Systematic Review of Medical Informatics-Supported Medication Decision Making.

PubMed

Melton, Brittany L

2017-01-01

This systematic review sought to assess the applications and implications of current medical informatics-based decision support systems related to medication prescribing and use. Studies published between January 2006 and July 2016 which were indexed in PubMed and written in English were reviewed, and 39 studies were ultimately included. Most of the studies looked at computerized provider order entry or clinical decision support systems. Most studies examined decision support systems as a means of reducing errors or risk, particularly associated with medication prescribing, whereas a few studies evaluated the impact medical informatics-based decision support systems have on workflow or operations efficiency. Most studies identified benefits associated with decision support systems, but some indicate there is room for improvement.

Applications of Formal Methods to Specification and Safety of Avionics Software

NASA Technical Reports Server (NTRS)

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

1996-01-01

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

Decision Support Framework (DSF) For Evaluating Planned Land And Resource Use Decisions: Hypothetical Application Of The DSF To Address Nutrient Loads In The Florida Keys

EPA Science Inventory

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

Decision Support Systems for Research and Management in Advanced Life Support

NASA Technical Reports Server (NTRS)

Rodriquez, Luis F.

2004-01-01

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

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.

Toward the Modularization of Decision Support Systems

NASA Astrophysics Data System (ADS)

Raskin, R. G.

2009-12-01

Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.

Experimenting with C2 Applications and Federated Infrastructures for Integrated Full-Spectrum Operational Environments in Support of Collaborative Planning and Interoperable Execution

DTIC Science & Technology

2004-06-01

Situation Understanding) Common Operational Pictures Planning & Decision Support Capabilities Message & Order Processing Common Operational...Pictures Planning & Decision Support Capabilities Message & Order Processing Common Languages & Data Models Modeling & Simulation Domain

Implementation of workflow engine technology to deliver basic clinical decision support functionality.

PubMed

Huser, Vojtech; Rasmussen, Luke V; Oberg, Ryan; Starren, Justin B

2011-04-10

Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform.

Design and realization of tourism spatial decision support system based on GIS

NASA Astrophysics Data System (ADS)

Ma, Zhangbao; Qi, Qingwen; Xu, Li

2008-10-01

In this paper, the existing problems of current tourism management information system are analyzed. GIS, tourism as well as spatial decision support system are introduced, and the application of geographic information system technology and spatial decision support system to tourism management and the establishment of tourism spatial decision support system based on GIS are proposed. System total structure, system hardware and software environment, database design and structure module design of this system are introduced. Finally, realization methods of this systemic core functions are elaborated.

A Bridging Opportunities Work-frame to develop mobile applications for clinical decision making

PubMed Central

van Rooij, Tibor; Rix, Serena; Moore, James B; Marsh, Sharon

2015-01-01

Background: Mobile applications (apps) providing clinical decision support (CDS) may show the greatest promise when created by and for frontline clinicians. Our aim was to create a generic model enabling healthcare providers to direct the development of CDS apps. Methods: We combined Change Management with a three-tier information technology architecture to stimulate CDS app development. Results: A Bridging Opportunities Work-frame model was developed. A test case was used to successfully develop an app. Conclusion: Healthcare providers can re-use this globally applicable model to actively create and manage regional decision support applications to translate evidence-based medicine in the use of emerging medication or novel treatment regimens. PMID:28031883

Decision blocks: A tool for automating decision making in CLIPS

NASA Technical Reports Server (NTRS)

Eick, Christoph F.; Mehta, Nikhil N.

1991-01-01

The human capability of making complex decision is one of the most fascinating facets of human intelligence, especially if vague, judgemental, default or uncertain knowledge is involved. Unfortunately, most existing rule based forward chaining languages are not very suitable to simulate this aspect of human intelligence, because of their lack of support for approximate reasoning techniques needed for this task, and due to the lack of specific constructs to facilitate the coding of frequently reoccurring decision block to provide better support for the design and implementation of rule based decision support systems. A language called BIRBAL, which is defined on the top of CLIPS, for the specification of decision blocks, is introduced. Empirical experiments involving the comparison of the length of CLIPS program with the corresponding BIRBAL program for three different applications are surveyed. The results of these experiments suggest that for decision making intensive applications, a CLIPS program tends to be about three times longer than the corresponding BIRBAL program.

Reviewing model application to support animal health decision making.

PubMed

Singer, Alexander; Salman, Mo; Thulke, Hans-Hermann

2011-04-01

Animal health is of societal importance as it affects human welfare, and anthropogenic interests shape decision making to assure animal health. Scientific advice to support decision making is manifold. Modelling, as one piece of the scientific toolbox, is appreciated for its ability to describe and structure data, to give insight in complex processes and to predict future outcome. In this paper we study the application of scientific modelling to support practical animal health decisions. We reviewed the 35 animal health related scientific opinions adopted by the Animal Health and Animal Welfare Panel of the European Food Safety Authority (EFSA). Thirteen of these documents were based on the application of models. The review took two viewpoints, the decision maker's need and the modeller's approach. In the reviewed material three types of modelling questions were addressed by four specific model types. The correspondence between tasks and models underpinned the importance of the modelling question in triggering the modelling approach. End point quantifications were the dominating request from decision makers, implying that prediction of risk is a major need. However, due to knowledge gaps corresponding modelling studies often shed away from providing exact numbers. Instead, comparative scenario analyses were performed, furthering the understanding of the decision problem and effects of alternative management options. In conclusion, the most adequate scientific support for decision making - including available modelling capacity - might be expected if the required advice is clearly stated. Copyright © 2011 Elsevier B.V. All rights reserved.

Biomedical Ontologies in Action: Role in Knowledge Management, Data Integration and Decision Support

PubMed Central

Bodenreider, O.

2008-01-01

Summary Objectives To provide typical examples of biomedical ontologies in action, emphasizing the role played by biomedical ontologies in knowledge management, data integration and decision support. Methods Biomedical ontologies selected for their practical impact are examined from a functional perspective. Examples of applications are taken from operational systems and the biomedical literature, with a bias towards recent journal articles. Results The ontologies under investigation in this survey include SNOMED CT, the Logical Observation Identifiers, Names, and Codes (LOINC), the Foundational Model of Anatomy, the Gene Ontology, RxNorm, the National Cancer Institute Thesaurus, the International Classification of Diseases, the Medical Subject Headings (MeSH) and the Unified Medical Language System (UMLS). The roles played by biomedical ontologies are classified into three major categories: knowledge management (indexing and retrieval of data and information, access to information, mapping among ontologies); data integration, exchange and semantic interoperability; and decision support and reasoning (data selection and aggregation, decision support, natural language processing applications, knowledge discovery). Conclusions Ontologies play an important role in biomedical research through a variety of applications. While ontologies are used primarily as a source of vocabulary for standardization and integration purposes, many applications also use them as a source of computable knowledge. Barriers to the use of ontologies in biomedical applications are discussed. PMID:18660879

An Environment for Guideline-based Decision Support Systems for Outpatients Monitoring.

PubMed

Zini, Elisa M; Lanzola, Giordano; Bossi, Paolo; Quaglini, Silvana

2017-08-11

We propose an architecture for monitoring outpatients that relies on mobile technologies for acquiring data. The goal is to better control the onset of possible side effects between the scheduled visits at the clinic. We analyze the architectural components required to ensure a high level of abstraction from data. Clinical practice guidelines were formalized with Alium, an authoring tool based on the PROforma language, using SNOMED-CT as a terminology standard. The Alium engine is accessible through a set of APIs that may be leveraged for implementing an application based on standard web technologies to be used by doctors at the clinic. Data sent by patients using mobile devices need to be complemented with those already available in the Electronic Health Record to generate personalized recommendations. Thus a middleware pursuing data abstraction is required. To comply with current standards, we adopted the HL7 Virtual Medical Record for Clinical Decision Support Logical Model, Release 2. The developed architecture for monitoring outpatients includes: (1) a guideline-based Decision Support System accessible through a web application that helps the doctors with prevention, diagnosis and treatment of therapy side effects; (2) an application for mobile devices, which allows patients to regularly send data to the clinic. In order to tailor the monitoring procedures to the specific patient, the Decision Support System also helps physicians with the configuration of the mobile application, suggesting the data to be collected and the associated collection frequency that may change over time, according to the individual patient's conditions. A proof of concept has been developed with a system for monitoring the side effects of chemo-radiotherapy in head and neck cancer patients. Our environment introduces two main innovation elements with respect to similar works available in the literature. First, in order to meet the specific patients' needs, in our work the Decision Support System also helps the physicians in properly configuring the mobile application. Then the Decision Support System is also continuously fed by patient-reported outcomes.

New approaches for real time decision support systems

NASA Technical Reports Server (NTRS)

Hair, D. Charles; Pickslay, Kent

1994-01-01

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

How Decision Support Systems Can Benefit from a Theory of Change Approach.

PubMed

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

How Decision Support Systems Can Benefit from a Theory of Change Approach

NASA Astrophysics Data System (ADS)

Allen, Will; Cruz, Jennyffer; Warburton, Bruce

2017-06-01

Decision support systems are now mostly computer and internet-based information systems designed to support land managers with complex decision-making. However, there is concern that many environmental and agricultural decision support systems remain underutilized and ineffective. Recent efforts to improve decision support systems use have focused on enhancing stakeholder participation in their development, but a mismatch between stakeholders' expectations and the reality of decision support systems outputs continues to limit uptake. Additional challenges remain in problem-framing and evaluation. We propose using an outcomes-based approach called theory of change in conjunction with decision support systems development to support both wider problem-framing and outcomes-based monitoring and evaluation. The theory of change helps framing by placing the decision support systems within a wider context. It highlights how decision support systems use can "contribute" to long-term outcomes, and helps align decision support systems outputs with these larger goals. We illustrate the benefits of linking decision support systems development and application with a theory of change approach using an example of pest rabbit management in Australia. We develop a theory of change that outlines the activities required to achieve the outcomes desired from an effective rabbit management program, and two decision support systems that contribute to specific aspects of decision making in this wider problem context. Using a theory of change in this way should increase acceptance of the role of decision support systems by end-users, clarify their limitations and, importantly, increase effectiveness of rabbit management. The use of a theory of change should benefit those seeking to improve decision support systems design, use and, evaluation.

Implementation of workflow engine technology to deliver basic clinical decision support functionality

PubMed Central

2011-01-01

Background Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. Results We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. Conclusions We describe an implementation of a free workflow technology software suite (available at http://code.google.com/p/healthflow) and its application in the domain of clinical decision support. Our implementation seamlessly supports clinical logic testing on retrospective data and offers a user-friendly knowledge representation paradigm. With the presented software implementation, we demonstrate that workflow engine technology can provide a decision support platform which evaluates well against an established clinical decision support architecture evaluation framework. Due to cross-industry usage of workflow engine technology, we can expect significant future functionality enhancements that will further improve the technology's capacity to serve as a clinical decision support platform. PMID:21477364

Multi-objective optimization of solid waste flows: environmentally sustainable strategies for municipalities.

PubMed

Minciardi, Riccardo; Paolucci, Massimo; Robba, Michela; Sacile, Roberto

2008-11-01

An approach to sustainable municipal solid waste (MSW) management is presented, with the aim of supporting the decision on the optimal flows of solid waste sent to landfill, recycling and different types of treatment plants, whose sizes are also decision variables. This problem is modeled with a non-linear, multi-objective formulation. Specifically, four objectives to be minimized have been taken into account, which are related to economic costs, unrecycled waste, sanitary landfill disposal and environmental impact (incinerator emissions). An interactive reference point procedure has been developed to support decision making; these methods are considered appropriate for multi-objective decision problems in environmental applications. In addition, interactive methods are generally preferred by decision makers as they can be directly involved in the various steps of the decision process. Some results deriving from the application of the proposed procedure are presented. The application of the procedure is exemplified by considering the interaction with two different decision makers who are assumed to be in charge of planning the MSW system in the municipality of Genova (Italy).

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.

Decision support and disease management: a logic engineering approach.

PubMed

Fox, J; Thomson, R

1998-12-01

This paper describes the development and application of PROforma, a unified technology for clinical decision support and disease management. Work leading to the implementation of PROforma has been carried out in a series of projects funded by European agencies over the past 13 years. The work has been based on logic engineering, a distinct design and development methodology that combines concepts from knowledge engineering, logic programming, and software engineering. Several of the projects have used the approach to demonstrate a wide range of applications in primary and specialist care and clinical research. Concurrent academic research projects have provided a sound theoretical basis for the safety-critical elements of the methodology. The principal technical results of the work are the PROforma logic language for defining clinical processes and an associated suite of software tools for delivering applications, such as decision support and disease management procedures. The language supports four standard objects (decisions, plans, actions, and enquiries), each of which has an intuitive meaning with well-understood logical semantics. The development toolset includes a powerful visual programming environment for composing applications from these standard components, for verifying consistency and completeness of the resulting specification and for delivering stand-alone or embeddable applications. Tools and applications that have resulted from the work are described and illustrated, with examples from specialist cancer care and primary care. The results of a number of evaluation activities are included to illustrate the utility of the technology.

Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

PubMed

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

Big-Data Based Decision-Support Systems to Improve Clinicians’ Cognition

PubMed Central

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians’ cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems. PMID:27990498

Scalable software architectures for decision support.

PubMed

Musen, M A

1999-12-01

Interest in decision-support programs for clinical medicine soared in the 1970s. Since that time, workers in medical informatics have been particularly attracted to rule-based systems as a means of providing clinical decision support. Although developers have built many successful applications using production rules, they also have discovered that creation and maintenance of large rule bases is quite problematic. In the 1980s, several groups of investigators began to explore alternative programming abstractions that can be used to build decision-support systems. As a result, the notions of "generic tasks" and of reusable problem-solving methods became extremely influential. By the 1990s, academic centers were experimenting with architectures for intelligent systems based on two classes of reusable components: (1) problem-solving methods--domain-independent algorithms for automating stereotypical tasks--and (2) domain ontologies that captured the essential concepts (and relationships among those concepts) in particular application areas. This paper highlights how developers can construct large, maintainable decision-support systems using these kinds of building blocks. The creation of domain ontologies and problem-solving methods is the fundamental end product of basic research in medical informatics. Consequently, these concepts need more attention by our scientific community.

Working in partnership: the application of shared decision-making to health visitor practice.

PubMed

Astbury, Ruth; Shepherd, Ashley; Cheyne, Helen

2017-01-01

To explore the processes that support shared decision-making when health visitors and parents are creating plans to improve the well-being of babies and children. Worldwide, there is a focus on promoting children's well-being to enhance the population health. Within the United Kingdom, health visitors have a key responsibility for working in partnership with parents to support this agenda. Despite evidence that the application of 'shared decision-making' frameworks can increase patient participation, improve patient satisfaction and improve health outcomes, there is limited research linking shared decision-making with health visitor practice. A qualitative, descriptive study. The study was undertaken in two phases: in Phase 1, data were collected by audio recording two health visitor-parent decision-making conversations, in the absence of the researcher, where decisions around planning for a baby or child were being made as part of usual care, and then the participants' experiences were sought through individual questionnaires. In Phase 2, semistructured interviews were conducted with nine health visitors and nine parents in relation to their recent experiences of planning care. Evidence of supportive processes included having a shared understanding around the issue needing to be addressed; being able to identify interventions that were accessible for the family; engaging in decision-making through deep, meaningful conversations using sensitive and responsive approaches; and establishing positive relationships between health visitors and parents, significant others within the family and other professionals. Despite evidence of strong, trusting relationships between parents and health visitors, there were times when shared decision-making was unable to take place due to the absence of supportive processes. Health visitors are aware that planning interventions with parents can be complex. These findings indicate the value of using a shared decision-making framework to structure planning, as application of a framework identified the processes that support a collaborative approach in practice. © 2016 John Wiley & Sons Ltd.

Decision support systems in health economics.

PubMed

Quaglini, S; Dazzi, L; Stefanelli, M; Barosi, G; Marchetti, M

1999-08-01

This article describes a system addressed to different health care professionals for building, using, and sharing decision support systems for resource allocation. The system deals with selected areas, namely the choice of diagnostic tests, the therapy planning, and the instrumentation purchase. Decision support is based on decision-analytic models, incorporating an explicit knowledge representation of both the medical domain knowledge and the economic evaluation theory. Application models are built on top of meta-models, that are used as guidelines for making explicit both the cost and effectiveness components. This approach improves the transparency and soundness of the collaborative decision-making process and facilitates the result interpretation.

Integrated Modeling and Simulation Verification, Validation, and Accreditation Strategy for Exploration Systems Mission Directorate

NASA Technical Reports Server (NTRS)

Hale, Joseph P.

2006-01-01

Models and simulations (M&S) are critical resources in the exploration of space. They support program management, systems engineering, integration, analysis, test, and operations and provide critical information and data supporting key analyses and decisions (technical, cost and schedule). Consequently, there is a clear need to establish a solid understanding of M&S strengths and weaknesses, and the bounds within which they can credibly support decision-making. Their usage requires the implementation of a rigorous approach to verification, validation and accreditation (W&A) and establishment of formal process and practices associated with their application. To ensure decision-making is suitably supported by information (data, models, test beds) from activities (studies, exercises) from M&S applications that are understood and characterized, ESMD is establishing formal, tailored W&A processes and practices. In addition, to ensure the successful application of M&S within ESMD, a formal process for the certification of analysts that use M&S is being implemented. This presentation will highlight NASA's Exploration Systems Mission Directorate (ESMD) management approach for M&S W&A to ensure decision-makers receive timely information on the model's fidelity, credibility, and quality.

Linking Data Access to Data Models to Applications: The Estuary Data Mapper

EPA Science Inventory

The U.S. Environmental Protection Agency (US EPA) is developing e-Estuary, a decision-support system for coastal management. E-Estuary has three elements: an estuarine geo-referenced relational database, watershed GIS coverages, and tools to support decision-making. To facilita...

The application of decision analysis to life support research and technology development

NASA Technical Reports Server (NTRS)

Ballin, Mark G.

1994-01-01

Applied research and technology development is often characterized by uncertainty, risk, and significant delays before tangible returns are obtained. Decision making regarding which technologies to advance and what resources to devote to them is a challenging but essential task. In the application of life support technology to future manned space flight, new technology concepts typically are characterized by nonexistent data and rough approximations of technology performance, uncertain future flight program needs, and a complex, time-intensive process to develop technology to a flight-ready status. Decision analysis is a quantitative, logic-based discipline that imposes formalism and structure to complex problems. It also accounts for the limits of knowledge that may be available at the time a decision is needed. The utility of decision analysis to life support technology R & D was evaluated by applying it to two case studies. The methodology was found to provide insight that is not possible from more traditional analysis approaches.

Integrating HL7 RIM and ontology for unified knowledge and data representation in clinical decision support systems.

PubMed

Zhang, Yi-Fan; Tian, Yu; Zhou, Tian-Shu; Araki, Kenji; Li, Jing-Song

2016-01-01

The broad adoption of clinical decision support systems within clinical practice has been hampered mainly by the difficulty in expressing domain knowledge and patient data in a unified formalism. This paper presents a semantic-based approach to the unified representation of healthcare domain knowledge and patient data for practical clinical decision making applications. A four-phase knowledge engineering cycle is implemented to develop a semantic healthcare knowledge base based on an HL7 reference information model, including an ontology to model domain knowledge and patient data and an expression repository to encode clinical decision making rules and queries. A semantic clinical decision support system is designed to provide patient-specific healthcare recommendations based on the knowledge base and patient data. The proposed solution is evaluated in the case study of type 2 diabetes mellitus inpatient management. The knowledge base is successfully instantiated with relevant domain knowledge and testing patient data. Ontology-level evaluation confirms model validity. Application-level evaluation of diagnostic accuracy reaches a sensitivity of 97.5%, a specificity of 100%, and a precision of 98%; an acceptance rate of 97.3% is given by domain experts for the recommended care plan orders. The proposed solution has been successfully validated in the case study as providing clinical decision support at a high accuracy and acceptance rate. The evaluation results demonstrate the technical feasibility and application prospect of our approach. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

APPLICATION OF THE US DECISION SUPPORT TOOL FOR MATERIALS AND WASTE MANAGEMENT

EPA Science Inventory

EPA¿s National Risk Management Research Laboratory has led the development of a municipal solid waste decision support tool (MSW-DST). The computer software can be used to calculate life-cycle environmental tradeoffs and full costs of different waste management plans or recycling...

Clinical genomics information management software linking cancer genome sequence and clinical decisions.

PubMed

Watt, Stuart; Jiao, Wei; Brown, Andrew M K; Petrocelli, Teresa; Tran, Ben; Zhang, Tong; McPherson, John D; Kamel-Reid, Suzanne; Bedard, Philippe L; Onetto, Nicole; Hudson, Thomas J; Dancey, Janet; Siu, Lillian L; Stein, Lincoln; Ferretti, Vincent

2013-09-01

Using sequencing information to guide clinical decision-making requires coordination of a diverse set of people and activities. In clinical genomics, the process typically includes sample acquisition, template preparation, genome data generation, analysis to identify and confirm variant alleles, interpretation of clinical significance, and reporting to clinicians. We describe a software application developed within a clinical genomics study, to support this entire process. The software application tracks patients, samples, genomic results, decisions and reports across the cohort, monitors progress and sends reminders, and works alongside an electronic data capture system for the trial's clinical and genomic data. It incorporates systems to read, store, analyze and consolidate sequencing results from multiple technologies, and provides a curated knowledge base of tumor mutation frequency (from the COSMIC database) annotated with clinical significance and drug sensitivity to generate reports for clinicians. By supporting the entire process, the application provides deep support for clinical decision making, enabling the generation of relevant guidance in reports for verification by an expert panel prior to forwarding to the treating physician. Copyright © 2013 Elsevier Inc. All rights reserved.

Will Anything Useful Come Out of Virtual Reality? Examination of a Naval Application

DTIC Science & Technology

1993-05-01

The term virtual reality can encompass varying meanings, but some generally accepted attributes of a virtual environment are that it is immersive...technology, but at present there are few practical applications which are utilizing the broad range of virtual reality technology. This paper will discuss an...Operability, operator functions, Virtual reality , Man-machine interface, Decision aids/decision making, Decision support. ASW.

Using a Context-aware Medical Application to Address Information Needs for Extubation Decisions

PubMed Central

Zhu, Xinxin; Lord, William

2005-01-01

Information overload has been one of the causes of preventable medical errors [1] and escalating costs [2]. A context-aware application with embedded clinical knowledge is proposed to provide practitioners with the appropriate amount of information and content. We developed a prototype of a context-aware medical application to address clinicians’ information needs that arise in a data-intensive unit, the Cardio-Thoracic Intensive Care Unit (CTICU). A major clinical decision supported by the prototype, the extubation decision, is illustrated. PMID:16779455

Mobile Clinical Decision Support System for Acid-base Balance Diagnosis and Treatment Recommendation.

PubMed

Mandzuka, Mensur; Begic, Edin; Boskovic, Dusanka; Begic, Zijo; Masic, Izet

2017-06-01

This paper presents mobile application implementing a decision support system for acid-base disorder diagnosis and treatment recommendation. The application was developed using the official integrated development environment for the Android platform (to maximize availability and minimize investments in specialized hardware) called Android Studio. The application identifies disorder, based on the blood gas analysis, evaluates whether the disorder has been compensated, and based on additional input related to electrolyte imbalance, provides recommendations for treatment. The application is a tool in the hands of the user, which provides assistance during acid-base disorders treatment. The application will assist the physician in clinical practice and is focused on the treatment in intensive care.

Invited review: Helping dairy farmers to improve economic performance utilizing data-driving decision support tools.

PubMed

Cabrera, V E

2018-01-01

The objective of this review paper is to describe the development and application of a suite of more than 40 computerized dairy farm decision support tools contained at the University of Wisconsin-Madison (UW) Dairy Management website http://DairyMGT.info. These data-driven decision support tools are aimed to help dairy farmers improve their decision-making, environmental stewardship and economic performance. Dairy farm systems are highly dynamic in which changing market conditions and prices, evolving policies and environmental restrictions together with every time more variable climate conditions determine performance. Dairy farm systems are also highly integrated with heavily interrelated components such as the dairy herd, soils, crops, weather and management. Under these premises, it is critical to evaluate a dairy farm following a dynamic integrated system approach. For this approach, it is crucial to use meaningful data records, which are every time more available. These data records should be used within decision support tools for optimal decision-making and economic performance. Decision support tools in the UW-Dairy Management website (http://DairyMGT.info) had been developed using combination and adaptation of multiple methods together with empirical techniques always with the primary goal for these tools to be: (1) highly user-friendly, (2) using the latest software and computer technologies, (3) farm and user specific, (4) grounded on the best scientific information available, (5) remaining relevant throughout time and (6) providing fast, concrete and simple answers to complex farmers' questions. DairyMGT.info is a translational innovative research website in various areas of dairy farm management that include nutrition, reproduction, calf and heifer management, replacement, price risk and environment. This paper discusses the development and application of 20 selected (http://DairyMGT.info) decision support tools.

Evaluation of satellite-based, modeled-derived daily solar radiation data for the continental U.S.

USDA-ARS?s Scientific Manuscript database

Many applications of simulation models and related decision support tools for agriculture and natural resource management require daily meteorological data as inputs. Availability and quality of such data, however, often constrain research and decision support activities that require use of these to...

A decision support tool for vehicle infrastructure integration : understanding information effects and advancing data fusion algorithms for traffic management applications.

DOT National Transportation Integrated Search

2009-10-15

This research seeks to explore vehicle-to-vehicle information networks to understand the interplay : between the information communicated and traffic conditions on the network. A longer-term goal is to : develop a decision support tool for processing...

U.S. CASE STUDIES USING MUNICIPAL SOLID WASTE DECISION SUPPORT TOOL

EPA Science Inventory

The paper provides an overview of some case studies using the recently completed muniicpal solid waste decision support tool (MSW-DST) in communities across the U.S. The purpose of the overview is to help illustrate the variety of potential applications of the tool. The methodolo...

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

Treesearch

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

2013-01-01

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

Flu Diagnosis System Using Jaccard Index and Rough Set Approaches

NASA Astrophysics Data System (ADS)

Efendi, Riswan; Azah Samsudin, Noor; Mat Deris, Mustafa; Guan Ting, Yip

2018-04-01

Jaccard index and rough set approaches have been frequently implemented in decision support systems with various domain applications. Both approaches are appropriate to be considered for categorical data analysis. This paper presents the applications of sets operations for flu diagnosis systems based on two different approaches, such as, Jaccard index and rough set. These two different approaches are established using set operations concept, namely intersection and subset. The step-by-step procedure is demonstrated from each approach in diagnosing flu system. The similarity and dissimilarity indexes between conditional symptoms and decision are measured using Jaccard approach. Additionally, the rough set is used to build decision support rules. Moreover, the decision support rules are established using redundant data analysis and elimination of unclassified elements. A number data sets is considered to attempt the step-by-step procedure from each approach. The result has shown that rough set can be used to support Jaccard approaches in establishing decision support rules. Additionally, Jaccard index is better approach for investigating the worst condition of patients. While, the definitely and possibly patients with or without flu can be determined using rough set approach. The rules may improve the performance of medical diagnosis systems. Therefore, inexperienced doctors and patients are easier in preliminary flu diagnosis.

Leveraging the geospatial advantage

Treesearch

Ben Butler; Andrew Bailey

2013-01-01

The Wildland Fire Decision Support System (WFDSS) web-based application leverages geospatial data to inform strategic decisions on wildland fires. A specialized data team, working within the Wildland Fire Management Research Development and Application group (WFM RD&A), assembles authoritative national-level data sets defining values to be protected. The use of...

Advancements in Risk-Informed Performance-Based Asset Management for Commercial Nuclear Power Plants

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

Liming, James K.; Ravindra, Mayasandra K.

2006-07-01

Over the past several years, ABSG Consulting Inc. (ABS Consulting) and the South Texas Project Nuclear Operating Company (STPNOC) have developed a decision support process and associated software for risk-informed, performance-based asset management (RIPBAM) of nuclear power plant facilities. RIPBAM applies probabilistic risk assessment (PRA) tools and techniques in the realm of plant physical and financial asset management. The RIPBAM process applies a tiered set of models and supporting performance measures (or metrics) that can ultimately be applied to support decisions affecting the allocation and management of plant resources (e.g., funding, staffing, scheduling, etc.). In general, the ultimate goal ofmore » the RIPBAM process is to continually support decision-making to maximize a facility's net present value (NPV) and long-term profitability for its owners. While the initial applications of RIPBAM have been for nuclear power stations, the methodology can easily be adapted to other types of power station or complex facility decision-making support. RIPBAM can also be designed to focus on performance metrics other than NPV and profitability (e.g., mission reliability, operational availability, probability of mission success per dollar invested, etc.). Recent advancements in the RIPBAM process focus on expanding the scope of previous RIPBAM applications to include not only operations, maintenance, and safety issues, but also broader risk perception components affecting plant owner (stockholder), operator, and regulator biases. Conceptually, RIPBAM is a comprehensive risk-informed cash flow model for decision support. It originated as a tool to help manage plant refueling outage scheduling, and was later expanded to include the full spectrum of operations and maintenance decision support. However, it differs from conventional business modeling tools in that it employs a systems engineering approach with broadly based probabilistic analysis of organizational 'value streams'. The scope of value stream inclusion in the process can be established by the user, but in its broadest applications, RIPBAM can be used to address how risk perceptions of plant owners and regulators are impacted by plant performance. Plant staffs can expand and refine RIPBAM models scope via a phased program of activities over time. This paper shows how the multi-metric uncertainty analysis feature of RIPBAM can apply a wide spectrum of decision-influencing factors to support decisions designed to maximize the probability of achieving, maintaining, and improving upon plant goals and objectives. In this paper, the authors show how this approach can be extremely valuable to plant owners and operators in supporting plant value-impacting decision-making processes. (authors)« less

Information management to enable personalized medicine: stakeholder roles in building clinical decision support.

PubMed

Downing, Gregory J; Boyle, Scott N; Brinner, Kristin M; Osheroff, Jerome A

2009-10-08

Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized decision-making, a comparison of current and future applications of clinical decision support to enable individualized medical treatment plans is presented. If clinical decision support tools are to impact outcomes in a clear and positive manner, their development and deployment must therefore consider the needs of the providers, including specific practice needs, information workflow, and practice environment.

Information management to enable personalized medicine: stakeholder roles in building clinical decision support

PubMed Central

2009-01-01

Background Advances in technology and the scientific understanding of disease processes are presenting new opportunities to improve health through individualized approaches to patient management referred to as personalized medicine. Future health care strategies that deploy genomic technologies and molecular therapies will bring opportunities to prevent, predict, and pre-empt disease processes but will be dependent on knowledge management capabilities for health care providers that are not currently available. A key cornerstone to the potential application of this knowledge will be effective use of electronic health records. In particular, appropriate clinical use of genomic test results and molecularly-targeted therapies present important challenges in patient management that can be effectively addressed using electronic clinical decision support technologies. Discussion Approaches to shaping future health information needs for personalized medicine were undertaken by a work group of the American Health Information Community. A needs assessment for clinical decision support in electronic health record systems to support personalized medical practices was conducted to guide health future development activities. Further, a suggested action plan was developed for government, researchers and research institutions, developers of electronic information tools (including clinical guidelines, and quality measures), and standards development organizations to meet the needs for personalized approaches to medical practice. In this article, we focus these activities on stakeholder organizations as an operational framework to help identify and coordinate needs and opportunities for clinical decision support tools to enable personalized medicine. Summary This perspective addresses conceptual approaches that can be undertaken to develop and apply clinical decision support in electronic health record systems to achieve personalized medical care. In addition, to represent meaningful benefits to personalized decision-making, a comparison of current and future applications of clinical decision support to enable individualized medical treatment plans is presented. If clinical decision support tools are to impact outcomes in a clear and positive manner, their development and deployment must therefore consider the needs of the providers, including specific practice needs, information workflow, and practice environment. PMID:19814826

Medication-related clinical decision support in computerized provider order entry systems: a review.

PubMed

Kuperman, Gilad J; Bobb, Anne; Payne, Thomas H; Avery, Anthony J; Gandhi, Tejal K; Burns, Gerard; Classen, David C; Bates, David W

2007-01-01

While medications can improve patients' health, the process of prescribing them is complex and error prone, and medication errors cause many preventable injuries. Computer provider order entry (CPOE) with clinical decision support (CDS), can improve patient safety and lower medication-related costs. To realize the medication-related benefits of CDS within CPOE, one must overcome significant challenges. Healthcare organizations implementing CPOE must understand what classes of CDS their CPOE systems can support, assure that clinical knowledge underlying their CDS systems is reasonable, and appropriately represent electronic patient data. These issues often influence to what extent an institution will succeed with its CPOE implementation and achieve its desired goals. Medication-related decision support is probably best introduced into healthcare organizations in two stages, basic and advanced. Basic decision support includes drug-allergy checking, basic dosing guidance, formulary decision support, duplicate therapy checking, and drug-drug interaction checking. Advanced decision support includes dosing support for renal insufficiency and geriatric patients, guidance for medication-related laboratory testing, drug-pregnancy checking, and drug-disease contraindication checking. In this paper, the authors outline some of the challenges associated with both basic and advanced decision support and discuss how those challenges might be addressed. The authors conclude with summary recommendations for delivering effective medication-related clinical decision support addressed to healthcare organizations, application and knowledge base vendors, policy makers, and researchers.

Towards a Decision Support Tool for 3d Visualisation: Application to Selectivity Purpose of Single Object in a 3d City Scene

NASA Astrophysics Data System (ADS)

Neuville, R.; Pouliot, J.; Poux, F.; Hallot, P.; De Rudder, L.; Billen, R.

2017-10-01

This paper deals with the establishment of a comprehensive methodological framework that defines 3D visualisation rules and its application in a decision support tool. Whilst the use of 3D models grows in many application fields, their visualisation remains challenging from the point of view of mapping and rendering aspects to be applied to suitability support the decision making process. Indeed, there exists a great number of 3D visualisation techniques but as far as we know, a decision support tool that facilitates the production of an efficient 3D visualisation is still missing. This is why a comprehensive methodological framework is proposed in order to build decision tables for specific data, tasks and contexts. Based on the second-order logic formalism, we define a set of functions and propositions among and between two collections of entities: on one hand static retinal variables (hue, size, shape…) and 3D environment parameters (directional lighting, shadow, haze…) and on the other hand their effect(s) regarding specific visual tasks. It enables to define 3D visualisation rules according to four categories: consequence, compatibility, potential incompatibility and incompatibility. In this paper, the application of the methodological framework is demonstrated for an urban visualisation at high density considering a specific set of entities. On the basis of our analysis and the results of many studies conducted in the 3D semiotics, which refers to the study of symbols and how they relay information, the truth values of propositions are determined. 3D visualisation rules are then extracted for the considered context and set of entities and are presented into a decision table with a colour coding. Finally, the decision table is implemented into a plugin developed with three.js, a cross-browser JavaScript library. The plugin consists of a sidebar and warning windows that help the designer in the use of a set of static retinal variables and 3D environment parameters.

Gathering Real World Evidence with Cluster Analysis for Clinical Decision Support.

PubMed

Xia, Eryu; Liu, Haifeng; Li, Jing; Mei, Jing; Li, Xuejun; Xu, Enliang; Li, Xiang; Hu, Gang; Xie, Guotong; Xu, Meilin

2017-01-01

Clinical decision support systems are information technology systems that assist clinical decision-making tasks, which have been shown to enhance clinical performance. Cluster analysis, which groups similar patients together, aims to separate patient cases into phenotypically heterogenous groups and defining therapeutically homogeneous patient subclasses. Useful as it is, the application of cluster analysis in clinical decision support systems is less reported. Here, we describe the usage of cluster analysis in clinical decision support systems, by first dividing patient cases into similar groups and then providing diagnosis or treatment suggestions based on the group profiles. This integration provides data for clinical decisions and compiles a wide range of clinical practices to inform the performance of individual clinicians. We also include an example usage of the system under the scenario of blood lipid management in type 2 diabetes. These efforts represent a step toward promoting patient-centered care and enabling precision medicine.

Decision support systems for robotic surgery and acute care

NASA Astrophysics Data System (ADS)

Kazanzides, Peter

2012-06-01

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

Patient-oriented Computerized Clinical Guidelines for Mobile Decision Support in Gestational Diabetes.

PubMed

García-Sáez, Gema; Rigla, Mercedes; Martínez-Sarriegui, Iñaki; Shalom, Erez; Peleg, Mor; Broens, Tom; Pons, Belén; Caballero-Ruíz, Estefanía; Gómez, Enrique J; Hernando, M Elena

2014-03-01

The risks associated with gestational diabetes (GD) can be reduced with an active treatment able to improve glycemic control. Advances in mobile health can provide new patient-centric models for GD to create personalized health care services, increase patient independence and improve patients' self-management capabilities, and potentially improve their treatment compliance. In these models, decision-support functions play an essential role. The telemedicine system MobiGuide provides personalized medical decision support for GD patients that is based on computerized clinical guidelines and adapted to a mobile environment. The patient's access to the system is supported by a smartphone-based application that enhances the efficiency and ease of use of the system. We formalized the GD guideline into a computer-interpretable guideline (CIG). We identified several workflows that provide decision-support functionalities to patients and 4 types of personalized advice to be delivered through a mobile application at home, which is a preliminary step to providing decision-support tools in a telemedicine system: (1) therapy, to help patients to comply with medical prescriptions; (2) monitoring, to help patients to comply with monitoring instructions; (3) clinical assessment, to inform patients about their health conditions; and (4) upcoming events, to deal with patients' personal context or special events. The whole process to specify patient-oriented decision support functionalities ensures that it is based on the knowledge contained in the GD clinical guideline and thus follows evidence-based recommendations but at the same time is patient-oriented, which could enhance clinical outcomes and patients' acceptance of the whole system. © 2014 Diabetes Technology Society.

XWeB: The XML Warehouse Benchmark

NASA Astrophysics Data System (ADS)

Mahboubi, Hadj; Darmont, Jérôme

With the emergence of XML as a standard for representing business data, new decision support applications are being developed. These XML data warehouses aim at supporting On-Line Analytical Processing (OLAP) operations that manipulate irregular XML data. To ensure feasibility of these new tools, important performance issues must be addressed. Performance is customarily assessed with the help of benchmarks. However, decision support benchmarks do not currently support XML features. In this paper, we introduce the XML Warehouse Benchmark (XWeB), which aims at filling this gap. XWeB derives from the relational decision support benchmark TPC-H. It is mainly composed of a test data warehouse that is based on a unified reference model for XML warehouses and that features XML-specific structures, and its associate XQuery decision support workload. XWeB's usage is illustrated by experiments on several XML database management systems.

Decision support for sustainable forestry: enhancing the basic rational model.

Treesearch

H.R. Ekbia; K.M. Reynolds

2007-01-01

Decision-support systems (DSS) have been extensively used in the management of natural resources for nearly two decades. However, practical difficulties with the application of DSS in real-world situations have become increasingly apparent. Complexities of decisionmaking, encountered in the context of ecosystem management, are equally present in sustainable forestry....

Decision Support Systems for Operational Level Command and Control

DTIC Science & Technology

1990-04-30

business -based. These definitions still have applicability to military command and control - the business of military operations. A synthesis of the...other hand, there are such studies that were conducted in business environments. An eight week empincal study39 was 37 bd, pp 8-1 I. 38 Ranesh Shada...pp 139-158. 19 conducted and the groups with access to decision support system made significantly more effective decisions :n a business simulation

Application of Electronic Meeting Systems to Military Organizations

DTIC Science & Technology

1989-06-21

June 1989. Bibliography 24. Gray, P., Vogel, D.R., Beauclair , R. "A Typology for Group Decision Support System Research," European Journal of Operations...3, 1984. 7. Beauclair , R.A., "An Experimental Study of the Effects of Specific GDSS Applica- tions on Small Group Decision Making," University of...Vogel, D.R., Beauclair , R. "A Typology for Group Decision Support System Research," European Journal of Operations Research, forthcoming 60. Grohowski

A decision support system for telemedicine through the mobile telecommunications platform.

PubMed

Eren, Ali; Subasi, Abdulhamit; Coskun, Osman

2008-02-01

In this paper we have discussed the application of artificial intelligence in telemedicine using mobile device. The main goal of our research is to develop methods and systems to collect, analyze, distribute and use medical diagnostics information from multiple knowledge sources and areas of expertise. Physicians may collect and analyze information obtained from experts worldwide with the help of a medical decision support system. In this information retrieval system, modern communication tools such as computers and mobile phones can be used efficiently. In this work we propose a medical decision support system using the general packet radio service (GPRS). GPRS, a data extension of the mobile telephony standard Global system for mobile communications (GSM) is emerging as the first true packet-switched architecture to allow mobile subscribers to benefit from high-speed transmission rates and run JAVA based applications from their mobile terminals. An academic prototype of a medical decision support system using mobile device was implemented. The results reveal that the system could find acceptance from the medical community and it could be an effective means of providing quality health care in developing countries.

Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations.

PubMed

Chorpita, Bruce F; Bernstein, Adam; Daleiden, Eric L

2008-03-01

This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

Mobile Clinical Decision Support System for Acid-base Balance Diagnosis and Treatment Recommendation

PubMed Central

Mandzuka, Mensur; Begic, Edin; Boskovic, Dusanka; Begic, Zijo; Masic, Izet

2017-01-01

Introduction: This paper presents mobile application implementing a decision support system for acid-base disorder diagnosis and treatment recommendation. Material and methods: The application was developed using the official integrated development environment for the Android platform (to maximize availability and minimize investments in specialized hardware) called Android Studio. Results: The application identifies disorder, based on the blood gas analysis, evaluates whether the disorder has been compensated, and based on additional input related to electrolyte imbalance, provides recommendations for treatment. Conclusion: The application is a tool in the hands of the user, which provides assistance during acid-base disorders treatment. The application will assist the physician in clinical practice and is focused on the treatment in intensive care. PMID:28883678

Efficient GIS-based model-driven method for flood risk management and its application in central China

NASA Astrophysics Data System (ADS)

Liu, Y.; Zhou, J.; Song, L.; Zou, Q.; Guo, J.; Wang, Y.

2014-02-01

In recent years, an important development in flood management has been the focal shift from flood protection towards flood risk management. This change greatly promoted the progress of flood control research in a multidisciplinary way. Moreover, given the growing complexity and uncertainty in many decision situations of flood risk management, traditional methods, e.g., tight-coupling integration of one or more quantitative models, are not enough to provide decision support for managers. Within this context, this paper presents a beneficial methodological framework to enhance the effectiveness of decision support systems, through the dynamic adaptation of support regarding the needs of the decision-maker. In addition, we illustrate a loose-coupling technical prototype for integrating heterogeneous elements, such as multi-source data, multidisciplinary models, GIS tools and existing systems. The main innovation is the application of model-driven concepts, which put the system in a state of continuous iterative optimization. We define the new system as a model-driven decision support system (MDSS ). Two characteristics that differentiate the MDSS are as follows: (1) it is made accessible to non-technical specialists; and (2) it has a higher level of adaptability and compatibility. Furthermore, the MDSS was employed to manage the flood risk in the Jingjiang flood diversion area, located in central China near the Yangtze River. Compared with traditional solutions, we believe that this model-driven method is efficient, adaptable and flexible, and thus has bright prospects of application for comprehensive flood risk management.

Development and application of air quality models at the US ...

EPA Pesticide Factsheets

Overview of the development and application of air quality models at the U.S. EPA, particularly focused on the development and application of the Community Multiscale Air Quality (CMAQ) model developed within the Computation Exposure Division (CED) of the National Exposure Research Laboratory (NERL). This presentation will provide a simple overview of air quality model development and application geared toward a non-technical student audience. The National Exposure Research Laboratory (NERL) Computational Exposure Division (CED) develops and evaluates data, decision-support tools, and models to be applied to media-specific or receptor-specific problem areas. CED uses modeling-based approaches to characterize exposures, evaluate fate and transport, and support environmental diagnostics/forensics with input from multiple data sources. It also develops media- and receptor-specific models, process models, and decision support tools for use both within and outside of EPA.

Hybrid Method for Mobile learning Cooperative: Study of Timor Leste

NASA Astrophysics Data System (ADS)

da Costa Tavares, Ofelia Cizela; Suyoto; Pranowo

2018-02-01

In the modern world today the decision support system is very useful to help in solving a problem, so this study discusses the learning process of savings and loan cooperatives in Timor Leste. The purpose of the observation is that the people of Timor Leste are still in the process of learning the use DSS for good saving and loan cooperative process. Based on existing research on the Timor Leste community on credit cooperatives, a mobile application will be built that will help the cooperative learning process in East Timorese society. The methods used for decision making are AHP (Analytical Hierarchy Process) and SAW (simple additive Weighting) method to see the result of each criterion and the weight of the value. The result of this research is mobile leaning cooperative in decision support system by using SAW and AHP method. Originality Value: Changed the two methods of mobile application development using AHP and SAW methods to help the decision support system process of a savings and credit cooperative in Timor Leste.

A Decision Support Framework for Science-Based, Multi-Stakeholder Deliberation: A Coral Reef Example

NASA Astrophysics Data System (ADS)

Rehr, Amanda P.; Small, Mitchell J.; Bradley, Patricia; Fisher, William S.; Vega, Ann; Black, Kelly; Stockton, Tom

2012-12-01

We present a decision support framework for science-based assessment and multi-stakeholder deliberation. The framework consists of two parts: a DPSIR (Drivers-Pressures-States-Impacts-Responses) analysis to identify the important causal relationships among anthropogenic environmental stressors, processes, and outcomes; and a Decision Landscape analysis to depict the legal, social, and institutional dimensions of environmental decisions. The Decision Landscape incorporates interactions among government agencies, regulated businesses, non-government organizations, and other stakeholders. It also identifies where scientific information regarding environmental processes is collected and transmitted to improve knowledge about elements of the DPSIR and to improve the scientific basis for decisions. Our application of the decision support framework to coral reef protection and restoration in the Florida Keys focusing on anthropogenic stressors, such as wastewater, proved to be successful and offered several insights. Using information from a management plan, it was possible to capture the current state of the science with a DPSIR analysis as well as important decision options, decision makers and applicable laws with a the Decision Landscape analysis. A structured elicitation of values and beliefs conducted at a coral reef management workshop held in Key West, Florida provided a diversity of opinion and also indicated a prioritization of several environmental stressors affecting coral reef health. The integrated DPSIR/Decision landscape framework for the Florida Keys developed based on the elicited opinion and the DPSIR analysis can be used to inform management decisions, to reveal the role that further scientific information and research might play to populate the framework, and to facilitate better-informed agreement among participants.

A "building block" approach to application development for education and decision support in radiology: implications for integrated clinical information systems environments.

PubMed

Greenes, R A

1991-11-01

Education and decision-support resources useful to radiologists are proliferating for the personal computer/workstation user or are potentially accessible via high-speed networks. These resources are typically made available through a set of application programs that tend to be developed in isolation and operate independently. Nonetheless, there is a growing need for an integrated environment for access to these resources in the context of professional work, during clinical problem-solving and decision-making activities, and for use in conjunction with other information resources. New application development environments are required to provide these capabilities. One such architecture for applications, which we have implemented in a prototype environment called DeSyGNER, is based on separately delineating the component information resources required for an application, termed entities, and the user interface and organizational paradigms, or composition methods, by which the entities are used to provide particular kinds of capability. Examples include composition methods to support query, book browsing, hyperlinking, tutorials, simulations, or question/answer testing. Future steps must address true integration of such applications with existing clinical information systems. We believe that the most viable approach for evolving this capability is based on the use of new software engineering methodologies, open systems, client-server communication, and delineation of standard message protocols.

Pheromone-based decision support tools for management of Halyomorpha halys in apple orchards: development of a trap-based treatment threshold

USDA-ARS?s Scientific Manuscript database

The invasive brown marmorated stink bug, Halyomorpha halys (Stål), has become a serious pest in mid-Atlantic apple orchards. Because no decision support tools exist for H. halys management, calendar-based insecticide applications have been the only successful technique for mitigating H. halys injur...

Experiences in Bridging the Gap Between Science and Decision Making at NASAs GSFC Earth Sciences Data and Information Services Center (GES DISC)

NASA Astrophysics Data System (ADS)

Kempler, S.; Teng, W.; Friedl, L.; Lynnes, C.

2008-12-01

In recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet's natural environment, NASA has implemented the 'Decision Support Through Earth Science Research Results' program to solicit "proposals that develop and demonstrate innovative and practicable applications of NASA Earth science observations and research"that focus on improving decision making activities", as stated in the NASA ROSES-2008, A.18 solicitation. This very successful program has yielded several monitoring, surveillance, and decision support systems through collaborations with benefiting organizations in the areas of agriculture, air quality, disaster management, ecosystems, public health, water resources, and aviation weather. The Goddard Space Flight Center (GSFC) Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations gaining much experience in the formulation, management, development, and implementation of decision support systems utilizing NASA Earth science data. Coupling this experience with the GES DISC's total understanding and vast experience regarding Earth science missions and resulting data and information, including data structures, data usability and interpretation, data interoperability, and information management systems, the GES DISC is in the unique position to more readily identify challenges that come with bringing science data to decision makers. These challenges consist of those that can be met within typical science data usage frameworks, as well as those challenges that arise when utilizing science data for previously unplanned applications, such as decision support systems. The purpose of this presentation is to share GES DISC decision support system project experiences in regards to system sustainability, required data quality (versus timeliness), data provider understanding how decisions are made, which leads to the data receivers willingness to use new types of information to make decisions, as well as other topics. In addition, defining metrics that 'really' evaluate success will be exemplified.

Using ILOG OPL-CPLEX and ILOG Optimization Decision Manager (ODM) to Develop Better Models

NASA Astrophysics Data System (ADS)

2008-10-01

This session will provide an in-depth overview on building state-of-the-art decision support applications and models. You will learn how to harness the full power of the ILOG OPL-CPLEX-ODM Development System (ODMS) to develop optimization models and decision support applications that solve complex problems ranging from near real-time scheduling to long-term strategic planning. We will demonstrate how to use ILOG's Open Programming Language (OPL) to quickly model problems solved by ILOG CPLEX, and how to use ILOG ODM to gain further insight about the model. By the end of the session, attendees will understand how to take advantage of the powerful combination of ILOG OPL (to describe an optimization model) and ILOG ODM (to understand the relationships between data, decision variables and constraints).

Understanding Optimal Military Decision Making: Year 2 Progress Report

DTIC Science & Technology

2014-01-01

measures. ARMY RELEVANCY AND MILITARY APPLICATION AREAS Objectively defining, measuring, and developing a means to assess military optimal decision making...has the potential to enhance training and refine procedures supporting more efficient learning and task accomplishment. Through the application of...26.79 (12.39) 7.94 (62.38) N/A = Not applicable ; as it is not possible to calculate this particular variable. Table 2. Descriptive statistics of

E-Health towards ecumenical framework for personalized medicine via Decision Support System.

PubMed

Kouris, Ioannis; Tsirmpas, Charalampos; Mougiakakou, Stavroula G; Iliopoulou, Dimitra; Koutsouris, Dimitris

2010-01-01

The purpose of the present manuscript is to present the advances performed in medicine using a Personalized Decision Support System (PDSS). The models used in Decision Support Systems (DSS) are examined in combination with Genome Information and Biomarkers to produce personalized result for each individual. The concept of personalize medicine is described in depth and application of PDSS for Cardiovascular Diseases (CVD) and Type-1 Diabetes Mellitus (T1DM) are analyzed. Parameters extracted from genes, biomarkers, nutrition habits, lifestyle and biological measurements feed DSSs, incorporating Artificial Intelligence Modules (AIM), to provide personalized advice, medication and treatment.

Are insurance companies liable under the Americans with Disabilities Act?

PubMed

Manning, J S

2000-03-01

Federal courts have split on the question of the applicability of the Americans with Disabilities Act to insurance coverage decisions that insurance companies make on the basis of disability; they have similarly split on other issues pertaining to the scope of that Act's application. In deciding whether to read the Act as prohibiting discrimination in insurance decisions that are often crucial in the lives of people with disabilities, courts have faced two problems. First, where it prohibits discrimination in the equal enjoyment of the goods and services of places of public accommodation, the Act's area of concern may be limited to the ability of people with disabilities to gain physical access to facilities; or that area may extend to all forms of disability-based discrimination in the provision of goods and services. This Comment argues that the language and legislative history of the Act are consistent only with the latter view. Second, the provision limiting the Act's applicability to insurance may create an exemption for all insurance decisions; or it may protect only the ability of an insurance company to make an insurance decision to the disadvantage of an insured with a disability where actuarial data support the decision. This comment argues that the ambiguous language of the limiting provision should be resolved in favor of the latter view. Legislative history and the broader background of the history of insurance discrimination law support this resolution. Consequently, the Act should be interpreted as prohibiting disability-based discrimination by insurance companies in selling insurance policies and as defining discrimination as making disability-based insurance decisions without the support of actuarial data. By accepting this interpretation, courts can help stop the pattern of judicial narrowing of the Act's application through inappropriately restrictive statutory construction.

Decision Support Framework Implementation Of The Web-Based Environmental Decision Analysis DASEES: Decision Analysis For A Sustainable Environment, Economy, And Society

EPA Science Inventory

Solutions to pervasive environmental problems often are not amenable to a straightforward application of science-based actions. These problems encompass large-scale environmental policy questions where environmental concerns, economic constraints, and societal values conflict ca...

Decision Support Framework (DSF) for Evaluating Planned Land and Resource Use Decisions/Hypothetical Application of the DSF

EPA Science Inventory

Land and resource use decisions are typically made by individuals, towns, counties, tribes, states and sometimes mutliple states (regions) to increase economic viability of an area with little attention to the long term effects on human health and the enviornment. Improved decis...

Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

Decision making is a complex process that requires taking into consideration multiple heterogeneous sources of uncertainty. Standard valuation and financial analysis techniques often fail to properly account for all these sources of risk as well as for all sources of additional flexibility. In this paper we explore applications of a modified binomial tree method for real options analysis (ROA) in an effort to improve decision making process. Usual cases of use of real options are analyzed with elaborate study on the applications and advantages that company management can derive from their application. A numeric results based on extending simple binomial tree approach for multiple sources of uncertainty are provided to demonstrate the improvement effects on management decisions.

Design and Development of a Sharable Clinical Decision Support System Based on a Semantic Web Service Framework.

PubMed

Zhang, Yi-Fan; Gou, Ling; Tian, Yu; Li, Tian-Chang; Zhang, Mao; Li, Jing-Song

2016-05-01

Clinical decision support (CDS) systems provide clinicians and other health care stakeholders with patient-specific assessments or recommendations to aid in the clinical decision-making process. Despite their demonstrated potential for improving health care quality, the widespread availability of CDS systems has been limited mainly by the difficulty and cost of sharing CDS knowledge among heterogeneous healthcare information systems. The purpose of this study was to design and develop a sharable clinical decision support (S-CDS) system that meets this challenge. The fundamental knowledge base consists of independent and reusable knowledge modules (KMs) to meet core CDS needs, wherein each KM is semantically well defined based on the standard information model, terminologies, and representation formalisms. A semantic web service framework was developed to identify, access, and leverage these KMs across diverse CDS applications and care settings. The S-CDS system has been validated in two distinct client CDS applications. Model-level evaluation results confirmed coherent knowledge representation. Application-level evaluation results reached an overall accuracy of 98.66 % and a completeness of 96.98 %. The evaluation results demonstrated the technical feasibility and application prospect of our approach. Compared with other CDS engineering efforts, our approach facilitates system development and implementation and improves system maintainability, scalability and efficiency, which contribute to the widespread adoption of effective CDS within the healthcare domain.

Use of volunteers' information to support proactive inspection of hydraulic structures

NASA Astrophysics Data System (ADS)

Cortes Arevalo, Juliette; Sterlacchini, Simone; Bogaard, Thom; Frigerio, Simone; Junier, Sandra; Schenato, Luca; van den Giesen, Nick

2016-04-01

Proactive management is particularly important to deal with the increasing occurrence of hydro-meteorological hazards in mountain areas were threats are often caused by multiple and sudden onset hazards such as debris flows. Citizen volunteers can be involved in supporting technicians on inspecting the structures' functional status. Such collaborative effort between managing organizations and local volunteers becomes more important under limited resources. To consider volunteers' information in support of proactive inspection of hydraulic structures, we developed a methodology applicable in day-to-day risk management. At first, in collaboration with technicians-in-charge, a data collection approach was developed for first level or pre-screening visual inspections that can be performed by volunteers. Methods comprise of a data collection exercise, an inspection forms and a learning session based on existent procedures in the FVG region and neighbouring regions. To systematically evaluate the individual inspection reports, we designed a support method by means of a multi-criteria method with fuzzy terms. The method allows the technicians-in-charge to categorize the reports in one of three levels, each corresponding with a course of action. To facilitate the evaluation of inspection reports, we transformed the decision support method into a prototype Web-GIS application. The design process of the Web-GIS framework followed a user-centred approach. The conceptual design incorporates four modules for managing the inspection reports: 1) Registered users, 2) Inspection planning; 3) Available reports and 4) Evaluation of reports. The development of the prototype focused on the evaluation module and was implemented based on standard and interoperable open source tools. Finally, we organized a workshop with technicians in the study area to test the decision support method and get insights about the usefulness of the Web-GIS framework. Participants that took part of the workshop included technicians that were not involved in previous research activities. The involvement of new technicians was important due to their fresh perspectives. We looked at the effect of the quality of the input reports on the output of the decision support method. In addition, we compared the differences in the participants' advice during the inspection and the output from the decision support method. Participants' feedback led to a set of suggested improvements in the decision support method and the web-GIS application. We hope that the knowledge, theory and concept behind this decision support method can be developed into a full-scale web-GIS application. The advantage of using this decision support method is that it allows inspections to be carried out by either skilled volunteers or technicians while ensuring technicians-in-charge that they can systematically evaluate the collected reports. Volunteers can become skilled inspectors by teaming up with technicians for the inspection of hydraulic structures. Technicians can become more aware about local impacts and changes in the structures' status by teaming up with volunteers.

MCSDSS: A Multi-Criteria Decision Support System for Merging Geoscience Information with Natural User Interfaces, Preference Ranking, and Interactive Data Utilities

NASA Astrophysics Data System (ADS)

Pierce, S. A.; Gentle, J.

2015-12-01

The multi-criteria decision support system (MCSDSS) is a newly completed application for touch-enabled group decision support that uses D3 data visualization tools, a geojson conversion utility that we developed, and Paralelex to create an interactive tool. The MCSDSS is a prototype system intended to demonstrate the potential capabilities of a single page application (SPA) running atop a web and cloud based architecture utilizing open source technologies. The application is implemented on current web standards while supporting human interface design that targets both traditional mouse/keyboard interactions and modern touch/gesture enabled interactions. The technology stack for MCSDSS 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 application integrates current frameworks for highly performant agile development with unit testing, statistical analysis, data visualization, mapping technologies, geographic data manipulation, and cloud infrastructure while retaining support for traditional HTML5/CSS3 web standards. The software lifecylcle for MCSDSS has following best practices to develop, share, and document the codebase and application. Code is documented and shared via an online repository with the option for programmers to see, contribute, or fork the codebase. Example data files and tutorial documentation have been shared with clear descriptions and data object identifiers. And the metadata about the application has been incorporated into an OntoSoft entry to ensure that MCSDSS is searchable and clearly described. MCSDSS is a flexible platform that allows for data fusion and inclusion of large datasets in an interactive front-end application capable of connecting with other science-based applications and advanced computing resources. In addition, MCSDSS offers functionality that enables communication with non-technical users for policy, education, or engagement with groups around scientific topics with societal relevance.

Development of a digital clinical pathway for emergency medicine: Lessons from usability testing and implementation failure.

PubMed

Gutenstein, Marc; Pickering, John W; Than, Martin

2018-06-01

Clinical pathways are used to support the management of patients in emergency departments. An existing document-based clinical pathway was used as the foundation on which to design and build a digital clinical pathway for acute chest pain, with the aim of improving clinical calculations, clinician decision-making, documentation, and data collection. Established principles of decision support system design were used to build an application within the existing electronic health record, before testing with a multidisciplinary team of doctors using a think-aloud protocol. Technical authoring was successful, however, usability testing revealed that the user experience and the flexibility of workflow within the application were critical barriers to implementation. Emergency medicine and acute care decision support systems face particular challenges to existing models of linear workflow that should be deliberately addressed in digital pathway design. We make key recommendations regarding digital pathway design in emergency medicine.

Decision strategies for handling the uncertainty of future extreme rainfall under the influence of climate change.

PubMed

Gregersen, I B; Arnbjerg-Nielsen, K

2012-01-01

Several extraordinary rainfall events have occurred in Denmark within the last few years. For each event, problems in urban areas occurred as the capacity of the existing drainage systems were exceeded. Adaptation to climate change is necessary but also very challenging as urban drainage systems are characterized by long technical lifetimes and high, unrecoverable construction costs. One of the most important barriers for the initiation and implementation of the adaptation strategies is therefore the uncertainty when predicting the magnitude of the extreme rainfall in the future. This challenge is explored through the application and discussion of three different theoretical decision support strategies: the precautionary principle, the minimax strategy and Bayesian decision support. The reviewed decision support strategies all proved valuable for addressing the identified uncertainties, at best applied together as they all yield information that improved decision making and thus enabled more robust decisions.

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

The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

PubMed

Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

2013-06-01

The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

Decision Support Methods and Tools

NASA Technical Reports Server (NTRS)

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

2006-01-01

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

Improving Water Management Decision Support Tools Using NASA Satellite and Modeling Data

NASA Astrophysics Data System (ADS)

Toll, D. L.; Arsenault, K.; Nigro, J.; Pinheiro, A.; Engman, E. T.; Triggs, J.; Cosgrove, B.; Alonge, C.; Boyle, D.; Allen, R.; Townsend, P.; Ni-Meister, W.

2006-05-01

One of twelve Applications of National priority within NASA's Applied Science Program, the Water Management Program Element addresses concerns and decision making related to water availability, water forecast and water quality. The goal of the Water Management Program Element is to encourage water management organizations to use NASA Earth science data, models products, technology and other capabilities in their decision support tools for problem solving. The Water Management Program Element partners with Federal agencies, academia, private firms, and may include international organizations. This paper further describes the Water Management Program with the objective of informing the applications community of the potential opportunities for using NASA science products for problem solving. We will illustrate some ongoing and application Water Management projects evaluating and benchmarking NASA data with partnering federal agencies and their decision support tools: 1) Environmental Protection Agency for water quality; 2) Bureau of Reclamation for water supply, demand and forecast; and 3) NOAA National Weather Service for improved weather prediction. Examples of the types of NASA contributions to the these agency decision support tools include: 1) satellite observations within models assist to estimate water storage, i.e., snow water equivalent, soil moisture, aquifer volumes, or reservoir storages; 2) model derived products, i.e., evapotranspiration, precipitation, runoff, ground water recharge, and other 4-dimensional data assimilation products; 3) improve water quality, assessments by using improved inputs from NASA models (precipitation, evaporation) and satellite observations (e.g., temperature, turbidity, land cover) to nonpoint source models; and 4) water (i.e., precipitation) and temperature predictions from days to decades over local, regional and global scales.

Decision support for evaluating the U.S. national criteria and indicators for forest ecosystem sustainability

Treesearch

Keith M. Reynolds

2006-01-01

This paper describes and illustrates the use of the Ecosystem Management Decision Support (EMDS) system for evaluating the U.S. national criteria and indicators for forest ecosystem sustainability at the scale of Resource Planning Act (RPA) regions. The evaluation component of EMDS uses a logic engine to evaluate landscape condition, and the RPA-scale application...

Development of interim oak assessment guidelines for the silvah decision-support system

Treesearch

Patrick H. Brose

2007-01-01

Updates to the SILVAH decision-support system make it more applicable to the mixed oak forests of Pennsylvania and other mid-Atlantic states. This update required establishing interim inventory guidelines for assessing the competitive ability of advance oak regeneration. This assessment was complicated by oak’s growth strategy, emphasizing root development in lieu of...

Tech Select Decision Aide: A Mobile Application to Facilitate Just-in-Time Decision Support for Instructional Designers

ERIC Educational Resources Information Center

Dabbagh, Nada; Fake, Helen

2017-01-01

With the ubiquitous use of mobile technologies and the increasing demand for just-in-time training, there is a need to prepare and support instructional designers and educators to meet the pedagogical and technological development requirements of their target audience in the most effective and efficient way. This paper reviews the iterative…

A Possible Approach for Addressing Neglected Human Factors Issues of Systems Engineering

NASA Technical Reports Server (NTRS)

Johnson, Christopher W.; Holloway, C. Michael

2011-01-01

The increasing complexity of safety-critical applications has led to the introduction of decision support tools in the transportation and process industries. Automation has also been introduced to support operator intervention in safety-critical applications. These innovations help reduce overall operator workload, and filter application data to maximize the finite cognitive and perceptual resources of system operators. However, these benefits do not come without a cost. Increased computational support for the end-users of safety-critical applications leads to increased reliance on engineers to monitor and maintain automated systems and decision support tools. This paper argues that by focussing on the end-users of complex applications, previous research has tended to neglect the demands that are being placed on systems engineers. The argument is illustrated through discussing three recent accidents. The paper concludes by presenting a possible strategy for building and using highly automated systems based on increased attention by management and regulators, improvements in competency and training for technical staff, sustained support for engineering team resource management, and the development of incident reporting systems for infrastructure failures. This paper represents preliminary work, about which we seek comments and suggestions.

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

NASA Astrophysics Data System (ADS)

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

2007-06-01

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

The conceptual foundation of environmental decision support.

PubMed

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

2015-05-01

Environmental decision support intends to use the best available scientific knowledge to help decision makers find and evaluate management alternatives. The goal of this process is to achieve the best fulfillment of societal objectives. This requires a careful analysis of (i) how scientific knowledge can be represented and quantified, (ii) how societal preferences can be described and elicited, and (iii) how these concepts can best be used to support communication with authorities, politicians, and the public in environmental management. The goal of this paper is to discuss key requirements for a conceptual framework to address these issues and to suggest how these can best be met. We argue that a combination of probability theory and scenario planning with multi-attribute utility theory fulfills these requirements, and discuss adaptations and extensions of these theories to improve their application for supporting environmental decision making. With respect to (i) we suggest the use of intersubjective probabilities, if required extended to imprecise probabilities, to describe the current state of scientific knowledge. To address (ii), we emphasize the importance of value functions, in addition to utilities, to support decisions under risk. We discuss the need for testing "non-standard" value aggregation techniques, the usefulness of flexibility of value functions regarding attribute data availability, the elicitation of value functions for sub-objectives from experts, and the consideration of uncertainty in value and utility elicitation. With respect to (iii), we outline a well-structured procedure for transparent environmental decision support that is based on a clear separation of scientific prediction and societal valuation. We illustrate aspects of the suggested methodology by its application to river management in general and with a small, didactical case study on spatial river rehabilitation prioritization. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

A medical informatics perspective on clinical decision support systems. Findings from the yearbook 2013 section on decision support.

PubMed

Bouaud, J; Lamy, J-B

2013-01-01

To summarize excellent research and to select best papers published in 2012 in the field of computer-based decision support in healthcare. A bibliographic search focused on clinical decision support systems (CDSSs) and computer provider order entry was performed, followed by a double-blind literature review. The review process yielded six papers, illustrating various aspects of clinical decision support. The first paper is a systematic review of CDSS intervention trials in real settings, and considers different types of possible outcomes. It emphasizes the heterogeneity of studies and confirms that CDSSs can improve process measures but that evidence lacks for other types of outcomes, especially clinical or economic. Four other papers tackle the safety of drug prescribing and show that CDSSs can be efficient in reducing prescription errors. The sixth paper exemplifies the growing role of ontological resources which can be used for several applications including decision support. CDSS research has to be continuously developed and assessed. The wide variety of systems and of interventions limits the understanding of factors of success of CDSS implementations. A standardization in the characterization of CDSSs and of intervention trial reporting will help to overcome this obstacle.

Ontology-based configuration of problem-solving methods and generation of knowledge-acquisition tools: application of PROTEGE-II to protocol-based decision support.

PubMed

Tu, S W; Eriksson, H; Gennari, J H; Shahar, Y; Musen, M A

1995-06-01

PROTEGE-II is a suite of tools and a methodology for building knowledge-based systems and domain-specific knowledge-acquisition tools. In this paper, we show how PROTEGE-II can be applied to the task of providing protocol-based decision support in the domain of treating HIV-infected patients. To apply PROTEGE-II, (1) we construct a decomposable problem-solving method called episodic skeletal-plan refinement, (2) we build an application ontology that consists of the terms and relations in the domain, and of method-specific distinctions not already captured in the domain terms, and (3) we specify mapping relations that link terms from the application ontology to the domain-independent terms used in the problem-solving method. From the application ontology, we automatically generate a domain-specific knowledge-acquisition tool that is custom-tailored for the application. The knowledge-acquisition tool is used for the creation and maintenance of domain knowledge used by the problem-solving method. The general goal of the PROTEGE-II approach is to produce systems and components that are reusable and easily maintained. This is the rationale for constructing ontologies and problem-solving methods that can be composed from a set of smaller-grained methods and mechanisms. This is also why we tightly couple the knowledge-acquisition tools to the application ontology that specifies the domain terms used in the problem-solving systems. Although our evaluation is still preliminary, for the application task of providing protocol-based decision support, we show that these goals of reusability and easy maintenance can be achieved. We discuss design decisions and the tradeoffs that have to be made in the development of the system.

A GH-Based Ontology to Support Applications for Automating Decision Support

DTIC Science & Technology

2005-03-01

architecture for a decision support sys - tem. For this reason, it obtains data from, and updates, a database. IDA also wanted the prototype’s architecture...Chief In- formation Officer CoABS Control of Agent Based Sys - tems DBMS Database Management System DoD Department of Defense DTD Document Type...Generic Hub, the Moyeu Générique, and the Generische Nabe , specifying each as a separate service description with property names and values of the GH

Mobile Clinical Decision Support Systems in Our Hands - Great Potential but also a Concern.

PubMed

Masic, Izet; Begic, Edin

2016-01-01

Due to the powerful computer resources as well as the availability of today's mobile devices, a special field of mobile systems for clinical decision support in medicine has been developed. The benefits of these applications (systems) are: availability of necessary hardware (mobile phones, tablets and phablets are widespread, and can be purchased at a relatively affordable price), availability of mobile applications (free or for a "small" amount of money) and also mobile applications are tailored for easy use and save time of clinicians in their daily work. In these systems lies a huge potential, and certainly a great economic benefit, so this issue must be approached multidisciplinary.

An Overview of R in Health Decision Sciences.

PubMed

Jalal, Hawre; Pechlivanoglou, Petros; Krijkamp, Eline; Alarid-Escudero, Fernando; Enns, Eva; Hunink, M G Myriam

2017-10-01

As the complexity of health decision science applications increases, high-level programming languages are increasingly adopted for statistical analyses and numerical computations. These programming languages facilitate sophisticated modeling, model documentation, and analysis reproducibility. Among the high-level programming languages, the statistical programming framework R is gaining increased recognition. R is freely available, cross-platform compatible, and open source. A large community of users who have generated an extensive collection of well-documented packages and functions supports it. These functions facilitate applications of health decision science methodology as well as the visualization and communication of results. Although R's popularity is increasing among health decision scientists, methodological extensions of R in the field of decision analysis remain isolated. The purpose of this article is to provide an overview of existing R functionality that is applicable to the various stages of decision analysis, including model design, input parameter estimation, and analysis of model outputs.

Decision Support Systems: Applications in Statistics and Hypothesis Testing.

ERIC Educational Resources Information Center

Olsen, Christopher R.; Bozeman, William C.

1988-01-01

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

COMMAND-AND-CONTROL AND MANAGEMENT DECISION MAKING,

DTIC Science & Technology

Reports that the development of command-and-con trol systems in support of decision making and action taking has been accomplished by military...methods applicable to management systems. Concludes that the command-and-control type system for top management decision making is a man-machine system having as its core an on going, dynamic operation. (Author)

Decision-support systems for forest management

Treesearch

H. Michael Rauscher

2005-01-01

The basic concept of sustainable development, formulated in the Brundtland report and applied to forest management by the Montreal Process, has focused attention on the need for formal decision processes (Brundtland. 1987). The application of decision theory is essential because meeting the needs of the present without compromising the ability of future generations to...

Introducing StatHand: A Cross-Platform Mobile Application to Support Students' Statistical Decision Making.

PubMed

Allen, Peter J; Roberts, Lynne D; Baughman, Frank D; Loxton, Natalie J; Van Rooy, Dirk; Rock, Adam J; Finlay, James

2016-01-01

Although essential to professional competence in psychology, quantitative research methods are a known area of weakness for many undergraduate psychology students. Students find selecting appropriate statistical tests and procedures for different types of research questions, hypotheses and data types particularly challenging, and these skills are not often practiced in class. Decision trees (a type of graphic organizer) are known to facilitate this decision making process, but extant trees have a number of limitations. Furthermore, emerging research suggests that mobile technologies offer many possibilities for facilitating learning. It is within this context that we have developed StatHand, a free cross-platform application designed to support students' statistical decision making. Developed with the support of the Australian Government Office for Learning and Teaching, StatHand guides users through a series of simple, annotated questions to help them identify a statistical test or procedure appropriate to their circumstances. It further offers the guidance necessary to run these tests and procedures, then interpret and report their results. In this Technology Report we will overview the rationale behind StatHand, before describing the feature set of the application. We will then provide guidelines for integrating StatHand into the research methods curriculum, before concluding by outlining our road map for the ongoing development and evaluation of StatHand.

An integrated strategy of knowledge application for optimal e-health implementation: A multi-method study protocol

PubMed Central

Gagnon, Marie-Pierre; Légaré, France; Fortin, Jean-Paul; Lamothe, Lise; Labrecque, Michel; Duplantie, Julie

2008-01-01

Background E-health is increasingly valued for supporting: 1) access to quality health care services for all citizens; 2) information flow and exchange; 3) integrated health care services and 4) interprofessional collaboration. Nevertheless, several questions remain on the factors allowing an optimal integration of e-health in health care policies, organisations and practices. An evidence-based integrated strategy would maximise the efficacy and efficiency of e-health implementation. However, decisions regarding e-health applications are usually not evidence-based, which can lead to a sub-optimal use of these technologies. This study aims at understanding factors influencing the application of scientific knowledge for an optimal implementation of e-health in the health care system. Methods A three-year multi-method study is being conducted in the Province of Quebec (Canada). Decision-making at each decisional level (political, organisational and clinical) are analysed based on specific approaches. At the political level, critical incidents analysis is being used. This method will identify how decisions regarding the implementation of e-health could be influenced or not by scientific knowledge. Then, interviews with key-decision-makers will look at how knowledge was actually used to support their decisions, and what factors influenced its use. At the organisational level, e-health projects are being analysed as case studies in order to explore the use of scientific knowledge to support decision-making during the implementation of the technology. Interviews with promoters, managers and clinicians will be carried out in order to identify factors influencing the production and application of scientific knowledge. At the clinical level, questionnaires are being distributed to clinicians involved in e-health projects in order to analyse factors influencing knowledge application in their decision-making. Finally, a triangulation of the results will be done using mixed methodologies to allow a transversal analysis of the results at each of the decisional levels. Results This study will identify factors influencing the use of scientific evidence and other types of knowledge by decision-makers involved in planning, financing, implementing and evaluating e-health projects. Conclusion These results will be highly relevant to inform decision-makers who wish to optimise the implementation of e-health in the Quebec health care system. This study is extremely relevant given the context of major transformations in the health care system where e-health becomes a must. PMID:18435853

Data-driven decision support for radiologists: re-using the National Lung Screening Trial dataset for pulmonary nodule management.

PubMed

Morrison, James J; Hostetter, Jason; Wang, Kenneth; Siegel, Eliot L

2015-02-01

Real-time mining of large research trial datasets enables development of case-based clinical decision support tools. Several applicable research datasets exist including the National Lung Screening Trial (NLST), a dataset unparalleled in size and scope for studying population-based lung cancer screening. Using these data, a clinical decision support tool was developed which matches patient demographics and lung nodule characteristics to a cohort of similar patients. The NLST dataset was converted into Structured Query Language (SQL) tables hosted on a web server, and a web-based JavaScript application was developed which performs real-time queries. JavaScript is used for both the server-side and client-side language, allowing for rapid development of a robust client interface and server-side data layer. Real-time data mining of user-specified patient cohorts achieved a rapid return of cohort cancer statistics and lung nodule distribution information. This system demonstrates the potential of individualized real-time data mining using large high-quality clinical trial datasets to drive evidence-based clinical decision-making.

Counseling Model Application: A Student Career Development Guidance for Decision Maker and Consultation

NASA Astrophysics Data System (ADS)

Irwan; Gustientiedina; Sunarti; Desnelita, Yenny

2017-12-01

The purpose of this study is to design a counseling model application for a decision-maker and consultation system. This application as an alternative guidance and individual career development for students, that include career knowledge, planning and alternative options from an expert tool based on knowledge and rule to provide the solutions on student’s career decisions. This research produces a counseling model application to obtain the important information about student career development and facilitating individual student’s development through the service form, to connect their plan with their career according to their talent, interest, ability, knowledge, personality and other supporting factors. This application model can be used as tool to get information faster and flexible for the student’s guidance and counseling. So, it can help students in doing selection and making decision that appropriate with their choice of works.

Consensus Recommendations for Systematic Evaluation of Drug-Drug Interaction Evidence for Clinical Decision Support

PubMed Central

Scheife, Richard T.; Hines, Lisa E.; Boyce, Richard D.; Chung, Sophie P.; Momper, Jeremiah; Sommer, Christine D.; Abernethy, Darrell R.; Horn, John; Sklar, Stephen J.; Wong, Samantha K.; Jones, Gretchen; Brown, Mary; Grizzle, Amy J.; Comes, Susan; Wilkins, Tricia Lee; Borst, Clarissa; Wittie, Michael A.; Rich, Alissa; Malone, Daniel C.

2015-01-01

Background Healthcare organizations, compendia, and drug knowledgebase vendors use varying methods to evaluate and synthesize evidence on drug-drug interactions (DDIs). This situation has a negative effect on electronic prescribing and medication information systems that warn clinicians of potentially harmful medication combinations. Objective To provide recommendations for systematic evaluation of evidence from the scientific literature, drug product labeling, and regulatory documents with respect to DDIs for clinical decision support. Methods A conference series was conducted to develop a structured process to improve the quality of DDI alerting systems. Three expert workgroups were assembled to address the goals of the conference. The Evidence Workgroup consisted of 15 individuals with expertise in pharmacology, drug information, biomedical informatics, and clinical decision support. Workgroup members met via webinar from January 2013 to February 2014. Two in-person meetings were conducted in May and September 2013 to reach consensus on recommendations. Results We developed expert-consensus answers to three key questions: 1) What is the best approach to evaluate DDI evidence?; 2) What evidence is required for a DDI to be applicable to an entire class of drugs?; and 3) How should a structured evaluation process be vetted and validated? Conclusion Evidence-based decision support for DDIs requires consistent application of transparent and systematic methods to evaluate the evidence. Drug information systems that implement these recommendations should be able to provide higher quality information about DDIs in drug compendia and clinical decision support tools. PMID:25556085

The process of development of a prioritization tool for a clinical decision support build within a computerized provider order entry system: Experiences from St Luke's Health System.

PubMed

Wolf, Matthew; Miller, Suzanne; DeJong, Doug; House, John A; Dirks, Carl; Beasley, Brent

2016-09-01

To establish a process for the development of a prioritization tool for a clinical decision support build within a computerized provider order entry system and concurrently to prioritize alerts for Saint Luke's Health System. The process of prioritizing clinical decision support alerts included (a) consensus sessions to establish a prioritization process and identify clinical decision support alerts through a modified Delphi process and (b) a clinical decision support survey to validate the results. All members of our health system's physician quality organization, Saint Luke's Care as well as clinicians, administrators, and pharmacy staff throughout Saint Luke's Health System, were invited to participate in this confidential survey. The consensus sessions yielded a prioritization process through alert contextualization and associated Likert-type scales. Utilizing this process, the clinical decision support survey polled the opinions of 850 clinicians with a 64.7 percent response rate. Three of the top rated alerts were approved for the pre-implementation build at Saint Luke's Health System: Acute Myocardial Infarction Core Measure Sets, Deep Vein Thrombosis Prophylaxis within 4 h, and Criteria for Sepsis. This study establishes a process for developing a prioritization tool for a clinical decision support build within a computerized provider order entry system that may be applicable to similar institutions. © The Author(s) 2015.

Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

PubMed Central

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2016-01-01

Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

[Attitudes and opinions of Palestinian decision-makers about premarital examination law].

PubMed

El Sharif, Nuha; Rifai, Ayshea; Assi, Sana'a; Al Hmidat, Amjad

2006-11-01

We explored the attitudes and opinions of 90 Palestinian decision-makers about the draft law on premarital examination. The findings revealed that decision-makers were aware of the spread of genetic diseases but not infectious diseases. The majority agreed on the draft law; however, they differed on the mode of its application. Half believed that the law is not ready yet for application due to insufficient financial support to establish the needed infrastructure. The most significant recommendations made by the decision-makers were to: enhance community awareness of the law, ensure proper coordination among the concerned ministries and institutions, and establish a national organization to work on endorsement of the tests and issuance of the appropriate application strategies and regulations.

The Use of Geoprocessing in Educational Research and Decision Support.

ERIC Educational Resources Information Center

Sexton, Porter

1982-01-01

Discusses geoprocessing, a computer mapping technique used by the Portland (Oregon) School District in which geographic analysis and data processing are combined. Several applications for administrative decision-making are discussed, including bus routing and redistricting. (JJD)

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

PubMed

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

2011-09-01

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

Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

PubMed

Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

2018-04-20

Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

Decision Support System for Determining Scholarship Selection using an Analytical Hierarchy Process

NASA Astrophysics Data System (ADS)

Puspitasari, T. D.; Sari, E. O.; Destarianto, P.; Riskiawan, H. Y.

2018-01-01

Decision Support System is a computer program application that analyzes data and presents it so that users can make decision more easily. Determining Scholarship Selection study case in Senior High School in east Java wasn’t easy. It needed application to solve the problem, to improve the accuracy of targets for prospective beneficiaries of poor students and to speed up the screening process. This research will build system uses the method of Analytical Hierarchy Process (AHP) is a method that solves a complex and unstructured problem into its group, organizes the groups into a hierarchical order, inputs numerical values instead of human perception in comparing relative and ultimately with a synthesis determined elements that have the highest priority. The accuracy system for this research is 90%.

Application of GIS in foreign direct investment decision support system

NASA Astrophysics Data System (ADS)

Zhou, Jianlan; Sun, Koumei

2007-06-01

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

Enabling Cross-Platform Clinical Decision Support through Web-Based Decision Support in Commercial Electronic Health Record Systems: Proposal and Evaluation of Initial Prototype Implementations

PubMed Central

Zhang, Mingyuan; Velasco, Ferdinand T.; Musser, R. Clayton; Kawamoto, Kensaku

2013-01-01

Enabling clinical decision support (CDS) across multiple electronic health record (EHR) systems has been a desired but largely unattained aim of clinical informatics, especially in commercial EHR systems. A potential opportunity for enabling such scalable CDS is to leverage vendor-supported, Web-based CDS development platforms along with vendor-supported application programming interfaces (APIs). Here, we propose a potential staged approach for enabling such scalable CDS, starting with the use of custom EHR APIs and moving towards standardized EHR APIs to facilitate interoperability. We analyzed three commercial EHR systems for their capabilities to support the proposed approach, and we implemented prototypes in all three systems. Based on these analyses and prototype implementations, we conclude that the approach proposed is feasible, already supported by several major commercial EHR vendors, and potentially capable of enabling cross-platform CDS at scale. PMID:24551426

Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology.

PubMed

Krieger, Janice L; Krok-Schoen, Jessica L; Dailey, Phokeng M; Palmer-Wackerly, Angela L; Schoenberg, Nancy; Paskett, Electra D; Dignan, Mark

2017-07-01

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients ( N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed.

Decision problems in management of construction projects

NASA Astrophysics Data System (ADS)

Szafranko, E.

2017-10-01

In a construction business, one must oftentimes make decisions during all stages of a building process, from planning a new construction project through its execution to the stage of using a ready structure. As a rule, the decision making process is made more complicated due to certain conditions specific for civil engineering. With such diverse decision situations, it is recommended to apply various decision making support methods. Both, literature and hands-on experience suggest several methods based on analytical and computational procedures, some less and some more complex. This article presents the methods which can be helpful in supporting decision making processes in the management of civil engineering projects. These are multi-criteria methods, such as MCE, AHP or indicator methods. Because the methods have different advantages and disadvantages, whereas decision situations have their own specific nature, a brief summary of the methods alongside some recommendations regarding their practical applications has been given at the end of the paper. The main aim of this article is to review the methods of decision support and their analysis for possible use in the construction industry.

Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: methods of a decision-maker-researcher partnership systematic review.

PubMed

Haynes, R Brian; Wilczynski, Nancy L

2010-02-05

Computerized clinical decision support systems are information technology-based systems designed to improve clinical decision-making. As with any healthcare intervention with claims to improve process of care or patient outcomes, decision support systems should be rigorously evaluated before widespread dissemination into clinical practice. Engaging healthcare providers and managers in the review process may facilitate knowledge translation and uptake. The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. The review was undertaken by the Health Information Research Unit, McMaster University, in partnership with Hamilton Health Sciences, the Hamilton, Niagara, Haldimand, and Brant Local Health Integration Network, and pertinent healthcare service teams. Following agreement on information needs and interests with decision-makers, our earlier systematic review was updated by searching Medline, EMBASE, EBM Review databases, and Inspec, and reviewing reference lists through 6 January 2010. Data extraction items were expanded according to input from decision-makers. Authors of primary studies were contacted to confirm data and to provide additional information. Eligible trials were organized according to clinical area of application. We included randomized controlled trials that evaluated the effect on practitioner performance or patient outcomes of patient care provided with a computerized clinical decision support system compared with patient care without such a system. Data will be summarized using descriptive summary measures, including proportions for categorical variables and means for continuous variables. Univariable and multivariable logistic regression models will be used to investigate associations between outcomes of interest and study specific covariates. When reporting results from individual studies, we will cite the measures of association and p-values reported in the studies. If appropriate for groups of studies with similar features, we will conduct meta-analyses. A decision-maker-researcher partnership provides a model for systematic reviews that may foster knowledge translation and uptake.

Comparison of Multi-Criteria Decision Support Methods (AHP, TOPSIS, SAW & PROMENTHEE) for Employee Placement

NASA Astrophysics Data System (ADS)

Widianta, M. M. D.; Rizaldi, T.; Setyohadi, D. P. S.; Riskiawan, H. Y.

2018-01-01

The right decision in placing employees in an appropriate position in a company will support the quality of management and will have an impact on improving the quality of human resources of the company. Such decision-making can be assisted by an approach through the Decision Support System (DSS) to improve accuracy in the employee placement process. The purpose of this paper is to compare the four methods of Multi Criteria Decision Making (MCDM), ie Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), Simple Additive Weighting (SAW), Analytic Hierarchy Process (AHP) and Preference Ranking Organization Method for Enrichment Of Evaluations (PROMETHEE) for the application of employee placement in accordance with predetermined criteria. The ranking results and the accuracy level obtained from each method are different depending on the different scaling and weighting processes in each method.

Marine Air Ground Task Force Distribution In The Battlespace

DTIC Science & Technology

2016-09-01

benefit of this research is a proposed systemic structure with an associated web application that provides the MAGTF commander with critical...associated web application that provides the MAGTF commander with critical information for supporting operations. vi THIS PAGE INTENTIONALLY LEFT BLANK... web analytics in order to support the decision making process. The potential benefit of this research is a methodology with associated application

CEOS Contributions to Informing Energy Management and Policy Decision Making Using Space-Based Earth Observations

NASA Technical Reports Server (NTRS)

Eckman, Richard S.

2009-01-01

Earth observations are playing an increasingly significant role in informing decision making in the energy sector. In renewable energy applications, space-based observations now routinely augment sparse ground-based observations used as input for renewable energy resource assessment applications. As one of the nine Group on Earth Observations (GEO) societal benefit areas, the enhancement of management and policy decision making in the energy sector is receiving attention in activities conducted by the Committee on Earth Observation Satellites (CEOS). CEOS has become the "space arm" for the implementation of the Global Earth Observation System of Systems (GEOSS) vision. It is directly supporting the space-based, near-term tasks articulated in the GEO three-year work plan. This paper describes a coordinated program of demonstration projects conducted by CEOS member agencies and partners to utilize Earth observations to enhance energy management end-user decision support systems. I discuss the importance of engagement with stakeholders and understanding their decision support needs in successfully increasing the uptake of Earth observation products for societal benefit. Several case studies are presented, demonstrating the importance of providing data sets in formats and units familiar and immediately usable by decision makers. These projects show the utility of Earth observations to enhance renewable energy resource assessment in the developing world, forecast space-weather impacts on the power grid, and improve energy efficiency in the built environment.

WIPCast: Probabilistic Forecasting for Aviation Decision Aid Applications

DTIC Science & Technology

2011-06-01

traders, or families planning an outing – manage weather-related risk. By quantifying risk , probabilistic forecasting enables optimization of actions via...confidence interval to the user’s risk tolerance helps drive highly effective and innovative decision support mechanisms for visually quantifying risk for

ENVIRONMENTAL FEATURE FINDER: A REMOTE SENSING DECISION SUPPORT TOOL

EPA Science Inventory

Land cover maps are essential to sound environmental stewardship and EPA’s mission to protect human health and the environment, but existing maps are not always sufficiently current, detailed, or appropriate for a given application. Consequently, we are developing a decision sup...

Value of information analysis in healthcare: a review of principles and applications.

PubMed

Tuffaha, Haitham W; Gordon, Louisa G; Scuffham, Paul A

2014-06-01

Economic evaluations are increasingly utilized to inform decisions in healthcare; however, decisions remain uncertain when they are not based on adequate evidence. Value of information (VOI) analysis has been proposed as a systematic approach to measure decision uncertainty and assess whether there is sufficient evidence to support new technologies. The objective of this paper is to review the principles and applications of VOI analysis in healthcare. Relevant databases were systematically searched to identify VOI articles. The findings from the selected articles were summarized and narratively presented. Various VOI methods have been developed and applied to inform decision-making, optimally designing research studies and setting research priorities. However, the application of this approach in healthcare remains limited due to technical and policy challenges. There is a need to create more awareness about VOI analysis, simplify its current methods, and align them with the needs of decision-making organizations.

Application of preprocessing filtering on Decision Tree C4.5 and rough set theory

NASA Astrophysics Data System (ADS)

Chan, Joseph C. C.; Lin, Tsau Y.

2001-03-01

This paper compares two artificial intelligence methods: the Decision Tree C4.5 and Rough Set Theory on the stock market data. The Decision Tree C4.5 is reviewed with the Rough Set Theory. An enhanced window application is developed to facilitate the pre-processing filtering by introducing the feature (attribute) transformations, which allows users to input formulas and create new attributes. Also, the application produces three varieties of data set with delaying, averaging, and summation. The results prove the improvement of pre-processing by applying feature (attribute) transformations on Decision Tree C4.5. Moreover, the comparison between Decision Tree C4.5 and Rough Set Theory is based on the clarity, automation, accuracy, dimensionality, raw data, and speed, which is supported by the rules sets generated by both algorithms on three different sets of data.

A framework for ecological decision support systems: Building the right systems and building the systems right

USGS Publications Warehouse

D'Erchia, Frank; Korschgen, Carl E.; Nyquist, M.; Root, Ralph; Sojda, Richard S.; Stine, Peter

2001-01-01

Workshops in the late 1990's launched the commitment of the U.S. Geological Survey's Biological Resources Division (BRD) to develop and implement decision support systems (DSS) applications. One of the primary goals of this framework document is to provide sufficient background and information for Department of the Interior (DOI) bureau stakeholders and other clients to determine the potential for DSS development. Such an understanding can assist them in carrying out effective land planning and management practices. This document provides a definition of DSS and its characteristics and capabilities. It proceeds to describe issues related to meeting resource managers needs, such as the needs for specific applications, customer requirements, information and technology transfer, user support, and institutionalization. Using the decision process as a means to guide DSS development and determine users needs is also discussed. We conclude with information on method to evaluate DSS development efforts and recommended procedures for verification and validation. 

Information systems: the key to evidence-based health practice.

PubMed Central

Rodrigues, R. J.

2000-01-01

Increasing prominence is being given to the use of best current evidence in clinical practice and health services and programme management decision-making. The role of information in evidence-based practice (EBP) is discussed, together with questions of how advanced information systems and technology (IS&T) can contribute to the establishment of a broader perspective for EBP. The author examines the development, validation and use of a variety of sources of evidence and knowledge that go beyond the well-established paradigm of research, clinical trials, and systematic literature review. Opportunities and challenges in the implementation and use of IS&T and knowledge management tools are examined for six application areas: reference databases, contextual data, clinical data repositories, administrative data repositories, decision support software, and Internet-based interactive health information and communication. Computerized and telecommunications applications that support EBP follow a hierarchy in which systems, tasks and complexity range from reference retrieval and the processing of relatively routine transactions, to complex "data mining" and rule-driven decision support systems. PMID:11143195

What We Can Learn from Amazon for Clinical Decision Support Systems.

PubMed

Abid, Sidra; Keshavjee, Karim; Karim, Arsalan; Guergachi, Aziz

2017-01-01

Health care continue to lag behind other industries, such as retail and financial services, in the use of decision-support-like tools. Amazon is particularly prolific in the use of advanced predictive and prescriptive analytics to assist its customers to purchase more, while increasing satisfaction, retention, repeat-purchases and loyalty. How can we do the same in health care? In this paper, we explore various elements of the Amazon website and Amazon's data science and big data practices to gather inspiration for re-designing clinical decision support in the health care sector. For each Amazon element we identified, we present one or more clinical applications to help us better understand where Amazon's.

Mass balance and swath displacement evaluations from agricultural application field trials

USDA-ARS?s Scientific Manuscript database

Spray drift is on an ongoing concern for any agricultural application and continues to be the focus for new developments and research efforts dealing with drift reduction technologies, best management application practices and the development of new decision support systems for applicators. Typical...

Enabling Real-time Water Decision Support Services Using Model as a Service

NASA Astrophysics Data System (ADS)

Zhao, T.; Minsker, B. S.; Lee, J. S.; Salas, F. R.; Maidment, D. R.; David, C. H.

2014-12-01

Through application of computational methods and an integrated information system, data and river modeling services can help researchers and decision makers more rapidly understand river conditions under alternative scenarios. To enable this capability, workflows (i.e., analysis and model steps) are created and published as Web services delivered through an internet browser, including model inputs, a published workflow service, and visualized outputs. The RAPID model, which is a river routing model developed at University of Texas Austin for parallel computation of river discharge, has been implemented as a workflow and published as a Web application. This allows non-technical users to remotely execute the model and visualize results as a service through a simple Web interface. The model service and Web application has been prototyped in the San Antonio and Guadalupe River Basin in Texas, with input from university and agency partners. In the future, optimization model workflows will be developed to link with the RAPID model workflow to provide real-time water allocation decision support services.

Is economic valuation of ecosystem services useful to decision-makers? Lessons learned from Australian coastal and marine management.

PubMed

Marre, Jean-Baptiste; Thébaud, Olivier; Pascoe, Sean; Jennings, Sarah; Boncoeur, Jean; Coglan, Louisa

2016-08-01

Economic valuation of ecosystem services is widely advocated as being useful to support ecosystem management decision-making. However, the extent to which it is actually used or considered useful in decision-making is poorly documented. This literature blindspot is explored with an application to coastal and marine ecosystems management in Australia. Based on a nation-wide survey of eighty-eight decision-makers representing a diversity of management organizations, the perceived usefulness and level of use of economic valuation of ecosystem services, in support of coastal and marine management, are examined. A large majority of decision-makers are found to be familiar with economic valuation and consider it useful - even necessary - in decision-making, although this varies across groups of decision-makers. However, most decision-makers never or rarely use economic valuation. The perceived level of importance and trust in estimated dollar values differ across ecosystem services, and are especially high for values that relate to commercial activities. A number of factors are also found to influence respondent's use of economic valuation. Such findings concur with conclusions from other studies on the usefulness and use of ESV in environmental management decision-making. They also demonstrate the strength of the survey-based approach developed in this application to examine this issue in a variety of contexts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Utilization of Live Localized Weather Information for Sustainable Agriculture

NASA Astrophysics Data System (ADS)

Anderson, J.; Usher, J.

2010-09-01

Authors: Jim Anderson VP, Global Network and Business Development WeatherBug® Professional Jeremy Usher Managing Director, Europe WeatherBug® Professional Localized, real-time weather information is vital for day-to-day agronomic management of all crops. The challenge for agriculture is twofold in that local and timely weather data is not often available for producers and farmers, and it is not integrated into decision-support tools they require. Many of the traditional sources of weather information are not sufficient for agricultural applications because of the long distances between weather stations, meaning the data is not always applicable for on-farm decision making processes. The second constraint with traditional weather information is the timeliness of the data. Most delivery systems are designed on a one-hour time step, whereas many decisions in agriculture are based on minute-by-minute weather conditions. This is especially true for decisions surrounding chemical and fertilizer application and frost events. This presentation will outline how the creation of an agricultural mesonet (weather network) can enable producers and farmers with live, local weather information from weather stations installed in farm/field locations. The live weather information collected from each weather station is integrated into a web-enabled decision support tool, supporting numerous on-farm agronomic activities such as pest management, or dealing with heavy rainfall and frost events. Agronomic models can be used to assess the potential of disease pressure, enhance the farmer's abilities to time pesticide applications, or assess conditions contributing to yield and quality fluctuations. Farmers and industry stakeholders may also view quality-assured historical weather variables at any location. This serves as a record-management tool for viewing previously uncharted agronomic weather events in graph or table form. This set of weather tools is unique and provides a significant enhancement to the agronomic decision-support process. Direct benefits to growers can take the form of increased yield and grade potential, as well as savings in money and time. Pest management strategies become more efficient due to timely and localized disease and pest modelling, and increased efficacy of pest and weed control. Examples from the Canadian Wheat Board (CWB) WeatherFarm weather network will be utilized to illustrate the processes, decision tools and benefits to producers and farmers.

WATCHMAN: A Data Warehouse Intelligent Cache Manager

NASA Technical Reports Server (NTRS)

Scheuermann, Peter; Shim, Junho; Vingralek, Radek

1996-01-01

Data warehouses store large volumes of data which are used frequently by decision support applications. Such applications involve complex queries. Query performance in such an environment is critical because decision support applications often require interactive query response time. Because data warehouses are updated infrequently, it becomes possible to improve query performance by caching sets retrieved by queries in addition to query execution plans. In this paper we report on the design of an intelligent cache manager for sets retrieved by queries called WATCHMAN, which is particularly well suited for data warehousing environment. Our cache manager employs two novel, complementary algorithms for cache replacement and for cache admission. WATCHMAN aims at minimizing query response time and its cache replacement policy swaps out entire retrieved sets of queries instead of individual pages. The cache replacement and admission algorithms make use of a profit metric, which considers for each retrieved set its average rate of reference, its size, and execution cost of the associated query. We report on a performance evaluation based on the TPC-D and Set Query benchmarks. These experiments show that WATCHMAN achieves a substantial performance improvement in a decision support environment when compared to a traditional LRU replacement algorithm.

Decision support for patient care: implementing cybernetics.

PubMed

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

2004-01-01

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

Challenges Associated With Applying Physiologically Based Pharmacokinetic Modeling for Public Health Decision-Making

EPA Science Inventory

The development and application of physiologically based pharmacokinetic (PBPK) models in chemical toxicology have grown steadily since their emergence in the 1980s. However, critical evaluation of PBPK models to support public health decision-making across federal agencies has t...

Usability and acceptance evaluation of ACESO: a Web-based breast cancer survivorship tool.

PubMed

Kapoor, Akshat; Nambisan, Priya

2018-06-01

The specific objective of this research is to design and develop a personalized Web application to support breast cancer survivors after treatment, as they deal with post-treatment challenges, such as comorbidities and side effects of treatment. A mixed-methods approach, utilizing a combination of think-aloud analysis, personal interviews, and surveys, was adopted for user acceptance and usability testing among a group of breast cancer survivors. User feedback was gathered on their perceived value of the application, and any user-interface issues that may hinder the overall usability were identified. The application's portability and capability of organizing their entire breast cancer-related medical history as well as tracking various quality of life indicators were perceived to be valuable features. The application had an overall high usability; however, certain sections of the application were not as intuitive to locate. Visual elements of the website were appreciated; however, overall experience would benefit from incorporating more sociable elements that exhibit positive re-enforcement within the end user and provide a friendlier experience. The results of the study showcase the need for more personalized tools and resources to support survivors in self-management. It also demonstrates the ability to integrate breast cancer survivorship care plans from diverse providers and paves the way to add further value-added features in consumer health applications, such as personal decision support. Using a personal decision support-based tool can serve as a training tool and resource, providing these patients with pertinent information about the various aspects of their long-term health, while educating them about any related side effects and symptoms. It is hoped that making such tools more accessible could help in engaging survivors to play an active role in managing their health and encourage shared decision-making with their providers.

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

PubMed Central

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

2018-01-01

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

An Innovative Excel Application to Improve Exam Reliability in Marketing Courses

ERIC Educational Resources Information Center

Keller, Christopher M.; Kros, John F.

2011-01-01

Measures of survey reliability are commonly addressed in marketing courses. One statistic of reliability is "Cronbach's alpha." This paper presents an application of survey reliability as a reflexive application of multiple-choice exam validation. The application provides an interactive decision support system that incorporates survey item…

A comparative assessment of tools for ecosystem services quantification and valuation

USGS Publications Warehouse

Bagstad, Kenneth J.; Semmens, Darius; Waage, Sissel; Winthrop, Robert

2013-01-01

To enter widespread use, ecosystem service assessments need to be quantifiable, replicable, credible, flexible, and affordable. With recent growth in the field of ecosystem services, a variety of decision-support tools has emerged to support more systematic ecosystem services assessment. Despite the growing complexity of the tool landscape, thorough reviews of tools for identifying, assessing, modeling and in some cases monetarily valuing ecosystem services have generally been lacking. In this study, we describe 17 ecosystem services tools and rate their performance against eight evaluative criteria that gauge their readiness for widespread application in public- and private-sector decision making. We describe each of the tools′ intended uses, services modeled, analytical approaches, data requirements, and outputs, as well time requirements to run seven tools in a first comparative concurrent application of multiple tools to a common location – the San Pedro River watershed in southeast Arizona, USA, and northern Sonora, Mexico. Based on this work, we offer conclusions about these tools′ current ‘readiness’ for widespread application within both public- and private-sector decision making processes. Finally, we describe potential pathways forward to reduce the resource requirements for running ecosystem services models, which are essential to facilitate their more widespread use in environmental decision making.

Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications.

PubMed

Berrouiguet, Sofian; Barrigón, Maria Luisa; Brandt, Sara A; Ovejero-García, Santiago; Álvarez-García, Raquel; Carballo, Juan Jose; Lenca, Philippe; Courtet, Philippe; Baca-García, Enrique

2016-01-01

The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio. The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine. In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system.

Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications

PubMed Central

Berrouiguet, Sofian; Barrigón, Maria Luisa; Brandt, Sara A.; Ovejero-García, Santiago; Álvarez-García, Raquel; Carballo, Juan Jose; Lenca, Philippe; Courtet, Philippe; Baca-García, Enrique

2016-01-01

Purpose The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. Method A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio. Results The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine. Conclusions In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system. PMID:27764107

Two-Stage Fracturing Wastewater Management in Shale Gas Development

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

Zhang, Xiaodong; Sun, Alexander Y.; Duncan, Ian J.

Here, management of shale gas wastewater treatment, disposal, and reuse has become a significant environmental challenge, driven by an ongoing boom in development of U.S. shale gas reservoirs. Systems-analysis based decision support is helpful for effective management of wastewater, and provision of cost-effective decision alternatives from a whole-system perspective. Uncertainties are inherent in many modeling parameters, affecting the generated decisions. In order to effectively deal with the recourse issue in decision making, in this work a two-stage stochastic fracturing wastewater management model, named TSWM, is developed to provide decision support for wastewater management planning in shale plays. Using the TSWMmore » model, probabilistic and nonprobabilistic uncertainties are effectively handled. The TSWM model provides flexibility in generating shale gas wastewater management strategies, in which the first-stage decision predefined by decision makers before uncertainties are unfolded is corrected in the second stage to achieve the whole-system’s optimality. Application of the TSWM model to a comprehensive synthetic example demonstrates its practical applicability and feasibility. Optimal results are generated for allowable wastewater quantities, excess wastewater, and capacity expansions of hazardous wastewater treatment plants to achieve the minimized total system cost. The obtained interval solutions encompass both optimistic and conservative decisions. Trade-offs between economic and environmental objectives are made depending on decision makers’ knowledge and judgment, as well as site-specific information. In conclusion, the proposed model is helpful in forming informed decisions for wastewater management associated with shale gas development.« less

Two-Stage Fracturing Wastewater Management in Shale Gas Development

DOE PAGES

Zhang, Xiaodong; Sun, Alexander Y.; Duncan, Ian J.; ...

2017-01-19

Here, management of shale gas wastewater treatment, disposal, and reuse has become a significant environmental challenge, driven by an ongoing boom in development of U.S. shale gas reservoirs. Systems-analysis based decision support is helpful for effective management of wastewater, and provision of cost-effective decision alternatives from a whole-system perspective. Uncertainties are inherent in many modeling parameters, affecting the generated decisions. In order to effectively deal with the recourse issue in decision making, in this work a two-stage stochastic fracturing wastewater management model, named TSWM, is developed to provide decision support for wastewater management planning in shale plays. Using the TSWMmore » model, probabilistic and nonprobabilistic uncertainties are effectively handled. The TSWM model provides flexibility in generating shale gas wastewater management strategies, in which the first-stage decision predefined by decision makers before uncertainties are unfolded is corrected in the second stage to achieve the whole-system’s optimality. Application of the TSWM model to a comprehensive synthetic example demonstrates its practical applicability and feasibility. Optimal results are generated for allowable wastewater quantities, excess wastewater, and capacity expansions of hazardous wastewater treatment plants to achieve the minimized total system cost. The obtained interval solutions encompass both optimistic and conservative decisions. Trade-offs between economic and environmental objectives are made depending on decision makers’ knowledge and judgment, as well as site-specific information. In conclusion, the proposed model is helpful in forming informed decisions for wastewater management associated with shale gas development.« less

A dedicated software application for treatment verification with off-line PET/CT imaging at the Heidelberg Ion Beam Therapy Center

NASA Astrophysics Data System (ADS)

Chen, W.; Bauer, J.; Kurz, C.; Tessonnier, T.; Handrack, J.; Haberer, T.; Debus, J.; Parodi, K.

2017-01-01

We present the workflow of the offline-PET based range verification method used at the Heidelberg Ion Beam Therapy Center, detailing the functionalities of an in-house developed software application, SimInterface14, with which range analysis is performed. Moreover, we introduce the design of a decision support system assessing uncertainties and facilitating physicians in decisions making for plan adaptation.

Informing Environmental Water Management Decisions: Using Conditional Probability Networks to Address the Information Needs of Planning and Implementation Cycles.

PubMed

Horne, Avril C; Szemis, Joanna M; Webb, J Angus; Kaur, Simranjit; Stewardson, Michael J; Bond, Nick; Nathan, Rory

2018-03-01

One important aspect of adaptive management is the clear and transparent documentation of hypotheses, together with the use of predictive models (complete with any assumptions) to test those hypotheses. Documentation of such models can improve the ability to learn from management decisions and supports dialog between stakeholders. A key challenge is how best to represent the existing scientific knowledge to support decision-making. Such challenges are currently emerging in the field of environmental water management in Australia, where managers are required to prioritize the delivery of environmental water on an annual basis, using a transparent and evidence-based decision framework. We argue that the development of models of ecological responses to environmental water use needs to support both the planning and implementation cycles of adaptive management. Here we demonstrate an approach based on the use of Conditional Probability Networks to translate existing ecological knowledge into quantitative models that include temporal dynamics to support adaptive environmental flow management. It equally extends to other applications where knowledge is incomplete, but decisions must still be made.

Informing Environmental Water Management Decisions: Using Conditional Probability Networks to Address the Information Needs of Planning and Implementation Cycles

NASA Astrophysics Data System (ADS)

Horne, Avril C.; Szemis, Joanna M.; Webb, J. Angus; Kaur, Simranjit; Stewardson, Michael J.; Bond, Nick; Nathan, Rory

2018-03-01

One important aspect of adaptive management is the clear and transparent documentation of hypotheses, together with the use of predictive models (complete with any assumptions) to test those hypotheses. Documentation of such models can improve the ability to learn from management decisions and supports dialog between stakeholders. A key challenge is how best to represent the existing scientific knowledge to support decision-making. Such challenges are currently emerging in the field of environmental water management in Australia, where managers are required to prioritize the delivery of environmental water on an annual basis, using a transparent and evidence-based decision framework. We argue that the development of models of ecological responses to environmental water use needs to support both the planning and implementation cycles of adaptive management. Here we demonstrate an approach based on the use of Conditional Probability Networks to translate existing ecological knowledge into quantitative models that include temporal dynamics to support adaptive environmental flow management. It equally extends to other applications where knowledge is incomplete, but decisions must still be made.

Risk assessment of sewer condition using artificial intelligence tools: application to the SANEST sewer system.

PubMed

Sousa, V; Matos, J P; Almeida, N; Saldanha Matos, J

2014-01-01

Operation, maintenance and rehabilitation comprise the main concerns of wastewater infrastructure asset management. Given the nature of the service provided by a wastewater system and the characteristics of the supporting infrastructure, technical issues are relevant to support asset management decisions. In particular, in densely urbanized areas served by large, complex and aging sewer networks, the sustainability of the infrastructures largely depends on the implementation of an efficient asset management system. The efficiency of such a system may be enhanced with technical decision support tools. This paper describes the role of artificial intelligence tools such as artificial neural networks and support vector machines for assisting the planning of operation and maintenance activities of wastewater infrastructures. A case study of the application of this type of tool to the wastewater infrastructures of Sistema de Saneamento da Costa do Estoril is presented.

Multi Criteria Evaluation Module for RiskChanges Spatial Decision Support System

NASA Astrophysics Data System (ADS)

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

2015-04-01

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

Towards meaningful medication-related clinical decision support: recommendations for an initial implementation.

PubMed

Phansalkar, S; Wright, A; Kuperman, G J; Vaida, A J; Bobb, A M; Jenders, R A; Payne, T H; Halamka, J; Bloomrosen, M; Bates, D W

2011-01-01

Clinical decision support (CDS) can improve safety, quality, and cost-effectiveness of patient care, especially when implemented in computerized provider order entry (CPOE) applications. Medication-related decision support logic forms a large component of the CDS logic in any CPOE system. However, organizations wishing to implement CDS must either purchase the computable clinical content or develop it themselves. Content provided by vendors does not always meet local expectations. Most organizations lack the resources to customize the clinical content and the expertise to implement it effectively. In this paper, we describe the recommendations of a national expert panel on two basic medication-related CDS areas, specifically, drug-drug interaction (DDI) checking and duplicate therapy checking. The goals of this study were to define a starter set of medication-related alerts that healthcare organizations can implement in their clinical information systems. We also draw on the experiences of diverse institutions to highlight the realities of implementing medication decision support. These findings represent the experiences of institutions with a long history in the domain of medication decision support, and the hope is that this guidance may improve the feasibility and efficiency CDS adoption across healthcare settings.

Integrated Forecast-Decision Systems For River Basin Planning and Management

NASA Astrophysics Data System (ADS)

Georgakakos, A. P.

2005-12-01

A central application of climatology, meteorology, and hydrology is the generation of reliable forecasts for water resources management. In principle, effective use of forecasts could improve water resources management by providing extra protection against floods, mitigating the adverse effects of droughts, generating more hydropower, facilitating recreational activities, and minimizing the impacts of extreme events on the environment and the ecosystems. In practice, however, realization of these benefits depends on three requisite elements. First is the skill and reliability of forecasts. Second is the existence of decision support methods/systems with the ability to properly utilize forecast information. And third is the capacity of the institutional infrastructure to incorporate the information provided by the decision support systems into the decision making processes. This presentation discusses several decision support systems (DSS) using ensemble forecasting that have been developed by the Georgia Water Resources Institute for river basin management. These DSS are currently operational in Africa, Europe, and the US and address integrated water resources and energy planning and management in river basins with multiple water uses, multiple relevant temporal and spatial scales, and multiple decision makers. The article discusses the methods used and advocates that the design, development, and implementation of effective forecast-decision support systems must bring together disciplines, people, and institutions necessary to address today's complex water resources challenges.

Institutionalizing telemedicine applications: the challenge of legitimizing decision-making.

PubMed

Zanaboni, Paolo; Lettieri, Emanuele

2011-09-28

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements--rationality, fairness, and efficiency--that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications--benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators' perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed.

Development of a decision support system for tsunami evacuation: application to the Jiyang District of Sanya city in China

NASA Astrophysics Data System (ADS)

Hou, Jingming; Yuan, Ye; Wang, Peitao; Ren, Zhiyuan; Li, Xiaojuan

2017-03-01

Major tsunami disasters often cause great damage in the first few hours following an earthquake. The possible severity of such events requires preparations to prevent tsunami disasters or mitigate them. This paper is an attempt to develop a decision support system for rapid tsunami evacuation for local decision makers. Based on the numerical results database of tsunami disasters, this system can quickly obtain the tsunami inundation and travel time. Because numerical models are calculated in advance, this system can reduce decision-making time. Population distribution, as a vulnerability factor, was analyzed to identify areas of high risk for tsunami disasters. Combined with spatial data, this system can comprehensively analyze the dynamic and static evacuation process and identify problems that negatively impact evacuation, thus supporting the decision-making for tsunami evacuation in high-risk areas. When an earthquake and tsunami occur, this system can rapidly obtain the tsunami inundation and travel time and provide information to assist with tsunami evacuation operations.

Strategies to support drug discovery through integration of systems and data.

PubMed

Waller, Chris L; Shah, Ajay; Nolte, Matthias

2007-08-01

Much progress has been made over the past several years to provide technologies for the integration of drug discovery software applications and the underlying data bits. Integration at the application layer has focused primarily on developing and delivering applications that support specific workflows within the drug discovery arena. A fine balance between creating behemoth applications and providing business value must be maintained. Heterogeneous data sources have typically been integrated at the data level in an effort to provide a more holistic view of the data packages supporting key decision points. This review will highlight past attempts, current status, and potential future directions for systems and data integration strategies in support of drug discovery efforts.

The Value of Participatory Decision-Making: A Collaborative Approach.

ERIC Educational Resources Information Center

Richardson, M. D.; And Others

This study investigated the practicality and feasibility of the public school administrator permitting those concerned, faculty, students, parents and interested citizens, to participate in the decision making process of the local school. An added purpose was to find applicable and effective ways the principal could support meaningful…

The Course Development Plan: Macro-Level Decisions and Micro-Level Processes

ERIC Educational Resources Information Center

Franker, Karen; James, Dennis

2016-01-01

A key step in distance learning project management is the creation of a course development plan. The plan should account for decisions related to materials, curriculum, delivery methods, staffing, technology applications, resources, reporting lines, and project management--issues that may require administrator involvement and support, particularly…

Battle Environment Assessment for Commanders: A Concept of Support for Joint and Component Strategy and Operations.

DTIC Science & Technology

1988-03-14

focused application of decision aids. These decision aids must incorporate standardized processes, computer assisted artificial intelligence, linkage...Theater Planning. A Strategic-Operational Perspective,’ by COL MIke ,or i n Olesak, John, LTC Office of the Deputy Chief of Staff, Inteligence , U S

The Use of Computer-Aided Decision Support Systems for Complex Source Selection Decisions

DTIC Science & Technology

1989-09-01

unique low noise interferometer developed at Fusetech Inc. by using divided Fabry - Perot fiber optic cells, common- mode rejection, matched path lengths and...potential techniques for a demodulation scheme. They proposed a detailed investigation of the approaches as part of the program. For mine applications

Weight of evidence evaluation of adverse outcome pathways converging at impaired vitellogenin synthesis leading to reproductive impairment

EPA Science Inventory

Adverse outcome pathways (AOPs) provide a framework that supports greater use of mechanistic data measured at lower levels of biological organization as a basis for regulatory decision-making. However, it is recognized that different types of regulatory applications and decisions...

8 CFR 245a.2 - Application for temporary residence.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of the benefit sought. Acceptable supporting documents for these three categories are discussed below... possession of thirty grams or less of marijuana; (iii) Paragraphs (27) (prejudicial to the public interest... decision that will grant the benefit which has been requested. The director's new decision must be served...

Supporting Neonatal Intensive Care Unit Parents Through Social Media.

PubMed

Dzubaty, Dolores R

2016-01-01

Parents of infants in the neonatal intensive care unit may often find themselves seeking healthcare information from online and social media sources. Social media applications are available to healthcare consumers and their families, as well as healthcare providers, in a variety of formats. Information that parents gather on their own, and information that is explained by providers, is then used when parents make healthcare decisions regarding their infants. Parents also seek support from peers and family while making healthcare decisions. The combination of knowledge obtained and social support given may empower the parent to feel more confident in their decision making. Healthcare professionals can guide parents to credible resources. The exchange of information between providers and parents can occur using a variety of communication methods. Misperceptions can be corrected, support given, open sharing of information occurs, and parent empowerment may result.

DSOM - Decision Support for Operations and Maintenance - Application to a USMC Base Centralized Energy System.

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

Meador, Richard J.; Hatley, Darrel D.

2004-06-01

PNNL DSOM technology coordinates efficient steam plant operation with EMCS and SCADA systems, providing generation support and automated load shedding to meet peak demand limits saving over $1M in two years.

Use of PRA in Shuttle Decision Making Process

NASA Technical Reports Server (NTRS)

Boyer, Roger L.; Hamlin, Teri L.

2010-01-01

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

A Digital Framework to Support Providers and Patients in Diabetes Related Behavior Modification.

PubMed

Abidi, Samina; Vallis, Michael; Piccinini-Vallis, Helena; Imran, Syed Ali; Abidi, Syed Sibte Raza

2017-01-01

We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients. We present the qualitative analysis of D-WISE usability by both physicians and patients.

Fronting Integrated Scientific Web Applications: Design Features and Benefits for Regulatory Environments

EPA Science Inventory

Integrated decision support systems for regulatory applications benefit from standardindustry practices such as code reuse, test-driven development, and modularization. Theseapproaches make meeting the federal government’s goals of transparency, efficiency, and quality assurance ...

An Application of Multidimensional Scaling to the Prioritization of Decision Aids in the S-3A.

DTIC Science & Technology

1980-09-01

subjects at once and recent research by Burton (1975] suggests that most people can do a single sorting of sixty(60) stimuli in fifteen to thirty...implicit ordering of areas in which TACCOs think decision aids would be useful. a. Gain Attack Criteria The Gain Attack Criteria decision function was...will provide you with better, more intelligent support from machines and will give you time to do what you do best - think and make decision. The whole

Implementing interactive decision support: A case for combining cyberinfrastructure, data fusion, and social process to mobilize scientific knowledge in sustainability problems

NASA Astrophysics Data System (ADS)

Pierce, S. A.

2014-12-01

Geosciences are becoming increasingly data intensive, particularly in relation to sustainability problems, which are multi-dimensional, weakly structured and characterized by high levels of uncertainty. In the case of complex resource management problems, the challenge is to extract meaningful information from data and make sense of it. Simultaneously, scientific knowledge alone is insufficient to change practice. Creating tools, and group decision support processes for end users to interact with data are key challenges to transforming science-based information into actionable knowledge. The ENCOMPASS project began as a multi-year case study in the Atacama Desert of Chile to design and implement a knowledge transfer model for energy-water-mining conflicts in the region. ENCOMPASS combines the use of cyberinfrastructure (CI), automated data collection, interactive interfaces for dynamic decision support, and participatory modelling to support social learning. A pilot version of the ENCOMPASS CI uses open source systems and serves as a structure to integrate and store multiple forms of data and knowledge, such as DEM, meteorological, water quality, geomicrobiological, energy demand, and groundwater models. In the case study, informatics and data fusion needs related to scientific uncertainty around deep groundwater flowpaths and energy-water connections. Users may upload data from field sites with handheld devices or desktops. Once uploaded, data assets are accessible for a variety of uses. To address multi-attributed decision problems in the Atacama region a standalone application with touch-enabled interfaces was created to improve real-time interactions with datasets by groups. The tool was used to merge datasets from the ENCOMPASS CI to support exploration among alternatives and build shared understanding among stakeholders. To date, the project has increased technical capacity among stakeholders, resulted in the creation of both for-profit and non-profit entities, enabled cross-sector collaboration with mining-indigenous stakeholders, and produced an interactive application for group decision support. ENCOMPASS leverages advances in computational tools to deliver data and models for group decision support applied to sustainability science problems.

GODDESS: A Goal-Directed Decision Structuring System.

DTIC Science & Technology

1980-06-01

differ- ent support techniques. From a practical viewpoint, though, the major drawback of manual interviews is their length and cost. Since real - time ...conducting his future inquiries. A direct man-machine interface could provide three distinct advantages. First, it offers the capability of real - time ...knowledge in tree form. In many real -world applications, the decision maker may not perceive a problem in the form of a time sequence of decision

Managing Decisions on Changes in the Virtual Enterprise Evolution

NASA Astrophysics Data System (ADS)

Drissen-Silva, Marcus Vinicius; Rabelo, Ricardo José

VE evolution deals with problems that happen during the VE operation and that put on risk planned results. This requires the application of problem-solving mechanisms to guarantee the construction of a new but feasible VE plan. Grounded on Project Management and Decision Support Systems foundations, this paper proposes a distributed collaborative decision support system to manage the VE evolution. Its main rationale is that VE’s members are autonomous and hence that all the affected partners should discuss about the necessary changes on the current VE’s plan. In the proposed approach, this discussion is guided by a decision protocol, and the impact of decisions can be evaluated. Results of a first prototype implementation are presented and discussed, with a special focus on the part which regulates the argumentation, voting and comparison of possible solutions.

On Developing a Taxonomy for Multidisciplinary Design Optimization: A Decision-Based Perspective

NASA Technical Reports Server (NTRS)

Lewis, Kemper; Mistree, Farrokh

1995-01-01

In this paper, we approach MDO from a Decision-Based Design (DBD) perspective and explore classification schemes for designing complex systems and processes. Specifically, we focus on decisions, which are only a small portion of the Decision Support Problem (DSP) Technique, our implementation of DBD. We map coupled nonhierarchical and hierarchical representations from the DSP Technique into the Balling-Sobieski (B-S) framework (Balling and Sobieszczanski-Sobieski, 1994), and integrate domain-independent linguistic terms to complete our taxonomy. Application of DSPs to the design of complex, multidisciplinary systems include passenger aircraft, ships, damage tolerant structural and mechanical systems, and thermal energy systems. In this paper we show that Balling-Sobieski framework is consistent with that of the Decision Support Problem Technique through the use of linguistic entities to describe the same type of formulations. We show that the underlying linguistics of the solution approaches are the same and can be coalesced into a homogeneous framework with which to base the research, application, and technology MDO upon. We introduce, in the Balling-Sobieski framework, examples of multidisciplinary design, namely, aircraft, damage tolerant structural and mechanical systems, and thermal energy systems.

A decision-support tool to predict spray deposition of insecticides in commercial potato fields and its implications for their performance.

PubMed

Nansen, Christian; Vaughn, Kathy; Xue, Yingen; Rush, Charlie; Workneh, Fekede; Goolsby, John; Troxclair, Noel; Anciso, Juan; Gregory, Ashley; Holman, Daniel; Hammond, Abby; Mirkov, Erik; Tantravahi, Pratyusha; Martini, Xavier

2011-08-01

Approximately US $1.3 billion is spent each year on insecticide applications in major row crops. Despite this significant economic importance, there are currently no widely established decision-support tools available to assess suitability of spray application conditions or of the predicted quality or performance of a given commercial insecticide applications. We conducted a field study, involving 14 commercial spray applications with either fixed wing airplane (N=8) or ground rig (N=6), and we used environmental variables as regression fits to obtained spray deposition (coverage in percentage). We showed that (1) ground rig applications provided higher spray deposition than aerial applications, (2) spray deposition was lowest in the bottom portion of the canopy, (3) increase in plant height reduced spray deposition, (4) wind speed increased spray deposition, and (5) higher ambient temperatures and dew point increased spray deposition. Potato psyllid, Bactericera cockerelli (Sulc) (Hemiptera: Triozidae), mortality increased asymptotically to approximately 60% in response to abamectin spray depositions exceeding around 20%, whereas mortality of psyllid adults reached an asymptotic response approximately 40% when lambda-cyhalothrin/thiamethoxam spray deposition exceeded 30%. A spray deposition support tool was developed (http://pilcc.tamu.edu/) that may be used to make decisions regarding (1) when is the best time of day to conduct spray applications and (2) selecting which insecticide to spray based on expected spray deposition. The main conclusion from this analysis is that optimization of insecticide spray deposition should be considered a fundamental pillar of successful integrated pest management programs to increase efficiency of sprays (and therefore reduce production costs) and to reduce risk of resistance development in target pest populations.

Decision support system development at the Upper Midwest Environmental Sciences Center

USGS Publications Warehouse

Fox, Timothy J.; Nelson, J. C.; Rohweder, Jason J.

2014-01-01

A Decision Support System (DSS) can be defined in many ways. The working definition used by the U.S. Geological Survey Upper Midwest Environmental Sciences Center (UMESC) is, “A spatially based computer application or data that assists a researcher or manager in making decisions.” This is quite a broad definition—and it needs to be, because the possibilities for types of DSSs are limited only by the user group and the developer’s imagination. There is no one DSS; the types of DSSs are as diverse as the problems they help solve. This diversity requires that DSSs be built in a variety of ways, using the most appropriate methods and tools for the individual application. The skills of potential DSS users vary widely as well, further necessitating multiple approaches to DSS development. Some small, highly trained user groups may want a powerful modeling tool with extensive functionality at the expense of ease of use. Other user groups less familiar with geographic information system (GIS) and spatial data may want an easy-to-use application for a nontechnical audience. UMESC has been developing DSSs for almost 20 years. Our DSS developers offer our partners a wide variety of technical skills and development options, ranging from the most simple Web page or small application to complex modeling application development.

Data Farming and Defense Applications

NASA Technical Reports Server (NTRS)

Horne, Gary; Meyer, Ted

2011-01-01

.Data farm,ing uses simulation modeling, high performance computing, experimental design and analysis to examine questions of interest with large possibility spaces. This methodology allows for the examination of whole landscapes of potential outcomes and provides the capability of executing enough experiments so that outliers might be captured and examined for insights. It can be used to conduct sensitivity studies, to support validation and verification of models, to iteratively optimize outputs using heuristic search and discovery, and as an aid to decision-makers in understanding complex relationships of factors. In this paper we describe efforts at the Naval Postgraduate School in developing these new and emerging tools. We also discuss data farming in the context of application to questions inherent in military decision-making. The particular application we illustrate here is social network modeling to support the countering of improvised explosive devices.

INRstar: computerised decision support software for anticoagulation management in primary care.

PubMed

Jones, Robert Treharne; Sullivan, Mark; Barrett, David

2005-01-01

Computerised decision support software (CDSS) for anticoagulation management has become established practice in the UK, offering significant advantages for patients and clinicians over traditional methods of dose calculation. The New GMS Contract has been partly responsible for this shift of management from secondary to primary care, in which INRstar has been the market leader for many years. In September 2004, INRstar received the John Perry Prize, awarded by the PHCSG for excellence and innovation in medical applications of information technology.

Institutionalizing Telemedicine Applications: The Challenge of Legitimizing Decision-Making

PubMed Central

Lettieri, Emanuele

2011-01-01

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements— rationality, fairness, and efficiency—that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications—benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators’ perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed. PMID:21955510

Applicability of aquifer impact models to support decisions at CO 2 sequestration sites

DOE PAGES

Keating, Elizabeth; Bacon, Diana; Carroll, Susan; ...

2016-07-25

The National Risk Assessment Partnership has developed a suite of tools to assess and manage risk at CO 2 sequestration sites. This capability includes polynomial or look-up table based reduced-order models (ROMs) that predict the impact of CO 2 and brine leaks on overlying aquifers. The development of these computationally-efficient models and the underlying reactive transport simulations they emulate has been documented elsewhere (Carroll et al., 2014a; Carroll et al., 2014b; Dai et al., 2014 ; Keating et al., 2016). Here in this paper, we seek to demonstrate applicability of ROM-based analysis by considering what types of decisions and aquifermore » types would benefit from the ROM analysis. We present four hypothetical examples where applying ROMs, in ensemble mode, could support decisions during a geologic CO 2 sequestration project. These decisions pertain to site selection, site characterization, monitoring network evaluation, and health impacts. In all cases, we consider potential brine/CO 2 leak rates at the base of the aquifer to be uncertain. We show that derived probabilities provide information relevant to the decision at hand. Although the ROMs were developed using site-specific data from two aquifers (High Plains and Edwards), the models accept aquifer characteristics as variable inputs and so they may have more broad applicability. We conclude that pH and TDS predictions are the most transferable to other aquifers based on the analysis of the nine water quality metrics (pH, TDS, 4 trace metals, 3 organic compounds). Guidelines are presented for determining the aquifer types for which the ROMs should be applicable.« less

Fire science application and integration in support of decision making

Treesearch

Tom Zimmerman

2011-01-01

Wildland fire management in the United States has historically been a challenging and complex program governed by a multitude of factors including situational status, objectives, operational capability, science and technology, and changes and advances in all these factors. The improvement and advancement of risk-informed decision making has the potential to improve...

NED-2: A decision support system for integrated forest ecosystem management

Treesearch

Mark J. Twery; Peter D. Knopp; Scott A. Thomasma; H. Michael Rauscher; Donald E. Nute; Walter D. Potter; Frederick Maier; Jin Wang; Mayukh Dass; Hajime Uchiyama; Astrid Glende; Robin E. Hoffman

2005-01-01

NED-2 is a Windows-based system designed to improve project-level planning and decision making by providing useful and scientifically sound information to natural resource managers. Resources currently addressed include visual quality, ecology, forest health, timber, water, and wildlife. NED-2 expands on previous versions of NED applications by integrating treatment...

NED-2: a decision support system for integrated forest ecosystem management

Treesearch

Mark J. Twery; Peter D. Knopp; Scott A. Thomasma; H. Michael Rauscher; Donald E. Nute; Walter D. Potter; Frederick Maier; Jin Wang; Mayukh Dass; Hajime Uchiyama; Astrid Glende; Robin E. Hoffman

2005-01-01

NED-2 is a Windows-based system designed to improve project-level planning and decision making by providing useful and scientifically sound information to natural resource managers. Resources currently addressed include visual quality, ecology, forest health, timber, water, and wildlife. NED-2 expands on previous versions of NED applications by integrating treatment...

Geographic information systems applications for climate change decision-making : Peer exchange summary report, Atlanta, Georgia, September 26-27, 2011

DOT National Transportation Integrated Search

2011-09-30

On September 26-27, 2011, the FHWA's Office of Planning sponsored a 1.5 day peer exchange focusing on the use of GIS to support transportation related climate change decisions. This report provides overviews of the presentations given at the peer exc...

A knowledge-based patient assessment system: conceptual and technical design.

PubMed Central

Reilly, C. A.; Zielstorff, R. D.; Fox, R. L.; O'Connell, E. M.; Carroll, D. L.; Conley, K. A.; Fitzgerald, P.; Eng, T. K.; Martin, A.; Zidik, C. M.; Segal, M.

2000-01-01

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs. Object-oriented methods were used to elicit functional requirements and to model the proposed system. A tools-based development approach is being used to facilitate rapid development and easy modification of assessment items and rules for decision support. Criteria for evaluation include perceived utility by clinician users, validity of decision support rules, time spent recording assessments, and perceived utility of aggregate reports for quality monitoring. PMID:11079970

A Flight Deck Decision Support Tool for Autonomous Airborne Operations

NASA Technical Reports Server (NTRS)

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

2002-01-01

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

A knowledge-based patient assessment system: conceptual and technical design.

PubMed

Reilly, C A; Zielstorff, R D; Fox, R L; O'Connell, E M; Carroll, D L; Conley, K A; Fitzgerald, P; Eng, T K; Martin, A; Zidik, C M; Segal, M

2000-01-01

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs. Object-oriented methods were used to elicit functional requirements and to model the proposed system. A tools-based development approach is being used to facilitate rapid development and easy modification of assessment items and rules for decision support. Criteria for evaluation include perceived utility by clinician users, validity of decision support rules, time spent recording assessments, and perceived utility of aggregate reports for quality monitoring.

An IT Architecture for Systems Medicine.

PubMed

Ganzinger, Matthias; Gietzelt, Matthias; Karmen, Christian; Firnkorn, Daniel; Knaup, Petra

2015-01-01

Systems medicine aims to support treatment of complex diseases like cancer by integrating all available data for the disease. To provide such a decision support in clinical practice, a suitable IT architecture is necessary. We suggest a generic architecture comprised of the following three layers: data representation, decision support, and user interface. For the systems medicine research project "Clinically-applicable, omics-based assessment of survival, side effects, and targets in multiple myeloma" (CLIOMMICS) we developed a concrete instance of the generic architecture. We use i2b2 for representing the harmonized data. Since no deterministic model exists for multiple myeloma we use case-based reasoning for decision support. For clinical practice, visualizations of the results must be intuitive and clear. At the same time, they must communicate the uncertainty immanent in stochastic processes. Thus, we develop a specific user interface for systems medicine based on the web portal software Liferay.

On implementing clinical decision support: achieving scalability and maintainability by combining business rules and ontologies.

PubMed

Kashyap, Vipul; Morales, Alfredo; Hongsermeier, Tonya

2006-01-01

We present an approach and architecture for implementing scalable and maintainable clinical decision support at the Partners HealthCare System. The architecture integrates a business rules engine that executes declarative if-then rules stored in a rule-base referencing objects and methods in a business object model. The rules engine executes object methods by invoking services implemented on the clinical data repository. Specialized inferences that support classification of data and instances into classes are identified and an approach to implement these inferences using an OWL based ontology engine is presented. Alternative representations of these specialized inferences as if-then rules or OWL axioms are explored and their impact on the scalability and maintenance of the system is presented. Architectural alternatives for integration of clinical decision support functionality with the invoking application and the underlying clinical data repository; and their associated trade-offs are discussed and presented.

Analysis of the process of representing clinical statements for decision-support applications: a comparison of openEHR archetypes and HL7 virtual medical record.

PubMed

González-Ferrer, A; Peleg, M; Marcos, M; Maldonado, J A

2016-07-01

Delivering patient-specific decision-support based on computer-interpretable guidelines (CIGs) requires mapping CIG clinical statements (data items, clinical recommendations) into patients' data. This is most effectively done via intermediate data schemas, which enable querying the data according to the semantics of a shared standard intermediate schema. This study aims to evaluate the use of HL7 virtual medical record (vMR) and openEHR archetypes as intermediate schemas for capturing clinical statements from CIGs that are mappable to electronic health records (EHRs) containing patient data and patient-specific recommendations. Using qualitative research methods, we analyzed the encoding of ten representative clinical statements taken from two CIGs used in real decision-support systems into two health information models (openEHR archetypes and HL7 vMR instances) by four experienced informaticians. Discussion among the modelers about each case study example greatly increased our understanding of the capabilities of these standards, which we share in this educational paper. Differing in content and structure, the openEHR archetypes were found to contain a greater level of representational detail and structure while the vMR representations took fewer steps to complete. The use of openEHR in the encoding of CIG clinical statements could potentially facilitate applications other than decision-support, including intelligent data analysis and integration of additional properties of data items from existing EHRs. On the other hand, due to their smaller size and fewer details, the use of vMR potentially supports quicker mapping of EHR data into clinical statements.

Using mobile health technology to deliver decision support for self-monitoring after lung transplantation.

PubMed

Jiang, Yun; Sereika, Susan M; DeVito Dabbs, Annette; Handler, Steven M; Schlenk, Elizabeth A

2016-10-01

Lung transplant recipients (LTR) experience problems recognizing and reporting critical condition changes during their daily health self-monitoring. Pocket PATH(®), a mobile health application, was designed to provide automatic feedback messages to LTR to guide decisions for detecting and reporting critical values of health indicators. To examine the degree to which LTR followed decision support messages to report recorded critical values, and to explore predictors of appropriately following technology decision support by reporting critical values during the first year after transplantation. A cross-sectional correlational study was conducted to analyze existing data from 96 LTR who used the Pocket PATH for daily health self-monitoring. When a critical value is entered, the device automatically generated a feedback message to guide LTR about when and what to report to their transplant coordinators. Their socio-demographics and clinical characteristics were obtained before discharge. Their use of Pocket PATH for health self-monitoring during 12 months was categorized as low (≤25% of days), moderate (>25% to ≤75% of days), and high (>75% of days) use. Following technology decision support was defined by the total number of critical feedback messages appropriately handled divided by the total number of critical feedback messages generated. This variable was dichotomized by whether or not all (100%) feedback messages were appropriately followed. Binary logistic regression was used to explore predictors of appropriately following decision support. Of the 96 participants, 53 had at least 1 critical feedback message generated during 12 months. Of these 53 participants, the average message response rate was 90% and 33 (62%) followed 100% decision support. LTR who moderately used Pocket PATH (n=23) were less likely to follow technology decision support than the high (odds ratio [OR]=0.11, p=0.02) and low (OR=0.04, p=0.02) use groups. The odds of following decision support were reduced in LTR whose income met basic needs (OR=0.01, p=0.01) or who had longer hospital stays (OR=0.94, p=0.004). A significant interaction was found between gender and past technology experience (OR=0.21, p=0.03), suggesting that with increased past technology experience, the odds of following decision support to report all critical values decreased in men but increased in women. The majority of LTR responded appropriately to mobile technology-based decision support for reporting recorded critical values. Appropriately following technology decision support was associated with gender, income, experience with technology, length of hospital stay, and frequency of use of technology for self-monitoring. Clinicians should monitor LTR, who are at risk for poor reporting of recorded critical values, more vigilantly even when LTR are provided with mobile technology decision support. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The National Aeronautics and Space Administration's Earth Science Applications Program: Exploring Partnerships to Enhance Decision Making in Public Health Practice

NASA Technical Reports Server (NTRS)

Vann, Timi S.; Venezia, Robert A.

2002-01-01

The National Aeronautics and Space Administration (NASA), Earth Science Enterprise is engaged in applications of NASA Earth science and remote sensing technologies for public health. Efforts are focused on establishing partnerships with those agencies and organizations that have responsibility for protecting the Nation's Health. The program's goal is the integration of NASA's advanced data and technology for enhanced decision support in the areas of disease surveillance and environmental health. A focused applications program, based on understanding partner issues and requirements, has the potential to significantly contribute to more informed decision making in public health practice. This paper intends to provide background information on NASA's investment in public health and is a call for partnership with the larger practice community.

GIS, modeling, and politics: on the tensions of collaborative decision support.

PubMed

Ramsey, Kevin

2009-05-01

A tension exists at the heart of efforts to support collaboration with GIS. Many scholars and practitioners seek to support two separate objectives: (1) problem solving and (2) the exploration of diverse problem understandings. GIS applications designed for problem solving often pre-define the problem space by structuring the kind of information that can be considered or the way in which the problem is conceptualized. In doing so, they necessarily privilege particular perspectives and understandings of the problem while marginalizing others. As a result, these initiatives undermine their second objective. This is problematic in the context of contentious environmental decisions which have broad-reaching impacts on people with diverse perspectives and interests. In such contexts, I argue that equitable collaboration is impossible without first emphasizing the exploration of diverse problem understandings. I support this argument theoretically by turning to the literatures on collaborative planning and spatial decision support, and empirically in my analysis of a case study of an effort to construct a GIS for supporting collaborative water resource management in rural Idaho. Reflecting upon the case, I provide a set of recommendations to those seeking to better negotiate the tensions of supporting collaboration with GIS in the context of contentious environmental and natural resource decisions.

Simple Additive Weighting to Diagnose Rabbit Disease

NASA Astrophysics Data System (ADS)

Ramadiani; Marissa, Dyna; Jundillah, Muhammad Labib; Azainil; Hatta, Heliza Rahmania

2018-02-01

Rabbit is one of the many pets maintained by the general public in Indonesia. Like other pet, rabbits are also susceptible to various diseases. Society in general does not understand correctly the type of rabbit disease and the way of treatment. To help care for sick rabbits it is necessary a decision support system recommendation diagnosis of rabbit disease. The purpose of this research is to make the application of rabbit disease diagnosis system so that can help user in taking care of rabbit. This application diagnoses the disease by tracing the symptoms and calculating the recommendation of the disease using Simple Additive Weighting method. This research produces a web-based decision support system that is used to help rabbit breeders and the general public.

Data warehousing: toward knowledge management.

PubMed

Shams, K; Farishta, M

2001-02-01

With rapid changes taking place in the practice and delivery of health care, decision support systems have assumed an increasingly important role. More and more health care institutions are deploying data warehouse applications as decision support tools for strategic decision making. By making the right information available at the right time to the right decision makers in the right manner, data warehouses empower employees to become knowledge workers with the ability to make the right decisions and solve problems, creating strategic leverage for the organization. Health care management must plan and implement data warehousing strategy using a best practice approach. Through the power of data warehousing, health care management can negotiate bettermanaged care contracts based on the ability to provide accurate data on case mix and resource utilization. Management can also save millions of dollars through the implementation of clinical pathways in better resource utilization and changing physician behavior to best practices based on evidence-based medicine.

The Flash Environmental Assessment Tool: worldwide first aid for chemical accidents response, pro action, prevention and preparedness.

PubMed

Posthuma, Leo; Wahlstrom, Emilia; Nijenhuis, René; Dijkens, Chris; de Zwart, Dick; van de Meent, Dik; Hollander, Anne; Brand, Ellen; den Hollander, Henri A; van Middelaar, Johan; van Dijk, Sander; Hall, E F; Hoffer, Sally

2014-11-01

The United Nations response mechanism to environmental emergencies requested a tool to support disaster assessment and coordination actions by United Nations Disaster Assessment and Coordination (UNDAC) teams. The tool should support on-site decision making when substantial chemical emissions affect human health directly or via the environment and should be suitable for prioritizing impact reduction management options under challenging conditions worldwide. To answer this need, the Flash Environmental Assessment Tool (FEAT) was developed and the scientific and practical underpinning and application of this tool are described in this paper. FEAT consists of a printed decision framework and lookup tables, generated by combining the scientific data on chemicals, exposure pathways and vulnerabilities with the pragmatic needs of emergency field teams. Application of the tool yields information that can help prioritize impact reduction measures. The first years of use illustrated the usefulness of the tool as well as suggesting additional uses and improvements. An additional use is application of the back-office tool (Hazard Identification Tool, HIT), the results of which aid decision-making by the authorities of affected countries and the preparation of field teams for on-site deployment. Another extra use is in disaster pro action and prevention. In this case, the application of the tool supports safe land-use planning and improved technical design of chemical facilities. UNDAC teams are trained to use the tool after large-scale sudden onset natural disasters. Copyright © 2014 Elsevier Ltd. All rights reserved.

Feasibility study on the use of groupware support for NASA source evaluation boards

NASA Technical Reports Server (NTRS)

Bishop, Peter C.; Yoes, Cissy

1991-01-01

Groupware is a class of computer based systems that support groups engaged in a common task (or goal) and that provide an interface to a shared environment. A potential application for groupware is the source evaluation board (SEB) process used in the procurement of government contracts. This study was undertaken to (1) identify parts of the SEB process which are candidates for groupware supports; and (2) identify tools which could be used to support the candidate process. Two processes of the SEB were identified as good candidates for groupware support: (1) document generation - a coordination and communication process required to present and document the findings of an SEB; and (2) group decision making - a highly analytical and integrative decision process requiring a clear and supportable outcome.

47 CFR 54.705 - Committees of the Administrator's Board of Directors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... decisions concerning: (i) How the Administrator projects demand for the schools and libraries support... libraries support mechanism; (iii) Administration of the application process, including activities to ensure... be applied to services purchased by eligible schools and libraries; (x) Performance of audits of...

Putting cognitive psychology to work: Improving decision-making in the medical encounter.

PubMed

Schwab, Abraham P

2008-12-01

Empirical research in social psychology has provided robust support for the accuracy of the heuristics and biases approach to human judgment. This research, however, has not been systematically investigated regarding its potential applications for specific health care decision-makers. This paper makes the case for investigating the heuristics and biases approach in the patient-physician relationship and recommends strategic empirical research. It is argued that research will be valuable for particular decisions in the clinic and for examining and altering the background conditions of patient and physician decision-making.

The Watershed and River Systems Management Program: Decision Support for Water- and Environmental-Resource Management

NASA Astrophysics Data System (ADS)

Leavesley, G.; Markstrom, S.; Frevert, D.; Fulp, T.; Zagona, E.; Viger, R.

2004-12-01

Increasing demands for limited fresh-water supplies, and increasing complexity of water-management issues, present the water-resource manager with the difficult task of achieving an equitable balance of water allocation among a diverse group of water users. The Watershed and River System Management Program (WARSMP) is a cooperative effort between the U.S. Geological Survey (USGS) and the Bureau of Reclamation (BOR) to develop and deploy a database-centered, decision-support system (DSS) to address these multi-objective, resource-management problems. The decision-support system couples the USGS Modular Modeling System (MMS) with the BOR RiverWare tools using a shared relational database. MMS is an integrated system of computer software that provides a research and operational framework to support the development and integration of a wide variety of hydrologic and ecosystem models, and their application to water- and ecosystem-resource management. RiverWare is an object-oriented reservoir and river-system modeling framework developed to provide tools for evaluating and applying water-allocation and management strategies. The modeling capabilities of MMS and Riverware include simulating watershed runoff, reservoir inflows, and the impacts of resource-management decisions on municipal, agricultural, and industrial water users, environmental concerns, power generation, and recreational interests. Forecasts of future climatic conditions are a key component in the application of MMS models to resource-management decisions. Forecast methods applied in MMS include a modified version of the National Weather Service's Extended Streamflow Prediction Program (ESP) and statistical downscaling from atmospheric models. The WARSMP DSS is currently operational in the Gunnison River Basin, Colorado; Yakima River Basin, Washington; Rio Grande Basin in Colorado and New Mexico; and Truckee River Basin in California and Nevada.

An Exploration of Closure as a Factor Influencing Group Member Satisfaction: Implications for Applications of Group Support Technology in Education.

ERIC Educational Resources Information Center

Small, Ruth V.; Venkatesh, Murali

Research that identifies factors that facilitate information processing and enhance performance without reducing group confidence and decision satisfaction may influence future development of groupwork systems. This paper contains a review of the literature on cognitive and motivational issues in both group decision-making and learning contexts…

Applying predictive analytics to develop an intelligent risk detection application for healthcare contexts.

PubMed

Moghimi, Fatemeh Hoda; Cheung, Michael; Wickramasinghe, Nilmini

2013-01-01

Healthcare is an information rich industry where successful outcomes require the processing of multi-spectral data and sound decision making. The exponential growth of data and big data issues coupled with a rapid increase of service demands in healthcare contexts today, requires a robust framework enabled by IT (information technology) solutions as well as real-time service handling in order to ensure superior decision making and successful healthcare outcomes. Such a context is appropriate for the application of real time intelligent risk detection decision support systems using predictive analytic techniques such as data mining. To illustrate the power and potential of data science technologies in healthcare decision making scenarios, the use of an intelligent risk detection (IRD) model is proffered for the context of Congenital Heart Disease (CHD) in children, an area which requires complex high risk decisions that need to be made expeditiously and accurately in order to ensure successful healthcare outcomes.

Verification and Validation of NASA-Supported Enhancements to PECAD's Decision Support Tools

NASA Technical Reports Server (NTRS)

McKellipo, Rodney; Ross, Kenton W.

2006-01-01

The NASA Applied Sciences Directorate (ASD), part of the Earth-Sun System Division of NASA's Science Mission Directorate, has partnered with the U.S. Department of Agriculture (USDA) to enhance decision support in the area of agricultural efficiency-an application of national importance. The ASD integrated the results of NASA Earth science research into USDA decision support tools employed by the USDA Foreign Agricultural Service (FAS) Production Estimates and Crop Assessment Division (PECAD), which supports national decision making by gathering, analyzing, and disseminating global crop intelligence. Verification and validation of the following enhancements are summarized: 1) Near-real-time Moderate Resolution Imaging Spectroradiometer (MODIS) products through PECAD's MODIS Image Gallery; 2) MODIS Normalized Difference Vegetation Index (NDVI) time series data through the USDA-FAS MODIS NDVI Database; and 3) Jason-1 and TOPEX/Poseidon lake level estimates through PECAD's Global Reservoir and Lake Monitor. Where possible, each enhanced product was characterized for accuracy, timeliness, and coverage, and the characterized performance was compared to PECAD operational requirements. The MODIS Image Gallery and the GRLM are more mature and have achieved a semi-operational status, whereas the USDA-FAS MODIS NDVI Database is still evolving and should be considered

Data Mashups: Potential Contribution to Decision Support on Climate Change and Health

PubMed Central

Fleming, Lora E.; Haines, Andy; Golding, Brian; Kessel, Anthony; Cichowska, Anna; Sabel, Clive E.; Depledge, Michael H.; Sarran, Christophe; Osborne, Nicholas J.; Whitmore, Ceri; Cocksedge, Nicola; Bloomfield, Daniel

2014-01-01

Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This paper outlines the challenges and opportunities presented by advances in data collection, storage, analysis, and access, particularly focusing on “data mashups”. These data mashups are integrations of different types and sources of data, frequently using open application programming interfaces and data sources, to produce enriched results that were not necessarily the original reason for assembling the raw source data. As an illustration of this potential, this paper describes a recently funded initiative to create such a facility in the UK for use in decision support around climate change and health, and provides examples of suitable sources of data and the purposes to which they can be directed, particularly for policy makers and public health decision makers. PMID:24499879

Data mashups: potential contribution to decision support on climate change and health.

PubMed

Fleming, Lora E; Haines, Andy; Golding, Brian; Kessel, Anthony; Cichowska, Anna; Sabel, Clive E; Depledge, Michael H; Sarran, Christophe; Osborne, Nicholas J; Whitmore, Ceri; Cocksedge, Nicola; Bloomfield, Daniel

2014-02-04

Linking environmental, socioeconomic and health datasets provides new insights into the potential associations between climate change and human health and wellbeing, and underpins the development of decision support tools that will promote resilience to climate change, and thus enable more effective adaptation. This paper outlines the challenges and opportunities presented by advances in data collection, storage, analysis, and access, particularly focusing on "data mashups". These data mashups are integrations of different types and sources of data, frequently using open application programming interfaces and data sources, to produce enriched results that were not necessarily the original reason for assembling the raw source data. As an illustration of this potential, this paper describes a recently funded initiative to create such a facility in the UK for use in decision support around climate change and health, and provides examples of suitable sources of data and the purposes to which they can be directed, particularly for policy makers and public health decision makers.

Design and implementation of the standards-based personal intelligent self-management system (PICS).

PubMed

von Bargen, Tobias; Gietzelt, Matthias; Britten, Matthias; Song, Bianying; Wolf, Klaus-Hendrik; Kohlmann, Martin; Marschollek, Michael; Haux, Reinhold

2013-01-01

Against the background of demographic change and a diminishing care workforce there is a growing need for personalized decision support. The aim of this paper is to describe the design and implementation of the standards-based personal intelligent care systems (PICS). PICS makes consistent use of internationally accepted standards such as the Health Level 7 (HL7) Arden syntax for the representation of the decision logic, HL7 Clinical Document Architecture for information representation and is based on a open-source service-oriented architecture framework and a business process management system. Its functionality is exemplified for the application scenario of a patient suffering from congestive heart failure. Several vital signs sensors provide data for the decision support system, and a number of flexible communication channels are available for interaction with patient or caregiver. PICS is a standards-based, open and flexible system enabling personalized decision support. Further development will include the implementation of components on small computers and sensor nodes.

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.

A preliminary psychometric evaluation of the eight-item cognitive load scale.

PubMed

Pignatiello, Grant A; Tsivitse, Emily; Hickman, Ronald L

2018-04-01

The aim of this article is to report the psychometric properties of the eight-item cognitive load scale. According to cognitive load theory, the formatting and delivery of healthcare education influences the degree to which patients and/or family members can engage their working memory systems for learning. However, despite its relevance, cognitive load has not yet been evaluated among surrogate decision makers exposed to electronic decision support for healthcare decisions. To date, no psychometric analyses of instruments evaluating cognitive load have been reported within healthcare settings. A convenience sample of 62 surrogate decision makers for critically ill patients were exposed to one of two healthcare decision support interventions were recruited from four intensive care units at a tertiary medical center in Northeast Ohio. Participants were administered a battery of psychosocial instruments and the eight-item cognitive load scale (CLS). The CLS demonstrated a bidimensional factor structure with acceptable discriminant validity and internal consistency reliability (Cronbach's α = 0.75 and 0.89). The CLS is a psychometrically sound instrument that may be used in the evaluation of decision support among surrogate decision makers of the critically ill. The authors recommend application of the cognitive load scale in the evaluation and development of healthcare education and interventions. Copyright © 2018 Elsevier Inc. All rights reserved.

Identifying Cost-Effective Water Resources Management Strategies: Watershed Management Optimization Support Tool (WMOST)

EPA Science Inventory

The Watershed Management Optimization Support Tool (WMOST) is a public-domain software application designed to aid decision makers with integrated water resources management. The tool allows water resource managers and planners to screen a wide-range of management practices for c...

A review of fuzzy cognitive maps in medicine: Taxonomy, methods, and applications.

PubMed

Amirkhani, Abdollah; Papageorgiou, Elpiniki I; Mohseni, Akram; Mosavi, Mohammad R

2017-04-01

A high percentage of medical errors, committed because of physician's lack of experience, huge volume of data to be analyzed, and inaccessibility to medical records of previous patients, can be reduced using computer-aided techniques. Therefore, designing more efficient medical decision-support systems (MDSSs) to assist physicians in decision-making is crucially important. Through combining the properties of fuzzy logic and neural networks, fuzzy cognitive maps (FCMs) are among the latest, most efficient, and strongest artificial intelligence techniques for modeling complex systems. This review study is conducted to identify different FCM structures used in MDSS designs. The best structure for each medical application can be introduced by studying the properties of FCM structures. This paper surveys the most important decision- making methods and applications of FCMs in the medical field in recent years. To investigate the efficiency and capability of different FCM models in designing MDSSs, medical applications are categorized into four key areas: decision-making, diagnosis, prediction, and classification. Also, various diagnosis and decision support problems addressed by FCMs in recent years are reviewed with the goal of introducing different types of FCMs and determining their contribution to the improvements made in the fields of medical diagnosis and treatment. In this survey, a general trend for future studies in this field is provided by analyzing various FCM structures used for medical purposes, and the results from each category. Due to the unique specifications of FCMs in integrating human knowledge and experience with computer-aided techniques, they are among practical instruments for MDSS design. In the not too distant future, they will have a significant role in medical sciences. Copyright © 2017 Elsevier B.V. All rights reserved.

Information and decision support needs in patients with type 2 diabetes.

PubMed

Weymann, Nina; Härter, Martin; Dirmaier, Jörg

2016-03-01

Diabetes and its sequelae cause a growing burden of morbidity and mortality. For many patients living with diabetes, the Internet is an important source of health information and support. In the course of the development of an Interactive Health Communication Application, combining evidence-based information with behavior change and decision support, we assessed the characteristics, information, and decision support needs of patients with type 2 diabetes.The needs assessment was performed in two steps. First, we conducted semi-structured interviews with 10 patients and seven physicians. In the second step, we developed a self-assessment questionnaire based on the results of the interviews and administered it to a new and larger sample of diabetes patients (N = 178). The questionnaire comprised four main sections: (1) Internet use and Internet experience, (2) diabetes knowledge, (3) relevant decisions and decision preferences, and (4) online health information needs. Descriptive data analyses were performed.In the questionnaire study, the patient sample was heterogeneous in terms of age, time since diagnosis, and glycemic control. (1) Most participants (61.7%) have searched the web for health information at least once. The majority (62%) of those who have used the web use it at least once per month. (2) Diabetes knowledge was scarce: Only a small percentage (1.9%) of the respondents answered all items of the knowledge questionnaire correctly. (3) The most relevant treatment decisions concerned glycemic control, oral medication, and acute complications. The most difficult treatment decision was whether to start insulin treatment. Of the respondents, 69.4 percent thought that medical decisions should be made by them and their doctor together. (4) The most important information needs concerned sequelae of diabetes, blood glucose control, and basic diabetes information.The Internet seems to be a feasible way to reach people with type 2 diabetes. The heterogeneity of the sample, especially with respect to diabetes knowledge, makes it clear that the projected Interactive Health Communication Application should tailor the content to the individual user, taking account of individual characteristics and preferences. A wide range of topics should be covered. Special attention should be paid to the advantages and disadvantages of insulin treatment and the fears and hopes associated with it. These results were taken into account when developing the Interactive Health Communication Application that is currently being evaluated in a randomized controlled trial (International Clinical Trials Registry DRKS00003322). © The Author(s) 2014.

A model-driven privacy compliance decision support for medical data sharing in Europe.

PubMed

Boussi Rahmouni, H; Solomonides, T; Casassa Mont, M; Shiu, S; Rahmouni, M

2011-01-01

Clinical practitioners and medical researchers often have to share health data with other colleagues across Europe. Privacy compliance in this context is very important but challenging. Automated privacy guidelines are a practical way of increasing users' awareness of privacy obligations and help eliminating unintentional breaches of privacy. In this paper we present an ontology-plus-rules based approach to privacy decision support for the sharing of patient data across European platforms. We use ontologies to model the required domain and context information about data sharing and privacy requirements. In addition, we use a set of Semantic Web Rule Language rules to reason about legal privacy requirements that are applicable to a specific context of data disclosure. We make the complete set invocable through the use of a semantic web application acting as an interactive privacy guideline system can then invoke the full model in order to provide decision support. When asked, the system will generate privacy reports applicable to a specific case of data disclosure described by the user. Also reports showing guidelines per Member State may be obtained. The advantage of this approach lies in the expressiveness and extensibility of the modelling and inference languages adopted and the ability they confer to reason with complex requirements interpreted from high level regulations. However, the system cannot at this stage fully simulate the role of an ethics committee or review board.

Environmental Geophysics

EPA Pesticide Factsheets

The Environmental Geophysics website features geophysical methods, terms and references; forward and inverse geophysical models for download; and a decision support tool to guide geophysical method selection for a variety of environmental applications.

Agent-Centric Approach for Cybersecurity Decision-Support with Partial Observability

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

Tipireddy, Ramakrishna; Chatterjee, Samrat; Paulson, Patrick R.

Generating automated cyber resilience policies for real-world settings is a challenging research problem that must account for uncertainties in system state over time and dynamics between attackers and defenders. In addition to understanding attacker and defender motives and tools, and identifying “relevant” system and attack data, it is also critical to develop rigorous mathematical formulations representing the defender’s decision-support problem under uncertainty. Game-theoretic approaches involving cyber resource allocation optimization with Markov decision processes (MDP) have been previously proposed in the literature. Moreover, advancements in reinforcement learning approaches have motivated the development of partially observable stochastic games (POSGs) in various multi-agentmore » problem domains with partial information. Recent advances in cyber-system state space modeling have also generated interest in potential applicability of POSGs for cybersecurity. However, as is the case in strategic card games such as poker, research challenges using game-theoretic approaches for practical cyber defense applications include: 1) solving for equilibrium and designing efficient algorithms for large-scale, general problems; 2) establishing mathematical guarantees that equilibrium exists; 3) handling possible existence of multiple equilibria; and 4) exploitation of opponent weaknesses. Inspired by advances in solving strategic card games while acknowledging practical challenges associated with the use of game-theoretic approaches in cyber settings, this paper proposes an agent-centric approach for cybersecurity decision-support with partial system state observability.« less

HIGH-RESOLUTION SPATIAL MODELING OF DAILY WEATHER ELEMENTS FOR A CATCHMENT IN THE OREGON CASCADE MOUNTAINS, UNITED STATES

EPA Science Inventory

High-quality, daily meteorological data at high spatial resolution are essential for a variety of hydrologic and ecological modeling applications that support environmental risk assessments and decision making. This paper describes the development, application, and assessment of ...

A GIS-based decision support system for regional eco-security assessment and its application on the Tibetan Plateau.

PubMed

Xiaodan, Wang; Xianghao, Zhong; Pan, Gao

2010-10-01

Regional eco-security assessment is an intricate, challenging task. In previous studies, the integration of eco-environmental models and geographical information systems (GIS) usually takes two approaches: loose coupling and tight coupling. However, the present study used a full coupling approach to develop a GIS-based regional eco-security assessment decision support system (ESDSS). This was achieved by merging the pressure-state-response (PSR) model and the analytic hierarchy process (AHP) into ArcGIS 9 as a dynamic link library (DLL) using ArcObjects in ArcGIS and Visual Basic for Applications. Such an approach makes it easy to capitalize on the GIS visualization and spatial analysis functions, thereby significantly supporting the dynamic estimation of regional eco-security. A case study is presented for the Tibetan Plateau, known as the world's "third pole" after the Arctic and Antarctic. Results verified the usefulness and feasibility of the developed method. As a useful tool, the ESDSS can also help local managers to make scientifically-based and effective decisions about Tibetan eco-environmental protection and land use. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

An Ontology-Based, Mobile-Optimized System for Pharmacogenomic Decision Support at the Point-of-Care

PubMed Central

Miñarro-Giménez, Jose Antonio; Blagec, Kathrin; Boyce, Richard D.; Adlassnig, Klaus-Peter; Samwald, Matthias

2014-01-01

Background The development of genotyping and genetic sequencing techniques and their evolution towards low costs and quick turnaround have encouraged a wide range of applications. One of the most promising applications is pharmacogenomics, where genetic profiles are used to predict the most suitable drugs and drug dosages for the individual patient. This approach aims to ensure appropriate medical treatment and avoid, or properly manage, undesired side effects. Results We developed the Medicine Safety Code (MSC) service, a novel pharmacogenomics decision support system, to provide physicians and patients with the ability to represent pharmacogenomic data in computable form and to provide pharmacogenomic guidance at the point-of-care. Pharmacogenomic data of individual patients are encoded as Quick Response (QR) codes and can be decoded and interpreted with common mobile devices without requiring a centralized repository for storing genetic patient data. In this paper, we present the first fully functional release of this system and describe its architecture, which utilizes Web Ontology Language 2 (OWL 2) ontologies to formalize pharmacogenomic knowledge and to provide clinical decision support functionalities. Conclusions The MSC system provides a novel approach for enabling the implementation of personalized medicine in clinical routine. PMID:24787444

An ontology-based, mobile-optimized system for pharmacogenomic decision support at the point-of-care.

PubMed

Miñarro-Giménez, Jose Antonio; Blagec, Kathrin; Boyce, Richard D; Adlassnig, Klaus-Peter; Samwald, Matthias

2014-01-01

The development of genotyping and genetic sequencing techniques and their evolution towards low costs and quick turnaround have encouraged a wide range of applications. One of the most promising applications is pharmacogenomics, where genetic profiles are used to predict the most suitable drugs and drug dosages for the individual patient. This approach aims to ensure appropriate medical treatment and avoid, or properly manage, undesired side effects. We developed the Medicine Safety Code (MSC) service, a novel pharmacogenomics decision support system, to provide physicians and patients with the ability to represent pharmacogenomic data in computable form and to provide pharmacogenomic guidance at the point-of-care. Pharmacogenomic data of individual patients are encoded as Quick Response (QR) codes and can be decoded and interpreted with common mobile devices without requiring a centralized repository for storing genetic patient data. In this paper, we present the first fully functional release of this system and describe its architecture, which utilizes Web Ontology Language 2 (OWL 2) ontologies to formalize pharmacogenomic knowledge and to provide clinical decision support functionalities. The MSC system provides a novel approach for enabling the implementation of personalized medicine in clinical routine.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients.

PubMed

Velickovski, Filip; Ceccaroni, Luigi; Roca, Josep; Burgos, Felip; Galdiz, Juan B; Marina, Nuria; Lluch-Ariet, Magí

2014-11-28

The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems.

Clinical Decision Support Systems (CDSS) for preventive management of COPD patients

PubMed Central

2014-01-01

Background The use of information and communication technologies to manage chronic diseases allows the application of integrated care pathways, and the optimization and standardization of care processes. Decision support tools can assist in the adherence to best-practice medicine in critical decision points during the execution of a care pathway. Objectives The objectives are to design, develop, and assess a clinical decision support system (CDSS) offering a suite of services for the early detection and assessment of chronic obstructive pulmonary disease (COPD), which can be easily integrated into a healthcare providers' work-flow. Methods The software architecture model for the CDSS, interoperable clinical-knowledge representation, and inference engine were designed and implemented to form a base CDSS framework. The CDSS functionalities were iteratively developed through requirement-adjustment/development/validation cycles using enterprise-grade software-engineering methodologies and technologies. Within each cycle, clinical-knowledge acquisition was performed by a health-informatics engineer and a clinical-expert team. Results A suite of decision-support web services for (i) COPD early detection and diagnosis, (ii) spirometry quality-control support, (iii) patient stratification, was deployed in a secured environment on-line. The CDSS diagnostic performance was assessed using a validation set of 323 cases with 90% specificity, and 96% sensitivity. Web services were integrated in existing health information system platforms. Conclusions Specialized decision support can be offered as a complementary service to existing policies of integrated care for chronic-disease management. The CDSS was able to issue recommendations that have a high degree of accuracy to support COPD case-finding. Integration into healthcare providers' work-flow can be achieved seamlessly through the use of a modular design and service-oriented architecture that connect to existing health information systems. PMID:25471545

Time to decision: the drivers of innovation adoption decisions

NASA Astrophysics Data System (ADS)

Ciganek, Andrew Paul; (Dave) Haseman, William; Ramamurthy, K.

2014-03-01

Organisations desire timeliness. Timeliness facilitates a better responsiveness to changes in an organisation's external environment to either attain or maintain competitiveness. Despite its importance, decision timeliness has not been explicitly examined. Decision timeliness is measured in this study as the time taken to commit to a decision. The research objective is to identify the drivers of decision timeliness in the context of adopting service-oriented architecture (SOA), an innovation for enterprise computing. A research model rooted in the technology-organisation-environment (TOE) framework is proposed and tested with data collected in a large-scale study. The research variables have been examined before in the context of adoption, but their applicability to the timeliness of innovation decision-making has not received much attention and their salience is unclear. The results support multiple hypothesised relationships, including the finding that a risk-oriented organisational culture as well as normative and coercive pressures accelerates decision timeliness. Top management support as well as the traditional innovation attributes (compatibility, relative advantage and complexity/ease-of-use) were not found to be significant when examining their influence on decision timeliness, which appears inconsistent with generally accepted knowledge and deserves further examination.

FlooDSuM - a decision support methodology for assisting local authorities in flood situations

NASA Astrophysics Data System (ADS)

Schwanbeck, Jan; Weingartner, Rolf

2014-05-01

Decision making in flood situations is a difficult task, especially in small to medium-sized mountain catchments (30 - 500 km2) which are usually characterized by complex topography, high drainage density and quick runoff response to rainfall events. Operating hydrological models driven by numerical weather prediction systems, which have a lead-time of several hours up to few even days, would be beneficial in this case as time for prevention could be gained. However, the spatial and quantitative accuracy of such meteorological forecasts usually decrease with increasing lead-time. In addition, the sensitivity of rainfall-runoff models to inaccuracies in estimations of areal rainfall increases with decreasing catchment size. Accordingly, decisions on flood alerts should ideally be based on areal rainfall from high resolution and short-term numerical weather prediction, nowcasts or even real-time measurements, which is transformed into runoff by a hydrological model. In order to benefit from the best possible rainfall data while retaining enough time for alerting and for prevention, the hydrological model should be fast and easily applicable by decision makers within local authorities themselves. The proposed decision support methodology FlooDSuM (Flood Decision Support Methodology) aims to meet those requirements. Applying FlooDSuM, a few successive binary decisions of increasing complexity have to be processed following a flow-chart-like structure. Prepared data and straightforwardly applicable tools are provided for each of these decisions. Maps showing the current flood disposition are used for the first step. While danger of flooding cannot be excluded more and more complex and time consuming methods will be applied. For the final decision, a set of scatter-plots relating areal precipitation to peak flow is provided. These plots take also further decisive parameters into account such as storm duration, distribution of rainfall intensity in time as well as the catchment's antecedent moisture conditions. The proposed approach is currently tested in two catchments in the Swiss Pre-Alps and Alps. We will show the general setup and selected results. The findings of those case studies will lead to further improvements of the proposed approach.

GROTTO visualization for decision support

NASA Astrophysics Data System (ADS)

Lanzagorta, Marco O.; Kuo, Eddy; Uhlmann, Jeffrey K.

1998-08-01

In this paper we describe the GROTTO visualization projects being carried out at the Naval Research Laboratory. GROTTO is a CAVE-like system, that is, a surround-screen, surround- sound, immersive virtual reality device. We have explored the GROTTO visualization in a variety of scientific areas including oceanography, meteorology, chemistry, biochemistry, computational fluid dynamics and space sciences. Research has emphasized the applications of GROTTO visualization for military, land and sea-based command and control. Examples include the visualization of ocean current models for the simulation and stud of mine drifting and, inside our computational steering project, the effects of electro-magnetic radiation on missile defense satellites. We discuss plans to apply this technology to decision support applications involving the deployment of autonomous vehicles into contaminated battlefield environments, fire fighter control and hostage rescue operations.

Lung Cancer Assistant: a hybrid clinical decision support application for lung cancer care.

PubMed

Sesen, M Berkan; Peake, Michael D; Banares-Alcantara, Rene; Tse, Donald; Kadir, Timor; Stanley, Roz; Gleeson, Fergus; Brady, Michael

2014-09-06

Multidisciplinary team (MDT) meetings are becoming the model of care for cancer patients worldwide. While MDTs have improved the quality of cancer care, the meetings impose substantial time pressure on the members, who generally attend several such MDTs. We describe Lung Cancer Assistant (LCA), a clinical decision support (CDS) prototype designed to assist the experts in the treatment selection decisions in the lung cancer MDTs. A novel feature of LCA is its ability to provide rule-based and probabilistic decision support within a single platform. The guideline-based CDS is based on clinical guideline rules, while the probabilistic CDS is based on a Bayesian network trained on the English Lung Cancer Audit Database (LUCADA). We assess rule-based and probabilistic recommendations based on their concordances with the treatments recorded in LUCADA. Our results reveal that the guideline rule-based recommendations perform well in simulating the recorded treatments with exact and partial concordance rates of 0.57 and 0.79, respectively. On the other hand, the exact and partial concordance rates achieved with probabilistic results are relatively poorer with 0.27 and 0.76. However, probabilistic decision support fulfils a complementary role in providing accurate survival estimations. Compared to recorded treatments, both CDS approaches promote higher resection rates and multimodality treatments.

Development by Design in Colombia: Making Mitigation Decisions Consistent with Conservation Outcomes

PubMed Central

Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

2013-01-01

Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition. PMID:24339972

Development by design in Colombia: making mitigation decisions consistent with conservation outcomes.

PubMed

Saenz, Shirley; Walschburger, Tomas; González, Juan Carlos; León, Jorge; McKenney, Bruce; Kiesecker, Joseph

2013-01-01

Mitigation policy and regulatory frameworks are consistent in their strong support for the mitigation hierarchy of: (1) avoiding impacts, (2) minimizing impacts, and then (3) offsetting/compensating for residual impacts. While mitigation frameworks require developers to avoid, minimize and restore biodiversity on-site before considering an offset for residual impacts, there is a lack of quantitative guidance for this decision-making process. What are the criteria for requiring impacts be avoided altogether? Here we examine how conservation planning can guide the application of the mitigation hierarchy to address this issue. In support of the Colombian government's aim to improve siting and mitigation practices for planned development, we examined five pilot projects in landscapes expected to experience significant increases in mining, petroleum and/or infrastructure development. By blending landscape-level conservation planning with application of the mitigation hierarchy, we can proactively identify where proposed development and conservation priorities would be in conflict and where impacts should be avoided. The approach we outline here has been adopted by the Colombian Ministry of Environment and Sustainable Development to guide licensing decisions, avoid piecemeal licensing, and promote mitigation decisions that maintain landscape condition.

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.

Evaluating the accuracy of VEMAP daily weather data for application in crop simulations on a regional scale

USDA-ARS?s Scientific Manuscript database

Weather plays a critical role in eco-environmental and agricultural systems. Limited availability of meteorological records often constrains the applications of simulation models and related decision support tools. The Vegetation/Ecosystem Modeling and Analysis Project (VEMAP) provides daily weather...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2013 CFR

2013-01-01

... FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation § 1484.21 How does FAS... that effectively supports the strategic decision-making initiatives of the Government Performance and... creation, expansion, or maintenance of foreign markets, FAS seeks to identify those projects that would...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROGRAMS TO HELP DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation... allocates funds in a manner that effectively supports the strategic decision-making initiatives of the... to the effective creation, expansion, or maintenance of foreign markets, FAS seeks to identify those...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2012 CFR

2012-01-01

... FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation § 1484.21 How does FAS... that effectively supports the strategic decision-making initiatives of the Government Performance and... creation, expansion, or maintenance of foreign markets, FAS seeks to identify those projects that would...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2014 CFR

2014-01-01

... FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation § 1484.21 How does FAS... that effectively supports the strategic decision-making initiatives of the Government Performance and... creation, expansion, or maintenance of foreign markets, FAS seeks to identify those projects that would...

7 CFR 1484.21 - How does FAS determine which Cooperator program applications are approved?

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROGRAMS TO HELP DEVELOP FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Application and Fund Allocation... allocates funds in a manner that effectively supports the strategic decision-making initiatives of the... to the effective creation, expansion, or maintenance of foreign markets, FAS seeks to identify those...

Applicability of aquifer impact models to support decisions at CO2 sequestration sites

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

Keating, Elizabeth; Bacon, Diana; Carroll, Susan

2016-09-01

The National Risk Assessment Partnership has developed a suite of tools to assess and manage risk at CO2 sequestration sites (www.netldoe.gov/nrap). This capability includes polynomial or look-up table based reduced-order models (ROMs) that predict the impact of CO2 and brine leaks on overlying aquifers. The development of these computationally-efficient models and the underlying reactive transport simulations they emulate has been documented elsewhere (Carroll et al., 2014, Dai et al., 2014, Keating et al., 2015). The ROMs reproduce the ensemble behavior of large numbers of simulations and are well-suited to applications that consider a large number of scenarios to understand parametermore » sensitivity and uncertainty on the risk of CO2 leakage to groundwater quality. In this paper, we seek to demonstrate applicability of ROM-based ensemble analysis by considering what types of decisions and aquifer types would benefit from the ROM analysis. We present four hypothetical four examples where applying ROMs, in ensemble mode, could support decisions in the early stages in a geologic CO2 sequestration project. These decisions pertain to site selection, site characterization, monitoring network evaluation, and health impacts. In all cases, we consider potential brine/CO2 leak rates at the base of the aquifer to be uncertain. We show that derived probabilities provide information relevant to the decision at hand. Although the ROMs were developed using site-specific data from two aquifers (High Plains and Edwards), the models accept aquifer characteristics as variable inputs and so they may have more broad applicability. We conclude that pH and TDS predictions are the most transferable to other aquifers based on the analysis of the nine water quality metrics (pH, TDS, 4 trace metals, 3 organic compounds). Guidelines are presented for determining the aquifer types for which the ROMs should be applicable.« less

Development of WMS Capabilities to Support NASA Disasters Applications and App Development

NASA Astrophysics Data System (ADS)

Bell, J. R.; Burks, J. E.; Molthan, A.; McGrath, K. M.

2013-12-01

During the last year several significant disasters have occurred such as Superstorm Sandy on the East coast of the United States, and Typhoon Bopha in the Phillipines, along with several others. In support of these disasters NASA's Short-term Prediction Research and Transition (SPoRT) Center delivered various products derived from satellite imagery to help in the assessment of damage and recovery of the affected areas. To better support the decision makers responding to the disasters SPoRT quickly developed several solutions to provide the data using open Geographical Information Service (GIS) formats. Providing the data in open GIS standard formats allowed the end user to easily integrate the data into existing Decision Support Systems (DSS). Both Tile Mapping Service (TMS) and Web Mapping Service (WMS) were leveraged to quickly provide the data to the end-user. Development of the deliver methodology allowed quick response to rapidly developing disasters and enabled NASA SPoRT to bring science data to decision makers in a successful research to operations transition.

Development of WMS Capabilities to Support NASA Disasters Applications and App Development

NASA Technical Reports Server (NTRS)

Bell, Jordan R.; Burks, Jason E.; Molthan, Andrew L.; McGrath, Kevin M.

2013-01-01

During the last year several significant disasters have occurred such as Superstorm Sandy on the East coast of the United States, and Typhoon Bopha in the Phillipines, along with several others. In support of these disasters NASA's Short-term Prediction Research and Transition (SPoRT) Center delivered various products derived from satellite imagery to help in the assessment of damage and recovery of the affected areas. To better support the decision makers responding to the disasters SPoRT quickly developed several solutions to provide the data using open Geographical Information Service (GIS) formats. Providing the data in open GIS standard formats allowed the end user to easily integrate the data into existing Decision Support Systems (DSS). Both Tile Mapping Service (TMS) and Web Mapping Service (WMS) were leveraged to quickly provide the data to the end-user. Development of the deliver methodology allowed quick response to rapidly developing disasters and enabled NASA SPoRT to bring science data to decision makers in a successful research to operations transition.

Decision support systems for clinical radiological practice — towards the next generation

PubMed Central

Stivaros, S M; Gledson, A; Nenadic, G; Zeng, X-J; Keane, J; Jackson, A

2010-01-01

The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully. PMID:20965900

Development of Web Mapping Service Capabilities to Support NASA Disasters Applications/App Development

NASA Technical Reports Server (NTRS)

Burks, Jason E.; Molthan, Andrew L.; McGrath, Kevin M.

2014-01-01

During the last year several significant disasters have occurred such as Superstorm Sandy on the East coast of the United States, and Typhoon Bopha in the Phillipines, along with several others. In support of these disasters NASA's Short-term Prediction Research and Transition (SPoRT) Center delivered various products derived from satellite imagery to help in the assessment of damage and recovery of the affected areas. To better support the decision makers responding to the disasters SPoRT quickly developed several solutions to provide the data using open Geographical Information Service (GIS) formats. Providing the data in open GIS standard formats allowed the end user to easily integrate the data into existing Decision Support Systems (DSS). Both Tile Mapping Service (TMS) and Web Mapping Service (WMS) were leveraged to quickly provide the data to the end-user. Development of the deliver methodology allowed quick response to rapidly developing disasters and enabled NASA SPoRT to bring science data to decision makers in a successful research to operations transition.

Development of Web Mapping Service Capabilities to Support NASA Disasters Applications / App Development

NASA Technical Reports Server (NTRS)

Burks, Jason E.; Molthan, Andrew L.; McGrath, Kevin M.

2014-01-01

During the last year several significant disasters have occurred such as Superstorm Sandy on the East coast of the United States, and Typhoon Bopha in the Phillipines, along with several others. In support of these disasters NASA's Short-term Prediction Research and Transition (SPoRT) Center delivered various products derived from satellite imagery to help in the assessment of damage and recovery of the affected areas. To better support the decision makers responding to the disasters SPoRT quickly developed several solutions to provide the data using open Geographical Information Service (GIS) formats. Providing the data in open GIS standard formats allowed the end user to easily integrate the data into existing Decision Support Systems (DSS). Both Tile Mapping Service (TMS) and Web Mapping Service (WMS) were leveraged to quickly provide the data to the end-user. Development of the deliver methodology allowed quick response to rapidly developing disasters and enabled NASA SPoRT to bring science data to decision makers in a successful research to operations transition.

Some Results of Weak Anticipative Concept Applied in Simulation Based Decision Support in Enterprise

NASA Astrophysics Data System (ADS)

Kljajić, Miroljub; Kofjač, Davorin; Kljajić Borštnar, Mirjana; Škraba, Andrej

2010-11-01

The simulation models are used as for decision support and learning in enterprises and in schools. Tree cases of successful applications demonstrate usefulness of weak anticipative information. Job shop scheduling production with makespan criterion presents a real case customized flexible furniture production optimization. The genetic algorithm for job shop scheduling optimization is presented. Simulation based inventory control for products with stochastic lead time and demand describes inventory optimization for products with stochastic lead time and demand. Dynamic programming and fuzzy control algorithms reduce the total cost without producing stock-outs in most cases. Values of decision making information based on simulation were discussed too. All two cases will be discussed from optimization, modeling and learning point of view.

Research on tobacco enterprise spatial decision support system based on GIS

NASA Astrophysics Data System (ADS)

Mei, Xin; Cui, Weihong

2006-10-01

Tobacco enterprise is a special enterprise, which has strong correlation to regional geography. But in the past research and application, the combination between tobacco and GIS is limited to use digital maps to assist cigarette distribution. How to comprehensively import 3S technique taking GIS as representation to construct spatial decision support system of tobacco enterprise is the main research aspect in this paper. The paper concretely analyzes the GIS requirements in tobacco enterprise for planning location of production, monitoring production management and product sale at the beginning. Then holistic solution is presented and frame design for tobacco enterprise spatial decision is given. At last the example of tobacco enterprise spatial CRM (client relation management) system is set up.

Clinical Use of an Enterprise Data Warehouse

PubMed Central

Evans, R. Scott; Lloyd, James F.; Pierce, Lee A.

2012-01-01

The enormous amount of data being collected by electronic medical records (EMR) has found additional value when integrated and stored in data warehouses. The enterprise data warehouse (EDW) allows all data from an organization with numerous inpatient and outpatient facilities to be integrated and analyzed. We have found the EDW at Intermountain Healthcare to not only be an essential tool for management and strategic decision making, but also for patient specific clinical decision support. This paper presents the structure and two case studies of a framework that has provided us the ability to create a number of decision support applications that are dependent on the integration of previous enterprise-wide data in addition to a patient’s current information in the EMR. PMID:23304288

Comprehensive mitigation framework for concurrent application of multiple clinical practice guidelines.

PubMed

Wilk, Szymon; Michalowski, Martin; Michalowski, Wojtek; Rosu, Daniela; Carrier, Marc; Kezadri-Hamiaz, Mounira

2017-02-01

In this work we propose a comprehensive framework based on first-order logic (FOL) for mitigating (identifying and addressing) interactions between multiple clinical practice guidelines (CPGs) applied to a multi-morbid patient while also considering patient preferences related to the prescribed treatment. With this framework we respond to two fundamental challenges associated with clinical decision support: (1) concurrent application of multiple CPGs and (2) incorporation of patient preferences into the decision making process. We significantly expand our earlier research by (1) proposing a revised and improved mitigation-oriented representation of CPGs and secondary medical knowledge for addressing adverse interactions and incorporating patient preferences and (2) introducing a new mitigation algorithm. Specifically, actionable graphs representing CPGs allow for parallel and temporal activities (decisions and actions). Revision operators representing secondary medical knowledge support temporal interactions and complex revisions across multiple actionable graphs. The mitigation algorithm uses the actionable graphs, revision operators and available (and possibly incomplete) patient information represented in FOL. It relies on a depth-first search strategy to find a valid sequence of revisions and uses theorem proving and model finding techniques to identify applicable revision operators and to establish a management scenario for a given patient if one exists. The management scenario defines a safe (interaction-free) and preferred set of activities together with possible patient states. We illustrate the use of our framework with a clinical case study describing two patients who suffer from chronic kidney disease, hypertension, and atrial fibrillation, and who are managed according to CPGs for these diseases. While in this paper we are primarily concerned with the methodological aspects of mitigation, we also briefly discuss a high-level proof of concept implementation of the proposed framework in the form of a clinical decision support system (CDSS). The proposed mitigation CDSS "insulates" clinicians from the complexities of the FOL representations and provides semantically meaningful summaries of mitigation results. Ultimately we plan to implement the mitigation CDSS within our MET (Mobile Emergency Triage) decision support environment. Copyright © 2016 Elsevier Inc. All rights reserved.

Configural displays can improve nutrition-related. decisions: an application of the proximity compatibility principle.

PubMed

Marino, Christopher J; Mahan, Robert R

2005-01-01

The nutrition label format currently used by consumers to make dietary-related decisions presents significant information-processing demands for integration-based decisions; however, those demands were not considered as primary factors when the format was adopted. Labels designed in accordance with known principles of cognitive psychology might enhance the kind of decision making that food labeling was intended to facilitate. Three experiments were designed on the basis of the proximity compatibility principle (PCP) to investigate the relationship between nutrition label format and decision making; the experiments involved two types of integration decisions and one type of filtering decision. Based on the PCP, decision performance was measured to test the overall hypothesis that matched task-display tandems would result in better decision performance than would mismatched tandems. In each experiment, a statistically significant increase in mean decision performance was found when the display design was cognitively matched to the demands of the task. Combined, the results from all three experiments support the general hypothesis that task-display matching is a design principle that may enhance the utility of nutrition labeling in nutrition-related decision making. Actual or potential applications of this research include developing robust display solutions that aid in less effortful assimilation of nutrition-related information for consumers.

Decision insight into stakeholder conflict for ERN.

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

Siirola, John; Tidwell, Vincent Carroll; Benz, Zachary O.

Participatory modeling has become an important tool in facilitating resource decision making and dispute resolution. Approaches to modeling that are commonly used in this context often do not adequately account for important human factors. Current techniques provide insights into how certain human activities and variables affect resource outcomes; however, they do not directly simulate the complex variables that shape how, why, and under what conditions different human agents behave in ways that affect resources and human interactions related to them. Current approaches also do not adequately reveal how the effects of individual decisions scale up to have systemic level effectsmore » in complex resource systems. This lack of integration prevents the development of more robust models to support decision making and dispute resolution processes. Development of integrated tools is further hampered by the fact that collection of primary data for decision-making modeling is costly and time consuming. This project seeks to develop a new approach to resource modeling that incorporates both technical and behavioral modeling techniques into a single decision-making architecture. The modeling platform is enhanced by use of traditional and advanced processes and tools for expedited data capture. Specific objectives of the project are: (1) Develop a proof of concept for a new technical approach to resource modeling that combines the computational techniques of system dynamics and agent based modeling, (2) Develop an iterative, participatory modeling process supported with traditional and advance data capture techniques that may be utilized to facilitate decision making, dispute resolution, and collaborative learning processes, and (3) Examine potential applications of this technology and process. The development of this decision support architecture included both the engineering of the technology and the development of a participatory method to build and apply the technology. Stakeholder interaction with the model and associated data capture was facilitated through two very different modes of engagement, one a standard interface involving radio buttons, slider bars, graphs and plots, while the other utilized an immersive serious gaming interface. The decision support architecture developed through this project was piloted in the Middle Rio Grande Basin to examine how these tools might be utilized to promote enhanced understanding and decision-making in the context of complex water resource management issues. Potential applications of this architecture and its capacity to lead to enhanced understanding and decision-making was assessed through qualitative interviews with study participants who represented key stakeholders in the basin.« less

Terrorist Material Support: A Sketch of 18 U.S.C. 2339A and 2339B

DTIC Science & Technology

2010-07-19

the challenge before it were not unconstitutionally vague nor was their proscription inconsistent with the First Amendment’s freedom of speech and...Circuit decision which had found unconstitutionally vague some of the terms used to define material support and found application to some forms of...its application may be unclear under other circumstances. The Court held that Section 2339B is not unconstitutionally vague as applied to the type

An architecture for a continuous, user-driven, and data-driven application of clinical guidelines and its evaluation.

PubMed

Shalom, Erez; Shahar, Yuval; Lunenfeld, Eitan

2016-02-01

Design, implement, and evaluate a new architecture for realistic continuous guideline (GL)-based decision support, based on a series of requirements that we have identified, such as support for continuous care, for multiple task types, and for data-driven and user-driven modes. We designed and implemented a new continuous GL-based support architecture, PICARD, which accesses a temporal reasoning engine, and provides several different types of application interfaces. We present the new architecture in detail in the current paper. To evaluate the architecture, we first performed a technical evaluation of the PICARD architecture, using 19 simulated scenarios in the preeclampsia/toxemia domain. We then performed a functional evaluation with the help of two domain experts, by generating patient records that simulate 60 decision points from six clinical guideline-based scenarios, lasting from two days to four weeks. Finally, 36 clinicians made manual decisions in half of the scenarios, and had access to the automated GL-based support in the other half. The measures used in all three experiments were correctness and completeness of the decisions relative to the GL. Mean correctness and completeness in the technical evaluation were 1±0.0 and 0.96±0.03 respectively. The functional evaluation produced only several minor comments from the two experts, mostly regarding the output's style; otherwise the system's recommendations were validated. In the clinically oriented evaluation, the 36 clinicians applied manually approximately 41% of the GL's recommended actions. Completeness increased to approximately 93% when using PICARD. Manual correctness was approximately 94.5%, and remained similar when using PICARD; but while 68% of the manual decisions included correct but redundant actions, only 3% of the actions included in decisions made when using PICARD were redundant. The PICARD architecture is technically feasible and is functionally valid, and addresses the realistic continuous GL-based application requirements that we have defined; in particular, the requirement for care over significant time frames. The use of the PICARD architecture in the domain we examined resulted in enhanced completeness and in reduction of redundancies, and is potentially beneficial for general GL-based management of chronic patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Invasive Species Forecasting System: A Decision Support Tool for the U.S. Geological Survey: FY 2005 Benchmarking Report v.1.6

NASA Technical Reports Server (NTRS)

Stohlgren, Tom; Schnase, John; Morisette, Jeffrey; Most, Neal; Sheffner, Ed; Hutchinson, Charles; Drake, Sam; Van Leeuwen, Willem; Kaupp, Verne

2005-01-01

The National Institute of Invasive Species Science (NIISS), through collaboration with NASA's Goddard Space Flight Center (GSFC), recently began incorporating NASA observations and predictive modeling tools to fulfill its mission. These enhancements, labeled collectively as the Invasive Species Forecasting System (ISFS), are now in place in the NIISS in their initial state (V1.0). The ISFS is the primary decision support tool of the NIISS for the management and control of invasive species on Department of Interior and adjacent lands. The ISFS is the backbone for a unique information services line-of-business for the NIISS, and it provides the means for delivering advanced decision support capabilities to a wide range of management applications. This report describes the operational characteristics of the ISFS, a decision support tool of the United States Geological Survey (USGS). Recent enhancements to the performance of the ISFS, attained through the integration of observations, models, and systems engineering from the NASA are benchmarked; i.e., described quantitatively and evaluated in relation to the performance of the USGS system before incorporation of the NASA enhancements. This report benchmarks Version 1.0 of the ISFS.

Performance measurement integrated information framework in e-Manufacturing

NASA Astrophysics Data System (ADS)

Teran, Hilaida; Hernandez, Juan Carlos; Vizán, Antonio; Ríos, José

2014-11-01

The implementation of Internet technologies has led to e-Manufacturing technologies becoming more widely used and to the development of tools for compiling, transforming and synchronising manufacturing data through the Web. In this context, a potential area for development is the extension of virtual manufacturing to performance measurement (PM) processes, a critical area for decision making and implementing improvement actions in manufacturing. This paper proposes a PM information framework to integrate decision support systems in e-Manufacturing. Specifically, the proposed framework offers a homogeneous PM information exchange model that can be applied through decision support in e-Manufacturing environment. Its application improves the necessary interoperability in decision-making data processing tasks. It comprises three sub-systems: a data model, a PM information platform and PM-Web services architecture. A practical example of data exchange for measurement processes in the area of equipment maintenance is shown to demonstrate the utility of the model.

Spatial decision support system for tobacco enterprise based on spatial data mining

NASA Astrophysics Data System (ADS)

Mei, Xin; Liu, Junyi; Zhang, Xuexia; Cui, Weihong

2007-11-01

Tobacco enterprise is a special enterprise, which has strong correlation to regional geography. But in the past research and application, the combination between tobacco and GIS is limited to use digital maps to assist cigarette distribution. How to comprehensively import 3S technique and spatial data mining (SDM) to construct spatial decision support system (SDSS) of tobacco enterprise is the main research aspect in this paper. The paper concretely analyzes the GIS requirements in tobacco enterprise for planning location of production, monitoring production management and product sale at the beginning. Then holistic solution is presented and frame design for tobacco enterprise spatial decision based on SDM is given. This paper describes how to use spatial analysis and data mining to realize the spatial decision processing such as monitoring tobacco planted acreage, analyzing and planning the cigarette sale network and so on.

A Decision Support System for Evaluating and Selecting Information Systems Projects

NASA Astrophysics Data System (ADS)

Deng, Hepu; Wibowo, Santoso

2009-01-01

This chapter presents a decision support system (DSS) for effectively solving the information systems (IS) project selection problem. The proposed DSS recognizes the multidimensional nature of the IS project selection problem, the availability of multicriteria analysis (MA) methods, and the preferences of the decision-maker (DM) on the use of specific MA methods in a given situation. A knowledge base consisting of IF-THEN production rules is developed for assisting the DM with a systematic adoption of the most appropriate method with the efficient use of the powerful reasoning and explanation capabilities of intelligent DSS. The idea of letting the problem to be solved determines the method to be used is incorporated into the proposed DSS. As a result, effective decisions can be made for solving the IS project selection problem. An example is presented to demonstrate the applicability of the proposed DSS for solving the problem of selecting IS projects in real world situations.

Development of a robust space power system decision model

NASA Astrophysics Data System (ADS)

Chew, Gilbert; Pelaccio, Dennis G.; Jacobs, Mark; Stancati, Michael; Cataldo, Robert

2001-02-01

NASA continues to evaluate power systems to support human exploration of the Moon and Mars. The system(s) would address all power needs of surface bases and on-board power for space transfer vehicles. Prior studies have examined both solar and nuclear-based alternatives with respect to individual issues such as sizing or cost. What has not been addressed is a comprehensive look at the risks and benefits of the options that could serve as the analytical framework to support a system choice that best serves the needs of the exploration program. This paper describes the SAIC developed Space Power System Decision Model, which uses a formal Two-step Analytical Hierarchy Process (TAHP) methodology that is used in the decision-making process to clearly distinguish candidate power systems in terms of benefits, safety, and risk. TAHP is a decision making process based on the Analytical Hierarchy Process, which employs a hierarchic approach of structuring decision factors by weights, and relatively ranks system design options on a consistent basis. This decision process also includes a level of data gathering and organization that produces a consistent, well-documented assessment, from which the capability of each power system option to meet top-level goals can be prioritized. The model defined on this effort focuses on the comparative assessment candidate power system options for Mars surface application(s). This paper describes the principles of this approach, the assessment criteria and weighting procedures, and the tools to capture and assess the expert knowledge associated with space power system evaluation. .

75 FR 22162 - Receipt of Applications for Permit

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-27

... agency decisions are: (1) Those supported by quantitative information or studies; and (2) Those that... to import the sport- hunted trophy of one male bontebok (Damaliscus pygargus pygargus) culled from a...

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

NASA Astrophysics Data System (ADS)

Brennan-Tonetta, Margaret

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

Science in the regulatory setting: a challenging but incompatible mix?

PubMed

Yetley, Elizabeth A

2007-01-01

Regulatory decisions informed by sound science have an important role in many regulatory applications involving drugs and foods, including applications related to dietary supplements. However, science is only one of many factors that must be taken into account in the regulatory decision-making process. In many cases, the scientific input to a regulatory decision must compete with other factors (e.g. economics, legal requirements, stakeholder interests) for impact on the resultant policy decision. Therefore, timely and effective articulation of the available science to support a regulatory decision can significantly affect the relative weight given to science. However, the incorporation of science into the regulatory process for dietary supplements is often fraught with challenges. The available scientific evidence has rarely been designed for the purpose of addressing regulatory questions and is often preliminary and of widely varying scientific quality. To add to the confusion, the same scientific evidence may result in what appears to be different regulatory decisions because the context in which the science is used differs. The underlying assumption is that scientists who have a basic understanding of the interface between science and policy decisions can more effectively provide scientific input into these decisions.

Applicability of randomized trials in radiation oncology to standard clinical practice.

PubMed

Apisarnthanarax, Smith; Swisher-McClure, Samuel; Chiu, Wing K; Kimple, Randall J; Harris, Stephen L; Morris, David E; Tepper, Joel E

2013-08-15

Randomized controlled trials (RCTs) are commonly used to inform clinical practice; however, it is unclear how generalizable RCT data are to patients in routine clinical practice. The authors of this report assessed the availability and applicability of randomized evidence guiding medical decisions in a cohort of patients who were evaluated for consideration of definitive management in a radiation oncology clinic. The medical records of consecutive, new patient consultations between January and March 2007 were reviewed. Patient medical decisions were classified as those with (Group 1) or without (Group 2) available, relevant level I evidence (phase 3 RCT) supporting recommended treatments. Group 1 medical decisions were further divided into 3 groups based on the extent of fulfilling eligibility criteria for each RCT: Group 1A included decisions that fulfilled all eligibility criteria; Group 1B, decisions that did not fulfill at least 1 minor eligibility criteria; or Group 1C, decisions that did not fulfill at least 1 major eligibility criteria. Patient and clinical characteristics were tested for correlations with the availability of evidence. Of the 393 evaluable patients, malignancies of the breast (30%), head and neck (18%), and genitourinary system (14%) were the most common presenting primary disease sites. Forty-seven percent of all medical decisions (n = 451) were made without available (36%) or applicable (11%) randomized evidence to inform clinical decision making. Primary tumor diagnosis was significantly associated with the availability of evidence (P < .0001). A significant proportion of medical decisions in an academic radiation oncology clinic were made without available or applicable level I evidence, underscoring the limitations of relying solely on RCTs for the development of evidence-based health care. Copyright © 2013 American Cancer Society.

MAUD: An Interactive Computer Program for the Structuring, Decomposition, and Recomposition of Preferences between Multiattributed Alternatives. Final Report. Technical Report 543.

ERIC Educational Resources Information Center

Humphreys, Patrick; Wisudha, Ayleen

As a demonstration of the application of heuristic devices to decision-theoretical techniques, an interactive computer program known as MAUD (Multiattribute Utility Decomposition) has been designed to support decision or choice problems that can be decomposed into component factors, or to act as a tool for investigating the microstructure of a…

Concept of information technology of monitoring and decision-making support

NASA Astrophysics Data System (ADS)

Kovalenko, Aleksandr S.; Tymchyk, Sergey V.; Kostyshyn, Sergey V.; Zlepko, Sergey M.; Wójcik, Waldemar; Kalizhanova, Aliya; Burlibay, Aron; Kozbekova, Ainur

2017-08-01

Presented concept of information technology monitoring and decision support to determine the health of students. The preconditions of a concept formulated its goal and purpose. Subject area concepts proposed to consider a set of problems, grouped into 8 categories, which in turn necessitates the application when creating technology basic principles from the principles of "first head" and "systems approach" to the principles of "interoperability" and "system integration ". The content of the information providing IT, its position in the segment of single information space, stages of creation. To evaluate the efficiency of the IT system developed proposed criteria.

Academic decision making and prospect theory.

PubMed

Mowrer, Robert R; Davidson, William B

2011-08-01

Two studies are reported that investigate the applicability of prospect theory to college students' academic decision making. Exp. 1 failed to provide support for the risk-seeking portion of the fourfold pattern predicted by prospect theory but did find the greater weighting of losses over gains. Using a more sensitive dependent measure, in Exp. 2 the results of the first experiment were replicated in terms of the gain-loss effect and also found some support for the fourfold pattern in the interaction between probabilities and gain versus loss. The greatest risk-seeking was found in the high probability loss condition.

Sound data management as a foundation for natural resources management and science

USGS Publications Warehouse

Burley, Thomas E.

2012-01-01

Effective decision making is closely related to the quality and completeness of available data and information. Data management helps to ensure data quality in any discipline and supports decision making. Managing data as a long-term scientific asset helps to ensure that data will be usable beyond the original intended application. Emerging issues in water-resources management and climate variability require the ability to analyze change in the conditions of natural resources over time. The availability of quality, well-managed, and documented data from the past and present helps support this requirement.

Heuristics: foundations for a novel approach to medical decision making.

PubMed

Bodemer, Nicolai; Hanoch, Yaniv; Katsikopoulos, Konstantinos V

2015-03-01

Medical decision-making is a complex process that often takes place during uncertainty, that is, when knowledge, time, and resources are limited. How can we ensure good decisions? We present research on heuristics-simple rules of thumb-and discuss how medical decision-making can benefit from these tools. We challenge the common view that heuristics are only second-best solutions by showing that they can be more accurate, faster, and easier to apply in comparison to more complex strategies. Using the example of fast-and-frugal decision trees, we illustrate how heuristics can be studied and implemented in the medical context. Finally, we suggest how a heuristic-friendly culture supports the study and application of heuristics as complementary strategies to existing decision rules.

NASA Applied Sciences Program Rapid Prototyping Results and Conclusions

NASA Astrophysics Data System (ADS)

Cox, E. L.

2007-12-01

NASA's Applied Sciences Program seeks to expand the use of Earth science research results to benefit current and future operational systems tasked with making policy and management decisions. The Earth Science Division within the Science Mission Directorate sponsors over 1000 research projects annually to answer the fundamental research question: How is the Earth changing and what are the consequences for life on Earth? As research results become available, largely from satellite observations and Earth system model outputs, the Applied Sciences Program works diligently with scientists and researchers (internal and external to NASA) , and other government agency officials (USDA, EPA, CDC, DOE, US Forest Service, US Fish and Wildlife Service, DHS, USAID) to determine useful applications for these results in decision-making, ultimately benefiting society. The complexity of Earth science research results and the breadth of the Applied Sciences Program national priority areas dictate a broad scope and multiple approaches available to implement their use in decision-making. Over the past five years, the Applied Sciences Program has examined scientific and engineering practices and solicited the community for methods and steps that can lead to the enhancement of operational systems (Decision Support Systems - DSS) required for decision-making. In November 2006, the Applied Sciences Program launched an initiative aimed at demonstrating the applicability of NASA data (satellite observations, models, geophysical parameters from data archive centers) being incorporated into decision support systems and their related environments at a low cost and quick turnaround of results., i.e. designed rapid prototyping. Conceptually, an understanding of Earth science research (and results) coupled with decision-making requirements and needs leads to a demonstration (experiment) depicting enhancements or improvements to an operational decisions process through the use of NASA data. Five NASA centers (GSFC, LaRC, SSC, MSFC, ARC) participated and are currently conducting fifteen prototyping experiments covering eight of the twelve national priority applications - Energy, Coastal, Carbon, and Disaster Management; Agricultural Efficiency, Aviation, Air Quality, and Ecological Forecasting. Results from six experiments will be discussed highlighting purpose, expected results, enhancement to the decision-making process achieved, and the potential plans for future collaboration and sustainable projects.

The Development and Evaluation of an Operational Aerobraking Strategy for the Mars 2001 Odyssey Orbiter

NASA Technical Reports Server (NTRS)

Tartabini, Paul V.; Munk, Michelle M.; Powell, Richard W.

2002-01-01

The Mars 2001 Odyssey Orbiter successfully completed the aerobraking phase of its mission on January 11, 2002. This paper discusses the support provided by NASA's Langley Research Center to the navigation team at the Jet Propulsion Laboratory in the planning and operational support of Mars Odyssey Aerobraking. Specifically, the development of a three-degree-of-freedom aerobraking trajectory simulation and its application to pre-flight planning activities as well as operations is described. The importance of running the simulation in a Monte Carlo fashion to capture the effects of mission and atmospheric uncertainties is demonstrated, and the utility of including predictive logic within the simulation that could mimic operational maneuver decision-making is shown. A description is also provided of how the simulation was adapted to support flight operations as both a validation and risk reduction tool and as a means of obtaining a statistical basis for maneuver strategy decisions. This latter application was the first use of Monte Carlo trajectory analysis in an aerobraking mission.

Approach of Decision Making Based on the Analytic Hierarchy Process for Urban Landscape Management

NASA Astrophysics Data System (ADS)

Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

2013-03-01

This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

Approach of decision making based on the analytic hierarchy process for urban landscape management.

PubMed

Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

2013-03-01

This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

Goal-oriented Site Characterization in Hydrogeological Applications: An Overview

NASA Astrophysics Data System (ADS)

Nowak, W.; de Barros, F.; Rubin, Y.

2011-12-01

In this study, we address the importance of goal-oriented site characterization. Given the multiple sources of uncertainty in hydrogeological applications, information needs of modeling, prediction and decision support should be satisfied with efficient and rational field campaigns. In this work, we provide an overview of an optimal sampling design framework based on Bayesian decision theory, statistical parameter inference and Bayesian model averaging. It optimizes the field sampling campaign around decisions on environmental performance metrics (e.g., risk, arrival times, etc.) while accounting for parametric and model uncertainty in the geostatistical characterization, in forcing terms, and measurement error. The appealing aspects of the framework lie on its goal-oriented character and that it is directly linked to the confidence in a specified decision. We illustrate how these concepts could be applied in a human health risk problem where uncertainty from both hydrogeological and health parameters are accounted.

78 FR 73877 - Endangered Species; Marine Mammals; Receipt of Applications for Permit

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... decisions are: (1) Those supported by quantitative information or studies; and (2) Those that include... (does not include Hawaiian goose or Hawaiian duck) Cathartidae Gruidae Sturnidae (does not include...

Human Cognitive Limitations. Broad, Consistent, Clinical Application of Physiological Principles Will Require Decision Support.

PubMed

Morris, Alan H

2018-02-01

Our education system seems to fail to enable clinicians to broadly understand core physiological principles. The emphasis on reductionist science, including "omics" branches of research, has likely contributed to this decrease in understanding. Consequently, clinicians cannot be expected to consistently make clinical decisions linked to best physiological evidence. This is a large-scale problem with multiple determinants, within an even larger clinical decision problem: the failure of clinicians to consistently link their decisions to best evidence. Clinicians, like all human decision-makers, suffer from significant cognitive limitations. Detailed context-sensitive computer protocols can generate personalized medicine instructions that are well matched to individual patient needs over time and can partially resolve this problem.

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2016-01-01

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

A decision-support tool to predict spray deposition of insecticides in commercial potato fields and its implications for their performance

USDA-ARS?s Scientific Manuscript database

In conventional and most IPM programs, application of insecticides continues to be the most important responsive pest control tactic. For both immediate and long-term optimization and sustainability of insecticide applications, it is paramount to study the factors affecting the performance of insect...

76 FR 14351 - Proposed Withdrawal of Certain Federal Aquatic Life Water Quality Criteria Applicable to Wisconsin

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... limits in National Pollutant Discharge Elimination System (NPDES) permits, and may affect Clean Water Act... approves revised numeric water quality criteria applicable to the Great Lakes System, thereby meeting the...'s basis for this decision is that Limited Aquatic Life waters only support an invertebrate community...

Linking Data Access to Geospatial Data Models to Applications at Local to National Scales: The Estuary Data Mapper

EPA Science Inventory

The U.S. Environmental Protection Agency (US EPA) is developing e-Estuary, a decision-support system for Clean Water Act applications in coastal management. E-Estuary has three elements: an estuarine geo-referenced relational database, watershed GIS coverages, and tools to suppo...

A Semantic Sensor Web for Environmental Decision Support Applications

PubMed Central

Gray, Alasdair J. G.; Sadler, Jason; Kit, Oles; Kyzirakos, Kostis; Karpathiotakis, Manos; Calbimonte, Jean-Paul; Page, Kevin; García-Castro, Raúl; Frazer, Alex; Galpin, Ixent; Fernandes, Alvaro A. A.; Paton, Norman W.; Corcho, Oscar; Koubarakis, Manolis; De Roure, David; Martinez, Kirk; Gómez-Pérez, Asunción

2011-01-01

Sensing devices are increasingly being deployed to monitor the physical world around us. One class of application for which sensor data is pertinent is environmental decision support systems, e.g., flood emergency response. For these applications, the sensor readings need to be put in context by integrating them with other sources of data about the surrounding environment. Traditional systems for predicting and detecting floods rely on methods that need significant human resources. In this paper we describe a semantic sensor web architecture for integrating multiple heterogeneous datasets, including live and historic sensor data, databases, and map layers. The architecture provides mechanisms for discovering datasets, defining integrated views over them, continuously receiving data in real-time, and visualising on screen and interacting with the data. Our approach makes extensive use of web service standards for querying and accessing data, and semantic technologies to discover and integrate datasets. We demonstrate the use of our semantic sensor web architecture in the context of a flood response planning web application that uses data from sensor networks monitoring the sea-state around the coast of England. PMID:22164110

Image analysis approach for development of a decision support system for detection of malaria parasites in thin blood smear images.

PubMed

Prasad, Keerthana; Winter, Jan; Bhat, Udayakrishna M; Acharya, Raviraja V; Prabhu, Gopalakrishna K

2012-08-01

This paper describes development of a decision support system for diagnosis of malaria using color image analysis. A hematologist has to study around 100 to 300 microscopic views of Giemsa-stained thin blood smear images to detect malaria parasites, evaluate the extent of infection and to identify the species of the parasite. The proposed algorithm picks up the suspicious regions and detects the parasites in images of all the views. The subimages representing all these parasites are put together to form a composite image which can be sent over a communication channel to obtain the opinion of a remote expert for accurate diagnosis and treatment. We demonstrate the use of the proposed technique for use as a decision support system by developing an android application which facilitates the communication with a remote expert for the final confirmation on the decision for treatment of malaria. Our algorithm detects around 96% of the parasites with a false positive rate of 20%. The Spearman correlation r was 0.88 with a confidence interval of 0.838 to 0.923, p<0.0001.

Practical example of game theory application for production route selection

NASA Astrophysics Data System (ADS)

Olender, M.; Krenczyk, D.

2017-08-01

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

D-WISE: Diabetes Web-Centric Information and Support Environment: conceptual specification and proposed evaluation.

PubMed

Abidi, Samina; Vallis, Michael; Raza Abidi, Syed Sibte; Piccinini-Vallis, Helena; Imran, Syed Ali

2014-06-01

To develop and evaluate Diabetes Web-Centric Information and Support Environment (D-WISE) that offers 1) a computerized decision-support system to assist physicians to A) use the Canadian Diabetes Association clinical practice guidelines (CDA CPGs) to recommend evidence-informed interventions; B) offer a computerized readiness assessment strategy to help physicians administer behaviour-change strategies to help patients adhere to disease self-management programs; and 2) a patient-specific diabetes self-management application, accessible through smart mobile devices, that offers behaviour-change interventions to engage patients in self-management. The above-mentioned objectives were pursued through a knowledge management approach that involved 1) Translation of paper-based CDA CPGs and behaviour-change models as computerized decision-support tools that will assist physicians to offer evidence-informed and personalized diabetes management and behaviour-change strategies; 2) Engagement of patients in their diabetes care by generating a diabetes self-management program that takes into account their preferences, challenges and needs; 3) Empowering patients to self-manage their condition by providing them with personalized educational and motivational messages through a mobile self-management application. The theoretical foundation of our research is grounded in behaviour-change models and healthcare knowledge management. We used 1) knowledge modelling to computerize the paper-based CDA CPGs and behaviour-change models, in particular, the behaviour-change strategy elements of A) readiness-to-change assessments; B) motivation-enhancement interventions categorized along the lines of patients' being ready, ambivalent or not ready; and C) self-efficacy enhancement. The CDA CPGs and the behaviour-change models are modelled and computerized in terms of A) a diabetes management ontology that serves as the knowledge resource for all the services offered by D-WISE; B) decision support services that use logic-based reasoning algorithms to utilize the knowledge encoded within the diabetes management ontology to assist physicians by recommending patient-specific diabetes-management interventions and behaviour-change strategies; C) a mobile diabetes self-management application to engage and educate diabetes patients to self-manage their condition in a home-based setting while working in concert with their family physicians. We have been successful in creating and conducting a usability assessment of the physician decision support tool. These results will be published once the patient self- management application has been evaluated. D-WISE will be evaluated through pilot studies measuring 1) the usability of the e-Health interventions; and 2) the impact of the interventions on patients' behaviour changes and diabetes control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

A DICOM-RT radiation oncology ePR with decision support utilizing a quantified knowledge base from historical data

NASA Astrophysics Data System (ADS)

Documet, Jorge R.; Liu, Brent; Le, Anh; Law, Maria

2008-03-01

During the last 2 years we have been working on developing a DICOM-RT (Radiation Therapy) ePR (Electronic Patient Record) with decision support that will allow physicists and radiation oncologists during their decision-making process. This ePR allows offline treatment dose calculations and plan evaluation, while at the same time it compares and quantifies treatment planning algorithms using DICOM-RT objects. The ePR framework permits the addition of visualization, processing, and analysis tools, which combined with the core functionality of reporting, importing and exporting of medical studies, creates a very powerful application that can improve the efficiency while planning cancer treatments. Usually a Radiation Oncology department will have disparate and complex data generated by the RT modalities as well as data scattered in RT Information/Management systems, Record & Verify systems, and Treatment Planning Systems (TPS) which can compromise the efficiency of the clinical workflow since the data crucial for a clinical decision may be time-consuming to retrieve, temporarily missing, or even lost. To address these shortcomings, the ACR-NEMA Standards Committee extended its DICOM (Digital Imaging & Communications in Medicine) standard from Radiology to RT by ratifying seven DICOM RT objects starting in 1997 [1,2]. However, they are not broadly used yet by the RT community in daily clinical operations. In the past, the research focus of an RT department has primarily been developing new protocols and devices to improve treatment process and outcomes of cancer patients with minimal effort dedicated to integration of imaging and information systems. Our attempt is to show a proof-of-concept that a DICOM-RT ePR system can be developed as a foundation to perform medical imaging informatics research in developing decision-support tools and knowledge base for future data mining applications.

The Invasive Species Forecasting System

NASA Technical Reports Server (NTRS)

Schnase, John; Most, Neal; Gill, Roger; Ma, Peter

2011-01-01

The Invasive Species Forecasting System (ISFS) provides computational support for the generic work processes found in many regional-scale ecosystem modeling applications. Decision support tools built using ISFS allow a user to load point occurrence field sample data for a plant species of interest and quickly generate habitat suitability maps for geographic regions of management concern, such as a national park, monument, forest, or refuge. This type of decision product helps resource managers plan invasive species protection, monitoring, and control strategies for the lands they manage. Until now, scientists and resource managers have lacked the data-assembly and computing capabilities to produce these maps quickly and cost efficiently. ISFS focuses on regional-scale habitat suitability modeling for invasive terrestrial plants. ISFS s component architecture emphasizes simplicity and adaptability. Its core services can be easily adapted to produce model-based decision support tools tailored to particular parks, monuments, forests, refuges, and related management units. ISFS can be used to build standalone run-time tools that require no connection to the Internet, as well as fully Internet-based decision support applications. ISFS provides the core data structures, operating system interfaces, network interfaces, and inter-component constraints comprising the canonical workflow for habitat suitability modeling. The predictors, analysis methods, and geographic extents involved in any particular model run are elements of the user space and arbitrarily configurable by the user. ISFS provides small, lightweight, readily hardened core components of general utility. These components can be adapted to unanticipated uses, are tailorable, and require at most a loosely coupled, nonproprietary connection to the Web. Users can invoke capabilities from a command line; programmers can integrate ISFS's core components into more complex systems and services. Taken together, these features enable a degree of decentralization and distributed ownership that have helped other types of scientific information services succeed in recent years.

EPA CENTER FOR EXPOSURE ASSESSMENT MODELING (CEAM)

EPA Science Inventory

The EPA Center for Exposure Assessment Modeling (CEAM) supports the Agency and professional community in environmental, risk-based decision-making by expanding their applications expertise for quantitatively assessing pollutant exposure via aquatic, terrestrial, and multimedia pa...

Unmanned aircraft systems for transportation decision support.

DOT National Transportation Integrated Search

2016-11-30

Our nation relies on accurate geospatial information to map, measure, and monitor transportation infrastructure and the surrounding landscapes. This project focused on the application of Unmanned Aircraft systems (UAS) as a novel tool for improving e...

Fast support vector data descriptions for novelty detection.

PubMed

Liu, Yi-Hung; Liu, Yan-Chen; Chen, Yen-Jen

2010-08-01

Support vector data description (SVDD) has become a very attractive kernel method due to its good results in many novelty detection problems. However, the decision function of SVDD is expressed in terms of the kernel expansion, which results in a run-time complexity linear in the number of support vectors. For applications where fast real-time response is needed, how to speed up the decision function is crucial. This paper aims at dealing with the issue of reducing the testing time complexity of SVDD. A method called fast SVDD (F-SVDD) is proposed. Unlike the traditional methods which all try to compress a kernel expansion into one with fewer terms, the proposed F-SVDD directly finds the preimage of a feature vector, and then uses a simple relationship between this feature vector and the SVDD sphere center to re-express the center with a single vector. The decision function of F-SVDD contains only one kernel term, and thus the decision boundary of F-SVDD is only spherical in the original space. Hence, the run-time complexity of the F-SVDD decision function is no longer linear in the support vectors, but is a constant, no matter how large the training set size is. In this paper, we also propose a novel direct preimage-finding method, which is noniterative and involves no free parameters. The unique preimage can be obtained in real time by the proposed direct method without taking trial-and-error. For demonstration, several real-world data sets and a large-scale data set, the extended MIT face data set, are used in experiments. In addition, a practical industry example regarding liquid crystal display micro-defect inspection is also used to compare the applicability of SVDD and our proposed F-SVDD when faced with mass data input. The results are very encouraging.

Evaluation and purchase of an analytical flow cytometer: some of the numerous factors to consider.

PubMed

Zucker, Robert M; Fisher, Nancy C

2013-01-01

When purchasing a flow cytometer, the decision of which brand, model, specifications, and accessories may be challenging. The decisions should initially be guided by the specific applications intended for the instrument. However, many other factors need to be considered, which include hardware, software, quality assurance, support, service, and price and recommendations from colleagues. These issues are discussed to help guide the purchasing process.

Analyzing Decision Logs to Understand Decision Making in Serious Crime Investigations.

PubMed

Dando, Coral J; Ormerod, Thomas C

2017-12-01

Objective To study decision making by detectives when investigating serious crime through the examination of decision logs to explore hypothesis generation and evidence selection. Background Decision logs are used to record and justify decisions made during serious crime investigations. The complexity of investigative decision making is well documented, as are the errors associated with miscarriages of justice and inquests. The use of decision logs has not been the subject of an empirical investigation, yet they offer an important window into the nature of investigative decision making in dynamic, time-critical environments. Method A sample of decision logs from British police forces was analyzed qualitatively and quantitatively to explore hypothesis generation and evidence selection by police detectives. Results Analyses revealed diversity in documentation of decisions that did not correlate with case type and identified significant limitations of the decision log approach to supporting investigative decision making. Differences emerged between experienced and less experienced officers' decision log records in exploration of alternative hypotheses, generation of hypotheses, and sources of evidential inquiry opened over phase of investigation. Conclusion The practical use of decision logs is highly constrained by their format and context of use. Despite this, decision log records suggest that experienced detectives display strategic decision making to avoid confirmation and satisficing, which affect less experienced detectives. Application Potential applications of this research include both training in case documentation and the development of new decision log media that encourage detectives, irrespective of experience, to generate multiple hypotheses and optimize the timely selection of evidence to test them.

Targeted business intelligence pays off.

PubMed

Hennen, James

2009-03-01

Application business intelligence can accomplish much of what large-scale, enterprisewide efforts can accomplish: Focus on a variety of data that are interrelated in a meaningful way, Support decision making at multiple levels within a given organization, Leverage data that are already captured but not fully used, Provide actionable information and support quick response via a dashboard or control panel.

Computational Toxicology as Implemented by the U.S. EPA: Providing High Throughput Decision Support Tools for Screening and Assessing Chemical Exposure, Hazard and Risk

EPA Science Inventory

Computational toxicology is the application of mathematical and computer models to help assess chemical hazards and risks to human health and the environment. Supported by advances in informatics, high-throughput screening (HTS) technologies, and systems biology, the U.S. Environ...

Risk-based decision making for terrorism applications.

PubMed

Dillon, Robin L; Liebe, Robert M; Bestafka, Thomas

2009-03-01

This article describes the anti-terrorism risk-based decision aid (ARDA), a risk-based decision-making approach for prioritizing anti-terrorism measures. The ARDA model was developed as part of a larger effort to assess investments for protecting U.S. Navy assets at risk and determine whether the most effective anti-terrorism alternatives are being used to reduce the risk to the facilities and war-fighting assets. With ARDA and some support from subject matter experts, we examine thousands of scenarios composed of 15 attack modes against 160 facility types on two installations and hundreds of portfolios of 22 mitigation alternatives. ARDA uses multiattribute utility theory to solve some of the commonly identified challenges in security risk analysis. This article describes the process and documents lessons learned from applying the ARDA model for this application.

Leveraging Open Standard Interfaces in Providing Efficient Discovery, Retrieval, and Information of NASA-Sponsored Observations and Predictions

NASA Astrophysics Data System (ADS)

Cole, M.; Alameh, N.; Bambacus, M.

2006-05-01

The Applied Sciences Program at NASA focuses on extending the results of NASA's Earth-Sun system science research beyond the science and research communities to contribute to national priority applications with societal benefits. By employing a systems engineering approach, supporting interoperable data discovery and access, and developing partnerships with federal agencies and national organizations, the Applied Sciences Program facilitates the transition from research to operations in national applications. In particular, the Applied Sciences Program identifies twelve national applications, listed at http://science.hq.nasa.gov/earth-sun/applications/, which can be best served by the results of NASA aerospace research and development of science and technologies. The ability to use and integrate NASA data and science results into these national applications results in enhanced decision support and significant socio-economic benefits for each of the applications. This paper focuses on leveraging the power of interoperability and specifically open standard interfaces in providing efficient discovery, retrieval, and integration of NASA's science research results. Interoperability (the ability to access multiple, heterogeneous geoprocessing environments, either local or remote by means of open and standard software interfaces) can significantly increase the value of NASA-related data by increasing the opportunities to discover, access and integrate that data in the twelve identified national applications (particularly in non-traditional settings). Furthermore, access to data, observations, and analytical models from diverse sources can facilitate interdisciplinary and exploratory research and analysis. To streamline this process, the NASA GeoSciences Interoperability Office (GIO) is developing the NASA Earth-Sun System Gateway (ESG) to enable access to remote geospatial data, imagery, models, and visualizations through open, standard web protocols. The gateway (online at http://esg.gsfc.nasa.gov) acts as a flexible and searchable registry of NASA-related resources (files, services, models, etc) and allows scientists, decision makers and others to discover and retrieve a wide variety of observations and predictions of natural and human phenomena related to Earth Science from NASA and other sources. To support the goals of the Applied Sciences national applications, GIO staff is also working with the national applications communities to identify opportunities where open standards-based discovery and access to NASA data can enhance the decision support process of the national applications. This paper describes the work performed to-date on that front, and summarizes key findings in terms of identified data sources and benefiting national applications. The paper also highlights the challenges encountered in making NASA-related data accessible in a cross-cutting fashion and identifies areas where interoperable approaches can be leveraged.

Leveraging Web Services in Providing Efficient Discovery, Retrieval, and Integration of NASA-Sponsored Observations and Predictions

NASA Astrophysics Data System (ADS)

Bambacus, M.; Alameh, N.; Cole, M.

2006-12-01

The Applied Sciences Program at NASA focuses on extending the results of NASA's Earth-Sun system science research beyond the science and research communities to contribute to national priority applications with societal benefits. By employing a systems engineering approach, supporting interoperable data discovery and access, and developing partnerships with federal agencies and national organizations, the Applied Sciences Program facilitates the transition from research to operations in national applications. In particular, the Applied Sciences Program identifies twelve national applications, listed at http://science.hq.nasa.gov/earth-sun/applications/, which can be best served by the results of NASA aerospace research and development of science and technologies. The ability to use and integrate NASA data and science results into these national applications results in enhanced decision support and significant socio-economic benefits for each of the applications. This paper focuses on leveraging the power of interoperability and specifically open standard interfaces in providing efficient discovery, retrieval, and integration of NASA's science research results. Interoperability (the ability to access multiple, heterogeneous geoprocessing environments, either local or remote by means of open and standard software interfaces) can significantly increase the value of NASA-related data by increasing the opportunities to discover, access and integrate that data in the twelve identified national applications (particularly in non-traditional settings). Furthermore, access to data, observations, and analytical models from diverse sources can facilitate interdisciplinary and exploratory research and analysis. To streamline this process, the NASA GeoSciences Interoperability Office (GIO) is developing the NASA Earth-Sun System Gateway (ESG) to enable access to remote geospatial data, imagery, models, and visualizations through open, standard web protocols. The gateway (online at http://esg.gsfc.nasa.gov) acts as a flexible and searchable registry of NASA-related resources (files, services, models, etc) and allows scientists, decision makers and others to discover and retrieve a wide variety of observations and predictions of natural and human phenomena related to Earth Science from NASA and other sources. To support the goals of the Applied Sciences national applications, GIO staff is also working with the national applications communities to identify opportunities where open standards-based discovery and access to NASA data can enhance the decision support process of the national applications. This paper describes the work performed to-date on that front, and summarizes key findings in terms of identified data sources and benefiting national applications. The paper also highlights the challenges encountered in making NASA-related data accessible in a cross-cutting fashion and identifies areas where interoperable approaches can be leveraged.

Flood Resilient Systems and their Application for Flood Resilient Planning

NASA Astrophysics Data System (ADS)

Manojlovic, N.; Gabalda, V.; Antanaskovic, D.; Gershovich, I.; Pasche, E.

2012-04-01

Following the paradigm shift in flood management from traditional to more integrated approaches, and considering the uncertainties of future development due to drivers such as climate change, one of the main emerging tasks of flood managers becomes the development of (flood) resilient cities. It can be achieved by application of non-structural - flood resilience measures, summarised in the 4As: assistance, alleviation, awareness and avoidance (FIAC, 2007). As a part of this strategy, the key aspect of development of resilient cities - resilient built environment can be reached by efficient application of Flood Resilience Technology (FReT) and its meaningful combination into flood resilient systems (FRS). FRS are given as [an interconnecting network of FReT which facilitates resilience (including both restorative and adaptive capacity) to flooding, addressing physical and social systems and considering different flood typologies] (SMARTeST, http://www.floodresilience.eu/). Applying the system approach (e.g. Zevenbergen, 2008), FRS can be developed at different scales from the building to the city level. Still, a matter of research is a method to define and systematise different FRS crossing those scales. Further, the decision on which resilient system is to be applied for the given conditions and given scale is a complex task, calling for utilisation of decision support tools. This process of decision-making should follow the steps of flood risk assessment (1) and development of a flood resilience plan (2) (Manojlovic et al, 2009). The key problem in (2) is how to match the input parameters that describe physical&social system and flood typology to the appropriate flood resilient system. Additionally, an open issue is how to integrate the advances in FReT and findings on its efficiency into decision support tools. This paper presents a way to define, systematise and make decisions on FRS at different scales of an urban system developed within the 7th FP Project SMARTeST. A web based three tier advisory system FLORETO-KALYPSO (http://floreto.wb.tu-harburg.de/, Manojlovic et al, 2009) devoted to support decision-making process at the building level has been further developed to support multi-scale decision making on resilient systems, improving the existing data mining algorithms of the Business Logic tier. Further tuning of the algorithms is to be performed based on the new developments and findings in applicability and efficiency of different FRe Technology for different flood typologies. The first results obtained at the case studies in Greater Hamburg, Germany indicate the potential of this approach to contribute to the multiscale resilient planning on the road to flood resilient cities. FIAC (2007): "Final report form the Awareness and Assistance Sub-committee", FIAC, Scottish Government Zevenbergen C. et al (2008) "Challenges in urban flood management: travelling across spatial and temporal scales", Journal of FRM Volume 1 Issue 2, p 81-88 Manojlovic N., et al (2009): "Capacity Building in FRM through a DSS Utilising Data Mining Approach", Proceed. 8th HIC, Concepcion, Chile, January, 2009

Improving the relevance and impact of decision support research: A co-production framework and water management case study

NASA Astrophysics Data System (ADS)

Smith, R.; Kasprzyk, J. R.; Dilling, L.; Basdekas, L.; Kaatz, L.

2016-12-01

In light of the unpredictable effects of climate change and population shifts, responsible resource management will require new types of information and strategies going forward. For water utilities, this means that water supply infrastructure systems must be expanded and/or managed for changes in overall supply and increased extremes. Utilities have begun seeking innovative tools and methods to support planning and decision making, but there are limited channels through which they can gain exposure to emerging tools from the research world, and for researchers to uptake important real-world planning and decision context. A transdisciplinary team of engineers, social and climate scientists, and water managers designed this study to develop and apply a co-production framework which explores the potential of an emerging decision support tool to enhance flexibility and adaptability in water utility planning. It also demonstrates how to improve the link between research and practice in the water sector. In this study we apply the co-production framework to the use of Multiobjective Evolutionary Algorithms (MOEAs). MOEAs have shown promise in being able to generate and evaluate new planning alternatives but they have had little testing or application in water utilities. Anchored by two workshops, this study (1) elicited input from water managers from six water suppliers on the Front Range of Colorado, USA, to create a testbed MOEA application, and (2) evaluated the managers' responses to multiobjective optimization results. The testbed consists of a Front Range-relevant hypothetical water supply model, the Borg MOEA, hydrology and demand scenarios, and a set of planning decisions and performance objectives that drive the link between the algorithm and the model. In this presentation we describe researcher-manager interactions at the initial workshop that served to establish relationships and provide in-depth information to researchers about regional water management context. We also describe the development of, and experiences from, the second workshop which included activities for water managers to interact directly with MOEA testbed results. Finally, we evaluate the co-production framework itself and the potential for the feedback from managers to shape future development of decision support tools.

Adult patient decision-making regarding implantation of complex cardiac devices: a scoping review.

PubMed

Malecki-Ketchell, Alison; Marshall, Paul; Maclean, Joan

2017-10-01

Complex cardiac rhythm management device (CRMD) therapy provides an important treatment option for people at risk of sudden cardiac death. Despite the survival benefit, device implantation is associated with significant physical and psychosocial concerns presenting considerable challenges for the decision-making process surrounding CRMD implantation for patients and physicians. The purpose of this scoping review was to explore what is known about how adult (>16 years) patients make decisions regarding implantation of CRMD therapy. Published, peer reviewed, English language studies from 2000 to 2016 were identified in a search across eight healthcare databases. Eligible studies were concerned with patient decision-making for first time device implantation. Quality assessment was completed using the mixed methods appraisal tool for all studies meeting the inclusion criteria. The findings of eight qualitative and seven quantitative studies, including patients who accepted or declined primary or secondary sudden cardiac death prevention devices, were clustered into two themes: knowledge acquisition and the process of decision-making, exposing similarities and distinctions with the treatment decision-making literature. The review revealed some insight in to the way patients approach decision-making but also exposed a lack of clarity and research activity specific to CRMD patients. Further research is recommended to support the development and application of targeted decision support mechanisms.

Application of wildfire simulation models for risk analysis

Treesearch

Alan A. Ager; Mark A. Finney

2009-01-01

Wildfire simulation models are being widely used by fire and fuels specialists in the U.S. to support tactical and strategic decisions related to the mitigation of wildfire risk. Much of this application has resulted from the development of a minimum travel time (MTT) fire spread algorithm (M. Finney) that makes it computationally feasible to simulate thousands of...

Determination of differences in crop injury from aerial application of glyphosate using vegetation indices and geostatistics

USDA-ARS?s Scientific Manuscript database

Injury to crops caused by off-target drift of glyphosate can seriously reduce growth and yield, and is of great concern to farmers and aerial applicators. Determining an indirect method for assessing the levels and extent of crop injury could support management decisions. The objectives of this stud...

Patent prosecution at the European Patent Office: what is new for life sciences applicants?

PubMed

Lidén, Camilla; Setréus, Ellen

2011-06-01

During the last couple of years, the European Patent Office (EPO) has gradually implemented the so-called 'Raising the Bar' initiative, which is aimed at improving the quality of European patents and, in combination with speeding up the procedure for grant, reducing uncertainty for third parties. As a part of this initiative, a series of changes to the implementing regulations of the European Patent Convention (EPC) were introduced last year. Applicants now need to be sure of their position with regard to supportive experimental data and a thorough argumentation at an earlier stage in the prosecution of a patent application. When evaluating the criteria of inventive step (Art 56 EPC) and sufficiency of disclosure (Art 83 EPC), the EPO frequently refers to two decisions issued by the Boards of Appeal. These decisions are also used to determine whether it is appropriate to further support a disclosed technical effect or a scope of protection with experimental data produced after the date of filing of the patent application. In view of recent case law, it is evident that applicants cannot rely on post-filed experimental data as the only evidence for a technical effect or a certain scope of protection claimed in the application.

Modeling Applications and Tools

EPA Pesticide Factsheets

The U.S. EPA's Air Quality Modeling Group (AQMG) conducts modeling analyses to support policy and regulatory decisions in OAR and provides leadership and direction on the full range of air quality models and other mathematical simulation techniques used in

The cornerstone of data warehousing for government applications

NASA Technical Reports Server (NTRS)

Kenbeek, Doug; Rothschild, Jack

1996-01-01

The purpose of this paper is to discuss data warehousing storage issues and the impact of EMC open storage technology for meeting the myriad of challenges government organizations face when building Decision Support/Data Warehouse system.

Utilizing Remote Sensing Data to Ascertain Soil Moisture Applications and Air Quality Conditions

NASA Technical Reports Server (NTRS)

Leptoukh, Gregory; Kempler, Steve; Teng, William; Friedl, Lawrence; Lynnes, Chris

2009-01-01

Recognizing the significance of NASA remote sensing Earth science data in monitoring and better understanding our planet's natural environment, NASA Earth Applied Sciences has implemented the 'Decision Support Through Earth Science Research Results' program. Several applications support systems through collaborations with benefiting organizations have been implemented. The Goddard Earth Sciences Data and Information Services Center (GES DISC) has participated in this program on two projects (one complete, one ongoing), and has had opportune ad hoc collaborations utilizing NASA Earth science data. GES DISC's understanding of Earth science missions and resulting data and information enables the GES DISC to identify challenges that come with bringing science data to research applications. In this presentation we describe applications research projects utilizing NASA Earth science data and a variety of resulting GES DISC applications support system project experiences. In addition, defining metrics that really evaluate success will be exemplified.

Automatic system testing of a decision support system for insulin dosing using Google Android.

PubMed

Spat, Stephan; Höll, Bernhard; Petritsch, Georg; Schaupp, Lukas; Beck, Peter; Pieber, Thomas R

2013-01-01

Hyperglycaemia in hospitalized patients is a common and costly health care problem. The GlucoTab system is a mobile workflow and decision support system, aiming to facilitate efficient and safe glycemic control of non-critically ill patients. Being a medical device, the GlucoTab requires extensive and reproducible testing. A framework for high-volume, reproducible and automated system testing of the GlucoTab system was set up applying several Open Source tools for test automation and system time handling. The REACTION insulin titration protocol was investigated in a paper-based clinical trial (PBCT). In order to validate the GlucoTab system, data from this trial was used for simulation and system tests. In total, 1190 decision support action points were identified and simulated. Four data points (0.3%) resulted in a GlucoTab system error caused by a defective implementation. In 144 data points (12.1%), calculation errors of physicians and nurses in the PBCT were detected. The test framework was able to verify manual calculation of insulin doses and detect relatively many user errors and workflow anomalies in the PBCT data. This shows the high potential of the electronic decision support application to improve safety of implementation of an insulin titration protocol and workflow management system in clinical wards.

Decision support system for emergency management of oil spill accidents in the Mediterranean Sea

NASA Astrophysics Data System (ADS)

Liubartseva, Svitlana; Coppini, Giovanni; Pinardi, Nadia; De Dominicis, Michela; Lecci, Rita; Turrisi, Giuseppe; Cretì, Sergio; Martinelli, Sara; Agostini, Paola; Marra, Palmalisa; Palermo, Francesco

2016-08-01

This paper presents an innovative web-based decision support system to facilitate emergency management in the case of oil spill accidents, called WITOIL (Where Is The Oil). The system can be applied to create a forecast of oil spill events, evaluate uncertainty of the predictions, and calculate hazards based on historical meteo-oceanographic datasets. To compute the oil transport and transformation, WITOIL uses the MEDSLIK-II oil spill model forced by operational meteo-oceanographic services. Results of the modeling are visualized through Google Maps. A special application for Android is designed to provide mobile access for competent authorities, technical and scientific institutions, and citizens.

Use of decision support systems as a drought management tool

USGS Publications Warehouse

Frevert, D.; Lins, H.; ,

2005-01-01

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

Communication-based behaviour support for adults with intellectual disabilities receiving dental care: A focus group study exploring dentists' decision-making and communication.

PubMed

Phadraig, Caoimhin Mac Giolla; Griffiths, Colin; McCallion, Philip; McCarron, Mary; Nunn, June

2017-01-01

A better understanding of how communication-based behaviour supports are applied with adults with intellectual disabilities may reduce reliance on restrictive practices such as holding, sedation and anaesthesia in dentistry. In this study, we explore how communication is used by dentists who provide treatment for adults with intellectual disabilities. A descriptive qualitative study, adopting synchronous online focus groups, was undertaken with six expert dentists in Ireland. Members were contacted again in pairs or individually for further data collection, analysed using thematic content analysis. Two relevant categories emerged from the data, relating to the selection and application of communication-based behaviour support for adults with intellectual disabilities. Decision-making processes were explored. Building on these categories, a co-regulating process of communication emerged as the means by which dentists iteratively apply and adapt communicative strategies. This exploration revealed rationalist and intuitive decision-making. Implications for education, practice and research are identified.

Eye-tracking for clinical decision support: A method to capture automatically what physicians are viewing in the EMR.

PubMed

King, Andrew J; Hochheiser, Harry; Visweswaran, Shyam; Clermont, Gilles; Cooper, Gregory F

2017-01-01

Eye-tracking is a valuable research tool that is used in laboratory and limited field environments. We take steps toward developing methods that enable widespread adoption of eye-tracking and its real-time application in clinical decision support. Eye-tracking will enhance awareness and enable intelligent views, more precise alerts, and other forms of decision support in the Electronic Medical Record (EMR). We evaluated a low-cost eye-tracking device and found the device's accuracy to be non-inferior to a more expensive device. We also developed and evaluated an automatic method for mapping eye-tracking data to interface elements in the EMR (e.g., a displayed laboratory test value). Mapping was 88% accurate across the six participants in our experiment. Finally, we piloted the use of the low-cost device and the automatic mapping method to label training data for a Learning EMR (LEMR) which is a system that highlights the EMR elements a physician is predicted to use.

Eye-tracking for clinical decision support: A method to capture automatically what physicians are viewing in the EMR

PubMed Central

King, Andrew J.; Hochheiser, Harry; Visweswaran, Shyam; Clermont, Gilles; Cooper, Gregory F.

2017-01-01

Eye-tracking is a valuable research tool that is used in laboratory and limited field environments. We take steps toward developing methods that enable widespread adoption of eye-tracking and its real-time application in clinical decision support. Eye-tracking will enhance awareness and enable intelligent views, more precise alerts, and other forms of decision support in the Electronic Medical Record (EMR). We evaluated a low-cost eye-tracking device and found the device’s accuracy to be non-inferior to a more expensive device. We also developed and evaluated an automatic method for mapping eye-tracking data to interface elements in the EMR (e.g., a displayed laboratory test value). Mapping was 88% accurate across the six participants in our experiment. Finally, we piloted the use of the low-cost device and the automatic mapping method to label training data for a Learning EMR (LEMR) which is a system that highlights the EMR elements a physician is predicted to use. PMID:28815151

Boundary work for implementing adaptive management: A water sector application.

PubMed

Adem Esmail, Blal; Geneletti, Davide; Albert, Christian

2017-09-01

Boundary work, defined as effort to mediate between knowledge and action, is a promising approach for facilitating knowledge co-production for sustainable development. Here, we investigate a case study of knowledge co-production, to assess the applicability of boundary work as a conceptual framework to support implementing adaptive management in the water sector. We refer to a boundary work classification recently proposed by Clark et al., (2016), based on three types of knowledge uses, i.e. enlightenment, decision-, and negotiation-support, and three types of sources, i.e. personal expertise, single, and multiple communities of expertise. Our empirical results confirm boundary work has been crucial for the three types of knowledge use. For enlightenment and decision-support, effective interaction among knowledge producers and users was achieved through diverse boundary work practices, including joint agenda setting, and sharing of data and expertise. This initial boundary work eased subsequent knowledge co-production for decision-support and negotiations, in combination with stepping up of cooperation between relevant actors, suitable legislation and pressure for problem solving. Our analysis highlighted the temporal dimension matters - building trust around enlightenment first, and then using this as a basis for managing knowledge co-production for decision-, and negotiation support. We reconfirmed that boundary work is not a single time achievement, rather is a dynamic process, and we emphasized the importance of key actors driving the process, such as water utilities. Our results provide a rich case study of how strategic boundary work can facilitate knowledge co-production for adaptive management in the water sector. The boundary work practices employed here could also be transferred to other cases. Water utilities, as intermediaries between providers and beneficiaries of the important water-related ecosystem service of clean water provision, can indeed serve as key actors for initiating such boundary work practices. Copyright © 2017 Elsevier B.V. All rights reserved.

Decision-making in nursing practice: An integrative literature review.

PubMed

Nibbelink, Christine W; Brewer, Barbara B

2018-03-01

To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. © 2017 John Wiley & Sons Ltd.

The Operational Movement Planning System: A Prototype for the Strategic Command Function

DTIC Science & Technology

1993-06-01

environment. The White Paper identifies "computer based systems to support the decision making of operational and higher level commanders" as an important...exist and objective decisions can be made. When extending the application of computers into the upper levels of an organisation higher productivity...thCtaspot. aiinssetstnttt dtrm In his magstepatecapsables tran lsptort O assets o ahie umr r dniid eemnn capabilty is avery coplex prcess . Cpabilit reuie

From complex questionnaire and interviewing data to intelligent Bayesian Network models for medical decision support

PubMed Central

Constantinou, Anthony Costa; Fenton, Norman; Marsh, William; Radlinski, Lukasz

2016-01-01

Objectives 1) To develop a rigorous and repeatable method for building effective Bayesian network (BN) models for medical decision support from complex, unstructured and incomplete patient questionnaires and interviews that inevitably contain examples of repetitive, redundant and contradictory responses; 2) To exploit expert knowledge in the BN development since further data acquisition is usually not possible; 3) To ensure the BN model can be used for interventional analysis; 4) To demonstrate why using data alone to learn the model structure and parameters is often unsatisfactory even when extensive data is available. Method The method is based on applying a range of recent BN developments targeted at helping experts build BNs given limited data. While most of the components of the method are based on established work, its novelty is that it provides a rigorous consolidated and generalised framework that addresses the whole life-cycle of BN model development. The method is based on two original and recent validated BN models in forensic psychiatry, known as DSVM-MSS and DSVM-P. Results When employed with the same datasets, the DSVM-MSS demonstrated competitive to superior predictive performance (AUC scores 0.708 and 0.797) against the state-of-the-art (AUC scores ranging from 0.527 to 0.705), and the DSVM-P demonstrated superior predictive performance (cross-validated AUC score of 0.78) against the state-of-the-art (AUC scores ranging from 0.665 to 0.717). More importantly, the resulting models go beyond improving predictive accuracy and into usefulness for risk management purposes through intervention, and enhanced decision support in terms of answering complex clinical questions that are based on unobserved evidence. Conclusions This development process is applicable to any application domain which involves large-scale decision analysis based on such complex information, rather than based on data with hard facts, and in conjunction with the incorporation of expert knowledge for decision support via intervention. The novelty extends to challenging the decision scientists to reason about building models based on what information is really required for inference, rather than based on what data is available and hence, forces decision scientists to use available data in a much smarter way. PMID:26830286

From complex questionnaire and interviewing data to intelligent Bayesian network models for medical decision support.

PubMed

Constantinou, Anthony Costa; Fenton, Norman; Marsh, William; Radlinski, Lukasz

2016-02-01

(1) To develop a rigorous and repeatable method for building effective Bayesian network (BN) models for medical decision support from complex, unstructured and incomplete patient questionnaires and interviews that inevitably contain examples of repetitive, redundant and contradictory responses; (2) To exploit expert knowledge in the BN development since further data acquisition is usually not possible; (3) To ensure the BN model can be used for interventional analysis; (4) To demonstrate why using data alone to learn the model structure and parameters is often unsatisfactory even when extensive data is available. The method is based on applying a range of recent BN developments targeted at helping experts build BNs given limited data. While most of the components of the method are based on established work, its novelty is that it provides a rigorous consolidated and generalised framework that addresses the whole life-cycle of BN model development. The method is based on two original and recent validated BN models in forensic psychiatry, known as DSVM-MSS and DSVM-P. When employed with the same datasets, the DSVM-MSS demonstrated competitive to superior predictive performance (AUC scores 0.708 and 0.797) against the state-of-the-art (AUC scores ranging from 0.527 to 0.705), and the DSVM-P demonstrated superior predictive performance (cross-validated AUC score of 0.78) against the state-of-the-art (AUC scores ranging from 0.665 to 0.717). More importantly, the resulting models go beyond improving predictive accuracy and into usefulness for risk management purposes through intervention, and enhanced decision support in terms of answering complex clinical questions that are based on unobserved evidence. This development process is applicable to any application domain which involves large-scale decision analysis based on such complex information, rather than based on data with hard facts, and in conjunction with the incorporation of expert knowledge for decision support via intervention. The novelty extends to challenging the decision scientists to reason about building models based on what information is really required for inference, rather than based on what data is available and hence, forces decision scientists to use available data in a much smarter way. Copyright © 2016 Elsevier B.V. All rights reserved.

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Technical Reports Server (NTRS)

Raiman, Laura B.

1992-01-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Implementation of quality improvement techniques for management and technical processes in the ACRV project

NASA Astrophysics Data System (ADS)

Raiman, Laura B.

1992-12-01

Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

Integrating Water Quality and River Rehabilitation Management - A Decision-Analytical Perspective

NASA Astrophysics Data System (ADS)

Reichert, P.; Langhans, S.; Lienert, J.; Schuwirth, N.

2009-04-01

Integrative river management involves difficult decisions about alternative measures to improve their ecological state. For this reason, it seems useful to apply knowledge from the decision sciences to support river management. We discuss how decision-analytical elements can be employed for designing an integrated river management procedure. An important aspect of this procedure is to clearly separate scientific predictions of the consequences of alternatives from objectives to be achieved by river management. The key elements of the suggested procedure are (i) the quantitative elicitation of the objectives from different stakeholder groups, (ii) the compilation of the current scientific knowledge about the consequences of the effects resulting from suggested measures in the form of a probabilistic mathematical model, and (iii) the use of these predictions and valuations to prioritize alternatives, to uncover conflicting objectives, to support the design of better alternatives, and to improve the transparency of communication about the chosen management strategy. The development of this procedure led to insights regarding necessary steps to be taken for rational decision-making in river management, to guidelines about the use of decision-analytical techniques for performing these steps, but also to new insights about the application of decision-analytical techniques in general. In particular, the consideration of the spatial distribution of the effects of measures and the potential added value of connected rehabilitated river reaches leads to favoring measures that have a positive effect beyond a single river reach. As these effects only propagate within the river network, this results in a river basin oriented management concept as a consequence of a rational decision support procedure, rather than as an a priori management paradigm. There are also limitations to the support that can be expected from the decision-analytical perspective. It will not provide the societal values that are driving prioritization in river management, it will only support their elicitation and rational use. This is particularly important for the assessment of micro-pollutants because of severe limitations in scientific knowledge of their effects on river ecosystems. This makes the influence of pollution by micro-pollutants on prioritization of measures strongly dependent on the weight of the precautionary principle relative to other societal objectives of river management.

Usability evaluation of the interactive Personal Patient Profile-Prostate decision support system with African American men.

PubMed

Jaja, Cheedy; Pares-Avila, Jose; Wolpin, Seth; Berry, Donna

2010-04-01

The Personal Patient Profile-Prostate (P4) program is an interactive Web-based decision support system that provides men with localized prostate cancer customized education and coaching with which to make the best personal treatment decision. This study assessed functionality and usability of the P4 program and identified problems in user-computer interaction in a sample of African American men. Usability testing was conducted with 12 community-dwelling African American adult men. The health status of participants was not known or collected by the research team. Each participant worked with the P4 program and provided simultaneous feedback using the "think aloud" technique. Handwritten field notes were collated and assigned to 3 standard coded categories. Aspects of P4 program usability was made based on common issues in the assigned categories. Summary statistics were derived for types and frequency of usability issues noted in the coded data. Twelve participants reported a total of 122 usability comments, with a mean of 9 usability comments. The most common usability issue by participant was completeness of information content, which comprised 53 (43%) of the total issues. Comprehensibility of text and graphics was second, comprising 51 (42%) of the total issues. This study provided initial inventory of usability issues for community African American men that may potentially interfere with application of the P4 system in the community setting and overall system usability, confirming the need for usability testing of a culturally appropriate Internet-based decision support system before community application.

Operational seasonal forecasting of crop performance.

PubMed

Stone, Roger C; Meinke, Holger

2005-11-29

Integrated, interdisciplinary crop performance forecasting systems, linked with appropriate decision and discussion support tools, could substantially improve operational decision making in agricultural management. Recent developments in connecting numerical weather prediction models and general circulation models with quantitative crop growth models offer the potential for development of integrated systems that incorporate components of long-term climate change. However, operational seasonal forecasting systems have little or no value unless they are able to change key management decisions. Changed decision making through incorporation of seasonal forecasting ultimately has to demonstrate improved long-term performance of the cropping enterprise. Simulation analyses conducted on specific production scenarios are especially useful in improving decisions, particularly if this is done in conjunction with development of decision-support systems and associated facilitated discussion groups. Improved management of the overall crop production system requires an interdisciplinary approach, where climate scientists, agricultural scientists and extension specialists are intimately linked with crop production managers in the development of targeted seasonal forecast systems. The same principle applies in developing improved operational management systems for commodity trading organizations, milling companies and agricultural marketing organizations. Application of seasonal forecast systems across the whole value chain in agricultural production offers considerable benefits in improving overall operational management of agricultural production.

Operational seasonal forecasting of crop performance

PubMed Central

Stone, Roger C; Meinke, Holger

2005-01-01

Integrated, interdisciplinary crop performance forecasting systems, linked with appropriate decision and discussion support tools, could substantially improve operational decision making in agricultural management. Recent developments in connecting numerical weather prediction models and general circulation models with quantitative crop growth models offer the potential for development of integrated systems that incorporate components of long-term climate change. However, operational seasonal forecasting systems have little or no value unless they are able to change key management decisions. Changed decision making through incorporation of seasonal forecasting ultimately has to demonstrate improved long-term performance of the cropping enterprise. Simulation analyses conducted on specific production scenarios are especially useful in improving decisions, particularly if this is done in conjunction with development of decision-support systems and associated facilitated discussion groups. Improved management of the overall crop production system requires an interdisciplinary approach, where climate scientists, agricultural scientists and extension specialists are intimately linked with crop production managers in the development of targeted seasonal forecast systems. The same principle applies in developing improved operational management systems for commodity trading organizations, milling companies and agricultural marketing organizations. Application of seasonal forecast systems across the whole value chain in agricultural production offers considerable benefits in improving overall operational management of agricultural production. PMID:16433097

A Buyer Behaviour Framework for the Development and Design of Software Agents in E-Commerce.

ERIC Educational Resources Information Center

Sproule, Susan; Archer, Norm

2000-01-01

Software agents are computer programs that run in the background and perform tasks autonomously as delegated by the user. This paper blends models from marketing research and findings from the field of decision support systems to build a framework for the design of software agents to support in e-commerce buying applications. (Contains 35…

Representing and querying now-relative relational medical data.

PubMed

Anselma, Luca; Piovesan, Luca; Stantic, Bela; Terenziani, Paolo

2018-03-01

Temporal information plays a crucial role in medicine. Patients' clinical records are intrinsically temporal. Thus, in Medical Informatics there is an increasing need to store, support and query temporal data (particularly in relational databases), in order, for instance, to supplement decision-support systems. In this paper, we show that current approaches to relational data have remarkable limitations in the treatment of "now-relative" data (i.e., data holding true at the current time). This can severely compromise their applicability in general, and specifically in the medical context, where "now-relative" data are essential to assess the current status of the patients. We propose a theoretically grounded and application-independent relational approach to cope with now-relative data (which can be paired, e.g., with different decision support systems) overcoming such limitations. We propose a new temporal relational representation, which is the first relational model coping with the temporal indeterminacy intrinsic in now-relative data. We also propose new temporal algebraic operators to query them, supporting the distinction between possible and necessary time, and Allen's temporal relations between data. We exemplify the impact of our approach, and study the theoretical and computational properties of the new representation and algebra. Copyright © 2018 Elsevier B.V. All rights reserved.

Decision Support in Diabetes Care: The Challenge of Supporting Patients in Their Daily Living Using a Mobile Glucose Predictor.

PubMed

Pérez-Gandía, Carmen; García-Sáez, Gema; Subías, David; Rodríguez-Herrero, Agustín; Gómez, Enrique J; Rigla, Mercedes; Hernando, M Elena

2018-03-01

In type 1 diabetes mellitus (T1DM), patients play an active role in their own care and need to have the knowledge to adapt decisions to their daily living conditions. Artificial intelligence applications can help people with type 1 diabetes in decision making and allow them to react at time scales shorter than the scheduled face-to-face visits. This work presents a decision support system (DSS), based on glucose prediction, to assist patients in a mobile environment. The system's impact on therapeutic corrective actions has been evaluated in a randomized crossover pilot study focused on interprandial periods. Twelve people with type 1 diabetes treated with insulin pump participated in two phases: In the experimental phase (EP) patients used the DSS to modify initial corrective decisions in presence of hypoglycemia or hyperglycemia events. In the control phase (CP) patients were asked to follow decisions without knowing the glucose prediction. A telemedicine platform allowed participants to register monitoring data and decisions and allowed endocrinologists to supervise data at the hospital. The study period was defined as a postprediction (PP) time window. After knowing the glucose prediction, participants modified the initial decision in 20% of the situations. No statistically significant differences were found in the PP Kovatchev's risk index change (-1.23 ± 11.85 in EP vs -0.56 ± 6.06 in CP). Participants had a positive opinion about the DSS with an average score higher than 7 in a usability questionnaire. The DSS had a relevant impact in the participants' decision making while dealing with T1DM and showed a high confidence of patients in the use of glucose prediction.

Application of a web-based Decision Support System in risk management

NASA Astrophysics Data System (ADS)

Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

2013-04-01

Increasingly, risk information is widely available with the help of advanced technologies such as earth observation satellites, global positioning technologies, coupled with hazard modeling and analysis, and geographical information systems (GIS). Even though it exists, no effort will be put into action if it is not properly presented to the decision makers. These information need to be communicated clearly and show its usefulness so that people can make better informed decision. Therefore, communicating available risk information has become an important challenge and decision support systems have been one of the significant approaches which can help not only in presenting risk information to the decision makers but also in making efficient decisions while reducing human resources and time needed. In this study, the conceptual framework of an internet-based decision support system is presented to highlight its importance role in risk management framework and how it can be applied in case study areas chosen. The main purpose of the proposed system is to facilitate the available risk information in risk reduction by taking into account of the changes in climate, land use and socio-economic along with the risk scenarios. It allows the users to formulate, compare and select risk reduction scenarios (mainly for floods and landslides) through an enhanced participatory platform with diverse stakeholders' involvement in the decision making process. It is based on the three-tier (client-server) architecture which integrates web-GIS plus DSS functionalities together with cost benefit analysis and other supporting tools. Embedding web-GIS provides its end users to make better planning and informed decisions referenced to a geographical location, which is the one of the essential factors in disaster risk reduction programs. Different risk reduction measures of a specific area (local scale) will be evaluated using this web-GIS tool, available risk scenarios obtained from Probabilistic Risk Assessment (PRA) model and the knowledge collected from experts. The visualization of the risk reduction scenarios can also be shared among the users on the web to support the on-line participatory process. In addition, cost-benefit ratios of the different risk reduction scenarios can be prepared in order to serve as inputs for high-level decision makers. The most appropriate risk reduction scenarios will be chosen using Multi-Criteria Evaluation (MCE) method by weighting different parameters according to the preferences and criteria defined by the users. The role of public participation has been changing from one-way communication between authorities, experts, stakeholders and citizens towards more intensive two-way interaction. Involving the affected public and interest groups can enhance the level of legitimacy, transparency, and confidence in the decision making process. Due to its important part in decision making, online participatory tool is included in the DSS in order to allow the involved stakeholders interactively in risk reduction and be aware of the existing vulnerability conditions of the community. Moreover, it aims to achieve a more transparent and better informed decision-making process. The system is under in progress and the first tools implemented will be presented showing the wide possibilities of new web technologies which can have a great impact on the decision making process. It will be applied in four pilot areas in Europe: French Alps, North Eastern Italy, Romania and Poland. Nevertheless, the framework will be designed and implemented in a way to be applicable in any other regions.

Benefit-cost analysis framework for evaluating inter-city transit investment.

DOT National Transportation Integrated Search

2008-10-01

This report describes the development and application of a benefit/cost analysis (BCA) model to support the evaluation of investment decisions for intercity bus services. The model recognizes two principle types of intercity bus benefits: benefits th...

Adverse outcome pathway (AOP) development: Guiding principles and best practices

EPA Science Inventory

Adverse outcome pathways (AOPs) represent a conceptual framework that can support greater application of mechanistic data in regulatory decision-making. However, in order for the scientific community to collectively address the daunting challenge of describing relevant toxicologi...

Bibliometrics as a Tool for Supporting Prospective R&D Decision-Making in the Health Sciences

PubMed Central

Ismail, Sharif; Nason, Edward; Marjanovic, Sonja; Grant, Jonathan

2012-01-01

Abstract Bibliometric analysis is an increasingly important part of a broader “toolbox” of evaluation methods available to research and development (R&D) policymakers to support decision-making. In the US, UK and Australia, for example, there is evidence of gradual convergence over the past ten years towards a model of university research assessment and ranking incorporating the use of bibliometric measures. In Britain, the Department of Health (England) has shown growing interest in using bibliometric analysis to support prospective R&D decision-making, and has engaged RAND Europe's expertise in this area through a number of exercises since 2005. These range from the macro-level selection of potentially high impact institutions, to micro-level selection of high impact individuals for the National Institute for Health Research's faculty of researchers. The aim of this study is to create an accessible, “beginner's guide” to bibliometric theory and application in the area of health R&D decision-making. The study also aims to identify future directions and possible next steps in this area, based on RAND Europe's work with the Department of Health to date. It is targeted at a range of audiences, and will be of interest to health and biomedical researchers, as well as R&D decision-makers in the UK and elsewhere. The study was completed with funding support from RAND Europe's Health R&D Policy Research Unit with the Department of Health. PMID:28083218

A Conceptual Analytics Model for an Outcome-Driven Quality Management Framework as Part of Professional Healthcare Education.

PubMed

Hervatis, Vasilis; Loe, Alan; Barman, Linda; O'Donoghue, John; Zary, Nabil

2015-10-06

Preparing the future health care professional workforce in a changing world is a significant undertaking. Educators and other decision makers look to evidence-based knowledge to improve quality of education. Analytics, the use of data to generate insights and support decisions, have been applied successfully across numerous application domains. Health care professional education is one area where great potential is yet to be realized. Previous research of Academic and Learning analytics has mainly focused on technical issues. The focus of this study relates to its practical implementation in the setting of health care education. The aim of this study is to create a conceptual model for a deeper understanding of the synthesizing process, and transforming data into information to support educators' decision making. A deductive case study approach was applied to develop the conceptual model. The analytics loop works both in theory and in practice. The conceptual model encompasses the underlying data, the quality indicators, and decision support for educators. The model illustrates how a theory can be applied to a traditional data-driven analytics approach, and alongside the context- or need-driven analytics approach.

A Conceptual Analytics Model for an Outcome-Driven Quality Management Framework as Part of Professional Healthcare Education

PubMed Central

Loe, Alan; Barman, Linda; O'Donoghue, John; Zary, Nabil

2015-01-01

Background Preparing the future health care professional workforce in a changing world is a significant undertaking. Educators and other decision makers look to evidence-based knowledge to improve quality of education. Analytics, the use of data to generate insights and support decisions, have been applied successfully across numerous application domains. Health care professional education is one area where great potential is yet to be realized. Previous research of Academic and Learning analytics has mainly focused on technical issues. The focus of this study relates to its practical implementation in the setting of health care education. Objective The aim of this study is to create a conceptual model for a deeper understanding of the synthesizing process, and transforming data into information to support educators’ decision making. Methods A deductive case study approach was applied to develop the conceptual model. Results The analytics loop works both in theory and in practice. The conceptual model encompasses the underlying data, the quality indicators, and decision support for educators. Conclusions The model illustrates how a theory can be applied to a traditional data-driven analytics approach, and alongside the context- or need-driven analytics approach. PMID:27731840

Development of spatial density maps based on geoprocessing web services: application to tuberculosis incidence in Barcelona, Spain.

PubMed

Dominkovics, Pau; Granell, Carlos; Pérez-Navarro, Antoni; Casals, Martí; Orcau, Angels; Caylà, Joan A

2011-11-29

Health professionals and authorities strive to cope with heterogeneous data, services, and statistical models to support decision making on public health. Sophisticated analysis and distributed processing capabilities over geocoded epidemiological data are seen as driving factors to speed up control and decision making in these health risk situations. In this context, recent Web technologies and standards-based web services deployed on geospatial information infrastructures have rapidly become an efficient way to access, share, process, and visualize geocoded health-related information. Data used on this study is based on Tuberculosis (TB) cases registered in Barcelona city during 2009. Residential addresses are geocoded and loaded into a spatial database that acts as a backend database. The web-based application architecture and geoprocessing web services are designed according to the Representational State Transfer (REST) principles. These web processing services produce spatial density maps against the backend database. The results are focused on the use of the proposed web-based application to the analysis of TB cases in Barcelona. The application produces spatial density maps to ease the monitoring and decision making process by health professionals. We also include a discussion of how spatial density maps may be useful for health practitioners in such contexts. In this paper, we developed web-based client application and a set of geoprocessing web services to support specific health-spatial requirements. Spatial density maps of TB incidence were generated to help health professionals in analysis and decision-making tasks. The combined use of geographic information tools, map viewers, and geoprocessing services leads to interesting possibilities in handling health data in a spatial manner. In particular, the use of spatial density maps has been effective to identify the most affected areas and its spatial impact. This study is an attempt to demonstrate how web processing services together with web-based mapping capabilities suit the needs of health practitioners in epidemiological analysis scenarios.

Development of spatial density maps based on geoprocessing web services: application to tuberculosis incidence in Barcelona, Spain

PubMed Central

2011-01-01

Background Health professionals and authorities strive to cope with heterogeneous data, services, and statistical models to support decision making on public health. Sophisticated analysis and distributed processing capabilities over geocoded epidemiological data are seen as driving factors to speed up control and decision making in these health risk situations. In this context, recent Web technologies and standards-based web services deployed on geospatial information infrastructures have rapidly become an efficient way to access, share, process, and visualize geocoded health-related information. Methods Data used on this study is based on Tuberculosis (TB) cases registered in Barcelona city during 2009. Residential addresses are geocoded and loaded into a spatial database that acts as a backend database. The web-based application architecture and geoprocessing web services are designed according to the Representational State Transfer (REST) principles. These web processing services produce spatial density maps against the backend database. Results The results are focused on the use of the proposed web-based application to the analysis of TB cases in Barcelona. The application produces spatial density maps to ease the monitoring and decision making process by health professionals. We also include a discussion of how spatial density maps may be useful for health practitioners in such contexts. Conclusions In this paper, we developed web-based client application and a set of geoprocessing web services to support specific health-spatial requirements. Spatial density maps of TB incidence were generated to help health professionals in analysis and decision-making tasks. The combined use of geographic information tools, map viewers, and geoprocessing services leads to interesting possibilities in handling health data in a spatial manner. In particular, the use of spatial density maps has been effective to identify the most affected areas and its spatial impact. This study is an attempt to demonstrate how web processing services together with web-based mapping capabilities suit the needs of health practitioners in epidemiological analysis scenarios. PMID:22126392

Geospatial decision support systems for societal decision making

USGS Publications Warehouse

Bernknopf, R.L.

2005-01-01

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

Application of a Dynamic Programming Algorithm for Weapon Target Assignment

DTIC Science & Technology

2016-02-01

25] A . Turan , “Techniques for the Allocation of Resources Under Uncertainty,” Middle Eastern Technical University, Ankara, Turkey, 2012. [26] K...UNCLASSIFIED UNCLASSIFIED Application of a Dynamic Programming Algorithm for Weapon Target Assignment Lloyd Hammond Weapons and...optimisation techniques to support the decision making process. This report documents the methodology used to identify, develop and assess a

Mapping the Relationships among Basic Facts, Concepts and Application, and Common Core Curriculum-Based Mathematics Measures

ERIC Educational Resources Information Center

Codding, Robin S.; Mercer, Sterett; Connell, James; Fiorello, Catherine; Kleinert, Whitney

2016-01-01

There is a paucity of evidence supporting the use of curriculum-based mathematics measures (M-CBMs) at the middle school level, which makes data-based decisions challenging for school professionals. The purpose of this study was to examine the relationships among three existing M-CBM indices: (a) basic facts, (b) concepts/application, and (c)…

Multiple stakeholders in multi-criteria decision-making in the context of Municipal Solid Waste Management: A review.

PubMed

Soltani, Atousa; Hewage, Kasun; Reza, Bahareh; Sadiq, Rehan

2015-01-01

Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, and finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Heuristic-based information acquisition and decision making among pilots.

PubMed

Wiggins, Mark W; Bollwerk, Sandra

2006-01-01

This research was designed to examine the impact of heuristic-based approaches to the acquisition of task-related information on the selection of an optimal alternative during simulated in-flight decision making. The work integrated features of naturalistic and normative decision making and strategies of information acquisition within a computer-based, decision support framework. The study comprised two phases, the first of which involved familiarizing pilots with three different heuristic-based strategies of information acquisition: frequency, elimination by aspects, and majority of confirming decisions. The second stage enabled participants to choose one of the three strategies of information acquisition to resolve a fourth (choice) scenario. The results indicated that task-oriented experience, rather than the information acquisition strategies, predicted the selection of the optimal alternative. It was also evident that of the three strategies available, the elimination by aspects information acquisition strategy was preferred by most participants. It was concluded that task-oriented experience, rather than the process of information acquisition, predicted task accuracy during the decision-making task. It was also concluded that pilots have a preference for one particular approach to information acquisition. Applications of outcomes of this research include the development of decision support systems that adapt to the information-processing capabilities and preferences of users.

Marshall Application Realignment System (MARS) Architecture

NASA Technical Reports Server (NTRS)

Belshe, Andrea; Sutton, Mandy

2010-01-01

The Marshall Application Realignment System (MARS) Architecture project was established to meet the certification requirements of the Department of Defense Architecture Framework (DoDAF) V2.0 Federal Enterprise Architecture Certification (FEAC) Institute program and to provide added value to the Marshall Space Flight Center (MSFC) Application Portfolio Management process. The MARS Architecture aims to: (1) address the NASA MSFC Chief Information Officer (CIO) strategic initiative to improve Application Portfolio Management (APM) by optimizing investments and improving portfolio performance, and (2) develop a decision-aiding capability by which applications registered within the MSFC application portfolio can be analyzed and considered for retirement or decommission. The MARS Architecture describes a to-be target capability that supports application portfolio analysis against scoring measures (based on value) and overall portfolio performance objectives (based on enterprise needs and policies). This scoring and decision-aiding capability supports the process by which MSFC application investments are realigned or retired from the application portfolio. The MARS Architecture is a multi-phase effort to: (1) conduct strategic architecture planning and knowledge development based on the DoDAF V2.0 six-step methodology, (2) describe one architecture through multiple viewpoints, (3) conduct portfolio analyses based on a defined operational concept, and (4) enable a new capability to support the MSFC enterprise IT management mission, vision, and goals. This report documents Phase 1 (Strategy and Design), which includes discovery, planning, and development of initial architecture viewpoints. Phase 2 will move forward the process of building the architecture, widening the scope to include application realignment (in addition to application retirement), and validating the underlying architecture logic before moving into Phase 3. The MARS Architecture key stakeholders are most interested in Phase 3 because this is where the data analysis, scoring, and recommendation capability is realized. Stakeholders want to see the benefits derived from reducing the steady-state application base and identify opportunities for portfolio performance improvement and application realignment.

RECOVER - An Automated Burned Area Emergency Response Decision Support System for Post-fire Rehabilitation Management of Savanna Ecosystems in the Western US

NASA Astrophysics Data System (ADS)

Weber, K.; Schnase, J. L.; Carroll, M.; Brown, M. E.; Gill, R.; Haskett, G.; Gardner, T.

2013-12-01

In partnership with the Department of Interior's Bureau of Land Management (BLM) and the Idaho Department of Lands (IDL), we are building and evaluating the RECOVER decision support system. RECOVER - which stands for Rehabilitation Capability Convergence for Ecosystem Recovery - is an automatically deployable, context-aware decision support system for savanna wildfires that brings together in a single application the information necessary for post-fire rehabilitation decision-making and long-term ecosystem monitoring. RECOVER uses state-of-the-art cloud-based data management technologies to improve performance, reduce cost, and provide site-specific flexibility for each fire. The RECOVER Server uses Integrated Rule-Oriented Data System (iRODS) data grid technology deployed in the Amazon Elastic Compute Cloud (EC2). The RECOVER Client is an Adobe Flex web map application that is able to provide a suite of convenient GIS analytical capabilities. In a typical use scenario, the RECOVER Server is provided a wildfire name and geospatial extent. The Server then automatically gathers Earth observational data and other relevant products from various geographically distributed data sources. The Server creates a database in the cloud where all relevant information about the wildfire is stored. This information is made available to the RECOVER Client and ultimately to fire managers through their choice of web browser. The Server refreshes the data throughout the burn and subsequent recovery period (3-5 years) with each refresh requiring two minutes to complete. Since remediation plans must be completed within 14 days of a fire's containment, RECOVER has the potential to significantly improve the decision-making process. RECOVER adds an important new dimension to post-fire decision-making by focusing on ecosystem rehabilitation in semiarid savannas. A novel aspect of RECOVER's approach involves the use of soil moisture estimates, which are an important but difficult-to-obtain element of post-fire rehabilitation planning. We will use downscaled soil moisture data from three primary observational sources to begin evaluation of soil moisture products and build the technology needed for RECOVER to use future SMAP products. As a result, RECOVER, BLM, and the fire applications community will be ready customers for data flowing out of new NASA missions, such as NPP, LDCM, and SMAP.

An Evolutionary Complex Systems Decision-Support Tool for the Management of Operations

NASA Astrophysics Data System (ADS)

Baldwin, J. S.; Allen, P. M.; Ridgway, K.

2011-12-01

This research aimed to add both to the development of complex systems thinking in the subject area of Operations and Production Management and to the limited number of applications of computational models and simulations from the science of complex systems. The latter potentially offer helpful decision-support tools for operations and production managers. A mechanical engineering firm was used as a case study where a combined qualitative and quantitative methodological approach was employed to extract the required data from four senior managers. Company performance measures as well as firm technologies, practices and policies, and their relation and interaction with one another, were elicited. The data were subjected to an evolutionary complex systems model resulting in a series of simulations. The findings included both reassuring and some unexpected results. The simulation based on the CEO's opinions led the most cohesive and synergistic collection of practices describing the firm, closely followed by the Marketing and R&D Managers. The Manufacturing Manager's responses led to the most extreme evolutionary trajectory where the integrity of the entire firm came into question particularly when considering how employees were utilised. By drawing directly from the opinions and views of managers rather than from logical 'if-then' rules and averaged mathematical representations of agents that characterise agent-based and other self-organisational models, this work builds on previous applications by capturing a micro-level description of diversity and a learning effect that has been problematical not only in terms of theory but also in application. This approach can be used as a decision-support tool for operations and other managers providing a forum with which to explore a) the strengths, weaknesses and consequences of different decision-making capacities within the firm; b) the introduction of new manufacturing technologies, practices and policies; and, c) the different evolutionary trajectories that a firm can take.

Knowledge assisted diagnosis of mood disorders using DSM-3

NASA Technical Reports Server (NTRS)

Fritz, Robert H.

1990-01-01

As part of an Expert Systems class at the University of Houston Clear Lake, a system has been developed using CLIPS to allow a clinical psychologist or psychiatrist to diagnose mood disturbances by providing answers to questions corresponding to branches of a DSM-III criteria tree. Experienced clinicians may assert indications of the client's behavior in order to circumvent multiple levels of the tree, thus speeding diagnosis. An explanation facility was developed for validation of the diagnosis . It also allows for 'what if' scenarios by allowing the clinician to move backwards from the diagnosis to any decision branch and alter the answer previously provided. The system was implemented with a limited vocabulary of symptoms associated primarily with depressive disorders. However, the design supports the addition of vocabulary modules and knowledge bases for other types of disorders. The system currently has applicability in an instructional setting. With the addition of a more complete vocabulary, it could have applicability in a clinical setting. The overall design will support any application where determinations are made via a decision tree.

Ropes: Support for collective opertions among distributed threads

NASA Technical Reports Server (NTRS)

Haines, Matthew; Mehrotra, Piyush; Cronk, David

1995-01-01

Lightweight threads are becoming increasingly useful in supporting parallelism and asynchronous control structures in applications and language implementations. Recently, systems have been designed and implemented to support interprocessor communication between lightweight threads so that threads can be exploited in a distributed memory system. Their use, in this setting, has been largely restricted to supporting latency hiding techniques and functional parallelism within a single application. However, to execute data parallel codes independent of other threads in the system, collective operations and relative indexing among threads are required. This paper describes the design of ropes: a scoping mechanism for collective operations and relative indexing among threads. We present the design of ropes in the context of the Chant system, and provide performance results evaluating our initial design decisions.

Land Cover Applications, Landscape Dynamics, and Global Change

USGS Publications Warehouse

Tieszen, Larry L.

2007-01-01

The Land Cover Applications, Landscape Dynamics, and Global Change project at U.S. Geological Survey (USGS) Center for Earth Resources Observation and Science (EROS) seeks to integrate remote sensing and simulation models to better understand and seek solutions to national and global issues. Modeling processes related to population impacts, natural resource management, climate change, invasive species, land use changes, energy development, and climate mitigation all pose significant scientific opportunities. The project activities use remotely sensed data to support spatial monitoring, provide sensitivity analyses across landscapes and large regions, and make the data and results available on the Internet with data access and distribution, decision support systems, and on-line modeling. Applications support sustainable natural resource use, carbon cycle science, biodiversity conservation, climate change mitigation, and robust simulation modeling approaches that evaluate ecosystem and landscape dynamics.

When Informationists Get Involved: the CHICA-GIS Project.

PubMed

Whipple, Elizabeth C; Odell, Jere D; Ralston, Rick K; Liu, Gilbert C

2013-01-01

Child Health Improvement through Computer Automation (CHICA) is a computer decision support system (CDSS) that interfaces with existing electronic medical record systems (EMRS) and delivers "just-in-time" patient-relevant guidelines to physicians during the clinical encounter and accurately captures structured data from all who interact with the system. "Delivering Geospatial Intelligence to Health Care Professionals (CHICA-GIS)" (1R01LM010923-01) expands the medical application of Geographic Information Systems (GIS) by integrating a geographic information system with CHICA. To provide knowledge management support for CHICA-GIS, three informationists at the Indiana University School of Medicine were awarded a supplement from the National Library Medicine. The informationists will enhance CHICA-GIS by: improving the accuracy and accessibility of information, managing and mapping the knowledge which undergirds the CHICA-GIS decision support tool, supporting community engagement and consumer health information outreach, and facilitating the dissemination of new CHICA-GIS research results and services.

Overcoming barriers to cancer-helpline professionals providing decision support for callers: an implementation study.

PubMed

Stacey, Dawn; Chambers, Suzanne K; Jacobsen, Mary Jane; Dunn, Jeff

2008-11-01

To evaluate the effect of an intervention on healthcare professionals' perceptions of barriers influencing their provision of decision support for callers facing cancer-related decisions. A pre- and post-test study guided by the Ottawa Model of Research Use. Australian statewide cancer call center that provides public access to information and supportive cancer services. 34 nurses, psychologists, and other allied healthcare professionals at the cancer call center. Participants completed baseline measures and, subsequently, were exposed to an intervention that included a decision support tutorial, coaching protocol, and skill-building workshop. Strategies were implemented to address organizational barriers. Perceived barriers and facilitators influencing provision of decision support, decision support knowledge, quality of decision support provided to standardized callers, and call length. Postintervention participants felt more prepared, confident in providing decision support, and aware of decision support resources. They had a stronger belief that providing decision support was within their role. Participants significantly improved their knowledge and provided higher-quality decision support to standardized callers without changing call length. The implementation intervention overcame several identified barriers that influenced call center professionals when providing decision support. Nurses and other helpline professionals have the potential to provide decision support designed to help callers understand cancer information, clarify their values associated with their options, and reduce decisional conflict. However, they require targeted education and organizational interventions to reduce their perceived barriers to providing decision support.

TEMPO Early Adopters in Air-Quality Forecasting, Planning and Assessment, Pollution Emissions, Health, Agriculture, and Environmental Impacts: Applications and Decision Support

NASA Astrophysics Data System (ADS)

Newchurch, M.; Zavodsky, B.; Chance, K.; Haynes, J.; Lefer, B. L.; Naeger, A.

2016-12-01

The AQ research community has a long legacy of using space-based observations (e.g., Solar Backscatter Ultraviolet Instrument [SBUV], Global Ozone Monitoring Experiment [GOME], Ozone Monitoring Instrument [OMI], and the Ozone Mapping & Profiler Suite [OMPS]) to study atmospheric chemistry. These measurements have been used to observe day-to-day and year-to-year changes in atmospheric constituents. However, they have not been able to capture the diurnal variability of pollution with enough temporal or spatial fidelity and a low enough latency for regular use by operational decision makers. As a result, the operational AQ community has traditionally relied on ground-based (e.g., collection stations, LIDAR) and airborne observing systems to study tropospheric chemistry. In order to maximize its utility for applications and decision support, there is a need to educate the community about the game-changing potential for the geostationary TEMPO mission well ahead of its expected launch date early in the third decade of this millinium. This NASA mission will engage user communities and enable science across the NASA Applied Science Focus Areas of Health and Air Quality, Disasters, Water Resources, and Ecological Forecasting, In addition, topics discussed will provide opportunities for collaborations extending TEMPO applications to future program areas in Agriculture, Weather and Climate (including Numerical Weather Prediction), Energy, and Oceans.

Mapping Application for Penguin Populations and Projected Dynamics (MAPPPD): Data and Tools for Dynamic Management and Decision Support

NASA Technical Reports Server (NTRS)

Humphries, G. R. W.; Naveen, R.; Schwaller, M.; Che-Castaldo, C.; McDowall, P.; Schrimpf, M.; Schrimpf, Michael; Lynch, H. J.

2017-01-01

The Mapping Application for Penguin Populations and Projected Dynamics (MAPPPD) is a web-based, open access, decision-support tool designed to assist scientists, non-governmental organizations and policy-makers working to meet the management objectives as set forth by the Commission for the Conservation of Antarctic Marine Living Resources (CCAMLR) and other components of the Antarctic Treaty System (ATS) (that is, Consultative Meetings and the ATS Committee on Environmental Protection). MAPPPD was designed specifically to complement existing efforts such as the CCAMLR Ecosystem Monitoring Program (CEMP) and the ATS site guidelines for visitors. The database underlying MAPPPD includes all publicly available (published and unpublished) count data on emperor, gentoo, Adelie) and chinstrap penguins in Antarctica. Penguin population models are used to assimilate available data into estimates of abundance for each site and year.Results are easily aggregated across multiple sites to obtain abundance estimates over any user-defined area of interest. A front end web interface located at www.penguinmap.com provides free and ready access to the most recent count and modelled data, and can act as a facilitator for data transfer between scientists and Antarctic stakeholders to help inform management decisions for the continent.

AERO: A Decision Support Tool for Wind Erosion Assessment in Rangelands and Croplands

NASA Astrophysics Data System (ADS)

Galloza, M.; Webb, N.; Herrick, J.

2015-12-01

Wind erosion is a key driver of global land degradation, with on- and off-site impacts on agricultural production, air quality, ecosystem services and climate. Measuring rates of wind erosion and dust emission across land use and land cover types is important for quantifying the impacts and identifying and testing practical management options. This process can be assisted by the application of predictive models, which can be a powerful tool for land management agencies. The Aeolian EROsion (AERO) model, a wind erosion and dust emission model interface provides access by non-expert land managers to a sophisticated wind erosion decision-support tool. AERO incorporates land surface processes and sediment transport equations from existing wind erosion models and was designed for application with available national long-term monitoring datasets (e.g. USDI BLM Assessment, Inventory and Monitoring, USDA NRCS Natural Resources Inventory) and monitoring protocols. Ongoing AERO model calibration and validation are supported by geographically diverse data on wind erosion rates and land surface conditions collected by the new National Wind Erosion Research Network. Here we present the new AERO interface, describe parameterization of the underpinning wind erosion model, and provide a summary of the model applications across agricultural lands and rangelands in the United States.

REMOTE SENSING APPLICATIONS FOR SUSTAINABLE WATERSHED MANAGEMENT AND FOOD SECURITY

EPA Science Inventory

The integration of IKONOS satellite data, airborne color infrared remote sensing, visualization, and decision support tools is discussed, within the contexts of management techniques for minimizing non-point source pollution in inland waterways, such s riparian buffer restoration...

Demonstration of the application of traffic management center decision support tools : [summary].

DOT National Transportation Integrated Search

2013-03-01

Among the most important advances in transportation systems in recent years has been the development and implementation of intelligent transportation systems (ITS), which relies on several means of monitoring traffic flows, coupled with real-time and...

Processing Technology Selection for Municipal Sewage Treatment Based on a Multi-Objective Decision Model under Uncertainty.

PubMed

Chen, Xudong; Xu, Zhongwen; Yao, Liming; Ma, Ning

2018-03-05

This study considers the two factors of environmental protection and economic benefits to address municipal sewage treatment. Based on considerations regarding the sewage treatment plant construction site, processing technology, capital investment, operation costs, water pollutant emissions, water quality and other indicators, we establish a general multi-objective decision model for optimizing municipal sewage treatment plant construction. Using the construction of a sewage treatment plant in a suburb of Chengdu as an example, this paper tests the general model of multi-objective decision-making for the sewage treatment plant construction by implementing a genetic algorithm. The results show the applicability and effectiveness of the multi-objective decision model for the sewage treatment plant. This paper provides decision and technical support for the optimization of municipal sewage treatment.

Simulation of cyber attacks with applications in homeland defense training

NASA Astrophysics Data System (ADS)

Brown, Bill; Cutts, Andrew; McGrath, Dennis; Nicol, David M.; Smith, Timothy P.; Tofel, Brett

2003-09-01

We describe a tool to help exercise and train IT managers who make decisions about IP networks in the midst of cyber calamity. Our tool is interactive, centered around a network simulation. It includes various modes of communications one would use to make informed decisions. Our tool is capable of simulating networks with hundreds of components and dozens of players. Test indicate that it could support an exercise an order of magnitude larger and more complex.

Intuitionistic fuzzy evidential power aggregation operator and its application in multiple criteria decision-making

NASA Astrophysics Data System (ADS)

Jiang, Wen; Wei, Boya

2018-02-01

The theory of intuitionistic fuzzy sets (IFS) is widely used for dealing with vagueness and the Dempster-Shafer (D-S) evidence theory has a widespread use in multiple criteria decision-making problems under uncertain situation. However, there are many methods to aggregate intuitionistic fuzzy numbers (IFNs), but the aggregation operator to fuse basic probability assignment (BPA) is rare. Power average (P-A) operator, as a powerful operator, is useful and important in information fusion. Motivated by the idea of P-A power, in this paper, a new operator based on the IFS and D-S evidence theory is proposed, which is named as intuitionistic fuzzy evidential power average (IFEPA) aggregation operator. First, an IFN is converted into a BPA, and the uncertainty is measured in D-S evidence theory. Second, the difference between BPAs is measured by Jousselme distance and a satisfying support function is proposed to get the support degree between each other effectively. Then the IFEPA operator is used for aggregating the original IFN and make a more reasonable decision. The proposed method is objective and reasonable because it is completely driven by data once some parameters are required. At the same time, it is novel and interesting. Finally, an application of developed models to the 'One Belt, One road' investment decision-making problems is presented to illustrate the effectiveness and feasibility of the proposed operator.

Capturing Ecosystem Services, Stakeholders' Preferences and Trade-Offs in Coastal Aquaculture Decisions: A Bayesian Belief Network Application

PubMed Central

Schmitt, Laetitia Helene Marie; Brugere, Cecile

2013-01-01

Aquaculture activities are embedded in complex social-ecological systems. However, aquaculture development decisions have tended to be driven by revenue generation, failing to account for interactions with the environment and the full value of the benefits derived from services provided by local ecosystems. Trade-offs resulting from changes in ecosystem services provision and associated impacts on livelihoods are also often overlooked. This paper proposes an innovative application of Bayesian belief networks - influence diagrams - as a decision support system for mediating trade-offs arising from the development of shrimp aquaculture in Thailand. Senior experts were consulted (n = 12) and primary farm data on the economics of shrimp farming (n = 20) were collected alongside secondary information on ecosystem services, in order to construct and populate the network. Trade-offs were quantitatively assessed through the generation of a probabilistic impact matrix. This matrix captures nonlinearity and uncertainty and describes the relative performance and impacts of shrimp farming management scenarios on local livelihoods. It also incorporates export revenues and provision and value of ecosystem services such as coastal protection and biodiversity. This research shows that Bayesian belief modeling can support complex decision-making on pathways for sustainable coastal aquaculture development and thus contributes to the debate on the role of aquaculture in social-ecological resilience and economic development. PMID:24155876

Extensions to regret-based decision curve analysis: an application to hospice referral for terminal patients.

PubMed

Tsalatsanis, Athanasios; Barnes, Laura E; Hozo, Iztok; Djulbegovic, Benjamin

2011-12-23

Despite the well documented advantages of hospice care, most terminally ill patients do not reap the maximum benefit from hospice services, with the majority of them receiving hospice care either prematurely or delayed. Decision systems to improve the hospice referral process are sorely needed. We present a novel theoretical framework that is based on well-established methodologies of prognostication and decision analysis to assist with the hospice referral process for terminally ill patients. We linked the SUPPORT statistical model, widely regarded as one of the most accurate models for prognostication of terminally ill patients, with the recently developed regret based decision curve analysis (regret DCA). We extend the regret DCA methodology to consider harms associated with the prognostication test as well as harms and effects of the management strategies. In order to enable patients and physicians in making these complex decisions in real-time, we developed an easily accessible web-based decision support system available at the point of care. The web-based decision support system facilitates the hospice referral process in three steps. First, the patient or surrogate is interviewed to elicit his/her personal preferences regarding the continuation of life-sustaining treatment vs. palliative care. Then, regret DCA is employed to identify the best strategy for the particular patient in terms of threshold probability at which he/she is indifferent between continuation of treatment and of hospice referral. Finally, if necessary, the probabilities of survival and death for the particular patient are computed based on the SUPPORT prognostication model and contrasted with the patient's threshold probability. The web-based design of the CDSS enables patients, physicians, and family members to participate in the decision process from anywhere internet access is available. We present a theoretical framework to facilitate the hospice referral process. Further rigorous clinical evaluation including testing in a prospective randomized controlled trial is required and planned.

Extensions to Regret-based Decision Curve Analysis: An application to hospice referral for terminal patients

PubMed Central

2011-01-01

Background Despite the well documented advantages of hospice care, most terminally ill patients do not reap the maximum benefit from hospice services, with the majority of them receiving hospice care either prematurely or delayed. Decision systems to improve the hospice referral process are sorely needed. Methods We present a novel theoretical framework that is based on well-established methodologies of prognostication and decision analysis to assist with the hospice referral process for terminally ill patients. We linked the SUPPORT statistical model, widely regarded as one of the most accurate models for prognostication of terminally ill patients, with the recently developed regret based decision curve analysis (regret DCA). We extend the regret DCA methodology to consider harms associated with the prognostication test as well as harms and effects of the management strategies. In order to enable patients and physicians in making these complex decisions in real-time, we developed an easily accessible web-based decision support system available at the point of care. Results The web-based decision support system facilitates the hospice referral process in three steps. First, the patient or surrogate is interviewed to elicit his/her personal preferences regarding the continuation of life-sustaining treatment vs. palliative care. Then, regret DCA is employed to identify the best strategy for the particular patient in terms of threshold probability at which he/she is indifferent between continuation of treatment and of hospice referral. Finally, if necessary, the probabilities of survival and death for the particular patient are computed based on the SUPPORT prognostication model and contrasted with the patient's threshold probability. The web-based design of the CDSS enables patients, physicians, and family members to participate in the decision process from anywhere internet access is available. Conclusions We present a theoretical framework to facilitate the hospice referral process. Further rigorous clinical evaluation including testing in a prospective randomized controlled trial is required and planned. PMID:22196308

Involved, inputting or informing: "Shared" decision making in adult mental health care.

PubMed

Bradley, Eleanor; Green, Debra

2018-02-01

A diagnosis of serious mental illness can impact on the whole family. Families informally provide significant amounts of care but are disproportionately at risk of carer burden when compared to those supporting people with other long-term conditions. Shared decision making (SDM) is an ethical model of health communication associated with positive health outcomes; however, there has been little research to evaluate how routinely family is invited to participate in SDM, or what this looks like in practice. This UK study aimed to better understand how the family caregivers of those diagnosed with SMI are currently involved in decision making, particularly decisions about treatment options including prescribed medication. Objectives were to Explore the extent to which family members wish to be involved in decisions about prescribed medication Determine how and when professionals engage family in these decisions Identify barriers and facilitators associated with the engagement of family in decisions about treatment. Open-ended questions were sent to professionals and family members to elicit written responses. Qualitative responses were analysed thematically. Themes included the definition of involvement and "rules of engagement." Staff members are gatekeepers for family involvement, and the process is not democratic. Family and staff ascribe practical, rather than recovery-oriented roles to family, with pre-occupation around notions of adherence. Staff members need support, training and education to apply SDM. Time to exchange information is vital but practically difficult. Negotiated teams, comprising of staff, service users, family, peers as applicable, with ascribed roles and responsibilities could support SDM. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Evaluating a Modular Decision Support Application for Colorectal Cancer Screening

PubMed Central

Diiulio, Julie B.; Borders, Morgan R.; Sushereba, Christen E.; Saleem, Jason J.; Haverkamp, Donald; Imperiale, Thomas F.

2017-01-01

Summary Background There is a need for health information technology evaluation that goes beyond randomized controlled trials to include consideration of usability, cognition, feedback from representative users, and impact on efficiency, data quality, and clinical workflow. This article presents an evaluation illustrating one approach to this need using the Decision-Centered Design framework. Objective To evaluate, through a Decision-Centered Design framework, the ability of the Screening and Surveillance App to support primary care clinicians in tracking and managing colorectal cancer testing. Methods We leveraged two evaluation formats, online and in-person, to obtain feedback from a range primary care clinicians and obtain comparative data. Both the online and in-person evaluations used mock patient data to simulate challenging patient scenarios. Primary care clinicians responded to a series of colorectal cancer-related questions about each patient and made recommendations for screening. We collected data on performance, perceived workload, and usability. Key elements of Decision-Centered Design include evaluation in the context of realistic, challenging scenarios and measures designed to explore impact on cognitive performance. Results Comparison of means revealed increases in accuracy, efficiency, and usability and decreases in perceived mental effort and workload when using the Screening and Surveillance App. Conclusion The results speak to the benefits of using the Decision-Centered Design approach in the analysis, design, and evaluation of Health Information Technology. Furthermore, the Screening and Surveillance App shows promise for filling decision support gaps in current electronic health records. PMID:28197619

NASA's Geospatial Interoperability Office(GIO)Program

NASA Technical Reports Server (NTRS)

Weir, Patricia

2004-01-01

NASA produces vast amounts of information about the Earth from satellites, supercomputer models, and other sources. These data are most useful when made easily accessible to NASA researchers and scientists, to NASA's partner Federal Agencies, and to society as a whole. A NASA goal is to apply its data for knowledge gain, decision support and understanding of Earth, and other planetary systems. The NASA Earth Science Enterprise (ESE) Geospatial Interoperability Office (GIO) Program leads the development, promotion and implementation of information technology standards that accelerate and expand the delivery of NASA's Earth system science research through integrated systems solutions. Our overarching goal is to make it easy for decision-makers, scientists and citizens to use NASA's science information. NASA's Federal partners currently participate with NASA and one another in the development and implementation of geospatial standards to ensure the most efficient and effective access to one another's data. Through the GIO, NASA participates with its Federal partners in implementing interoperability standards in support of E-Gov and the associated President's Management Agenda initiatives by collaborating on standards development. Through partnerships with government, private industry, education and communities the GIO works towards enhancing the ESE Applications Division in the area of National Applications and decision support systems. The GIO provides geospatial standards leadership within NASA, represents NASA on the Federal Geographic Data Committee (FGDC) Coordination Working Group and chairs the FGDC's Geospatial Applications and Interoperability Working Group (GAI) and supports development and implementation efforts such as Earth Science Gateway (ESG), Space Time Tool Kit and Web Map Services (WMS) Global Mosaic. The GIO supports NASA in the collection and dissemination of geospatial interoperability standards needs and progress throughout the agency including areas such as ESE Applications, the SEEDS Working Groups, the Facilities Engineering Division (Code JX) and NASA's Chief Information Offices (CIO). With these agency level requirements GIO leads, brokers and facilitates efforts to, develop, implement, influence and fully participate in standards development internationally, federally and locally. The GIO also represents NASA in the OpenGIS Consortium and ISO TC211. The OGC has made considerable progress in regards to relations with other open standards bodies; namely ISO, W3C and OASIS. ISO TC211 is the Geographic and Geomatics Information technical committee that works towards standardization in the field of digital geographic information. The GIO focuses on seamless access to data, applications of data, and enabling technologies furthering the interoperability of distributed data. Through teaming within the Applications Directorate and partnerships with government, private industry, education and communities, GIO works towards the data application goals of NASA, the ESE Applications Directorate, and our Federal partners by managing projects in four categories: Geospatial Standards and Leadership, Geospatial One Stop, Standards Development and Implementation, and National and NASA Activities.

Next generation terminology infrastructure to support interprofessional care planning.

PubMed

Collins, Sarah; Klinkenberg-Ramirez, Stephanie; Tsivkin, Kira; Mar, Perry L; Iskhakova, Dina; Nandigam, Hari; Samal, Lipika; Rocha, Roberto A

2017-11-01

Develop a prototype of an interprofessional terminology and information model infrastructure that can enable care planning applications to facilitate patient-centered care, learn care plan linkages and associations, provide decision support, and enable automated, prospective analytics. The study steps included a 3 step approach: (1) Process model and clinical scenario development, and (2) Requirements analysis, and (3) Development and validation of information and terminology models. Components of the terminology model include: Health Concerns, Goals, Decisions, Interventions, Assessments, and Evaluations. A terminology infrastructure should: (A) Include discrete care plan concepts; (B) Include sets of profession-specific concerns, decisions, and interventions; (C) Communicate rationales, anticipatory guidance, and guidelines that inform decisions among the care team; (D) Define semantic linkages across clinical events and professions; (E) Define sets of shared patient goals and sub-goals, including patient stated goals; (F) Capture evaluation toward achievement of goals. These requirements were mapped to AHRQ Care Coordination Measures Framework. This study used a constrained set of clinician-validated clinical scenarios. Terminology models for goals and decisions are unavailable in SNOMED CT, limiting the ability to evaluate these aspects of the proposed infrastructure. Defining and linking subsets of care planning concepts appears to be feasible, but also essential to model interprofessional care planning for common co-occurring conditions and chronic diseases. We recommend the creation of goal dynamics and decision concepts in SNOMED CT to further enable the necessary models. Systems with flexible terminology management infrastructure may enable intelligent decision support to identify conflicting and aligned concerns, goals, decisions, and interventions in shared care plans, ultimately decreasing documentation effort and cognitive burden for clinicians and patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Multi-test decision tree and its application to microarray data classification.

PubMed

Czajkowski, Marcin; Grześ, Marek; Kretowski, Marek

2014-05-01

The desirable property of tools used to investigate biological data is easy to understand models and predictive decisions. Decision trees are particularly promising in this regard due to their comprehensible nature that resembles the hierarchical process of human decision making. However, existing algorithms for learning decision trees have tendency to underfit gene expression data. The main aim of this work is to improve the performance and stability of decision trees with only a small increase in their complexity. We propose a multi-test decision tree (MTDT); our main contribution is the application of several univariate tests in each non-terminal node of the decision tree. We also search for alternative, lower-ranked features in order to obtain more stable and reliable predictions. Experimental validation was performed on several real-life gene expression datasets. Comparison results with eight classifiers show that MTDT has a statistically significantly higher accuracy than popular decision tree classifiers, and it was highly competitive with ensemble learning algorithms. The proposed solution managed to outperform its baseline algorithm on 14 datasets by an average 6%. A study performed on one of the datasets showed that the discovered genes used in the MTDT classification model are supported by biological evidence in the literature. This paper introduces a new type of decision tree which is more suitable for solving biological problems. MTDTs are relatively easy to analyze and much more powerful in modeling high dimensional microarray data than their popular counterparts. Copyright © 2014 Elsevier B.V. All rights reserved.

Water flow algorithm decision support tool for travelling salesman problem

NASA Astrophysics Data System (ADS)

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

2016-08-01

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

NASA Ice, Cloud and land Elevation Satellite-2 Applications - Advancing Dialogue for More Effective Decisions and Societal benefits

NASA Astrophysics Data System (ADS)

Delgado Arias, S.; Brown, M. E.; Escobar, V. M.; Jasinski, M. F.; Neumann, T.

2016-12-01

Since 2012, the NASA Ice, Cloud, and land Elevation Satellite-2 (ICESat-2) Applications Program has worked to understand how future mission observations can be effectively used to inform operational sea ice forecasting for Arctic shipping, global flood risk monitoring, fire fuel mapping, and other applications. The ICESat-2 Applications Program has implemented various engagement and outreach activities, as well as an Early Adopter program, to facilitate dialogue between potential users, project scientists, science definition team members, NASA Headquarters and the mission's data distribution center. This dialogue clarifies how ICESat-2's science data can be integrated, improved or leveraged to advance science objectives aligned with or beyond those of the mission, and in support of a range of decisions and actions of benefit to communities across the globe. In this presentation, we will present an overview of the Program initiatives and highlight the research-to-applications chains that mission Early Adopters are helping build for ICESat-2. With a total of 19 Early Adopters and more than 400 people engaged as part of the applications community, ICESat-2 has positioned itself to ensure applications where its observations are used to meet the needs of decision makers, policy makers and managers at different scales. For more information visit: http://icesat-2.gsfc.nasa.gov/applications

Delivering information: A descriptive study of Australian women’s information needs for decision-making about birth facility

PubMed Central

2012-01-01

Background Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Methods Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. Results On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women’s recommendations about the facility, freedom to choose one’s preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. Conclusions The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities. PMID:22708648

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

PubMed Central

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

2018-01-01

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

Delivering information: a descriptive study of Australian women's information needs for decision-making about birth facility.

PubMed

Thompson, Rachel; Wojcieszek, Aleena M

2012-06-18

Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women's recommendations about the facility, freedom to choose one's preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities.

Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard.

PubMed

Lobach, David F; Kawamoto, Kensaku; Anstrom, Kevin J; Russell, Michael L; Woods, Peter; Smith, Dwight

2007-01-01

Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, these systems are not widely available. This lack of availability arises in part because most decision support systems are not portable or scalable. The Health Level 7 international standard development organization recently adopted a draft standard known as the Decision Support Service standard to facilitate the implementation of clinical decision support systems using software services. In this paper, we report the first implementation of a clinical decision support system using this new standard. This system provides point-of-care chronic disease management for diabetes and other conditions and is deployed throughout a large regional health system. We also report process measures and usability data concerning the system. Use of the Decision Support Service standard provides a portable and scalable approach to clinical decision support that could facilitate the more extensive use of decision support systems.

Science and Systems in Support of Multi-hazard Early Warnings and Decisions

NASA Astrophysics Data System (ADS)

Pulwarty, R. S.

2015-12-01

The demand for improved climate knowledge and information is well documented. As noted in the IPCC (SREX, AR5), the UNISDR Global Assessment Reports and other assessments, this demand has increased pressure for information to support planning under changing rates and emergence of multiple hazards including climate extremes (drought, heat waves, floods). "Decision support" is now a popular term in the climate applications research community. While existing decision support activities can be identified in many disparate settings (e.g. federal, academic, private), the challenge of changing environments (coupled physical and social) is actually one of crafting implementation strategies for improving decision quality (not just meeting "user needs"). This includes overcoming weaknesses in co-production models, moving beyond DSSs as simply "software", coordinating innovation mapping and diffusion, and providing fora and gaming tools to identify common interests and differences in the way risks are perceived and managed among the affected groups. We outline the development and evolution of multi-hazard early warning systems in the United States and elsewhere, focusing on climate-related hazards. In particular, the presentation will focus on the climate science and information needed for (1) improved monitoring and modeling, (2) generating risk profiles, (3) developing information systems and scenarios for critical thresholds, (4) the net benefits of using new information (5) characterizing and bridging the "last mile" in the context of longer-term risk management.

Overview of the SMAP Applications and the SMAP Early Adopters Program - NASA's First Mission-Directed Outreach Effort

NASA Technical Reports Server (NTRS)

Escobar, V. M.; Delgado Arias, S.; Nearing, G.; Entekhabi, D.; Njoku, E.; Yueh, S.; Doorn, B.; Reichle, R.

2016-01-01

Satellite data provide global observations of many of the earths system processes and features. These data are valuable for developing scientific products that increase our understanding of how the earths systems are integrated. The water, energy and carbon cycle exchanges between the land and atmosphere are linked by soil moisture. NASAs Soil Moisture Active Passive (SMAP) mission provides soil moisture and freeze thaw measurements from space and allows scientists to link the water energy and carbon cycles. In order for SMAP data to be best integrated into decision support systems, the mission has engaged with the stakeholder community since 2009 and has attempted to scale the utility of the data to the thematic societal impacts of the satellite product applications. The SMAP Mission, which launched on January 31, 2015, has actively grown an Early Adopter (EA) community as part of its applications effort and worked with these EAs to demonstrate a scaled thematic impact of SMAP data product in societally relevant decision support applications. The SMAP mission provides global observations of the Earths surface soil moisture, providing high accuracy, resolution and continuous global coverage. Through the Early Adopters Program, the SMAP Applications Team will spend the next 2 years after launch documenting and evaluating the use of SMAP science products in applications related to weather forecasting, drought, agriculture productivity, floods, human health and national security.

Towards knowledge-based systems in clinical practice: development of an integrated clinical information and knowledge management support system.

PubMed

Kalogeropoulos, Dimitris A; Carson, Ewart R; Collinson, Paul O

2003-09-01

Given that clinicians presented with identical clinical information will act in different ways, there is a need to introduce into routine clinical practice methods and tools to support the scientific homogeneity and accountability of healthcare decisions and actions. The benefits expected from such action include an overall reduction in cost, improved quality of care, patient and public opinion satisfaction. Computer-based medical data processing has yielded methods and tools for managing the task away from the hospital management level and closer to the desired disease and patient management level. To this end, advanced applications of information and disease process modelling technologies have already demonstrated an ability to significantly augment clinical decision making as a by-product. The wide-spread acceptance of evidence-based medicine as the basis of cost-conscious and concurrently quality-wise accountable clinical practice suffices as evidence supporting this claim. Electronic libraries are one-step towards an online status of this key health-care delivery quality control environment. Nonetheless, to date, the underlying information and knowledge management technologies have failed to be integrated into any form of pragmatic or marketable online and real-time clinical decision making tool. One of the main obstacles that needs to be overcome is the development of systems that treat both information and knowledge as clinical objects with same modelling requirements. This paper describes the development of such a system in the form of an intelligent clinical information management system: a system which at the most fundamental level of clinical decision support facilitates both the organised acquisition of clinical information and knowledge and provides a test-bed for the development and evaluation of knowledge-based decision support functions.

Guided medication dosing for elderly emergency patients using real-time, computerized decision support.

PubMed

Griffey, Richard T; Lo, Helen G; Burdick, Elisabeth; Keohane, Carol; Bates, David W

2012-01-01

To evaluate the impact of a real-time computerized decision support tool in the emergency department that guides medication dosing for the elderly on physician ordering behavior and on adverse drug events (ADEs). A prospective controlled trial was conducted over 26 weeks. The status of the decision support tool alternated OFF (7/17/06-8/29/06), ON (8/29/06-10/10/06), OFF (10/10/06-11/28/06), and ON (11/28/06-1/16/07) in consecutive blocks during the study period. In patients ≥65 who were ordered certain benzodiazepines, opiates, non-steroidals, or sedative-hypnotics, the computer application either adjusted the dosing or suggested a different medication. Physicians could accept or reject recommendations. The primary outcome compared medication ordering consistent with recommendations during ON versus OFF periods. Secondary outcomes included the admission rate, emergency department length of stay for discharged patients, 10-fold dosing orders, use of a second drug to reverse the original medication, and rate of ADEs using previously validated explicit chart review. 2398 orders were placed for 1407 patients over 1548 visits. The majority (49/53; 92.5%) of recommendations for alternate medications were declined. More orders were consistent with dosing recommendations during ON (403/1283; 31.4%) than OFF (256/1115; 23%) periods (p≤0.0001). 673 (43%) visits were reviewed for ADEs. The rate of ADEs was lower during ON (8/237; 3.4%) compared with OFF (31/436; 7.1%) periods (p=0.02). The remaining secondary outcomes showed no difference. Single institution study, retrospective chart review for ADEs. Though overall agreement with recommendations was low, real-time computerized decision support resulted in greater acceptance of medication recommendations. Fewer ADEs were observed when computerized decision support was active.

Application and Survey of Business Intelligence (BI) Tools within the Context of Military Decision Making

DTIC Science & Technology

2012-06-01

International Financial Reporting Standards ( IFRS ) are principles-based Standards, Interpretations and the Framework (1989) adopted by the International...direction of the organization and based on a four- perspective view of the world: Financial measures supported by customer, internal, and learning and...scorecard applications, financial consolidation, and statutory and financial reporting . 27 7. Performance Scorecards and Dashboards Dashboards and

Application of Decision Support Tools for Integrated Water Resources Management

EPA Science Inventory

Integrated Water Resources Management (IWRM) involves “a process which promotes the coordinated development and management of water, land, and related resources in order to maximize the resultant economic and social welfare in an equitable manner without compromising the su...

A Framework for Sustainability Indicators at EPA

EPA Science Inventory

The purpose of this document is to provide useful methods and guidance to support the application of sustainability indicators in EPA decision making, and particularly within the Office of Research and Development’s (ORD) research programs. The primary target audience is EPA rese...

Decision making and coping in healthcare: the Coping in Deliberation (CODE) framework.

PubMed

Witt, Jana; Elwyn, Glyn; Wood, Fiona; Brain, Kate

2012-08-01

To develop a framework of decision making and coping in healthcare that describes the twin processes of appraisal and coping faced by patients making preference-sensitive healthcare decisions. We briefly review the literature for decision making theories and coping theories applicable to preference-sensitive decisions in healthcare settings. We describe first decision making, then coping and finally attempt to integrate these processes by building on current theory. Deliberation in healthcare may be described as a six step process, comprised of the presentation of a health threat, choice, options, preference construction, the decision itself and consolidation post-decision. Coping can be depicted in three stages, beginning with a threat, followed by primary and secondary appraisal and ultimately resulting in a coping effort. Drawing together concepts from prominent decision making theories and coping theories, we propose a multidimensional, interactive framework which integrates both processes and describes coping in deliberation. The proposed framework offers an insight into the complexity of decision making in preference-sensitive healthcare contexts from a patient perspective and may act as theoretical basis for decision support. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Building a computer program to support children, parents, and distraction during healthcare procedures.

PubMed

Hanrahan, Kirsten; McCarthy, Ann Marie; Kleiber, Charmaine; Ataman, Kaan; Street, W Nick; Zimmerman, M Bridget; Ersig, Anne L

2012-10-01

This secondary data analysis used data mining methods to develop predictive models of child risk for distress during a healthcare procedure. Data used came from a study that predicted factors associated with children's responses to an intravenous catheter insertion while parents provided distraction coaching. From the 255 items used in the primary study, 44 predictive items were identified through automatic feature selection and used to build support vector machine regression models. Models were validated using multiple cross-validation tests and by comparing variables identified as explanatory in the traditional versus support vector machine regression. Rule-based approaches were applied to the model outputs to identify overall risk for distress. A decision tree was then applied to evidence-based instructions for tailoring distraction to characteristics and preferences of the parent and child. The resulting decision support computer application, titled Children, Parents and Distraction, is being used in research. Future use will support practitioners in deciding the level and type of distraction intervention needed by a child undergoing a healthcare procedure.

iPads, mobile technologies, and communication applications: a survey of family wants, needs, and preferences.

PubMed

Meder, Allison M; Wegner, Jane R

2015-03-01

Families of children with communication disabilities were surveyed to explore wants and preferences relative to mobile media technology, including iPads, as a form of augmentative and alternative communication (AAC). The families surveyed reported wanting information and support from professionals, including speech language pathologists (SLPs), who are knowledgeable about AAC. These families wanted devices to meet their children's individual needs and reported that ease of use and affordability were the most influential characteristics in the purchase of mobile media devices and communication applications. SLPs who understand family decision making can utilize collaborative clinical decision making that respects families' wants and needs, while also focusing on device feature matching and family education.

Application of HTA research on policy decision-making.

PubMed

Youngkong, Sitaporn

2014-05-01

This article provides an overview of the potential uses of health technology assessment (HTA) in health technology or health intervention-related policy decision-making. It summarises the role of HTA in policy planning, health system investment, price negotiation, development of clinical practice guidelines, and communication with health professionals. While the multifaceted nature of HTA means that some aspects of the data can result in conflicting conclusions, the comprehensive approach of HTA is still recommended. To help minimise the potential conflicts within HTA data, a multicriteria decision analysis (MCDA) approach is recommended as a way to assess a number of decision criteria simultaneously. A combination of HTA with MCDA allows policy decision-making to be undertaken in an empirically rigorous and rational way. This combination can be used to support policy decision-makers in Thailand and help them prioritise topics for assessment and make informed health benefit package coverage decisions. This approach enhances the legitimacy of policy decisions by increasing the transparency, systematic nature, and inclusiveness of the process.

Workshop on using natural language processing applications for enhancing clinical decision making: an executive summary

PubMed Central

Pai, Vinay M; Rodgers, Mary; Conroy, Richard; Luo, James; Zhou, Ruixia; Seto, Belinda

2014-01-01

In April 2012, the National Institutes of Health organized a two-day workshop entitled ‘Natural Language Processing: State of the Art, Future Directions and Applications for Enhancing Clinical Decision-Making’ (NLP-CDS). This report is a summary of the discussions during the second day of the workshop. Collectively, the workshop presenters and participants emphasized the need for unstructured clinical notes to be included in the decision making workflow and the need for individualized longitudinal data tracking. The workshop also discussed the need to: (1) combine evidence-based literature and patient records with machine-learning and prediction models; (2) provide trusted and reproducible clinical advice; (3) prioritize evidence and test results; and (4) engage healthcare professionals, caregivers, and patients. The overall consensus of the NLP-CDS workshop was that there are promising opportunities for NLP and CDS to deliver cognitive support for healthcare professionals, caregivers, and patients. PMID:23921193

Assessment of the quality of antenatal care services provided by health workers using a mobile phone decision support application in northern Nigeria: a pre/post-intervention study.

PubMed

McNabb, Marion; Chukwu, Emeka; Ojo, Oluwayemisi; Shekhar, Navendu; Gill, Christopher J; Salami, Habeeb; Jega, Farouk

2015-01-01

Given the shortage of skilled healthcare providers in Nigeria, frontline community health extension workers (CHEWs) are commonly tasked with providing maternal and child health services at primary health centers. In 2012, we introduced a mobile case management and decision support application in twenty primary health centers in northern Nigeria, and conducted a pre-test/post-test study to assess whether the introduction of the app had an effect on the quality of antenatal care services provided by this lower-level cadre. Using the CommCare mobile platform, the app dynamically guides CHEWs through antenatal care protocols and collects client data in real time. Thirteen health education audio clips are also embedded in the app for improving and standardizing client counseling. To detect changes in quality, we developed an evidence-based quality score consisting of 25 indicators, and conducted a total of 266 client exit interviews. We analyzed baseline and endline data to assess changes in the overall quality score as well as changes in the provision of key elements of antenatal care. Overall, the quality score increased from 13.3 at baseline to 17.2 at endline (p<0.0001), out of a total possible score of 25, with the most significant improvements related to health counseling, technical services provided, and quality of health education. These study results suggest that the introduction of a low-cost mobile case management and decision support application can spur behavior change and improve the quality of services provided by a lower level cadre of healthcare workers. Future research should employ a more rigorous experimental design to explore potential longer-term effects on client health outcomes.

Clinical Decision Support in Electronic Prescribing: Recommendations and an Action Plan

PubMed Central

Teich, Jonathan M.; Osheroff, Jerome A.; Pifer, Eric A.; Sittig, Dean F.; Jenders, Robert A.

2005-01-01

Clinical decision support (CDS) in electronic prescribing (eRx) systems can improve the safety, quality, efficiency, and cost-effectiveness of care. However, at present, these potential benefits have not been fully realized. In this consensus white paper, we set forth recommendations and action plans in three critical domains: (1) advances in system capabilities, including basic and advanced sets of CDS interventions and knowledge, supporting database elements, operational features to improve usability and measure performance, and management and governance structures; (2) uniform standards, vocabularies, and centralized knowledge structures and services that could reduce rework by vendors and care providers, improve dissemination of well-constructed CDS interventions, promote generally applicable research in CDS methods, and accelerate the movement of new medical knowledge from research to practice; and (3) appropriate financial and legal incentives to promote adoption. PMID:15802474

Determinants of the Army Applicant Job Choice Decision and the Development of a Decision Support Tool for the Enlistment Incentive Review Board

DTIC Science & Technology

2012-02-01

USMA) to assess which preferences of youth could be influenced by incentives (Joles, Charbonneau , & Barr, 1998; Henry, Dice, & Davis, 2001). More... Charbonneau , and Barr (1998) and Henry, Dice, and Davis (2001) conducted surveys to assess the extent to which preferences of youth could be influenced by...Army enlistment initiatives. West Point, NY: United States Military Academy. Joles, J., Charbonneau , S., & Barr, D. (1998, February). An enlistment

Decision Support | Solar Research | NREL

Science.gov Websites

informed solar decision making with credible, objective, accessible, and timely resources. Solar Energy Decision Support Decision Support NREL provides technical and analytical support to support provide unbiased information on solar policies and issues for state and local government decision makers

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

PubMed

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-04-01

To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

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.

Reconciling uncertain costs and benefits in bayes nets for invasive species management

USGS Publications Warehouse

Burgman, M.A.; Wintle, B.A.; Thompson, C.A.; Moilanen, A.; Runge, M.C.; Ben-Haim, Y.

2010-01-01

Bayes nets are used increasingly to characterize environmental systems and formalize probabilistic reasoning to support decision making. These networks treat probabilities as exact quantities. Sensitivity analysis can be used to evaluate the importance of assumptions and parameter estimates. Here, we outline an application of info-gap theory to Bayes nets that evaluates the sensitivity of decisions to possibly large errors in the underlying probability estimates and utilities. We apply it to an example of management and eradication of Red Imported Fire Ants in Southern Queensland, Australia and show how changes in management decisions can be justified when uncertainty is considered. ?? 2009 Society for Risk Analysis.

Performance evaluation of the machine learning algorithms used in inference mechanism of a medical decision support system.

PubMed

Bal, Mert; Amasyali, M Fatih; Sever, Hayri; Kose, Guven; Demirhan, Ayse

2014-01-01

The importance of the decision support systems is increasingly supporting the decision making process in cases of uncertainty and the lack of information and they are widely used in various fields like engineering, finance, medicine, and so forth, Medical decision support systems help the healthcare personnel to select optimal method during the treatment of the patients. Decision support systems are intelligent software systems that support decision makers on their decisions. The design of decision support systems consists of four main subjects called inference mechanism, knowledge-base, explanation module, and active memory. Inference mechanism constitutes the basis of decision support systems. There are various methods that can be used in these mechanisms approaches. Some of these methods are decision trees, artificial neural networks, statistical methods, rule-based methods, and so forth. In decision support systems, those methods can be used separately or a hybrid system, and also combination of those methods. In this study, synthetic data with 10, 100, 1000, and 2000 records have been produced to reflect the probabilities on the ALARM network. The accuracy of 11 machine learning methods for the inference mechanism of medical decision support system is compared on various data sets.

A web platform for integrated surface water - groundwater modeling and data management

NASA Astrophysics Data System (ADS)

Fatkhutdinov, Aybulat; Stefan, Catalin; Junghanns, Ralf

2016-04-01

Model-based decision support systems are considered to be reliable and time-efficient tools for resources management in various hydrology related fields. However, searching and acquisition of the required data, preparation of the data sets for simulations as well as post-processing, visualization and publishing of the simulations results often requires significantly more work and time than performing the modeling itself. The purpose of the developed software is to combine data storage facilities, data processing instruments and modeling tools in a single platform which potentially can reduce time required for performing simulations, hence decision making. The system is developed within the INOWAS (Innovative Web Based Decision Support System for Water Sustainability under a Changing Climate) project. The platform integrates spatially distributed catchment scale rainfall - runoff, infiltration and groundwater flow models with data storage, processing and visualization tools. The concept is implemented in a form of a web-GIS application and is build based on free and open source components, including the PostgreSQL database management system, Python programming language for modeling purposes, Mapserver for visualization and publishing the data, Openlayers for building the user interface and others. Configuration of the system allows performing data input, storage, pre- and post-processing and visualization in a single not disturbed workflow. In addition, realization of the decision support system in the form of a web service provides an opportunity to easily retrieve and share data sets as well as results of simulations over the internet, which gives significant advantages for collaborative work on the projects and is able to significantly increase usability of the decision support system.

Measurement-based care for refractory depression: a clinical decision support model for clinical research and practice.

PubMed

Trivedi, Madhukar H; Daly, Ella J

2007-05-01

Despite years of antidepressant drug development and patient and provider education, suboptimal medication dosing and duration of exposure resulting in incomplete remission of symptoms remains the norm in the treatment of depression. Additionally, since no one treatment is effective for all patients, optimal implementation focusing on the measurement of symptoms, side effects, and function is essential to determine effective sequential treatment approaches. There is a need for a paradigm shift in how clinical decision making is incorporated into clinical practice and for a move away from the trial-and-error approach that currently determines the "next best" treatment. This paper describes how our experience with the Texas Medication Algorithm Project (TMAP) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial has confirmed the need for easy-to-use clinical support systems to ensure fidelity to guidelines. To further enhance guideline fidelity, we have developed an electronic decision support system that provides critical feedback and guidance at the point of patient care. We believe that a measurement-based care (MBC) approach is essential to any decision support system, allowing physicians to individualize and adapt decisions about patient care based on symptom progress, tolerability of medication, and dose optimization. We also believe that successful integration of sequential algorithms with MBC into real-world clinics will facilitate change that will endure and improve patient outcomes. Although we use major depression to illustrate our approach, the issues addressed are applicable to other chronic psychiatric conditions including comorbid depression and substance use disorder as well as other medical illnesses.

Measurement-Based Care for Refractory Depression: A Clinical Decision Support Model for Clinical Research and Practice

PubMed Central

Trivedi, Madhukar H.; Daly, Ella J.

2009-01-01

Despite years of antidepressant drug development and patient and provider education, suboptimal medication dosing and duration of exposure resulting in incomplete remission of symptoms remains the norm in the treatment of depression. Additionally, since no one treatment is effective for all patients, optimal implementation focusing on the measurement of symptoms, side effects, and function is essential to determine effective sequential treatment approaches. There is a need for a paradigm shift in how clinical decision making is incorporated into clinical practice and for a move away from the trial-and-error approach that currently determines the “next best” treatment. This paper describes how our experience with the Texas Medication Algorithm Project (TMAP) and the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial has confirmed the need for easy-to-use clinical support systems to ensure fidelity to guidelines. To further enhance guideline fidelity, we have developed an electronic decision support system that provides critical feedback and guidance at the point of patient care. We believe that a measurement-based care (MBC) approach is essential to any decision support system, allowing physicians to individualize and adapt decisions about patient care based on symptom progress, tolerability of medication, and dose optimization. We also believe that successful integration of sequential algorithms with MBC into real-world clinics will facilitate change that will endure and improve patient outcomes. Although we use major depression to illustrate our approach, the issues addressed are applicable to other chronic psychiatric conditions including comorbid depression and substance use disorder as well as other medical illnesses. PMID:17320312

Harnessing ecosystem models and multi-criteria decision analysis for the support of forest management.

PubMed

Wolfslehner, Bernhard; Seidl, Rupert

2010-12-01

The decision-making environment in forest management (FM) has changed drastically during the last decades. Forest management planning is facing increasing complexity due to a widening portfolio of forest goods and services, a societal demand for a rational, transparent decision process and rising uncertainties concerning future environmental conditions (e.g., climate change). Methodological responses to these challenges include an intensified use of ecosystem models to provide an enriched, quantitative information base for FM planning. Furthermore, multi-criteria methods are increasingly used to amalgamate information, preferences, expert judgments and value expressions, in support of the participatory and communicative dimensions of modern forestry. Although the potential of combining these two approaches has been demonstrated in a number of studies, methodological aspects in interfacing forest ecosystem models (FEM) and multi-criteria decision analysis (MCDA) are scarcely addressed explicitly. In this contribution we review the state of the art in FEM and MCDA in the context of FM planning and highlight some of the crucial issues when combining ecosystem and preference modeling. We discuss issues and requirements in selecting approaches suitable for supporting FM planning problems from the growing body of FEM and MCDA concepts. We furthermore identify two major challenges in a harmonized application of FEM-MCDA: (i) the design and implementation of an indicator-based analysis framework capturing ecological and social aspects and their interactions relevant for the decision process, and (ii) holistic information management that supports consistent use of different information sources, provides meta-information as well as information on uncertainties throughout the planning process.

Harnessing Ecosystem Models and Multi-Criteria Decision Analysis for the Support of Forest Management

NASA Astrophysics Data System (ADS)

Wolfslehner, Bernhard; Seidl, Rupert

2010-12-01

The decision-making environment in forest management (FM) has changed drastically during the last decades. Forest management planning is facing increasing complexity due to a widening portfolio of forest goods and services, a societal demand for a rational, transparent decision process and rising uncertainties concerning future environmental conditions (e.g., climate change). Methodological responses to these challenges include an intensified use of ecosystem models to provide an enriched, quantitative information base for FM planning. Furthermore, multi-criteria methods are increasingly used to amalgamate information, preferences, expert judgments and value expressions, in support of the participatory and communicative dimensions of modern forestry. Although the potential of combining these two approaches has been demonstrated in a number of studies, methodological aspects in interfacing forest ecosystem models (FEM) and multi-criteria decision analysis (MCDA) are scarcely addressed explicitly. In this contribution we review the state of the art in FEM and MCDA in the context of FM planning and highlight some of the crucial issues when combining ecosystem and preference modeling. We discuss issues and requirements in selecting approaches suitable for supporting FM planning problems from the growing body of FEM and MCDA concepts. We furthermore identify two major challenges in a harmonized application of FEM-MCDA: (i) the design and implementation of an indicator-based analysis framework capturing ecological and social aspects and their interactions relevant for the decision process, and (ii) holistic information management that supports consistent use of different information sources, provides meta-information as well as information on uncertainties throughout the planning process.

The STRATEGY project: decision tools to aid sustainable restoration and long-term management of contaminated agricultural ecosystems.

PubMed

Howard, B J; Beresford, N A; Nisbet, A; Cox, G; Oughton, D H; Hunt, J; Alvarez, B; Andersson, K G; Liland, A; Voigt, G

2005-01-01

The STRATEGY project (Sustainable Restoration and Long-Term Management of Contaminated Rural, Urban and Industrial Ecosystems) aimed to provide a holistic decision framework for the selection of optimal restoration strategies for the long-term sustainable management of contaminated areas in Western Europe. A critical evaluation was carried out of countermeasures and waste disposal options, from which compendia of state-of-the-art restoration methods were compiled. A decision support system capable of optimising spatially varying restoration strategies, that considered the level of averted dose, costs (including those of waste disposal) and environmental side effects was developed. Appropriate methods of estimating indirect costs associated with side effects and of communicating with stakeholders were identified. The importance of stakeholder consultation at a local level and of ensuring that any response is site and scenario specific were emphasised. A value matrix approach was suggested as a method of addressing social and ethical issues within the decision-making process, and was designed to be compatible with both the countermeasure compendia and the decision support system. The applicability and usefulness of STRATEGY outputs for food production systems in the medium to long term is assessed.

The Modular Modeling System (MMS): A modeling framework for water- and environmental-resources management

USGS Publications Warehouse

Leavesley, G.H.; Markstrom, S.L.; Viger, R.J.

2004-01-01

The interdisciplinary nature and increasing complexity of water- and environmental-resource problems require the use of modeling approaches that can incorporate knowledge from a broad range of scientific disciplines. The large number of distributed hydrological and ecosystem models currently available are composed of a variety of different conceptualizations of the associated processes they simulate. Assessment of the capabilities of these distributed models requires evaluation of the conceptualizations of the individual processes, and the identification of which conceptualizations are most appropriate for various combinations of criteria, such as problem objectives, data constraints, and spatial and temporal scales of application. With this knowledge, "optimal" models for specific sets of criteria can be created and applied. The U.S. Geological Survey (USGS) Modular Modeling System (MMS) is an integrated system of computer software that has been developed to provide these model development and application capabilities. MMS supports the integration of models and tools at a variety of levels of modular design. These include individual process models, tightly coupled models, loosely coupled models, and fully-integrated decision support systems. A variety of visualization and statistical tools are also provided. MMS has been coupled with the Bureau of Reclamation (BOR) object-oriented reservoir and river-system modeling framework, RiverWare, under a joint USGS-BOR program called the Watershed and River System Management Program. MMS and RiverWare are linked using a shared relational database. The resulting database-centered decision support system provides tools for evaluating and applying optimal resource-allocation and management strategies to complex, operational decisions on multipurpose reservoir systems and watersheds. Management issues being addressed include efficiency of water-resources management, environmental concerns such as meeting flow needs for endangered species, and optimizing operations within the constraints of multiple objectives such as power generation, irrigation, and water conservation. This decision support system approach is being developed, tested, and implemented in the Gunni-son, Yakima, San Juan, Rio Grande, and Truckee River basins of the western United States. Copyright ASCE 2004.

Merging Air Quality and Public Health Decision Support Systems

NASA Astrophysics Data System (ADS)

Hudspeth, W. B.; Bales, C. L.

2003-12-01

The New Mexico Air Quality Mapper (NMAQM) is a Web-based, open source GIS prototype application that Earth Data Analysis Center is developing under a NASA Cooperative Agreement. NMAQM enhances and extends existing data and imagery delivery systems with an existing Public Health system called the Rapid Syndrome Validation Project (RSVP). RSVP is a decision support system operating in several medical and public health arenas. It is evolving to ingest remote sensing data as input to provide early warning of human health threats, especially those related to anthropogenic atmospheric pollutants and airborne pathogens. The NMAQM project applies measurements of these atmospheric pollutants, derived from both remotely sensed data as well as from in-situ air quality networks, to both forecasting and retrospective analyses that influence human respiratory health. NMAQM provides a user-friendly interface for visualizing and interpreting environmentally-linked epidemiological phenomena. The results, and the systems made to provide the information, will be applicable not only to decision-makers in the public health realm, but also to air quality organizations, demographers, community planners, and other professionals in information technology, and social and engineering sciences. As an accessible and interactive mapping and analysis application, it allows environment and health personnel to study historic data for hypothesis generation and trend analysis, and then, potentially, to predict air quality conditions from daily data acquisitions. Additional spin off benefits to such users include the identification of gaps in the distribution of in-situ monitoring stations, the dissemination of air quality data to the public, and the discrimination of local vs. more regional sources of air pollutants that may bear on decisions relating to public health and public policy.

Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations.

PubMed

Quigley, Matthew; Dillon, Michael P; Fatone, Stefania

2018-02-01

Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important as the approach is introduced in prosthetic-/orthotic-related practice.

Steps to consider for effective decision making when selecting and prioritizing eHealth services.

PubMed

Vimarlund, Vivian; Davoody, Nadia; Koch, Sabine

2013-01-01

Making the best choice for an organization when selecting IT applications or eHealth services is not always easy as there are a lot of parameters to take into account. The aim of this paper is to explore some steps to support effective decision making when selecting and prioritizing eHealth services prior to implementation and/or procurement. The steps presented in this paper were identified by interviewing nine key stakeholders at Stockholm County Council. They are supposed to work as a guide for decision making and aim to identify objectives and expected effects, technical, organizational, and economic requirements, and opportunities important to consider before decisions are taken. The steps and their respective issues and variables are concretized in a number of templates to be filled in by decision makers when selecting and prioritizing eHealth services.

The role of emotion in decision-making: a cognitive neuroeconomic approach towards understanding sexual risk behavior.

PubMed

Gutnik, Lily A; Hakimzada, A Forogh; Yoskowitz, Nicole A; Patel, Vimla L

2006-12-01

Models of decision-making usually focus on cognitive, situational, and socio-cultural variables in accounting for human performance. However, the emotional component is rarely addressed within these models. This paper reviews evidence for the emotional aspect of decision-making and its role within a new framework of investigation, called neuroeconomics. The new approach aims to build a comprehensive theory of decision-making, through the unification of theories and methods from economics, psychology, and neuroscience. In this paper, we review these integrative research methods and their applications to issues of public health, with illustrative examples from our research on young adults' safe sex practices. This approach promises to be valuable as a comprehensively descriptive and possibly, better predictive model for construction and customization of decision support tools for health professionals and consumers.

Digital roadway interactive visualization and evaluation network applications to WSDOT operational data usage.

DOT National Transportation Integrated Search

2016-12-01

DRIVE Net is a region-wide, Web-based transportation decision support system that adopts digital roadway maps as : the base, and provides data layers for integrating and analyzing a variety of data sources (e.g., traffic sensors, incident : records)....

HOLISTIC APPROACH TO ENVIRONMENTAL MANAGEMENT OF MUNICIPAL SOLID WASTE

EPA Science Inventory

The paper presents results from the application of a new municipal solid waste (MSW) management planning aid to EPA's new facility in the Research Triangle Park, NC. This planning aid, or decision support tool, is computer software that analyzes the cost and environmental impact ...

7 CFR 1940.331 - Public involvement.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) PROGRAM REGULATIONS (CONTINUED) GENERAL Environmental Program § 1940.331 Public involvement. (a) Objective... environmental review status of FmHA or its successor agency under Public Law 103-354's funding applications... the environmental documents supporting FmHA or its successor agency under Public Law 103-354 decisions...

7 CFR 1940.331 - Public involvement.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) PROGRAM REGULATIONS (CONTINUED) GENERAL Environmental Program § 1940.331 Public involvement. (a) Objective... environmental review status of FmHA or its successor agency under Public Law 103-354's funding applications... the environmental documents supporting FmHA or its successor agency under Public Law 103-354 decisions...

7 CFR 1940.331 - Public involvement.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) PROGRAM REGULATIONS (CONTINUED) GENERAL Environmental Program § 1940.331 Public involvement. (a) Objective... environmental review status of FmHA or its successor agency under Public Law 103-354's funding applications... the environmental documents supporting FmHA or its successor agency under Public Law 103-354 decisions...

Demonstration and Hands-on Exercises with the Estuary Data Mapper

EPA Science Inventory

The U.S. Environmental Protection Agency (US EPA) is developing e-Estuary, a decision-support system for applications of the Clean Water Act in coastal management. E-Estuary has three elements: an estuarine geo-referenced relational database, watershed GIS coverages, and tools t...

Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes

PubMed Central

2012-01-01

Background Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites) that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM) to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Methods Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. Results After modification by dropping two indicators that showed poor measures in the measurement models’ quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of ‘transparency’, ‘participation’, ‘scientific rigour’ and ‘reasonableness’. Conclusions The structural equation model was among the first applications of PLS-PM to coverage decision-making. It allowed testing of hypotheses in situations where there are links between several non-observable constructs. PLS-PM was compatible in accounting for the complexity of coverage decisions to obtain a more realistic perspective for empirical analysis. The model specification can be used for hypothesis testing by using larger sample sizes and for data in the full domain of health technologies. PMID:22856325

Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes.

PubMed

Fischer, Katharina E

2012-08-02

Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites) that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM) to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. After modification by dropping two indicators that showed poor measures in the measurement models' quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of 'transparency', 'participation', 'scientific rigour' and 'reasonableness'. The structural equation model was among the first applications of PLS-PM to coverage decision-making. It allowed testing of hypotheses in situations where there are links between several non-observable constructs. PLS-PM was compatible in accounting for the complexity of coverage decisions to obtain a more realistic perspective for empirical analysis. The model specification can be used for hypothesis testing by using larger sample sizes and for data in the full domain of health technologies.

Current Capabilities, Issues, and Trends in LMSs and Authoring Tools

DTIC Science & Technology

2009-08-18

architecture  Embedded best-practice design principles  Support for immersive learning technologies  Support for social media 8 LMSs LMS Functionality is... Learning System Multimedia content Application demos VOIP Real-time Collaboration technologies from Adobe Connect Pro, WebEx, LiveMeeting, & Centra...ORGANIZATION NAME(S) AND ADDRESS(ES) Advanced Decision Learning (ADL),ADL Co-Lab,1901 N. Beauregard Street Suite 600,Alexandria,VA,22311 8

Application of an Informatics-Based Decision-Making Framework and Process to the Assessment of Radiation Safety in Nanotechnology

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

Hoover, Mark D.; Myers, David S.; Cash, Leigh J.

The National Council on Radiation Protection and Measurements (NCRP) has established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between approximately 1 and 100 nanometers, where unique phenomena enable novel applications. While the full report is in preparation, this article presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are alreadymore » present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.« less

Application of an informatics-based decision-making framework and process to the assessment of radiation safety in nanotechnology.

PubMed

Hoover, Mark D; Myers, David S; Cash, Leigh J; Guilmette, Raymond A; Kreyling, Wolfgang G; Oberdörster, Günter; Smith, Rachel; Cassata, James R; Boecker, Bruce B; Grissom, Michael P

2015-02-01

The National Council on Radiation Protection and Measurements (NCRP) established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between ∼1 and 100 nm, where unique phenomena enable novel applications. While the full report is in preparation, this paper presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are already present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.

Use of multicriteria analysis (MCA) for sustainable hydropower planning and management.

PubMed

Vassoney, Erica; Mammoliti Mochet, Andrea; Comoglio, Claudio

2017-07-01

Multicriteria analysis (MCA) is a decision-making tool applied to a wide range of environmental management problems, including renewable energy planning and management. An interesting field of application of MCA is the evaluation and analysis of the conflicting aspects of hydropower (HP) exploitation, affecting the three pillars of sustainability and involving several different stakeholders. The present study was aimed at reviewing the state of the art of MCA applications to sustainable hydropower production and related decision-making problems, based on a detailed analysis of the scientific papers published over the last 15 years on this topic. The papers were analysed and compared, focusing on the specific features of the MCA methods applied in the described case studies, highlighting the general aspects of the MCA application (purpose, spatial scale, software used, stakeholders, etc.) and the specific operational/technical features of the selected MCA technique (methodology, criteria, evaluation, approach, sensitivity, etc.). Some specific limitations of the analysed case studies were identified and a set of "quality indexes" of an exhaustive MCA application were suggested as potential improvements for more effectively support decision-making processes in sustainable HP planning and management problems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Application of an Informatics-Based Decision-Making Framework and Process to the Assessment of Radiation Safety in Nanotechnology

DOE PAGES

Hoover, Mark D.; Myers, David S.; Cash, Leigh J.; ...

2015-01-01

The National Council on Radiation Protection and Measurements (NCRP) has established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between approximately 1 and 100 nanometers, where unique phenomena enable novel applications. While the full report is in preparation, this article presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are alreadymore » present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.« less

A decision support tool to determine cost-to-benefit of a family-centered in-home program for at-risk adolescents.

PubMed

Wilson, Fernando A; Araz, Ozgur M; Thompson, Ronald W; Ringle, Jay L; Mason, W Alex; Stimpson, Jim P

2016-06-01

Family-centered program research has demonstrated its effectiveness in improving adolescent outcomes. However, given current fiscal constraints faced by governmental agencies, a recent report from the Institute of Medicine and National Research Council highlighted the need for cost-benefit analyses to inform decision making by policymakers. Furthermore, performance management tools such as balanced scorecards and dashboards do not generally include cost-benefit analyses. In this paper, we describe the development of an Excel-based decision support tool that can be used to evaluate a selected family-based program for at-risk children and adolescents relative to a comparison program or the status quo. This tool incorporates the use of an efficient, user-friendly interface with results provided in concise tabular and graphical formats that may be interpreted without need for substantial training in economic evaluation. To illustrate, we present an application of this tool to evaluate use of Boys Town's In-Home Family Services (IHFS) relative to detention and out-of-home placement in New York City. Use of the decision support tool can help mitigate the need for programs to contract experts in economic evaluation, especially when there are financial or time constraints. Copyright © 2016 Elsevier Ltd. All rights reserved.

Creating and sharing clinical decision support content with Web 2.0: Issues and examples.

PubMed

Wright, Adam; Bates, David W; Middleton, Blackford; Hongsermeier, Tonya; Kashyap, Vipul; Thomas, Sean M; Sittig, Dean F

2009-04-01

Clinical decision support is a powerful tool for improving healthcare quality and patient safety. However, developing a comprehensive package of decision support interventions is costly and difficult. If used well, Web 2.0 methods may make it easier and less costly to develop decision support. Web 2.0 is characterized by online communities, open sharing, interactivity and collaboration. Although most previous attempts at sharing clinical decision support content have worked outside of the Web 2.0 framework, several initiatives are beginning to use Web 2.0 to share and collaborate on decision support content. We present case studies of three efforts: the Clinfowiki, a world-accessible wiki for developing decision support content; Partners Healthcare eRooms, web-based tools for developing decision support within a single organization; and Epic Systems Corporation's Community Library, a repository for sharing decision support content for customers of a single clinical system vendor. We evaluate the potential of Web 2.0 technologies to enable collaborative development and sharing of clinical decision support systems through the lens of three case studies; analyzing technical, legal and organizational issues for developers, consumers and organizers of clinical decision support content in Web 2.0. We believe the case for Web 2.0 as a tool for collaborating on clinical decision support content appears strong, particularly for collaborative content development within an organization.

Application and Exploration of Big Data Mining in Clinical Medicine.

PubMed

Zhang, Yue; Guo, Shu-Li; Han, Li-Na; Li, Tie-Ling

2016-03-20

To review theories and technologies of big data mining and their application in clinical medicine. Literatures published in English or Chinese regarding theories and technologies of big data mining and the concrete applications of data mining technology in clinical medicine were obtained from PubMed and Chinese Hospital Knowledge Database from 1975 to 2015. Original articles regarding big data mining theory/technology and big data mining's application in the medical field were selected. This review characterized the basic theories and technologies of big data mining including fuzzy theory, rough set theory, cloud theory, Dempster-Shafer theory, artificial neural network, genetic algorithm, inductive learning theory, Bayesian network, decision tree, pattern recognition, high-performance computing, and statistical analysis. The application of big data mining in clinical medicine was analyzed in the fields of disease risk assessment, clinical decision support, prediction of disease development, guidance of rational use of drugs, medical management, and evidence-based medicine. Big data mining has the potential to play an important role in clinical medicine.

Applications Integration Strategy in the Mission Development Process

NASA Astrophysics Data System (ADS)

Cox, E. L., Jr.

2016-12-01

NASA's Earth Science Applied Science Program has worked for the past four to five years with the Earth Science Division's Flight Program to cultivate an understanding of the importance of satellite remote sensing impacts on decision-making policy and decision support tools utilized by academia, state and local governments, other government agencies, private sector companies, and non-profit organizations. It has long been recognized that applications projects and studies in areas such as Health and Air Quality, Water Resources, Disasters, and Ecological Forecasting, have benefited and been enhanced through the use of satellite remote sensing. Applications researchers often use remote sensing data once it becomes available after the post-launch evaluation phase in the format and level of fidelity that is available. The results from the many applications projects, over the years, have been significant and there are countless examples of improvements and enhancements to operational systems and decision-making policies in the Applied Sciences community. However, feedback received from the applications community regarding the need for improved data availability and latency; processing and formatting, to name a few, prompted the idea of applied science involvement early in the life cycle of mission development. Over time, the Applied Science Program personnel have learned a great deal from the flight mission development life cycle process and recognized key areas of alignment. This presentation will discuss specific aspects of applied science that investigators should consider when proposing to future announcements involving an applications dimension. The Program's experience with user community needs, decision-making requirements, and stakeholder operations requirements will be highlighted.

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

EPA Pesticide Factsheets

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

Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study

PubMed Central

Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

2016-01-01

OBJECTIVE: To explore multiple stakeholders’ perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. METHODS: An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators’, clinicians’, parents’ and youths’ perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. RESULTS: Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders’ knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital’s culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. CONCLUSIONS: Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors’ paediatric hospital. PMID:27398058

Challenges Associated With Applying Physiologically Based Pharmacokinetic Modeling for Public Health Decision-Making.

PubMed

Tan, Yu-Mei; Worley, Rachel R; Leonard, Jeremy A; Fisher, Jeffrey W

2018-04-01

The development and application of physiologically based pharmacokinetic (PBPK) models in chemical toxicology have grown steadily since their emergence in the 1980s. However, critical evaluation of PBPK models to support public health decision-making across federal agencies has thus far occurred for only a few environmental chemicals. In order to encourage decision-makers to embrace the critical role of PBPK modeling in risk assessment, several important challenges require immediate attention from the modeling community. The objective of this contemporary review is to highlight 3 of these challenges, including: (1) difficulties in recruiting peer reviewers with appropriate modeling expertise and experience; (2) lack of confidence in PBPK models for which no tissue/plasma concentration data exist for model evaluation; and (3) lack of transferability across modeling platforms. Several recommendations for addressing these 3 issues are provided to initiate dialog among members of the PBPK modeling community, as these issues must be overcome for the field of PBPK modeling to advance and for PBPK models to be more routinely applied in support of public health decision-making.

Risk-Informed Decision Making: Application to Technology Development Alternative Selection

NASA Technical Reports Server (NTRS)

Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

2010-01-01

NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

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

PubMed

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

2017-07-01

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

Amplifying Each Patient's Voice: A Systematic Review of Multi-criteria Decision Analyses Involving Patients.

PubMed

Marsh, Kevin; Caro, J Jaime; Hamed, Alaa; Zaiser, Erica

2017-04-01

Qualitative methods tend to be used to incorporate patient preferences into healthcare decision making. However, for patient preferences to be given adequate consideration by decision makers they need to be quantified. Multi-criteria decision analysis (MCDA) is one way to quantify and capture the patient voice. The objective of this review was to report on existing MCDAs involving patients to support the future use of MCDA to capture the patient voice. MEDLINE and EMBASE were searched in June 2014 for English-language papers with no date restriction. The following search terms were used: 'multi-criteria decision*', 'multiple criteria decision*', 'MCDA', 'benefit risk assessment*', 'risk benefit assessment*', 'multicriteri* decision*', 'MCDM', 'multi-criteri* decision*'. Abstracts were included if they reported the application of MCDA to assess healthcare interventions where patients were the source of weights. Abstracts were excluded if they did not apply MCDA, such as discussions of how MCDA could be used; or did not evaluate healthcare interventions, such as MCDAs to assess the level of health need in a locality. Data were extracted on weighting method, variation in patient and expert preferences, and discussion on different weighting techniques. The review identified ten English-language studies that reported an MCDA to assess healthcare interventions and involved patients as a source of weights. These studies reported 12 applications of MCDA. Different methods of preference elicitation were employed: direct weighting in workshops; discrete choice experiment surveys; and the analytical hierarchy process using both workshops and surveys. There was significant heterogeneity in patient responses and differences between patients, who put greater weight on disease characteristics and treatment convenience, and experts, who put more weight on efficacy. The studies highlighted cognitive challenges associated with some weighting methods, though patients' views on their ability to undertake weighting tasks was positive. This review identified several recent examples of MCDA used to elicit patient preferences, which support the feasibility of using MCDA to capture the patient voice. Challenges identified included, how best to reflect the heterogeneity of patient preferences in decision making and how to manage the cognitive burden associated with some MCDA tasks.

NASA Applications and Lessons Learned in Reliability Engineering

NASA Technical Reports Server (NTRS)

Safie, Fayssal M.; Fuller, Raymond P.

2011-01-01

Since the Shuttle Challenger accident in 1986, communities across NASA have been developing and extensively using quantitative reliability and risk assessment methods in their decision making process. This paper discusses several reliability engineering applications that NASA has used over the year to support the design, development, and operation of critical space flight hardware. Specifically, the paper discusses several reliability engineering applications used by NASA in areas such as risk management, inspection policies, components upgrades, reliability growth, integrated failure analysis, and physics based probabilistic engineering analysis. In each of these areas, the paper provides a brief discussion of a case study to demonstrate the value added and the criticality of reliability engineering in supporting NASA project and program decisions to fly safely. Examples of these case studies discussed are reliability based life limit extension of Shuttle Space Main Engine (SSME) hardware, Reliability based inspection policies for Auxiliary Power Unit (APU) turbine disc, probabilistic structural engineering analysis for reliability prediction of the SSME alternate turbo-pump development, impact of ET foam reliability on the Space Shuttle System risk, and reliability based Space Shuttle upgrade for safety. Special attention is given in this paper to the physics based probabilistic engineering analysis applications and their critical role in evaluating the reliability of NASA development hardware including their potential use in a research and technology development environment.

A research-based child welfare employee selection protocol: strengthening retention of the workforce.

PubMed

Ellett, Alberta J; Ellett, Chad D; Ellis, Jacquelyn; Lerner, Betsy

2009-01-01

This article describes the development and initial implementation of a new employee selection protocol (ESP) for child welfare grounded in the results of recent large-scale employee retention studies and a set of research-based, minimally essential knowledge, skills, abilities, and values. The complete ESP consists of a sequenced set of Web- and site-based assessment processes and procedures for potential applicants. Using the ESP, applicants and employers make informed decisions about the goodness of fit between the applicant and the demands of a career in child welfare. To date, the new ESP has been piloted in three Georgia Division of Family and Children Services (DFCS) regions and implemented by all nine colleges and universities participating in IV-E child welfare education programs. Evaluation data collected from students and new employees in one DFCS region strongly support the value of the ESP Web-based activities to make a more informed decision about whether to apply for the IV-E stipends and child welfare positions. Feedback from trained ESP assessors supports the value of various ESP activities. A major goal of implementing the ESP is to select more professionally committed and highly qualified applicants to strengthen employee retention and outcomes for children and families.

ToxPi GUI: an interactive visualization tool for transparent integration of data from diverse sources of evidence.

PubMed

Reif, David M; Sypa, Myroslav; Lock, Eric F; Wright, Fred A; Wilson, Ander; Cathey, Tommy; Judson, Richard R; Rusyn, Ivan

2013-02-01

Scientists and regulators are often faced with complex decisions, where use of scarce resources must be prioritized using collections of diverse information. The Toxicological Prioritization Index (ToxPi™) was developed to enable integration of multiple sources of evidence on exposure and/or safety, transformed into transparent visual rankings to facilitate decision making. The rankings and associated graphical profiles can be used to prioritize resources in various decision contexts, such as testing chemical toxicity or assessing similarity of predicted compound bioactivity profiles. The amount and types of information available to decision makers are increasing exponentially, while the complex decisions must rely on specialized domain knowledge across multiple criteria of varying importance. Thus, the ToxPi bridges a gap, combining rigorous aggregation of evidence with ease of communication to stakeholders. An interactive ToxPi graphical user interface (GUI) application has been implemented to allow straightforward decision support across a variety of decision-making contexts in environmental health. The GUI allows users to easily import and recombine data, then analyze, visualize, highlight, export and communicate ToxPi results. It also provides a statistical metric of stability for both individual ToxPi scores and relative prioritized ranks. The ToxPi GUI application, complete user manual and example data files are freely available from http://comptox.unc.edu/toxpi.php.

Assessment of the Current Level of Automation in the Manufacture of Fuel Cell Systems for Combined Heat and Power Applications

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

Ulsh, M.; Wheeler, D.; Protopappas, P.

The U.S. Department of Energy (DOE) is interested in supporting manufacturing research and development (R&D) for fuel cell systems in the 10-1,000 kilowatt (kW) power range relevant to stationary and distributed combined heat and power applications, with the intent to reduce manufacturing costs and increase production throughput. To assist in future decision-making, DOE requested that the National Renewable Energy Laboratory (NREL) provide a baseline understanding of the current levels of adoption of automation in manufacturing processes and flow, as well as of continuous processes. NREL identified and visited or interviewed key manufacturers, universities, and laboratories relevant to the study usingmore » a standard questionnaire. The questionnaire covered the current level of vertical integration, the importance of quality control developments for automation, the current level of automation and source of automation design, critical balance of plant issues, potential for continuous cell manufacturing, key manufacturing steps or processes that would benefit from DOE support for manufacturing R&D, the potential for cell or stack design changes to support automation, and the relationship between production volume and decisions on automation.« less

Machine Learning Approach to Extract Diagnostic and Prognostic Thresholds: Application in Prognosis of Cardiovascular Mortality

PubMed Central

Mena, Luis J.; Orozco, Eber E.; Felix, Vanessa G.; Ostos, Rodolfo; Melgarejo, Jesus; Maestre, Gladys E.

2012-01-01

Machine learning has become a powerful tool for analysing medical domains, assessing the importance of clinical parameters, and extracting medical knowledge for outcomes research. In this paper, we present a machine learning method for extracting diagnostic and prognostic thresholds, based on a symbolic classification algorithm called REMED. We evaluated the performance of our method by determining new prognostic thresholds for well-known and potential cardiovascular risk factors that are used to support medical decisions in the prognosis of fatal cardiovascular diseases. Our approach predicted 36% of cardiovascular deaths with 80% specificity and 75% general accuracy. The new method provides an innovative approach that might be useful to support decisions about medical diagnoses and prognoses. PMID:22924062

Urban Climate Resilience - Connecting climate models with decision support cyberinfrastructure using open standards

NASA Astrophysics Data System (ADS)

Bermudez, L. E.; Percivall, G.; Idol, T. A.

2015-12-01

Experts in climate modeling, remote sensing of the Earth, and cyber infrastructure must work together in order to make climate predictions available to decision makers. Such experts and decision makers worked together in the Open Geospatial Consortium's (OGC) Testbed 11 to address a scenario of population displacement by coastal inundation due to the predicted sea level rise. In a Policy Fact Sheet "Harnessing Climate Data to Boost Ecosystem & Water Resilience", issued by White House Office of Science and Technology (OSTP) in December 2014, OGC committed to increase access to climate change information using open standards. In July 2015, the OGC Testbed 11 Urban Climate Resilience activity delivered on that commitment with open standards based support for climate-change preparedness. Using open standards such as the OGC Web Coverage Service and Web Processing Service and the NetCDF and GMLJP2 encoding standards, Testbed 11 deployed an interoperable high-resolution flood model to bring climate model outputs together with global change assessment models and other remote sensing data for decision support. Methods to confirm model predictions and to allow "what-if-scenarios" included in-situ sensor webs and crowdsourcing. A scenario was in two locations: San Francisco Bay Area and Mozambique. The scenarios demonstrated interoperation and capabilities of open geospatial specifications in supporting data services and processing services. The resultant High Resolution Flood Information System addressed access and control of simulation models and high-resolution data in an open, worldwide, collaborative Web environment. The scenarios examined the feasibility and capability of existing OGC geospatial Web service specifications in supporting the on-demand, dynamic serving of flood information from models with forecasting capacity. Results of this testbed included identification of standards and best practices that help researchers and cities deal with climate-related issues. Results of the testbeds will now be deployed in pilot applications. The testbed also identified areas of additional development needed to help identify scientific investments and cyberinfrastructure approaches needed to improve the application of climate science research results to urban climate resilence.

Tools to support evidence-informed public health decision making

PubMed Central

2014-01-01

Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence-informed decision making. Conclusion Tools are available to support the process of evidence-informed decision making among public health professionals. The usability and usefulness of these tools for advancing and sustaining evidence-informed decision making are discussed, including recommendations for the tools’ application in other public health settings beyond this study. Knowledge and awareness of these tools may assist other health professionals in their efforts to implement evidence-informed practice. PMID:25034534

Tools to support evidence-informed public health decision making.

PubMed

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

2014-07-18

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

Providing guidance for genomics-based cancer treatment decisions: insights from stakeholder engagement for post-prostatectomy radiation therapy.

PubMed

Abe, James; Lobo, Jennifer M; Trifiletti, Daniel M; Showalter, Timothy N

2017-08-24

Despite the emergence of genomics-based risk prediction tools in oncology, there is not yet an established framework for communication of test results to cancer patients to support shared decision-making. We report findings from a stakeholder engagement program that aimed to develop a framework for using Markov models with individualized model inputs, including genomics-based estimates of cancer recurrence probability, to generate personalized decision aids for prostate cancer patients faced with radiation therapy treatment decisions after prostatectomy. We engaged a total of 22 stakeholders, including: prostate cancer patients, urological surgeons, radiation oncologists, genomic testing industry representatives, and biomedical informatics faculty. Slides were at each meeting to provide background information regarding the analytical framework. Participants were invited to provide feedback during the meeting, including revising the overall project aims. Stakeholder meeting content was reviewed and summarized by stakeholder group and by theme. The majority of stakeholder suggestions focused on aspects of decision aid design and formatting. Stakeholders were enthusiastic about the potential value of using decision analysis modeling with personalized model inputs for cancer recurrence risk, as well as competing risks from age and comorbidities, to generate a patient-centered tool to assist decision-making. Stakeholders did not view privacy considerations as a major barrier to the proposed decision aid program. A common theme was that decision aids should be portable across multiple platforms (electronic and paper), should allow for interaction by the user to adjust model inputs iteratively, and available to patients both before and during consult appointments. Emphasis was placed on the challenge of explaining the model's composite result of quality-adjusted life years. A range of stakeholders provided valuable insights regarding the design of a personalized decision aid program, based upon Markov modeling with individualized model inputs, to provide a patient-centered framework to support for genomic-based treatment decisions for cancer patients. The guidance provided by our stakeholders may be broadly applicable to the communication of genomic test results to patients in a patient-centered fashion that supports effective shared decision-making that represents a spectrum of personal factors such as age, medical comorbidities, and individual priorities and values.

Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

NASA Astrophysics Data System (ADS)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2017-02-01

Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on the decision-making processes of others, enhances decision-making competence. In addition, this study examines whether this process is supported by elements of self-regulated learning, i.e., self-reflection regarding one's own performance and the setting of goals for subsequent tasks. A computer-based training program which involves the resolution of socioscientific issues related to sustainable development was developed in two versions: with and without elements of self-regulated learning. Its effects on decision-making competence were analyzed using a pre test-post test follow-up control-group design ( N = 242 high school students). Decision-making competence was assessed using an open-ended questionnaire that focused on three facets: consideration of advantages and disadvantages, metadecision aspects, and reflection on the decision-making processes of others. The findings suggest that students in both training groups incorporated aspects of metadecision into their statements more often than students in the control group. Furthermore, both training groups were more successful in reflecting on the decision-making processes of others. The students who received additional training in self-regulated learning showed greater benefits in terms of metadecision aspects and reflection, and these effects remained significant two months later. Overall, our findings demonstrate that the application of decision-making strategies, combined with reflections on the decision-making process and elements of self-regulated learning, is a fruitful approach in STSE education.

The Use of Life Cycle Tools to Support Decision Making for Sustainable Nanotechnologies

EPA Science Inventory

Nanotechnology is a broad-impact technology with applications ranging from materials and electronics to analytical methods and metrology. The many benefits that can be realized through the utilization of nanotechnology are intended to lead to an improved quality of life. However,...

Challenges for continuity of L-Band observations over land

USDA-ARS?s Scientific Manuscript database

Over land, L-band observations are primarily used for the detection of soil freeze/thaw events and the quantification of surface soil moisture content. Both products have important science, climate and decision support applications and would benefit from longer historical data records derived from s...

GEOGRAPHICAL INFORMATION SYSTEM, DECISION SUPPORT SYSTEMS, AND URBAN STORMWATER MANAGEMENT

EPA Science Inventory

The full report reviews the application of Geographic Inforamtion System (GIS) technology to the field of urban stormwater modeling. The GIS literature is reviewed in the context of its use as a spatial database for urban stormwater modeling, integration of GIS and hydroloic time...

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...

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

DOT National Transportation Integrated Search

2010-03-01

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

Report on Enhanced Framework (SUSTAIN) and Field Applications to Placement of BMPs in Urban Watersheds

EPA Science Inventory

The System for Urban Stormwater Treatment and Analysis Integration (SUSTAIN) was developed by the U.S. Environmental Protection Agency (EPA) to provide stormwater managers with a decision support system for the cost-efficient selection and placement of stormwater best management ...

A miniature ultrasonic actuator-control system for plant stem diameter micro-variation measurements

USDA-ARS?s Scientific Manuscript database

Measurements of micro-variations in plant stem diameter are potentially useful to optimize irrigation decision support systems that are based on plant physiological responses. However, for this technology to be suitable for field applications, problems associated with stem softness and micro variati...

APPLICATION OF THE REGIONAL VULNERABILITY ASSESSMENT (REVA) INTEGRATION TOOL AND UNDERLYING METHODS FOR MULTI-SCALE DECISION MAKING

EPA Science Inventory

In support of the National Science and Technology Council's cross-Agency priority of Integrated Science for Ecological Challenges (ISEC) EPA is conducting research to improve capabilities in the area of regional vulnerability assessment and ecological forecasting. EPA's research...

Coordinating Aircraft During Field Campaigns: Real Time Mission Monitor Tool

NASA Technical Reports Server (NTRS)

Goodman, Michael

2012-01-01

RTMM has evolved into a powerful and easy to use application in support of planning, situational awareness and strategic decision-making during airborne field campaigns. NASA is very open to sharing these capabilities with any interested group through interagency collaborations in future field activities.

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

PubMed

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

2011-01-01

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

Designing a web-application to support home-based care of childhood CKD stages 3-5: qualitative study of family and professional preferences.

PubMed

Swallow, Veronica M; Hall, Andrew G; Carolan, Ian; Santacroce, Sheila; Webb, Nicholas J A; Smith, Trish; Hanif, Noreen

2014-02-18

There is a lack of online, evidence-based information and resources to support home-based care of childhood CKD stages 3-5. Qualitative interviews were undertaken with parents, patients and professionals to explore their views on content of the proposed online parent information and support (OPIS) web-application. Data were analysed using Framework Analysis, guided by the concept of Self-efficacy. 32 parents, 26 patients and 12 professionals were interviewed. All groups wanted an application that explains, demonstrates, and enables parental clinical care-giving, with condition-specific, continously available, reliable, accessible material and a closed communication system to enable contact between families living with CKD. Professionals advocated a regularly updated application to empower parents to make informed health-care decisions. To address these requirements, key web-application components were defined as: (i) Clinical care-giving support (information on treatment regimens, video-learning tools, condition-specific cartoons/puzzles, and a question and answer area) and (ii) Psychosocial support for care-giving (social-networking, case studies, managing stress, and enhancing families' health-care experiences). Developing a web-application that meets parents' information and support needs will maximise its utility, thereby augmenting parents' self-efficacy for CKD caregiving, and optimising outcomes. Self-efficacy theory provides a schema for how parents' self-efficacy beliefs about management of their child's CKD could potentially be promoted by OPIS.

Electronic decision support for diagnostic imaging in a primary care setting

PubMed Central

Reed, Martin H

2011-01-01

Methods Clinical guideline adherence for diagnostic imaging (DI) and acceptance of electronic decision support in a rural community family practice clinic was assessed over 36 weeks. Physicians wrote 904 DI orders, 58% of which were addressed by the Canadian Association of Radiologists guidelines. Results Of those orders with guidelines, 76% were ordered correctly; 24% were inappropriate or unnecessary resulting in a prompt from clinical decision support. Physicians followed suggestions from decision support to improve their DI order on 25% of the initially inappropriate orders. The use of decision support was not mandatory, and there were significant variations in use rate. Initially, 40% reported decision support disruptive in their work flow, which dropped to 16% as physicians gained experience with the software. Conclusions Physicians supported the concept of clinical decision support but were reluctant to change clinical habits to incorporate decision support into routine work flow. PMID:21486884

Application of the principles of evidence-based practice in decision making among senior management in Nova Scotia's addiction services agencies.

PubMed

Murphy, Matthew; MacCarthy, M Jayne; McAllister, Lynda; Gilbert, Robert

2014-12-05

Competency profiles for occupational clusters within Canada's substance abuse workforce (SAW) define the need for skill and knowledge in evidence-based practice (EBP) across all its members. Members of the Senior Management occupational cluster hold ultimate responsibility for decisions made within addiction services agencies and therefore must possess the highest level of proficiency in EBP. The objective of this study was to assess the knowledge of the principles of EBP, and use of the components of the evidence-based decision making (EBDM) process in members of this occupational cluster from selected addiction services agencies in Nova Scotia. A convenience sampling method was used to recruit participants from addiction services agencies. Semi-structured qualitative interviews were conducted with eighteen Senior Management. The interviews were audio-recorded, transcribed verbatim and checked by the participants. Interview transcripts were coded and analyzed for themes using content analysis and assisted by qualitative data analysis software (NVivo 9.0). Data analysis revealed four main themes: 1) Senior Management believe that addictions services agencies are evidence-based; 2) Consensus-based decision making is the norm; 3) Senior Management understand the principles of EBP and; 4) Senior Management do not themselves use all components of the EBDM process when making decisions, oftentimes delegating components of this process to decision support staff. Senior Management possess an understanding of the principles of EBP, however, when making decisions they often delegate components of the EBDM process to decision support staff. Decision support staff are not defined as an occupational cluster in Canada's SAW and have not been ascribed a competency profile. As such, there is no guarantee that this group possesses competency in EBDM. There is a need to advocate for the development of a defined occupational cluster and associated competency profile for this critical group.

Supporting end of life decision making: Case studies of relational closeness in supported decision making for people with severe or profound intellectual disability.

PubMed

Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

2017-11-01

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions. Five people with severe or profound intellectual disability's experiences of supported decision making were examined. This article is particularly focused on one participant's experiences at the end of his life. All five case studies identified that supporters were most effective in providing decision-making support for participants when they were relationally close to the person and had knowledge of the person's life story, particularly in relation to events that demonstrated preference. Findings from this study provide new understandings of supported decision making for people with severe or profound intellectual disability and have particular relevance for supporting decision making at the end of life. © 2017 John Wiley & Sons Ltd.

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

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

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

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

A Framework for Comprehensive Health Terminology Systems in the United States

PubMed Central

Chute, Christopher G.; Cohn, Simon P.; Campbell, James R.

1998-01-01

Health care in the United States has become an information-intensive industry, yet electronic health records represent patient data inconsistently for lack of clinical data standards. Classifications that have achieved common acceptance, such as the ICD-9-CM or ICD, aggregate heterogeneous patients into broad categories, which preclude their practical use in decision support, development of refined guidelines, or detailed comparison of patient outcomes or benchmarks. This document proposes a framework for the integration and maturation of clinical terminologies that would have practical applications in patient care, process management, outcome analysis, and decision support. Arising from the two working groups within the standards community—the ANSI (American National Standards Institute) Healthcare Informatics Standards Board Working Group and the Computer-based Patient Records Institute Working Group on Codes and Structures—it outlines policies regarding 1) functional characteristics of practical terminologies, 2) terminology models that can broaden their applications and contribute to their sustainability, 3) maintenance attributes that will enable terminologies to keep pace with rapidly changing health care knowledge and process, and 4) administrative issues that would facilitate their accessibility, adoption, and application to improve the quality and efficiency of American health care. PMID:9824798

Building Capacity for Earth Observations in Support of the United Nations Sustainable Development Goals

NASA Astrophysics Data System (ADS)

Blevins, B.; Prados, A. I.; Hook, E.

2017-12-01

The Group on Earth Observations (GEO) looks to build a future where the international community uses Earth observations to make better, informed decisions. This includes application in international agreements such as the UN Sustainable Development Goals (SDGs), the Sendai Framework for Disaster Risk Reduction, and the Convention on Biological Diversity. To do this, decision makers first need to build the necessary skills. NASA's Applied Remote Sensing Training program (ARSET) seeks to build capacity through remote sensing training. In-person and online trainings raise awareness, enable data access, and demonstrate applications of Earth observations. Starting in 2017, ARSET began offering training focused on applying Earth data to the UN SDGs. These trainings offer insight into applications of satellite data in support of implementing, monitoring, and evaluating the SDGs. This presentation will provide an overview of the use of NASA satellite data to track progress towards increased food security, disaster risk reduction, and conservation of natural resources for societal benefit. It will also include a discussion on capacity building best practices and lessons learned for using Earth observations to meet SDG targets, based on feedback from engaging over 800 participants from 89 nations and 580 organizations in ARSET SDG trainings.

Employer attitudes about criminal histories.

PubMed

Swanson, Sarah J; Langfitt-Reese, Sandra; Bond, Gary R

2012-09-01

Although the individual placement and support (IPS) approach has demonstrated superior competitive employment outcomes for people with severe mental illness, practitioners report that job obtainment for people with criminal convictions is particularly challenging. The current study examined employer hiring decisions and attitudes regarding job applicants with felonies. The main purpose of the study was to identify the percentage of employers who had knowingly hired applicants with felonies, and if the hiring patterns differed by employer type. Twelve employment specialists from nine states interviewed 128 employers about their past hiring practices. Two IPS trainers coordinated the project with the specialists. Survey findings did not support common assumptions held by employment specialists about employer attitudes. Sixty-three percent of employers surveyed said that they had knowingly hired at least one person with a felony conviction. Further, few businesses had written policies that would prohibit the hiring of people with felony convictions. Employers' reported reasons for having hired individuals with felony convictions provide a framework to help jobseekers improve their prospects for favorable hiring decisions. Employers suggested that relationships with employment specialists can also facilitate the hiring of applicants with felonies. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

The availability and effectiveness of tools supporting shared decision making in metastatic breast cancer care: a review.

PubMed

Spronk, Inge; Burgers, Jako S; Schellevis, François G; van Vliet, Liesbeth M; Korevaar, Joke C

2018-05-11

Shared decision-making (SDM) in the management of metastatic breast cancer care is associated with positive patient outcomes. In daily clinical practice, however, SDM is not fully integrated yet. Initiatives to improve the implementation of SDM would be helpful. The aim of this review was to assess the availability and effectiveness of tools supporting SDM in metastatic breast cancer care. Literature databases were systematically searched for articles published since 2006 focusing on the development or evaluation of tools to improve information-provision and to support decision-making in metastatic breast cancer care. Internet searches and experts identified additional tools. Data from included tools were extracted and the evaluation of tools was appraised using the GRADE grading system. The literature search yielded five instruments. In addition, two tools were identified via internet searches and consultation of experts. Four tools were specifically developed for supporting SDM in metastatic breast cancer, the other three tools focused on metastatic cancer in general. Tools were mainly applicable across the care process, and usable for decisions on supportive care with or without chemotherapy. All tools were designed for patients to be used before a consultation with the physician. Effects on patient outcomes were generally weakly positive although most tools were not studied in well-designed studies. Despite its recognized importance, only two tools were positively evaluated on effectiveness and are available to support patients with metastatic breast cancer in SDM. These tools show promising results in pilot studies and focus on different aspects of care. However, their effectiveness should be confirmed in well-designed studies before implementation in clinical practice. Innovation and development of SDM tools targeting clinicians as well as patients during a clinical encounter is recommended.

Sequential decision tree using the analytic hierarchy process for decision support in rectal cancer.

PubMed

Suner, Aslı; Çelikoğlu, Can Cengiz; Dicle, Oğuz; Sökmen, Selman

2012-09-01

The aim of the study is to determine the most appropriate method for construction of a sequential decision tree in the management of rectal cancer, using various patient-specific criteria and treatments such as surgery, chemotherapy, and radiotherapy. An analytic hierarchy process (AHP) was used to determine the priorities of variables. Relevant criteria used in two decision steps and their relative priorities were established by a panel of five general surgeons. Data were collected via a web-based application and analyzed using the "Expert Choice" software specifically developed for the AHP. Consistency ratios in the AHP method were calculated for each set of judgments, and the priorities of sub-criteria were determined. A sequential decision tree was constructed for the best treatment decision process, using priorities determined by the AHP method. Consistency ratios in the AHP method were calculated for each decision step, and the judgments were considered consistent. The tumor-related criterion "presence of perforation" (0.331) and the patient-surgeon-related criterion "surgeon's experience" (0.630) had the highest priority in the first decision step. In the second decision step, the tumor-related criterion "the stage of the disease" (0.230) and the patient-surgeon-related criterion "surgeon's experience" (0.281) were the paramount criteria. The results showed some variation in the ranking of criteria between the decision steps. In the second decision step, for instance, the tumor-related criterion "presence of perforation" was just the fifth. The consistency of decision support systems largely depends on the quality of the underlying decision tree. When several choices and variables have to be considered in a decision, it is very important to determine priorities. The AHP method seems to be effective for this purpose. The decision algorithm developed by this method is more realistic and will improve the quality of the decision tree. Copyright © 2012 Elsevier B.V. All rights reserved.

Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems

PubMed Central

Menychtas, Andreas; Tsanakas, Panayiotis

2016-01-01

The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging. PMID:27222731

Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems.

PubMed

Menychtas, Andreas; Tsanakas, Panayiotis; Maglogiannis, Ilias

2016-03-01

The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging.

Information warehouse - a comprehensive informatics platform for business, clinical, and research applications.

PubMed

Kamal, Jyoti; Liu, Jianhua; Ostrander, Michael; Santangelo, Jennifer; Dyta, Ravi; Rogers, Patrick; Mekhjian, Hagop S

2010-11-13

Since its inception in 1997, the IW (Information Warehouse) at the Ohio State University Medical Center (OSUMC) has gradually transformed itself from a single purpose business decision support system to a comprehensive informatics platform supporting basic, clinical, and translational research. The IW today is the combination of four integrated components: a clinical data repository containing over a million patients; a research data repository housing various research specific data; an application development platform for building business and research enabling applications; a business intelligence environment assisting in reporting in all function areas. The IW is structured and encoded using standard terminologies such as SNOMED-CT, ICD, and CPT. The IW is an important component of OSUMC's Clinical and Translational Science Award (CTSA) informatics program.

A "simulation chain" to define a Multidisciplinary Decision Support System for landslide risk management in pyroclastic soils

NASA Astrophysics Data System (ADS)

Damiano, E.; Mercogliano, P.; Netti, N.; Olivares, L.

2012-04-01

This paper proposes a Multidisciplinary Decision Support System (MDSS) as an approach to manage rainfall-induced shallow landslides of the flow type (flowslides) in pyroclastic deposits. We stress the need to combine information from the fields of meteorology, geology, hydrology, geotechnics and economics to support the agencies engaged in land monitoring and management. The MDSS consists of a "simulation chain" to link rainfall to effects in terms of infiltration, slope stability and vulnerability. This "simulation chain" was developed at the Euro-Mediterranean Centre for Climate Change (CMCC) (meteorological aspects), at the Geotechnical Laboratory of the Second University of Naples (hydrological and geotechnical aspects) and at the Department of Economics of the University of Naples "Federico II" (economic aspects). The results obtained from the application of this simulation chain in the Cervinara area during eleven years of research allowed in-depth analysis of the mechanisms underlying a flowslide in pyroclastic soil.

EPA Technical Support Centers (TSC): FY14 Lessons ...

EPA Pesticide Factsheets

EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this information to users in both direct applications (i.e., site-specific technical support) and general applications (i.e., technical transfer activities such as technical guidance documents, conferences, or workshops) . The TSCs are charged with providing solutions by: 1) linking EPA research to Agency decision-makers; 2) applying best practices to real world field applications; and 3) channeling feedback from field application to research communities. The TSP goal is to provide Regional Remedial Project Managers (RPMs), Corrective Action Staff, and On-Scene Coordinators (OSCs) with a diverse set of readily-accessible resources for technical assistance. This research summary provides six case studies – two from each of the three TSCs (Ground Water Technical Support Center, Engineering Technical Support Center, and Site Characterization Technical Support Center) – to exemplify and summarize the variety of TSC approaches that contribute to fulfilling the TSP mission. EPA’s Technical Support Centers (TSC) included in ORD’s Safe and Healthy Communities (SHC) Research Action Plan fill the need for supplying subject-matter experts to continually assess state-of-the-art research and practices and channel this informati

Smart homes and ambient assisted living applications: from data to knowledge-empowering or overwhelming older adults? Contribution of the IMIA Smart Homes and Ambiant Assisted Living Working Group.

PubMed

Demiris, G; Thompson, H

2011-01-01

As health care systems face limited resources and workforce shortages to address the complex needs of older adult populations, innovative approaches utilizing information technology can support aging. Smart Home and Ambient Assisted Living (SHAAL) systems utilize advanced and ubiquitous technologies including sensors and other devices that are integrated in the residential infrastructure or wearable, to capture data describing activities of daily living and health related events. This paper highlights how data from SHAAL systems can lead to information and knowledge that ultimately improves clinical outcomes and quality of life for older adults as well as quality of health care services. We conducted a review of personal health record applications specifically for older adults and approaches to using information to improve elder care. We present a framework that showcases how data captured from SHAAL systems can be processed to provide meaningful information that becomes part of a personal health record. Synthesis and visualization of information resulting from SHAAL systems can lead to knowledge and support education, delivery of tailored interventions and if needed, transitions in care. Such actions can involve multiple stakeholders as part of shared decision making. SHAAL systems have the potential to support aging and improve quality of life and decision making for older adults and their families. The framework presented in this paper demonstrates how emphasis needs to be placed into extracting meaningful information from new innovative systems that will support decision making. The challenge for informatics designers and researchers is to facilitate an evolution of SHAAL systems expanding beyond demonstration projects to actual interventions that will improve health care for older adults.

Translating research into practice through user-centered design: An application for osteoarthritis healthcare planning.

PubMed

Carr, Eloise Cj; Babione, Julie N; Marshall, Deborah

2017-08-01

To identify the needs and requirements of the end users, to inform the development of a user-interface to translate an existing evidence-based decision support tool into a practical and usable interface for health service planning for osteoarthritis (OA) care. We used a user-centered design (UCD) approach that emphasized the role of the end-users and is well-suited to knowledge translation (KT). The first phase used a needs assessment focus group (n=8) and interviews (n=5) with target users (health care planners) within a provincial health care organization. The second phase used a participatory design approach, with two small group sessions (n=6) to explore workflow, thought processes, and needs of intended users. The needs assessment identified five design recommendations: ensuring the user-interface supports the target user group, allowing for user-directed data explorations, input parameter flexibility, clear presentation, and provision of relevant definitions. The second phase identified workflow insights from a proposed scenario. Graphs, the need for a visual overview of the data, and interactivity were key considerations to aid in meaningful use of the model and knowledge translation. A UCD approach is well suited to identify health care planners' requirements when using a decision support tool to improve health service planning and management of OA. We believe this is one of the first applications to be used in planning for health service delivery. We identified specific design recommendations that will increase user acceptability and uptake of the user-interface and underlying decision support tool in practice. Our approach demonstrated how UCD can be used to enable knowledge translation. Copyright © 2017 Elsevier B.V. All rights reserved.

Adapting Nielsen’s Design Heuristics to Dual Processing for Clinical Decision Support

PubMed Central

Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

2016-01-01

The study objective was to improve the applicability of Nielson’s standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access. PMID:28269915

Adapting Nielsen's Design Heuristics to Dual Processing for Clinical Decision Support.

PubMed

Taft, Teresa; Staes, Catherine; Slager, Stacey; Weir, Charlene

2016-01-01

The study objective was to improve the applicability of Nielson's standard design heuristics for evaluating electronic health record (EHR) alerts and linked ordering support by integrating them with Dual Process theory. Through initial heuristic evaluation and a user study of 7 physicians, usability problems were identified. Through independent mapping of specific usability criteria to support for each of the Dual Cognitive processes (S1 and S2) and deliberation, agreement was reached on mapping criteria. Finally, usability errors from the heuristic and user study were mapped to S1 and S2. Adding a dual process perspective to specific heuristic analysis increases the applicability and relevance of computerized health information design evaluations. This mapping enables designers to measure that their systems are tailored to support attention allocation. System 1 will be supported by improving pattern recognition and saliency, and system 2 through efficiency and control of information access.

Practical considerations to guide development of access controls and decision support for genetic information in electronic medical records.

PubMed

Darcy, Diana C; Lewis, Eleanor T; Ormond, Kelly E; Clark, David J; Trafton, Jodie A

2011-11-02

Genetic testing is increasingly used as a tool throughout the health care system. In 2011 the number of clinically available genetic tests is approaching 2,000, and wide variation exists between these tests in their sensitivity, specificity, and clinical implications, as well as the potential for discrimination based on the results. As health care systems increasingly implement electronic medical record systems (EMRs) they must carefully consider how to use information from this wide spectrum of genetic tests, with whom to share information, and how to provide decision support for clinicians to properly interpret the information. Although some characteristics of genetic tests overlap with other medical test results, there are reasons to make genetic test results widely available to health care providers and counterbalancing reasons to restrict access to these test results to honor patient preferences, and avoid distracting or confusing clinicians with irrelevant but complex information. Electronic medical records can facilitate and provide reasonable restrictions on access to genetic test results and deliver education and decision support tools to guide appropriate interpretation and use. This paper will serve to review some of the key characteristics of genetic tests as they relate to design of access control and decision support of genetic test information in the EMR, emphasizing the clear need for health information technology (HIT) to be part of optimal implementation of genetic medicine, and the importance of understanding key characteristics of genetic tests when designing HIT applications.

Big Data Architectures for Operationalized Seismic and Subsurface Monitoring and Decision Support Workflows

NASA Astrophysics Data System (ADS)

Irving, D. H.; Rasheed, M.; Hillman, C.; O'Doherty, N.

2012-12-01

Oilfield management is moving to a more operational footing with near-realtime seismic and sensor monitoring governing drilling, fluid injection and hydrocarbon extraction workflows within safety, productivity and profitability constraints. To date, the geoscientific analytical architectures employed are configured for large volumes of data, computational power or analytical latency and compromises in system design must be made to achieve all three aspects. These challenges are encapsulated by the phrase 'Big Data' which has been employed for over a decade in the IT industry to describe the challenges presented by data sets that are too large, volatile and diverse for existing computational architectures and paradigms. We present a data-centric architecture developed to support a geoscientific and geotechnical workflow whereby: ●scientific insight is continuously applied to fresh data ●insights and derived information are incorporated into engineering and operational decisions ●data governance and provenance are routine within a broader data management framework Strategic decision support systems in large infrastructure projects such as oilfields are typically relational data environments; data modelling is pervasive across analytical functions. However, subsurface data and models are typically non-relational (i.e. file-based) in the form of large volumes of seismic imaging data or rapid streams of sensor feeds and are analysed and interpreted using niche applications. The key architectural challenge is to move data and insight from a non-relational to a relational, or structured, data environment for faster and more integrated analytics. We describe how a blend of MapReduce and relational database technologies can be applied in geoscientific decision support, and the strengths and weaknesses of each in such an analytical ecosystem. In addition we discuss hybrid technologies that use aspects of both and translational technologies for moving data and analytics across these platforms. Moving to a data-centric architecture requires data management methodologies to be overhauled by default and we show how end-to-end data provenancing and dependency management is implicit in such an environment and how it benefits system administration as well as the user community. Whilst the architectural experiences are drawn from the oil industry, we believe that they are more broadly applicable in academic and government settings where large volumes of data are added to incrementally and require revisiting with low analytical latency and we suggest application to earthquake monitoring and remote sensing networks.

Implementation of a Mobile Clinical Decision Support Application to Augment Local Antimicrobial Stewardship.

PubMed

Hoff, Brian M; Ford, Diana C; Ince, Dilek; Ernst, Erika J; Livorsi, Daniel J; Heintz, Brett H; Masse, Vincent; Brownlee, Michael J; Ford, Bradley A

2018-01-01

Medical applications for mobile devices allow clinicians to leverage microbiological data and standardized guidelines to treat patients with infectious diseases. We report the implementation of a mobile clinical decision support (CDS) application to augment local antimicrobial stewardship. We detail the implementation of our mobile CDS application over 20 months. Application utilization data were collected and evaluated using descriptive statistics to quantify the impact of our implementation. Project initiation focused on engaging key stakeholders, developing a business case, and selecting a mobile platform. The preimplementation phase included content development, creation of a pathway for content approval within the hospital committee structure, engaging clinical leaders, and formatting the first version of the guide. Implementation involved a media campaign, staff education, and integration within the electronic medical record and hospital mobile devices. The postimplementation phase required ongoing quality improvement, revision of outdated content, and repeated staff education. The evaluation phase included a guide utilization analysis, reporting to hospital leadership, and sustainability and innovation planning. The mobile application was downloaded 3056 times and accessed 9259 times during the study period. The companion web viewer was accessed 8214 times. Successful implementation of a customizable mobile CDS tool enabled our team to expand beyond microbiological data to clinical diagnosis, treatment, and antimicrobial stewardship, broadening our influence on antimicrobial prescribing and incorporating utilization data to inspire new quality and safety initiatives. Further studies are needed to assess the impact on antimicrobial utilization, infection control measures, and patient care outcomes.

Information Product Development: Data product life cycle links engineering, science, and applications

NASA Astrophysics Data System (ADS)

Stavros, E. N.; Owen, S. E.

2016-12-01

Information products are assimilated and used to: a) conduct scientific research and b) provide decision support for management and policy. For example, aboveground biomass (i.e. an information product) can be integrated into Earth system models to test hypotheses about the changing world, or used to inform decision-making with respect to natural resource management and policy. Production and dissemination of an information product is referred to as the data product life cycle, which includes: 1) identifying needed information from decision-makers and researchers, 2) engineering an instrument and collecting the raw physical measurements (e.g, number of photons returned), 3) the scientific algorithm(s) for processing the data into an observable (e.g., number of dying trees), and 4) the integration and utilization of that observables by researchers and decision-makers. In this talk, I will discuss the data product life cycle in detail and provide examples from the pre-Hyperspectral Infrared Imager (HyspIRI) airborne campaign and the upcoming NASA-ISRO Synthetic Aperture Radar (NISAR) mission. Examples will focus on information products related to terrestrial ecosystems and natural resource management and will demonstrate that the key to providing information products for advancing scientific understanding and informing decision-makers, is the interdisciplinary integration of science, engineering and applied science - noting that applied science defines the wider impact and adoption of scientific principles by a wider community. As pre-HyspIRI airborne data is for research and development and NISAR is not yet launched, examples will include current plans for developing exemplar data products (from pre-HyspIRI) and the mission Applications Plan (for NISAR). Copyright 2016 California Institute of Technology. All Rights Reserved. We acknowledge support of the US Government, NASA, the Earth Science Division and Terrestrial Ecology program.

A Bayesian paradigm for decision-making in proof-of-concept trials.

PubMed

Pulkstenis, Erik; Patra, Kaushik; Zhang, Jianliang

2017-01-01

Decision-making is central to every phase of drug development, and especially at the proof of concept stage where risk and evidence must be weighed carefully, often in the presence of significant uncertainty. The decision to proceed or not to large expensive Phase 3 trials has significant implications to both patients and sponsors alike. Recent experience has shown that Phase 3 failure rates remain high. We present a flexible Bayesian quantitative decision-making paradigm that evaluates evidence relative to achieving a multilevel target product profile. A framework for operating characteristics is provided that allows the drug developer to design a proof-of-concept trial in light of its ability to support decision-making rather than merely achieve statistical significance. Operating characteristics are shown to be superior to traditional p-value-based methods. In addition, discussion related to sample size considerations, application to interim futility analysis and incorporation of prior historical information is evaluated.

USER MANUAL FOR THE EPA THIRD-GENERATION AIR QUALITY MODELING SYSTEM (MODELS-3 VERSION 3.0)

EPA Science Inventory

Models-3 is a flexible software system designed to simplify the development and use of environmental assessment and other decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of atmospheri...

SYSTEM INSTALLATION AND OPERATION MANUAL FOR THE EPA THIRD-GENERATION AIR QUALITY MODELING SYSTEM (MODELS-3) VERSION 3.0

EPA Science Inventory

Models-3 is a flexible software system designed to simplify the development and use of environmental assessment and other decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of atmospheri...

USER'S GUIDE TO CLOSURE EVALUATION SYSTEM: CES BETA-TEST VERSION 1.0

EPA Science Inventory

The Closure Evaluation System (CES) is a decision support tool, developed by the U.S. EPA's Risk Reduction Engineering Laboratory, to assist reviewers and preparers of Resource Conservation and Recovery Act (RCRA) Part B permit applications. CES is designed to serve as a checklis...

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... associated with the verification of student identity at the time of registration or enrollment. (Authority...

Topographic and physicochemical controls on soil denitrification potential in prior converted croplands located on the Delmarva Peninsula, USA

USDA-ARS?s Scientific Manuscript database

Topography and soil physiochemical characteristics exert substantial controls on denitrification in agricultural lands. In order to depict these controls at a landscape scale for decision support applications, metrics (i.e., proxies) must be developed based on commonly available geospatial data. In ...

77 FR 35809 - Revision of Fee Schedules; Fee Recovery for Fiscal Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

..., 1974, the U.S. Supreme Court rendered major decisions in two cases, National Cable Television...- submission audit has been useful in improving the quality of applications which helps to expedite reviews... and to support nuclear technology programs at minority- serving institutions. Response. The purposes...

Data Mining and Knowledge Management in Higher Education -Potential Applications.

ERIC Educational Resources Information Center

Luan, Jing

This paper introduces a new decision support tool, data mining, in the context of knowledge management. The most striking features of data mining techniques are clustering and prediction. The clustering aspect of data mining offers comprehensive characteristics analysis of students, while the predicting function estimates the likelihood for a…

MODELS-3 INSTALLATION PROCEDURES FOR A PC WITH AN NT OPERATING SYSTEM (MODELS-3 VERSION 4.0)

EPA Science Inventory

Models-3 is a flexible software system designed to simplify the development and use of air quality models and other environmental decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of at...

MODELS-3 INSTALLATION PROCEDURES FOR A PERSONAL COMPUTER WITH A NT OPERATING SYSTEM (MODELS-3 VERSION 4.1)

EPA Science Inventory

Models-3 is a flexible system designed to simplify the development and use of air quality models and other environmental decision support tools. It is designed for applications ranging from regulatory and policy analysis to understanding the complex interactions of atmospheric...

GLIMPSE: An integrated assessment model-based tool for coordinated energy and environmental planning

EPA Science Inventory

Dan Loughlin will describe the GCAM-USA integrated assessment model and how that model is being improved and integrated into the GLIMPSE decision support system. He will also demonstrate the application of the model to evaluate the emissions and health implications of hypothetica...

Targeting Tumor-Initiating Cells for the Therapeutics of Breast Cancer

DTIC Science & Technology

2017-10-01

policy or decision unless so designated by other documentation. REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 Public reporting...clarifies or supports the text. Examples include original copies of journal articles, reprints of manuscripts and abstracts, a curriculum vitae, patent applications, study questionnaires, and surveys , etc. None.

MATREX: A Unifying Modeling and Simulation Architecture for Live-Virtual-Constructive Applications

DTIC Science & Technology

2007-05-23

Deployment Systems Acquisition Operations & Support B C Sustainment FRP Decision Review FOC LRIP/IOT& ECritical Design Review Pre-Systems...CMS2 – Comprehensive Munitions & Sensor Server • CSAT – C4ISR Static Analysis Tool • C4ISR – Command & Control, Communications, Computers

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2012 CFR

2012-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2013 CFR

2013-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2011 CFR

2011-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

34 CFR 602.17 - Application of standards in reaching an accrediting decision.

Code of Federal Regulations, 2014 CFR

2014-07-01

... program to prepare, following guidance provided by the agency, an in-depth self-study that includes the... on-site review; (e) Conducts its own analysis of the self-study and supporting documentation... standards, including areas needing improvement; and (2) The institution's or program's performance with...

DECISION-SUPPORT SOFTWARE FOR SOIL VAPOR EXTRACTION TECHNOLOGY APPLICATION: HYPERVENTILATE

EPA Science Inventory

The U.S. Environmental Protection Agency (EPA) estimate* that 15% to 20% of the approximately 1.7 million underground storage tank (UST) systems containing petroleum products are either leaking or will leak In the near future. These UST systems could pose a serious threat to p...

8 CFR 245a.2 - Application for temporary residence.

Code of Federal Regulations, 2010 CFR

2010-01-01

... adjudicate a claim may result in denial of the benefit sought. Acceptable supporting documents for these...) (narcotics) except for a single offense of simple possession of thirty grams or less of marijuana; (iii... benefit which has been requested. The director's new decision must be served on the appealing party within...

8 CFR 245a.2 - Application for temporary residence.

Code of Federal Regulations, 2013 CFR

2013-01-01

... adjudicate a claim may result in denial of the benefit sought. Acceptable supporting documents for these...) (narcotics) except for a single offense of simple possession of thirty grams or less of marijuana; (iii... benefit which has been requested. The director's new decision must be served on the appealing party within...

8 CFR 245a.2 - Application for temporary residence.

Code of Federal Regulations, 2012 CFR

2012-01-01

... adjudicate a claim may result in denial of the benefit sought. Acceptable supporting documents for these...) (narcotics) except for a single offense of simple possession of thirty grams or less of marijuana; (iii... benefit which has been requested. The director's new decision must be served on the appealing party within...

8 CFR 245a.2 - Application for temporary residence.

Code of Federal Regulations, 2011 CFR

2011-01-01

... adjudicate a claim may result in denial of the benefit sought. Acceptable supporting documents for these...) (narcotics) except for a single offense of simple possession of thirty grams or less of marijuana; (iii... benefit which has been requested. The director's new decision must be served on the appealing party within...

Impact of Seasonal Forecasts on Agriculture

NASA Astrophysics Data System (ADS)

Aldor-Noiman, S. C.

2014-12-01

More extreme and volatile weather conditions are a threat to U.S. agricultural productivity today, as multiple environmental conditions during the growing season impact crop yields. That's why farmers' agronomic management decisions are dominated by consideration for near, medium and seasonal forecasts of climate. The Climate Corporation aims to help farmers around the world protect and improve their farming operations by providing agronomic decision support tools that leverage forecasts on multiple timescales to provide valuable insights directly to farmers. In this talk, we will discuss the impact of accurate seasonal forecasts on major decisions growers face each season. We will also discuss assessment and evaluation of seasonal forecasts in the context of agricultural applications.

Data to Decisions: Valuing the Societal Benefit of Geospatial Information

NASA Astrophysics Data System (ADS)

Pearlman, F.; Kain, D.

2016-12-01

The March 10-11, 2016 GEOValue workshop on "Data to Decisions" was aimed at creating a framework for identification and implementation of best practices that capture the societal value of geospatial information for both public and private uses. The end-to-end information flow starts with the earth observation and data acquisition systems, includes the full range of processes from geospatial information to decisions support systems, and concludes with the end user. Case studies, which will be described in this presentation, were identified for a range of applications. The goal was to demonstrate and compare approaches to valuation of geospatial information and forge a path forward for research that leads to standards of practice.

[Current situation and development trend of Chinese medicine information research].

PubMed

Dong, Yan; Cui, Meng

2013-04-01

Literature resource service was the main service that Chinese medicine (CM) information offered. But in recent years users have started to request the health information knowledge service. The CM information researches and application service mainly included: (1) the need of strength studies on theory, application of technology, information retrieval, and information standard development; (2) Information studies need to support clinical decision making, new drug research; (3) Quick response based on the network monitoring and support to emergency countermeasures. CM information researches have the following treads: (1) developing the theory system structure of CM information; (2) studying the methodology system of CM information; (3) knowledge discovery and knowledge innovation.

Research on Classification of Chinese Text Data Based on SVM

NASA Astrophysics Data System (ADS)

Lin, Yuan; Yu, Hongzhi; Wan, Fucheng; Xu, Tao

2017-09-01

Data Mining has important application value in today’s industry and academia. Text classification is a very important technology in data mining. At present, there are many mature algorithms for text classification. KNN, NB, AB, SVM, decision tree and other classification methods all show good classification performance. Support Vector Machine’ (SVM) classification method is a good classifier in machine learning research. This paper will study the classification effect based on the SVM method in the Chinese text data, and use the support vector machine method in the chinese text to achieve the classify chinese text, and to able to combination of academia and practical application.

Clinical Note Creation, Binning, and Artificial Intelligence

PubMed Central

Deliberato, Rodrigo Octávio; Stone, David J

2017-01-01

The creation of medical notes in software applications poses an intrinsic problem in workflow as the technology inherently intervenes in the processes of collecting and assembling information, as well as the production of a data-driven note that meets both individual and healthcare system requirements. In addition, the note writing applications in currently available electronic health records (EHRs) do not function to support decision making to any substantial degree. We suggest that artificial intelligence (AI) could be utilized to facilitate the workflows of the data collection and assembly processes, as well as to support the development of personalized, yet data-driven assessments and plans. PMID:28778845

Development of the Supported Decision Making Inventory System.

PubMed

Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

2017-12-01

Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

Evaluating business value of IT towards optimisation of the application portfolio

NASA Astrophysics Data System (ADS)

Sun, Lily; Liu, Kecheng; Indrayani Jambari, Dian; Michell, Vaughan

2016-05-01

Information technology has become heavily embedded in business operations. As business needs change over time, IT applications are expected to continue providing required support. Whether the existing IT applications are still fit for the business purpose they were intended or new IT applications should be introduced is a strategic decision for business, IT and business-aligned IT. In this article, we present a method that aims to analyse business functions and IT roles and to evaluate business-aligned IT from both social and technical perspectives. The method introduces a set of techniques that systematically supports the evaluation of the existing IT applications in relation to their technical capabilities for maximising business value. Furthermore, we discuss the evaluation process and results that are illustrated and validated through a real-life case study of a UK borough council and followed by discussion on implications for researchers and practitioners.

Space applications of Automation, Robotics and Machine Intelligence Systems (ARAMIS). Volume 2: Space projects overview

NASA Technical Reports Server (NTRS)

Miller, R. H.; Minsky, M. L.; Smith, D. B. S.

1982-01-01

Applications of automation, robotics, and machine intelligence systems (ARAMIS) to space activities, and their related ground support functions are studied so that informed decisions can be made on which aspects of ARAMIS to develop. The space project breakdowns, which are used to identify tasks ('functional elements'), are described. The study method concentrates on the production of a matrix relating space project tasks to pieces of ARAMIS.

Heuristic decomposition for non-hierarchic systems

NASA Technical Reports Server (NTRS)

Bloebaum, Christina L.; Hajela, P.

1991-01-01

Design and optimization is substantially more complex in multidisciplinary and large-scale engineering applications due to the existing inherently coupled interactions. The paper introduces a quasi-procedural methodology for multidisciplinary optimization that is applicable for nonhierarchic systems. The necessary decision-making support for the design process is provided by means of an embedded expert systems capability. The method employs a decomposition approach whose modularity allows for implementation of specialized methods for analysis and optimization within disciplines.

Gain Modulation by an Urgency Signal Controls the Speed–Accuracy Trade-Off in a Network Model of a Cortical Decision Circuit

PubMed Central

Standage, Dominic; You, Hongzhi; Wang, Da-Hui; Dorris, Michael C.

2011-01-01

The speed–accuracy trade-off (SAT) is ubiquitous in decision tasks. While the neural mechanisms underlying decisions are generally well characterized, the application of decision-theoretic methods to the SAT has been difficult to reconcile with experimental data suggesting that decision thresholds are inflexible. Using a network model of a cortical decision circuit, we demonstrate the SAT in a manner consistent with neural and behavioral data and with mathematical models that optimize speed and accuracy with respect to one another. In simulations of a reaction time task, we modulate the gain of the network with a signal encoding the urgency to respond. As the urgency signal builds up, the network progresses through a series of processing stages supporting noise filtering, integration of evidence, amplification of integrated evidence, and choice selection. Analysis of the network's dynamics formally characterizes this progression. Slower buildup of urgency increases accuracy by slowing down the progression. Faster buildup has the opposite effect. Because the network always progresses through the same stages, decision-selective firing rates are stereotyped at decision time. PMID:21415911

Gain modulation by an urgency signal controls the speed-accuracy trade-off in a network model of a cortical decision circuit.

PubMed

Standage, Dominic; You, Hongzhi; Wang, Da-Hui; Dorris, Michael C

2011-01-01

The speed-accuracy trade-off (SAT) is ubiquitous in decision tasks. While the neural mechanisms underlying decisions are generally well characterized, the application of decision-theoretic methods to the SAT has been difficult to reconcile with experimental data suggesting that decision thresholds are inflexible. Using a network model of a cortical decision circuit, we demonstrate the SAT in a manner consistent with neural and behavioral data and with mathematical models that optimize speed and accuracy with respect to one another. In simulations of a reaction time task, we modulate the gain of the network with a signal encoding the urgency to respond. As the urgency signal builds up, the network progresses through a series of processing stages supporting noise filtering, integration of evidence, amplification of integrated evidence, and choice selection. Analysis of the network's dynamics formally characterizes this progression. Slower buildup of urgency increases accuracy by slowing down the progression. Faster buildup has the opposite effect. Because the network always progresses through the same stages, decision-selective firing rates are stereotyped at decision time.

Volatile decision dynamics: experiments, stochastic description, intermittency control and traffic optimization

NASA Astrophysics Data System (ADS)

Helbing, Dirk; Schönhof, Martin; Kern, Daniel

2002-06-01

The coordinated and efficient distribution of limited resources by individual decisions is a fundamental, unsolved problem. When individuals compete for road capacities, time, space, money, goods, etc, they normally make decisions based on aggregate rather than complete information, such as TV news or stock market indices. In related experiments, we have observed a volatile decision dynamics and far-from-optimal payoff distributions. We have also identified methods of information presentation that can considerably improve the overall performance of the system. In order to determine optimal strategies of decision guidance by means of user-specific recommendations, a stochastic behavioural description is developed. These strategies manage to increase the adaptibility to changing conditions and to reduce the deviation from the time-dependent user equilibrium, thereby enhancing the average and individual payoffs. Hence, our guidance strategies can increase the performance of all users by reducing overreaction and stabilizing the decision dynamics. These results are highly significant for predicting decision behaviour, for reaching optimal behavioural distributions by decision support systems and for information service providers. One of the promising fields of application is traffic optimization.