from risks of surgery). Application of a successful marketing technique, the 'Voice of the Customer', in a clinical setting elicits non-obvious attributes that highlight unique patient decision-making concerns. Use of this method in the development of decision aids may result in more effective decision support.

Distributed decision-making in electric power system transmission maintenance scheduling using multi-agent systems (MAS)

NASA Astrophysics Data System (ADS)

Zhang, Zhong

In this work, motivated by the need to coordinate transmission maintenance scheduling among a multiplicity of self-interested entities in restructured power industry, a distributed decision support framework based on multiagent negotiation systems (MANS) is developed. An innovative risk-based transmission maintenance optimization procedure is introduced. Several models for linking condition monitoring information to the equipment's instantaneous failure probability are presented, which enable quantitative evaluation of the effectiveness of maintenance activities in terms of system cumulative risk reduction. Methodologies of statistical processing, equipment deterioration evaluation and time-dependent failure probability calculation are also described. A novel framework capable of facilitating distributed decision-making through multiagent negotiation is developed. A multiagent negotiation model is developed and illustrated that accounts for uncertainty and enables social rationality. Some issues of multiagent negotiation convergence and scalability are discussed. The relationships between agent-based negotiation and auction systems are also identified. A four-step MAS design methodology for constructing multiagent systems for power system applications is presented. A generic multiagent negotiation system, capable of inter-agent communication and distributed decision support through inter-agent negotiations, is implemented. A multiagent system framework for facilitating the automated integration of condition monitoring information and maintenance scheduling for power transformers is developed. Simulations of multiagent negotiation-based maintenance scheduling among several independent utilities are provided. It is shown to be a viable alternative solution paradigm to the traditional centralized optimization approach in today's deregulated environment. This multiagent system framework not only facilitates the decision-making among competing power system entities, but also provides a tool to use in studying competitive industry relative to monopolistic industry.

10 CFR 300.11 - Independent verification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... verifiers, and has been empowered to make decisions relevant to the provision of a verification statement... methods; and (v) Risk assessment and methodologies and materiality analysis procedures outlined by other... Accreditation Board program for Environmental Management System auditors (ANSI-RAB-EMS); Board of Environmental...

10 CFR 300.11 - Independent verification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... verifiers, and has been empowered to make decisions relevant to the provision of a verification statement... methods; and (v) Risk assessment and methodologies and materiality analysis procedures outlined by other... Accreditation Board program for Environmental Management System auditors (ANSI-RAB-EMS); Board of Environmental...

Instructional Approaches in Teaching the Holocaust

ERIC Educational Resources Information Center

Lindquist, David H.

2011-01-01

Holocaust education requires teachers to carefully determine which instructional approaches ensure effective teaching of the subject while avoiding potential difficulties. The article identifies several complicating factors that must be considered when making pedagogical decisions. It then examines five methodological approaches that can be used…

A decision support system for transportation infrastructure and supply chain system planning.

DOT National Transportation Integrated Search

2013-07-01

This project makes the results (models and methodology) of the research and development efforts on freight movement modeling (FMM) and supply chain design carried out by faculty at OSU and OU available to transportation and logistics professionals. A...

Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden

PubMed Central

Eckard, Nathalie; Janzon, Magnus; Levin, Lars-Åke

2014-01-01

Background: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases. Methods: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions. Results: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies. Conclusion: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit. PMID:25396208

Postnatal Psychosocial Assessment and Clinical Decision-Making, a Descriptive Study.

PubMed

Sims, Deborah; Fowler, Cathrine

2018-05-18

The aim of this study is to describe experienced child and family health nurses' clinical decision-making during a postnatal psychosocial assessment. Maternal emotional wellbeing in the postnatal year optimises parenting and promotes infant development. Psychosocial assessment potentially enables early intervention and reduces the risk of a mental disorder occurring during this time of change. Assessment accuracy, and the interventions used are determined by the standard of nursing decision-making. A qualitative methodology was employed to explore decision-making behaviour when conducting a postnatal psychosocial assessment. This study was conducted in an Australian early parenting organisation. Twelve experienced child and family health nurses were interviewed. A detailed description of a postnatal psychosocial assessment process was obtained using a critical incident technique. Template analysis was used to determine the information domains the nurses accessed, and content analysis was used to determine the nurses' thinking strategies, to make clinical decisions from this assessment. The nurses described 24 domains of information and used 17 thinking strategies, in a variety of combinations. The four information domains most commonly used were parenting, assessment tools, women-determined issues and sleep. The seven thinking strategies most commonly used were searching for information, forming relationships between the information, recognising a pattern, drawing a conclusion, setting priorities, providing explanations for the information and judging the value of the information. The variety and complexity of the clinical decision-making involved in postnatal psychosocial assessment confirms that the nurses use information appropriately and within their scope of nursing practice. The standard of clinical decision-making determines the results of the assessment and the optimal access to care. Knowledge of the information domains and the decision-making strategies that experienced nurses use for psychosocial assessment potentially improves practice by providing a framework for education and mentoring. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Selecting Health Care Improvement Projects: A Methodology Integrating Cause-and-Effect Diagram and Analytical Hierarchy Process.

PubMed

Testik, Özlem Müge; Shaygan, Amir; Dasdemir, Erdi; Soydan, Guray

It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes experts' opinions with different points of view, is needed for better decision making. The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating experts' opinions. An approach for collecting data from experts and a graphical display for summarizing the obtained information are also provided. The methodology is implemented for improving a hospital appointment system. The top-ranked 2 major project categories for improvements were identified to be system- and accessibility-related causes (45%) and capacity-related causes (28%), respectively. For each of the major project category, subprojects were then ranked for selecting the improvement needs. The methodology is useful in cases where an aggregate decision based on experts' opinions is expected. Some suggestions for practical implementations are provided.

Study protocol: developing a decision system for inclusive housing: applying a systematic, mixed-method quasi-experimental design.

PubMed

Zeeman, Heidi; Kendall, Elizabeth; Whitty, Jennifer A; Wright, Courtney J; Townsend, Clare; Smith, Dianne; Lakhani, Ali; Kennerley, Samantha

2016-03-15

Identifying the housing preferences of people with complex disabilities is a much needed, but under-developed area of practice and scholarship. Despite the recognition that housing is a social determinant of health and quality of life, there is an absence of empirical methodologies that can practically and systematically involve consumers in this complex service delivery and housing design market. A rigorous process for making effective and consistent development decisions is needed to ensure resources are used effectively and the needs of consumers with complex disability are properly met. This 3-year project aims to identify how the public and private housing market in Australia can better respond to the needs of people with complex disabilities whilst simultaneously achieving key corporate objectives. First, using the Customer Relationship Management framework, qualitative (Nominal Group Technique) and quantitative (Discrete Choice Experiment) methods will be used to quantify the housing preferences of consumers and their carers. A systematic mixed-method, quasi-experimental design will then be used to quantify the development priorities of other key stakeholders (e.g., architects, developers, Government housing services etc.) in relation to inclusive housing for people with complex disabilities. Stakeholders randomly assigned to Group 1 (experimental group) will participate in a series of focus groups employing Analytical Hierarchical Process (AHP) methodology. Stakeholders randomly assigned to Group 2 (control group) will participate in focus groups employing existing decision making processes to inclusive housing development (e.g., Risk, Opportunity, Cost, Benefit considerations). Using comparative stakeholder analysis, this research design will enable the AHP methodology (a proposed tool to guide inclusive housing development decisions) to be tested. It is anticipated that the findings of this study will enable stakeholders to incorporate consumer housing preferences into commercial decisions. Housing designers and developers will benefit from the creation of a parsimonious set of consumer-led housing preferences by which to make informed investments in future housing and contribute to future housing policy. The research design has not been applied in the Australian research context or elsewhere, and will provide a much needed blueprint for market investment to develop viable, consumer directed inclusive housing options for people with complex disability.

RECOVERY ACT - Methods for Decision under Technological Change Uncertainty and Risk Assessment for Integrated Assessment of Climate Change

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

Webster, Mort David

2015-03-10

This report presents the final outcomes and products of the project as performed at the Massachusetts Institute of Technology. The research project consists of three main components: methodology development for decision-making under uncertainty, improving the resolution of the electricity sector to improve integrated assessment, and application of these methods to integrated assessment. Results in each area is described in the report.

Applying Various Methods of Communicating Science for Community Decision-Making and Public Awareness: A NASA DEVELOP National Program Case Study

NASA Astrophysics Data System (ADS)

Miller, T. N.; Brumbaugh, E. J.; Barker, M.; Ly, V.; Schick, R.; Rogers, L.

2015-12-01

The NASA DEVELOP National Program conducts over eighty Earth science projects every year. Each project applies NASA Earth observations to impact decision-making related to a local or regional community concern. Small, interdisciplinary teams create a methodology to address the specific issue, and then pass on the results to partner organizations, as well as providing them with instruction to continue using remote sensing for future decisions. Many different methods are used by individual teams, and the program as a whole, to communicate results and research accomplishments to decision-makers, stakeholders, alumni, and the general public. These methods vary in scope from formal publications to more informal venues, such as social media. This presentation will highlight the communication techniques used by the DEVELOP program. Audiences, strategies, and outlets will be discussed, including a newsletter, microjournal, video contest, and several others.

Multi-criteria multi-stakeholder decision analysis using a fuzzy-stochastic approach for hydrosystem management

NASA Astrophysics Data System (ADS)

Subagadis, Y. H.; Schütze, N.; Grundmann, J.

2014-09-01

The conventional methods used to solve multi-criteria multi-stakeholder problems are less strongly formulated, as they normally incorporate only homogeneous information at a time and suggest aggregating objectives of different decision-makers avoiding water-society interactions. In this contribution, Multi-Criteria Group Decision Analysis (MCGDA) using a fuzzy-stochastic approach has been proposed to rank a set of alternatives in water management decisions incorporating heterogeneous information under uncertainty. The decision making framework takes hydrologically, environmentally, and socio-economically motivated conflicting objectives into consideration. The criteria related to the performance of the physical system are optimized using multi-criteria simulation-based optimization, and fuzzy linguistic quantifiers have been used to evaluate subjective criteria and to assess stakeholders' degree of optimism. The proposed methodology is applied to find effective and robust intervention strategies for the management of a coastal hydrosystem affected by saltwater intrusion due to excessive groundwater extraction for irrigated agriculture and municipal use. Preliminary results show that the MCGDA based on a fuzzy-stochastic approach gives useful support for robust decision-making and is sensitive to the decision makers' degree of optimism.

Using systematic reviews for hazard and risk assessment of endocrine disrupting chemicals

PubMed Central

Beronius, Anna; Vandenberg, Laura N.

2016-01-01

The possibility that endocrine disrupting chemicals (EDCs) in our environment contribute to hormonally related effects and diseases observed in human and wildlife populations has caused concern among decision makers and researchers alike. EDCs challenge principles traditionally applied in chemical risk assessment and the identification and assessment of these compounds has been a much debated topic during the last decade. State of the science reports and risk assessments of potential EDCs have been criticized for not using systematic and transparent approaches in the evaluation of evidence. In the fields of medicine and health care, systematic review methodologies have been developed and used to enable objectivity and transparency in the evaluation of scientific evidence for decision making. Lately, such approaches have also been promoted for use in the environmental health sciences and risk assessment of chemicals. Systematic review approaches could provide a tool for improving the evaluation of evidence for decision making regarding EDCs, e.g. by enabling systematic and transparent use of academic research data in this process. In this review we discuss the advantages and challenges of applying systematic review methodology in the identification and assessment of EDCs. PMID:26847432

Using systematic reviews for hazard and risk assessment of endocrine disrupting chemicals.

PubMed

Beronius, Anna; Vandenberg, Laura N

2015-12-01

The possibility that endocrine disrupting chemicals (EDCs) in our environment contribute to hormonally related effects and diseases observed in human and wildlife populations has caused concern among decision makers and researchers alike. EDCs challenge principles traditionally applied in chemical risk assessment and the identification and assessment of these compounds has been a much debated topic during the last decade. State of the science reports and risk assessments of potential EDCs have been criticized for not using systematic and transparent approaches in the evaluation of evidence. In the fields of medicine and health care, systematic review methodologies have been developed and used to enable objectivity and transparency in the evaluation of scientific evidence for decision making. Lately, such approaches have also been promoted for use in the environmental health sciences and risk assessment of chemicals. Systematic review approaches could provide a tool for improving the evaluation of evidence for decision making regarding EDCs, e.g. by enabling systematic and transparent use of academic research data in this process. In this review we discuss the advantages and challenges of applying systematic review methodology in the identification and assessment of EDCs.

Thinking about the patient's wishes: practical wisdom of discharge planning nurses in assisting surrogate decision-making.

PubMed

Kageyama, Yoko; Asano, Midori

2017-12-01

The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms. Participants were six discharge planning nurses and one person with previous experience as a discharge planning nurse, all working at discharge planning departments of acute care hospitals. Separate, semi-structured, interactive interviews were conducted with each participant. The study design was qualitative descriptive in form with qualitative content analysis. All participants provided written informed consent to participate in the study, which was approved by the study institution. Three concepts were extracted as the basis for discharge planning nurses' perception and judgement at acute care hospitals: working for mutual envisionment of the available postdischarge options; helping the family act as spokesperson(s) for the patient's wishes; and understanding the family inclusive of the patient as a relationship of strongly interaffecting interests. The practical wisdom of the nurse, working in mutual envisionment with the family, and collaborative decision-making through discussion with those who know the patient, leads to rational discharge assistance. © 2017 Nordic College of Caring Science.

In-hospital experiences of families of potential organ donors: A systematic review and qualitative synthesis

PubMed Central

Dicks, Sean Glenton; Ranse, Kristen; van Haren, Frank MP; Boer, Douglas P

2017-01-01

Information and compassion assist families of potential organ donors to make informed decisions. However, psychological implications of the in-hospital process are not well described with past research focusing on decision-making. To enhance understanding and improve service delivery, a systematic review was conducted. Inductive analysis and synthesis utilised Grounded Theory Methodology within a systems theory framework and contributed to a model proposing that family and staff form a System of Systems with shared responsibility for process outcomes. This model can guide evaluation and improvement of care and will be tested by means of a longitudinal study of family experiences. PMID:28680696

Canadian Innovations in Siting Hazardous Waste Management Facilities

PubMed

Kuhn; Ballard

1998-07-01

/ Siting hazardous waste facilities is an extremely complex and difficult endeavor. Public aversion to the construction of these facilities in or near their community often results in concerted opposition, referred to as the NIMBY syndrome. For the most part, siting processes do not fail because of inadequate environmental or technical considerations, but because of the adversarial decision-making strategies employed by the proponents. Innovative siting processes used in the provinces of Alberta and Manitoba offer tangible evidence of the successful application of an innovative siting approach based on the principles of decentralization of decision-making authority and full and meaningful public involvement. The purpose of this paper is to evaluate four Canadian siting processes from the perspective of public participation and access to decision-making authority. Examples of siting processes related to hazardous waste management facilities are provided from the provinces of Alberta, Manitoba, British Columbia, and Ontario. Siting has evolved from approaches dominated by top-down decision making to increasing decentralized and pluralistic approaches. Focusing on social and political concerns of potentially affected communities and on the process of decision making itself are fundamental to achieving siting success. In Alberta initially, and later in Manitoba, this new "open approach" to siting has resulted in the construction of the first two comprehensive hazardous waste treatment facilities in Canada.KEY WORDS: Hazardous waste facilities; Siting methodologies; Public participation

A framework for multi-stakeholder decision-making and ...

EPA Pesticide Factsheets

We propose a decision-making framework to compute compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives. In our setting, we shape the stakeholder dis-satisfaction distribution by solving a conditional-value-at-risk (CVaR) minimization problem. The CVaR problem is parameterized by a probability level that shapes the tail of the dissatisfaction distribution. The proposed approach allows us to compute a family of compromise solutions and generalizes multi-stakeholder settings previously proposed in the literature that minimize average and worst-case dissatisfactions. We use the concept of the CVaR norm to give a geometric interpretation to this problem +and use the properties of this norm to prove that the CVaR minimization problem yields Pareto optimal solutions for any choice of the probability level. We discuss a broad range of potential applications of the framework that involve complex decision-making processes. We demonstrate the developments using a biowaste facility location case study in which we seek to balance stakeholder priorities on transportation, safety, water quality, and capital costs. This manuscript describes the methodology of a new decision-making framework that computes compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives as needed for SHC Decision Science and Support Tools project. A biowaste facility location is employed as the case study

Performing purity: reproductive decision-making and implications for a community under threat of zika in iquitos, Peru.

PubMed

Guerra-Reyes, Lucia; Iguiñiz-Romero, Ruth A

2018-06-11

The long-term management and prevention of Zika virus requires understanding of reproductive and sexual health behaviours, including mechanisms of partnered decision-making. In this article, we report on a qualitative study conducted before the arrival of Zika in Iquitos, Peru. We assessed existing patterns of reproductive decision-making among partnered men and women in a community under threat of Zika and discuss how these may impact Zika prevention in the long-term. We used a rapid qualitative assessment methodology, including in-depth semi-structured interviews with partnered women (28) and men (21). Deeply unequal gender role expectations limit discussion of reproductive decisions until after a first child is born. Women needed to perform a domestic 'of-the-house' role to be considered suitable partners, leading them to hide their knowledge of sexual and reproductive health. Condoms symbolise risk and are unused with partners in committed relationships. A shared perception that men must take care of female partner's sexual health, translates into male sexual and reproductive preferences overcoming female desires. Existing decision-making patterns lead to an increased risk of Zika exposure. Long-term response should expand Zika virus information and preventive messages to men and young people, in addition to engaging with broader societal challenges to gender inequity.

Good Practices for Real-World Data Studies of Treatment and/or Comparative Effectiveness: Recommendations from the Joint ISPOR-ISPE Special Task Force on Real-World Evidence in Health Care Decision Making.

PubMed

Berger, Marc L; Sox, Harold; Willke, Richard J; Brixner, Diana L; Eichler, Hans-Georg; Goettsch, Wim; Madigan, David; Makady, Amr; Schneeweiss, Sebastian; Tarricone, Rosanna; Wang, Shirley V; Watkins, John; Mullins, C Daniel

2017-09-01

Real-world evidence (RWE) includes data from retrospective or prospective observational studies and observational registries and provides insights beyond those addressed by randomized controlled trials. RWE studies aim to improve health care decision making. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the International Society for Pharmacoepidemiology (ISPE) created a task force to make recommendations regarding good procedural practices that would enhance decision makers' confidence in evidence derived from RWD studies. Peer review by ISPOR/ISPE members and task force participants provided a consensus-building iterative process for the topics and framing of recommendations. The ISPOR/ISPE Task Force recommendations cover seven topics such as study registration, replicability, and stakeholder involvement in RWE studies. These recommendations, in concert with earlier recommendations about study methodology, provide a trustworthy foundation for the expanded use of RWE in health care decision making. The focus of these recommendations is good procedural practices for studies that test a specific hypothesis in a specific population. We recognize that some of the recommendations in this report may not be widely adopted without appropriate incentives from decision makers, journal editors, and other key stakeholders. Copyright © 2017. Published by Elsevier Inc.

Development of a program theory for shared decision-making: a realist review protocol.

PubMed

Groot, Gary; Waldron, Tamara; Carr, Tracey; McMullen, Linda; Bandura, Lori-Ann; Neufeld, Shelley-May; Duncan, Vicky

2017-06-17

The practicality of applying evidence to healthcare systems with the aim of implementing change is an ongoing challenge for practitioners, policy makers, and academics. Shared decision- making (SDM), a method of medical decision-making that allows a balanced relationship between patients, physicians, and other key players in the medical decision process, is purported to improve patient and system outcomes. Despite the oft-mentioned benefits, there are gaps in the current literature between theory and implementation that would benefit from a realist approach given the value of this methodology to analyze complex interventions. In this protocol, we outline a study that will explore: "In which situations, how, why, and for whom does SDM between patients and health care providers contribute to improved decision making?" A seven step iterative process will be described including preliminary theory development, establishment of a search strategy, selection and appraisal of literature, data extraction, analysis and synthesis of extracted results from literature, and formation of a revised program theory with the input of patients, physicians, nurse navigators, and policy makers from a stakeholder session. The goal of the realist review will be to identify and refine a program theory for SDM through the identification of mechanisms which shape the characteristics of when, how, and why SDM will, and will not, work. PROSPERO CRD42017062609.

Group assessment of key indicators of sustainable waste management in developing countries.

PubMed

Tot, Bojana; Vujić, Goran; Srđević, Zorica; Ubavin, Dejan; Russo, Mário Augusto Tavares

2017-09-01

Decision makers in developing countries are struggling to solve the present problems of solid waste management. Prioritisation and ranking of the most important indicators that influence the waste management system is very useful for any decision maker for the future planning and implementation of a sustainable waste management system. The aim of this study is to evaluate key indicators and their related sub-indicators in a group decision-making environment. In order to gain insight into the subject it was necessary to obtain the qualified opinions of decision makers from different countries who understand the situation in the sector of waste management in developing countries. An assessment is performed by 43 decision makers from both developed and developing countries, and the applied methodology is based on a combined use of the analytic hierarchy process, from the multi-criteria decision-making set of tools, and the preferential voting method known as Borda Count, which belongs to social choice theory. Pairwise comparison of indicators is performed with the analytic hierarchy process, and the ranking of indicators once obtained is assessed with Borda Count. Detailed analysis of the final results showed that the Institutional-Administrative indicator was the most important one, with the maximum weight as derived by both groups of decision makers. The results also showed that the combined use of the analytic hierarchy process and Borda Count contributes to the credibility and objectivity of the decision-making process, allowing its use in more complex waste management group decision-making problems to be recommended.

Accounting for methodological, structural, and parameter uncertainty in decision-analytic models: a practical guide.

PubMed

Bilcke, Joke; Beutels, Philippe; Brisson, Marc; Jit, Mark

2011-01-01

Accounting for uncertainty is now a standard part of decision-analytic modeling and is recommended by many health technology agencies and published guidelines. However, the scope of such analyses is often limited, even though techniques have been developed for presenting the effects of methodological, structural, and parameter uncertainty on model results. To help bring these techniques into mainstream use, the authors present a step-by-step guide that offers an integrated approach to account for different kinds of uncertainty in the same model, along with a checklist for assessing the way in which uncertainty has been incorporated. The guide also addresses special situations such as when a source of uncertainty is difficult to parameterize, resources are limited for an ideal exploration of uncertainty, or evidence to inform the model is not available or not reliable. for identifying the sources of uncertainty that influence results most are also described. Besides guiding analysts, the guide and checklist may be useful to decision makers who need to assess how well uncertainty has been accounted for in a decision-analytic model before using the results to make a decision.

The framing effect in medical decision-making: a review of the literature.

PubMed

Gong, Jingjing; Zhang, Yan; Yang, Zheng; Huang, Yonghua; Feng, Jun; Zhang, Weiwei

2013-01-01

The framing effect, identified by Tversky and Kahneman, is one of the most striking cognitive biases, in which people react differently to a particular choice depending whether it is presented as a loss or as a gain. Numerous studies have subsequently demonstrated the robustness of the framing effect in a variety of contexts, especially in medical decision-making. Compared to daily decisions, medical decisions are of low frequency but of paramount importance. The framing effect is a well-documented bias in a variety of studies, but research is inconsistent regarding whether and how variables influence framing effects in medical decision-making. To clarify the discrepancy in the previous literature, published literature in the English language concerning the framing effect was retrieved using electronic and bibliographic searches. Two reviewers examined each article for inclusion and evaluated the articles' methodological quality. The framing effect in medical decision-making was reviewed in these papers. No studies identified an influence of framing information upon compliance with health recommendations, and different studies demonstrate different orientations of the framing effect. Because so many variables influence the presence or absence of the framing effect, the unexplained heterogeneity between studies suggests the possibility of a framing effect under specific conditions. Further research is needed to determine why the framing effect is induced and how it can be precluded.

Value choices and considerations when limiting intensive care treatment: a qualitative study.

PubMed

Halvorsen, K; Førde, R; Nortvedt, P

2009-01-01

To shed light on the values and considerations that affect the decision-making processes and the decisions to limit intensive care treatment. Qualitative methodology with participant observation and in-depth interviews, with an emphasis on eliciting the underlying rationale of the clinicians' actions and choices when limiting treatment. Informants perceived over-treatment in intensive care medicine as a dilemma. One explanation was that the decision-making base was somewhat uncertain, complex and difficult. The informants claimed that those responsible for taking decisions from the admitting ward prolonged futile treatment because they may bear guilt or responsibility for something that had gone wrong during the course of treatment. The assessments of the patient's situation made by physicians from the admitting ward were often more organ-oriented and the expectations were less realistic than those of clinicians in the intensive care unit who frequently had a more balanced and overall perspective. Aspects such as the personality and the speciality of those involved, the culture of the unit and the degree of interdisciplinary cooperation were important issues in the decision-making processes. Under-communicated considerations jeopardise the principle of equal treatment. If intensive care patients are to be ensured equal treatment, strategies for interdisciplinary, transparent and appropriate decision-making processes must be developed in which open and hidden values are rendered visible, power structures disclosed, employees respected and the various perspectives of the treatment given their legitimate place.

Fuzzy methods in decision making process - A particular approach in manufacturing systems

NASA Astrophysics Data System (ADS)

Coroiu, A. M.

2015-11-01

We are living in a competitive environment, so we can see and understand that the most of manufacturing firms do the best in order to accomplish meeting demand, increasing quality, decreasing costs, and delivery rate. In present a stake point of interest is represented by the development of fuzzy technology. A particular approach for this is represented through the development of methodologies to enhance the ability to managed complicated optimization and decision making aspects involving non-probabilistic uncertainty with the reason to understand, development, and practice the fuzzy technologies to be used in fields such as economic, engineering, management, and societal problems. Fuzzy analysis represents a method for solving problems which are related to uncertainty and vagueness; it is used in multiple areas, such as engineering and has applications in decision making problems, planning and production. As a definition for decision making process we can use the next one: result of mental processes based upon cognitive process with a main role in the selection of a course of action among several alternatives. Every process of decision making can be represented as a result of a final choice and the output can be represented as an action or as an opinion of choice. Different types of uncertainty can be discovered in a wide variety of optimization and decision making problems related to planning and operation of power systems and subsystems. The mixture of the uncertainty factor in the construction of different models serves for increasing their adequacy and, as a result, the reliability and factual efficiency of decisions based on their analysis. Another definition of decision making process which came to illustrate and sustain the necessity of using fuzzy method: the decision making is an approach of choosing a strategy among many different projects in order to achieve some purposes and is formulated as three different models: high risk decision, usual risk decision and low risk decision - some specific formulas of fuzzy logic. The fuzzy set concepts has some certain parameterization features which are certain extensions of crisp and fuzzy relations respectively and have a rich potential for application to the decision making problems. The proposed approach from this paper presents advantages of fuzzy approach, in comparison with other paradigm and presents a particular way in which fuzzy logic can emerge in decision making process and planning process with implication, as a simulation, in manufacturing - involved in measuring performance of advanced manufacturing systems. Finally, an example is presented to illustrate our simulation.

Perceptions of and decision making about clinical trials in adolescent and young adults with Cancer: a qualitative analysis.

PubMed

Bell, Jennifer A H; Forcina, Victoria; Mitchell, Laura; Tam, Seline; Wang, Kate; Gupta, Abha A; Lewin, Jeremy

2018-06-04

Adolescent and young adults (AYA) enrolment rates into cancer clinical trials (CCT) are the lowest of any age group globally. As AYA have distinct biological, psychosocial and relational needs, we aimed to explore any unique factors influencing their CCT decision-making process, including AYA-specific perceptions or attitudes towards CCT. Qualitative interpretive descriptive methodology was used to explore AYA perceptions and decision-making related to CCT. An analytic approach conducive to inductive imagining and exploratory questioning was used in order to generate insights and interpret data. A total of 21 AYA were interviewed (median age: 31 (18-39)). Twelve (57%) participants had previously been approached to participate in CCT. Major themes influencing trial enrolment decisions were: 1) severity of illness/urgency for new treatment 2) side effect profile of investigational drug in the short and long term (e.g., impact on future quality of life) 3) who approached patient for trial participation (oncologist vs. other) 4) additional information found on-line about the trial and investigators, and 5) family, friends and peer group opinion regarding the CCT. Several psychosocial and relational factors were identified as influencing AYA CCT decisions, some of which are unique to this demographic. Specific strategies to address barriers to CCT and enable supportive decision-making include: 1) involving family in decision-making and 2) helping AYA appreciate short- and long-term implications of trial participation. Finally, exploring social networking and general education about CCT that AYA can independently access may increase participation.

Evaluation of STD/AIDS prevention programs: a review of approaches and methodologies.

PubMed

da Cruz, Marly Marques; dos Santos, Elizabeth Moreira; Monteiro, Simone

2007-05-01

The article presents a review of approaches and methodologies in the evaluation of STD/AIDS prevention programs, searching for theoretical and methodological support for the institutionalization of evaluation and decision-making. The review included the MEDLINE, SciELO, and ISI Web of Science databases and other sources like textbooks and congress abstracts from 1990 to 2005, with the key words: "evaluation", "programs", "prevention", "STD/AIDS", and similar terms. The papers showed a predominance of quantitative outcome or impact evaluative studies with an experimental or quasi-experimental design. The main use of evaluation is accountability, although knowledge output and program improvement were also identified in the studies. Only a few evaluative studies contemplate process evaluation and its relationship to the contexts. The review aimed to contribute to the debate on STD/AIDS, which requires more effective, consistent, and sustainable decisions in the field of prevention.

Real time simulation of computer-assisted sequencing of terminal area operations

NASA Technical Reports Server (NTRS)

Dear, R. G.

1981-01-01

A simulation was developed to investigate the utilization of computer assisted decision making for the task of sequencing and scheduling aircraft in a high density terminal area. The simulation incorporates a decision methodology termed Constrained Position Shifting. This methodology accounts for aircraft velocity profiles, routes, and weight classes in dynamically sequencing and scheduling arriving aircraft. A sample demonstration of Constrained Position Shifting is presented where six aircraft types (including both light and heavy aircraft) are sequenced to land at Denver's Stapleton International Airport. A graphical display is utilized and Constrained Position Shifting with a maximum shift of four positions (rearward or forward) is compared to first come, first serve with respect to arrival at the runway. The implementation of computer assisted sequencing and scheduling methodologies is investigated. A time based control concept will be required and design considerations for such a system are discussed.

Midwives׳ clinical reasoning during second stage labour: Report on an interpretive study.

PubMed

Jefford, Elaine; Fahy, Kathleen

2015-05-01

clinical reasoning was once thought to be the exclusive domain of medicine - setting it apart from 'non-scientific' occupations like midwifery. Poor assessment, clinical reasoning and decision-making skills are well known contributors to adverse outcomes in maternity care. Midwifery decision-making models share a common deficit: they are insufficiently detailed to guide reasoning processes for midwives in practice. For these reasons we wanted to explore if midwives actively engaged in clinical reasoning processes within their clinical practice and if so to what extent. The study was conducted using post structural, feminist methodology. to what extent do midwives engage in clinical reasoning processes when making decisions in the second stage labour? twenty-six practising midwives were interviewed. Feminist interpretive analysis was conducted by two researchers guided by the steps of a model of clinical reasoning process. Six narratives were excluded from analysis because they did not sufficiently address the research question. The midwives narratives were prepared via data reduction. A theoretically informed analysis and interpretation was conducted. using a feminist, interpretive approach we created a model of midwifery clinical reasoning grounded in the literature and consistent with the data. Thirteen of the 20 participant narratives demonstrate analytical clinical reasoning abilities but only nine completed the process and implemented the decision. Seven midwives used non-analytical decision-making without adequately checking against assessment data. over half of the participants demonstrated the ability to use clinical reasoning skills. Less than half of the midwives demonstrated clinical reasoning as their way of making decisions. The new model of Midwifery Clinical Reasoning includes 'intuition' as a valued way of knowing. Using intuition, however, should not replace clinical reasoning which promotes through decision-making can be made transparent and be consensually validated. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Neural Basis of Decision-Making and Reward Processing in Adults with Euthymic Bipolar Disorder or Attention-Deficit/Hyperactivity Disorder (ADHD)

PubMed Central

Ibanez, Agustin; Cetkovich, Marcelo; Petroni, Agustin; Urquina, Hugo; Baez, Sandra; Gonzalez-Gadea, Maria Luz; Kamienkowski, Juan Esteban; Torralva, Teresa; Torrente, Fernando; Strejilevich, Sergio; Teitelbaum, Julia; Hurtado, Esteban; Guex, Raphael; Melloni, Margherita; Lischinsky, Alicia; Sigman, Mariano; Manes, Facundo

2012-01-01

Background Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) share DSM-IV criteria in adults and cause problems in decision-making. Nevertheless, no previous report has assessed a decision-making task that includes the examination of the neural correlates of reward and gambling in adults with ADHD and those with BD. Methodology/Principal Findings We used the Iowa gambling task (IGT), a task of rational decision-making under risk (RDMUR) and a rapid-decision gambling task (RDGT) which elicits behavioral measures as well as event-related potentials (ERPs: fERN and P3) in connection to the motivational impact of events. We did not observe between-group differences for decision-making under risk or ambiguity (RDMUR and IGT); however, there were significant differences for the ERP-assessed RDGT. Compared to controls, the ADHD group showed a pattern of impaired learning by feedback (fERN) and insensitivity to reward magnitude (P3). This ERP pattern (fERN and P3) was associated with impulsivity, hyperactivity, executive function and working memory. Compared to controls, the BD group showed fERN- and P3-enhanced responses to reward magnitude regardless of valence. This ERP pattern (fERN and P3) was associated with mood and inhibitory control. Consistent with the ERP findings, an analysis of source location revealed reduced responses of the cingulate cortex to the valence and magnitude of rewards in patients with ADHD and BD. Conclusions/Significance Our data suggest that neurophysiological (ERPs) paradigms such as the RDGT are well suited to assess subclinical decision-making processes in patients with ADHD and BD as well as for linking the cingulate cortex with action monitoring systems. PMID:22624011

The missing link: Creating science policies that facilitate the use of research in environmental and water-related decision-making

NASA Astrophysics Data System (ADS)

Dilling, L.; Pielke, R.; Sarewitz, D.

2005-12-01

Despite all good intentions, it is clear that science intended to serve decision making needs often fails to achieve that purpose. The aftermath of Hurricane Katrina provides a recent, tragic example. The reasons for failures of science to support decision making are varied. Researchers studying forecasts of climate variability have found, for example, cases where information provided is not needed; information is needed but not provided; information lacks regional specificity; information is provided in an inaccessible form; poor communication exists between potential users and providers; there is a lack of trust in information or deliverers; institutional constraints prevent use of new information; and so on. Traditional science policies have institutionalized the separation of the conduct of science from its application and use. It is clear that as long as such a separation, reinforced by tradition, institution and culture, is the dominant paradigm of science policies, the efficient and effective use of science in environmental and water-related decision making will be hampered. We introduce here a research methodology for examining the decision making involved in setting science policies for research aimed at being useful. Based on the economic concept, the notion of "reconciling supply and demand" for information offers a framework for identifying missed opportunities where science policies can be adjusted to improve the usefulness of a given research portfolio. We present results from a case study focused on internal science policies and decision making within the Regional Integrated Sciences and Assessments (RISA) projects. The RISA program aims to "expand the range of choices available to private and public communities in a region, by...enabling practical decisions...using research-based knowledge" and so provides an excellent opportunity for harvesting lessons for creating usable science.

The roles of dopamine and serotonin in decision making: evidence from pharmacological experiments in humans.

PubMed

Rogers, Robert D

2011-01-01

Neurophysiological experiments in primates, alongside neuropsychological and functional magnetic resonance investigations in humans, have significantly enhanced our understanding of the neural architecture of decision making. In this review, I consider the more limited database of experiments that have investigated how dopamine and serotonin activity influences the choices of human adults. These include those experiments that have involved the administration of drugs to healthy controls, experiments that have tested genotypic influences upon dopamine and serotonin function, and, finally, some of those experiments that have examined the effects of drugs on the decision making of clinical samples. Pharmacological experiments in humans are few in number and face considerable methodological challenges in terms of drug specificity, uncertainties about pre- vs post-synaptic modes of action, and interactions with baseline cognitive performance. However, the available data are broadly consistent with current computational models of dopamine function in decision making and highlight the dissociable roles of dopamine receptor systems in the learning about outcomes that underpins value-based decision making. Moreover, genotypic influences on (interacting) prefrontal and striatal dopamine activity are associated with changes in choice behavior that might be relevant to understanding exploratory behaviors and vulnerability to addictive disorders. Manipulations of serotonin in laboratory tests of decision making in human participants have provided less consistent results, but the information gathered to date indicates a role for serotonin in learning about bad decision outcomes, non-normative aspects of risk-seeking behavior, and social choices involving affiliation and notions of fairness. Finally, I suggest that the role played by serotonin in the regulation of cognitive biases, and representation of context in learning, point toward a role in the cortically mediated cognitive appraisal of reinforcers when selecting between actions, potentially accounting for its influence upon the processing salient aversive outcomes and social choice.

Proceedings--symposium on recreation choice behavior

Treesearch

George H. Stankey; Stephen F. McCool

1985-01-01

Presents an overview paper and 11 contributed papers focused on the issue of the processes that underlie decision making by recreationists. The papers span a range of topics including the theory of choice behavior, empirical investigations of choice, and methodological approaches to the study of choice behavior.

Development of a Methodology for Assessment of Crash Costs at Highway-Rail Grade Crossings in Nebraska

DOT National Transportation Integrated Search

2012-05-01

An accurate measure of crash costs is required to support effective decision-making about transportation investments. In particular, underinvestment will occur if measurement fails to capture the full cost of crashes. Such mis-measurement and underin...

THE USE OF CELLULAR AUTOMATA MODELING APPROACHES TO UNDERSTAND POTENTIAL IMPACTS OF GM PLANTS ON PLANT COMMUNITIES

EPA Science Inventory

The development of models is of interest to ecologists, regulators and developers, since it may assist theoretical understanding, decision making in experimental design, product development and risk assessment. A successful modeling methodology for investigating such characteris...

Creating Business Intelligence from Course Management Systems

ERIC Educational Resources Information Center

van Dyk, Liezl; Conradie, Pieter

2007-01-01

Purpose: This article seeks to address the interface between individual learning facilitators that use course management systems (CMS) data to support decision-making and course design and institutional infrastructure providers that are responsible for institutional business intelligence. Design/methodology/approach: The design of a data warehouse…

Reflexive Principlism as an Effective Approach for Developing Ethical Reasoning in Engineering.

PubMed

Beever, Jonathan; Brightman, Andrew O

2016-02-01

An important goal of teaching ethics to engineering students is to enhance their ability to make well-reasoned ethical decisions in their engineering practice: a goal in line with the stated ethical codes of professional engineering organizations. While engineering educators have explored a wide range of methodologies for teaching ethics, a satisfying model for developing ethical reasoning skills has not been adopted broadly. In this paper we argue that a principlist-based approach to ethical reasoning is uniquely suited to engineering ethics education. Reflexive Principlism is an approach to ethical decision-making that focuses on internalizing a reflective and iterative process of specification, balancing, and justification of four core ethical principles in the context of specific cases. In engineering, that approach provides structure to ethical reasoning while allowing the flexibility for adaptation to varying contexts through specification. Reflexive Principlism integrates well with the prevalent and familiar methodologies of reasoning within the engineering disciplines as well as with the goals of engineering ethics education.

Multi-criteria decision making development of ion chromatographic method for determination of inorganic anions in oilfield waters based on artificial neural networks retention model.

PubMed

Stefanović, Stefica Cerjan; Bolanča, Tomislav; Luša, Melita; Ukić, Sime; Rogošić, Marko

2012-02-24

This paper describes the development of ad hoc methodology for determination of inorganic anions in oilfield water, since their composition often significantly differs from the average (concentration of components and/or matrix). Therefore, fast and reliable method development has to be performed in order to ensure the monitoring of desired properties under new conditions. The method development was based on computer assisted multi-criteria decision making strategy. The used criteria were: maximal value of objective functions used, maximal robustness of the separation method, minimal analysis time, and maximal retention distance between two nearest components. Artificial neural networks were used for modeling of anion retention. The reliability of developed method was extensively tested by the validation of performance characteristics. Based on validation results, the developed method shows satisfactory performance characteristics, proving the successful application of computer assisted methodology in the described case study. Copyright © 2011 Elsevier B.V. All rights reserved.

A Psychobiographical Study of Intuition in a Writer's Life: Paulo Coelho Revisited

PubMed Central

Mayer, Claude-Hélène; Maree, David

2017-01-01

Intuition is defined as a form of knowledge which materialises as awareness of thoughts, feelings and physical sensations. It is a key to a deeper understanding and meaningfulness. Intuition, used as a psychological function, supports the transmission and integration of perceptions from unconscious and conscious realms. This study uses a psychobiographical single case study approach to explore intuition across the life span of Paulo Coelho. Methodologically, the study is based on a single case study, using the methodological frame of Dilthey's modern hermeneutics. The author, Paulo Coelho, was chosen as a subject of research, based on the content analysis of first- and third-person perspective documents. Findings show that Paulo Coelho, as one of the most famous and most read contemporary authors in the world, uses his intuitions as a deeper guidance in life, for decision-making and self-development. Intuitive decision-making is described throughout his life and by referring to selected creative works. PMID:28904596

An Analytic Network Process approach for the environmental aspect selection problem — A case study for a hand blender

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

Bereketli Zafeirakopoulos, Ilke, E-mail: ibereketli@gsu.edu.tr; Erol Genevois, Mujde, E-mail: merol@gsu.edu.tr

Life Cycle Assessment is a tool to assess, in a systematic way, the environmental aspects and its potential environmental impacts and resources used throughout a product's life cycle. It is widely accepted and considered as one of the most powerful tools to support decision-making processes used in ecodesign and sustainable production in order to learn about the most problematic parts and life cycle phases of a product and to have a projection for future improvements. However, since Life Cycle Assessment is a cost and time intensive method, companies do not intend to carry out a full version of it, exceptmore » for large corporate ones. Especially for small and medium sized enterprises, which do not have enough budget for and knowledge on sustainable production and ecodesign approaches, focusing only on the most important possible environmental aspect is unavoidable. In this direction, finding the right environmental aspect to work on is crucial for the companies. In this study, a multi-criteria decision-making methodology, Analytic Network Process is proposed to select the most relevant environmental aspect. The proposed methodology aims at providing a simplified environmental assessment to producers. It is applied for a hand blender, which is a member of the Electrical and Electronic Equipment family. The decision criteria for the environmental aspects and relations of dependence are defined. The evaluation is made by the Analytic Network Process in order to create a realistic approach to inter-dependencies among the criteria. The results are computed via the Super Decisions software. Finally, it is observed that the procedure is completed in less time, with less data, with less cost and in a less subjective way than conventional approaches. - Highlights: • We present a simplified environmental assessment methodology to support LCA. • ANP is proposed to select the most relevant environmental aspect. • ANP deals well with the interdependencies between aspects and impacts. • The methodology is less subjective, less complicated, and less time–money consuming. • The proposed methodology is suitable for use by SMEs.« less

No Change in Social Decision-Making Following Transcranial Direct Current Stimulation of the Right Temporoparietal Junction.

PubMed

Blair-West, Laura F; Hoy, Kate E; Hall, Phillip J; Fitzgerald, Paul B; Fitzgibbon, Bernadette M

2018-01-01

The right temporoparietal junction (rTPJ) is thought to play an important role in social cognition and pro-social decision-making. One way to explore this link is through the use of transcranial direct current stimulation (tDCS), a non-invasive brain stimulation method that is able to modulate cortical activity. The aim of this research was therefore to determine whether anodal tDCS to the rTPJ altered response to a social decision-making task. In this study, 34 healthy volunteers participated in a single-center, double-blinded, sham-controlled crossover design. Subjects received 20 min of active/sham anodal tDCS to the rTPJ before undertaking the Ultimatum Game (UG), a neuroeconomics paradigm in which participants are forced to choose between monetary reward and punishing an opponent's unfairness. Contrary to expectations, we found no significant difference between anodal and sham stimulation with regard to either the total number or reaction time of unfair offer rejections in the UG. This study draws attention to methodological issues in tDCS studies of the rTPJ, and highlights the complexity of social decision-making in the UG.

Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges.

PubMed

Mustafa, Reem A; Wiercioch, Wojtek; Cheung, Adrienne; Prediger, Barbara; Brozek, Jan; Bossuyt, Patrick; Garg, Amit X; Lelgemann, Monika; Büehler, Diedrich; Schünemann, Holger J

2017-12-01

In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

Pain Assessment and Treatment Disparities: A Virtual Human Technology Investigation

PubMed Central

Hirsh, Adam T.; George, Steven Z.; Robinson, Michael E.

2009-01-01

Pain assessment and treatment is influenced by patient demographic characteristics and nonverbal expressions. Methodological challenges have limited the empirical investigation of these issues. The current analogue study employed an innovative research design and novel virtual human (VH) technology to investigate disparities in pain-related clinical decision making. Fifty-four nurses viewed vignettes consisting of a video clip of the VH patient and clinical summary information describing a post-surgical context. Participants made assessment (pain intensity and unpleasantness) and treatment (non-opioid and opioid medications) decisions on computerized visual analogue scales. VH demographic cues of sex, race, and age, as well as facial expression of pain, were systematically manipulated and hypothesized to influence decision ratings. Idiographic and nomothetic statistical analyses were conducted to test these hypotheses. Idiographic results indicated that sex, race, age, and pain expression cues accounted for significant, unique variance in decision policies among many nurses. Pain expression was the most salient cue in this context. Nomothetic results indicated differences within VH cues of interest; the size and consistency of these differences varied across policy domains. This study demonstrates the application of VH technology and lens model methodology to the study of disparities in pain-related decision making. Assessment and treatment of acute post-surgical pain often varies based on VH demographic and facial expression cues. These data contribute to the existing literature on disparities in pain practice and highlight the potential of a novel approach that may serve as a model for future investigation of these critical issues. PMID:19269742

Pain assessment and treatment disparities: a virtual human technology investigation.

PubMed

Hirsh, Adam T; George, Steven Z; Robinson, Michael E

2009-05-01

Pain assessment and treatment is influenced by patient demographic characteristics and nonverbal expressions. Methodological challenges have limited the empirical investigation of these issues. The current analogue study employed an innovative research design and novel virtual human (VH) technology to investigate disparities in pain-related clinical decision-making. Fifty-four nurses viewed vignettes consisting of a video clip of the VH patient and clinical summary information describing a post-surgical context. Participants made assessment (pain intensity and unpleasantness) and treatment (non-opioid and opioid medications) decisions on computerized visual analogue scales. VH demographic cues of sex, race, and age, as well as facial expression of pain, were systematically manipulated and hypothesized to influence decision ratings. Idiographic and nomothetic statistical analyses were conducted to test these hypotheses. Idiographic results indicated that sex, race, age, and pain expression cues accounted for significant, unique variance in decision policies among many nurses. Pain expression was the most salient cue in this context. Nomothetic results indicated differences within VH cues of interest; the size and consistency of these differences varied across policy domains. This study demonstrates the application of VH technology and lens model methodology to the study of disparities in pain-related decision-making. Assessment and treatment of acute post-surgical pain often varies based on VH demographic and facial expression cues. These data contribute to the existing literature on disparities in pain practice and highlight the potential of a novel approach that may serve as a model for future investigation of these critical issues.

Cost-benefit analysis of space technology

NASA Technical Reports Server (NTRS)

Hein, G. F.; Stevenson, S. M.; Sivo, J. N.

1976-01-01

A discussion of the implications and problems associated with the use of cost-benefit techniques is presented. Knowledge of these problems is useful in the structure of a decision making process. A methodology of cost-benefit analysis is presented for the evaluation of space technology. The use of the methodology is demonstrated with an evaluation of ion thrusters for north-south stationkeeping aboard geosynchronous communication satellites. A critique of the concept of consumers surplus for measuring benefits is also presented.

Watermark: An Application and Methodology and Application for Interactive and intelligent Decision Support for Groundwater Systems

NASA Astrophysics Data System (ADS)

Pierce, S. A.; Wagner, K.; Schwartz, S.; Gentle, J. N., Jr.

2016-12-01

Critical water resources face the effects of historic drought, increased demand, and potential contamination, the need has never been greater to develop resources to effectively communicate conservation and protection across a broad audience and geographical area. The Watermark application and macro-analysis methodology merges topical analysis of context rich corpus from policy texts with multi-attributed solution sets from integrated models of water resource and other subsystems, such as mineral, food, energy, or environmental systems to construct a scalable, robust, and reproducible approach for identifying links between policy and science knowledge bases. The Watermark application is an open-source, interactive workspace to support science-based visualization and decision making. Designed with generalization in mind, Watermark is a flexible platform that allows for data analysis and inclusion of large datasets with an interactive front-end capable of connecting with other applications as well as advanced computing resources. In addition, the Watermark analysis methodology offers functionality that streamlines communication with non-technical users for policy, education, or engagement with groups around scientific topics of societal relevance. The technology stack for Watermark was selected with the goal of creating a robust and dynamic modular codebase that can be adjusted to fit many use cases and scale to support usage loads that range between simple data display to complex scientific simulation-based modelling and analytics. The methodology uses to topical analysis and simulation-optimization to systematically analyze the policy and management realities of resource systems and explicitly connect the social and problem contexts with science-based and engineering knowledge from models. A case example demonstrates use in a complex groundwater resources management study highlighting multi-criteria spatial decision making and uncertainty comparisons.

Inferring influence and leadership in moving animal groups.

PubMed

Strandburg-Peshkin, Ariana; Papageorgiou, Danai; Crofoot, Margaret C; Farine, Damien R

2018-05-19

Collective decision-making is a daily occurrence in the lives of many group-living animals, and can have critical consequences for the fitness of individuals. Understanding how decisions are reached, including who has influence and the mechanisms by which information and preferences are integrated, has posed a fundamental challenge. Here, we provide a methodological framework for studying influence and leadership in groups. We propose that individuals have influence if their actions result in some behavioural change among their group-mates, and are leaders if they consistently influence others. We highlight three components of influence (influence instances, total influence and consistency of influence), which can be assessed at two levels (individual-to-individual and individual-to-group). We then review different methods, ranging from individual positioning within groups to information-theoretic approaches, by which influence has been operationally defined in empirical studies, as well as how such observations can be aggregated to give insight into the underlying decision-making process. We focus on the domain of collective movement, with a particular emphasis on methods that have recently been, or are being, developed to take advantage of simultaneous tracking data. We aim to provide a resource bringing together methodological tools currently available for studying leadership in moving animal groups, as well as to discuss the limitations of current methodologies and suggest productive avenues for future research.This article is part of the theme issue 'Collective movement ecology'. © 2018 The Author(s).

Factors that influence case managers' resource allocation decisions in pediatric home care: an ethnographic study.

PubMed

Fraser, Kimberly D; Estabrooks, Carole; Allen, Marion; Strang, Vicki

2009-03-01

Case managers make decisions that directly affect the amount and type of services home care clients receive and subsequently affect the overall available health care resources of home care programs. A recent systematic review of the literature identified significant knowledge gaps with respect to resource allocation decision-making in home care. Using Spradley's methodology, we designed an ethnographic study of a children's home care program in Western Canada. The sample included 11 case managers and program leaders. Data sources included interviews, card sorts, and participant observation over a 5-month period. Data analyses included open coding, domain, taxonomic, and componential analysis. One of the key findings was a taxonomy of factors that influence case manager resource allocation decisions. The factors were grouped into one of four main categories: system-related, home care program-related, family related, or client-related. Family related factors have not been previously reported as influencing case manager resource allocation decision-making and nor has the team's role been reported as an influencing factor. The findings of this study are examined in light of Daniels and Sabin's Accountability for Reasonableness framework, which may be useful for future knowledge development about micro-level resource allocation theory.

Understanding and applying principles of social cognition and decision making in adaptive environmental governance.

PubMed

DeCaro, Daniel A; Arnol, Craig Anthony Tony; Boama, Emmanuel Frimpong; Garmestani, Ahjond S

2017-03-01

Environmental governance systems are under greater pressure to adapt and to cope with increased social and ecological uncertainty from stressors like climate change. We review principles of social cognition and decision making that shape and constrain how environmental governance systems adapt. We focus primarily on the interplay between key decision makers in society and legal systems. We argue that adaptive governance must overcome three cooperative dilemmas to facilitate adaptation: (1) encouraging collaborative problem solving, (2) garnering social acceptance and commitment, and (3) cultivating a culture of trust and tolerance for change and uncertainty. However, to do so governance systems must cope with biases in people's decision making that cloud their judgment and create conflict. These systems must also satisfy people's fundamental needs for self-determination, fairness, and security, ensuring that changes to environmental governance are perceived as legitimate, trustworthy, and acceptable. We discuss the implications of these principles for common governance solutions (e.g., public participation, enforcement) and conclude with methodological recommendations. We outline how scholars can investigate the social cognitive principles involved in cases of adaptive governance.

Understanding and applying principles of social cognition and decision making in adaptive environmental governance

PubMed Central

DeCaro, Daniel A.; Arnol, Craig Anthony (Tony); Boama, Emmanuel Frimpong; Garmestani, Ahjond S.

2018-01-01

Environmental governance systems are under greater pressure to adapt and to cope with increased social and ecological uncertainty from stressors like climate change. We review principles of social cognition and decision making that shape and constrain how environmental governance systems adapt. We focus primarily on the interplay between key decision makers in society and legal systems. We argue that adaptive governance must overcome three cooperative dilemmas to facilitate adaptation: (1) encouraging collaborative problem solving, (2) garnering social acceptance and commitment, and (3) cultivating a culture of trust and tolerance for change and uncertainty. However, to do so governance systems must cope with biases in people’s decision making that cloud their judgment and create conflict. These systems must also satisfy people’s fundamental needs for self-determination, fairness, and security, ensuring that changes to environmental governance are perceived as legitimate, trustworthy, and acceptable. We discuss the implications of these principles for common governance solutions (e.g., public participation, enforcement) and conclude with methodological recommendations. We outline how scholars can investigate the social cognitive principles involved in cases of adaptive governance. PMID:29780425

The decision-making process in Brazil's ratification of the World Health Organization Framework Convention on Tobacco Control.

PubMed

Rangel, Erica Cavalcanti; Pereira, Andre; Cavalcante, Tania Maria; Oliveira, Egléubia Andrade; Silva, Vera Luiza da Costa E

2017-09-21

Tobacco consumption is a leading cause of various types of cancer and other tobacco-related diseases. In 2003, the World Health Assembly adopted the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), which aims to protect citizens from the health, social, environmental, and economic consequences of tobacco consumption and exposure to tobacco smoke. The Convention was to be ratified by the Member States of the WHO; in Brazil's case, ratification involved the National Congress, which held public hearings in the country's leading tobacco growing communities (municipalities). The current study analyzes this decision-making process according to the different interests, positions, and stakeholders. In methodological terms, this is a qualitative study based on document research, drawing primarily on the shorthand notes from the public hearings. We analyze the interests and arguments for and against ratification. The article shows that although preceded by intense debates, the final decision in favor of ratification was made by a limited group of government stakeholders, characterizing a decision-making process similar to a funnel.

Culture, intangibles and metrics in environmental management.

PubMed

Satterfield, Terre; Gregory, Robin; Klain, Sarah; Roberts, Mere; Chan, Kai M

2013-03-15

The demand for better representation of cultural considerations in environmental management is increasingly evident. As two cases in point, ecosystem service approaches increasingly include cultural services, and resource planners recognize indigenous constituents and the cultural knowledge they hold as key to good environmental management. Accordingly, collaborations between anthropologists, planners, decision makers and biodiversity experts about the subject of culture are increasingly common-but also commonly fraught. Those whose expertise is culture often engage in such collaborations because they worry a practitioner from 'elsewhere' will employ a 'measure of culture' that is poorly or naively conceived. Those from an economic or biophysical training must grapple with the intangible properties of culture as they intersect with economic, biological or other material measures. This paper seeks to assist those who engage in collaborations to characterize cultural benefits or impacts relevant to decision-making in three ways; by: (i) considering the likely mindset of would-be collaborators; (ii) providing examples of tested approaches that might enable innovation; and (iii) characterizing the kinds of obstacles that are in principle solvable through methodological alternatives. We accomplish these tasks in part by examining three cases wherein culture was a critical variable in environmental decision making: risk management in New Zealand associated with Māori concerns about genetically modified organisms; cultural services to assist marine planning in coastal British Columbia; and a decision-making process involving a local First Nation about water flows in a regulated river in western Canada. We examine how 'culture' came to be manifest in each case, drawing from ethnographic and cultural-models interviews and using subjective metrics (recommended by theories of judgment and decision making) to express cultural concerns. We conclude that the characterization of cultural benefits and impacts is least amenable to methodological solution when prevailing cultural worldviews contain elements fundamentally at odds with efforts to quantify benefits/impacts, but that even in such cases some improvements are achievable if decision-makers are flexible regarding processes for consultation with community members and how quantification is structured. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Emergent collective decision-making: Control, model and behavior

NASA Astrophysics Data System (ADS)

Shen, Tian

In this dissertation we study emergent collective decision-making in social groups with time-varying interactions and heterogeneously informed individuals. First we analyze a nonlinear dynamical systems model motivated by animal collective motion with heterogeneously informed subpopulations, to examine the role of uninformed individuals. We find through formal analysis that adding uninformed individuals in a group increases the likelihood of a collective decision. Secondly, we propose a model for human shared decision-making with continuous-time feedback and where individuals have little information about the true preferences of other group members. We study model equilibria using bifurcation analysis to understand how the model predicts decisions based on the critical threshold parameters that represent an individual's tradeoff between social and environmental influences. Thirdly, we analyze continuous-time data of pairs of human subjects performing an experimental shared tracking task using our second proposed model in order to understand transient behavior and the decision-making process. We fit the model to data and show that it reproduces a wide range of human behaviors surprisingly well, suggesting that the model may have captured the mechanisms of observed behaviors. Finally, we study human behavior from a game-theoretic perspective by modeling the aforementioned tracking task as a repeated game with incomplete information. We show that the majority of the players are able to converge to playing Nash equilibrium strategies. We then suggest with simulations that the mean field evolution of strategies in the population resemble replicator dynamics, indicating that the individual strategies may be myopic. Decisions form the basis of control and problems involving deciding collectively between alternatives are ubiquitous in nature and in engineering. Understanding how multi-agent systems make decisions among alternatives also provides insight for designing decentralized control laws for engineering applications from mobile sensor networks for environmental monitoring to collective construction robots. With this dissertation we hope to provide additional methodology and mathematical models for understanding the behavior and control of collective decision-making in multi-agent systems.

Robust Sensitivity Analysis for the Joint Improvised Explosive Device Defeat Organization (JIEDDO) Proposal Selection Model

DTIC Science & Technology

2009-03-01

making process (Skinner, 2001, 9). According to Clemen , before we can begin to apply any methodology to a specific decision problem, the analyst...it is possible to work with them to determine the values and objectives that relate to the decision in question ( Clemen , 2001, 21). Clemen ...value hierarchy is constructed, Clemen and Reilly suggest that a trade off is made between varying objectives. They introduce weights to determine

TIES for Dummies 3rd Edition (Technology Identification, Evaluation, and Selection) Basic how to's to implement the TIES method

NASA Technical Reports Server (NTRS)

Kirby, Michelle R.

2002-01-01

The TIES method is a forecasting environment whereby the decision-maker has the ability to easily assess and trade-off the impact of various technologies without sophisticated and time-consuming mathematical formulations. TIES provides a methodical approach where technically feasible alternatives can be identified with accuracy and speed to reduce design cycle time, and subsequently, life cycle costs, and was achieved through the use of various probabilistic methods, such as Response Surface Methodology and Monte Carlo Simulations. Furthermore, structured and systematic techniques are utilized from other fields to identify possible concepts and evaluation criteria by which comparisons can be made. This objective is achieved by employing the use of Morphological Matrices and Multi-Attribute Decision Making techniques. Through the execution of each step, a family of design alternatives for a given set of customer requirements can be identified and assessed subjectively or objectively. This methodology allows for more information (knowledge) to be brought into the earlier phases of the design process and will have direct implications on the affordability of the system. The increased knowledge allows for optimum allocation of company resources and quantitative justification for program decisions. Finally, the TIES method provided novel results and quantitative justification to facilitate decision making in the early stages of design so as to produce affordable and quality products.

Risk and Strategic Decision-Making in Developing Evidence-Based Practice Guidelines

ERIC Educational Resources Information Center

Wilczynski, Susan M.

2012-01-01

Evidence-based practice (EBP) represents an important approach to educating and treating individuals diagnosed with disabilities or disorders. Understanding research findings is the cornerstone of EBP. The methodology of systematic reviews, which involves carefully analyzing research findings, can result a practice guideline that recommends…

Risk Assessment and Decision-Making at the Local Level:?Who does what when, how, and to what extent?

EPA Science Inventory

Problem: Exposure to multiple stressors increases the likelihood of an adverse response in human and ecosystem communities. Challenge: A rigorous and scientifically robust assessment methodology is needed to characterize stressors and receptors of interest, calculate risk estimat...

Representing causal knowledge in environmental policy interventions: Advantages and opportunities for qualitative influence diagram applications

EPA Science Inventory

This article develops and explores a methodology for using qualitative influence diagrams in environmental policy and management to support decision-making efforts that minimize risk and increase resiliency. Influence diagrams are representations of the conditional aspects of a p...

Comments on Method in Comparative Higher Education.

ERIC Educational Resources Information Center

Wasser, Henry

The methodologies employed in comparative higher education and comparative education are briefly summarized and analyzed. Weaknesses of the following approaches used by scholars/researchers in the field are identified: (1) locating decision-making structures and relations in broadly differentiated aggregations of systems; (2) case study; (3)…

3D methodology for evaluating rail crossing roughness : vehicle dynamic modeling.

DOT National Transportation Integrated Search

2015-09-28

In order for the results of the approach to be useful in decision making, one must consider that the accelerations (modeled or measured) at a rail crossing location can derive from either condition or construction of the crossing. That is to say, a c...

Spatial Planning of School Districts

ERIC Educational Resources Information Center

Maxfield, Donald W.

1972-01-01

The development of several plans based on linear programming and geographic methodology will permit school administrators to make better decisions concerning the planning of school districts: where to locate boundaries, how to eliminate overcrowding, where to locate new classrooms, and how to overcome de facto segregation. The primal and dual…

THE EPA'S EMERGING FOCUS ON LIFE CYCLE ASSESSMENT

EPA Science Inventory

EPA has been actively engaged in LCA research since 1990 to help advance the methodology and application of life cycle thinking in decision making. Across the Agency consideration of the life cycle concept is increasing in the development of policies and programs. A major force i...

Toward methodological emancipation in applied health research.

PubMed

Thorne, Sally

2011-04-01

In this article, I trace the historical groundings of what have become methodological conventions in the use of qualitative approaches to answer questions arising from the applied health disciplines and advocate an alternative logic more strategically grounded in the epistemological orientations of the professional health disciplines. I argue for an increasing emphasis on the modification of conventional qualitative approaches to the particular knowledge demands of the applied practice domain, challenging the merits of what may have become unwarranted attachment to theorizing. Reorienting our methodological toolkits toward the questions arising within an evidence-dominated policy agenda, I encourage my applied health disciplinary colleagues to make themselves useful to that larger project by illuminating that which quantitative research renders invisible, problematizing the assumptions on which it generates conclusions, and filling in the gaps in knowledge needed to make decisions on behalf of people and populations.

3D technology of Sony Bloggie has no advantage in decision-making of tennis serve direction: A randomized placebo-controlled study.

PubMed

Liu, Sicong; Ritchie, Jason; Sáenz-Moncaleano, Camilo; Ward, Savanna K; Paulsen, Cody; Klein, Tyler; Gutierrez, Oscar; Tenenbaum, Gershon

2017-06-01

This study aimed at exploring whether 3D technology enhances tennis decision-making under the conceptual framework of human performance model. A 3 (skill-level: varsity, club, recreational) × 3 (experimental condition: placebo, weak 3D [W3D], strong 3D [S3D]) between-participant design was used. Allocated to experimental conditions by a skill-level stratified randomization, 105 tennis players judged tennis serve direction from video scenarios and rated their perceptions of enjoyment, flow, and presence during task performance. Results showed that varsity players made more accurate decisions than less skilled ones. Additionally, applying 3D technology to typical video displays reduced tennis players' decision-making accuracy, although wearing the 3D glasses led to a placebo effect that shortened the decision-making reaction time. The unexpected negative effect of 3D technology on decision-making was possibly due to participants being more familiar to W3D than to S3D, and relatedly, a suboptimal task-technology match. Future directions for advancing this area of research are offered. Highlights 3D technology augments binocular depth cues to tradition video displays, and thus results in the attainment of more authentic visual representation. This process enhances task fidelity in researching perceptual-cognitive skills in sports. The paper clarified both conceptual and methodological difficulties in testing 3D technology in sports settings. Namely, the nomenclature of video footage (with/without 3D technology) and the possible placebo effect (arising from wearing glasses of 3D technology) merit researchers' attention. Participants varying in level of domain-specific expertise were randomized into viewing conditions using a placebo-controlled design. Measurement consisted of both participants' subjective experience (i.e., presence, flow, and enjoyment) and objective performance (i.e., accuracy and reaction time) in a decision-making task. Findings revealed that wearing glasses of 3D technology resulted in a placebo effect that shortened participants' reaction times in decision-making. Moreover, participants' decision-making accuracy decreased when viewing video scenarios using 3D technology. The findings generated meaningful implications regarding applying 3D technology to sports research.

A conversation-based process tracing method for use with naturalistic decisions: an evaluation study.

PubMed

Williamson, J; Ranyard, R; Cuthbert, L

2000-05-01

This study is an evaluation of a process tracing method developed for naturalistic decisions, in this case a consumer choice task. The method is based on Huber et al.'s (1997) Active Information Search (AIS) technique, but develops it by providing spoken rather than written answers to respondents' questions, and by including think aloud instructions. The technique is used within a conversation-based situation, rather than the respondent thinking aloud 'into an empty space', as is conventionally the case in think aloud techniques. The method results in a concurrent verbal protocol as respondents make their decisions, and a retrospective report in the form of a post-decision summary. The method was found to be virtually non-reactive in relation to think aloud, although the variable of Preliminary Attribute Elicitation showed some evidence of reactivity. This was a methodological evaluation, and as such the data reported are essentially descriptive. Nevertheless, the data obtained indicate that the method is capable of producing information about decision processes which could have theoretical importance in terms of evaluating models of decision-making.

Review of evaluation on ecological carrying capacity: The progress and trend of methodology

NASA Astrophysics Data System (ADS)

Wang, S. F.; Xu, Y.; Liu, T. J.; Ye, J. M.; Pan, B. L.; Chu, C.; Peng, Z. L.

2018-02-01

The ecological carrying capacity (ECC) has been regarded as an important reference to indicate the level of regional sustainable development since the very beginning of twenty-first century. By a brief review of the main progress in ECC evaluation methodologies in recent five years, this paper systematically discusses the features and differences of these methods and expounds the current states and future development trend of ECC methodology. The result shows that further exploration in terms of the dynamic, comprehensive and intelligent assessment technologies needs to be provided in order to form a unified and scientific ECC methodology system and to produce a reliable basis for environmental-economic decision-makings.

Psychosocial correlates of delayed decisions to abort.

PubMed

Bracken, M B; Kasl, S V

1976-01-01

Two samples of women aborting in New York and Connecticut during 1972 and 1973 were studied. In all, six hundred and fifty eight women about to undergo first and second trimester procedures completed a self-administered questionnaire. Items include: demographic, psychosocial and personality parameters, and a detailed review of the decision process leading to abortion. Analyses of the correlates of delay are organized around four components: acknowledgment of pregnancy; seeing a physician ; deciding to abort; and locating a clinic. Other analyses focus on the role of decisional conflict in delay. Methodological issues, implications for educational practice and for theory of decision-making are discussed.

Performance evaluation of automated manufacturing systems using generalized stochastic Petri Nets. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Al-Jaar, Robert Y.; Desrochers, Alan A.

1989-01-01

The main objective of this research is to develop a generic modeling methodology with a flexible and modular framework to aid in the design and performance evaluation of integrated manufacturing systems using a unified model. After a thorough examination of the available modeling methods, the Petri Net approach was adopted. The concurrent and asynchronous nature of manufacturing systems are easily captured by Petri Net models. Three basic modules were developed: machine, buffer, and Decision Making Unit. The machine and buffer modules are used for modeling transfer lines and production networks. The Decision Making Unit models the functions of a computer node in a complex Decision Making Unit Architecture. The underlying model is a Generalized Stochastic Petri Net (GSPN) that can be used for performance evaluation and structural analysis. GSPN's were chosen because they help manage the complexity of modeling large manufacturing systems. There is no need to enumerate all the possible states of the Markov Chain since they are automatically generated from the GSPN model.

Perspectives on benefit-risk decision-making in vaccinology: Conference report.

PubMed

Greenberg, M; Simondon, F; Saadatian-Elahi, M

2016-01-01

Benefit/risk (B/R) assessment methods are increasingly being used by regulators and companies as an important decision-making tool and their outputs as the basis of communication. B/R appraisal of vaccines, as compared with drugs, is different due to their attributes and their use. For example, vaccines are typically given to healthy people, and, for some vaccines, benefits exist both at the population and individual level. For vaccines in particular, factors such as the benefit afforded through herd effects as a function of vaccine coverage and consequently impact the B/R ratio, should also be taken into consideration and parameterized in B/R assessment models. Currently, there is no single agreed methodology for vaccine B/R assessment that can fully capture all these aspects. The conference "Perspectives on Benefit-Risk Decision-making in Vaccinology," held in Annecy (France), addressed these issues and provided recommendations on how to advance the science and practice of B/R assessment of vaccines and vaccination programs.

Expertise transfer for expert system design

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

Boose, J.H.

This book is about the Expertise Transfer System-a computer program which interviews experts and helps them build expert systems, i.e. computer programs that use knowledge from experts to make decisions and judgements under conditions of uncertainty. The techniques are useful to anyone who uses decision-making information based on the expertise of others. The methods can also be applied to personal decision-making. The interviewing methodology is borrowed from a branch of psychology called Personal Construct Theory. It is not necessary to use a computer to take advantage of the techniques from Personal Construction Theory; the fundamental procedures used by the Expertisemore » Transfer System can be performed using paper and pencil. It is not necessary that the reader understand very much about computers to understand the ideas in this book. The few relevant concepts from computer science and expert systems that are needed are explained in a straightforward manner. Ideas from Personal Construct Psychology are also introduced as needed.« less

Hydrogen Hazards Assessment Protocol (HHAP): Approach and Methodology

NASA Technical Reports Server (NTRS)

Woods, Stephen

2009-01-01

This viewgraph presentation reviews the approach and methodology to develop a assessment protocol for hydrogen hazards. Included in the presentation are the reasons to perform hazards assessment, the types of hazard assessments that exist, an analysis of hydrogen hazards, specific information about the Hydrogen Hazards Assessment Protocol (HHAP). The assessment is specifically tailored for hydrogen behavior. The end product of the assesment is a compilation of hazard, mitigations and associated factors to facilitate decision making and achieve the best practice.

Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context.

PubMed

Jefford, Elaine; Jomeen, Julie; Martin, Colin R

2016-04-28

The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general midwifery practice'. EDAM would generally appear to be a robust, valid and reliable psychometric instrument for measuring midwifery decision-making, which performs consistently across differing international contexts. The 'women's relationship with midwife' subscale marginally failed to meet the threshold for determining good instrument reliability, which may be due to its brevity. Further research using larger samples and in a wider international context to confirm the veracity of the instrument's measurement properties and its wider global utility, would be advantageous.

Cultivating Peace through Design Thinking: Problem Solving with PAST Foundation

ERIC Educational Resources Information Center

Deaner, Kat; McCreery-Kellert, Heather

2018-01-01

Design thinking is a methodology that emphasizes reasoning and decision-making as part of the problem-solving process. It is a structured framework for identifying challenges, gathering information, generating potential solutions, refining ideas, and testing solutions. Design thinking offers valuable skills that will serve students well as they…

The role of reporting standards in producing robust literature reviews

NASA Astrophysics Data System (ADS)

Haddaway, Neal Robert; Macura, Biljana

2018-06-01

Literature reviews can help to inform decision-making, yet they may be subject to fatal bias if not conducted rigorously as `systematic reviews'. Reporting standards help authors to provide sufficient methodological detail to allow verification and replication, clarifying when key steps, such as critical appraisal, have been omitted.

A social-ecological impact assessment for public land management: application of a conceptual and methodological framework

USDA-ARS?s Scientific Manuscript database

According to the U.S. National Environmental Policy Act of 1969 (NEPA), federal action to manipulate habitat for species conservation requires an environmental impact statement (EIS), which should integrate natural and social sciences in planning and decision-making. Nonetheless, most impact assessm...

Children's Spirit: Leadership Standards and Chief School Executives

ERIC Educational Resources Information Center

Boske, Christa

2009-01-01

Purpose: The purpose of this study is to increase awareness of the interactions among school leadership standards, cultural competence, and decision-making practices for chief school executives. Design/methodology/approach: To achieve this objective, 1,087 chief school executives, who were members of the American Association of School…

Net-Zero Building Technologies Create Substantial Energy Savings -

Science.gov Websites

-by-step information for decision making around net-zero energy building technologies. The past three improved insulation, windows, and heating and cooling systems. Despite these strides, energy use by energy building methodologies and technologies during a tour of the RSF's rooftop PV system. Photo by

Risk and Infrastructure Science Center - Global Security Sciences

Science.gov Websites

delivers scientific tools and methodologies to inform decision making regarding the most challenging Sciences ASD Accelerator Systems AES APS Engineering Support XSD X-ray Science Physical Sciences and Leadership Strategic Alliance for Global Energy Solutions Overview Leadership Systems Science Center Overview

An Evolving Simulation/Gaming Process to Facilitate Adaptive Watershed Management in Northern Mountainous Thailand

ERIC Educational Resources Information Center

Barnaud, Cecile; Promburom, Tanya; Trebuil, Guy; Bousquet, Francois

2007-01-01

The decentralization of natural resource management provides an opportunity for communities to increase their participation in related decision making. Research should propose adapted methodologies enabling the numerous stakeholders of these complex socioecological settings to define their problems and identify agreed-on solutions. This article…

Bayesian Monte Carlo and Maximum Likelihood Approach for Uncertainty Estimation and Risk Management: Application to Lake Oxygen Recovery Model

EPA Science Inventory

Model uncertainty estimation and risk assessment is essential to environmental management and informed decision making on pollution mitigation strategies. In this study, we apply a probabilistic methodology, which combines Bayesian Monte Carlo simulation and Maximum Likelihood e...

Saving the Lost Boys: Narratives of Discipline Disproportionality

ERIC Educational Resources Information Center

Gray, Mariama Smith

2016-01-01

In this article, I explore how discriminatory adult practices disproportionately involve Latino boys in the juvenile justice system. I use the critical methodologies of critical ethnography, critical discourse analysis and Critical Race Theory (CRT) to provide a race-centered analysis of decision-making in student discipline. My findings reveal…

Third Sector Involvement in Public Education: The Israeli Case

ERIC Educational Resources Information Center

Berkovich, Izhak; Foldes, Vincent Jonathan

2012-01-01

Purpose: The purpose of this article is to address the involvement of third sector organizations in state public education in Israel, with emphasis on the decision-making processes affecting the geographic distribution of service provision. Design/methodology/approach: A collective case study approach was used to investigate non-governmental…

Shared Governance in Times of Change: A Practical Guide for Universities and Colleges

ERIC Educational Resources Information Center

Bahls, Steven S.

2014-01-01

Today's challenging higher education environment demands a new way of making decisions. Changing business models and methodologies for delivering academic programs present new opportunities (as well as risks) and call for innovative responses. This publication aims to "reboot" dialogues among boards, presidents, and faculties. It creates…

Using Problem-Based Learning to Enhance Team and Player Development in Youth Soccer

ERIC Educational Resources Information Center

Hubball, Harry; Robertson, Scott

2004-01-01

Problem-based learning (PBL) is a coaching and teaching methodology that develops knowledge, abilities, and skills. It also encourages participation, collaborative investigation, and the resolution of authentic, "ill-structured" problems through the use of problem definition, teamwork, communication, data collection, decision-making,…

Modeling human-environmental systems

Treesearch

Morgan Grove; Charlie Schweik; Tom Evans; Glen Green

2002-01-01

This chapter focuses on the integration and development of environmental models that include human decision making. While many methodological and technical issues are common to all types of environmental models, our goal is to highlight the unique characteristics that need to be considered when modeling human-environmental dynamics and to identify future directions for...

Participatory modeling of recreation and tourism

Treesearch

Lisa C. Chase; Roelof M.J. Boumans; Stephanie Morse

2007-01-01

Communities involved in recreation and tourism planning need to understand the broad range of benefits and challenges--economic, social, and ecological--in order to make informed decisions. Participatory computer modeling is a methodology that involves a community in the process of collectively building a model about a particular situation that affects participants...

Honors as Validation

ERIC Educational Resources Information Center

Jones, Dan R.

2015-01-01

The presence of honor societies and programs on a university campus is an important component of its reputation for excellence. While we may quibble with the methodologies employed by various rankings, reputation is one of the key drivers of choice when students and their families are making that all-important decision about which university to…

Motivation and Methodology in Moral Education.

ERIC Educational Resources Information Center

Wilson, John

1981-01-01

The author asserts that moral decision making can be taught, but that choosing the moral direction we wish students to take is problematical. He argues that the proper goal or direction is primarily allegiance to certain principles of rationality and justice, personal benevolence being a desirable goal but too fragile. (Author/SJL)

Post-Secondary Enrolment Forecasting with Traditional and Cross Pressure-Impact Methodologies.

ERIC Educational Resources Information Center

Hoffman, Bernard B.

A model for forecasting postsecondary enrollment, the PDEM-1, is considered, which combines the traditional with a cross-pressure impact decision-making model. The model is considered in relation to its background, assumptions, survey instrument, model conception, applicability to educational environments, and implementation difficulties. The…

How Data Use for Accountability Undermines Equitable Science Education

ERIC Educational Resources Information Center

Braaten, Melissa; Bradford, Chris; Kirchgasler, Kathryn L.; Barocas, Sadie Fox

2017-01-01

Purpose: When school leaders advance strategic plans focused on improving educational equity through data-driven decision making, how do policies-as-practiced unfold in the daily work of science teachers? The paper aims to discuss this issue. Design/methodology/approach: This ethnographic study examines how data-centric accountability and…

Relationship of Evidence-Based Practice and Treatments: A Survey of Community Mental Health Providers

ERIC Educational Resources Information Center

DiMeo, Michelle A.; Moore, G. Kurt; Lichtenstein, Carolyn

2012-01-01

Evidence-based treatments (EBTs) are "interventions" that have been proven effective through rigorous research methodologies. Evidence-based practice (EBP), however, refers to a "decision-making process" that integrates the best available research, clinician expertise, and client characteristics. This study examined community mental health service…

Using GIS Tools and Environmental Scanning to Forecast Industry Workforce Needs

ERIC Educational Resources Information Center

Gaertner, Elaine; Fleming, Kevin; Marquez, Michelle

2009-01-01

The Centers of Excellence (COE) provide regional workforce data on high growth, high demand industries and occupations for use by community colleges in program planning and resource enhancement. This article discusses the environmental scanning research methodology and its application to data-driven decision making in community college program…

Assessing Financial Education Methods: Principles vs. Rules-of-Thumb Approaches

ERIC Educational Resources Information Center

Skimmyhorn, William L.; Davies, Evan R.; Mun, David; Mitchell, Brian

2016-01-01

Despite thousands of programs and tremendous public and private interest in improving financial decision-making, little is known about how best to teach financial education. Using an experimental approach, the authors estimated the effects of two different education methodologies (principles-based and rules-of-thumb) on the knowledge,…

Reclaiming "Sense" from "Cents" in Accounting Education

ERIC Educational Resources Information Center

Dellaportas, Steven

2015-01-01

This essay adopts an interpretive methodology of relevant literature to explore the limitations of accounting education when it is taught purely as a technical practice. The essay proceeds from the assumption that conventional accounting education is captured by a positivistic neo-classical model of decision-making that draws on economic rationale…

Developing a Quantitative Tool for Sustainability Assessment of HEIs

ERIC Educational Resources Information Center

Waheed, Bushra; Khan, Faisal I.; Veitch, Brian

2011-01-01

Purpose: Implementation of a sustainability paradigm demands new choices and innovative ways of thinking. The main objective of this paper is to provide a meaningful sustainability assessment tool for make informed decisions, which is applied to higher education institutions (HEIs). Design/methodology/approach: The objective is achieved by…

Environmental change challenges decision-making during post-market environmental monitoring of transgenic crops.

PubMed

Sanvido, Olivier; Romeis, Jörg; Bigler, Franz

2011-12-01

The ability to decide what kind of environmental changes observed during post-market environmental monitoring of genetically modified (GM) crops represent environmental harm is an essential part of most legal frameworks regulating the commercial release of GM crops into the environment. Among others, such decisions are necessary to initiate remedial measures or to sustain claims of redress linked to environmental liability. Given that consensus on criteria to evaluate 'environmental harm' has not yet been found, there are a number of challenges for risk managers when interpreting GM crop monitoring data for environmental decision-making. In the present paper, we argue that the challenges in decision-making have four main causes. The first three causes relate to scientific data collection and analysis, which have methodological limits. The forth cause concerns scientific data evaluation, which is controversial among the different stakeholders involved in the debate on potential impacts of GM crops on the environment. This results in controversy how the effects of GM crops should be valued and what constitutes environmental harm. This controversy may influence decision-making about triggering corrective actions by regulators. We analyse all four challenges and propose potential strategies for addressing them. We conclude that environmental monitoring has its limits in reducing uncertainties remaining from the environmental risk assessment prior to market approval. We argue that remaining uncertainties related to adverse environmental effects of GM crops would probably be assessed in a more efficient and rigorous way during pre-market risk assessment. Risk managers should acknowledge the limits of environmental monitoring programmes as a tool for decision-making.

Decision making in asthma exacerbation: a clinical judgement analysis

PubMed Central

Jenkins, John; Shields, Mike; Patterson, Chris; Kee, Frank

2007-01-01

Background Clinical decisions which impact directly on patient safety and quality of care are made during acute asthma attacks by individual doctors based on their knowledge and experience. Decisions include administration of systemic corticosteroids (CS) and oral antibiotics, and admission to hospital. Clinical judgement analysis provides a methodology for comparing decisions between practitioners with different training and experience, and improving decision making. Methods Stepwise linear regression was used to select clinical cues based on visual analogue scale assessments of the propensity of 62 clinicians to prescribe a short course of oral CS (decision 1), a course of antibiotics (decision 2), and/or admit to hospital (decision 3) for 60 “paper” patients. Results When compared by specialty, paediatricians' models for decision 1 were more likely to include level of alertness as a cue (54% vs 16%); for decision 2 they were more likely to include presence of crepitations (49% vs 16%) and less likely to include inhaled CS (8% vs 40%), respiratory rate (0% vs 24%) and air entry (70% vs 100%). When compared to other grades, the models derived for decision 3 by consultants/general practitioners were more likely to include wheeze severity as a cue (39% vs 6%). Conclusions Clinicians differed in their use of individual cues and the number included in their models. Patient safety and quality of care will benefit from clarification of decision‐making strategies as general learning points during medical training, in the development of guidelines and care pathways, and by clinicians developing self‐awareness of their own preferences. PMID:17428817

Can streamlined multi-criteria decision analysis be used to implement shared decision making for colorectal cancer screening?

PubMed Central

Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas F.

2013-01-01

Background Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multi-criteria decision analysis (MCDA) is an established methodology well suited for supporting shared decision making. Our study goal was to determine if a streamlined form of MCDA using rank order based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods We converted priorities for four decision criteria and three sub-criteria regarding colorectal cancer screening obtained from 484 average risk patients using the Analytic Hierarchy Process (AHP) in a prior study into rank order-based priorities using rank order centroids. We compared the two sets of priorities using Spearman rank correlation and non-parametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank order-based versus the AHP-based priorities on the results of a full MCDA comparing three currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Results Correlations between the two sets of priorities for the seven criteria ranged from 0.55 to 0.92. The proportions of absolute differences between rank order-based and AHP-based priorities that were more than ± 0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal and the relative rankings of the three screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Conclusion Rank order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making. PMID:24300851

A Discussion on Uncertainty Representation and Interpretation in Model-Based Prognostics Algorithms based on Kalman Filter Estimation Applied to Prognostics of Electronics Components

NASA Technical Reports Server (NTRS)

Celaya, Jose R.; Saxen, Abhinav; Goebel, Kai

2012-01-01

This article discusses several aspects of uncertainty representation and management for model-based prognostics methodologies based on our experience with Kalman Filters when applied to prognostics for electronics components. In particular, it explores the implications of modeling remaining useful life prediction as a stochastic process and how it relates to uncertainty representation, management, and the role of prognostics in decision-making. A distinction between the interpretations of estimated remaining useful life probability density function and the true remaining useful life probability density function is explained and a cautionary argument is provided against mixing interpretations for the two while considering prognostics in making critical decisions.

A Risk Analysis Methodology to Address Human and Organizational Factors in Offshore Drilling Safety: With an Emphasis on Negative Pressure Test

NASA Astrophysics Data System (ADS)

Tabibzadeh, Maryam

According to the final Presidential National Commission report on the BP Deepwater Horizon (DWH) blowout, there is need to "integrate more sophisticated risk assessment and risk management practices" in the oil industry. Reviewing the literature of the offshore drilling industry indicates that most of the developed risk analysis methodologies do not fully and more importantly, systematically address the contribution of Human and Organizational Factors (HOFs) in accident causation. This is while results of a comprehensive study, from 1988 to 2005, of more than 600 well-documented major failures in offshore structures show that approximately 80% of those failures were due to HOFs. In addition, lack of safety culture, as an issue related to HOFs, have been identified as a common contributing cause of many accidents in this industry. This dissertation introduces an integrated risk analysis methodology to systematically assess the critical role of human and organizational factors in offshore drilling safety. The proposed methodology in this research focuses on a specific procedure called Negative Pressure Test (NPT), as the primary method to ascertain well integrity during offshore drilling, and analyzes the contributing causes of misinterpreting such a critical test. In addition, the case study of the BP Deepwater Horizon accident and their conducted NPT is discussed. The risk analysis methodology in this dissertation consists of three different approaches and their integration constitutes the big picture of my whole methodology. The first approach is the comparative analysis of a "standard" NPT, which is proposed by the author, with the test conducted by the DWH crew. This analysis contributes to identifying the involved discrepancies between the two test procedures. The second approach is a conceptual risk assessment framework to analyze the causal factors of the identified mismatches in the previous step, as the main contributors of negative pressure test misinterpretation. Finally, a rational decision making model is introduced to quantify a section of the developed conceptual framework in the previous step and analyze the impact of different decision making biases on negative pressure test results. Along with the corroborating findings of previous studies, the analysis of the developed conceptual framework in this paper indicates that organizational factors are root causes of accumulated errors and questionable decisions made by personnel or management. Further analysis of this framework identifies procedural issues, economic pressure, and personnel management issues as the organizational factors with the highest influence on misinterpreting a negative pressure test. It is noteworthy that the captured organizational factors in the introduced conceptual framework are not only specific to the scope of the NPT. Most of these organizational factors have been identified as not only the common contributing causes of other offshore drilling accidents but also accidents in other oil and gas related operations as well as high-risk operations in other industries. In addition, the proposed rational decision making model in this research introduces a quantitative structure for analysis of the results of a conducted NPT. This model provides a structure and some parametric derived formulas to determine a cut-off point value, which assists personnel in accepting or rejecting an implemented negative pressure test. Moreover, it enables analysts to assess different decision making biases involved in the process of interpreting a conducted negative pressure test as well as the root organizational factors of those biases. In general, although the proposed integrated research methodology in this dissertation is developed for the risk assessment of human and organizational factors contributions in negative pressure test misinterpretation, it can be generalized and be potentially useful for other well control situations, both offshore and onshore; e.g. fracking. In addition, this methodology can be applied for the analysis of any high-risk operations, in not only the oil and gas industry but also in other industries such as nuclear power plants, aviation industry, and transportation sector.

Application of TOPSIS and VIKOR improved versions in a multi criteria decision analysis to develop an optimized municipal solid waste management model.

PubMed

Aghajani Mir, M; Taherei Ghazvinei, P; Sulaiman, N M N; Basri, N E A; Saheri, S; Mahmood, N Z; Jahan, A; Begum, R A; Aghamohammadi, N

2016-01-15

Selecting a suitable Multi Criteria Decision Making (MCDM) method is a crucial stage to establish a Solid Waste Management (SWM) system. Main objective of the current study is to demonstrate and evaluate a proposed method using Multiple Criteria Decision Making methods (MCDM). An improved version of Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) applied to obtain the best municipal solid waste management method by comparing and ranking the scenarios. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Besides, Viekriterijumsko Kompromisno Rangiranje (VIKOR) compromise solution method applied for sensitivity analyses. The proposed method can assist urban decision makers in prioritizing and selecting an optimized Municipal Solid Waste (MSW) treatment system. Besides, a logical and systematic scientific method was proposed to guide an appropriate decision-making. A modified TOPSIS methodology as a superior to existing methods for first time was applied for MSW problems. Applying this method in order to rank treatment methods is introduced as one contribution of the study. Next, 11 scenarios of MSW treatment methods are defined and compared environmentally and economically based on the waste management conditions. Results show that integrating a sanitary landfill (18.1%), RDF (3.1%), composting (2%), anaerobic digestion (40.4%), and recycling (36.4%) was an optimized model of integrated waste management. An applied decision-making structure provides the opportunity for optimum decision-making. Therefore, the mix of recycling and anaerobic digestion and a sanitary landfill with Electricity Production (EP) are the preferred options for MSW management. Copyright © 2015 Elsevier Ltd. All rights reserved.

Managing industrial risk--having a tested and proven system to prevent and assess risk.

PubMed

Heller, Stephen

2006-03-17

Some relatively easy techniques exist to improve the risk picture/profile to aid in preventing losses. Today with the advent of computer system resources, focusing on specific aspects of risk through systematic scoring and comparison, the risk analysis can be relatively easy to achieve. Techniques like these demonstrate how working experience and common sense can be combined mathematically into a flexible risk management tool or risk model for analyzing risk. The risk assessment methodology provided by companies today is no longer the ideas and practices of one group or even one company. It is reflective of the practice of many companies, as well as the ideas and expertise of academia and government regulators. The use of multi-criteria decision making (MCDM) techniques for making critical decisions has been recognized for many years for a variety of purposes. In today's computer age, the easy accessing and user-friendly nature for using these techniques, makes them a favorable choice for use in the risk assessment environment. The new user of these methodologies should find many ideas directly applicable to his or her needs when approaching risk decision making. The user should find their ideas readily adapted, with slight modification, to accurately reflect a specific situation using MCDM techniques. This makes them an attractive feature for use in assessment and risk modeling. The main advantage of decision making techniques, such as MCDM, is that in the early stages of a risk assessment, accurate data on industrial risk, and failures are lacking. In most cases, it is still insufficient to perform a thorough risk assessment using purely statistical concepts. The practical advantages towards deviating from strict data-driven protocol seem to outweigh the drawbacks. Industry failure data often comes at a high cost when a loss occurs. We can benefit from this unfortunate acquisition of data through the continuous refining of our decisions by incorporating this new information into our assessments. MCDM techniques offer flexibility in accessing comparison within broad data sets to reflect our best estimation of their importance towards contribution to the risk picture. This allows for the accurate determination of the more probable and more consequential issues. This can later be refined using more intensive risk techniques and the avoidance of less critical issues.

Knowledge Co-production Strategies for Water Resources Modeling and Decision Making

NASA Astrophysics Data System (ADS)

Gober, P.

2016-12-01

The limited impact of scientific information on policy making and climate adaptation in North America has raised awareness of the need for new modeling strategies and knowledge transfer processes. This paper outlines the rationale for a new paradigm in water resources modeling and management, using examples from the USA and Canada. Principles include anticipatory modeling, complex system dynamics, decision making under uncertainty, visualization, capacity to represent and manipulate critical trade-offs, stakeholder engagement, local knowledge, context-specific activities, social learning, vulnerability analysis, iterative and collaborative modeling, and the concept of a boundary organization. In this framework, scientists and stakeholders are partners in the production and dissemination of knowledge for decision making, and local knowledge is fused with scientific observation and methodology. Discussion draws from experience in building long-term collaborative boundary organizations in Phoenix, Arizona in the USA and the Saskatchewan River Basin (SRB) in Canada. Examples of boundary spanning activities include the use of visualization, the concept of a decision theater, infrastructure to support social learning, social networks, and reciprocity, simulation modeling to explore "what if" scenarios of the future, surveys to elicit how water problems are framed by scientists and stakeholders, and humanistic activities (theatrical performances, art exhibitions, etc.) to draw attention to local water issues. The social processes surrounding model development and dissemination are at least as important as modeling assumptions, procedures, and results in determining whether scientific knowledge will be used effectively for water resources decision making.

Methodological Issues in Economic Evaluations Submitted to the Pan-Canadian Oncology Drug Review (pCODR).

PubMed

Masucci, Lisa; Beca, Jaclyn; Sabharwal, Mona; Hoch, Jeffrey S

2017-12-01

Public drug plans are faced with increasingly difficult funding decisions. In Canada, the pan-Canadian Oncology Drug Review (pCODR) makes funding recommendations to the provincial and territorial drug plans responsible for cancer drugs. Assessments of the economic models submitted by pharmaceutical manufacturers are publicly reported. The main objective of this research was to identify recurring methodological issues in economic models submitted to pCODR for funding reviews. The secondary objective was to explore whether there exists any observed relationships between reported methodological issues and funding recommendations made by pCODR's expert review committee. Publicly available Economic Guidance Reports from July 2011 (inception) until June 2014 for drug reviews with a final funding recommendation (N = 34) were independently examined by two authors. Major methodological issues from each review were abstracted and grouped into nine main categories. Each issue was also categorized based on perception of the reviewer's actions to manage it. The most commonly reported issues involved costing (59% of reviews), time horizon (56%), and model structure (36%). Several types of issues were identified that usually could not be resolved, such as quality of clinical data or uncertainty with indirect comparisons. Issues with costing or choice of utility estimates could usually be addressed or explored by reviewers. No statistically significant relationship was found between any methodological issue and funding recommendations from the expert review committee. The findings provide insights that can be used by parties who submit or review economic evidence for continuous improvement and consistency in economic modeling, reporting, and decision making.

Metabolic State Alters Economic Decision Making under Risk in Humans

PubMed Central

Drew, Megan E.; Batterham, Rachel L.; Dolan, Raymond J.

2010-01-01

Background Animals' attitudes to risk are profoundly influenced by metabolic state (hunger and baseline energy stores). Specifically, animals often express a preference for risky (more variable) food sources when below a metabolic reference point (hungry), and safe (less variable) food sources when sated. Circulating hormones report the status of energy reserves and acute nutrient intake to widespread targets in the central nervous system that regulate feeding behaviour, including brain regions strongly implicated in risk and reward based decision-making in humans. Despite this, physiological influences per se have not been considered previously to influence economic decisions in humans. We hypothesised that baseline metabolic reserves and alterations in metabolic state would systematically modulate decision-making and financial risk-taking in humans. Methodology/Principal Findings We used a controlled feeding manipulation and assayed decision-making preferences across different metabolic states following a meal. To elicit risk-preference, we presented a sequence of 200 paired lotteries, subjects' task being to select their preferred option from each pair. We also measured prandial suppression of circulating acyl-ghrelin (a centrally-acting orexigenic hormone signalling acute nutrient intake), and circulating leptin levels (providing an assay of energy reserves). We show both immediate and delayed effects on risky decision-making following a meal, and that these changes correlate with an individual's baseline leptin and changes in acyl-ghrelin levels respectively. Conclusions/Significance We show that human risk preferences are exquisitely sensitive to current metabolic state, in a direction consistent with ecological models of feeding behaviour but not predicted by normative economic theory. These substantive effects of state changes on economic decisions perhaps reflect shared evolutionarily conserved neurobiological mechanisms. We suggest that this sensitivity in human risk-preference to current metabolic state has significant implications for both real-world economic transactions and for aberrant decision-making in eating disorders and obesity. PMID:20585383

Patient preferences versus physicians' judgement: does it make a difference in healthcare decision making?

PubMed

Mühlbacher, Axel C; Juhnke, Christin

2013-06-01

Clinicians and public health experts make evidence-based decisions for individual patients, patient groups and even whole populations. In addition to the principles of internal and external validity (evidence), patient preferences must also influence decision making. Great Britain, Australia and Germany are currently discussing methods and procedures for valuing patient preferences in regulatory (authorization and pricing) and in health policy decision making. However, many questions remain on how to best balance patient and public preferences with physicians' judgement in healthcare and health policy decision making. For example, how to define evaluation criteria regarding the perceived value from a patient's perspective? How do physicians' fact-based opinions also reflect patients' preferences based on personal values? Can empirically grounded theories explain differences between patients and experts-and, if so, how? This article aims to identify and compare studies that used different preference elicitation methods and to highlight differences between patient and physician preferences. Therefore, studies comparing patient preferences and physician judgements were analysed in a review. This review shows a limited amount of literature analysing and comparing patient and physician preferences for healthcare interventions and outcomes. Moreover, it shows that methodology used to compare preferences is diverse. A total of 46 studies used the following methods-discrete-choice experiments, conjoint analyses, standard gamble, time trade-offs and paired comparisons-to compare patient preferences with doctor judgements. All studies were published between 1985 and 2011. Most studies reveal a disparity between the preferences of actual patients and those of physicians. For most conditions, physicians underestimated the impact of intervention characteristics on patients' decision making. Differentiated perceptions may reflect ineffective communication between the provider and the patient. This in turn may keep physicians from fully appreciating the impact of certain medical conditions on patient preferences. Because differences exist between physicians' judgement and patient preferences, it is important to incorporate the needs and wants of the patient into treatment decisions.

Exploring the Functioning of Decision Space: A Review of the Available Health Systems Literature

PubMed Central

Roman, Tamlyn Eslie; Cleary, Susan; McIntyre, Diane

2017-01-01

Background: The concept of decision space holds appeal as an approach to disaggregating the elements that may influence decision-making in decentralized systems. This narrative review aims to explore the functioning of decision space and the factors that influence decision space. Methods: A narrative review of the literature was conducted with searches of online databases and academic journals including PubMed Central, Emerald, Wiley, Science Direct, JSTOR, and Sage. The articles were included in the review based on the criteria that they provided insight into the functioning of decision space either through the explicit application of or reference to decision space, or implicitly through discussion of decision-making related to organizational capacity or accountability mechanisms. Results: The articles included in the review encompass literature related to decentralisation, management and decision space. The majority of the studies utilise qualitative methodologies to assess accountability mechanisms, organisational capacities such as finance, human resources and management, and the extent of decision space. Of the 138 articles retrieved, 76 articles were included in the final review. Conclusion: The literature supports Bossert’s conceptualization of decision space as being related to organizational capacities and accountability mechanisms. These functions influence the decision space available within decentralized systems. The exact relationship between decision space and financial and human resource capacities needs to be explored in greater detail to determine the potential influence on system functioning. PMID:28812832

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

DTIC Science & Technology

2003-04-01

34action orientetion ". T^ks concerned pre-flight safety assessments for military combat aircraft and were performed 1^ Army Cobra aviators. Dependent...evaluations are vital during future assessments of team performance and especially for modeling purposes, as the literature lacks empirical...a similar scale, and then assign probabilities to likelihood’s for these in the future . Once completed, one can multiply expected feature values of

Evidence-based management - healthcare manager viewpoints.

PubMed

Janati, Ali; Hasanpoor, Edris; Hajebrahimi, Sakineh; Sadeghi-Bazargani, Homayoun

2018-06-11

Purpose Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework. Design/methodology/approach A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines. Findings Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers' professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers' personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing). Originality/value Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.

Good practices for real-world data studies of treatment and/or comparative effectiveness: Recommendations from the joint ISPOR-ISPE Special Task Force on real-world evidence in health care decision making.

PubMed

Berger, Marc L; Sox, Harold; Willke, Richard J; Brixner, Diana L; Eichler, Hans-Georg; Goettsch, Wim; Madigan, David; Makady, Amr; Schneeweiss, Sebastian; Tarricone, Rosanna; Wang, Shirley V; Watkins, John; Daniel Mullins, C

2017-09-01

Real-world evidence (RWE) includes data from retrospective or prospective observational studies and observational registries and provides insights beyond those addressed by randomized controlled trials. RWE studies aim to improve health care decision making. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) and the International Society for Pharmacoepidemiology (ISPE) created a task force to make recommendations regarding good procedural practices that would enhance decision makers' confidence in evidence derived from RWD studies. Peer review by ISPOR/ISPE members and task force participants provided a consensus-building iterative process for the topics and framing of recommendations. The ISPOR/ISPE Task Force recommendations cover seven topics such as study registration, replicability, and stakeholder involvement in RWE studies. These recommendations, in concert with earlier recommendations about study methodology, provide a trustworthy foundation for the expanded use of RWE in health care decision making. The focus of these recommendations is good procedural practices for studies that test a specific hypothesis in a specific population. We recognize that some of the recommendations in this report may not be widely adopted without appropriate incentives from decision makers, journal editors, and other key stakeholders. © 2017 The Authors. Pharmacoepidemiology & Drug Safety published by John Wiley & Sons Ltd.

Deciding about fast and slow decisions.

PubMed

Croskerry, Pat; Petrie, David A; Reilly, James B; Tait, Gordon

2014-02-01

Two reports in this issue address the important topic of clinical decision making. Dual process theory has emerged as the dominant model for understanding the complex processes that underlie human decision making. This theory distinguishes between the reflexive, autonomous processes that characterize intuitive decision making and the deliberate reasoning of an analytical approach. In this commentary, the authors address the polarization of viewpoints that has developed around the relative merits of the two systems. Although intuitive processes are typically fast and analytical processes slow, speed alone does not distinguish them. In any event, the majority of decisions in clinical medicine are not dependent on very short response times. What does appear relevant to diagnostic ease and accuracy is the degree to which the symptoms of the disease being diagnosed are characteristic ones. There are also concerns around some methodological issues related to research design in this area of enquiry. Reductionist approaches that attempt to isolate dependent variables may create such artificial experimental conditions that both external and ecological validity are sacrificed. Clinical decision making is a complex process with many independent (and interdependent) variables that need to be separated out in a discrete fashion and then reflected on in real time to preserve the fidelity of clinical practice. With these caveats in mind, the authors believe that research in this area should promote a better understanding of clinical practice and teaching by focusing less on the deficiencies of intuitive and analytical systems and more on their adaptive strengths.

Expediting evidence synthesis for healthcare decision-making: exploring attitudes and perceptions towards rapid reviews using Q methodology

PubMed Central

Moher, David; Clifford, Tammy J.

2016-01-01

Background Rapid reviews expedite the knowledge synthesis process with the goal of providing timely information to healthcare decision-makers who want to use evidence-informed policy and practice approaches. A range of opinions and viewpoints on rapid reviews is thought to exist; however, no research to date has formally captured these views. This paper aims to explore evidence producer and knowledge user attitudes and perceptions towards rapid reviews. Methods A Q methodology study was conducted to identify central viewpoints about rapid reviews based on a broad topic discourse. Participants rank-ordered 50 text statements and explained their Q-sort in free-text comments. Individual Q-sorts were analysed using Q-Assessor (statistical method: factor analysis with varimax rotation). Factors, or salient viewpoints on rapid reviews, were identified, interpreted and described. Results Analysis of the 11 individual Q sorts identified three prominent viewpoints: Factor A cautions against the use of study design labels to make judgements. Factor B maintains that rapid reviews should be the exception and not the rule. Factor C focuses on the practical needs of the end-user over the review process. Conclusion Results show that there are opposing viewpoints on rapid reviews, yet some unity exists. The three factors described offer insight into how and why various stakeholders act as they do and what issues may need to be resolved before increase uptake of the evidence from rapid reviews can be realized in healthcare decision-making environments. PMID:27761324

Economic feasibility study for new technological alternatives in wastewater treatment processes: a review.

PubMed

Molinos-Senante, María; Hernández-Sancho, Francesc; Sala-Garrido, Ramón

2012-01-01

The concept of sustainability involves the integration of economic, environmental, and social aspects and this also applies in the field of wastewater treatment. Economic feasibility studies are a key tool for selecting the most appropriate option from a set of technological proposals. Moreover, these studies are needed to assess the viability of transferring new technologies from pilot-scale to full-scale. In traditional economic feasibility studies, the benefits that have no market price, such as environmental benefits, are not considered and are therefore underestimated. To overcome this limitation, we propose a new methodology to assess the economic viability of wastewater treatment technologies that considers internal and external impacts. The estimation of the costs is based on the use of cost functions. To quantify the environmental benefits from wastewater treatment, the distance function methodology is proposed to estimate the shadow price of each pollutant removed in the wastewater treatment. The application of this methodological approach by decision makers enables the calculation of the true costs and benefits associated with each alternative technology. The proposed methodology is presented as a useful tool to support decision making.

Using Discrete Choice Experiments to Inform the Benefit-Risk Assessment of Medicines: Are We Ready Yet?

PubMed

Vass, Caroline M; Payne, Katherine

2017-09-01

There is emerging interest in the use of discrete choice experiments as a means of quantifying the perceived balance between benefits and risks (quantitative benefit-risk assessment) of new healthcare interventions, such as medicines, under assessment by regulatory agencies. For stated preference data on benefit-risk assessment to be used in regulatory decision making, the methods to generate these data must be valid, reliable and capable of producing meaningful estimates understood by decision makers. Some reporting guidelines exist for discrete choice experiments, and for related methods such as conjoint analysis. However, existing guidelines focus on reporting standards, are general in focus and do not consider the requirements for using discrete choice experiments specifically for quantifying benefit-risk assessments in the context of regulatory decision making. This opinion piece outlines the current state of play in using discrete choice experiments for benefit-risk assessment and proposes key areas needing to be addressed to demonstrate that discrete choice experiments are an appropriate and valid stated preference elicitation method in this context. Methodological research is required to establish: how robust the results of discrete choice experiments are to formats and methods of risk communication; how information in the discrete choice experiment can be presented effectually to respondents; whose preferences should be elicited; the correct underlying utility function and analytical model; the impact of heterogeneity in preferences; and the generalisability of the results. We believe these methodological issues should be addressed, alongside developing a 'reference case', before agencies can safely and confidently use discrete choice experiments for quantitative benefit-risk assessment in the context of regulatory decision making for new medicines and healthcare products.

Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial.

PubMed

Churilov, Leonid; Liu, Daniel; Ma, Henry; Christensen, Soren; Nagakane, Yoshinari; Campbell, Bruce; Parsons, Mark W; Levi, Christopher R; Davis, Stephen M; Donnan, Geoffrey A

2013-04-01

The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes. The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial. A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution. Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented. The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

Conceptual, Methodological, and Ethical Problems in Communicating Uncertainty in Clinical Evidence

PubMed Central

Han, Paul K. J.

2014-01-01

The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”— second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making. PMID:23132891

Regulating the economic evaluation of pharmaceuticals and medical devices: a European perspective.

PubMed

Cookson, Richard; Hutton, John

2003-02-01

Throughout the developed world, economic evaluation of costly new pharmaceuticals and medical devices became increasingly widespread and systematic during the 1990s. However, serious concerns remain about the validity and relevance of this economic evidence, and about the transparency and accountability of its use in public sector reimbursement decisions. In this article, we summarise current concerns in Europe, based on interviews with European health economists from industry, universities, research institutes and consulting firms. We identify five challenges for European policy-makers, and conclude that there is considerable scope for improving decision-making without damaging incentives to innovate. The challenges are: (1). full publication of the economic evidence used in reimbursement decisions; (2). the redesign of licensing laws to improve the relevance of economic data available at product launch; (3). harmonisation of economic evaluation methodologies; (4). development of methodologies for evaluation of health inequality impacts; and (5). negotiation of price-performance deals to facilitate the use of economic evidence in post-launch pricing review decisions, as information is gathered from studies of product performance in routine use.

Ubiquitous Working: Do Work Versus Non-work Environments Affect Decision-Making and Concentration?

PubMed

Burmeister, Carolin P; Moskaliuk, Johannes; Cress, Ulrike

2018-01-01

New communication technologies and mobile devices have enabled knowledge workers to work independently of location and in more than one fixed environment (ubiquitous working). Previous research shows that physical environments can influence cognition and work performance. We manipulated environment (i.e., a virtual office as a typical work environment compared to a virtual garden as a non-work environment ) and time pressure (i.e., inducing time pressure vs. no time pressure ) in order to investigate whether the environment influences decision-making and concentration. N = 109 students participated in this laboratory experiment. We posited (a) that a work environment would activate a work-related schema which in turn would enhance concentration performance and make decisions more risky compared to non-work environments and (b) that the environmental effect is more pronounced if time pressure is present compared to conditions where no time pressure is present. We found modest hypothesis-confirming main effects of environment on decision-making and concentration but no interaction effect with time pressure. As we used an innovative methodology that entails several limitations, future research is needed to give insights into the process and to investigate whether results hold true for all types of work settings, work demands, or work activities.

[Information from the invoicing sector as support for decision-making: a case study at the University Hospital of the Federal University of Grande Dourados (UFGD)].

PubMed

Cintra, Renato Fabiano; Vieira, Saulo Fabiano Amâncio; Hall, Rosemar José; Fernandes, Cristiano Rodrigues

2013-10-01

The public sector is the main financing agent of hospital admissions and the information generated constitutes the input for the hospital information network of the Unified Health System (SUS). This paper seeks to design a report template to be used for decision-making in both public and university hospitals. The theoretical approach sought inspiration in discussions about the SUS, hospital institutions, hospital information systems and decision-making. The methodological procedures used are characterized as qualitative-descriptive methods and were conducted in a single case study and action research. The primary data analysis was carried out in two stages from January through December 2007 and from January through December 2008. Based on these periods, the findings were described and the elaboration of new reports was presented, with the importance and need for each being duly emphasized. Lastly, a structured report template was created for the case study that includes information discussed in the article. The conclusion reached is that the hospital information system can become a potential support tool, as the necessary adjustments are made and the report is structured to furnish the institution with an objective communication tool for decision-making.

Challenges in the estimation of Net SURvival: The CENSUR working survival group.

PubMed

Giorgi, R

2016-10-01

Net survival, the survival probability that would be observed, in a hypothetical world, where the cancer of interest would be the only possible cause of death, is a key indicator in population-based cancer studies. Accounting for mortality due to other causes, it allows cross-country comparisons or trends analysis and provides a useful indicator for public health decision-making. The objective of this study was to show how the creation and formalization of a network comprising established research teams, which already had substantial and complementary experience in both cancer survival analysis and methodological development, make it possible to meet challenges and thus provide more adequate tools, to improve the quality and the comparability of cancer survival data, and to promote methodological transfers in areas of emerging interest. The Challenges in the Estimation of Net SURvival (CENSUR) working survival group is composed of international researchers highly skilled in biostatistics, methodology, and epidemiology, from different research organizations in France, the United Kingdom, Italy, Slovenia, and Canada, and involved in French (FRANCIM) and European (EUROCARE) cancer registry networks. The expected advantages are an interdisciplinary, international, synergistic network capable of addressing problems in public health, for decision-makers at different levels; tools for those in charge of net survival analyses; a common methodology that makes unbiased cross-national comparisons of cancer survival feasible; transfer of methods for net survival estimations to other specific applications (clinical research, occupational epidemiology); and dissemination of results during an international training course. The formalization of the international CENSUR working survival group was motivated by a need felt by scientists conducting population-based cancer research to discuss, develop, and monitor implementation of a common methodology to analyze net survival in order to provide useful information for cancer control and cancer policy. A "team science" approach is necessary to address new challenges concerning the estimation of net survival. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Assessment of clinical practice guideline methodology for the treatment of knee osteoarthritis with intra-articular hyaluronic acid.

PubMed

Altman, Roy D; Schemitsch, Emil; Bedi, Asheesh

2015-10-01

Clinical practice guidelines are of increasing importance in the decision making for the treatment of knee osteoarthritis. Inconsistent recommendations regarding the use of intra-articular hyaluronic acid for the treatment of knee osteoarthritis have led to confusion among treating physicians. Literature search to identify clinical practice guidelines that provide recommendations regarding the use of intra-articular hyaluronic acid treatment for knee osteoarthritis was conducted. Included guidelines were appraised using the AGREE II instrument. Guideline development methodologies, how the results were assessed, the recommendation formation, and work group composition were summarized. Overall, 10 clinical practice guidelines were identified that met our inclusion criteria. AGREE II domain scores were variable across the included guidelines. The methodology utilized across the guidelines was heterogeneous regarding the evidence inclusion criteria, analysis of evidence results, formulation of clinical practice recommendations, and work group composition. The recommendations provided by the guidelines for intra-articular hyaluronic acid treatment for knee osteoarthritis are highly inconsistent as a result of the variability in guideline methodology. Overall, 30% of the included guidelines recommended against the use of intra-articular hyaluronic acid in the treatment of knee osteoarthritis, while 30% deemed the treatment an appropriate intervention under certain scenarios. The remaining 40% of the guidelines provided either an uncertain recommendation or no recommendation at all, based on the high variability in reviewed evidence regarding efficacy and trial quality. There is a need for a standard "appropriate methodology" that is agreed upon for osteoarthritis clinical practice guidelines in order to prevent the development of conflicting recommendations for intra-articular hyaluronic acid treatment for knee osteoarthritis, and to assure that treating physicians who are utilizing these guidelines are making their clinical decisions on the best available evidence. At present, the inconsistent recommendations provided for intra-articular hyaluronic acid treatment make it difficult for clinical professionals to determine its appropriateness when treating patients with knee osteoarthritis. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

The SIMRAND methodology: Theory and application for the simulation of research and development projects

NASA Technical Reports Server (NTRS)

Miles, R. F., Jr.

1986-01-01

A research and development (R&D) project often involves a number of decisions that must be made concerning which subset of systems or tasks are to be undertaken to achieve the goal of the R&D project. To help in this decision making, SIMRAND (SIMulation of Research ANd Development Projects) is a methodology for the selection of the optimal subset of systems or tasks to be undertaken on an R&D project. Using alternative networks, the SIMRAND methodology models the alternative subsets of systems or tasks under consideration. Each path through an alternative network represents one way of satisfying the project goals. Equations are developed that relate the system or task variables to the measure of reference. Uncertainty is incorporated by treating the variables of the equations probabilistically as random variables, with cumulative distribution functions assessed by technical experts. Analytical techniques of probability theory are used to reduce the complexity of the alternative networks. Cardinal utility functions over the measure of preference are assessed for the decision makers. A run of the SIMRAND Computer I Program combines, in a Monte Carlo simulation model, the network structure, the equations, the cumulative distribution functions, and the utility functions.

Using Covert Response Activation to Test Latent Assumptions of Formal Decision-Making Models in Humans.

PubMed

Servant, Mathieu; White, Corey; Montagnini, Anna; Burle, Borís

2015-07-15

Most decisions that we make build upon multiple streams of sensory evidence and control mechanisms are needed to filter out irrelevant information. Sequential sampling models of perceptual decision making have recently been enriched by attentional mechanisms that weight sensory evidence in a dynamic and goal-directed way. However, the framework retains the longstanding hypothesis that motor activity is engaged only once a decision threshold is reached. To probe latent assumptions of these models, neurophysiological indices are needed. Therefore, we collected behavioral and EMG data in the flanker task, a standard paradigm to investigate decisions about relevance. Although the models captured response time distributions and accuracy data, EMG analyses of response agonist muscles challenged the assumption of independence between decision and motor processes. Those analyses revealed covert incorrect EMG activity ("partial error") in a fraction of trials in which the correct response was finally given, providing intermediate states of evidence accumulation and response activation at the single-trial level. We extended the models by allowing motor activity to occur before a commitment to a choice and demonstrated that the proposed framework captured the rate, latency, and EMG surface of partial errors, along with the speed of the correction process. In return, EMG data provided strong constraints to discriminate between competing models that made similar behavioral predictions. Our study opens new theoretical and methodological avenues for understanding the links among decision making, cognitive control, and motor execution in humans. Sequential sampling models of perceptual decision making assume that sensory information is accumulated until a criterion quantity of evidence is obtained, from where the decision terminates in a choice and motor activity is engaged. The very existence of covert incorrect EMG activity ("partial error") during the evidence accumulation process challenges this longstanding assumption. In the present work, we use partial errors to better constrain sequential sampling models at the single-trial level. Copyright © 2015 the authors 0270-6474/15/3510371-15$15.00/0.

Health care decision making autonomy of women from rural districts of Southern Ethiopia: a community based cross-sectional study

PubMed Central

Alemayehu, Mihiretu; Meskele, Mengistu

2017-01-01

Introduction Millions of women have little health care decision making autonomy in many cultures and tribes. African women are often perceived to have little participation in health care decisions. However, little has been investigated to identify factors contributing to decision making autonomy. Hence, it is important to obtain information on the contributing factors of decision making autonomy and disparities across different socio-cultural contexts. Methodology A cross-sectional study was conducted in Wolaita and Dawro zones, Southern Ethiopia from February to March 2015. A total of 967 women were selected through multistage sampling. A survey was administered face-to-face through an interview format. EpiData v1.4.4.0 and SPSS version 20 were used to enter and analyze data, respectively. Proportions and means were used to describe the study population. Variables with P-value <0.2 in bivariate analysis were selected for multivariable regression. Finally, variables with P-value <0.05 in multivariable logistic regressions were identified as independent predictors. Odds ratios along with confidence intervals were used to determine the presence of association. Result It was determined that 58.4% of women have autonomy, while 40.9% of study participants’ health care decisions were made by their husbands. The husband’s education (adjusted odds ratio [AOR] =1.91 [1.10, 3.32]), wealth index (AOR =0.62 [0.42, 0.92]), age (AOR =2.42 [1.35, 4.32] and AOR =7 [3.45, 14.22]), family size (AOR =0.53 [0.33, 0.85] and AOR =0.42 [0.23, 0.75]), and occupation (AOR =1.66 [1.14, 2.41]), were predictors of health care decision making autonomy. Conclusion Even though every woman has the right to participate in her own health care decision making, more than two fifths of them have no role in making health care decisions about their own health. Husbands play a major role in making health care decisions about their wives. A comprehensive strategy needs to be implemented in order to empower women, as well as to challenge the traditional male dominance. Special attention has to be given to women living in rural areas in order to reduce their dependency through education and income generating activities. PMID:28458582

NextGen Future Safety Assessment Game

NASA Technical Reports Server (NTRS)

Ancel, Ersin; Gheorghe, Adian; Jones, Sharon Monica

2010-01-01

The successful implementation of the next generation infrastructure systems requires solid understanding of their technical, social, political and economic aspects along with their interactions. The lack of historical data that relate to the long-term planning of complex systems introduces unique challenges for decision makers and involved stakeholders which in turn result in unsustainable systems. Also, the need to understand the infrastructure at the societal level and capture the interaction between multiple stakeholders becomes important. This paper proposes a methodology in order to develop a holistic approach aiming to provide an alternative subject-matter expert (SME) elicitation and data collection method for future sociotechnical systems. The methodology is adapted to Next Generation Air Transportation System (NextGen) decision making environment in order to demonstrate the benefits of this holistic approach.

NextGen Future Safety Assessment Game

NASA Technical Reports Server (NTRS)

Ancel, Ersin; Gheorghe, Adrian; Jones, Sharon Monica

2011-01-01

The successful implementation of the next generation infrastructure systems requires solid understanding of their technical, social, political and economic aspects along with their interactions. The lack of historical data that relate to the long-term planning of complex systems introduces unique challenges for decision makers and involved stakeholders which in turn result in unsustainable systems. Also, the need to understand the infrastructure at the societal level and capture the interaction between multiple stakeholders becomes important. This paper proposes a methodology in order to develop a holistic approach aiming to provide an alternative subject-matter expert (SME) elicitation and data collection method for future sociotechnical systems. The methodology is adapted to Next Generation Air Transportation System (NextGen) decision making environment in order to demonstrate the benefits of this holistic approach.

A Clinical Decision Support System for Breast Cancer Patients

NASA Astrophysics Data System (ADS)

Fernandes, Ana S.; Alves, Pedro; Jarman, Ian H.; Etchells, Terence A.; Fonseca, José M.; Lisboa, Paulo J. G.

This paper proposes a Web clinical decision support system for clinical oncologists and for breast cancer patients making prognostic assessments, using the particular characteristics of the individual patient. This system comprises three different prognostic modelling methodologies: the clinically widely used Nottingham prognostic index (NPI); the Cox regression modelling and a partial logistic artificial neural network with automatic relevance determination (PLANN-ARD). All three models yield a different prognostic index that can be analysed together in order to obtain a more accurate prognostic assessment of the patient. Missing data is incorporated in the mentioned models, a common issue in medical data that was overcome using multiple imputation techniques. Risk group assignments are also provided through a methodology based on regression trees, where Boolean rules can be obtained expressed with patient characteristics.

Rough Set Theory based prognostication of life expectancy for terminally ill patients.

PubMed

Gil-Herrera, Eleazar; Yalcin, Ali; Tsalatsanis, Athanasios; Barnes, Laura E; Djulbegovic, Benjamin

2011-01-01

We present a novel knowledge discovery methodology that relies on Rough Set Theory to predict the life expectancy of terminally ill patients in an effort to improve the hospice referral process. Life expectancy prognostication is particularly valuable for terminally ill patients since it enables them and their families to initiate end-of-life discussions and choose the most desired management strategy for the remainder of their lives. We utilize retrospective data from 9105 patients to demonstrate the design and implementation details of a series of classifiers developed to identify potential hospice candidates. Preliminary results confirm the efficacy of the proposed methodology. We envision our work as a part of a comprehensive decision support system designed to assist terminally ill patients in making end-of-life care decisions.

Parent Experience of Care and Decision Making for Children Who Snore.

PubMed

Boss, Emily F; Links, Anne R; Saxton, Ron; Cheng, Tina L; Beach, Mary Catherine

2017-03-01

Sleep-disordered breathing (SDB) is prevalent and has an impact on the physical and behavioral health of children. Adenotonsillectomy (AT), the primary treatment, is subject to unexplained variation in utilization, which may be reduced by improving physician-patient communication and decision quality for this elective procedure. To identify factors are associated with parental experience and decision making in pediatric SDB and AT surgery. In this qualitative study, parents of children with prior SDB evaluation participated in semistructured, audiorecorded interviews. Open-ended questions regarded experiences of having a child with SDB, communication with pediatric clinicians and surgeons, and experiences with AT surgery. Recordings were transcribed and analyzed for emergent themes using grounded theory methodology. Eleven parents of children ages 2 to 17 years who had previously been diagnosed or treated for SDB were identified via purposive sampling and interviewed between January and April 2015. Interviews were conducted at locations convenient for the participants and separate from the pediatric clinic. A goal of this study was to ascertain how parents perceived sharing decisions with their physicians. Themes of parental experiences and treatment decision-making processes with pediatric SDB. Overarching themes were inclusive of (1) clinical factors of SDB and AT and (2) clinician interpersonal behaviors and communication. Parents described an urgency that led them to seek evaluation or treatment, including fear that the child would stop breathing, or behavioral and/or cognitive delays. Parents often viewed surgery as a "last resort" and had explored alternate therapies prior to seeing the surgeon. Nearly all parents feared anesthesia more than AT surgery itself. Parents described satisfaction when physicians provided them with options, engaged their child in conversation, depicted SDB visually, and were responsive or accessible to questions. Parents regarded a trusting relationship with their pediatrician, confidence in the surgeon, and inclusion in decision making as important. While clinical factors were influential for decision making, interpersonal factors helped parents feel comfortable and influenced their overall experience. Shared decision making, in which parents receive evidence-based information allowing them to accurately perceive risks, benefits, and alternatives about SDB treatment in the setting of trusting clinician-family relationships, may reduce parental decision conflict and improve decision quality toward AT surgery.

Accuracy and Calibration of Computational Approaches for Inpatient Mortality Predictive Modeling.

PubMed

Nakas, Christos T; Schütz, Narayan; Werners, Marcus; Leichtle, Alexander B

2016-01-01

Electronic Health Record (EHR) data can be a key resource for decision-making support in clinical practice in the "big data" era. The complete database from early 2012 to late 2015 involving hospital admissions to Inselspital Bern, the largest Swiss University Hospital, was used in this study, involving over 100,000 admissions. Age, sex, and initial laboratory test results were the features/variables of interest for each admission, the outcome being inpatient mortality. Computational decision support systems were utilized for the calculation of the risk of inpatient mortality. We assessed the recently proposed Acute Laboratory Risk of Mortality Score (ALaRMS) model, and further built generalized linear models, generalized estimating equations, artificial neural networks, and decision tree systems for the predictive modeling of the risk of inpatient mortality. The Area Under the ROC Curve (AUC) for ALaRMS marginally corresponded to the anticipated accuracy (AUC = 0.858). Penalized logistic regression methodology provided a better result (AUC = 0.872). Decision tree and neural network-based methodology provided even higher predictive performance (up to AUC = 0.912 and 0.906, respectively). Additionally, decision tree-based methods can efficiently handle Electronic Health Record (EHR) data that have a significant amount of missing records (in up to >50% of the studied features) eliminating the need for imputation in order to have complete data. In conclusion, we show that statistical learning methodology can provide superior predictive performance in comparison to existing methods and can also be production ready. Statistical modeling procedures provided unbiased, well-calibrated models that can be efficient decision support tools for predicting inpatient mortality and assigning preventive measures.

Exploration of Advanced Probabilistic and Stochastic Design Methods

NASA Technical Reports Server (NTRS)

Mavris, Dimitri N.

2003-01-01

The primary objective of the three year research effort was to explore advanced, non-deterministic aerospace system design methods that may have relevance to designers and analysts. The research pursued emerging areas in design methodology and leverage current fundamental research in the area of design decision-making, probabilistic modeling, and optimization. The specific focus of the three year investigation was oriented toward methods to identify and analyze emerging aircraft technologies in a consistent and complete manner, and to explore means to make optimal decisions based on this knowledge in a probabilistic environment. The research efforts were classified into two main areas. First, Task A of the grant has had the objective of conducting research into the relative merits of possible approaches that account for both multiple criteria and uncertainty in design decision-making. In particular, in the final year of research, the focus was on the comparison and contrasting between three methods researched. Specifically, these three are the Joint Probabilistic Decision-Making (JPDM) technique, Physical Programming, and Dempster-Shafer (D-S) theory. The next element of the research, as contained in Task B, was focused upon exploration of the Technology Identification, Evaluation, and Selection (TIES) methodology developed at ASDL, especially with regards to identification of research needs in the baseline method through implementation exercises. The end result of Task B was the documentation of the evolution of the method with time and a technology transfer to the sponsor regarding the method, such that an initial capability for execution could be obtained by the sponsor. Specifically, the results of year 3 efforts were the creation of a detailed tutorial for implementing the TIES method. Within the tutorial package, templates and detailed examples were created for learning and understanding the details of each step. For both research tasks, sample files and tutorials are attached in electronic form with the enclosed CD.

Developing a Robust Strategy for Implementing a Water Resources Master Plan in Lima, Peru

NASA Astrophysics Data System (ADS)

Kalra, N.; Groves, D.; Bonzanigo, L.; Molina-Perez, E.

2015-12-01

Lima, the capital of Peru, faces significant water stress. It is the fifth largest metropolitan area in Latin America, and the second largest desert city in the world. The city has developed a Master Plan of major investment projects to improve water reliability until 2040. Yet key questions remain. Is the Master Plan sufficient for ensuring reliability in the face of deeply uncertain future climate change and demand? How do uncertain budget and project feasibility conditions shape Lima's options? How should the investments in the plan be prioritized, and can some be delayed? Lima is not alone in facing these planning challenges. Governments invest billions of dollars annually in long-term projects. Yet deep uncertainties pose formidable challenges to making near-term decisions that make long-term sense. The World Bank has spearheaded a community of practice on methods for Decision Making Under Deep Uncertainty (DMU). This pilot project in Peru is the first in-depth application of DMU techniques to water supply planning in a developing country. It builds on prior analysis done in New York, California, and for the Colorado River, yet shows how these methods can be applied in regions which do not have as advanced data or tools available. The project combines three methods in particular -- Robust Decision Making, Decision Scaling, and Adaptive Pathways -- to help Lima implement its Master Plan in a way that is robust, no-regret, and adaptive. It was done in close partnership with SEDAPAL, the water utility company in Lima, and in coordination with other national WRM and meteorological agencies. This talk will: Present the planning challenges Lima and other cities face, including climate change Describe DMU methodologies and how they were applied in collaboration with SEDAPAL Summarize recommendations for achieving long-term water reliability in Lima Suggest how these methodologies can benefit other investment projects in developing countries.

Life support decision making in critical care: Identifying and appraising the qualitative research evidence.

PubMed

Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

2009-04-01

The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and stress). Both designs can provide useful reflections for improving care. Given the diversity of qualitative research in critical care, room for improvement exists regarding both the quality and transparency of reported methodology.

A Practical, Robust Methodology for Acquiring New Observation Data Using Computationally Expensive Groundwater Models

NASA Astrophysics Data System (ADS)

Siade, Adam J.; Hall, Joel; Karelse, Robert N.

2017-11-01

Regional groundwater flow models play an important role in decision making regarding water resources; however, the uncertainty embedded in model parameters and model assumptions can significantly hinder the reliability of model predictions. One way to reduce this uncertainty is to collect new observation data from the field. However, determining where and when to obtain such data is not straightforward. There exist a number of data-worth and experimental design strategies developed for this purpose. However, these studies often ignore issues related to real-world groundwater models such as computational expense, existing observation data, high-parameter dimension, etc. In this study, we propose a methodology, based on existing methods and software, to efficiently conduct such analyses for large-scale, complex regional groundwater flow systems for which there is a wealth of available observation data. The method utilizes the well-established d-optimality criterion, and the minimax criterion for robust sampling strategies. The so-called Null-Space Monte Carlo method is used to reduce the computational burden associated with uncertainty quantification. And, a heuristic methodology, based on the concept of the greedy algorithm, is proposed for developing robust designs with subsets of the posterior parameter samples. The proposed methodology is tested on a synthetic regional groundwater model, and subsequently applied to an existing, complex, regional groundwater system in the Perth region of Western Australia. The results indicate that robust designs can be obtained efficiently, within reasonable computational resources, for making regional decisions regarding groundwater level sampling.

Healthcare resource allocation decisions affecting uninsured services

PubMed Central

Harrison, Krista Lyn; Taylor, Holly A.

2017-01-01

Purpose Using the example of community access programs (CAPs), the purpose of this paper is to describe resource allocation and policy decisions related to providing health services for the uninsured in the USA and the organizational values affecting these decisions. Design/methodology/approach The study used comparative case study methodology at two geographically diverse sites. Researchers collected data from program documents, meeting observations, and interviews with program stakeholders. Findings Five resource allocation or policy decisions relevant to providing healthcare services were described at each site across three categories: designing the health plan, reacting to funding changes, and revising policies. Organizational values of access to care and stewardship most frequently affected resource allocation and policy decisions, while economic and political pressures affect the relative prioritization of values. Research limitations/implications Small sample size, the potential for social desirability or recall bias, and the exclusion of provider, member or community perspectives beyond those represented among participating board members. Practical implications Program directors or researchers can use this study to assess the extent to which resource allocation and policy decisions align with organizational values and mission statements. Social implications The description of how healthcare decisions are actually made can be matched with literature that describes how healthcare resource decisions ought to be made, in order to provide a normative grounding for future decisions. Originality/value This study addresses a gap in literature regarding how CAPs actually make resource allocation decisions that affect access to healthcare services. PMID:27934550

Explaining why nurses remain in or leave bedside nursing: a critical ethnography.

PubMed

Mahon, Paula; McPherson, Gladys

2014-09-01

To describe the application of critical ethnography to explain nurses' decisions to remain in or leave bedside nursing, and to describe researcher positioning and reflexivity. Enquiry into hospital nurses' decisions to remain in or leave bedside nursing positions has been conducted from a variety of theoretical perspectives by researchers adopting a range of methodological approaches. This research helps to explain how work environments can affect variables such as job satisfaction and turnover, but provides less insight into how personal and professional factors shape decisions to remain in or leave bedside nursing. A critical theoretical perspective was taken to examine the employment decisions made by nurses in a paediatric intensive care unit (PICU). Data was collected from nurses (n=31) through semi-structured interviews and unobtrusive observation. The authors describe critical ethnography as a powerful research framework for enquiry that allowed them to challenge assumptions about why nurses remain in or leave their jobs, and to explore how issues of fairness and equity contribute to these decisions. Critical ethnography offers a powerful methodology for investigations into complex interactions, such as those between nurses in a PICU. In adopting this methodology, researchers should be sensitised to manifestations of power, attend to their stance and location, and reflexion. The greatest challenges from this research included how to make sense of the insider position, how to acknowledge assumptions and allow these to be challenged, and how to ensure that power relationships in the environment and in the research were attended to.

HUMAN DECISIONS AND MACHINE PREDICTIONS.

PubMed

Kleinberg, Jon; Lakkaraju, Himabindu; Leskovec, Jure; Ludwig, Jens; Mullainathan, Sendhil

2018-02-01

Can machine learning improve human decision making? Bail decisions provide a good test case. Millions of times each year, judges make jail-or-release decisions that hinge on a prediction of what a defendant would do if released. The concreteness of the prediction task combined with the volume of data available makes this a promising machine-learning application. Yet comparing the algorithm to judges proves complicated. First, the available data are generated by prior judge decisions. We only observe crime outcomes for released defendants, not for those judges detained. This makes it hard to evaluate counterfactual decision rules based on algorithmic predictions. Second, judges may have a broader set of preferences than the variable the algorithm predicts; for instance, judges may care specifically about violent crimes or about racial inequities. We deal with these problems using different econometric strategies, such as quasi-random assignment of cases to judges. Even accounting for these concerns, our results suggest potentially large welfare gains: one policy simulation shows crime reductions up to 24.7% with no change in jailing rates, or jailing rate reductions up to 41.9% with no increase in crime rates. Moreover, all categories of crime, including violent crimes, show reductions; and these gains can be achieved while simultaneously reducing racial disparities. These results suggest that while machine learning can be valuable, realizing this value requires integrating these tools into an economic framework: being clear about the link between predictions and decisions; specifying the scope of payoff functions; and constructing unbiased decision counterfactuals. JEL Codes: C10 (Econometric and statistical methods and methodology), C55 (Large datasets: Modeling and analysis), K40 (Legal procedure, the legal system, and illegal behavior).

HUMAN DECISIONS AND MACHINE PREDICTIONS*

PubMed Central

Kleinberg, Jon; Lakkaraju, Himabindu; Leskovec, Jure; Ludwig, Jens; Mullainathan, Sendhil

2018-01-01

Can machine learning improve human decision making? Bail decisions provide a good test case. Millions of times each year, judges make jail-or-release decisions that hinge on a prediction of what a defendant would do if released. The concreteness of the prediction task combined with the volume of data available makes this a promising machine-learning application. Yet comparing the algorithm to judges proves complicated. First, the available data are generated by prior judge decisions. We only observe crime outcomes for released defendants, not for those judges detained. This makes it hard to evaluate counterfactual decision rules based on algorithmic predictions. Second, judges may have a broader set of preferences than the variable the algorithm predicts; for instance, judges may care specifically about violent crimes or about racial inequities. We deal with these problems using different econometric strategies, such as quasi-random assignment of cases to judges. Even accounting for these concerns, our results suggest potentially large welfare gains: one policy simulation shows crime reductions up to 24.7% with no change in jailing rates, or jailing rate reductions up to 41.9% with no increase in crime rates. Moreover, all categories of crime, including violent crimes, show reductions; and these gains can be achieved while simultaneously reducing racial disparities. These results suggest that while machine learning can be valuable, realizing this value requires integrating these tools into an economic framework: being clear about the link between predictions and decisions; specifying the scope of payoff functions; and constructing unbiased decision counterfactuals. JEL Codes: C10 (Econometric and statistical methods and methodology), C55 (Large datasets: Modeling and analysis), K40 (Legal procedure, the legal system, and illegal behavior) PMID:29755141

Investigation of Multi-Criteria Decision Consistency: A Triplex Approach to Optimal Oilfield Portfolio Investment Decisions

NASA Astrophysics Data System (ADS)

Qaradaghi, Mohammed

Complexity of the capital intensive oil and gas portfolio investments is continuously growing. It is manifested in the constant increase in the type, number and degree of risks and uncertainties, which consequently lead to more challenging decision making problems. A typical complex decision making problem in petroleum exploration and production (E&P) is the selection and prioritization of oilfields/projects in a portfolio investment. Prioritizing oilfields maybe required for different purposes, including the achievement of a targeted production and allocation of limited available development resources. These resources cannot be distributed evenly nor can they be allocated based on the oilfield size or production capacity alone since various other factors need to be considered simultaneously. These factors may include subsurface complexity, size of reservoir, plateau production and needed infrastructure in addition to other issues of strategic concern, such as socio-economic, environmental and fiscal policies, particularly when the decision making involves governments or national oil companies. Therefore, it would be imperative to employ decision aiding tools that not only address these factors, but also incorporate the decision makers' preferences clearly and accurately. However, the tools commonly used in project portfolio selection and optimization, including intuitive approaches, vary in their focus and strength in addressing the different criteria involved in such decision problems. They are also disadvantaged by a number of drawbacks, which may include lacking the capacity to address multiple and interrelated criteria, uncertainty and risk, project relationship with regard to value contribution and optimum resource utilization, non-monetary attributes, decision maker's knowledge and expertise, in addition to varying levels of ease of use and other practical and theoretical drawbacks. These drawbacks have motivated researchers to investigate other tools and techniques that can provide more flexibility and inclusiveness in the decision making process, such as Multi-Criteria Decision Making (MCDM) methods. However, it can be observed that the MCDM literature: 1) is primarily focused on suggesting certain MCDM techniques to specific problems without providing sufficient evidence for their selection, 2) is inadequate in addressing MCDM in E&P portfolio selection and prioritization compared with other fields, and 3) does not address prioritizing brownfields (i.e., developed oilfields). This research study aims at addressing the above drawbacks through combining three MCDM methods (i.e., AHP, PROMETHEE and TOPSIS) into a single decision making tool that can support optimal oilfield portfolio investment decisions by helping determine the share of each oilfield of the total development resources allocated. Selecting these methods is reinforced by a pre-deployment and post-deployment validation framework. In addition, this study proposes a two-dimensional consistency test to verify the output coherence or prioritization stability of the MCDM methods in comparison with an intuitive approach. Nine scenarios representing all possible outcomes of the internal and external consistency tests are further proposed to reach a conclusion. The methodology is applied to a case study of six major oilfields in Iraq to generate percentage shares of each oilfield of a total production target that is in line with Iraq's aspiration to increase oil production. However, the methodology is intended to be applicable to other E&P portfolio investment prioritization scenarios by taking the specific contextual characteristics into consideration.

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.

Rational decision-making in mental health: the role of systematic reviews.

PubMed

Gilbody, Simon M.; Petticrew, Mark

1999-09-01

BACKGROUND: "Systematic reviews" have come to be recognized as the most rigorous method of summarizing confusing and often contradictory primary research in a transparent and reproducible manner. Their greatest impact has been in the summarization of epidemiological literature - particularly that relating to clinical effectiveness. Systematic reviews also have a potential to inform rational decision-making in healthcare policy and to form a component of economic evaluation. AIMS OF THE STUDY: This article aims to introduce the rationale behind systematic reviews and, using examples from mental health, to introduce the strengths and limitations of systematic reviews, particularly in informing mental health policy and economic evaluation. METHODS: Examples are selected from recent controversies surrounding the introduction of new psychiatric drugs (anti-depressants and anti-schizophrenia drugs) and methods of delivering psychiatric care in the community (case management and assertive community treatment). The potential for systematic reviews to (i) produce best estimates of clinical efficacy and effectiveness, (ii) aid economic evaluation and policy decision-making and (iii) highlight gaps in the primary research knowledge base are discussed. Lastly examples are selected from outside mental health to show how systematic reviews have a potential to be explicitly used in economic and health policy evaluation. RESULTS: Systematic reviews produce the best estimates of clinical efficacy, which can form an important component of economic evaluation. Importantly, serious methodological flaws and areas of uncertainty in the primary research literature are identified within an explicit framework. Summary indices of clinical effectiveness can be produced, but it is difficult to produce such summary indices of cost effectiveness by pooling economic data from primary studies. Modelling is commonly used in economic and policy evaluation. Here, systematic reviews can provide the best estimates of effectiveness and, importantly, highlight areas of uncertainty that can be used in "sensitivity analysis". DISCUSSION: Systematic reviews are an important recent methodological advance, the potential for which has only begun to be realized in mental health. This use of systematic reviews is probably most advanced in producing critical summaries of clinical effectiveness data. Systematic reviews cannot produce valid and believable conclusions when the primary research literature is of poor quality. An important function of systematic reviews will be in highlighting this poor quality research which is of little use in mental health decision making. IMPLICATIONS FOR HEALTH PROVISION: Health care provision should be both clinically and cost effective. Systematic reviews are a key component in ensuring that this goal is achieved. IMPLICATIONS FOR HEALTH POLICIES: Systematic reviews have potential to inform health policy. Examples presented show that health policy is often made without due consideration of the research evidence. Systematic reviews can provide robust and believable answers, which can help inform rational decision-making. Importantly, systematic reviews can highlight the need for important primary research and can inform the design of this research such that it provides answers that will help in forming healthcare policy. IMPLICATIONS FOR FURTHER RESEARCH: Systematic reviews should precede costly (and often unnecessary) primary research. Many areas of health policy and practice have yet to be evaluated using systematic review methodology. Methods for the summarization of economic data are methodologically complex and deserve further research

A Methodology to Support Decision Making in Flood Plan Mitigation

NASA Astrophysics Data System (ADS)

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

2009-04-01

The focus of the present document is on specific decision-making aspects of flood risk analysis. A flood is the result of runoff from rainfall in quantities too great to be confined in the low-water channels of streams. Little can be done to prevent a major flood, but we may be able to minimize damage within the flood plain of the river. This broad definition encompasses many possible mitigation measures. Floodplain management considers the integrated view of all engineering, nonstructural, and administrative measures for managing (minimizing) losses due to flooding on a comprehensive scale. The structural measures are the flood-control facilities designed according to flood characteristics and they include reservoirs, diversions, levees or dikes, and channel modifications. Flood-control measures that modify the damage susceptibility of floodplains are usually referred to as nonstructural measures and may require minor engineering works. On the other hand, those measures designed to modify the damage potential of permanent facilities are called non-structural and allow reducing potential damage during a flood event. Technical information is required to support the tasks of problem definition, plan formulation, and plan evaluation. The specific information needed and the related level of detail are dependent on the nature of the problem, the potential solutions, and the sensitivity of the findings to the basic information. Actions performed to set up and lay out the study are preliminary to the detailed analysis. They include: defining the study scope and detail, the field data collection, a review of previous studies and reports, and the assembly of needed maps and surveys. Risk analysis can be viewed as having many components: risk assessment, risk communication and risk management. Risk assessment comprises an analysis of the technical aspects of the problem, risk communication deals with conveying the information and risk management involves the decision process. In the present paper we propose a novel methodology for supporting the priority setting in the assessment of such issues, beyond the typical "expected value" approach. Scientific contribution and management aspects are merged to create a simplified method for plan basin implementation, based on risk and economic analyses. However, the economic evaluation is not the sole criterion for flood-damage reduction plan selection. Among the different criteria that are relevant to the decision process, safety and quality of human life, economic damage, expenses related with the chosen measures and environmental issues should play a fundamental role on the decisions made by the authorities. Some numerical indices, taking in account administrative, technical, economical and risk aspects, are defined and are combined together in a mathematical formula that defines a Priority Index (PI). In particular, the priority index defines a ranking of priority interventions, thus allowing the formulation of the investment plan. The research is mainly focused on the technical factors of risk assessment, providing quantitative and qualitative estimates of possible alternatives, containing measures of the risk associated with those alternatives. Moreover, the issues of risk management are analyzed, in particular with respect to the role of decision making in the presence of risk information. However, a great effort is devoted to make this index easy to be formulated and effective to allow a clear and transparent comparison between the alternatives. Summarizing this document describes a major- steps for incorporation of risk analysis into the decision making process: framing of the problem in terms of risk analysis, application of appropriate tools and techniques to obtain quantified results, use of the quantified results in the choice of structural and non-structural measures. In order to prove the reliability of the proposed methodology and to show how risk-based information can be incorporated into a flood analysis process, its application to some middle italy river basins is presented. The methodology assessment is performed by comparing different scenarios and showing that the optimal decision stems from a feasibility evaluation.

Assessment, design and control strategy development of a fuel cell hybrid electric vehicle for CSU's EcoCAR

NASA Astrophysics Data System (ADS)

Fox, Matthew D.

Advanced automotive technology assessment and powertrain design are increasingly performed through modeling, simulation, and optimization. But technology assessments usually target many competing criteria making any individual optimization challenging and arbitrary. Further, independent design simulations and optimizations take considerable time to execute, and design constraints and objectives change throughout the design process. Changes in design considerations usually require re-processing of simulations and more time. In this thesis, these challenges are confronted through CSU's participation in the EcoCAR2 hybrid vehicle design competition. The complexity of the competition's design objectives leveraged development of a decision support system tool to aid in multi-criteria decision making across technologies and to perform powertrain optimization. To make the decision support system interactive, and bypass the problem of long simulation times, a new approach was taken. The result of this research is CSU's architecture selection and component sizing, which optimizes a composite objective function representing the competition score. The selected architecture is an electric vehicle with an onboard range extending hydrogen fuel cell system. The vehicle has a 145kW traction motor, 18.9kWh of lithium ion battery, a 15kW fuel cell system, and 5kg of hydrogen storage capacity. Finally, a control strategy was developed that improves the vehicles performance throughout the driving range under variable driving conditions. In conclusion, the design process used in this research is reviewed and evaluated against other common design methodologies. I conclude, through the highlighted case studies, that the approach is more comprehensive than other popular design methodologies and is likely to lead to a higher quality product. The upfront modeling work and decision support system formulation will pay off in superior and timely knowledge transfer and more informed design decisions. The hypothesis is supported by the three case studies examined in this thesis.

From Collectives to Collective Decision-Making and Action: Farmer Field Schools in Vietnam

ERIC Educational Resources Information Center

van de Fliert, Elske; Dung, Ngo Tien; Henriksen, Ole; Dalsgaard, Jens Peter Tang

2007-01-01

In 1992, even before a formalized agricultural extension system existed, the Farmer Field School was introduced in Vietnam as a farmer education methodology aiming at enhancing farmers' agroecological knowledge, critical skills and collective action to support sustainable agricultural development. Over the years, the model saw a wide range of…

Power Principles for Educational Leaders: Research into Practice

ERIC Educational Resources Information Center

Hoy, Wayne K.; Tarter, C. John

2011-01-01

Purpose: The aim of this article is to examine the empirical literature on irrationality and identify a set of concepts to help administrators cope with irrationality in decision making. Design/methodology/approach: This analysis is a synthesis of the selected research literature on irrationality. Findings: A set of seven concepts and propositions…

What Do All These Numbers Mean? Data Visualization as an Innovative Methodology to Make Program Decisions

ERIC Educational Resources Information Center

Porter, Susan G.; Koch, Steven P.; Henderson, Andrew

2010-01-01

Background: There is a lack of consistent, comprehensible data collection and analysis methods for evaluating teacher preparation program's coverage of required standards for accreditation. Of particular concern is the adequate coverage of standards and competencies that address the teaching of English learners and teachers of students from…

Knowledge Wisdom and Networks: A Project Management Centre of Excellence Example

ERIC Educational Resources Information Center

Walker, Derek H. T.; Christenson, Dale

2005-01-01

Purpose: This conceptual paper aims to explain how "project management centres of excellence (CoEs)", a particular class of knowledge network, can be viewed as providing great potential for assisting project management (PM) teams to make wise decisions. Design/methodology/approach: The paper presents a range of knowledge network types and…

A Phenomenological Study of an Emergent National Digital Library, Part I: Theory and Methodological Framework

ERIC Educational Resources Information Center

Dalbello, Marija

2005-01-01

The activities surrounding the National Digital Library Program (NDLP) at the Library of Congress (1995-2000) are used to study institutional processes associated with technological innovation in the library context. The study identified modalities of successful innovation and the characteristics of creative decision making. Theories of social…

Implementing Competency-Based Education: Challenges, Strategies, and a Decision-Making Framework

ERIC Educational Resources Information Center

Dragoo, Amie; Barrows, Richard

2016-01-01

The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…